Learning to ask for help is an important skill.

Once your child is able to ask for assistance when he/she needs it, his/her frustration and the frequently resulting tantrums are more likely to decrease.

There are many ways of how you can promote your child to ask for help, including:

• Model: every time your child takes your hand to pull you somewhere, PAUSE and clearly say “HELP”
• Longer Pause: Once your child is used to you MODELLING ‘help’, pause longer and hopefully your child may look in your direction and then say “help”. If your child doesn’t do so, don’t get discouraged…. just try again next time!
• Increase Expectations: increase your expectation for your child to vocalize any part of the word ‘help’. For example, this may be the start of the word “he” or the end “p”
• Encourage: when your child is able to make a sound then you can then encourage them to say ‘help’ more and more clearly.
• Short Phrase: Children who already have single words can be encouraged to add peers/adults name to form short phrases. For example, ‘Help Mummy’ or ‘Help please’
• Sign: Use the sign for help together with the visual symbol (shown below) Place your right hand into left hand – palms together. Move joined hands forward.

  REMEMBER:

  • If you allow your child to ‘pull you’ without prompting any language, they will continue to do this as they know that it works.
  • Consistency is the key … stick at it!
  • All visuals should ideally be accompanied by speech
  • Keep visuals in place even after your child has learnt to say ‘help’ if needed

  Written by Didem Karademir, Speech Pathologist.

Narrative skills refer to telling a story or series of events. This is an important type of communication we use every day.  For instance, children use narratives when they tell you what happened at school, tell an adult about an incident that happened, discuss a topic with you or when they make plans about the weekend.When you ask your child what they did at school, this requires the child to remember what happened, sequence the events, include the details, and express their thoughts in grammatically correct sentences. This is a complex skill and some children may have difficulty conveying their ideas.

Children with difficulty conveying their ideas may present with some of the following in their narratives:

– use shorter sentences

– include little details

– provide details without giving background information

– include irrelevant details

– may jump around within the story and story may not be coherent

Difficulties with narratives can create challenges for the child when he/she is participating in conversations, telling a story or even when completing their written work in school. As children get older, they transfer their narrative skills to their written work.  So it is important children have good narrative ability so they are confident to write a good story.

Speech therapists can help children develop their narrative skills by using visuals and help them explicitly understand all the story elements (e.g.: who, where, when, first/next/last). This will help them succeed in school and in social situations.

Written by Tasneem Abdul Samad, Speech Pathologist.

Yes, crawling is a super power! Or at least those who work in child development think so! Children progress through hundreds of developmental milestones, each having their own unique and critical role in brain and body development. Crawling supports sensory integration, motor development and visual motor skills. If a developmental stage is skipped, sped through or inefficient it can impact on a child’s later development. So no mater your child’s age, get crawling!

Fun crawling games to try at home:

1. Create an obstacle of couch cushions, pillows and soft toys a child has to navigate crawling
2. Use pop up tunnels or blankets over tables to crawl and hide under
3. Play animal games! Walk like a bear, crawl like a puppy, wriggle like a worm!
4. Place toy pieces such as puzzle pieces or board game counters at one end of an obstacle so your child has to crawl between to keep the game going!

Written by Laura Taylor, Occupational Therapist.

Sometimes, saying ‘no’ is almost like a reflex when we are trying to stop our children from doing something. Sure, it does stop them, but it doesn’t actually help a young child learn what he/she needs to do instead.

There are many reasons WHY it doesn’t teach/inform a child:

• Confusion: ‘No’ is a very confusing word. It can mean “stop”, “wrong”, “that is not the choice”, “there isn’t any left”, “later”, “time to stop or finish” or “you don’t want it”
• Behaviour escalation: the word ‘no’ will often escalate to behaviours, such as screaming, crying or hitting, rather than reducing them.
• Literal meaning: some children are very literal so when an adult says “no juice”, the child may think that there will NEVER AGAIN be juice. However, the adult really meant was the juice was ‘all gone’ or that the child could have it later

• Positive response: If your child nag you long enough adults frequently change a negative respond into a positive one. In this situation, the child learns ‘no’ can also mean “yes” or “maybe”

• Use escalation: Once an adult starts to use ‘no’, its use may escalate. When ‘no’ is overused – children frequently stop responding to it. This may have consequences if a child does not respond appropriate in an emergency

Parents might ask, but what else can I say?

Focus on telling the child what you want him/her to do rather than focusing on what he is not to do. For example, if he rushed into the bathroom and started to play with the taps, rather than saying “no”. Say “first toilet, then wash hands”. OR if she rushed to the table to eat food without cleaning up her toys first, rather than saying “no”, say “first pick up toys, then food”.

Other words that can be used instead of ‘No’ are:

• Wait
• All finished
• All gone
• I don’t want it
• Can’t go in
• Try again
• Finish
• Later
• Help
• Walk (rather than NO running)
• Stop

These are more supportive and directive for the child and don’t elicit negative behaviours. It’s always easier for the child to understand what TO do rather than what NOT to do. Give it a go!

Written by Didem Karademir, Speech Pathologist

Oral motor and sensory input

The muscles that we use for respiration are also the muscles used for posture and stability. Developing the muscles around the mouth, head, neck and trunk provide good stability to develop other skills and refine movements. Oral motor activities, including biting, sucking, chewing and blowing, will also assist with promoting calmness and is one of the most organising and effective ways for your child to self-regulate and pay attention.

Here are some activities to help develop these skills!

• Whistles and other similar toys. There are many different types available. Look for ones that have moving parts, different sized mouth pieces, require different forces of breath.

• Introduce oral toys into play. Examples include, rubber toys, teething rings (different temperatures and textures). You can also buy teething rings that vibrate when your child bites on them.

• Encourage drinking with a straw. Use a variety of different length and width. Curly straws are fun and motivating! Also experiment with different textured drinks such as really thick smoothies with a thin straw.
• Use a straw to blow bubbles in water or a drink. Again try a variety of length and widths.
• Bubble blowing.
• Experiment with different foods – look at chewy, crunchy, lumpy, cold, hot, sour, sweet foods. These all activate and use different muscles.
• Sucking on flavored ice blocks.
• Try some bubble gum!
• Play musical instruments such as a recorder, harmonica, flute, kazoo or trumpet.
• Use a straw to blow a table tennis ball around a maze or table. Create an ‘obstacle course’ to blow the ball through!
• Blow up some balloons – try different sizes and shapes of balloons.
• Play games which involve copying mouth movements such as blowing raspberries, puffing cheeks out, and silly speech sounds.

Your therapist may incorporate any of the above activities within therapy sessions. Hopefully next time you are in a therapy session with your child and therapist, you will have a better idea of some of the reasoning behind the introduction of oral motor use within the session. Experiment with these activities at home and take note of the effects implementation has their self-regulation and attention.

Some red flags to keep an eye out for as indicators your child is processing oral sensory input in a disorganised manor include:

• Biting, chewing and mouthing of non-food items including fingers, hands, clothing, toys and pencils
• Making lots of noises and sounds including humming, vocalisations, clicking or grinding teeth
• Holding food in mouth or cheek during meal times

If you have any questions about your child oral motor and sensory development please feel free to contact us at any time to chat with an occupational therapist.

Written by Alannah Santomartino, Occupational Therapist.

Gross motor development is important to consider as a factor influencing your child’s everyday activities. A great example of this is your child’s day at school participating in classroom activities – sitting for long periods in class (requires endurance and sensory processing) at their table (requires upper body strength and postural control) to learn a new writing technique (requires motor planning and learning, sensory processing and coordination).

When the body has to perform any movement, the brain is required to plan the position and movement of body parts to produce a certain outcome.  This planning and movement becomes particularly important when performing unfamiliar actions.  The following activities are suggestions to help facilitate the planning and movement skills that are required for different gross motor activities.  These activities can be incorporated into your child’s normal playtime. The most important thing to remember is to have fun!

• Obstacle course – this is a great activity to encourage your child to perform different movement patterns. Set the obstacles so that your child has to climb over, through, between, wriggle under and slide along different objects.  Use things like tables, pillows, boxes, steps, rugs and blankets.
• Move like an animal – encourage your child to move like different animals eg; hop like a kangaroo, waddle like a duck, jump like a frog.
• Practicing throwing bean bags/objects into hoops or at targets
• Twister and Simon Says
• Wheelbarrow races – walk along on hands with someone holding feet. This provides joint compression and facilitates upper limb strength.
• Practice walking/moving along a rope or a line taped on the floor. Try the following:
• Criss-cross walking along the rope – Wheelbarrow along the rope with one hand on either side of the rope. When the child has got the hang of this activity, try crossing the hands over (see above)
• Practice jumping to either side of the rope – increase the number of sequences eg: do two jumps on one side, jump over the rope, three jumps on the other side.
• Line games – (using a straight or squiggled line on the floor) try crawling along the line backwards, wheelbarrows along the line, and walking along on your knees (forwards, backwards and sideways).

Gross motor skill games can help to increase the awareness of your child’s own body in space and can help with the organising and planning body movements. Frequent participation in gross motor activities can help to develop a solid base and foundation to support your child to be able to ‘use’ their entire body more efficiently and transfer these skills when learning new motor skills.

An occupational therapist can assist if you have any concerns about your child gross motor skills and help to investigate if your child is having difficulties with secondary factors (including learning new motor tasks, fine motor activities, handwriting and coordination) due to underlying gross motor difficulties.

Written by Alannah Santomartino, Occupational Therapist.

Eye contact is used to show that you are listening. It is also used to gain someone’s attention. Sometimes, children with speech and language delays tend to give slightly less eye contact. Insisting the child to look into someone else’s eyes can be uncomfortable and he/she may not be ready for it.

Here are some fun ideas you could use to encourage your child to look at you more

1. You can get down to their level. This will make it easier for your child to look at you. If your child is sitting on the floor and playing a game, you should play on the floor with the child, so you are at the same level.
2. You can use finger puppets and hold them up near your eyes. Make them move and talk so it seems fun for your child.
3. Playing people games such as peek-a-boo or tickling games can also encourage eye contact. After playing the activity a few times, you can stop the activity, look at your child expectantly and wait for your child to look at you before continuing the game.
4. You can sing songs together. Occasionally, you can stop singing, look at your child expectantly, and wait for your child to look at you before continuing the song

If your child is not ready to look directly into your eyes, you can first work on encouraging him/her to look in your direction instead of specifically your face. This is especially useful for children who often look at the floor or wall instead of the person.

It is important to remember that some children with other underlying difficulties such as autism spectrum disorder can find looking at other people’s eyes too overwhelming. Insisting on eye contact may not be something he/she is ready for. It is important that you speak to your speech pathologist to understand if the ideas would be helpful for your child.

Written by Tasneem Abdul Samad, Speech Pathologist.

Starting school? Let’s learn how to support your child’s pencil grip!

Has your child just started school? Are they finding it difficult to hold their pencil, let alone learn how to write!? Many children experience difficulty holding their pencil efficiently enough to be able to write.

Children often learn crucial skills in the lead up to prep, with a particular spurt of fine motor skills in their final year of kindergarten. By age 6 we should aim for a child to foster hand and finger coordination, strength and endurance as well as ability to maintain efficient use of pencils.

However here are the key skills Occupational Therapist look to support in the early stages of pencil grip.

• Have a dominant hand preference
• To be able to hold their pencil with 3-4 fingers in a ‘Tripod or Quadruped grip’
• To isolate and coordinate their finger control, e.g. pinching (thumb to fingertip) and pointing
• To be able to trace and draw vertical, horizontal, diagonal and some intersecting lines.

What can you do at home to help?

1. Make it fun! In the OT room you rarely see a child learning to hold their pencil by practising writing!. We often encourage fun games that support grip development, by focussing on using hands in a range of different grips and actions to build the muscles in the child’s hands.

Some go to games for home include;

• Thera putty, Plasticine and playdoh. Manipulating this texture not only builds the small muscles of the hands but is super fun! Try to encourage rolling a sausage, pinching with thumb and index finger, squishing a large ball, rolling tiny balls with the tips of your fingers
• Fine motor games that encourage finger isolation, such as tong and tweezers, spray bottles, twist tops, connect 4, flicking games.
• Gross motor! Supporting strength and stability of posture, shoulder, arm, wrist and hands! Encourage monkey bars, push/pull games, swings, tug’o’war, vertical drawing, crawling and animal walking.

Occupational Therapists can assess whether there are any greater barriers to your child’s motor development and can individualise strategies, adaptation and equipment.

If you have any concerns regarding your child and related to the information above, please do not hesitate to touch base with one of our fantastic OT’s!

Written by Laura Taylor, Occupational Therapist.

Books are a great way to develop your child’s language skills and imagination. Here are some tips:

1) Choose a book that is age appropriate

Books with flaps, pop up characters or texture books that the child can feel are great to start with. Toddlers are often attracted by brightly coloured pictures of simple objects. You can choose books with topics that interest them (e.g.: animals).

2) Follow your child’s lead

Children love to be actively involved when reading the book with you. So if your child wants to hold the book and turn the pages, let them have a go.  Some children may only look at a few pages and other children may want to look at the entire book. Your child may skip some pages and that is okay. At this stage, it is more important that your child has an enjoyable experience with the book.

3) Talk about the picture

When your child points or looks at something in the book, you can describe what is happening in the picture. Try to follow your child’s interest and use a variety of words to describe (e.g.: use action words to describe that is happening).

4) Wait

After you read a page or talk about a picture, pause and wait for your child. This will give your child an opportunity to say something. Avoid asking questions such as ‘What is this?’ or ‘What colour is this?’

5) Expand the language

When your child says something, you can repeat it or even add a word. For instance, if your child says “bird”, you could say “big bird” or “bird fly”.

Reading to your child as often as possible will help to develop their language. The most important thing is that you and your toddler have fun as you explore the world of books together.

Written by Tasneem Abdul Samad, Speech Pathologist.

What is PECS?

PECS stands for ‘Picture Exchange Communication System’ and it’s a low level AAC system (augmentative alternative communication system).

That’s great but what does that mean?!

It’s a 6 phase communication system which teaches children how to communicate with other people by supporting them to select symbol pictures and give them to a communication partner in order to request.

Who is it suitable for?

-PECS is suitable for any child who needs support to learn how to begin to communicate with other people

-It is particularly useful for non-verbal children or children who have difficulties communicating their wants and needs

-‘PECS is one of only a handful of interventions that have shown efficacy in the treatment of autism’ (Maglione, Gans, Das, Timbie, Kasari and HRSA Autism Intervention Research, 2012)

How does it work?

Phase 1- How to Communicate
Students learn to exchange single pictures for items or activities they really want.

Phase 2- Distance and Persistence
Using single pictures, students learn to use this new skill in different places, with different people and across distances. They are also taught to be more persistent communicators.

Phase 3- Picture Discrimination

Students learn to select from two or more pictures to ask for their favourite things. These are placed in a communication book—a ring binder with Velcro strips where pictures are stored and easily removed for communication.

Phases 4-6 continue to develop language skills including sentence structure, answering questions and commenting.

What do I need to start?

-You need to have access to support from a professional who is trained in PECS. This could be a speech pathologist, a teacher or an occupational therapist.

-Someone within your support team will need to have access to a printer/laminator to create the small symbol pictures

-You need to have the time and motivation to implement the system and support your child to use PECS to communicate daily

For further information see https://pecsaustralia.com/

If you have any questions about PECS or you’d like to begin supporting your child with this process, please don’t hesitate to get in touch.

Written by Philippa Brown, Speech Pathologist