Occupational Therapists often bring up the term ‘sensory processing’ when they assess a child’s ability to engage in a range of daily activities. Sensory processing is important in many areas of a child’s life, including fine motor skills, being calm and organised, playing sport and socialising.

But what is sensory processing and why is it important?

Sensory processing is the ability of a child to correctly take in, interpret and respond to sensory information that they receive from their environment. This includes what we hear, see, feel, smell, taste and touch. It also includes the lesser known senses of vestibular (balance and motion) and proprioception (body position awareness).

Sensory processing forms the foundation of development, guiding how we understand, interpret and respond to the world around us.

Inefficient sensory processing can interfere with a child’s motor, emotional, social and academic development.

Common Sensory Processing difficulties include;

• Being easily overwhelmed by busy environments, including the sights, sounds, textures, smells or other sensory inputs. This contributes to ‘sensory overload/meltdowns’, an emotional response to sensory inputs.

• Seeking or avoiding certain movement input such as swinging, spinning, falling, jumping. This contributes to balance, motor planning and motor skills.

• Having difficulty safely organising your body in space, known as poor body awareness. These children often appear clumsy, have poor posture, appear accident prone, seek rough play, avoid motor play or take risks.

• Being under sensitive to sensory input (hyposensitivity), such as having a high pain threshold, low registration of touch, not noticing when your face is messy. This can impact on things such as self-care, safety and fine motor skills.

What can we do?

An occupational therapist can assess whether a child processes sensory information differently to their peers through a variety of formal and informal assessment including, parent and teacher discussions, observing the child and performing sensory motor assessments.

Occupational therapists are experienced and trained in sensory integration therapies, task modification and environmental adaptation to best support sensory motor development.

If you believe your child may have sensory processing difficulties that are interfering with daily life, please contact one of our Occupational Therapist.

Written by Laura Taylor, Occupational Therapist.

Are you the parent of a child who is struggling at school? There are some areas like art, sports, music, technology that they do well in however other more traditionally academic subjects which involve lots of talking and discussion are far more difficult for them? You may also find that they find it difficult to follow conversations and you sometimes find it hard to understand what they are trying to explain to you. It’s possible that your child may have ‘Specific Language Impairment’.

What is ‘Specific Language Impairment’?

Specific language impairment or SLI, as it’s sometimes known, is when someone has typical skills across all areas of their development with one exception; their ability to understand and use spoken language. Additionally, their difficulty with language must not be associated with any other condition e.g. hearing loss, autism or Downs Syndrome. Their difficulties could be quite mild and short-lived or they could have significant difficulties which continue into adulthood.

What are the typical traits of someone who has SLI?

• They frequently struggle to communicate their ideas to others
• They find it difficult to understand and remember long stories or instructions
• They find puns, idioms or other non-literal language confusing
• They may talk in sentences however they are frequently difficult to understand
• They find learning and using new words hard, often having words ‘on the tip of their tongue’
• They find word maths questions far more difficult than maths questions using numbers and symbols
• They may prefer physical play e.g. football instead of spending lots of their free time talking
• They may find it difficult to join their peers in conversations which may make it hard for them to make friends
• All of these difficulties may mean that they frequently become frustrated and some behavioural difficulties may occur as a result of this

How do I find out if my child has SLI?

Unfortunately there is no specific ‘test’ for SLI however it’s possible to diagnose by comparing the child’s language skills to their other cognitive abilities e.g. spatial awareness, non-verbal reasoning. In order to do this your child will need a language assessment which is completed by a Speech Pathologist and a cognitive assessment which is completed by a psychologist.

What causes SLI and how many children have it?

We know that there is a genetic link in people who have specific language impairment however there is no specific ‘cause’ which has been identified so far. Studies have shown that in 5 year olds, SLI affects about 2 children in every classroom (about 7%). It is more common in boys than girls.

How can we support children with SLI?

Children typically learn language naturally through listening to others and practising as they grow up, however the same cannot be said for children with SLI. These children need language to be specifically taught to them using visual support and having lots of opportunities to practice. A Speech Pathologist will be able to help your child with this. Additionally, they will be able to give teaching staff advice and strategies about how to adapt school work to maximise your child’s learning potential.

Written by Philippa Brown, Speech Pathologist.

Most therapy is completed at a frequency of approximately one session per week, fortnight or even monthly. A once off session with an occupational therapist, speech and language therapist or psychologist is not ideal if this is the only skill development that your child is receiving.

That’s where home program comes in to play. Continuing with strategies and interventions you have observed and practised in sessions with a therapist is crucial to achieving goals. Research shows that spending shorter durations of time, more frequently, helps to instill and develop skills and will help with reaching your families goals in therapy.

Below are some strategies to ensure that you can continue with interventions at home during your busy day with all else that you need to fit in.

• Involve strategies from therapy sessions in your everyday activities.
  • Avoid resorting to use of technology at meal time, travel in the car, when out in the community. Use these times as opportunities to incorporate strategies.
  • Be flexible and find ways to incorporate elements of therapy goals every day in all environments.

• Create a routine that incorporates home program strategies to reach therapy goals.
  • Completing an activity at the same time each day for a short duration. You could use a visual schedule!

• Use strategies to motivation your child to ensure that they are having fun, are engaged and finding working towards therapy goals enjoyable.
  • Take a look at previous blog post on ‘Motivation’ for some ideas if this is a barrier to completing your home program on a regular basis.

• Have a go at practising intervention strategies in sessions with your child.
  • This way you can get a good idea if you will have success with trying to replicate strategies at home.
  • The therapist is there to assist you with this and provide you with any coaching

• Celebrate reaching the small goals and achievements.
  • Don’t wait until you reach long term goals to realise that progress has been made.
  • Smaller achievements may not be the ultimate goal, but it is the journal through these smaller targets that leads to long term goal. Start small and move up from there.

• Check in with your therapist for ideas of how strategies can be used at home.
  • Make contact via email with your therapist between appointments to let them know any progress or areas of concern

Written by Alannah Santomartino, Occupational Therapist.

Attention and listening for students in school

Students need to have good listening skills at school. They need to be able to listen to the teacher when given instructions in the classroom. If they are completing an activity in the classroom, they need to be able to switch their attention from the task to the speaker.

A student with attention and listening difficulties may be unable to focus on what they are hearing. They may also have difficulty retaining the information long enough to act upon it. This can affect their performance at school.

Here are some strategies to help students improve their listening and attention:

Use Visuals: Introduce them to the ‘good listening’ poster. You can put this poster next to where they are seated. This will remind them to practice their ‘good listening’ skills.

‘Good listening’ means:

– eyes looking at the person who is talking

– quiet body, sitting still

– thinking about what the speaker is saying

Before giving an instruction, you can also point to your ears to help them to be aware of when they need to make a particular effort to listen.

Reduce background distractions: When giving the student instructions, ensure you have his/her full attention. Think about where he/ she is seated- is he/she distracted by the students walking pass the classroom or something out of the window? Reducing distractions in the environment will help the student focus his/her attention on the speaker.

Pair them up with a listening partner: A listening partner can remind them of what to do. This will provide the students who are still struggling with a good role model.

Keep your instruction short: Break down the directions to single instructions. Take pauses in between thoughts and repeat your instruction if needed. This will give the student time to process the information and act upon it.

These strategies will build the student’s ability to listen to instructions and improve their ability to learn.

Written by Tasneem Abdul Samad, Speech Pathologist.

Praising children for their achievements are often used to increase children’s motivation.

Research shows that ‘process praise’, the type of praise that is related to the child’s effort, motivates children to:

• Work hard
• Learn
• Explore
• Have a healthy outlook on their abilities

We then might question as to “How we should praise young children?” Below are some ideas of how to effectively praise your child into everyday activities:

• Describe your child’s behaviour and effort – use statements that say what you see, like “You used all the blocks to build your tower” or “Your picture has beautiful colours”. Provide statements with specific information that will help him/her to continue the desired behaviour.
• Be mindful when praising after failure or mistakes – Praise such as “Try harder” does not give any information about how your child can improve his or her effort. It may best to use statements that identify your child’s behaviour and effort and then talk about what your child thinks he/she can do to improve their performance. For example, “You worked very carefully on using capital letters and full stops. What’s another way you could make your sentences longer”
• Reduce the amount of praise – our goal is to encourage children to be self-motivated and to embrace challenge. ‘Over praising’ can become a habit – which may make our children dependent on praise. You don’t need to use praise at all when your child is naturally interested and self-motivated in an activity.

By using praise, you’re showing your child to think and talk positively about themselves. You’re helping your child learn how to recognise when he/she does well and to pat himself/herself on the back.

Written by Didem Karademir, Speech Pathologist.

Questions to Ask Your Child After School

Parents may have lots of questions when their child comes home, either on the first few days or throughout the school year.

Does your child often answer with “nothing” or “good” when you ask “What did you do at school” or “How was school”. Below are some tips to talk to your child about school:

• Ask open-ended questions to KEEP the conversation going. Most often, you will get a one-word response if the question can be answered with one word
• Start with factual questions to START the conversation. For example “I know your class size in Art is much bigger this year than last year. What is it like?
• Ask positive questions to give your child the opportunity to express concerns.
• Avoid negative questions as they tend to stop a conversation

Conversation Starters After School

Questions                                        Try these instead

How was school?                                – What’s the biggest difference between this year and last year?

Who did you sit with?                       – Tell me 3 of the children who sat near you

Were the kids in your class nice?   – Who did you enjoy talking to the most?

Was the work hard?                          – What was the best thing your teacher asked you to do?

How was lunch time?                       – Who sat near you at lunch time?

– What was something funny that someone said at lunch time?

– What was a game you played at lunch time?

Keeping communication open between yourself and your child is important, especially when they are in school and away from you for hours each day.

Use the question (s) that work for you and your children. The important thing is to start talking to them on a regular basis

Written by Didem Karademir, Speech Pathologist

Phonological awareness is the ability to manipulate sounds in spoken words. Syllables and words are made of individual sounds called phonemes. For example, the word ‘cat’ has three phonemes: /c/ /a/ /t/.

Some children struggle with perceiving and manipulating sounds. For instance, they may struggle to identify different sounds in words or the number of syllables in words. This may lead to weak reading and spelling skills. They may then get frustrated and perform poorly in school.

The good news is a speech pathologist can help by identifying if a child has phonological awareness difficulties and provide a therapy program to develop these skills.

Here are some strategies speech pathologist use to develop a child’s awareness of sounds:

– Breaking words into their individual sounds

For example, b-u-n (bun), s-t-o-m-p (stomp)

– Clap out the number of syllables in a word or sentence

For example, clap your hands as you say your name ‘Ra-chel’. Now, tell me the number of parts in the name ‘Rachel’

– Deleting, adding or substituting syllables or sounds

For example, say ‘man’ without the /m/ sound, or say ‘doorbell’ now say it again, but don’t say ‘door’

– Producing rhyming words

For example, tell me a word that rhymes with ‘big’ (pig)

Studies have shown that children with strong phonological awareness skills are more likely to have strong reading and writing skills.  So teach your child connections of speech sounds within words using fun activities. If your child seems to be struggling with reading and spelling, they may benefit from phonological awareness instruction.

Written by Tasneem Abdul Samad, Speech Pathologist.

Using sign and gestures can be an important way to develop communication for some children.

The Research:

There is much confusion among parents, teachers and other health professionals about using key word sign with your child. The most common question I come across is “will signing cause my child to stop/delay speech development”. The current research indicates that signing will not stop speech development if the person is going to learn to speak. It may actually support their ability to speak!

What does this all mean?

Signing, or any other form of augmentative communication, can take the pressure of having to ‘talk’ while giving the person a way of communicating, of interacting and becoming social.

How do I teach my child?

The potential for using sign and gesture is unlimited, so where do you start?

• Choose key word signs: You don’t need to sign EVERY word you speak. Instead, select words that are common first words in typically developing children and just sign those when they come up in conversation. For example,
  • Nouns: dog, car, girl, boy, block, milk
  • Social words: no, stop, more, finish, my
  • Verbs: eat, throw, open, help, wash, sit down
  • Family: I (me), mum, dad, brother, sister
• Learn the key word sign: Using flashcards, with a picture of the word and the sign, is an effective approach.

• Use key word approach: Sign the words you have chosen by themselves, when doing the action or showing the object to your child, or when you say the word in a sentence. For example, if the sentence “Lucy, go wash your hands and eat your banana” was said, the words underlined will be signed as you say it.

• Repeat, model and be persistent: Some children may take a while to understand what is being said (and signed) and require consistent repetition and modelling. Children will learn to use sign quicker if they see it around them all the time! Below are some ideas of activities:

PLAY: When playing with the child:

• Sign the key concepts about what you and the child are doing when using toys in play (e.g. teddy bear jump, doll eating, big banana).

Books: When looking at books with the child

• Sign key concepts when completing routines throughout the day such as taking a bath and getting ready for bedtime (e.g. shoes off, in the bed).
• Sign the question word and key information when asking questions (e.g. “Where is the girl?).
• Sign the key words within you or the child’s comments when describing the picture and/or answering a question (e.g. “the girl is under the table”).

         Sing songs/nursery rhymes

• Sign the key words within the song (e.g. star in ‘Twinkle Twinkle’, the different animals in ‘Old Mac Donald’).

Daily Routines: For example:

• When asking for food (e.g. “I want apple please”).
• When asking for a drink (e.g. “Can I have water please?”).
• To go to the toilet (e.g. “I need to go to the toilet“).

Keep doing this and eventually your child may begin to imitate the signs or word on their own!!

Written by Didem Karademir, Speech Pathologist.

Children can communicate with their communication partner by using a combination of sounds, gestures (e.g. pointing, waving “hello” and “bye”) and eye gaze (e.g. looking at you and then what he is ‘talking’ about). Your child may be sending a clear message – just not without words. Build your child’s language skills with some of these handy tips:

Put your child’s message into words
Place your child’s message into words of what you think he/she is trying to tell you. For example, if your child is pointing to their favourite blue cup wanting you to give it to him, say “You want the blue cup”. Keep it short to capture their message!!

Tell your child it’s their turn by pausing during a familiar routine

Encourage your child to “tell” you to continue a routine – allowing them to experience power of communication. Pause during an activity that you and your child are repeating over and over – such as tickles or jumping on a trampoline. For example, after you have jumped on the trampoline a few times, stop jumping and wait – without saying anything – to encourage your child to let you know that they want more jumping.

Use ‘fun’ words

Children enjoy sounds that are fun to ‘hear’ and ‘make’. These words are easy to remember and understand because they are said with lots of intonation. Examples of words include:

Boom! – when something falls

Yummy! Or Mmmm! – during meal times

Pop or uh-oh – during play with bubbles

Bye-bye – when you wave

Cheep-cheep, woof, oink-oink – sounds that animals make

Whee or crash   – when playing with cars or trucks

Offer choices

Hold up two objects and ask “Do you want banana or some apple” showing each object in your hand as you say its name. Your child will use their own way to send you a message and let you know what she wants, including looking at the item they want, reaching, pointing or making a sound while looking at it. As soon as they let you know what they want, give it to her.
Be face to face

When playing with your child, get down at their physical level – so that the two of you are eye to eye. For example, sit facing your child when they are in a high chair, lie down on the floor when she is playing on the floor. When you are face to face, you and your child:

• connect more easily and share the moment
• see and hear each other’s messages better

Ask fewer questions

It can be difficult for your child to answer most questions when they are not yet using words. Try to reduce questions, balancing them with comments (or statements). Use your child’s interest to comment about things in everyday life. For example, comment on what your child’s doing “oh, you are squeezing the play dough” as your child squeezes some play dough. While your child is looking at animal pictures in a book, you could comment “That’s a small mouse”.

Written by Didem Karademir, Speech Pathologist.

Is your child moving out of the stage of life where they are dependent on parents for prompting and assistance for most activities of daily living into a more independent stage of their life? Or is this a goal for your family? Lack of motivation to complete tasks independently is often a barrier that can prevent the smooth transition between these stages of life.

Ask yourself.. Would you go to work if you didn’t get paid? Although lots of us love our jobs, we probably wouldn’t go into work without our weekly pay check coming in. This is the same for some children who do not have the motivation to change or complete a task. The main thing is to remember that they cannot change not caring about what you want them to care about and they can’t change the way they feel.

Some children have difficulties with foresight about consequences of their actions and instead only think about here and now. Implementation of strategies to initiate the motivation for a child to change a behaviour may be beneficial.

Expectations

• May be that your expectations too high?
• Set goals that are realistic, measureable and achievable

Motivators

• Figure out what your child cares about and what motivates them
• Use rewards and incentives as a motivator
• Limit always using consequences to motivate your child
• Find a balance between use of rewards and consequences
• Use these with lots of empathy and understanding

Rewards

• Does not always need to be a physical thing, toy or object
• Might be choosing what’s for dinner, what movie the family will watch all together on the weekend, or what treat to eat while having movie night

Changing the behaviour

• Think about what the ‘good experience’ would look like for you and for your family
• Focus on a specific behaviour that you are wanting to change

For an additional support or direction with strategies get in touch with an occupational therapist. Please feel free to give us a call at De Silva Kids Clinic on 8418 8544 and speak with an occupational therapist about your concerns.

Written by Alannah Santomartino, occupational therapist.