Framing Questions and Commands So Your Child Will Listen

The way in which a directive is presented can elicit a variety of responses. Prior to communicating with your child, set your expectation.

Is your goal to remove choice to ensure a task is completed or is your goal to offer choice to empower the child? These tips from our Pediatric Social Worker will explain when to “tell” your child to do something or when to “ask.”

When to “tell” your child what to do:

If there is a time-sensitive task that must be completed, posing a question might not be in your best interest. Asking your child to do something may imply a choice. Saying, “Johnny, can you take out the trash?’ can open pandora’s box for reactions and can, in fact, allow Johnny the option to say “no.” Telling Johnny to take out the trash doesn’t give any alternative option and the direction is cut and dry.

If you would like to provide choices when telling, you can say, “Johnny, please take out the trash and then you can resume watching TV.”

When to “ask” your child to do something:

Asking your child to do something can allow the child to feel more empowered in regards to making their own choices. You can structure these choices so that any response that you receive is okay. For example, asking your child, “Do you want macaroni and cheese or chicken parm for dinner?” offers options that you are ok with (you were planning to make one or the other so their input isn’t going to greatly alter your plans).

Tips while “telling” or “asking”:

Regardless if you are telling or asking, make sure that you stay calm and that your non-verbal and verbal cues are non-threatening (threatening cues may foster increased child resistance). If you are telling your child to do something, stay firm but recognize the tone of your voice and attitude. If you are raising your voice and showing signs of being mad, this may put the child on the defense. Staying firm but continuing to use a calm voice and body will maintain your message, show that you will ignore negative behavior, and aid in child investment quicker.

Click here to read more about handling stubborn behavior.

How Do I Know if My Child Has a Reading Disability?

Reading Disabilities are estimated to occur at a prevalence rate of 5-10%.  A disability, which is a more chronic struggle with reading without early identification and intervention, must be differentiated from the child who demonstrates a slower process in the normal developmental curve of reading development.  A disability will not resolve with repeated practice, extra attention, or the passage of time.  Below are a few clues to help figure out if there really is a disability.

Clues that Indicate Your Child May Have a Reading Disability:

  • Your child has difficulty with basic rhyming.
  • Your child has always been slow to learn the alphabet and maybe even numbers.
  • Your child struggles with sound-letter associations.
  •  Your child’s writing is illegible.
  • Your child likes to be read to but never wants to read.
  • Sight words, despite repeated practice, are easily forgotten by your child.

At times, differentiating between a disability and other factors (e.g., attention, motivation and interest, or behavior) can make accurate identification difficult.  An evaluation can help tease apart any related factors that may be impacting your child’s success.  If you are concerned with your child’s reading development, you can request an evaluation through our Neuropsychology Diagnostic Clinic.  We have clinicians trained in the diagnosis and assessment of reading disabilities and are able to provide efficacious recommendations to best help your child.
Click here to read about signs of a reading disability across grades.


Turn a Bully Into an Ally

What is one seemingly positive characteristic of a bully?

Great leadership skills. They can gather a group of followers and move in a pack to accomplish a lot.  Most bullies use this skill for negative outcomes, but think of what good could be accomplished if we taught bullies to use this strength for good?

We need to teach bullies that great leaders have certain qualities.  Bullies can be taught that they are great leaders, and great leaders use their leadership skills for good.   The bully can be taught this by the assignment of positive leadership tasks.  For example, assign the bully to a time of day to make sure each and every kid is taken care of.  At lunch, the bully ensures each child has food and is not eating alone. If she is, charge the bully with finding a solution.  At PE, have the bully ensure each girl is picked first on a team at least once and gets to be team captain at least once.

Once the bully feels the power of leading for good, she may just become one of the best leaders and members of the class.  Make strong powered kids into true positive leaders and see more leaders and team players blossom!

For more on handling bullies, read Mean Girls and bullying Boys: How Parents Can Help, and How to Include Bullying In Your Child’s IEP.

Relaxation Strategies for Children

How do we teach our children to relax and self-soothe in a society that is inundated with constant stimuli? How do we re-frame the evil term “boredom” into an opportunity to make peace with our inner thoughts and feelings and calm our body? Often times, even adults, need prompting to relax and take a load off.

Here are some examples of activities that both you and your children can engage in to “recharge your batteries” and face the world with a more balanced mindset:

1. Mindfulness—Easier said than done. Mindfulness is the practice of connecting the mind and body to enhance attention and focus to the task at hand.  It means living in the moment and quieting out other “noise” to focus your attention moment to moment. This is a nonjudgmental practice that incorporates all the senses to be fully present. Two of my favorite ways to practice mindfulness are when you are eating or bathing.

  • Eating. We commonly eat in transit, in front of the TV, talking with others, or while multitasking. When we don’t focus on just the act of eating we miss a lot of cues such as satiety, flavor, texture, etc. Practice mindfulness when eating. Prepare your food and sit in a quiet space. Before indulging your food notice your body cues about the food. Are you starving, craving salt, is your stomach growling. Still, before consummation, notice the color of your food, the texture of your sandwich, the way the sandwich smells. We are wanting to eat with all our senses. Take a bite. What does it taste like and smell like? How does the meat and cheese and bread feel in your mouth? How many bites does it take to swallow? What does the sandwich feel like in your stomach? You get the picture. When we focus on the experience of eating in the moment we are more attune to how we feel and our mind and body and in connection.
  • Bathing. The same can be said for bathing. Notice how the water feels on your body, the temperature, the texture. Notice the smells of the product and how it feels to massage your scalp full of shampoo. Remember, use your senses to be present in the experience and try and steer clear of other intrusive thoughts that may enter about your upcoming day.

2. Music—Music can be such a relaxing outlet but make sure that the music matches the mood that you are seeking. Kids commonly want to relax to Top 40 hits, Hip Hop, or other high energy music but this in fact does not aid in relaxation as the body will mirror the energy it is hearing. If you truly want to relax, I recommend jazz or classical in addition to natural noises provided by a sound machine (waves crashing, rain falling, rainforest, etc.). Listening to music can help kids relax in times of transition (after school before homework, after homework and before bed) or when they are emotionally triggered.

3. Deep Breathing and Muscle Relaxation—Relaxing the body and calming our breath can enhance relaxation either when someone is emotionally triggered to be upset or anxious, during transitions, or prior to upcoming stressful events. Deep breathing requires breathing in through your nose for 5 seconds, holding the breath for 5 seconds, and exhaling the breath through the mouth for 5 seconds. Repeat this 5 times. Muscle relaxation includes tightening and then releasing various muscle groups. Sit in a chair or lay down in a quiet space. Start from the bottom of the body and work your way up. Squeeze your feet and toes tightly for 10 seconds and then release. Squeeze your calves for 10 seconds and then release. Squeeze your thigh muscles for 10 seconds and then release. Continue up the body. By isolating each individual large muscle group you are calling your attention to that part of the body and scanning it to release any tension or stress. You can use these strategies when you want to relax or you can make these into habits and incorporate them into a daily routine.

Click here for 10 ways to help your child unwind before bed.



What is Co-Treating?

You may have heard your therapist say, “I think a co-treat would be a great option for your child!” But what does that really entail? Will your child still be getting a full treatment session? Will his current and most important goals be worked on? Will he benefit as much as a one-on-one session? When a co-treatment session is appropriate, the answer to all of those questions is…YES!

What is a co-treatment session?

Co-treatment sessions are when two therapists from different disciplines (Speech Therapy (SLP), Occupational Therapy (OT), Physical Therapy (PT), etc.) work together with your child to maximize therapeutic goals and progress.

When is a co-treatment session appropriate?

When the two disciplines share complimentary or similar goals.

EXAMPLE: Maintaining attention to task, executive functioning, pragmatics, etc. Playing a game where the child needs to interact with and attend to multiple people while sitting on a stability ball for balance. [all disciplines]
*When children have difficulty sustaining attention and arousal needed to participate in back-to-back therapy sessions.
EXAMPLE: Working on endurance/strength/coordination while simultaneously addressing language skills. Obstacle courses through the gym while working on verbal sequencing and following directions. [SLP + PT or OT]
*When activities within the co-treatment session can address goals of both disciplines.
EXAMPLE: Art projects can address fine motor functioning as well as language tasks like sequencing, verbal reasoning, and categorizing.
*When a child needs motivations or distractions. [OT + SLP]
EXAMPLE: Research has shown that physical activity increases expressive output. Playing catch while naming items in category or earning “tickets” for the swing by practicing speech sounds.  [PT or OT + SLP]
EXAMPLE: PT’s need distraction for some of their little clients who are working on standing or walking and working on language through play during these activities works well. [PT + SLP]

Why co-treat?

  • Allows therapists to create cohesive treatment plans that work towards both discipline’s goal in a shorter amount of time.
  • Allows for therapists to use similar strategies to encourage participation and good behavior in their one-on-one sessions with the child.
  • Allows for therapists to collaborate and discuss the child’s goals, treatment, and progress throughout the therapy process. Together, they can consistently update and generate plans and goals as the child succeeds.
  • Aids in generalization of skills to different environments, contexts, and communication partners.
  • Allows for problem-solving to take place in the moment. For example, an extra set of hands to teach or demonstrate a skill or utilizing a strategy to address a negative behavior.

Co-treatments sessions can be extremely beneficial for a child. There are endless ways therapists can work together to promote progress and success towards a child’s therapeutic goals.. However, co-treatments may not always be appropriate and are only done when the decision to do so is made collaboratively with the therapists and the parents.

Contact us for more information on the benefits of co-treating in therapy sessions.

The Sleep Discrepancy: How Much Sleep We Need and What We Actually Get

Sleep is incredibly vital to our everyday health.  The questions of why we sleep and in the manner we do (consolidated to approximately eight hours) has been accumulating and theories surround its “cleansing” and “restoring” properties have been coming to light.

Theories on Why We Sleep:

One theory suggests that sleep helps to clear our brains of unwanted toxins (Xie, L., Kang, H., Xu, Q., Chen, M., Liao, Y., Thiyagarajan, M., O’Donnell, J., Christensen, D.J., Nicholson, C., Iliff, J.J., Takano, T., Deane, R., & Nedergaard, M., 2013).

An additional theory hypothesizes that our brains have a limited capacity based on a 24-cycle which can only be restored through sleep (Nauert, 2010).  So, if we fall short an hour or two every night, you can imagine the cumulative effect on our cognitive functioning!

Why Are We Sleeping Less Than Before?

Nonetheless, the fact remains that we are all getting fewer hours of sleep than in generations before. Why?  Reasons can be explained by our longer work days that often continue well beyond the time we arrive home, easy access to distracting (albeit entertaining) modes of technology, more events and activities to attend, and an increasing academic workload for junior high and high school students, to name a few.

How Much Sleep Do We Really Need and How Much Are We Actually Getting?

In the school years (6-12), the recommended duration of sleep is between 11 to 12 hours.  Yet the incidence of sleep problems may be as common as 30-40% in children at any one time (Fricke-Oerkermann, L., Pluck, J., Schredl, M., Heinz, K., Mitschke, A., Wiater, A., & Lehmkuhl, G., 2007).  While likely to be transient and not in need of professional care, when the problem is persistent and clearly interferes with the child’s functioning, intervention is warranted.  It is best to begin with your pediatrician who can determine whether Melatonin (an over-the-counter supplement with sleep-enhancing properties), cognitive-behavior therapy, and/or a sleep study to rule-out medical conditions are warranted.

What About Teens and Sleep?

As I have mentioned in my previous blog: Teens and Sleep-How Technology Plays a Role in Restless Nights, adolescents are notorious for their poor sleeping habits and insufficient sleep.  While it is recommended that teens get 9 to 9.25 hours of sleep per night, the reality is closer to 7 hours on weekdays and 8.5 hours on weekends.  Clearly, these teens are not “catching up” on non-school days, creating an ever-increasing cumulative deficiency.  If you suspect that your teen is struggling with optimal sleep and is being negatively impacted as a result, first consider whether environmental factors (e.g., late-night cell phone use, late-night homework and study sessions, overscheduled nighttime activities, etc.) may be contributing and could be adjusted to make sleep a priority.  When this is not successful, recommendations are similar to those for school-age children and include speaking with your pediatrician about effective treatment options (Melatonin or other sleep-enhancing agents, cognitive-behavior therapy, and/or a sleep study to rule-out medical conditions).

To Summarize:

The fact is that our society is one that values hard work, grueling academic schedules, and an abundance of extra-curricular activities, which ultimately end up harming us when it comes to sleep.  It is time for the focus to be placed on sleep once again so that we are in a position to raise healthy adults who will pass on this wisdom.

Need help getting your family’s sleep on track?  Meet with our sleep specialist.

How to Explain a Language Disorder to a Teacher

Of all the categories available under IDEA law, language impairments are often one of the most difficult to understand. It is not a surface level issue and is often lost in the shuffle. Explaining what a language disorder is and how it will impact your child to a teacher can be tricky. Here are some tips.

How to Explain a Language Disorder to a Teacher:

  1. Language disorders come in a wide variety of cases. Each child will present differently and as an advocate, you need to do your best to describe your child’s needs specifically. Language disorders can impact a child’s ability to verbally express themselves efficiently, effectively and with appropriate grammar. It can result in difficulty understanding sentences, following directions, asking/answering questions or in a number of other impairments.
  2. Enlist the school Speech Language Pathologist. Ask for help in explaining the disorder to the teacher and ask for ideas. Discuss options for adjustments and supports for your child like a visual schedule, repetitions of the directions or having him repeat the direction back to the teacher to ensure comprehension. Many school districts or state programs have materials and resources that can educate teachers on strategies to ensure better classroom learning.
  3. Remind the teacher to notice how your child interacts socially. Teachers will be able to identify a child that is isolating themselves from peers secondary to trouble communicating with them.
  4. Discuss the difference between listening, understanding and attending. One of the biggest complaints of teachers will be “He’s not listening to me!” As often as not, your child does not understand the direction provided and is not complying simply because he does not know what is required of him. It can be very frustrating to have difficulty communicating effectively and patience will go a long way.
  5. Know your child’s IEP or 504 plan and take the opportunity to discuss it with the teacher. Be specific about the types of services and accommodations he will receive and what they will look like in the classroom.

Remember, be proactive and provide as much information up front about your child and his diagnosis to avoid potential difficulties. Refer to this page from the National Dissemination Center for Children with Disabilities for 8 Tips for Teachers who have students with speech and language issues in the classroom.

How to Set Achievable Goals for the New Year

Want to set a New Year’s Resolution that not only sounds good, but is feasible to achieve too? Goal setting is a national past time during this time of year as we reflect on what we have accomplished and what changes we can continue to make as we evolve into the person we strive to be.

The first step to success is to be realistic in terms of size and scope of the goal. No one is saying NOT to shoot for the stars and become bikini ready…just opt for bikini ready for 4th of July and not Spring Break. Setting realistic time frames will prevent a defeated attitude since you are not setting yourself up to fail.

Along with this, you need to identify realistic short-term goals that will help you to master smaller steps on your way to your larger goal. Short-term goals help to modify the long-term goal and reduce overwhelming feelings and increase accountability. For example, if you’re child wants to make a resolution to become more organized, don’t assume that by the time winter break is over they’ll be a wiz.

Create manageable short-term goals to help reach a long-term goal.  For example:

Long term goal: Become more organized Read more

Questions to Ask Your Pediatrician When You Suspect a Developmental Delay

Pediatricians oftentimes only have fifteen to twenty minutes with a child and family during a wellness visit.  Most of that time would bequestions to ask your pediatrician when you expect a developmental delay used to ensure the medical health of the child.  It is imperative that time also be spent on ascertaining information regarding the social, emotional, and behavioral development of the child.  I always recommend that parents bring with them a list of questions that they have regarding their child’s development.

Questions to Ask Your Pediatrician About Your Child’s Development:

  • Ask the doctor questions about his or her language development.   Is the child meeting necessary developmental milestones with regard to his or her speech and language?  Are there any concerns that might be addressed through speech and language therapy? Read more

Who’s putting the “Work” in “Homework?”

Many parents can relate to the struggles that homework can create each and every night. Although, at times, it may seem more frustrating than anything else, homework provides an opportunity to practice and integrate what your child has been learning. It also lets the teacher see how your child is doing…so resist doing it for him! 

What is your role as the parent during homework time?

Your child has a better chance of being successful during homework time if he feels you are interested in what he is doing. It lets him know that what he is doing is important. You can show your support by doing the following:

  • Demonstrating organizational skills
  • Doing your own work with them (i.e. paying bills, reading, etc.) Read more