Changing Colors: The Blog of Spectrum Pediatrics

Archive for the ‘Uncategorized’ Category

July 12, 2017

Trick of the Trade from Jamie Hinchey, M.S., CCC-SLP

DIY Kitchen

There are many different play kitchen sets on the market today for young children. As a speech therapist, I often see children in their home where there may be limited space. I recently had a family share with me their version of a Do-It-Yourself kitchen to help save space. Pretend play is such an important part of development, it is crucial that your child has the ability to use their cognitive and play skills to engage in activities such as pretending to clean, cook, or copy what they may see you do around the house. To create this DIY kitchen you need two things: a plastic  container (size may vary) and a sharpie marker. On the top of the plastic container, this parent chose to draw a stove, similar to the one they had at home. You can customize this kitchen to look like your stove or oven so your child is familiar with it.

To help with storage of all of the various “kitchen toys”, the container opens up and is able to fit all of the accessories, even while fitting under the bed! In this version, there are toy pots, pans, and utensils. Feel free to use your own pots or pans that may be in your kitchen. This DIY kitchen would also be a great way to work on safety directions and helping your child recognize what is “safe”. For example, you could use the pretend stove to work on what it means for something to be “hot” or what it looks like when the stove is on or off. I hope you enjoy this DIY kitchen as much as this family does! Time to get cooking!

Picture credit from one of our Spectrum families who created their own kitchen!

May 17, 2017

Why the Push for Tummy Time?

By: Colleen Donley, PT, DPT

Often as physical therapists, we push and push for tummy time. We work with families on how to make tummy time easier. We help parents figure out how to fit tummy time into their schedule, while hitting the recommended amount of tummy time. Lastly, we educate parents and caregivers on the reasons tummy time is essential to development.

Back in the early 1990s, The American Academy of Pediatrics advised parents to adhere to the Back to Sleep program to reduce the risk of Sudden Infant Death Syndrome (SIDS). Following this start of this suggestion, there was a significant decrease in the incidence of SIDS. However, doctors and therapists have seen a rise in developmental delays, torticollis (twisted, tight neck), and plagiocephaly (flat head syndrome) since babies were spending more time on their backs and less time on their tummies. We now recommend Back to Sleep, Tummy to Play!

Tummy time is essential to integrate primitive reflexes, develop muscle strength throughout the trunk, and begin to experiment with early movement.

Integrate Primitive Reflexes

Initially, a newborn is curled in a ball because of the “primitive flexion” present at birth. Think the “fetal position” or how the newborn was curled up in the womb. Spending time on the tummy helps break up this flexion tone by providing deep input from weight bearing. This input helps relax the muscle tone of this primitive flexion and allows the baby to spread out their limbs and begin to extend through their neck and back muscles. As the flexion muscle tone continues to relax and fade, baby will begin to move their arms and legs separate of one another.

Develop Strength

When lying on their tummy, babies have to use the muscles neck and back to hold their head up or turn their head to look at parents or toys. This is the key to developing head control early on. As the baby gets stronger during tummy time, they will push up their elbows or arms and begin to hold the chest up. This weight bearing thru the arms will help develop proximal stability to hold the shoulder blade on the back. This is necessary for the baby to begin to bear weight thru one arm at a time to crawl.

Explore with Movement

As the baby gets stronger on their tummy and those muscles begin to relax, they will begin to move their arms and legs. They will continue to experiment with his movement and learn how to roll off their tummy to their back or to move towards a toy. The movement and exploration continues as they start to push up on straight arms and reach for toys. You might see they begin to kick or push their feet. As they learn to combine this reach and kick movements, they will begin to move forward in a belly crawling motion!

Tummy time should start as soon as you come home from the hospital with baby. Start off with small bursts, such as 1-2 minutes, throughout the day. Some parents find it easy to remember to fit in tummy time by making it a part of the routine after each diaper change. Gradually work up to a 60-90 minutes spread out over several increments by the time baby is 3 months old. By the time baby is 4 months old, they should enjoy tummy time since they now have full head control and push up on their elbows to play with toys. Around this time, you might see that baby sees tummy time as play time and nor work time.

Check out some of our other resources about tummy time here:

Making it Easier

Using a Boppy Pillow

Tummy Time Tips Video

April 24, 2017

Exact Instructions Challenge

By: Tracy Magee, M.Ed, CCC-SLP

I recently saw this video on social media, and it really spoke to my “SLP” heart! We don’t often think about how we use language and the importance of the words we use. This dad created a fun game for his kids to practice sequencing, using concept words, like “First, Then, in, on top of,” etc. Watch the video to see how these kids learn the importance of the vocabulary that they use.

You can do this in your own house with your kids to work on prepositions (in, on top, next to, under), time words (First, Then, Last), and other descriptors (color words, long/short, big/small, etc.). Here are some ideas to practice sequencing in your home with this family challenge!

1. How to tie your shoes

2. How to ride a bike/scooter

3. How to put on your jacket

 

April 13, 2017

Mealtime Stress: Adding Fuel to the Fire

By: Heidi Moreland, MS, CCC-SLP, BRS-S, CLC

When you have a child with a feeding problem, it can be very difficult to find people who understand how tough it is, and how pervasive the fear and pressure can be. It is tempting to talk about the problem you are having with everyone around, in hopes of finding someone who can help. However, we have found that there are some people who can make the problem worse instead of better. We have also added a few strategies or phrases on how to handle some of these personalities to avoid increased stress.

Well-meaning friends and family: People who are genuinely concerned, but keep asking about how the feeding is going can unintentionally increase stress levels around parenting a child who struggles with eating. Whether the questions induce guilt, anger, frustration, or just fatigue, these emotions will not be helpful if added to your own stress.

  • Re-direct the conversation to other topics.
  • If you do have a “safe” person in the family, you may talk to them about being a go-between so that the rest of the family can stay updated, without interfering.
  • Have an honest conversation with the person or people that you need to take a break from thinking and talking about eating: “This is a tough time for us, it helps me to take a break from talking about it so much.”
  • Reassure them that you are seeing help: “I appreciate your concern, we are working through this with our feeding team.”

Fellow worriers: People who may not add negative emotions, but are more than happy to worry with you. If you know someone is prone to worrying, it won’t be helpful to bring up your concerns to them.

  • Avoid going to eat or feeding your child when they are around
  • Tell them you are struggling with worry around your child’s eating, and ask them to help you re-direct your own thoughts when you become too anxious: “I know I worry too much. Can you help me practice re-directing my thoughts?”

Bullies: People who make negative comments about eating or feeding, or your approach to either one. It can be unintentional, but often has an element of superiority. It can be from people who feel strongly about topics such as parenting, nutrition, breastfeeding, feeding or discipline

  • It rarely seems helpful to argue, as bullies usually don’t have an interest in meaningful dialogue. Their main concern seems to be making sure that you understand their approach and why they believe they are right.
  • If possible, avoid interaction with them, especially around feeding.
  • Be prepared to tactfully change the topic.
  • Remember the truth about what you believe so they gain less emotional leverage over you.
  • You may say that you appreciate their input, but that they don’t have the full story or you have differing philosophies: “I’m glad that worked for you, but we find that those strategies actually didn’t work in our house.”
  • Sometimes a neutral, factual comment can help: “That’s interesting, because there is a lot of research that shows that adult pressure around mealtimes can actually make food struggles worse, instead of better.”

Stay tuned for next week’s post on what to do when the bully is part of the medical team!

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March 8, 2017

Mealtime Stress: Should I Be Worried?

By: Heidi Moreland, MS, CCC-SLP, BRS-S, CLC

Should I be worried about my child’s nutrition? How do I know if my child is getting enough of the right nutrients? Will I know if my child isn’t getting enough to eat? My child is a picky eater, what if they are missing important foods that they need to reach their full potential?

As a parent, it is hard to stop the cycle of anxious thoughts, especially those around food. Our culture exacerbates the problem with continuous reminders about the importance of healthy eating. Because there is no better customer than an anxious parent, the marketing community takes full advantage of that to sell various products to solve the problem. Can you have too much focus on health?

Actually, too much of a focus on healthy eating CAN cause problems. Pressure to prepare and eat healthy food can bring a significant amount of UN-healthy pressure to the mealtime that backfires with greater refusal. It is especially harmful to children who already have an uncertain relationship with food due to medical problems, prematurity, prolonged hospitalizations or sensitivities to the way foods smell, touch, taste or feel. Katja Rowell explains how families get trapped in what she calls The Worry Cycle, which leads to counter-productive feeding practices and increased food refusal and anxiety.

What if it’s me? Next week we will go through some of the most common mistakes parents make in an effort to get their children to eat more healthy foods.

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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 6, 2017

Trick of the Trade from Tracy Magee, MS, CCC-SLP

Yoga

Lately, I have been doing yoga with many of my clients, and I have found that it has many benefits for speech and language. Here are a few reasons you should try with your kids today!

1. Attention and Imitation – These skills are necessary to develop verbal speech skills. A child needs to be able to look at someone and copy movements in order to copy lip movements and words.

2. Comprehension – A child must focus on the verbal instructions being given to follow along with the yoga “flow” and assume the correct positioning. This skill helps with processing language and learning new words.

3. Breath Control – Yoga focuses on breath. The deep breaths in and out that are required help a child learn how to control his/her breathing. This is important for controlling breath when producing sounds, too. Deep breaths are also a great way to help kids learn how to stay calm and “regulate” their bodies and emotions.

Some yoga resources that are great for kids are:

  • GoNoodle – available for FREE on their website or on the AppleTV app
  • Yoga Kids by Kirsten Hall
  • Once Upon a Mat… Starring Jessie Forston
  • The Kids’ Yoga Deck: 50 Poses and Games by Annie Buckley

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January 20, 2017

Crawling Part 2: The Basics

By Colleen Donley, PT, DPT
  • What does it look like when a baby is learning to crawl?
  • Crawling, either on the tummy or hands and knees, is one of the first times we see a baby piece together “I can move and get to this toy.”
  • True crawling on hands and knees follows a fairly typical progression beginning around 7-8 months and lasting a few weeks.

Belly/commando crawling or creeping: Most babies start with belly crawling as they learn they can move forward to get places, but do not have the strength to maintain a hands and knees position yet.

Rocking on hands and knees: Babies will learn how to push up to a hands and knees position and then begin rocking back and forth. Holding this position and rocking helps babies build stability and strength at the shoulder joint and learn what it feels like to bear weight through their hands and knees.

Inchworm crawling: Sometimes babies will skip this stage, but don’t be alarmed if you see what looks like an inchworm crawling pattern. This looks just like it sounds…baby up on hands and knees, rocking, launching forward onto belly, and pulling legs under them back to hands and knees. Your child has likely learned to use this pattern to move forward because they are still building the stability at the shoulder to pick one arm up at a time.

 

Hands and knees crawling- Jackpot! The key to know they have mastered crawling is reciprocal arm and leg movements. This means they move the right arm forward while pulling the left knee along and vice versa.

Is your baby stuck at one of these stages and not moving to a new pattern or mastering hands and knees crawling? Stay tuned to the last edition of our crawling series for strategies and tips to make crawling easier and more fun!

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January 17, 2017

Crawling Part 1: The Benefits

By: Colleen Donley, PT, DPT

As an early intervention therapist, I often start working with little ones around their first birthday because they are not crawling yet. More times than not, I hear parents ask if we really should address crawling because walking is the ultimate goal and can’t we just start there. Despite popular belief, crawling on hands and knees is still a major motor milestone!

So why do we really want to push crawling on hands and knees? The benefits of crawling extend far beyond the gross motor domain. Crawling on hands and knees stimulates virtually every area of development from gross motor to cognitive, and even, to speech and language.

Here are my Top 10 reasons why not to skip crawling:

1. Development of arches in the hand: All babies are born with fat pads in their hands. While these pudgy hands are super cute, the fat pads need to disintegrate in order for muscles of the hand to develop. Weight bearing through the hands is the most effective way to help those fat pads disintegrate while encouraging all the tiny, but important, muscles in the hand to develop.

2. Integration of primitive reflexes: Maintaining and crawling in a hands and knees position provides input all throughout baby’s body to help primitive reflexes integrate. Two reflexes are key players during crawling- the symmetric tonic neck reflex (STNR) and the asymmetric tonic neck reflex (ATNR). ATNR is present shortly after birth and is seen when baby lays on their back and turns their head to one side, that same-side arm will extend out to the side while the opposite-side arm will bend at the elbow and come up to the shoulder. We see the STNR emerge around this time and help with crawling. With the STNR, baby’s arms will extend in response to neck extension while the legs will bend. This is seen very easily when baby is on hands and knees and looking ahead.

3. Development of visual system: The visual system actually develops in multiple ways with crawling. Baby will learn to keep their eyes fixed while moving and move separate from their motion. As baby is moving, they must be able to stabilize their gaze on an object and hold it steady or else they will just see blurry images as their weight bounces from side to side.

4. Development of the thumb: Shifting weight from hand to hand when crawling helps elongate the space between the thumb and the index finger. This creates more room for toys to be held with maturing grasp patterns. It also promotes development of the muscles of the thumb.

5. Trunk strength for basic activities: With all this hands and knees positioning, the belly is lifted off the ground and muscles of the trunk and core are in constant contraction/relaxation, or co-contraction. Developing muscles of the trunk have massive implications on feeding, talking, and play skills in sitting.

6. Proximal stability: Crawling helps strength and stabilize the muscles close to the center of the body, like neck, shoulders, hips, and back. The muscles close to the joints that help keep them strong and stable are given constant input to contract and thus strengthen. As these joints and muscles strengthen, baby has a stronger base to move and learn new motor skills, both gross and fine.

7. Motor planning: As baby begins to move more in their environment, they will undoubtedly encounter many obstacles. Obstacles can come in all shapes and sizes and can be put in baby’s way intentionally or not. The brain will be stimulated to help baby problem solve how to move around these obstacles. This is one of the first times we see baby begin to motor plan movement strategies, but it is just the very beginning of motor planning.

8. Bilateral coordination:  Remember up top where we talked about what reciprocal crawling looks like? Hint: right arm and left leg move at the same time. This shows us that both sides of the brain and working at the same time and communicating. Activating both sides of the brain at the same time is huge for cognitive development.

9. Exploration of environment: Tied in with motor planning, crawling on hands and knees provides baby with a new independent form of mobility and allows them the opportunity to explore their environment. Babies still learn best at this stage through exploration and experimentation! Let them have the run of the place and see what they get into. So break out those baby gates while encouraging exploration!

10. Of course the best reason for any new skill is to give baby new opportunities for play! We begin to see expansion of baby’s concept of cause and effect with crawling. They begin to engage in more social play, such as peekaboo or hide and seek, now that they can move and find a familiar face around the corner or behind the sofa. Babies also begin to grow their reciprocal interaction skills as they play ball and chase after rolled balls.

Not sure if what baby is doing looks right? Having trouble or feeling frustrated in helping baby master crawling? Stay tuned for parts 2 and 3 on crawling for what typical crawling looks like and how to make it easier to master!

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December 15, 2016

Feeding Friday: Holiday Food Play

Christmas is a season of celebration, gift giving, celebrating family and faith traditions, and food. For picky eaters, non-eaters, and those struggling with their weight, it can become so much about the food that everything else can be pushed aside. Here are a few other thoughts:

  • Giving food as gifts allows kids to see the nurturing side of food. This may be especially helpful for kids who have always found food to be a task.
  • Giving food that kids helped make or serve allows kids to feel pride in their work and get their hands dirty without the pressure to eat it, especially if it is for someone they like to please, such as a teacher or grandparent.
  • Making food platters or gifts is a good together time activity, while also preparing for a party or crossing a name off the shopping list. Making fun foods together allows children to be messy and creative without pressure to eat.
  • Making more than one type of food allows all foods to be seen as fun – fruits, vegetables, cookies and snack foods can all be fun, creative and festive without the pressure of “good food” or “bad food.” It is ok to have some of each, don’t feel pressured to make them all healthy, or all decadent.
  • The time together allows you to talk about what a “treat” it is to work together. Reminding both of you that not all “treats” are something you eat.
  • Making treats can target all kinds of strengths or areas that need help: touching new textures, cutting, rolling, sorting, making designs or patterns, picking up small objects, or counting. There are many ideas to cover each one of these skills.

Here are some ideas to get you started. Roll up your sleeves, clear an area that can get a little messy and have fun! For more resources on these fun food activities check out our Pinterest board here! For other sites with some helpful tips check out this website or here!

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