The Symbiotic Relationship of Play and Speech Therapy
You may have wondered why your child’s speech therapist spends so much time playing with your child. We are often on the floor being silly, making animal sounds, talking into a banana, or pretending to make a fabulous spaghetti and meatball feast. It looks too fun to be therapeutic, right? But in reality, those are the moments where the magic happens. To understand why speech therapy involves so much playing, it helps to know why and how children play.
Why do kids play?
Play helps children to understand their world. A child can pretend to be an astronaut without ever leaving the ground, or they can pretend to be a doctor before they have started elementary school. Play helps children try new things, test out theories, and imagine new worlds. Communication is an essential piece of this process. A child who plays with another child or with an adult will use language to craft a shared, imaginary world. Delayed play skills may be a red flag that a child may also have delayed language skills.
Play skills develop in tandem with language skills.
Children typically say their first word at about one year of age. Before then, they ‘practice’ language when they watch others speak and when they babble. A one year old is likely to understand more than they say, and they may be able to respond to a simple request such as, “bring me your shoe.” That same one year old is starting to realize that objects they can’t see still exist. In other words, they may be able to retrieve those shoes even if they are out of sight, in another room.
By age two, a typically developing child will be expressing their wants and needs using spoken words. They may still do a lot of pointing and crying, but they can also combine two words for a variety of purposes, such as to greet someone (e.g., “Hi Mommy”), label objects (e.g., “big dog”), or to make requests (e.g., “want banana”). A two-year-old uses play to connect with another person and to practice using new words and phrases.
As children continue to grow, they express themselves using more complex words – learning to use words to describe concepts such as time, location, and size as well as to discuss abstract ideas and feelings. When language becomes more detailed and complex, play also becomes more sophisticated. Children progress from observing play, to playing by themselves, to playing next to other children (but separately), and ultimately to playing interactively with others. By the time a typically developing child is three years old, they are able to engage in imaginary play, and their play schemes may follow a sequence. For example, a child might pretend to choose ingredients, cook food, and then eat it. Or, they might pretend to be a doctor – inspecting and treating an injury.
How and why play is used during speech therapy.
Since play and language skills develop in tandem, we often play during speech therapy to encourage language. Rule-based “game play” is often built into speech activities and/or combined with other forms of play to entice children to join in. We use “symbolic play” (pretend play) to get a children talking, since pretending requires the use of language in order to build a shared understanding. We also utilize our sensory motor gym, where we have the option to collaborate with our occupational therapists to engage in “practice play” (play that involves a lot of movement), which has the added benefit of helping children to maintain a state of sensory regulation, or optimal band of arousal, so they are happy and having fun while engaging in speech learning activities. During all these different forms of therapeutic play, we can incorporate gestures, facial expressions, and signed language in order to help build language skills in children whose verbal skills are delayed.
So, the next time you see your giggling child on the floor sitting next to a speech therapist who has a banana phone in her hand, rest assured that play is the fun way to build communication and language skills.
Autism awareness requires an understanding of the importance of addressing language processing and social skills deficits.
As we enter Autism Awareness Month, we want to help parents understand the importance of a multi-disciplinary approach to working therapeutically with children on the spectrum.
Children on the spectrum are at risk for language and social challenges, often due to their individual processing challenges. Finding a team of professionals, (Occupational Therapist, Speech Therapist) who can identify the root of a child’s struggles is the first step to creating a plan on how to build a base for development in these areas.
By taking into consideration the “whole child”, Occupational Therapists and Speech Therapists, working collaboratively under one roof, are able to help parents prioritize next steps to maximizing their child’s development and potential. The skilled clinicians will evaluate a child, determining his/her interests, personality, goals, motivation and strengths, as well as areas that can be improved. Using this information, they can plan an engaging program of intervention to target and remediate the child’s difficulties, and strengthen language processing and social skills concepts such as collaborative play, cooperation and negotiation.
The compassionate therapists will work hard to form a solid, trusting and fun relationship with each child. They will pivot and evolve therapeutic strategies and implementations, to help a child generalize skills across the disciplines.
Social Pragmatic Language and Autism
Pragmatic language is the use of appropriate communication in social situations. Language deficits in children with autism will contribute to their difficulties with social interaction with peers, as they do not intuitively understand and use social communication concepts, and must be guided in the learning of these skills.
Because language is the vehicle that drives social interaction , difficulties with literal language comprehension and use will hinder success in turn taking, perspective taking, and reading social cues. Additionally, when a child cannot easily access language “on demand” during peer interactions, anxiety can form, and this can affect their self-confidence.
Bringing a child into a sensory gym allows the speech and occupational therapists to also observe and analyze a child’s behaviors as they engage in play, both solitary and peer-to-peer. The therapists use this environment to encourage use of language to facilitate successful play and engagement, resulting in a positive and confidence-building outcome for the child.
This interaction between language and social engagement, will also exercise and strengthen executive functioning, appropriate behavior, conversation and narrative language, reasoning, social problem solving (organization of thought), perspective taking, whole body listening, and humor.
During Autism Awareness Month, if your child is struggling on the spectrum, consider reaching out and learn more about learning opportunities facilitated by informed, knowledgeable and compassionate mentors, including teachers and therapists. Together, we can bridge the gap for your child and help him/her build the “scaffold” needed to move to higher learning and more successful social engagements.
Is your child struggling to participate in family life?
An “at the end of her rope” mom once said to me, “our son is holding our family hostage.” The stress and tension in the home were weighing heavy on mom, dad and older siblings.
While that sounds pretty dramatic, it is in fact a scene that plays out in families quite commonly, and perhaps even more now during the Covid-19 pandemic. This mom went on to tell me that her young son was loving, big hearted, and smart, as well as controlling, manipulative, prone to frequent temper tantrums and had a hard time keeping friends, and playing a role in family life as a team member and not dictator. With a deeper dive into the consultation, it was revealed that this young child was also hyper-sensitive to loud noises and rough clothing, and loved to cuddle and build things. What the mom sensed but didn’t really know, was that her son wasn’t a troubled child with behavior issues – but that something more was going on that made the world a harder place for him to thrive in. This child was a sensory child.
To be fair, we all are “sensory”, in as much as we all take in and process the sensory input we are constantly receiving. But, and this is big, when there is a “glitch” in the sensory processing systems , the results can be stressful on the brain, resulting in challenging behaviors – a child who is harder to parent and finds it hard to thrive in social environments.
Sensory processing skills develop differently for each child.
Sometime between the ages of two and three, children begin to develop the ability to extend their attention span and follow an external plan – skills vital to social emotional growth. If, during this time, a child seems to be struggling in this area of development, there may be underlying factors impeding the process. We are all wonderful and unique in how our brain grows and develops. Different speeds and different strengths and challenges do occur along the journey. Sensory processing challenges can result in outbursts, tantrums, an unwillingness to socialize, go to school or play by the rules, and may be a precursor for learning or emotional challenges in the school aged child. We encourage parents that believe their child may be struggling in these areas, to get early support.
Helping the sensory child thrive, not just survive.
When we know why a child is struggling we can modify, adapt and create an individual plan that sets up the child for emotional, social and learning success. An occupational therapist utilizing a sensory processing approach, can assess a child to identify the underlying sensory processing challenges. At that point, an individualized therapeutic strategy will be created that will address those challenges, and build the child’s self-regulation, joint attention, and promote imitation and shared reciprocal play.
It is critical to understand why a child’s nervous system is struggling to calm and regulate, listen and participate, and to empathize and relate successfully to others. The occupational therapist can help parents to identify and implement strategies that will build their child’s regulation, joint attention, attunement and engagement in the relationships and activities of the family, building a foundation for lifelong attention and learning.
Early therapeutic intervention can help prevent negative relationships, micro trauma, negative interactions, and stress and frustration within the family unit.
Seeking information to help you parent your individual child is a joyful and wonderful gift. Fear of the unknown often prevents parents from reaching out for more information. We all have a unique and individual sensory processing system. When each member of the family understands the unique sensory needs of the other, peaceful, successful interactions can occur with less challenge and stress.
If your child is struggling, and you are a struggling parent, please reach out to get help. We invite you to come and learn about your own sensory processing systems and those of your children so that your family can create goodness of fit for peace and joy in your family.
Like all things topsy turvy in this strange new world we’re learning to live in, learning to learn, itself, has been turned upside down.
As occupational therapists working with children, we talk a lot about and address challenges common for children with sensory processing disorder – or the difficulty in dealing with sensory overload. Now, with parents, teachers, caregivers and peers all wearing masks, suddenly the problem is a lack of enough sensory input, in this case, visual input, making it difficult for young children developing early social skills, to understand feelings and expectations being communicated to them.
Our whole body is responsible for non-verbal communication, with verbal communication only accounting for 10%-30% overall. For young children or children with neuro-developmental differences, interacting with others in masks can be challenging – but our smile or frown, or anything in between, only accounts for a small amount of our non-verbal communications.
Now is a good time to encourage and guide your child to become a “social detective”, looking for whole body language (non-verbal) cues that hold the clues to ideas, thoughts, feelings, attitude and state of mind being communicated, much of which is produced subconsciously. While eyes opened wide or brows furrowed are pretty obvious indicators of feelings, many children have difficulty with the intimacy of sustained eye contact. The “social detective” will need to pay closer attention to a person’s posture, movements, and arm placement (crossed or open, for example), for bigger and easier indicators to use when determining friendship and attention.
To support a child’s critical early social development during this time of masks and social distancing, parents might try role playing with their children, pointing out different body postures and positions, and discussing what information those positions might be relaying. Practicing guessing how family members are feeling at home with and without masks can help with feelings of anxiety when venturing out of the house. Using favorite TV shows or YouTube characters can be helpful as well! Pause the show, cover up the character’s face on the screen and see if the posture of the character matches the emotion they are feeling. A few non-verbal check-ins a day will help grow your child’s awareness and understanding of non-verbal communication, and how to connect to those communications and the people sending them.
Yummy sensory opportunities for children to explore the tastes and textures of food.
Exploring foods provides young children myriad opportunities to get messy and experience delicious and colorful sensory play! Paige, one of our deeply trained pediatric occupational therapists, shares some of her favorite summer food sensory activities for you to try at home with your kiddos.
Containers of food for “musical containers“.
To target the auditory, olfactory, visual, and tactile systems play a game called, “musical containers.” Fill various size containers with various foods with unique sensory attributes. Cereal or pretzels will make lots of noise when the container is shaken. Orange slices will tantalize the olfactory system. M&M’s or Skittles will literally be eye candy as a child’s visual system is delighted by all the bright colors.
After you have filled various containers, pass them around the table or back and forth, playing music your child enjoys. Stop the music, then open the containers to look, smell, and touch! The benefits of this activity include developing your child’s impulse control (waiting until the music stops to open the containers and to stop passing when the music is paused). Your child’s auditory system is challenged by having to focus on listening to know when the music has stopped. They will learn to filter out distractions in his/her environment to focus on the activity. The different food items give your child a chance to explore his or her sensory systems, talk about those systems, and label how he feels about each of the sensory experiences. All processes which are crucial for development.
Changing the shape of food for fun messy play.
This next activity suggestion helps to develop your child’s motor skills and encourages messy tactile play. Gather various food in the house in which the form of the food can be changed. For example, you can chop up zucchini, you can slice apples, you can peel an orange, you can sift your hands through flour; you can place raspberries on each of your fingers. By facilitating your child’s exploration of food, he or she is gaining more comfort, which in turn helps children who are picky eaters due to sensory challenges and/or tactile sensitivity. By utilizing various tools/body parts to alter the form of the food (fingers, knife, fork, food hammer etc.), you are facilitating your child’s development of his/her fine motor skills, and hand dexterity – skills necessary to develop age appropriate self-care skills and be successful in the classroom setting as well!
Categorizing food for academic based learning
The following food activity is academic based and helps your child learn. It is recommended you choose a variety of food items that can then be categorized. Some categories you can choose include sorting by color, shape, size, attributes.
For example, peaches, apples, and bananas are all fruit. Tomatoes, apples, ketchup, and pasta sauce are all red. You can also facilitate your child’s vocabulary development by having him or her practice describing flavors during mealtimes/snack time. For example, this piece of broccoli is crunchy; this apple is sweet; this sweet potato is mushy and sweet.
Take a field trip and check out your local farmers market
When your child is involved in picking out the food he or she wants to try, he or she may be more excited about trying the food, especially if your child is a picky eater. Children will enjoy meeting the farmers and learning about where the food they eat comes from.
Resources for parents:
“The Little Mouse, the Red Ripe Strawberry, and the Big Hungry Bear” – the playful account of two animal’s interactions surrounding their strong desire to eat delicious strawberries.
Zoom Teletherapy: An Educational Therapist’s Perspective
A series of articles by Ann B. – Educational Therapist
In these uncertain, and sometimes bleak days the Corona virus has imposed upon us, I am going to admit to something surprising, and perhaps controversial: I enjoy, and actually benefit from, treating my educational therapy clients using Zoom. I know, I agree – it has its drawbacks, but its advantages are too numerous to ignore.
I’ve been using Zoom to conduct my 50-minute educational teletherapy sessions since the shutdown, and it was surprisingly easy to transition from “in-person” to “in-camera,” even though I had limited experience with Zoom prior to the pandemic. My clients range from age 6-17 – some have special needs, while others have some identified learning difficulty such as dyslexia or ADD. My overall experience these past 4 months (is that all it’s been?) with distance learning has been unquestionably positive. Zoom is, hands-down, a helpful tool that aids me in keeping my clients’ skills from becoming rusty, and much more. I am even using Zoom to teach clients to read, to write, and to actually create and use a schedule! I profess, even I am a little surprised at this!
The Zoom Benefits
The benefits of using Zoom are both personal and professional. Personally, I sure don’t miss those pre-Covid early morning wake-ups, followed by a quick dog walk, then making breakfast, which I drank on my drive to work. Nor do I miss the responsibility of keeping up appearances by dressing up for work. I find I use less make-up now, due to how well Zoom’s “touch up my appearance” feature works. No commute means the expense of time and money are now erased, and I get to sleep in a little.
Professionally, the benefits of Zoom teletherapy are even broader. It definitely makes sharing digital resources with students a more direct experience. It’s ironic – we call it “distance learning,” but it’s really the opposite. In fact, when you think about it, the distance between my lips and my students’ ears actually decreases in the Zoom environment. Same with the digital document and my students’ eyes. Being this “close” enhances both the educational and the therapeutic relationship, and I still feel connected when I see my students’ faces. That is, when I can see their face, which, at times, can be a challenge. Imagine what it looks like if your view is being controlled by a youngster holding an iPad (i.e., your head) between their two hands. I usually end up getting queasy at the sight of bouncing unintelligible objects that appear upside down and this way and that. Often I get to admire the ceiling, but sometimes I am rewarded by the sight of my student’s quizzical face, because s/he needs to “check in.” Those can be the best moments, because it usually happens when they just learned something – sigh.
Here’s a recent example of what I mean by ease of using resources. I had to get creative to get my 1st grade client with special needs back to our session (she thinks it’s hilarious to pretend to shut the laptop, saying, “OK, ‘bye!”). Once, she walked away, but I felt she must be nearby, so I Googled the first thing I could think of – an armadillo. The educational video that I was playing for her, less than 10 seconds later, brought her back with eyes wide and mouth closed. Then we continued with the session, and later rolled up like an armadillo for a body break. And that’s just one resource – I could have pulled up an eternal supply of relevant and effective material. It’s virtually unlimited!
I have two adult children of my own, and I really feel for the parents out there who have young children in school in 2020. Let’s face it – it’s scary to send your child to school these days! I am glad we have teletherapy, now at CSC, so that I can continue to deliver vital educational therapy to the fabulous kids I work with.
Learning – it’s fundamental. Teaching – a job parents and caregivers gladly shared with teachers and others trained in child development and education. Until now.
During the time of Covid-19 school closures, the role of “teacher” now falls much heavier on parents at home, and as a result, a “reimagining of learning” is having to occur.
How to Help your Child Thrive this Summer and Beyond.
You’ve heard it before; we are living in challenging times. As we move through this summer, you may be wondering what challenges your child will face when they return to school/if they return to school, in the fall. You may feel lost and have many questions that seem to have no easy answers. How will I make sure my child keeps learning the academic skills they’ll need for success? How can I support my child while keeping them safe? While we don’t know exactly what schools will look like in the fall, we can use this opportunity to reimagine what education can be for our kids over the summer as they shore up important skills they will need in the new school year.
Creating a Micro Learning Pod
One option for your child may be to partner with other families to create a “micro learning pod.” Unlike a typical homeschool, in which parents can be left to fend for themselves, this setup is integrated with teachers and other professionals to lessen the load on the family and increase positive learning outcomes.
One or more educators are hired to work with a small group of children (typically 2-4 works best) to facilitate learning. An educational specialist helps develop a curriculum based on the specific needs and interests of the students in the group, and also consults with teachers to make sure progress is occurring.
Children experience the first critical window of brain development between the ages of 2 and 7. Research indicates that some skills cannot be learned nearly as well after this time. For example, research also shows that this is the best time for children to learn the patterns of language development, even master a second language! The same can be true for the acquisition of musical abilities, which in turn can set the path for the enjoyment of math learning. Special classes such as foreign language or music class could be added as well.
Classes could be held outdoors and with social distancing to promote both safety and learning. Online learning could also be incorporated. Parents could rotate during instructional time, if necessary, to provide support without feeling overwhelmed by the academics.
If you are interested in setting up a micro learning pod for your child, we are currently offering consultations with our Lead Educational Therapist, Jennifer, who is creating and coordinating our learning programs here at Child Success Center. She is available to discuss educational options to reimagine learning and support you and your child, this summer and beyond. Call our office to set up your consultation today.
During the Covid crisis, speech therapists are using telehealth to support kiddos and their families during extended at home time.
At this time, perhaps more than ever, we count our blessings, and we are indeed blessed to have at Child Success Center, an extraordinary team of therapists. This May, as usual, we honor our speech therapists during Better Hearing and Speech Month.
Two of our speech therapists, Jeni and Samar, recently spoke via Zoom with CSC Director, Melissa Idelson, about their use of telehealth therapy sessions during the “shelter-at-home” period associated with the Covid-19 crisis, and how they have benefited both therapist and client.
Jeni talks about why she became a speech therapist, and how she uses various methods of therapy, including Augmentative Alternative Communication (AAC) to help children communicate and build their social brain. She also shares the ways she’s currently using telehealth to support her clients during the Covid-19 crisis.
Samar shares her experiences using telehealth to conduct speech therapy sessions during “shelter-at-home” period. She has discovered a plethora of new online resources that she is utilizing in her sessions, and feels strongly that many of them will continue to be useful, even after in-person therapy resumes. She is looking forward to having teletherapy as a future alternative when children are unable to make an appointment in person, like during a vacation or when mild illness makes staying home preferable.
The weather is perfect for some time outdoors engaging your child in fun sensory motor activities!
The 4 videos below demonstrate easy, fun and engaging ways to use sensory motor activities to advance academic learning. The kids will have a great time as they are motivated and challenged, both physically and mentally.
Practicing math, spelling and handwriting has never been so much fun!
Sensory motor play with shaving cream is a great way for kids to practice letter and number formation.
How to use fun, engaging sensory motor learning to advance academic learning at home.
Fun and engaging “at home” activities for kids use balance and core work while practicing math and spelling.
Listening, thinking, matching, moving – sensory motor learning at home.
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Your child is entering Kindergarten in the fall. But is he really prepared for the big transition?
The big day is almost here – your child is making the transition from pre-school into Kindergarten in the fall. As a parent, this can be both an exciting and emotional time, but for the child it is a major shift in routine, environment and academic expectations. Is your child really prepared? Common Core Standards have raised the academic bar, even at the Kindergarten level, but it is a child’s ability to attune, adapt, anticipate and efficiently process information, that is critical to a successful transition from the pre-school environment.
Typically, in pre-school a child may be given a single level task, that when autonomously completed, frees the child to go off and play. In contrast, as a Kindergartener a child may be asked to remain with an activity for a longer period of time, requiring auditory attention to both learn and follow an external plan. The activity may involve a series of directions that require the child to adjust his perspective or body multiple times, while self-regulating his emotions and actions. Since more time is spent in Kindergarten with whole-class, teacher-led instruction, a child must have the ability to think as a “we”; to attend and adjust to a group activity that requires social collaboration such as discussions about a story being told, its characters, settings and how they can relate to the story.
Social Brain Building Skills
The new Kindergartener will now have to attune to surroundings and peers, a shift from the more self-attuned pre-school positioning. The child must be able to walk into a situation and be able to observe and listen, then perceive what is expected of them. For example: the child walks into a classroom where other children are sitting and drawing. The child can then conclude that he/she is expected to sit and draw. This awareness, or metacognition, will keep the child from getting distracted and disorganized, helping to facilitate the efficacy of each learning experience. Auditory processing allows the child to attune to teacher directions and turn language into actions in order to follow new routines or complete a task. Repetition established by the kindergarten teacher will support this learning curve throughout the kinder year.
The ability to think as a “we” and follow directions, listen, attend, modify behavior and anticipate change, are the building blocks of executive function, a set of processes, or neurologically-based skills, that all have to do with managing oneself (mental control and self-regulation) and one’s resources in order to achieve a goal. A solid foundation of Executive Function skills is imperative to all future learning.
Understanding Letters and Numbers
All of these so-called “soft skills” are necessary for the Kindergartener to achieve success in the development of the “hard skills” such as the acquisition of the understanding of letters and numbers. Kindergarteners are expected to recognize the letters of the alphabet, both in upper and lower cases when they enter kindergarten. They need to understand the difference between sounds, letters and words and that words have meaning and make up sentences. They must know number formation so they can begin the process of learning how to break out numbers.
Fine Motor Skills
Fine motor skills such as holding and using a pencil/crayon/marker/ and scissors, are required as children, over the course of the school year, will need to be able to express their thoughts, ideas and experiences through drawing and writing.
How to Prepare Your Child for the Transition from Pre-School into Kindergarten
It is important to note that approximately 1 in 5 children experience one or more challenges with behavior, communication, body movement and learning. While these challenges are common, each child’s root issues can be vastly different. If your child is struggling in any of these areas as the transition to Kindergarten approaches, it would be wise to seek out a consultation or assessment with a pediatric therapist who can get to the root issue and facilitate a program of occupational, speech/language, educational or multi-disciplinary therapy.
Kindergarten Enrichment Camp is fun way to help prepare children over the summer for the new challenges of Kindergarten. This type of program helps children develop confidence when taking the first steps toward reading, writing, attending to a new routine, developing social-emotional skills, being mindful of themselves and others and making new friends.