Engaging Your Newborn Baby: 5 Simple Tips for Interacting with Your Baby

As a new parent, chances are that you have spent countless hours just gazing into your newborn’s eyes. However, between nonstop feedings, washing copious amounts of laundry, all of those diaper changes , and trying to sneak in a nap, some new parents may feel left in the dark when it comes to play time.  As your baby starts to become more interactive daily, you may quietly think to yourself, “Well, now what?”.

mom and infant playing

Here are some simple activities you can do with your baby throughout the day to help lay the appropriate foundation for language development:

Never underestimate the power of a smile

Babies love to look at faces. Even at an early age, they are able to be easily engaged and will focus on exaggerated facial expressions for a brief period of time. Therefore, take moments throughout the day to block off some face-to-face time. You will be amazed at how attentive your baby is during these times, and you will see him/her start to attempt to imitate the facial movements you make (especially with your tongue). They’ll get a kick out of seeing you smile, and how can you resist staring back at that adorable little toothless grin?

Turn bath time into play time

Bath time provides many opportunities for sensory exploration, so help maximize this time as much as you can by offering various textures of objects (washcloth, bubbles, water toys etc.) that contain different sensory properties. Talk about how the items look and feel, and even sing to your child during this time as well. Your baby will be calmed by the warmth of the water and soothed by the sound of your voice. Also, try to time bath time immediately before putting your child to bed in order to establish a nighttime routine.

Introduce books

You will help to facilitate a lifelong love of reading and literature when you introduce books at an early age. Provide your child with plenty of soft books and board books, which contain many bright and colorful pictures. Touch and feel books are perfect for this age, as they allow your child to be more interactive as well. Also, keep the books brief, as your little one is not exactly ready for a novel anyway. Short and simple books containing repetition are perfect for infants.

The importance of exercise

Any PT will tell you about the importance of tummy time, so help make this activity more fun and interactive for your child by providing various toys and objects for them to interact with. Try placing a child-friendly mirror directly in front of them, as your baby will love looking that the “other” baby staring back. Also, help encourage babies to follow your voice by moving to either side of them. Even at a young age, children are able to identify their parent’s voices, so by simply changing your position in relation to your baby, you will be enhancing this skill. You can also play simple games, such as peek-a-boo when facing your child, in order to keep them engaged.

Talk, talk, talk

Talk to your child throughout the day, especially when completing familiar activities such as washing the dishes, doing the laundry, and cooking dinner. Doing so will help to expose your child to the language associated with these activities. Though the “conversations” with your baby will seem very one-sided at first, over time you will notice that your baby will attempt to chime in when you are speaking. You will be able to quickly observe the give-and-take, as your child will quiet when you begin talking, then “comment” after you speak.

As a new parent, it can be completely overwhelming trying to juggle all of your responsibilities, so just remember to breathe! Don’t feel as though you have to do everything right off the bat. As you and your baby settle into a routine, you will notice that you are able to find some extra time to sneak in these activities.  By introducing just a couple of these ideas throughout the day, you will quickly notice that your child becomes more engaged during these times and will start to anticipate the activities as well.  Congratulations and welcome to the exciting world of parenthood!

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Navigating Early Speech & Language Milestones: What to expect between age 1 and 2

Parents often wonder if their child’s skills are developing typically.  Between gross motor skills, fine motor skills, speech-language skills, social-emotional functioning, and overall growth, there’s a lot to keep track of!  In fact, it might feel overwhelming.  Mother communicating with infantIt’s important for parents to remember that every child develops at their own rate, with some skills emerging faster, and other skills taking more time.  When considering your child’s development, referring to developmental milestones can be an excellent guide.  In Part 1 of this blog, we reviewed speech and language milestones to expect during the first year of your baby’s life.  In Part 2, we’ll review communication milestones you might expect to see between age 1 and 2.  If you begin to feel concerned regarding your child’s development, seek help from a licensed professional right away.  A trained therapist will give you accurate information, ease your worries, and if needed, give your child any help they might need.

Speech & Language Skills Emerging Between 1 and 2 Years

1 – 1½ years

Your child might:

  • easily understand his own speech
  • use a variety of words (between about 3-20) to communicate
  • understand between 50-75 words to communicate
  • be able to point to various objects or body parts as you say them
  • be able to follow simple 1-step directions
  • use words that contain a consonant + vowel (e.g. “bo” for boat)
  • be eager to imitate words they hear others say
  • use some jargon when they’re communicating
  • request things by pointing or vocalizing
  • let you know what they don’t want, by shaking their head “no” or pushing objects away

1½ – 2 years

Your child might:

  • be likely using more true words, and less jargon to communicate
  • be asking questions by using a rising intonation
  • begin to include sounds at the end of their words (e.g. hot)
  • use more than 50 words to communicate
  • understand about 300 words to communicate
  • begin to combine words into simple phrases
  • be able to follow 2-step related directions (e.g. “open the box and give me the bear.”)
  • begin to respond to yes/no questions
  • understand location concepts “in” and “on”
  • begin using words to tell you when they don’t want something (e.g. “no bed”)

For more information about speech and language development in childhood, visit the American Speech-Language-Hearing Association at http://www.asha.org/public/speech/development/.

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What to do when your Child Doesn’t Play with Toys Appropriately

One exciting thing about being a child is all the cool and fun toys you get to play with. However, some children struggle with playing appropriately, and can be too rough and unsafe with toys. Parents sometimes have difficulty getting their children to use toys appropriately.

To help you gain better control during playtime, and keep your child and others safe, try the following strategies with your children:

  1. Model. When your child gets a new toy, model how the toy should be used. You should provide lots of prompts and hand-over-hand assistance to teach and encourage your child to appropriately play with the new toy.Infant girl playing with toys
  2. Practice. Have your child practice appropriately playing with the toy. If your child starts to get too rough with it, show them the appropriate way to use it and then have them repeat it back to you.
  3. Praise. When your child is appropriately playing with their toys, provide them with praise and let them know they are doing a great job. For example, you can say, “Suzy, I love how nicely you are playing with your dolls!” or “Josh, you are doing a great job of racing your cars and not throwing them!”
  4. Take It Away. If your child continues to play with toys inappropriately (i.e., throwing them, hitting others with them, trying to break them), immediately take the toys away. Let your child know that this is not how one plays with the toys. Talk to your child about why it is unsafe (i.e., someone can get hurt, you can break the toy or other items that are nearby, others might not want to play with you). You can then reintroduce the toy and show your child how to appropriately play with it. Let your child know that if they do not play the right way with the toy, then they will not be able to play with it for the rest of the day.
  5. Make a Story. You can also create a story about how we should and should not play with our toys. Within the story, identify the appropriate ways to play with toys and why we should play with them that way. Your story can also illustrate inappropriate behavior with the toys, highlighting again why we do not want to use toys in that manner. Review the story with your child before they go on a play date or start playing with toys. In addition, you and your child can reread the story after they misbehave with a toy.
  6. Just Not Ready. Some children just may not be developmentally ready to play with a specific toy, despite the age limits listed by the manufacturer. If this is the case, pull the toy out every now and again and see if your child is at the right stage. The toy will be much more fun for both of you when they can use it appropriately.

To keep your child playing safely with toys, always remember to model, practice, and praise; and if you have to, do not be afraid to take the toy away until your child can appropriately play with it.

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When Friends Are A Bad Influence on Your Children | Pediatric Therapy Tv

In today’s webisode a Licensed Professional Counselor provides tips on what to do if our children are influenced badly outside of the home setting.

 In this video you will learn:

  • When a parent should discuss bad influences with the child
  • How to best approach the bad influence situation
  • What is the best way for the child to handle the situation

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV, where we provide experience and
innovation to maximize your child’s potential. Now, your host, here’s
Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host Robyn
Ackerman, and today I’m standing here with Marnie Ehrenberg, a
licensed professional counselor. Marnie, can you give us some
advice on what to do when our children are hanging out with bad
influences?

Marnie: Sure. I think it’s a topic that comes up a lot across the age
groups, and I think it kind of depends on the age, but for older
kids, I think that your first step should not be to say, “You
can’t hang out with that person.” I think that that makes that
person really desirable. I think that talking to your kids about
how to make good decisions is really important, and as well as
reinforcing that you have your own family rules, and if another
person they want to hang out with doesn’t follow those kinds of
rules or jeopardizes that, that they need to learn how to say no
and how to end it.

I think giving them a chance to be able to make those decisions
on their own and see if they break any rules is important. And
then at that point, then you can decide if you’re at the point
where you’re going to forbid them to see somebody. But I think
it’s important to talk about how your family works and how other
families work and keep that integrity in your home.

Robyn: All right. Thank you so much, Marnie. And thank you to our
viewers, and remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of
mind to your family with the best in educational programming. To
subscribe to our broadcast, read our blogs, or learn more, visit
our website at LearnMore.me. That’s LearnMore.me.

Preemies: Special Little Ones with Special Nutrition Needs

When going through pregnancy, most mothers expect to have nine months to prepare for a newborn. Caring for a preemie, however, is not something that pregnancy books and newborn care classes cover.

In terms of preemie nutrition and feeding, the following information can help prepare you or provide insight into what you may be experiencing:

Mother eating with infant

1. Nutrition support

This refers to an alternate route of nutrition for your baby. Babies may require nutrition support if they have low birth weight or other medical complications. If born before 34 weeks, he or she may not be able to coordinate sucking, swallowing, and breathing during oral feeding. Your baby may receive breastmilk or formula through a tiny tube that goes into the nostril or mouth and down to the gut (enteral nutrition). In cases of very early preemies, many have to receive parenteral nutrition, or nutrition through an IV (intravenous). This is because their digestive system is not yet developed enough to handle the full volume of breastmilk or formula that is required to sustain growth. There can be a number of factors that limit an infant’s ability to tolerate enteral nutrition, and parenteral nutrition becomes necessary.

2. Fortified breast milk or special formulas

Being outside the womb early presents challenges and demands on the infant’s body that can increase nutrition needs. Preemies with low birth weight need more calories, protein, vitamins and minerals than infants born at full term, to promote “catch up growth”. Human breastmilk has been analyzed from mothers of preemies and mothers of term infants, and preemie breastmilk actually contains more calories, protein, vitamins and minerals than term breastmilk. Often times, preemie breastmilk needs to be fortified further to meet the infant’s needs. There are also formulas designed for premature infants in the event that breastmilk is not available. Proper nutrition is critical for the development of vital organs like the lungs, heart, brain, and gut. Neonatologists and registered dietitians assess each baby in the NICU for nutrition needs, and create individualized recipes and feeding regimens. Sometimes these special recipes and feeding regimens need to be continued once the baby goes home from the NICU, and parents get educated by the medical team on how to do this.

3. Swallowing or oral feeding issues

Babies develop the ability to coordinate sucking, swallowing, and breathing around 33 or 34 weeks. There are a number of circumstances that may impact this developmental stage for preemies born prior to that. The baby may require a ventilator for oxygen, which would not allow oral feeding to occur. Or, the baby may require nutrition support during this time for a variety of reasons, and oral feeding attempts may not be possible. These scenarios can have lingering effects on how the baby feeds and swallows in the future. Babies may require special feeding techniques or “thickened” liquids if they have swallowing difficulties. Sometimes babies develop oral sensory issues and aversion to oral feeds, in which case tube feedings may continue until this is overcome.

An article published in Neonatology in 2008 titled “Strategies for feeding the preterm infant”, by Dr. William Hay, provides a review of preemie nutrition (for free full text, click here). As your infant gets older, his or her nutrition needs will change. Growth should be monitored closely by your child’s doctor.  Nutrition is critical, and expert care should be provided to ensure maximum development. If you or your doctor has concerns about growth, nutrition, or feeding, schedule an appointment with a dietitian at North Shore Pediatric Therapy.

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The More the Merrier- Why Having a Fieldwork Student is Beneficial for Your Child

NSPT strongly believes in taking on new fieldwork students in order to create a great learning environment for both the therapists and the families.  As a parent, you may be asking, “what’s in this process for me”?  Here is a list of 5 examples why having a fieldwork student working beside your child’s therapist serves as such a wonderful growth opportunity for everyone involved. Pediatric therapist smiling

  1. New knowledge:  Oftentimes, new editions of textbooks come out each year, which include new case studies and updated information.  When a student comes in, she is able to share this current knowledge, and apply it to the therapist’s caseload as appropriate.  Similarly, a student usually subscribes to research-based articles through her school, which can be a great resource for families (e.g. OT Practice Magazine; ASHA).
  2. Flexibility:  Having a fieldwork student helps your child work on his flexibility skills as he has to build a relationship with a new person, follow a new set of directions, and possibly follow a new layout for the treatment session.  Flexibility is an important life-long skill, as things won’t always go as your child  hopes or plans, and it is crucial to be able to work through these situations and say “no big deal”.
  3. Extra set of hands and eyes:  When an extra body is present, this allows for an extra set of hands and eyes to watch how the child moves around and interacts with the environment.   Having a student typically helps the child’s therapist try new equipment and/or more complicated treatment activities that she might not otherwise be able to use (e.g. the rainbow swing- one person needs to open up the swing, and one person needs to lift the child onto the swing).
  4. Fresh perspective on treatment ideas:  As a fieldwork supervisor, the therapist tries to challenge the fieldwork student to bring in new creative treatment ideas to the child’s therapy sessions each week.  This helps the child work through novel tasks and demands, and it also puts a new spin on how to help the child work towards his current goals.
  5. Extra practice for social skills:  Having a fieldwork student means that your child will have a new person to meet and greet.  This will help your child continue to work on eye contact, manners (e.g. shaking hands), and turn-taking (e.g. during games or when creating a plan/schedule for the session).

There are many benefits that come from allowing a student to complete her fieldwork rotation at NSPT, both for the clinicians and the clients.  A student can bring a new perspective to the table, and can offer new creative strategies  to help the child best reach his goals.

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If you have any questions or concerns regarding the process of taking on a fieldwork student, please feel free to reach out to your child’s current therapist, or contact anyone on our NSPT team.

Healthy Supermarket Shopping for Your Family

The first step to having a healthy diet for your family happens when you make a trip to the grocery store. Choosing what foods you put in the cart actually determines your child’s health, in a lot of ways.

Here are some tips to make grocery trips a healthy success

Make a habit and priority of going to the grocery store at least once a week.
This sounds basic, but what happens when you are low on food in the house? Often this means picking up fast food, random snacks, or making a meal out of chips. Also, cooking food at home is key to a healthy lifestyle. Research supports this, and also shows that families who eat together eat more fruits and vegetables. It’s also wonderful family bonding time and a place for kids to learn healthy eating habits from their parents

Here is a basic list of foods to get weekly for the family

  • Meats, beans, tofu, or seafood for main dishes
  • A variety of fresh fruit for side dishes and snacks, frozen fruit for smoothies, and/or dried fruit for snack.Mother shops for food with child at the supermarket
  • Vegetables to eat raw, like salad greens, carrots, tomatoes, celery. Vegetables to eat cooked like potatoes, onions, garlic, brussell sprouts, zucchini, squash, peas, green beans, broccoli, cauliflower.
  • Eggs (if your family eats them), for breakfast or to cook with.
  • Milk or milk alternative.
  • Cereal and/or oatmeal.
  • A jar of nut butter.
  • “Flavoring and cooking” items like sauces, dressings, olives, seasonings, cheese, olive oil, etc.
  • Whole grain bread.
  • Whole grain side dishes like pasta, quinoa, or brown rice.
  • The rest of your list can be the specialty items needed for new recipes or specific meals.
Make a list based on healthy recipes.

Keep a pen and paper handy for an ongoing list for the next grocery trip. That way if you come across a good recipe in a magazine or online, you can write down the ingredients needed. Some people find it helpful to create a “menu” plan for the week for dinners, and use new recipes throughout the week. A list keeps you focused and organized while you are in the store.

Be sure to gather plenty from the perimeter of the grocery store.

Picture a typical grocery store in your mind and how it is set up. The middle aisles draw you in, but what do you find there? What do you find when you walk the perimeter of the store? It is not random that most grocery stores are set up this way. The middle aisles draw you in, but mostly are filled with processed foods. The outer part of the store is where many whole foods are:  fruits, vegetables, meat and seafood. Don’t skip the produce section.

Organic or on sale? Reduced fat or regular? Local or best buy? 

There are many side by side options of every food product out there, making a grocery trip feel like a “Where’s Waldo” experience. My choice is to buy organic and local as much as possible. Reduced fat or regular depends on what you and your family needs as part of a healthy diet. I choose regular, as many reduced fat foods are loaded with sugar or other chemicals in place of the reduced fat.

Let the kids pick!

If you’re brave enough to bring the kids along to the grocery store (or maybe you don’t have a choice), let them pick from healthy options you have preselected. For example, give them a few breakfast cereal options and let them pick which one they want. Or bring them to the produce section and let them pick one fruit and vegetable each. This gets kids engaged in healthy eating, and if they picked it, they are more likely to be excited about eating it.

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Keeping Your Child With Special Needs Safe

How do I keep my child safe?
Sometimes, I wake up in the middle of the night screaming after a nightmare that my child wandered off and I never found him again.  Children with special needs have an even higher chance of wandering off. What do I do to keep him in my sight?
This week, we all read about Kahil Gray, the missing boy from Chicago with autism.  Kahil was found 3 days later, 26 miles from his home.  Kahil has autism and only speaks a few words.  Support for Autism symbolHis parents were lucky that someone spotted him days after he went missing.   What can be done to prevent losing our kids?

How to prevent your child from wandering off:

GPS tracking technology is often associated with fun gadgets and navigation for vehicles, but there are many potential security applications for this type of technology as well. Product and software developers have created a handful of tools to harness the power of GPS tracking for better safety and security, allowing parents to keep track of their children. http://securitynews.hubpages.com/hub/Safety-for-Wandering-Seniors-with-GPS-Tracking

Here are some additional tips to keep the kids from wandering:

  1. Use a tracking/watch device that you can purchase.
  2. Download an app for your child’s iPhone so you can track the phone.
  3. Have the child memorize a plan if he is lost; keep a piece of paper with that plan and have the child practice handing it to people to help him.  He should have several copies of it with him at all times.
  4. Keep medical bracelets on kids that tend to wander.
  5. Alert police even before the child is lost so that they will keep an eye out for your child; many cities now keep a database on special needs children should they go missing.

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Daily Activities to Improve Fine Motor Strength

Decreased hand strength can make participating in fine motor activities very difficult for a child.

Here are some activities to help improve hand strength:

  1. Stirring batter or dough with a large spoon: This activity will help improve your child’s grip strength in both hands; one holding the bowl and one stirring with the spoon. The child will be motivated by the desirable end product, which could be brownies, cookies, or even play-doh.Child pressing a paint glue
  2. Squeeze, roll, and play with play-doh or silly putty: Play-doh and silly putty can be used to encourage pinch and grip strength by having your child make balls, pinch them into pancakes, squeeze them into a long snake, etc.
  3. Climbing up ladders or playground equipment: Holding on to ladders, monkey bars or climbing equipment will help improve functional grip strength, as the child must support their body with their hands.
  4. Buckles and snaps on clothing, helmets, etc.: Encourage your child to learn and complete difficult fasteners on their clothing and accessories. This will help promote independence and hand strength for everyday tasks.
  5. Tennis ball friend: Cut a slit in a tennis ball and draw eyes on it to make a puppet. Have your child ‘feed’ the tennis ball different small objects by squeezing the tennis ball with their hand to open the slit.
  6. Craft projects with hole punchers/ staplers: Using hole punchers and staplers are difficult hand tasks that require a lot of strength. Challenge your child to create a whole art project using only these two items.
  7. Cutting different thicknesses of paper: Using different thicknesses of paper will turn a cutting activity into a strengthening activity. Challenge your child to progress from thinner to thicker papers (for example, computer paper, to construction paper, to poster board, to cardboard, etc).
  8. Squeezing a glue bottle: Create a raised maze with glue and when it is dry, have your child color it in. Another option is to put paint in old glue bottles and have your child squeeze the paint out to make a picture.
  9. Putting together and taking apart Legos: Legos are a great activity for strengthening all fine motor skills. To add an extra challenge, push two legos together very tightly and then have the child try to pull them apart.
  10. Play with clothespins: This will promote the strengthening of small muscles in the fingers for improved pinch strength. Some ideas for clothespin use are: hanging things on a string, moving game pieces, and picking up small snacks.

Performing these activities will help encourage proper finger strength, which promotes independent self-care, academic success, good play skills, and overall improved function on a daily basis. If you have concerns regarding your child’s finger and hand strength or fine motor performance, please seek out an occupational therapist for a consultation or an evaluation in order to help your child achieve their potential.

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Home Activities for Articulation Therapy

The more you practice a movement, the stronger your muscle memory gets, until the movement becomes habitual. This concept applies to both gross and fine motor movements as well as to the movement of the articulators: the jaw, tongue, and lips. If a child focuses on practicing speech sounds once a week, they will progress. However, if the target sound is practiced every day, the child will demonstrate even faster progress.Father communicating with child

Think of doing a jumping jack. We all learned that jumping jacks are done by jumping up and spreading your legs apart horizontally while clapping your hands above your head. Now try doing a jumping jack by jumping up and spreading your legs front/back while clapping your hands above your head. (Caution: you may feel very uncoordinated!) It may be difficult at first, but after doing it a few times, the movement becomes easier. Because you were taught the traditional way of doing a jumping jack, trying to do it another way is difficult. Keep this demonstration in mind as your child similarly tries to re-learn how to pronounce their target sound.

Tips for carry-over activities at home

  1. Repetition: make it a point to set up times throughout the day to practice target sounds (For example, driving home from school or before you brush your teeth).
  2. Encouragement: I see children that try their very best and still just can’t quite get the sound right. Offer positive encouragement and only prompt the child to pronounce the target word/sound three times before moving on to the next item.
  3. Acknowledgement:  Mention that you know the child is doing their best and recognize how challenging this is for them.