Gross Motor Milestones in the First Year

Developmental check-ups with a Pediatrician throughout your child’s first year of life (at 2, 4, 6, 9, and 12 months) are a perfect place to bring up any concerns you as a parent may have about your child’s development. While pediatricians have their own set of developmental red flags, these only hit the “big-bad-uglys” as we like to call them, including: is your child rolling by 6 months, sitting independently by 8 months, crawling by 12 months, and walking by 18 months.

These red flags are very specific, meaning a child who exhibits these red flags would be identified for services, but not very sensitive, meaning many children who would benefit from therapy services are missed. I have seen many children referred to physical therapy for delayed walking skills, who are not standing independently or didn’t roll consistently until 8 months.

To help these children who are being missed by the pediatrician’s red flags, I have put together a list of gross motor skills to discuss with your pediatrician at your child’s check-ups throughout their first year.

A gif of a toddler taking a couple of steps while using a chair to stand up.2 Months:

  • Lifts and maintains head up when on belly

4 Months:

  • Controls head during pull to sit
  • Controls head when held at shoulder
  • Controls head while in supported sitting

6 Months:

  • Sits independently for 1 minute
  • Rolls from belly to back
  • Rolls from back to belly
  • Lifts chest off ground when on belly, pushing onto extended arms
  • Grabs feet or knees when on back
  • Bears weight through legs in supported standing

9 Months:

  • Gets into and out of sitting independently
  • Army crawls or crawls on hands and knees

12 Months:

  • Pulls to stand at stable surface
  • Cruises along furniture
  • Stands independently for 5 seconds
  • Walks forward with hands held

NSPT offers services in the Chicagoland Area. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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North Shore Pediatric Therapy wishes you a Happy Hanukkah, Happy Kwanzaa, and Merry Christmas!

13 Holiday Crafts for Fine Motor Development

North Shore Pediatric Therapy wishes you a Happy Hanukkah, Happy Kwanzaa, and Merry Christmas!We’re into the holiday season with Christmas, Hanukkah, and Kwanzaa just three weeks away, so why not get your children into the spirit by getting them involved in prepping the decorations? Here are 13 simple craft ideas that will entertain, add some cheer to your home and also promote your child’s fine motor development:

13 Holiday Crafts to Promote Fine Motor Skills

  1. String beads onto pipe cleaners and shape them into various holiday symbols such as candy canes, dreidels or wreaths.
  2. Fold up pieces of paper and cut out snowflake designs.
  3. Make a snowman picture by pulling apart cotton ball pieces and gluing them onto paper. You could also draw a snowman on the paper and have your child carefully secure marshmallows over the lines.
  4. Create your favorite holiday image using pony beads and elastic cord. You can find free instructions for various patterns online so there are plenty of options for this one!
  5. Paint the ends of an acorn using a thin paintbrush. You can also use glue instead and cover with glitter.
  6. Build a Christmas tree, menorah, or Kinara using popsicle sticks and glue. Decorate each stick however you would like using glitter, markers, stamps, sequins, crumpled tissue paper, paint, ribbon, etc.
  7. Create a window cling. This can be done using a craft kit or by following simple do-it-yourself instructions online. Your child can use a template as a guide or make an original design of his own.
  8. Decorate holiday cookies using cookie cutters, frosting, sprinkles, or other small pieces of candy. Be sure to have your child help with baking preparation too for extra strengthening and skill development while stirring, scooping, and rolling out the dough!
  9. Similar to baking cookies, you can use play dough to work on many of the same fine motor skills. Use plastic play utensils and scissors to cut playdough apart, roll out large pieces using a rolling pin or the palm of your hand, and use fingers to roll small pieces of play dough into balls. Use playdough stamps and other molds to create your favorite holiday symbols. For creations that you and your child are especially proud of, bake them in the oven for a few minutes to harden the dough and preserve the shape. Then they go on display or even on your tree!
  10. Make your own ornaments. The options are endless with this one but some ideas are to decorate ornament balls, use cardboard cut-outs, or glue together felt pieces. Your child may also enjoy turning their baked playdough into a holiday ornament!
  11. Build a gingerbread house. This is a great activity for siblings to work on together as it allows for plenty of creativity and a variety of challenges for different skill levels.
  12. Create a dreidel gift box using a printable template.
  13. Make a holiday count-down chain. Cut out strips of construction paper and secure them into loops that link together. Make this a fun family activity by hanging the chain in a common area of your home and removing one link daily as the holiday approaches!

Click here for tips on the perfect holiday gift for motor development!

 

 

parent teacher conferences

Ten Tips for Parents for Successful Parent-Teacher Conferences

parent teacher conferencesParent-teacher conferences serve as an important time in a child’s academic year. The teacher can provide updates and insight into your child’s progress within the classroom. In today’s schools, teacher’s conferences schedules are often jam-packed and you might only have fifteen precious minutes with the teacher to talk about your child. If you want to get the most out of this vital time with your child’s teacher, then a little prep is needed! Here are our top 10 tips for a successful parent conference:

10 Tips to Prepare for Conferences:

 

  1. Ahead of the conference (in fact starting today!) ask the teacher to log behaviors or issues, so you have concrete examples about behaviors your child is engaging in that the teacher wants to discuss.
  2. Make a questions list beforehand. Focus questions not only how the child is doing academically but also socially and behaviorally.
  3. Invite your child to suggest if there is anything you should know before you go in or any concerns he or she would like to raise.
  4. Ask your child what he or she likes about school and also what he or she does not like.
  5. Ask the teacher how you can make sure your child reaches his or her potential? What extra activities would be recommended?
  6. Ask the teacher who your child is friends with and how that aspect of school is going.
  7. Ask the teacher who your child sits with at lunch and if he or she smiles a lot and looks happy.
  8. Ask the teacher if she has any other concerns about your child besides academics.
  9. If the teacher says anything negative about your child, without follow up, ask for a solution(s) and tell her you also will think of some.
  10. Don’t be defensive, just ask good questions!

 

Remember that the teacher is there to help your child develop to the highest potential. It is important to take the advice that is provided as they have seen many children and can readily identify areas of strength and weakness. It is important to work as a team to make sure your child’s academic and social needs are met.

If your child’s teacher identifies concerns regarding your child; the best advice is to be proactive and garnish additional information instead of waiting. If there are possible concerns regarding the child’s attentional regulation, learning, and/or social-emotional functioning, it would be recommended to seek out a comprehensive neuropsychological evaluation to help identify whether or not there is a specific diagnosis such as ADHD, a learning disability, anxiety, or Autism Spectrum Disorder. If and when a specific diagnosis is identified, individualized recommendations would be able to be created to help the child progress at the highest level possible.

If you are in the Chicago area and would like to discuss issues that arise from parent-teacher conferences or you have other concerns regarding your child, please contacts us at 1-866-309-4610 or fill in the contact form on this page.

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Increasing & Decreasing Behavior With ABA

What behaviors does ABA seek to increase or decrease?

Applied behavior analysis (ABA) uses the principles of behavior for increasing and decreasing specific behaviors of social significance. Behaviors to increase or decrease are selected in collaboration with parents. Additionally, it is wise to involve other relevant stakeholders, like extended family or your child’s teacher.

When selecting ABA goals, it’s important to consider:

For challenging behavior, it’s crucial to consider how much is the behavior impacting the child’s functioning, learning, social opportunities, or ability to access the community. If parents cannot take a child to the store because of tantrums, it can impact a family significantly. (e.g., decreased access to social skills, difficulty completing common routines, or cost of childcare so the parent can go to the store). Similarly, if a child cannot communicate his or her wants or needs, this may cause problems for the family system as a whole.

It is important to consider the following points for increasing skills:

* What should the child be doing?

* How far outside of typical development is this behavior?

* Typically, what should a child this age be doing or expected to do?

* In what manner are these skills pivotal to future areas of development?

Small steps may lead to a larger goal

All goals should be prioritized based on some of the questions listed above. It is also essential to consider prerequisite skills and look at the larger picture. It may be that before you get to the big point of concern that there are other smaller goals to meet along the way. If your child cannot wait at home for five minutes, then waiting at a store for a toy may be more difficult. First, work on the smaller skills to build to the larger ones. With patience and practice, your child will be on their way to achieving their goals.

ABA therapy can be implemented in different environments, like home, our clinics, or in the classroom.

At NSPT, your child will receive 1:1 therapy along with the ongoing analysis of his/her progress to ensure he/she is continuing to progress and succeed.

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How to Teach Play Skills to a Child With Autism

Play skills are one of the most important areas that children, especially those with Autism, need to learn. These skills provide opportunities for the child to entertain themselves in meaningful ways, interact with others, and learn important cognitive skills. A successful way to teach play skills to children with autism is to initially teach the specific play skill in a very structured manner. Play Skills

  • Break the play skill into small, discrete steps and teach one step at a time. As the child demonstrates success in learning one step, add the next step. (After the child can add eyes to Mr. Potato Head, then add ears, then arms, etc.)
  • Use modeling to teach the skill (e.g. the adult builds a tower of Legos as the child watches, then the child builds his own tower).
  • Always provide reinforcement (behavior specific praise “Nice job putting the piece in the puzzle”, immediately following the child’s demonstration of the skill.). As the child exhibits improved accuracy of the skill, reinforce successive approximations.
  • The child should have plenty of opportunities to rehearse the skill in a structured setting. Practice, practice, practice!
  • In the structured setting, have the learning opportunities be short and sweet, so the task does not become aversive to the child.
  • Fade the adult prompting and presence out gradually, so the child can gain more independence. Systematically fade the reinforcement so that it is provided after longer durations.
  • Remember to keep the activity fun and exciting. You want your child to WANT to play with the toys and games.

Once the child masters the skill in the structured environment by independently completing the play tasks for extended periods of time, he or she can then begin to practice and develop the skill in more natural settings. Bring the toys and games into other rooms of the house, to school, and eventually have peers present, so the child can use the skills learned in a social setting.

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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5 Things to Keep in Mind When Potty Training a Child with Autism

Potty training is a big milestone for any child. It definitely is an important milestone for parents as well! No more diapers!! However, there are some things to keep in mind prior to considering potty training as well as during potty training. Blog-Potty-Training-Main-Landscape

  1. When should you consider potty training?
    • On average you would consider potty training when the child is around 2.5 years of age and above, can hold urine for 60-90 minutes, recognize the sensation of a full bladder, and show some form of awareness that they need to go to the bathroom.
    • Do at a time when you can spend large amounts of time at home! Some parents find it best to do in the summer (less clothing!).
  2. What schedule should you use when potty training?
    • You want to take your child to the bathroom every 90 minutes, if your child urinates then you wait for the next 90 minute interval, if not you reduce the time by 30 minutes.
    • Consistency is extremely important to ensure success.
  3. While on the toilet what should we do?
    • Praise your child for sitting appropriately on the toilet.
    • You can do activities with them as long as they are not too engaging or involved.
    • If they do urinate you want to CELEBRATE!
    • You need to wait up to 15 minutes if there is still no urination, then you let them get off and bring them back after 60 minutes (this keeps decreasing by 30 minutes each time there is not urination).
  4. What should you do when there is an accident?
    • It happens! Make sure you have your child help you clean it up, this is not meant to be punishing but more a natural consequence of having an accident. Keep a neutral tone and assist your child if needed to clean up the mess.
    • If your child is having too many accidents you may need to shorten the intervals of going to the toilet, or it may be that your child is not ready to be potty trained yet. Always rule out any medical reasons as well!
  5. Things to remember!
    • When starting potty training you want to make sure you child can sit on the toilet for up to 15 minutes with minimal challenging behaviors.
    • The goal is INDEPENDECE, you want to work towards your child walking to the bathroom on their own and removing and putting on their underwear and pants independently as well as washing their hands.
    • Make sure you child is in underwear throughout potty training! NO DIAPERS/PULL UPS!
    • Diapers and pull-ups are okay during nap time and bed time.
    • Number one thing to remember is PATIENCE, try to be consistently upbeat and encouraging to your child and deal with accidents as calmly as possible!

It is important to ensure that potty training is as positive an experience as possible for your child! Maintain your positive energy and constantly praise appropriate behavior seen throughout the potty training process! This will encourage your child to become more independent as well as want to go to the bathroom more often on their own!

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Moving Away from Positioning Devices in 2017

Obviously, no baby is going to spend 100% of their time playing on the floor or a mat/blanket. At some point you need to cook or shower and you need a place for the baby where they’re safe Blog-Positioning Devices-Main-Landscapefrom the toddler, the dog, or somewhere you know they won’t roll away. This is the time to use the exersaucer, sling seat, or bumbo seat; but try to limit the time spent in these devices to 20-30 minutes per day, collectively.

Here’s why you should consider moving away from positioning devices…

The biggest problem with these devices is children are placed in them well before they have the proper trunk and/or head control to really utilize them properly. With an exersaucer, most babies are also unable to place their feet flat on the bottom but are still pushing up into standing. This can increase extension tone, decrease ankle range of motion/muscle shortening, and can possibly be linked to future toe walking.

With a bumbo or sling seat, the baby is not placed in optimal sitting alignment causing poor sitting posture. While these appear to provide great support and make 4 month old babies look like they can sit independently, the truth is the device isn’t allowing your baby to utilize their core muscles to actively sit.

The bottom line is, if the positioning device is doing all the work, what is your child learning to do?

The best place for your child to play and spend the majority of their time is on the floor or on a blanket/mat. This allows them the opportunity to properly explore their environments and practice typical movement patterns like reaching for their feet, rolling to their side, rolling over, spending time in prone, pivoting, and creeping/crawling.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Everything Tummy Time

Parents of infants all know that they should be working on tummy time every day from an early age. However, most parents also experience difficulty consistently working on tummy time, since babies are often initially resistant to this position.Blog-Tummy Time-Main-Landscape

Below is a list of reasons why tummy time is so important, even if your child does not initially enjoy the position:

  1. Strength: When a baby is placed on her stomach, she actively works against gravity to lift her head, arms, legs and trunk up from the ground. Activating the muscle groups that control these motions and control the motor skills that your child will learn in tummy time allows for important strengthening of these muscle groups that your baby won’t be able to achieve lying on her back.
  1. Sensory development: Your child will experience different sensory input through the hands, stomach, and face when she is lying on her stomach, which is an integral part of her sensory development. When your baby is on her stomach her head is a different position than she experiences when on her back or sitting up, which helps further develop her vestibular system.
  1. Motor skill acquisition: There are a lot of motor skills that your child will learn by spending time on her stomach. Rolling, pivoting, belly crawling, and creeping (crawling on hands and knees) are just a few of many important motor skills that your child will only learn by spending time on her stomach. Along with being able to explore her environment by learning these new skills, your baby will also create important pathways in the brain to develop her motor planning and coordination that impact development of later motor skills, such as standing and walking.
  1. Head shape: Infants who spend a lot of time on their backs are at risk for developing areas of flattening along the back of the skull. It is recommended that babies sleep on their backs to decrease the risk of sudden infant death syndrome, and since babies spend a lot of time sleeping, they are also already spending a lot of time lying flat on the back. Spending time on the tummy when awake therefore allows for more time with pressure removed from the back of the head, and also helps to develop the neck muscles to be able to independently re-position the head more frequently while lying on the back.

It is important to remember that your child should only spend time on his or her stomach when awake and supervised. Many infants are initially resistant to tummy time because it is a new and challenging position at first. However, by starting with just a few minutes per day at a young age and gradually increasing your child’s amount of tummy time, your child’s tolerance for the position will also improve.

For more tips on how to improve your child’s tummy time, watch our video!

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Occupational Therapy’s Role in Improving Self-Care Performance in Children

The role of the occupational therapist, when working with clients of any age, is to support participation and daily functioning. For a child, one of the primary occupations is self-care. Self-care Blog-Self-Care-Skills-Main-Landscapeskills, which include feeding, toileting, dressing, bathing and grooming, are classified as Activities of Daily Living (ADL’s), because they are a critical part of a child’s overall health and participation each and every day. In order to participate in self-care, a child must have component skills within a variety of performance areas, and delays in any of these areas can make seemingly simple tasks feel nearly impossible.

During an initial evaluation, an occupational therapist will help you determine which performance deficits or barriers within the child’s environment are causing your child to struggle with self-care. The OT will first obtain information by asking you questions about your home setup, your family’s routines, what kind of assistance your child currently needs to perform age-appropriate self-care skills, and what your goals are in terms of self-care independence.

These questions will help the therapist obtain a snapshot of your child’s current self-care performance and provide more information about the home environment in which your child is performing. The therapist will also complete a comprehensive evaluation of your child’s underlying skills through clinical observation and standardized testing to determine potential causes of delayed self-care skills.

Below are a variety of performance areas an occupational therapist will assess that could contribute to self-care performance:

  • Motor performance: A child’s physical ability to perform the motor tasks required for a self-care skill is dependent on his or her strength and endurance, range of motion, body awareness, grasp, manual dexterity, and bilateral coordination. In addition, a child may have decreased motor planning, or difficulty generating an idea for and executing a specific movement pattern.
    • Example: A child may be unable to tie his shoes because he cannot maintain a pincer grasp on the shoelaces.
  • Executive Functioning and Attention: A child may have difficulty sustaining attention to a self-care task, sequencing the steps of a task in an efficient order, or remembering when and how to do the task at all.
    • Example: A child may not be able to remember or mix up the order of steps to tying shoes.
  • Sensory Modulation: A child may have decreased sensory modulation, or ability to filter out irrelevant sensory stimuli. Children with poor sensory modulation may be hypersensitive to input, which can often make children very uncomfortable in their own skin, easily distractible, or easily upset and overwhelmed. Other children may be hyposensitive and not notice certain important sensory input. You can read more about how sensory processing impacts self-care and hygiene in one of our other blogs, “Horrible Haircuts and Terrible Toothpaste” https://www.nspt4kids.com/occupational-therapy/horrible-haircuts-and-terrible-toothpaste-helping-your-child-with-sensory-processing-disorder-tolerate-hygiene/
    • Example: A hypersensitive child may be bothered by the feeling of their socks and refuse to wear tie shoes; a hyposensitive child may not notice that his shoes feel or look funny when on the wrong feet.

Once the evaluation is complete, the occupational therapist will be able to determine if the child would benefit from ongoing occupational therapy. Future treatment would focus not only practicing specific self-care skills, but also engaging in activities that facilitate the overall development of underlying motor, sensory integration, and executive functioning abilities. In addition, the therapist will work with you to adapt your child’s environment through the use of home modifications, visual supports, and adaptive equipment to support performance. Through all of these modalities, the occupational therapist will be able to increase your child’s participation in self-care activities, thereby increasing his or her independence and overall development.

Check out one of our previous blogs on self-care written by a Board Certified Behavior Analyst: Self-Care Skills for Children with Autism

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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10 Common Household Items to Develop Fine Motor Skills

The building blocks for fine motor success begins on day one. Skill development is commonly observed when the child becomes explorative in their environment and increasingly independent. Independence in age appropriate tasks is often a great measure of where they are developmentally. Specifically, the common influencing skills for fine motor development are strength, coordination, visual perception and motor planning. To assist in maturation of these skill areas you can engage your child in simple activities with things you may already have around the house! Blog-Home Fine Motor Skills-Main-Landscape

10 great tools you may find around the house to develop fine motor skills:

  • Broken crayons– Don’t get rid of those broke crayons! Coloring with these can assist with precision, hand strength and grasp maturity.
  • Q-tips– They can be utilized for painting, dotting and erasing from a chalk or white board. Fine motor precision and grasp maturity are challenged in activities with Q-tips.
  • Clothes pins– Transferring small items while playing different games such as matching, minute to win it, and relay races. Clothes pins also assist with motor planning, strength, and coordination.
  • Tweezers– This is another great tool for transferring small items while playing different games that addresses motor planning, strength, and coordination skills.
  • Child safe scissors– Begin with snipping construction paper and progress into more complex activities such as cutting shapes. To start, make a fun fringed edge for a picture they drew or advanced beginners can make a snowflake with parental assistance. Cutting activities can be difficult, but it significantly addresses coordination, strength, visual motor, and motor planning skills.
  • Legos– These small pieces may hurt when stepped on, but they are great for coordination, precision, visual attention, and strength.
  • Small blocks– Blocks can be used in many ways. A few suggestions would be to stack, string, and build various structures. Blocks are wonderful tools for coordination, visual perception, and grasp maturity.
  • Play Doh– Great way to mature manipulation, coordination, strength, and creativity skills.
  • Shaving cream– A fun way to practice their drawing skills in a non-traditional pencil and paper way. This can assist with precision and motor maturity as well.
  • Spray bottle– Clean up from the shaving cream and painting activities with a spray bottle filled with water. This can really test as well as develop the child’s grasp strength and endurance.

**All activities should be closely supervised and supported by an adult.

NSPT offers services in Bucktown, Evanston, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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