Changing Colors: The Blog of Spectrum Pediatrics

Archive for the ‘School Age’ Category

March 21, 2017

Everything Sprouts in Spring: What makes a good book?

By: Brianna Craite, MS, CCC-SLP

Recently, the therapists at Spectrum Pediatrics had a discussion on “What makes a good book?” We know how important book routines are to develop strong early literacy and pre-reading skills. Books can also help foster hand eye coordination while turning pages. You can practice supported or independent sitting while reading.

Walking into the book section in any store or browsing the library can be overwhelming with the wide selection. Here are a few things our therapists’ thought of especially when looking at the pictures that may ease your search:

  • Bright simple pictures
  • Pictures that include early vocabulary themes like body parts, animals, toys etc.
  • Pictures “tell the story”

As children get older we suggest books with words or phrases that repeat to practice early literacy skills. Check out the list below and you’ll see some of my book choices for the upcoming spring season!

Toddler

Board books are easy for early readers to turn the pages. It is important to look for interactive flaps, bright colors, and spring vocabulary. As a speech therapist, I often recommend that parents label the pictures they see in the book while allowing their child to explore the interactive parts of the book. Using books with interactive flaps can help increase your child’s attention on the book.

Preschool/Kindergarten

While looking for books for preschool age, focus on books that have repetitive words such as I see Spring. The repetitive words are great for early readers. The Tiny Seed by Eric Carle is one of my favorite books for Spring. After reading this book, try planting seeds of your own for an interactive activity to go along with the story! And Then it’s Spring by Julie Fogliano is a great book for early readers, especially when focusing on teaching the concept of changing seasons. Spring is Here by Will Hillenbrand is a wonderful book for introducing spring vocabulary and learning about friendship!

Enjoy your books!

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February 22, 2017

Tips for Improving Your Child’s Communication

At Spectrum Pediatrics, we often find ourselves talking to parents about small changes they can make during their daily routines to help build their child’s communication skills. Two of our speech therapists are sharing four of their all-time favorite tips for parents. Check out the video below to hear Jamie and Krystina discuss these tips and explain what makes them so important and how to build them into your everyday routine!

Stay posted for more helpful videos on tummy time and feeding behaviors at mealtimes!

February 21, 2017

Screen Time: What are the new guidelines?

By: Tracy Magee, MS, CCC-SLP

Recently, the American Academy of Pediatrics (AAP) released new guidelines on their website regarding screen time and young children. Previously, it was suggested that children should not be exposed to any type of screen – TV, smart phone, or tablet – until a child was at least 2 years of age. Nevertheless, with technology becoming more and more a part of our daily lives, it is almost impossible to completely avoid screens until a child is 2 years old. Here are some highlights from the newly released guidelines…

1. It is best to continue to limit screen exposure for all kids under 18 months. There is one exception – video chat. Feel free to let your little one interact with Grandma and Grandpa each day! Research shows that babies may not be able to participate in the conversational part of a video chat, but they will be able to benefit from playing peek-a-boo with their relative on the screen.

2. With children from 15 months to 2 years old, it is best to sit and watch an educational program with them. It has been found that a child can actually learn some new vocabulary if the parent is participating in watching the program and talking about it.

3. Children between ages 2 and 5 are able to process at least some of the information that is shown in a television program, yet of course, the screen time should still be kept in moderation. Programs and apps developed by the Sesame Street Workshop and PBS have the most research to prove their highly educational value.

Despite these new educational videos and apps, it is important to remember that kids learn best through human interaction! Keep playing and talking with your child each day!

The organization, Common Sense Media, provides great guidance to parents about age-appropriate television, movies, and smart phone apps. You can access information from them at this website or download their free app here!

 

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January 17, 2017

Trick of the Trade from Jamie Hinchey, MS, CCC-SLP

Videos

As a speech therapist I am often working on articulation or development of speech sounds with children between the ages of 5-8. After this holiday season, I noticed that so many of the children I see received some form of technology for Christmas, whether it was an iPad or a different type of tablet. Although it is important to set boundaries on the amount of technology your child uses, it actually can be helpful when working on articulation and home practice. This provides a motivating and fun way for children to want to participate in articulation therapy, which is not always the most fun.

Lately, I have started to use the video or camera feature on the tablet to have the child record how they are producing the sounds. This provides the opportunity for the parents to see how therapy is going if they are unable to be home. It also gives the child a chance to see how they produce each sound and “rate” their sounds. If a child is able to hear the difference in their sound production it often helps them to fix their errors and accurately produce the sound. Another way to have this video feature used in therapy is to record activities so the child can continue to practice throughout the week. The most important part of articulation therapy is the carryover while at home.

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January 10, 2017

W-Sitting: What’s the big problem?

By: Colleen Donley, PT, DPT
  • A w-sit is often seen as a very preferred position for play
  • W-sitting can be harmful to the hip and knee joints as well as muscles throughout the legs
  • W-Sitting can have a negative impact on little ones developing appropriate trunk strength and postural control

A w-sit is when a child is sitting on their bottom with both knees bent and their legs turned out away from their body. If you were to look with a bird’s eye view at your child sitting, their legs would make a W.

Before the age of 3, the bones in little ones are still very malleable (aka flexible) and can twist, turn, etc. due to the stresses put on their body. If we let them sit in a w-sit all day, the ball of the femur bone that goes in the hip joint can actually rotate to a more forward position. This ends up looking like the classic “knock-kneed” position when your child stands, their thighs angle inwards so their knees almost touch. Additionally, a w-sit position puts a child at an increased risk for hip dislocation.

W-sitting can also shorten or tighten muscles in the hip and legs. The hamstrings and hip rotators are most at-risk to become tight in kids who prefer w-sitting. Their knees are always bent so the hamstring is put in a shortened position for a long period of time. This can negatively impact a child’s coordination, balance, and mastering other gross motor skills such as galloping or skipping as they get older.

Most often, I see kiddos prefer to w-sit when they are getting tired and especially those with low muscle tone. W-sit can be considered a “lazy position” because the child does not have to use their trunk muscles to sit upright and not fall over when they want to reach for a toy. W-sitting takes away the hard part of sitting and playing! We do not see children rotate through their trunk to reach for toys when w-sitting. This also discourages crossing midline, which is an amazing skill to develop for the growing and learning brain. Also, splaying the legs out in a w-sit creates a very large base of support so the child doesn’t have to worry about falling over when reaching for a toy. Their legs are going to make sure that doesn’t happen but this does not let them develop the trunk stability and postural control to learn how to balance appropriately. Think…if a child cannot balance appropriate in sitting then they will have a harder time learning how to balance in standing as their center of gravity is raised higher.

At the end of the day, it is likely virtually impossible to follow your busy infant or toddler around the house for all awake moments. As they move from crawling to sitting to rolling and back to sitting, it would be exhausting to correct every instance of w-sitting. Of biggest concern is when you might see your little one sitting in this w-position for an extended period of time while playing with toys or hanging out there during story time or a movie break. This would be the perfect time to ask them to “fix your feet!”

Here are some alternative sitting positions to encourage during playtime: Criss-cross applesauce, long-sitting, side-sitting.

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January 4, 2017

Feeding Friday: Family Mealtimes with Tube Fed Kids

Our last post was about the importance of eating together as a family regularly. This is particularly important for kids who are tube-fed, but it is often more difficult. Stringent tube-feeding schedules and extended time spent on the tube feeding itself can make sitting down and eating together feel like either an additional chore, or an impossible luxury. Add in a history of stressful mealtimes that feel like failures, and the result is often allowing tube-fed kids to opt out of the family dinner table. Sometimes medical and behavioral complications have disrupted daily routines so much that family mealtimes have never even been attempted. Unfortunately, this results in a crucial missed opportunity on the road to becoming a healthy eater. In addition to the advantages mentioned last week, kids who are tube-fed benefit by:

  • Being part of a family routine
  • Seeing food as enjoyable
  • Having mealtime expectations that aren’t just volume or eating related
  • Being exposed to a variety of foods through sight and smell
  • Watching parents and siblings eat (research has shown these to be the most powerful tools in the development of healthy eating habits).

Even if kids don’t put a bite in their mouths, there are other measures of success:

  • Helping to prepare food, making it clear that eating is not an expectation. It allows children to feel the pride of contributing and increases food experience. Even young children can tear, toss, stir, scoop and spread with some help.
  • Staying at the table for a certain period of time. Even if it begins at 2 minutes, time at the table can then be extended. If your child shows significant anxiety just with being at the table, this is an even more important step in becoming an eater.
  • Completion of mealtime chores such as helping to set the table, cleaning up the silverware, and helping to pass the serving plates can put the child in proximity to food that doesn’t force eating.
  • Participating in family conversation, even if it begins with one or two responses. Non-food conversation is important for family bonding and for helping the child to become a part of the “eating world” in preparation for becoming an eater themselves.

Talk to your therapist about other ways in which to build up to pleasant mealtimes. Past fears may need to be worked through before any food is part of the equation. If this is frustrating, remember that many families struggle with this, not just families with tube-fed children. If you missed it, check out the resources in last week’s post here.

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December 19, 2016

Feeding Friday: Family Mealtimes

According to the Family Dinner Project, which is a nonprofit organization operating from the offices of Project Zero at Harvard University, there are a number of benefits to having a family mealtime. Research indicates that children and adolescents who are part of regular family mealtimes have:

  • Lower rates of substance abuse, teen pregnancy, and depression
  • Higher grade-point averages
  • Higher self-esteem
  • Lower rates of obesity and eating disorders

Other benefits include the dinner conversation, which can be a vocabulary booster that is even more powerful than reading. Telling family stories can increase pride in family heritage, resilience through adversity, and a sense of belonging. Finally, don’t underestimate the simple value of time together. This emotional video shows children’s ideas about mealtime with their parents.

Many families struggle with how to get family mealtimes started, and how to manage conversation with kids of different ages. Check out these resources at the Family Dinner Project for helpful resources on building conversation with your child at mealtimes. For a few other ideas on getting mealtime conversations going, check out here or this website!

Stay tuned for next week’s post on the importance of family mealtimes for children who are on feeding tubes.

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December 18, 2016

Trick of the Trade from Jamie Hinchey, MS, CCC-SLP

Coloring Books

As a speech therapist, I often find myself working on various activities with children such as puzzles, reading books, or building blocks. Recently, I have been using coloring books in my therapy sessions and I have found that it is a great way to incorporate language and other goals! I start with having the child choose which page from the coloring book if this is a new activity for them. Once the child chooses a page, I will tape the coloring page to the table to eliminate the distraction of picking up the paper off of the table. Choosing one page also allows you to target attention as this will help the child focus on the one task that they are supposed to be working on. I will target receptive language skills by giving verbal or visual directions, depending on the child’s developmental level. For example, “Color the airplane blue and the little girl’s eyes brown”. If you have a younger child you can keep the directions more simple such as “Pick the purple crayon”. If you are working on expressive language goals, have your child comment on what they see in the picture or expand on their phrases when they label. For example if your child points and says “airplane”, expand with “Wow that airplane is in the sky”.

Our occupational therapists also love to use coloring books within therapy since this is a fun and simple way to target pencil/crayon grips for children of all ages. Although this is technically a fine motor task, if your child has trouble sitting in a chair or attending to one activity, use this in a visual schedule or have a timer available. This way, your child can complete the task, but also see what might be next or how much time is left. We often use large coloring pages, but a blank piece of paper is also fine to help build your child’s creativity!

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December 2, 2016

Breaking Down Language: Part 3 “Tips and Tricks”

By: Brianna Craite, MS, CCC-SLP
  • We have reviewed the basics of expressive and receptive language and now it’s time for some tips and tricks!
  • Here are my three favorite strategies for building language.
  • You can use these tips and tricks to help you think of new ways to stimulate your little one’s language!

Narrating: Talking to your child as you go about your day, naming the objects and actions as they happen in real time. I like to think of this as a “sports commentator”, but instead of talking about a sports game you’re talking about your life. As your child gets older, your narrating can get more advanced. For example; at meal times you would name the food for your child “banana”. Eventually this narrating could advance to sentences “I want a banana, Mom”. This strategy provides language stimulation for both expressive and receptive skills. Your child first needs to listen to words before starting to use them independently. Don’t forget to add quiet times too! Narrating is great for language development, but quiet times provide your child with opportunities to try to use what they are hearing on their own.

Book Reading: Research supports the idea that early reading exposure leads to better language and literacy skills. Reading to your baby from an early age sets the routine around books, which eventually expands as your child gains attention and interest. If you’re having trouble getting your child interested in books try picture only books or books with interactive features like flaps to open. While your child interacts with books you can use the above tip of narrating to enhance book time. You can talk about the pictures or actions like “turn the page” or “the end”. Eventually, as your child gains more attention to books, you can ask them to find things in the pictures to work on their understanding of vocabulary. Once they can identify a picture by pointing or patting the picture, try adding a question “What is it?” to have them name the picture with a sound or word.

Check out this resource for more information on HOW and WHY books are an important part of a child’s development.

Novelty: New experiences, objects, and interactions can help to naturally build on language. Novelty provides you, as the caregiver, the opportunity to teach new skills that may be more interesting for your child to learn or provide additional challenge for them. Many of my families report success with their child developing new language skills while on family vacations, visits with new family members, or trying out a new playground. While routine proves to be one of the best ways children learn, it is also important for these new skills to be tested out in new ways and environments. Teaching vocabulary with a new toy (expressive), practicing familiar directions (receptive) in a new place (“Go get the ball” or “Throw this in the trash” allows practice for generalization of skills) , or working on greeting new people are some of my favorite activities (expressive).

If you missed part 1 or part 2 of our Breaking Down Language series see those posts here!

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November 29, 2016

Feeding Friday: Building a Medical Team

No one plans to have a child who NEEDS a Medical Team, so it isn’t a process that many people are prepared for.  Even for parents who have advance knowledge that there might be some health issues to deal with after their child’s birth, the actual process of walking through the healthcare system can be more exhausting and frustrating than it should be.  Here are a few reminders that may help you navigate your way.

  1. Most healthcare providers and institutions mean well, even if they don’t align with your expectations and needs.   However, they all have their own guidelines and training that shapes their view of your child and his or her situation.  Looking at the situation from their perspective and considering their values may help you determine the best way to proceed in creating an alliance.
  2. Don’t assume that institutions and providers have access to all the information.  On-line medical records can be helpful, but HIPPA guidelines and heavy caseloads sometimes prevent people and places from sharing information, especially once you are outside of the hospital environment.   Keep a binder or electronic copy of records handy for all hospital visits.
  3. Assume the role as team leader as soon as you can.  During a crisis, a doctor may be the most appropriate person to head up the team for making decisions that require specialty knowledge.  Remember that you always have a role on the team, and that you should become a leader of that team as soon as you can.  Asking questions until you understand all the explanations and options is OK and will help you feel more comfortable with making decisions as your child matures.
  4. Find a pediatrician (or primary care doctor) who suits your needs.  In complex medical cases, there may always be a need for informed medical advice.  Some pediatricians defer to specialists to make many of the decisions and take a sideline role.  Others feel more comfortable making decisions and refer to specialists only as needed. Remember that they are here to help, and you need to be able to work as a team.
  5. Working with specialists.  We are fortunate in many areas of the country to have specialists who can provide exceptional care for very focused needs.  For this reason, they can become experts in that area.  However, they are NOT necessarily experts in your child.  YOU are!  Although you are likely to have fewer choices in specialty providers, there are ways to work with providers whose goals differ from yours when it comes to your child’s treatments.

 

Stay tuned for our next post on what to do when you feel the medical recommendations don’t align with your own goals for your child.

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