Turn-Taking and Language Development

Turn-taking is a foundation for speech and language development. Think of language as a back-and-forth exchange system: one person talks while the other listens, and vice versa. The ability to understand and demonstrate turn-taking is a critical step in building speech and language skills in children. It’s the framework for which children will ultimately use their growing speech and language skills. Here are 7 ways parents can promote turn-taking skills in children:

Ways to promote turn-taking skills

  • Play a turn-taking game. Choose an age-appropriate turn-taking game (e.g. Barn Yarn Bingo), and guide your child while you each take turns. Give your child hand-over-hand assistance as needed, and verbalize whose turn it is (e.g. “Mommy’s turn!” or 2 kids taking turns“Your turn!”). Taking turns might feel very challenging and unfamiliar to young children, so be sure to make it a positive experience, and give your child lots of positive praise as they participate.
  • Pass a ball back and forth. Encourage your child to pass the ball to you, by reaching out your arms and asking for the ball. Encourage your child to get ready as you pass the ball back to them. Rolling a ball back and forth mirrors the reciprocal interaction that occurs during verbal communication.
  • Share a toy. Encourage your child to take turns while playing with their toy. Prompt them to give you a turn (e.g. “Mommy’s turn”), and give your child lots of praise when they share. Try to keep turns short and consistent, so your child sees that they will get their turn again quickly.
  • Imitate your child. Imitation is a critical part of language development, and an excellent context for turn-taking routines. Imitate your child’s actions in a fun and playful way. For example, if your child covers their mouth, cover your mouth too. You might imitate speech sounds, gestures, or actions. Imitation games involve listening, watching, anticipating, and repeating: all of which require turn-taking.
  • Create anticipation. Engage your child in routine games that create anticipation. For example, you might play peek-a-boo, pat-a-cake, sing songs, or read familiar books with repetitive phrases. During activities, pause and allow your child to anticipate what comes next.
  • Wait for your child to respond. Show your child that you’re eager to hear their ideas, by actively listening. Lean in close, and give your child attention through eye contact and eager facial expressions. Most importantly, give your child ample time to respond by simply waiting.
  • Talk about “talking-turns”. For older children, introduce the concept of “talking turns”. Encourage your child to let other people have their talking turn, and wait for their own turn to talk. You might even narrate this (e.g. “It’s mom’s talking turn right now” or “Now it’s your talking turn!”).

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Helping Your Child Who Is Not Social | Pediatric Therapy Tv

In today’s Webisode below, our Pediatric Neuropsychologist answers a question from a viewer on what to do when a child does not know how to make friends.

In This Video You Will Learn:

  • What to do when your child is not social
  • How to investigate the reasons
  • How to intervene on your child’s behalf

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. I am Robyn Ackerman with Pediatric Therapy TV. I am standing here today with Dr. Stasi. In today’s segment we will be answering questions from our viewers. Charlie has given us a question from Kansas City. Charlie asks, “My 4-year-old son is having a hard time making friends in school. What can I do to help him?”

Dr. Stasi: Thank you. That’s a great question. What we often think about in school is the child’s academic needs and the child’s behavioral concerns. We often neglect the social emotional concerns of the child. It is just as vital to identify these concerns as the academics and the behavioral functioning. What I really recommend first, if a child is struggling in the social realm, is to make an evaluation to determine why. Is it some underlying construct that this child has, an internal deficit with interacting with another child? Is it anxiety, that they are afraid to approach others? Or is it something else? Already being teased or bullied?

Once you can identify the reason for the behavior, then we can intervene for this child to develop what is going to be appropriate. It has to be individually. We cannot just create a plan for any child to improve his or her social functioning. It has to be based on specific needs. It works as a team, then, working with the school social worker, the school psychologist, the teacher, and also outside advocates that you have, be it a child’s therapist or a neuropsychologist. We really want to intervene for the child to determine what is going on and then where to go from here.

So, I think, Charlie, the answer to your question is that we can’t answer that question. We need to figure out why. We need to determine what’s going on. Then we have the basics to really intervene and make sure that this child succeeds socially.

Robyn: Thank you, Dr. Stasi, and thank you, Charlie. 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.

Top 10 Tips to get your Shy Child to Speak

Many children thrive in new environments or situations. They separate quickly from their parents, make friends easily and are eager to participate in the classroom. Not all children are like this, however. Some children are resistant to entering a room full of children and prefer to play alone. They may also be more reserved in circle time or in the classroom. They may have a hard time making new friends and having a conversation. Below are some ways you can encourage your shy child to come out of his/her shell.

 10 Tips To Encourage Your Shy Child To Speak:

1. Encourage play groups with friends – Many children will have an easier time playing or talking when there are less people around. Ask your child’s teacher who your child tends to sit next to or who shares some of the same interests and invite them over for a play date. Start by having the play date at your house. Once your shy girlchild is comfortable playing with his new friend in your house, change the setting and go to the park. When he/she seems ready to go over to the friend’s house, let your child bring some of his/her favorite toys to make the transition easier.

2. Help your child make friends – Making new friends isn’t something that comes easy to everyone. Start by introducing your child to someone his/her own age. Try to find out what the other child likes to do and see if they share any common interests. When you make the introduction, it’s helpful to say, “Scott is your age too! And guess what? He loves dinosaurs!” This will help your child ease into the process of making friends. Once your child becomes more comfortable or at ease, you can then invite the other friend over for a play date.

3. Role play – Use some of your child’s favorite toys to role play what may happen in real life. Let’s say your child has a hard time entering his/her classroom in the morning and saying hi to his/her peers. Use dolls or stuffed animals and act out this situation. Ask your child, “What could bear say to his friends?” If your child has a hard time playing with the other kids during free time, you could act this out as well. The goal here is to get your child thinking about what he/she could say or do. The roles can be reversed as well. You play the shy child and have your child’s bear be the one to help you think it through. Additionally, when you’re out in public, model what you would like your child to be doing in social situations. When you come in contact other people, say hello and ask how they are doing. Smile too!!

4. Don’t force your child – It’s important not to label your child as shy. While it’s okay to be a shy child, if you start labeling him/her or the behavior, it negatively reinforces the problem.

5. Incorporate their interests – What is your child really interested in? Does he/she love polar bears? Have him/her bring some books, toys or pictures to the classroom. While we just talked about how important it is not to force your child to talk, provide him/her with an opportunity to share what he/she brought in with classmates.

6. Give your child some “go to” lines – Sometimes it’s just the initial communication exchange that can be most challenging. Once they’re over the “hump” engaging with another peer becomes easier. Go over some “go to” lines that your child can use when meeting a new friend or wanting to play with a friend in his/her class.

  • Hi, how are you?
  • What’s your name?
  • Do you want to play?
  • Can I play too?
  • I like your ____.

7. Read books – There are many books that talk about being shy or have a shy character in them. Some book ideas include, “Are You Shy?” “Little Miss Shy” and “Shy Spaghetti and Excited Eggs.”

8. Social stories – Social stories are a great way to talk about difficult situations. Social stories provide a child with information about situations that he/she may find difficult or uncomfortable. You can find stories online or even write one of your own. By making one yourself, you can use pictures of actual people and places to make it more lifelike.

9. Improve your child’s self-esteem – You always want your child to feel good about him/her. Have your child tell you 10 things they like about himself/herself. Provide positive feedback when it’s appropriate (i.e. “You did such a great job saying hi to your friend.”) Teachers can also be helpful in promoting your child’s self-esteem.

10. Seek outside help – if it seems like your child is more than just shy, it may be helpful to seek advice from a professional. Some red flags include being socially withdrawn, avoiding eye contact, having a tantrum or crying before going to a social situation.  Remember to stay positive, be patient and always model good social skill behaviors!

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How To Improve Handwriting in Children Part 1 | Pediatric Therapy Tv

In part 1 of 2, a Pediatric Occupational Therapist shows all the ways to prepare a child for optimum handwriting skills.

In This Video You Will Learn:

  • How to wake up a child’s hands prior to writing
  • How to slow a child’s hands down
  • Which materials are best for a child’s handwriting

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 am your host, Robyn Ackerman. Today I am standing with occupational therapist Deborah Michael. Deborah is going to show us how to work with a child on handwriting.

Deborah: The first thing that we’re going to do is wake up your hands. Before we start writing, we have to wake up your hands because they could be sleepy and tired. Go ahead and put that Theraputty on the table. This is called Theraputty, Levi. What does it feel like?

Levi: Gooey.

Deborah: Gooey and hard. It exercises your fingers. Go ahead and make holes in there and wake those fingers up. Roll it like a snake. Do all kinds of stuff with it. This comes in all different kinds of hardness. You can get it a little softer, a little harder, depending on how old you are and how strong you are. That’s how we wake up your fingers.

You can wake up your fingers with Theraputty, you can do some pushups, you can do some moving around of your hands, you can do some pegs on the peg board. You can do all kinds of stuff to wake up your hands.

Now that your hands are awake, we are going to start to write. Now how does your engine feel? How does your body feel right now, Levi? Does it feel just right, fast, slow? A little bit fast, right?

Levi: Yeah.

Deborah: There are a couple of things that you like to do when your engine is fast in order to be able to sit down and write. One thing we can do is we have this weighted, heavy blanket. We can put this on you and it will give you a little weight to hold you down. We also have a vest that we could use for that.

Another thing we could do if you don’t want the vest, and we can only use these for 20 minutes, once you’re done with that, we can put you on a ball or another kind of ball that’s called a peanut. That is so that you’re constantly moving around a little bit, and kids can sit still better. Right? You’ve used these before? All right. We’re just going to leave that right next to you.

Now we are going to write. Levi, you write very fast and a little bit messy because your engine is going so fast. We already tried to slow you down a little bit. Some other ways that we try to slow you down could be, first of all, using a timer so that you have to write until the timer stops so that you don’t write too fast. Correct?

Levi: Yeah.

Deborah: And then we have pencils that have weights on them so they slow you down a little bit. These are fidget pencils. This is more for when you’re just waiting after you’re done writing the sentence so that you don’t have to sit doing nothing. It’s something to do and it doesn’t come off. And we have paper that has lines on it to keep you in the lines. So you have to stay between the two red lines, right?

Robyn: Thank you, Deborah, 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.

Language Fun with Halloween

Halloween is a super fun holiday! There are so many great ways to use Halloween to build your child’s language skills. Here are a few ideas:

“Categories and Sorting” to Boost Language

After your child goes trick or treating, have them sort their candy into different categories. They could sort candy by type (chocolate vs. gummies), size, shape, color or taste.Boy in Costume Sorting Candy

“Describing” To Boost Language

Picking out the perfect Halloween costume is always fun! When talking about costumes, have your child describe what it is that they’d like to be this year. Have them talk about costume colors, accessories, emotions/feelings associated with the character, etc. Or when you’re at the store, play a guessing game. “Guess who I am thinking about…I wear a pointy hat, fly on a broomstick and can be a little scary!”

“Following Directions” To Boost Language

There are lots and lots of Halloween art projects and craft ideas. Take any project and turn it into a following directions activity. Depending on what level your child is at, you can have him/her follow 1 or 2 step directions. It could be as simple as a drawing activity. Start with a haunted house picture. Tell your child, “draw a pumpkin next to the door” or “Put a scary ghost in one of the top windows.”

Vocabulary

Halloween is a great time to work on different vocabulary words. You can work on synonyms or antonyms, definitions, grammar or even salient features. For example, take the word “spooky.”

You can ask the following questions:

  • What does spooky mean?
  • What is the opposite of spooky? What is another word for spooky?
  • Tell me something that is spooky – once they give you an object, have them tell you more about the object. For example, let’s say they say “witch.”   Then have him/her tell you what a witch has, where you find a witch, what does a witch do, etc (these are all salient features).

Reading Comprehension

There are many thematic books for Halloween. Find a book that is appropriate for your child’s reading level and work on reading comprehension skills. Ask wh- questions (i.e. who, what, where, why, why) while reading the book. You can ask text-based questions (questions that stem directly from what you read) or critical thinking questions (questions that will stimulate your child’s thought process). For example, if you’re reading about a scary character, you could ask “What makes you scared?” or “What do you do when you’re scared?”

For a list of great Halloween Books, click here.  You can read summaries and even take a look at the first few pages of the books.

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Teaching Children To Follow Directions

Here are some easy tips to help your child follow directions:

Yes and No Directions Simplify instructions:

  • Use short, simple phrases, with episodes of repetition when necessary.
  • When possible, break down multi-step instructions into distinct component parts. Say “sit down, put shoes on” rather than “Go to the table, sit down, and put your shoes on.”
  • Be specific “please put your socks in the hamper” rather than “clean up your room.”
  • Phrase directions as a statement rather than as a question (i.e. “please put the book on the shelf” rather than “will you put the book on the shelf?”)

 Check for understanding:

  • After hearing instructions, encourage your child to repeat them back to you.

Using pictures and schedules:

  • Implement pictures to provide visual representation and establish routine. For example, use sequential pictures to show the sequencing of washing hands or brushing teeth.  These can be placed on the mirror in the bathroom.
  • Use daily or task specific picture schedules to provide visual representation of language, assist in transitions, and establish routines.

 Multi-step instructions:

  • Apply a “first, then” model (i.e., first work, then play).
  • Pair related instructions together (i.e., Get your shoes, then put your shoes on).  As consistency and accuracy of following related multi-step directions increases, begin to incorporate unrelated directions (i.e., Take off your shoes, then sit at the table).

 Use positive rather than negatives:

  • Phrase directions positively and tell your child what you want him/her to do rather than what you want him/her not to do. For example, say “please walk” rather than “don’t run.” The same specific and descriptive language should be used when praising. For example, instead of saying “You are being helpful, ” it would be better to say exactly what you want/like about his/her behavior, such as “thank you for taking out the garbage without us having to remind you.”

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New Guidelines for ADHD Diagnosis

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmetnal disorders.  Current data suggest that the prevalence rates in school age children is between eight to ten percent.  This is a disorder which is characterized by significant inattention and/or hyperactivity-impulsivity.

New Guidelines For an ADHD Diagnosis:

ADHD is a buzz topic that has been highly discussed in the media this past week (here in the Chicago Tribune and in The Wall Street Journal).

The American Academy of Pediatrics published new guidelines regardinboy with adhdg the initial diagnosis of the condition. According to these new guidelines, children can now be officially diagnosed with the disorder when they are as young as four years old.  Prior to these new guidelines (which were just published this month) a child was unable to be diagnosed with the condition under he or she was six years old.

What benefit does an early diagnosis pose?  Quite a bit of benefit for families who have a child with the condition.  These children are now able to receive accommodations and interventions within the home and school domains to ensure social and academic success.

There have been plenty of past policy statements that document the best practice for treating ADHD.  Now these young children will be able to receive treatments that they might otherwise have been missing out on.  The American Academy of Pediatrics published a best practice paper for the intervention of ADHD in 2001.  In a nutshell, the paper states that the two primary interventions for ADHD include the use of stimulant medication and behavioral therapy.  Donna Palumbo, a neuropsychologist from New York, wrote a chapter in a pediatric neuropsychology textbook in 2007 “Pediatric Neuropsychological Intervention“, that updated the AAP practice guidelines to include parent training and social skills training in addition to the already mentioned stimulant medication and behavior therapy.

What are your thoughts on children getting diagnosed as young as 4 years old for ADHD?

To learn more on ADHD- sign up for a Free ADHD 101 Webinar by clicking here!

5 FUN FINE MOTOR ACTIVITIES FOR HALLOWEEN

The weather is getting chilly again, and Halloween is almost here! Here are some great ideas for indoor fun that will help children develop their fine motor strength and coordination skills.

5 Fun Fine Motor Activities For Halloween:

Tissue Paper Pumpkin:

Supplies: construction paper, markers, tissue paper, gluegirl carving a pumpkin

*Draw a pumpkin on construction paper. Tear small pieces of tissue paper, and using one hand, scrunch up the pieces with your thumb, index and middle fingers. Dip the tissue paper into glue and place it on the construction paper to fill in the pumpkin.

Haunted House:

Supplies: popsicle sticks, glue or superglue (use with supervision), construction paper, paint

Use construction paper as a base for the popsicle stick house, as the glue may get messy on a table. *Make a floor out of popsicle sticks and secure it with glue to the construction paper. Glue popsicle sticks together to make the walls and the roof. To make a slanted roof, secure the roof to the walls on a diagonal. Once the glue on the house is dry, you can paint it black and paint on ghosts and goblins.

Ghosts:

Supplies: kleenex or paper towel (to make a bigger ghost), cotton balls, thread, marker

*Place a few cotton balls in the center of the kleenex or paper towel for the head of the ghost. Next, fold the napkin in to wrap it around the cotton ball, and secure the head by tying a thread around it while letting the rest of the napkin flow.

To hang it up, pull a threaded needle through the top of the ghost’s head. Make sure the thread is long enough to hang to hang on something, and loop it through to make a knot.

Pumpkin Carving:

Supplies: pumpkin, marker, pumpkin carver (it is easier and safer to use than a knife, and you can buy one at walmart, stencils (optional)

*Draw a face on the pumpkin with stencils or free-hand, and carve away! This is a great activity to develop motor control and strength.

Halloween Necklace:

Supplies: Halloween colored beads of all shapes and sizes, beading wire or thread

*Make a knot on one of the thread, and start stringing the beads! Using small beads is great for fine motor control and precision. For additional coordination and fine motor muscle development, instruct your child to hold 3-5 beads in the palm of their hand, and as they need the next bead, have them use their thumb, index and middle finger to get the bead out of their palm. Make sure their palm is facing up so that they cannot compensate and use gravity to help them get the beads!

Where To Go If Your Child Has Been Misdiagnosed

Parents come to professionals in order to ascertain what is going on with their child.  As a neuropsychologist, the two most common questions I hearmother upset with child are:What is wrong with my child? And How do I fix it?  

A diagnosis will help clarify the symptom characteristics that the child exhibits which in turn will lead to developing the most effective interventions and accommodations for that child within the home, school, and private clinic settings.

Many times parents question the appropriateness of a diagnosis that was given to their child.  It is important to understand that there are several factors that can lead a clinician towards an inappropriate diagnosis or a diagnosis that is not the best fitting based upon the child’s symptom characteristics.

How Assessments Are Conducted:

An evaluation constitutes several hours out of one day of your child’s life.  Many factors impact the child’s performance during the testing, including;

  • Lack of appropriate sleep the night before
  • Being hungry during the evaluation
  • Anxiety over the testing situation

How many of those factors contributed to the diagnosis that was handed to the child?  Second, did the diagnostician receive or ascertain all appropriate information.  Did that individual receive information from the school, past medical records, detailed information regarding the child’s early development?  You are your child’s best advocate.  As much as any diagnostician may know about the responses on the testing, the response to the testing as well as explanations for the testing has to gel with you.  If you are uncomfortable with a diagnosis, ask questions.  Explain to the diagnostician that the behaviors that were observed are not consistent with what is observed on a daily basis.  Work as a team to figure out what lead to the discrepancy between actual behavior and observed behavior/test scores.

If you do not feel that your questions were answered with a diagnosis or are hesitant to follow through with the interventions that were offered, it is then recommended to seek a second opinion.  Oftentimes a second set of eyes, even in the form of reviewing the report/test performance can help solidify the diagnosis that was given or help establish what additional testing/information would be needed.




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Child Struggling In School | Pediatric Therapy Tv

Today’s episode answers a question from a viewer.  The mother asks if she should be worried that her son’s teacher tells her that her son has a hard time paying attention in class.  Pediatric Neuropsychologist Dr. Stasi answers her with what her next steps should be.

In This Video You Will Learn:

  • If a parent should listen to a teacher’s concerns even if the parent disagrees
  • Figuring out the why’s of the child’s struggle
  • What the goal of an evaluation is

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 am your host, Robyn Ackerman. Today I’m standing here with pediatric neuropsychologist Dr. Greg Stasi. Doctor, we have a question from Tina from Arlington Heights. Tina asks, “My son’s kindergarten teacher says he has a hard time paying attention in class. I think he is just being an active boy. Should I be worried?”

Dr. Stasi: Thank you. Tina, that’s a great question. I get a lot of parents coming in and telling me that their child struggles to pay attention or that the teacher told them that he has trouble paying attention on a day-to-day basis. Should the parent be worried? I don’t know. It’s a concern, and the teacher has the best viewpoint as far as identifying whether or not the child pays attention. She is comparing him to the peers in the classroom.

The goal is to identify the ‘whys’. Why is this child struggling? Is it because it’s ADHD? Is it because of some type of learning disorder, that the child has difficulty comprehending the text? Is it a language disorder, that they are really not comprehending what is being instructed to them? Or is the child bored? The goal is to get an evaluation and figure out why is the child struggling and then we can move forward. Thank you.

Robyn: Thank you very much, Dr. Stasi, and thank you, Tina, for submitting your question. 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.

Submit your own question to robyna@NSPT4kids.com (all questions will be answered discretely and question submitters will receive the response in an email as well).