Encouraging Siblings to Help With Speech & Language Practice

Save Time By Getting The Whole Family Involved

One of the most important contributors to progress in speech-language therapy is consistent practice at home. I often compare therapy to working-out at the gym: once a week is unlikely to make a big impact. In order to master new speech and language skills, Young Sisters Reading To Each Otherchildren should practice several times during the week, which is no easy task for the average family that juggles sibling activities and busy schedules. Parents frequently share their challenge to find time for one-on-one practice with their child, especially with competing sibling demands. With a little creativity, however, this task is not impossible! Here are a few tips to practice your child’s speech and language goals while incorporating siblings.

Tips to encourage positive speech-language skills among siblings

  • Create an atmosphere of support and encouragement among siblings. Talk to your kids about “kind” things to say to each other. Give them specific examples of phrases to encourage their sibling’s speech and language, such as “I like when you share your idea”, or “You’re really good at saying your S-sound!”. Praise your kids every time you hear encouraging words (e.g. “Wow, that was a kind thing to say. You’re a really good big brother.”)
  • Minimize interrupting between siblings by encouraging “talking turns”. Competing for a turn to talk can exacerbate speech and language difficulties. Foster a safe environment to talk and share, by explaining “talking turns” to your kids (e.g. “It’s Ava’s talking turn right now. You’re talking turn is next!”). If needed, use a tangible object (e.g. a ball, a pretend microphone, a teddy bear) to pass back and forth during each talking turn.
  • Encourage siblings to be “active listeners”. Explain what active listening is (e.g. “We listen with our ears, our eyes are looking at the person talking, our mouth is not talking, our body is still, our hands are quiet,” etc.) Praise active listening skills as you observe them (e.g. “Wow Alex! You are such a good listener! Your eyes are looking at Ava. I can tell you’re listening.”).
  • Incorporate siblings into practice games and activities. Ask your child’s speech therapist for specific activities that are hand-tailored to your child’s therapy goals. As you play together, include siblings in practicing target speech sounds or language structures. Encourage your kids to give one another positive feedback (e.g. “That was a really good S-sound!” or “That was a really good try!”). Listening to each other while practicing will build greater awareness and self-monitoring skills.

Fun activities to get siblings involved in speech and language practice

  • Practice following directions during “Simon Says”.
  • Read books together and take turns answering questions, labeling objects or retelling the story in your own words (depending on each child’s level).
  • Play turn-taking games while working on target speech sounds or language structures.
  • Create a fun recipe or craft together, and practice target speech sounds between each step.
  • Plan a scavenger hunt. Have siblings take turns giving each other clues where items are hidden.
  • Sing songs together and use hand-motions or gestures while you sing.
  • For more ideas to encourage speech and language skills, see a previous post “5 Fun & Easy Activities to Promote Speech & Language Skills During Summer

 

Start The School Year Out Right

A Guide To Meeting With Your Child’s New Education Team

Summer vacation is almost over and the first day of school for many children is on the horizon. The majority of children (and teachers) experience difficulty transitioning from the A Parent and Teacher Meetcarefree days of summer to the rigid structure of school. Children with special needs and learning disabilities are even more likely to exhibit difficulty with the school year. As a parent, it is your duty to advocate for your child in order to ensure that the academic year starts smoothly and that the child’s needs are being met.

I recommend that the parents establish a meeting with the child’s teacher and any ancillary staff that has an impact on his or her academic success (special education teachers, social worker, speech/language therapist, occupational therapist). In addition, it is always recommended that you have your child’s outside therapy team be part of this meeting in order to share information and develop effective strategies. Five specific goals of this initial meeting are listed below:

5 New Teacher Meeting Goals

1. It is important that all individuals working with the child be made aware of the child’s issues as well as what has worked/not worked in the past. It is vital that last year’s teacher have an opportunity to share information with parents about the challenges from the previous year as well as what solutions she has found helpful in the classroom.

2. Any outside therapist needs to be present at the meeting to share how things have been going over the summer. What has the child been working on as part of therapy, what goals were achieved, and what goals were not met. This will help establish expectations for the child.

3. Creation of specific, attainable, and measurable goals is important. If a child is getting out of his seat every five minutes it would not be realistic for his new teacher to expect him to sit for hours on end. We might set up an initial goal so that the child is expected to remain seated for ten minutes. Once that is achieved with regularity we move the goal up to fifteen minutes, and so on.

4. Establish a frequent communication system between parents and teachers. The goal of this is to not bombard teachers with constant emails/phone calls but to be able to have constant communication between all parties so that parents can help organize the daily assignments and ensure that all work is completed.

5. Identify that everyone is on the same team. The goal of this meeting is not to burden the academic staff with more work but to help develop solutions to ensure that the child’s needs are met.

How Does The Illinois Law For Children With Autism Affect My Insurance Coverage?

In December of 2008, the state of Illinois passed a law that would force insurance companies to provide benefits for children with autism. That law states that all benefits such as co-insurance, co-payments, and deductibles must be applied to the annual benefit Rejected Insurance Claimfor children with an autism spectrum disorder. Autism spectrum disorder, as defined by the law, includes autism, Asperger’s disorder, and pervasive developmental disorder not otherwise specified.

The annual benefit at the time of the law passing was $36,000. This translated to a long lasting year of coverage for children with autism who often receive multiple therapy services. Each year, the Director of the Division of Insurance revises the law and updates the yearly maximum for inflation. For the year of 2011, the annual benefit for a child with autism is $38,527.

What does this mean for my child who has an autism diagnosis?

If you have a deductible in your plan, you will need to satisfy it before benefits will be paid. Once that deductible is met, your co-insurance will take effect. Some common insurance plans have a 90/10 benefit. This means that your insurance policy will pay 90% of the allowable charges and the member will be responsible for 10% of the charges. Other plans have an 80/20 benefit which translates the same way.

Should you choose to seek services from an out of network provider, your out of pocket cost will change. In addition to being responsible for the member’s portion of the co-insurance, you will also be responsible for anything deemed over the allowable amount by your insurance carrier. Where you choose to receive services for your child is your personal choice as a parent, just be sure to verify that you have out of network benefits available for the services you seek.

Are all children with autism covered under this annual benefit?

No. There are a few exclusions to the law, formally known as Public Act 095-1005. The following types of insurance policies are exempt from following the law:

  • Self-insured, non-public employers
  • Self-insured health and welfare plans
  • Insurance policies or trusts issued in other states

PPO vs. HMO

In my honest opinion, many large insurance carriers in Illinois still do not have any idea how to manage this annual benefit for children with autism. Often with the Participating Provider Option (PPO) policies from various insurance carriers, benefits are not paid for children with autism. This causes stress on the parents while they fight with their insurance carrier to get the benefits that are required by law.

As a result of the challenges I have witnessed with PPO insurance policies, I have witnessed the immense care, compassion, and organization that the Health Maintenance Organization (HMO) policies offer to families who have a child with autism. HMO policies have an excellent handle on how to manage this annual benefit. HMO policies have also been able to find providers local to a family’s area that provide the services that children with autism commonly benefit from, such as applied behavior analysis (ABA), occupational therapy, speech therapy, physical therapy, psychiatric care, and psychological care.

There are differences with HMO’s compared to PPO policies. A referral is needed for any service that is provided to an HMO patient, with the exception of those services provided by your primary care physician.

Does this new law improve insurance coverage?

This all may sound like an amazing benefit, and it is, however when I look at the benefit as a whole, only one thing changes from your traditional insurance benefits. Your yearly maximum for a therapeutic discipline may be 75 visits per year. This law changes the 75 visit limit to $38,527 for the annual 2011 benefit for services provided to a child with autism.

More Information

To read the full version of the Illinois Law For Children With Autism click here

To read an easy to understand fact sheet click here

Milestones for Kid’s Success

Active BabyHow do we identify the milestones our kids need to succeed? How fast should your child be developing mentally and physically? Does every child develop on their own schedule or should you compare your child to the “norm”?

Milestones are important to be aware of because if children are not in the general range of normal or typical development, parents need to be proactive and start asking questions.

7 Steps to Measuring Milestones and Making Sure Your Child Is On The Right Track:

1) Use a check list and log your child’s new skills.

2) Make a separate checklist of areas you may feel your child is behind on.

3) Read well-respected parenting blogs and articles by licensed professionals to stay on top of what your child should be doing

4) Read E-Books and Popular Publications that include Milestone Checklists and Guides For Parents and Doctors

5) If your child is delayed in a developmental area, move on it quickly. Better safe than sorry.

6) Make a visit to your MD and tell him/her your concerns.

7) Visit the necessary specialists and find someone you can trust and do what you need to do.

Always trust your instincts as the parent and remain proactive!

Save Time: Incorporate Your Child’s Home Exercise Programs into your Daily Routine

Therapy Homework Doesn’t Have To Be Another Task On Your Long To-Do List

Girl Helping Un-pack GroceriesSometimes, it can be overwhelming to fit everything into your day when there is just so much to do! That feeling has often led me to wish that there were at least 28 hours to each day so that it could all be accomplished! Instead of feeling like your child’s occupational therapy homework is another thing to cross off your list, there are ways you can incorporate it into your usual daily routine. Below are some ideas to incorporate this homework into your routine to make it easy to get it done.

Ways To Incorporate Occupational Therapy Homework Into Your Daily Routine

1. Have your child transition from activity to activity as he gets ready to leave the house for the day by doing heavy work.

  • For example, he can wake up and do 10 jumping jacks before going to the bathroom to brush teeth, crab walk to the kitchen for breakfast, bear crawl to the bedroom to get dressed, and then frog jump from the front door to the car to leave for the day.

2.Have your child help you with household chores. For example they can:

  • push a laundry basket
  • help vacuum
  • wipe the table off after dinner
  • push in chairs
  • shovel snow
  • rake leaves
  • changing sheets on the bed
  • take out the garbage
  • help carry groceries from the car to the house and help put them away

3. Have your child use tweezers or clothespins to help make pizza for dinner (or another meal). Have him pick up pieces of cheese or pepperoni with the tweezers and put it on the pizza dough.

Please leave a comment if you have any additional tricks to fit your child’s therapy homework into your daily schedule!

How To Motivate Children With Autism Using Reinforcers

Reinforcer SetA common difference between children with autism and typically-developing children is their motivation for social feedback and other natural consequences that occur for learning to take place. Typically, developing children have an easier time learning because they are motivated by social feedback from their parents and teachers. But with a child with autism, it is not always as simple as saying “great job!” to encourage learning. Without motivation, it can be very difficult to gain the attention of an autistic child, and even more difficult for learning to take place.

So, how do you motivate a child diagnosed with autism?

Reinforcers Can Help Motivate Children!

Reinforcers motivate children to learn new skills. Often times, children with autism are not readily motivated by social feedback or other natural consequences received from parents, teachers or peers. Insensitivity to social consequences and signals is a core aspect of the disorder.

How To Find A Powerful Reinforcer: Read more

An Introduction on Interventions for Executive Functioning

As discussed in my previous blog “What is Executive Functioning”, executive functions are the skills that help organize and guide a child through daily life.
There are many aspects of executive functioning:

  • Organization

  • Planning

  • Problem solving

  • Working memory

  • Initiation of tasks

  • Impulse control

  • The ability to monitor the effectiveness of one’s work

While these are different skill sets that require various accommodations and interventions, they all have several things in common.  The most common link between the various interventions is that they must involve a real-world, structured approach to teaching problem solving during everyday activities. The problem that we see all too often with clinical interventions, which don’t include practice in the child’s ‘real-world,’ is that the child may be a rock-star when completing tasks in a contrived clinical setting but still may struggle within the classroom. Read more

Basic Principles and Practices for Teaching Children With Autism New Skills

Teaching new skills to children with autism can be very difficult. It is important to first understand the fundamentals of behavior.

Behavior is an important part of teaching because in order to learn a new skill, a child must understand what response is desired and when. A child learns when a response is desired by experiencing a stimulus (i.e. item/request/instruction) and discrimination (Sd- discriminative stimulus).  A child simultaneously learns there is a desired response and discriminates that the response is only desired in the presence of the Sd. For example, if you are teaching a child to say “book” in the presence of a book, the Sd would be the book itself and the desired response would be saying “book.” That child will learn to say “book” only when that book is present. Later on, that child may begin saying “book” in the presence of new books, a pattern called generalization.

So, why is behavior important in teaching a new skill? It is important because a child’s response IS a behavior!

 Descriptions Of Behaviors:

Reflexive Behavior is our bodies’ natural reaction to environmental stimuli (e.g. blinking when someone blows in your eyes, or jerking your leg when someone hits your knee cap). These behaviors are called reflexes and occur without being learned. Read more

Why Does My Child Need a Diagnosis?

-“I don’t want to label my child.”

-“Teachers are biased against diagnosed children.”

-“My son doesn’t act like most kids with _________ (particular diagnosis).”

 

These are statements that I hear on a routine basis, and they are all valid points. Any diagnosis that a child or adolescent may have carries a certain stigma to it. This is human nature. As a neuropsychologist, one of my biggest tasks is to develop the most appropriate and effective diagnosis for any child. My goal with writing this blog is to help identify the importance of an appropriate diagnosis.

How A Diagnosis Can Help Your Child:

First and foremost, an appropriate diagnosis will help explain and answer the “why” questions. Why does my child continue to struggle to read? Why is it impossible for my child to sit still? Why is it that my child cannot make friends? Once we identify the “whys,” we are on our way to solving the problems.  An appropriate diagnosis is intended to help develop the most effective means of intervention. If I diagnosis a child with Dyslexia, I know that traditional teaching of reading and phonics wouldn’t do much good. I would know instead to utilize an empirical approach consistent with the disorder at hand. Read more

Gifted Children And What It Means To Be Advanced

gifted childI was asked to write a blog on giftedness in children – specifically, how to access it and how to ensure that a child with cognitive strength is able to reach his or her potential. This has proven to be a hard topic to write about. I don’t like the term “giftedness” for several reasons, but before I divulge those, I need to discuss what it means to be “gifted.”

A quick review of basic statistics is necessary in order to understand how we assess children has demonstrating superior ability. Traditionally, when we think of giftedness, we are thinking of a child’s IQ score. The vast majority of IQ scores used standard scores. A standard score is a statistical term in which a score of 100 is solidly average (50th percentile) and a standard deviation (the spread of scores from the mean of 100) of 15. In layman terms, scores between 85-115 are considered to be average.

When you are talking about giftedness, we see scores with at least two standard deviations greater than the mean (meaning an IQ score of 130 or higher). So, gifted children are those children that have IQ scores of 130 or higher. Pretty easy to identify, right? Wrong. One of my major critiques of giftedness is that parents and some academic folk rely way too much on the overall IQ score to determine if a child is gifted.

What Are IQ Measurements For Children?

The current gold-standard IQ measure, the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) came out in 2003. On the WISC-IV, children attain a Full Scale IQ score, which is comprised of several factors: verbal reasoning and comprehension, nonverbal reasoning, immediate attention and memory, and processing speed. Here lies one of the concerns in assessing giftedness. Which score should one use? Read more