Fine Motor Skills: Ideas for At-Home Improvement

Fine motor coordination is the capacity of the small muscles of the upper body to allow for controlled movements of the fingers and hands. They include the ability to hold a writing utensil, eat with a fork, open containers, and fasten clothing. These small movements correspond with larger muscles such as the shoulder girdle, back, and core to provide stability for gross motor functioning and with the eyes for hand-eye coordination. Weaknesses in fine motor skills are often the result of poor hand strength and poor motor coordination.

Does My Child Need to Improve His/Her Fine Motor Skills?

For a comprehensive list of fine motor development red flags, please view my previous post, Fine Motor Skills: Is your Child Lagging Behind?

Why Should I Seek Therapy if I Notice Difficulties with Fine Motor Skills? 

  • To improve ability in and persistence with fine motor tasks
  • Increase school readiness
  • To help your child complete self-care tasks, such as buttons and zippers
  • To avoid disengagement in an academic environment due to difficulties completing fine motor activities (e.g. writing, cutting, drawing)
  • To help maintain and develop a positive sense of well-being
  • To ensure that your child doesn’t fall behind their peers in handwriting development

A Word About the Tripod Grasp

The “tripod grasp” is the way we occupational therapists describe what the fingers look like as they hold a pencil or other small utensil. Like a triangle, or a tripod, the thumb, index, and middle fingers work together to maneuver the pencil, clothespin, fork, etc. Mastering this grasp indicates a mature manner of utilizing those small hand muscles. Most kiddos have learned to utilize this grasp by the age of 5 or 6.mightyhands2

Fine Motor Toolkit

As a pediatric occupational therapist, parents continuously request ideas for easy activities to do at
home. Recently, one of my families requested ideas for the car ride to school. Introducing….the Mighty Hands kit! This bin is a fine motor development dream (from an occupational therapy standpoint), AND it’s fun! Tailor it to what you’ve got on hand, show your child how to use the items inside, place it in your home (or even your car!), and let your kiddo go to town. You can thank me later.

What’s Inside the Mighty Hands Kit and What Do I Have My Child Do with This Stuff?

Theraputty: Hide small beads in the putty to use pincer grasp to dig them out, play tug-of-war, pull and twist, but don’t use the table to help! Medium-soft (red) and Medium (green) grade.

fine-motor-theraputty

Theraputty

Clothing fasteners: Practice fastening clothing items such as buttons, zippers and laces for increased finger dexterity and independence!

Screw-top jars: Screw-top and push-top jars filled with small items such as coins, marbles, pom poms, cotton balls, small toys such as these dinosaurs. I hold all of my Mighty Hands items in jars or Tupperware for additional fine motor practice!

Play-Doh: Roll, pound, squeeze, press, pinch!

Locks puzzle: Practice opening various types of locks – a great way to strengthen fingers!

Spoons: Practice scooping small items and transferring them from jar to jar.

fine-motor-spoon

Spoon and pom poms.

Playing cards: Kept in a sandwich-sized plastic bag. Practice shuffling cards and deal them one by one.

Kiddie Tweezers: Use thumb and first two fingers to squeeze objects and transfer them to a container. Great for hand strength and coordination!

Magnetic Mini Games: Great for pincer grasp (the use of the thumb and forefinger)!

Cardstock: Kept in freezer-sized plastic bag. Tear paper into small pieces (one hand turning away from body, one hand turning toward body) using tripod grasp with thumbs at the top of the paper.

Q-Tips: Hold the Q-tip in the middle, dip either end into two different colors of paint, rotate Q-tip in hand to create fun art – make sure to use dominant hand only!

Screwdriver With Nuts & Bolts: Hold the screwdriver with dominant hand and the set with the non-dominant hand to practice turning nuts and bolts.

fine-motor-tweezers

Tweezers

Bank: Encourage your child to hold three coins in his/her hand with the ring and pinky fingers while pushing a coin through the slot one at a time without dropping the other coins.

Craft/Jewelry Sorting Case: Label individual segments 1-15. Have your child hold a few small pom poms in his/her hand (again, using the ring and pinky fingers) while placing them into the container one by one by moving a single pom pom up to the fingertips each time. Or, use the tweezers to sort!

Scissors: Draw straight lines across 4×6” scraps of paper and cut in half.

Clothespins: Clothespins can be used for a series of great activities that facilitate the tripod grasp, strength, and coordination. Be sure to use the pads of the thumb and forefinger.

Tennis Ball Container & Pipe Cleaners: Punch holes in the top of the container and use the dominant hand to push the pipe cleaners into the hole while stabilizing the container with the non-dominant hand.

fine-motor-tennis

Tennis ball container and pipe cleaners.

Tennis ball With Horizontal Slit: Squeeze ball open with one hand (tennis ball resting in palm) while removing small objects from its “mouth” with the other hand.

Pegboard: Stretch bands across pegs to increase hand strength and coordination.

Squigz: Adhere these toys to a wall, door, or refrigerator and pull off! It’s trickier than one might think!

Additional Activities for Around the House

Chores can be a great way to practice fine motor development – and help out mom and dad around the house! Have your child help you put away silverware, turn the door handle and lock the door when leaving the house, unscrew jars and containers while cleaning out the refrigerator, pull weeds, pour laundry detergent, refill soap bottles (be sure to have your child open and close the lid!), and close Ziploc bags.

How Will These Activities Help?

All of the items in my toolkit are designed to strengthen small hand & forearm muscles as well as improve in-hand manipulation, finger isolation and dexterity, and fine motor coordination. As your child’s fine motor skills improve, you will begin to notice an improvement in his/her larger (gross motor) movement, trunk stability, and hand-eye coordination as well. It’s a win-win-win! As always, be sure to consult with an occupational therapist to ensure proper follow-through of fine motor activities and for a more tailored plan.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. 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!

Meet-With-An-Occupational-Therapist
Resources:

http://www.childdevelopment.com.au/areas-of-concern/fine-motor-skills/92

The Best Games for Language and Social Skill Development

Let’s be honest, who doesn’t love a good family game night? A little friendly competition, some yummy Blog-Language-Development-Main-Landscapesnacks and, of course, fun! As a pediatric speech therapist, I use games every day in my speech sessions. To be honest, I would be lost without them. Games are exciting, motivating, and best of all, they help children learn important speech and language skills without even realizing it!  There are many games that encourage the development of speech, language, and social skills. You can work on everything from learning how to take turns, to categorizing, making inferences, and oral narratives (i.e. story telling). Grab one of the following games for your next family game (and learning!) night!

These first few games are perfect for children who are just learning to play games as they are not language heavy. These games are great for promoting skills such as joint attention, turn-taking, cause and effect, commenting, and learning basic vocabulary and concepts (i.e. on, off, in, out, next). Some of these games introduce letter, shape and number concepts as well.

  • Sneaky, Snacky, Squirrel by Educational Insights
  • Frankie’s Food Truck Fiasco by Educational Insights
  • Frida’s Fruit Fiesta by Educational Insights
  • Hoot, Owl, Hoot by Peaceable Kingdom
  • Feed the Woozle by Peaceable Kingdom
  • Pop-Up Pirate by TOMY
  • Pop the Pig by Goliath Games
  • Zingo by Think Fun
    • There are many varieties of Zingo including numbers, letters, and telling time.

The next few games support turn-taking and overall social skills, but delve a little deeper into specific language skills.

Categorizing

  • Spot It! by Blue Orange
    • There are many varieties of Spot It, from Junior Edition to the special Frozen Spot It
  • Scattegories Junior
  • Speedeebee by Blue Orange
  • Rally Up by Blue Orange
  • HedBanz by Spin Master

Following Directions

  • Hullabaloo by Cranium
  • Cat in the Hat, I Can Do That! by Wonder Forge
  • Roll and Play by Think Fun
  • Ring It! by Blue Orange

Story Telling

  • Rory’s Story Cubes by Gamewright
  • Tell Tale by Blue Orange

Grab a game and have some fun!

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. 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!

Meet-With-A-Speech-Pathologist

Fine Motor Skills: Is Your Child Lagging Behind?

Fine motor coordination is the capacity of the small muscles of the upper body to allow Blog-fine-motor-skills-Main-Portraitfor controlled movements of the fingers and hands. They include the ability to hold a writing utensil, eat with a fork, open containers, and fasten clothing. These small movements correspond with larger muscles such as the shoulder girdle, back, and core to provide stability for gross motor functioning and with the eyes for hand-eye coordination. Weaknesses in fine motor skills are often the result of poor hand strength and poor motor coordination.

Red Flags for School-Aged Children

As a former Kindergarten teacher, at the start of each school year, I received a group of children with an assortment of fine motor skill-sets. Because children have such different preschool experiences, their skills will vary based on the activities to which they have been exposed. If a child has had the opportunity to practice cutting with scissors, for example, he or she will likely be able to accomplish snipping a piece of paper by 2.5 years old. Fine motor development occurs at an irregular pace, but follows a step-by-step progression and builds onto previously acquired skills.

By the approximate ages listed below, your child should be able to demonstrate these fine motor skills:

2 to 2.5 Years

  • Puts on and takes off socks and shoes
  • Can use a spoon by himself, keeping it upright
  • Draws a vertical line when given a visual example or after an adult demonstrates
  • Holds crayon with fingers, not fist

2.5 to 3 Years

  • Builds a tower of blocks
  • Draws horizontal & vertical lines when given a visual example or after an adult demonstrates
  • Unscrews a lid from a jar
  • Snips paper with scissors
  • Able to string large beads
  • Drinks from an open cup with two hands, may spill occasionally

3 to 3.5 Years

  • Can get himself dressed & undressed independently, still needs help with buttons, may confuse front/back of clothes and right/left shoe
  • Draws a circle when given a visual example or after an adult demonstrates
  • Can feed himself solid foods with little to no spilling, using a spoon or fork
  • Drinks from an open cup with one hand
  • Cuts 8×11” paper in half with scissors

3.5 to 4 Years

  • Can pour water from a half-filled pitcher
  • Able to string small beads
  • Uses a “tripod” grasp (thumb and tips of first two fingers) to draw, but moves forearm and wrist as a unit
  • Uses fork or spoon to scoop food away from self and maneuver to mouth without using other hand to help food onto fork/spoon

4 to 4.5 Years

  • Maneuvers scissors to cut both straight and curved lines
  • Manages zippers and snaps independently, buttons and unbuttons with minimal assistance
  • Draws and copies a square and a cross
  • Uses a “tripod” grasp (thumb and tips of first two fingers) to draw, but begins to move hand independently from forearm
  • Writes first name with or without visual example

4.5 to 5 Years

  • Can feed himself soup with little to no spilling
  • Folds paper in half with edges meeting
  • Puts key in a lock and opens it

5 to 6 Years

  • Can get dressed completely independently, including buttons and snaps, able to tie shoelaces
  • Cuts square, triangle, circle, and simple pictures with scissors
  • Draws and copies a diagonal line and a triangle
  • Uses a knife to spread food items
  • Consistently uses “tripod” grasp to write, draw, and hold feeding utensils while moving hand independently from forearm
  • Colors inside the lines
  • Writes first name without a visual example, last name may be written with visual
  • Handedness well established

By age 7, children are usually adept at most fine motor skills, but refinement continues into late childhood. If you notice your young child demonstrating difficulties in the above “red flag” areas, it may be time to consult with an occupational therapist. For at-home ideas to improve hand strength and fine motor abilities, read my other blog, Fine Motor Skills: Ideas for At-Home Improvement.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. 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!

Meet-With-An-Occupational-Therapist
Resources:

Beery, K.E., & Beery, N.A. (2006). The Beery-Buktenica Developmental Test of Visual Motor Integration. Minneapolis: NSC Pearson

Folio, M.R., & Fewell, R.R. (2000). Peabody Developmental Motor Scales, 2nd Ed. Austin: Pro-Ed.

Retherford, K.S. (1996). Normal Development: A Database of Communication and Related Behaviors. Greenville, SC: Super Duper Publications

Should I Be Concerned With My Child’s Speech?

As a parent, everyone wants the best for their child. They want their child to grow and Blog-Speech-Concerns-Main-Landscapedevelop appropriately, and flourish socially and academically. One component to success is your child’s ability to effectively communicate their wants, needs, and ideas. Which begs the question, when should you be concerned with your child’s speech and language development? In a world where no child is the same, one thing is for certain: early intervention is better than late intervention, and late intervention is better than no intervention at all. Look for these red flags early in development.

  • Difficulty following directions
  • Difficulty answering questions
  • Difficulty understanding gestures and nonverbal cues
  • Difficulty engaging in conversation
  • Difficulty identifying age-appropriate vocabulary and concepts
  • Frustration when communicating

Expressive Language

More specifically, children should be babbling between 6 and 8 months, with their first words produced around the age of 12 months. By 18 months, your child should possess an expressive vocabulary (spoken words) of approximately 50 words. Two-word combinations are expected around 24 months, with an expressive vocabulary growing to about 300 words. By the time your child is 36 months old, expect 3-5 word combinations (or more!), with most adult language structures mastered around 60 months (5 years).

Receptive Language

Children should follow basic commands around 12 months (“Come here”), and use gestures to communicate along with a few real words. They should be demonstrating comprehension of common objects and animals, by following commands involving those items or identifying them in books (puppy, cup, shoes, etc.) around 18 months of age. Look for your child to answer questions, ask questions, and talk about their day around the age of 3 years.

Articulation

It is typical for a young child (1-2 years) to have some sound errors in their speech. However, by the age of 3, a child’s speech should be at least 75% intelligible to an unfamiliar listener, and more intelligible to familiar listeners. By age 3, a child should have the following sounds mastered: /b, d, h, m, n, p, f, g, k, t, w/. All speech sounds should be mastered by age 8.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. 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!

Meet-With-A-Speech-Pathologist

Take the “Chore” Out of Doing Chores

All work and no play? No way! It can be difficult to encourage children to participate in daily routines and chores at home. Chores are hard for all of us to complete at times. However, chores don’t have to be all work and no play! By utilizing several simple Blog-Chores-Main-Landscapestrategies, doing chores can turn into fun activities for the whole family to complete together.

Participating in chores is a very important part of development. Completing household tasks will foster increased independence and self-esteem within your child. Your child will also learn the importance of working together. He or she will gain a sense of accomplishment and pride once tasks are completed, which will build internal motivation to continue participating in chores in the future.

For more information on selecting developmentally appropriate chores for children of all ages, please see the previous blog Household Chores for Children by Age. By selecting age-appropriate chores, you will help maximize your child’s success. In addition to establishing realistic expectations for your child, you can utilize the following strategies to take the “chore” out of doing chores!

Make chores into a game:

Be creative with the daily routine! Have a race with your child to see who can complete their task first. Try to beat the clock or timer while cleaning up toys. Turn the task into a sport, like shooting baskets with clothes into the laundry hamper.

Play pretend:

Create a secret mission for your child to complete. Make an obstacle course throughout the house while completing tasks. Have your child pretend to be their favorite character while cleaning. Sing songs while completing chores or cleaning up.

Call chores by a different name:

“Chore” can have a negative connotation and feel like a burden to a child. Chores could be called projects, jobs, or secret missions, among many others, in order to make it seem more fun and exciting.

Implement a reward system:

Reward systems can provide a source of external motivation for completing daily tasks and routines. Provide your child with a token or object after completing a chore. This token could be a sticker on a reward chart, a marble in a jar, or a check mark on a checklist. After the child receives a pre-determined number of tokens, he or she can receive a larger reward.

Create visuals:

Utilize a calendar or chart in order to provide an additional visual cue of responsibilities to be completed throughout the week. Incorporate the child’s favorite pictures, characters, or interests in order to make the chart personal and unique.

Keep in mind that new chores may be more difficult for a child at first. It is important to provide cues and reminders in order to support your child and foster confidence in completing new tasks. You can assist your child by breaking down the chore into smaller tasks. Encouragement and praise are also very important for increasing your child’s confidence and independence. By utilizing these simple strategies on a regular basis, you can turn boring chores into exciting fun for the whole family!

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. 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!

Meet-With-An-Occupational-Therapist

Pronunciation Library

There are 44 phonemes (or speech sounds) in the English language. These speech soundsBlogPronunciationLibrary-Main-Landscape can be broken into the two broad categories of consonants and vowels. When a consonant is produced, the air flow is cut off partially or completely. When a vowel is produced, the air flow is unobstructed. In order to make this wide array of sounds, our articulators do a lot of work! Our articulators include our lips, teeth, alveolar ridge (the ridge on the roof of your mouth behind your front teeth), hard palate (the roof of your mouth), soft palate (the back portion of the roof of your mouth), jaw, vocal folds, and last but not least, our tongue. Each speech sound is made by placing these articulators in different positions, pushing through air, and turning our voice on or off.

Each sound has an age range at which it is typically emerging and mastered by. While producing these sounds comes naturally to some children, many children struggle to make certain speech sounds, and describing to a child how to make these sounds with muscles they cannot see can be even trickier! Below is a pronunciation chart of 24 early, middle, and later developing speech sounds and a description of how to make each sound:

PHONEME DESCRIPTION OF PLACEMENT OF THE ARTICULATORS
Early 8 Emerging pronunciation development between ages 1-3, consistent production around 3 y/o
/p/ Press your lips tightly together and push air up into your mouth, feeling the air build up behind your lips. Let the air push your lips apart creating a “pop.”
/b/ Press your lips tightly together and push air up into your mouth, feeling the air build up behind your lips. Turn your voice on and let the air push your lips apart.
/m/ Lightly press your lips together, turn your voice on, and let air flow through your nose, just like you are humming.
/n/ Open your mouth slightly and press the tip of your tongue right behind your front teeth. Turn your voice on and let air flow through your nose like you are humming.
“y” Lightly touch the back of your tongue to the roof of your mouth and pull the corners of your lips back. Turn your voice on and then move your bottom jaw down, pulling your tongue away from the roof of your mouth.
/w/ Round your lips and pull them close together in a tight circle. Then, raise the back of your tongue so it touches the roof of your mouth. Turn your voice on and then pull your jaw down and relax your lips.
/h/ Let your mouth rest slightly open. Quickly push breath through your throat.
/d/ Lift the tip of your tongue and place it right behind your top front teeth. Push your tongue, turn your voice on, and let your tongue drop slightly as you let the air burst through.

 

Middle 8 Emerging pronunciation development between ages 3-6.5, consistent production around 5.5 y/o
/t/ Lift the tip of your tongue and place it right behind your top front teeth. Push your tongue and let your tongue drop slightly as you let the air burst through your tongue.
“ng” Lift the back of your tongue to touch the roof of your mouth and turn your voice on, letting the air flow through your nose. Keep your voice on as you pull your tongue down away from the roof of your mouth.
/k/ Bring the back of your tongue up to touch the roof of your mouth while keeping the tip of your tongue down. Push your tongue up and then let a puff of air out between your tongue and the roof of your mouth as you pull your tongue slightly down.
/g/ Bring the back of your tongue up to touch the roof of your mouth while keeping the tip of your tongue down. Turn your voice on as you push your tongue up and then let a puff of air out as you pull your tongue slightly down.
/f/ Place your upper teeth on your bottom lip and push air through.
/v/ Place your upper teeth on your bottom lip and turn your voice on as you push air through your teeth and lip.
“ch” Touch the front of your tongue to the ridge behind your top front teeth and push your lips out (slightly rounding them). Let the sides of your tongue touch your upper back teeth to trap the air. Push a puff of air over your tongue as you let the tip of your tongue fall slightly.
“j” Touch the front of your tongue to the ridge behind your top front teeth and round your lips. Let the sides of your tongue touch your teeth to trap the air. Turn your voice on as you push a puff of air over your tongue as you let the tip of your tongue fall slightly.

 

Late 8 Emerging pronunciation development between ages 5-7.5, consistent production around 7 y/o
“sh” Touch the sides of your tongue to your upper back teeth, tilt the tip of your tongue down, and push your lips out (slightly rounding them). Push air over your tongue and through your front teeth.
“zh” (as in ‘treasure’) Touch the sides of your tongue to your upper back teeth, tilt the tip of your tongue down, and push your lips out (slightly rounding them). Turn your voice on as you push air over your tongue and through your front teeth.
/s/ Put your teeth together, slightly part your lips, lift the sides of your tongue to touch the insides of your top teeth, and bring the tip of your tongue down. Push air down the middle of your tongue and out through your teeth.
/z/ Put your teeth together, slightly part your lips, lift the sides of your tongue to touch the insides of your top teeth, and bring the tip of your tongue down. Turn your voice on as you push air down the middle of your tongue and out through your teeth.
Voiceless “th” Place your tongue between your top and bottom teeth and push air through.
Voiced “th” Place your tongue between your top and bottom teeth and turn your voice on as you push air through.
/r/ Pull the back of your tongue back and up. Press the sides of your tongue to the insides of your upper back teeth and slightly curl your tongue tip up. Turn your voice on and let the air flow through your mouth and over your tongue.
/l/ Lift the tip of your tongue and place it behind your top front teeth. Turn your voice on and let the air flow through your mouth as you let your tongue drop down.

If your child is continuing to struggle with one or many sounds past the age at which the sound is typically mastered by, a speech-language pathologist can help!

[1] Johnson, C., & Horton, J. (2009). Webber Jumbo Artic Drill Book Add-on (Vol. 2). Greenville, South Carolina: Super Duper Publications.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. 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!

Meet-With-A-Speech-Pathologist

When to Be Concerned About Your Child’s Articulation of the L Sound

“I Wove You!” For young children, substitutions of the /l/ sound are common, but when should ‘wove’ become ‘love’? Blog/l/-Articulation-Main-Portrait

The /l/ sound is characterized as one of the ‘late eight’ sounds or, the later developing sounds in English-speaking children. Research has shown that 90% of children master the /l/ sound by 6;0. (Data from Templin, 1957; Wellman et al., 1931). (Sanders, 1972)

So…What Does This Mean for My Child?

In young children, these articulatory errors are developmentally appropriate and often resolve on their own. However, if you are noticing the persistence of these errors around 5 or 6 years of age, a speech and language evaluation might be an appropriate next step. An evaluation could be warranted sooner if there are other accompanying speech errors, or if you are concerned about your child’s overall ability to be understood.

How to Make the /l/ Sound:

This sound can be taught as “the singing sound”. The /l/ sound is made with the tongue elevated to touch the alveolar ridge or, the bumps on the hard palate behind the front teeth. Have your child watch your mouth as you say ‘la-la-la’, then, let her have a try.

Having your child practice in front of a mirror can be a particularly useful tool as well, giving her the opportunity to trouble-shoot her productions. Talk about the bumps on the roof of the mouth behind the front teeth as being the ‘magic spot’ where we want our tongue tip. If your child is comfortable with it, use a tongue depressor to touch the alveolar ridge if tongue placement is particularly difficult.

One of the most common errors associated with production of /l/ is called gliding, where /l/ is substituted with a glide sound (/w/ or /j/). If your child is substituting a /w/ for an /l/, it’s important to discuss relaxing the lips (or even having them in a slight smile) to avoid lip rounding.

Feel free to make this fun and interactive! Use a play dough head and make a tongue out of dough to demonstrate tongue tip elevation. Find what makes this interesting and salient to your child!

Shape the sound from one the child already has!

-Have your child prolong an ‘ahhhh’ sound and have her slowly elevate her tongue tip to the alveolar ridge.

-If your child is able to produce a /t/ or /d/, talk about having your tongue tip in the same spot for /l/ as for these sounds. Alternate between saying /ti/-/li/, /ti/-/li/.

Once your child is able to produce /l/ in isolation and in syllable shapes, begin targeting this sound in various positions in words (i.e., initial, medial, and final).

*It is worth noting that /l/ has two different placements depending on its position in a word. Light /l/ occurs at the beginning of a syllable (e.g., leaf), and dark /l/ occurs at the end of a syllable (e.g., milk).

Suggestions for Activities:

The /l/ sound is everywhere! Feel free to be creative.

Here are some activities to try out:

-Build a Lego tower and formulate two-word phrases (e.g, red Lego, blue Lego) as you build.

-Point out objects in your environment with /l/, or play I spy.

-Read a book with your child and have her produce some of the words with /l/.

The following books are heavily loaded with /l/ sounds:

Llama Llama Red Pajama, by Anna Dewdney

Five Little Monkeys Jumping on the Bed, by Eileen Christelow

Lyle, Lyle Crocodile, by Bernard Waber

The Luckiest Leprechaun, by Justine Korman

It Looked Like Spilt Milk, by Charles G. Shaw

Should you have concerns about your child’s articulation, consult with a licensed speech-language pathologist.

[1] Sanders, E. (1972). “When Are Speech Sounds Learned?”. Journal of Speech and Hearing Disorders, 37, 55-63.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. 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!

Meet-With-A-Speech-Pathologist

Zika Guidelines | What You Need To Know During The Outbreak

This Guest Blog Post was written by Dr. Kudus Akinde, MD FAAP of Glencoe Pediatrics.

Today, the World Health Organization (WHO) declared a public health emergency (AAP News). There is strong suspicion that recent clusters of fetal microcephaly are occurring in babies of infected mothers in areas where Zika virus transmission appears to be common. The CDC & the AAP have become involved in issuing recommendations to health care providers and to the general public in the matter.

Zika is a mosquito-borne flavivirus with RNA as its genetic material. It is transmitted by Aedes aegypti mosquitos. An estimated 80% of all people infected have no symptoms according to the CDC’s Morbidity and Mortality Weekly Report (MMWR) from Jan 22, 2016. The report goes on to explain that symptoms are usually mild with usually a few days of fever, rash, joint aching and pink eyes without mucus or pus buildup. No antiviral medicines exist to treat Zika virus. Treatment is supportive (acetaminophen, rest, oral fluids); avoid aspirin or ibuprofen in pregnant women.

So what’s the big deal about the Zika Virus? Infections happen all over the world. Right?

Well, it turns out that there are areas in the Caribbean, North and South America where children are being born with microcephaly (heads. therefore brains, that are abnormally small for their gestational age) or intracranial calcifications. This is a problem because these findings can be associated with a whole host of neurologic and developmental delays that can be lifelong in duration.

Since the outbreak is currently ongoing, it is difficult to make associations and good reliable information about infection during pregnancy is unavailable. As a matter of fact, pregnant women aren’t known to be more susceptible to infection with Zika virus than anybody else. It seems to infect people of all ages across the board. However, it can infect pregnant women in any trimester and if they are infected, the virus can be transmitted to the developing fetus in any trimester as well.

How To Prevent The Zika Virus?

All pregnant women should be screened for travel. If they haven’t traveled, they should strongly consider postponing travel to all endemic areas. If they do travel, they should practice strict mosquito avoidance. This includes:

  • Long-sleeved shirts and pants are preferred to the shorter varieties
  • EPA-approved insect repellants
  • Permethrin-infused clothing and other equipment
  • Using screens and air conditioning as much as possible

Pregnant women who have travelled to areas of ongoing Zika, dengue and chukungunya (similar flaviviruses with similar symptoms and also transmitted by Aedes mosquitos) infection should be tested according to CDC guidelines if they have symptoms consistent with Zika (fever, rash, pink eyes within 2 weeks of travel OR fetal microcephaly or intracranial calcifications after travel). Women wtihout symptoms and with normal fetal ultrasounds do not need to be tested according to current recommendations. If lab testing confirms Zika by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR), then prenatal ultrasounds to diagnose and monitor problems are recommended as well as Meternal-Fetal Medicine (MFM) specialist (high-risk obstetrics) or an Infectious Diseases specialist with expertise in the care of pregnant women. An antibody test also exists but the decision for which test to order should be made with/by the treating provider.

What Testing Can Be Done For The Zika Virus?

RT-PCR can be done on amniotic fluid but there are limitations to the testing. Amniocentesis carries higher risk of complications early in pregnancy (at 14 weeks or less) so it should be done at a minimum 15 weeks gestation. For babies born with evidence of Zika, testing should be done on available tissues (umbilical cord and placenta). In cases of fetal loss, RT-PCR should be done on fetal tissues as well (cord and placenta). There are no commercial tests available for Zika virus infection. The CDC and state public health agencies are the ones who can help with testing. ​

A Summary of the Zika Virus:

  • Zika virus infection is suspected of an association with clusters of fetal microcephaly and intracranial calcifications in many countries in North and South America as well as the Caribbean Islands.
  • Most infected people don’t even know they’re infected (up to 80%).​​
  • Pregnant women are being cautioned not to travel to areas Zika virus transmission. Pregnant women should be asked about travel at their pre-natal visits. If they have traveled and felt no symptoms of illness, they do not need testing.
  • Testing should be done for Zika virus (also dengue and chukungunya) on symptomatic pregnant women who have travelled to endemic areas.
  • ​​If testing is positive for Zika, serial ultrasounds and very specialized care with MFM or Infectious Diseases specialist with focus on pregnancy should be obtained.
  • If a baby is born with evidence of Zika virus infection, testing of the umbilical cord and placenta by RT-PCR should be done.
  • ​​If fetal loss occurs in a symptomatic mother with known travel to an endemic area, RT-PCR should be done.

*Special thanks to the CDC, WHO, and AAP for their leadership in this emerging matter.

 


Dr. AkindeDr ​Kudus Akinde, MD FAAP is the practicing physician at Glencoe Pediatrics in beautiful Glencoe, IL. Glencoe Pediatrics provides services including: sick or urgent visits, minor scrapes & bumps, annual check-ups, school physicals, camp physicals, sports physicals, pre-surgical physicals and more.  Dr. Akinde graduated from University of Illinois with a Bachelor of Science Degree in 1995. He attended the University of Illinois College of Medicine and obtained his MD in 2002. He completed his Pediatrics Residency at Rush University Medical Center in 2005.  He has practiced in various locales from small to large communities, urban, suburban and rural (including Rockford, Belvidere, Evergreen Park, Oak Lawn, Highland Park & Chicago, IL).  He has never met a kid he does not like.  His interests include newborn care, immunizations, nutrition, gastroenterology and adolescent issues.  He loves to spend time with his children when he is not at work.  He enjoys web browsing, bike riding, football, basketball, music and traveling among other things.

the development of play

From Stacking Blocks to Tea Parties: The Development of Play

At each stage of our lives we have certain responsibilities; as adults we work, as highschoolers we went to school, as kids we played. Playing is a fundamental skill for children, and often acts as an avenue for other skills to develop. While playing, kids explore the world; they learn how things work, they arethe development of play exposed to new vocabulary and they learn to interact with other kids.

Play mirrors language development. As a child ages, their language skills develop, progressing from one word utterances to 3 – 4 word phrases and ultimately reaching conversational level skills. Along with this improvement and development of language abilities, a child’s play skills will also progress through a developmental hierarchy. Therefore, just as there are developmental steps with language development, there are certain play milestones that a child will progress through.

Use the table below as a reference to determine appropriate play skills for your own child for his or her age.

The Development of Play:

Age Play Skills
0-6 Months – Demonstrates reaching and banging behaviors for toys- Starts to momentarily look at items and smile in a mirror

– Rattles and Tummy Time mats are very popular at this age

6-12 Months – Begins to participate in adult-led routine games(e.g., Peek-a-boo).

Functional play skills are emerging at this age (i.e., playing with a toy as it is meant to be used). Examples of functional play are pushing a car or stirring with a spoon.

– Demonstrates smiling and laughing during games

 

12-18 Months – Consistently demonstrates functional use of toys- Emerging symbolic play skills were be observed at this age (i.e., the use of an object to represent something else). For example, pretending a banana is a telephone or pretending to brush a doll’s hair with an imaginary brush

– A child will also ask for help from a caregiver or adult if his or her toy is not working

 

18-24 Months – Pretend/symbolic play will become more advanced with the use of multiple toys in one play situation (e.g., playing kitchen or house)- There is much more manipulation of toys at this age – grouping of like items and assembling a complex situation

– Children will also become more independent in putting toys away or repairing broken pieces

 

24-30 Months – At this age children will begin to demonstrate parallel play. In other words, children will engage in the same play activity with the absence of interacting with each other- Although at this age, children are not yet interacting together directly, they will begin to verbalize more around children as well as share toys with other peers

 

30-36 Months – Children at this age are becoming expert playmates – long play sequences will be carried out. Typically, children will begin by playing out familiar routines, such as a parent’s dinner routine. As children age, new endings to play sequences will emerge- Dolls or other play animals may become active participants in a play sequence.

 

Rossetti, L. (2006). The Rossetti Infant-Toddler Language Scale. Linguisystems, Inc.

Encourage your child to explore and interact with new toys. Try sabotaging a play sequence (e.g., putting a block on your head rather than on the floor) to add extra fun or laughs to an afternoon. While playing with your child, also encourage and add language to the situation. You can do this by asking the child, “What should the horse do next?” or even just narrating what you are doing, e.g., “First I’m going to stir my pot, then…”.

Playing is meant to be fun and enjoyable for parents and their kids. Enjoy the warm weather, encourage language and play development and go outside to play!

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. 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!

5 things you didn't know about how your baby learns language

5 Things You Didn’t Know About How Your Baby Learns Language

Has your child ever surprised you with his knowledge and actions, or used a word that you thought he had never heard before? Have you ever thought, ‘My child is a genius’? If so, I have to agree that children and the way that they develop language skills is quite impressive!

Here are 5 things you didn’t know about how your baby learnslanguage development language:

  1. Babies cannot learn language from iPads and TV. Although there are many apps available that target language skills, they do not replace human interaction. Patricia Kuhl and her research team concluded that language learning takes place in a social context (interaction with a person!) (Roehrich, 2013). Their research has shown that American babies exposed to non-native sounds (sounds not in their primary language) in a face-to-face context were able to learn to distinguish these sounds from their native sounds. However, when presented with the non-native sounds via audiovisual and audio recordings only, they were not able to distinguish between the two.
  2. Motherese works. Motherese (also known as baby talk or infant directed speech) is spoken by mothers around the world. Is there a purpose to this talk? The answer is yes! Motherese helps babies to learn the sounds, patterns, and intonation of their language. The prosody of motherese is thought to facilitate processing in domains such as word segmentation (Thiessen, Hill, & Saffran, 2005) and word learning (Graf-Estes, 2008).
  3. Babies start learning language in the womb. Believe it or not, the number of neurons (nerve cells) in our brains peaks before we are even born!  Babies have a critical period for learning sounds in their native language, and this critical period occurs before your child turns 1 year old. This period begins when your baby first develops the ability to hear (around 16 weeks after conception). Before this critical period, babies are able to discriminate between any sounds in any language. At approximately the age of 8-10 months, babies are pruning connections in their brain and fine-tuning the connections that are used most frequently. This is why, after the critical period, your baby no longer has the ability to discriminate sounds in native and non-native languages. When your baby is 6 months old, they have an ability that you as an adult do not have! (Roehrich, 2013)
  4. Babies communicate via eye gaze. Have you ever wondered how your baby communicates without using words (or cries?) The answer is eye gaze! Eye gaze is one of the first ways that a baby and their mother connect socially. Babies show preference for items and people by demonstrating longer eye gaze towards a person or object. When they are a little older, babies also use joint attention and gestures to communicate. This is demonstrated by the baby looking at a preferred object, then making eye contact with their communication partner, and then back to the preferred object again, attempting to draw the adult’s attention to their preferred object.
  5. Toddlers fast-map. During the second year of life, toddlers learn and retain new words after minimal exposure to the word and its use. This enables them to expand their receptive and expressive vocabularies at a rapid rate.

Watch this TED Talk that provides additional information about how babies learn language. If you are concerned with your child’s language skills, consult a speech and language pathologist!

New Call-to-action


NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. 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!  

References: