Fussy eating is common in children, particularly between the ages of 18 months and five years. Fussy eating can vary from the child who has a few specific likes and dislikes to the one who will only eat a limited range of familiar foods and refuses to try anything new.

It is important to remember that a healthy child with not starve themselves. Most fussy eaters manage to get enough nutrients to remain strong and develop normally until they grow out of it. Healthy children eat when they are hungry, and usually not before.

Tips to encouraging healthy eating:

• Keep meal and snack times regular – Smaller meals and snacks are easier for children to manage than three big meals.
• Choose healthy snacks. Offer fruit, milk, yoghurt, sandwiches, cracker biscuits and cereals.
• Avoid letting children fill up on drinks which may dull their appetite. Water is the way to go!! Limit cordials and soft drinks.
• Providing a variety of food from within the 5 main food groups will provide children with all necessary nutrients. If they don’t like pumpkin, try carrots. If they don’t like milk, try yoghurt or cheese.

Strategies for managing food aversions or fussy eating:

• Introduce new foods in a fun way to build up taste and textural tolerance.
  • Disguise food- Try shaping foods into something your child loves
  • Prepare food together – make it fun!!
  • Trial and Error – It can take ten or more tastes of a new food before a child will learn to accept a new flavour, so don’t give up if something is refused after one taste.

• Try preparing foods with textures your child likes. If they don’t like chewing meat, try softer meats e.g mince, or meat substitutes i.e baked beans.
• Offer a choice between two foods – This gives your child a sense of self control
• Let your child choose some food at the supermarket
• Praise your child when they try a new food!

Strategies to avoid:

• Forcing your child eat a new food by using negative language or punishing your child will create negative associations with eating the food.
• Ignoring the fussy eating i.e making separate meals for your child.

Written by Carmel Walsh – Speech Pathologist for De Silva Kids Clinic

Bilingualism and Language

Often times, parents have questions regarding bilingualism and its effects on language acquisition or language delay.

There are many benefits of being Bilingual: 

• Bilingualism improves memory, concentration and numeracy skills.
• It builds the child’s identity and will help in maintaining strong relationships with family, friends, culture and community.
• As Bilingual children learn to switch languages, they develop flexible thinking as well as creative and problem solving skills.
• Being Bilingual, increases the chances of obtaining jobs as they are able to participate in the global community and have access to a wider range of resources.

FAQ:

Will Bilingualism cause a language delay?

No. Bilingualism does not cause a language delay. The research has shown that children who are bilingual can have a smaller than average vocabulary in both languages however his total vocabulary from both languages may be the same size as a monolingual child. Children should be producing their first words between 8-15 months so if your bilingual child is demonstrating significant delays in acquiring his/her language milestones then he could have a language disorder. In this case, seek advice from a Speech Pathologist who can confirm whether or not it is a language disorder.

My child is mixing both languages. Does that mean they are confused?

When children or adults mix two or more languages it is called code-switching. Code-switching is normal and is a natural occurrence when bilingual speakers engage in conversation or when learning a second language.

Should I stop speaking in my native language at home?

No. Currently there is no evidence to suggest that increasing the use of English or the desired language at home is essential to improving the child’s acquisition of that language.  Speaking a language that is not your native language at home can cause the interactions with your child to be unnatural and uncomfortable. It is better to speak in a language that you are fluent and comfortable with than in a language that you are not proficient in as this will provide your child with a less than ideal model and this can consequently cause your child to speak in sentences that are grammatically incorrect or consist of the incorrect word order.

How can I support my bilingual child?

• Speak the language that you are fluent in at home.
• Provide as many opportunities as you can for your child to hear, speak, play and interact using your home language.
• If you feel your child’s language is delayed, seek advice from a Speech Pathologist.

Written by Senali Alahakone – Speech Pathologist at De Silva Kids Clinic

Parallel play involves children playing next to each other in the same area with their own toys.

To target this play skill:

• Have two sets of the same toy set out on the floor
• Put a little bit of distance between yourself and your child
• Play with the toys separately
• Be sure to talk to your child about what you are doing and comment on what they are doing!

RECIPROCAL PLAY

Reciprocal play involves engaging in a play activity with another person. Many language skills can be targeted when engaging in reciprocal play (turn taking, sharing, verbal communication, following directions – just to name a few!).

When your child has mastered the above play skills, encourage them to engage in reciprocal play. You can do this using any play activity or game that involves two people. Examples include pop-up-pirate, throwing and catching a ball, board games and using blocks to build a tower.

If you have any concerns about your child’s play skills, call us today and have a chat about whether there is any way we can help you.

Written by Sarah Pritchard – Speech Pathologist at De Silva Kids Clinic.

Learning Through Reinforcement: Operant Conditioning

What is Reinforcement?

• Reinforcement is the consequence or feedback given to a child following their behaviour or response.
• It is given following a correct or desirable response

Types of Reinforcement

• POSITIVE REINFORCEMENT: The addition of something pleasant. Examples: toys, food, social praise, sensory feedback
• NEGATIVE REINFORCEMENT: The removal of something unpleasant. Examples: finishing work, going on a break, turning off a loud sound
• Both Positive and Negative Reinforcement INCREASE the likelihood of a behaviour occurring again in the future and creates desire and motivation to learn

Punishment

• The removal of something pleasant (e.g., taking away a toy, turning off the TV, etc.) or the addition of something unpleasant (e.g., more work, clean up, etc.)
• Punishment is NOT reinforcement
• In theory, punishment is designed to DECREASE the likelihood of a behaviour occurring again in the future.
• NOTE: The effects of punishment are often short term

Reinforcement should be:

• Contingent on the child’s behaviour/response. Example: If a child says “ball” they should receive the ball as reinforcement, not something unrelated such as tickles or a high 5

• Immediately following a child’s behaviour/response. Do not allow a delay
• Consistent. All those working with the child should be reinforcing the child the same way, and for the same behaviours. Reinforcement needs to be extremely frequent when teaching a new skill
• Graded. Reinforcement should be dependent on the QUALITY of a child’s response. Higher reinforcement should be reserved for highly desirable responses/behaviour. Remember to reinforce attempts also to maintain the child’s motivation.

Playing with transport toys such as trains, cars and trucks can be a fun and engaging way to help support your child’s language development. Use the following cheat sheet to help work on these communication skills whilst you and your child are playing with transport!

Describing/labelling

Colour: red, blue, yellow, green etc.

Size: big, little, small

Shape: circle, round, square

Sound: whistling, noisy and loud

Speed: fast, slow, quick

Expanding vocabulary

Nouns: sounds (horn), parts of transport (wheels), places they go (road), traffic signs (stop signs)

Functions: what are different parts used for? (horn, wipers, wings)

Concepts: under, around, next to, behind, in front, between

Receptive language

Following directions: give directions using prepositions (e.g. under, around, next to, behind, in front, between, on, off)

Action words

• Go
• Push
• Stop
• Drive
• Pull
• Park
• Open
• Close
• Steer
• Move
• Start
• Fly
• Brake
• Turn
• Open/close

Play and social skills

• Encourage joint attention and pretend play
• Make eye contact and sharing
• Construct together and make stories
• Practise giving and following directions
• Learn road rules

Written by Sarah Pritchard, Speech Pathologist at De Silva Kids Clinic

Reading is a great way to support your child’s language development. Reading will help improve both their receptive and expressive language skills. Studies have reported that reading to your child as early as eight months old can have significant impact on early language development.

Tips for reading with your child:

• It is ok to read the story again and again. Repetition will help your child learn language.
• Choose books with rhymes or songs. Clap along to the rhythm and help your child clap along.
• Talk about the objects and actions in the picture (e.g. “Look the boy is diving into the deep water!”)
• You can expand language (e.g. if your child says “tree”, you can respond by saying “yes that is a big, green tree”)
• Model language by commenting more and questioning less, so that it does not feel like a test.
• Relate the story’s events to the child’s interests, hobbies and daily activities (e.g. “That boy is riding a blue bike like yours”).
• Discuss the story with your child. (“Why do you think the monkey stole the key?”)
• Help your child become aware of letter sounds. (While pointing to a picture of a snake, ask: “What sound does a snake make?”) As your child develops, ask more complex questions. (While pointing to a picture of a ball, ask: “What sound does ‘ball’ start with?”)
• Play sound games with your child. List words that rhyme (“ball,” “tall”) or start with the same sound (“mummy,” “mix”).

Written by Senali Alahakone – Speech Pathologist at De Silva Kids Clinic

Many families have heard about Autism (or Autism Spectrum Disorder “ASD”) but it is sometimes hard to know what to look out for in your own child. Children with autism have a range of skills and abilities and don’t all act the same way. Here are just a few signs that may indicate it’s worth seeking advice from a healthcare professional:

• Your child doesn’t talk as much as other children their age
• Your child doesn’t respond when you call their name
• Your child doesn’t use eye contact to share interest with others
• Your child has difficulty with changes in routine
• Your child goes out of their way to avoid sensory input or seeks it out
• Your child uses toys in repetitive ways and doesn’t like ‘pretend play’

If you have a child between 11 and 30 months old, you can also use a free app called ‘ASDetect’ to monitor your child’s social attention and communication behaviours. The app was developed at La Trobe University in Melbourne and is free and easy to use.

More information on ASD and child development is also available on the Raising Children’s Network.

Written by Eleanor Brignell – Speech Pathologist for De Silva Kids Clinic.

Play-dough can be used to create a fun and engaging activity to work on a number of different communication skills. This can include describing, labelling, expanding vocabulary, receptive language, using action words (verbs) and play and social skills. Use the following cheat sheet to help work on these communication skills whilst you and your child are playing with play-dough!

Describing/labelling

Colour: red, blue, yellow, green etc.
Size: big, little, small
Shape: circle, round, square
Texture: smooth, sticky, squishy
Quantity: all, none, empty, full

Expanding vocabulary

Nouns: play-dough, lip, cup, scissors, knife, rolling pin, cookie cutter, table, bench
Concepts: in/out, long/short, more/less, same/different, on/off

Receptive language

Following directions: give directions using prepositions (e.g. under, around, next to, behind, in front, between, on, off)

Action words

• Make – Stick
• Give – Fold
• Push – Squeeze
• Pinch – Pull
• Squash – Roll
• Open – Close

Play and social skills

• Encourage joint attention
• Practise turn taking by taking turns to choose what to make
• Encourage eye contact
• Develop pretend play skills (e.g. pretending to use a play-dough object as something else)

Written by Sarah Pritchard – Speech Pathologist for De Silva Kids Clinic.

Young children often mispronounce words with the /k/ sound. Children usually replace the /k/ sound with a /t/ sound. For instance, instead of saying ‘car’, the child may say ‘tar’ or instead of saying ‘cat’, the child may say ‘tat’. This is normal for a 2 year old child.

However, children around the age of 3 1/2  years of age, would usually be able to say the /k/ sound clearly.

You can try some of these tricks if your child is unable to say the /k/ sound:

– Start with the single sound /k/

It will be easier for your child to try saying the single sound /k/ before saying a word with the /k/ sound (e.g.: bike, cold).

– Explain to your child using the support of a mirror

The /k/ sound is pronounced by lifting the back of the tongue to the roof of the mouth. Children who are replacing the /k/ sound with the /t/ sound are usually lifting the front of the tongue instead of the back of the tongue.   You can explain to your child that he/ she needs to lift the back of the tongue. You can use a mirror to support the child by showing them what is going on with the tongue in the mouth. When your child lifts the back of the tongue, praise by saying “Well done! I saw your tongue go up in the back.”

– Lie on the back

Get your child to lay on the back on the floor. Your child’s tongue will typically fall to the back of the mouth. Then encourage your child to try saying the /k/ sound keeping the tongue at the back. Praise your child for trying!

If your child manages to say the /k/ sound whilst keeping the tongue back, you can encourage them to put the /k/ sound in words and practise saying a few words. It will take time for your child to say it correctly in conversation. Always keep practise relaxed, fun and provide your child with positive feedback.

The above tricks may work for some children. However, if after trying a few times you notice that your child is struggling to make the /k/ sound, do see a speech pathologist for support and advice.

Written by Tasneem Abdul Samad – Speech Pathologist at De Silva Kids Clinic

The BOT 2 is a comprehensive assessment that can be administered by an Occupational Therapist. The BOT 2 uses engaging and goal directed tasks that measures various gross motor and fine motor skills for individuals aged between 4 and 21. This has been designed to be easy to administer in addition to being more fun to help engage the participants.

Completing the full form of BOT 2 provides therapists with the most reliable measure of the participant’s motor proficiency. This is essential in better understanding the participant’s strengths and weakness. The BOT 2 may assist in supporting a diagnosis of motor impairments and assess children with motor difficulties to help with further evaluation or interventions.

The BOT 2 is the most widely used assessment to test motor proficiency. The kit includes:

– BOT 2 Manual: This provides information and guidelines regarding the assessment.

– Administration easel: This provides instructions regarding the 8 subtests of the assessment; Fine motor precision, fine motor integration, manual dexterity, bilateral control, balance, running speed and agility, upper limb coordination and strength.

– Fine motor administration easel: This provides instructions related to the fine motor aspects of BOT 2.
– Materials needed for gross motor and fine motor aspects of the assessment.

The BOT 2 is designed to assess 4 motor areas of the participants, these include:
– Fine manual control: This area is aimed to assess the control and coordination of the hands and fingers through activities involving grasping, writing and drawing.
– Manual coordination: This area is aimed to assess the control and coordination of the upper limbs through activities that engage object manipulation.
– Body coordination: This area is aimed to assess the control and coordination of the body through engaging in activities that assess posture and balance.
– Strength and agility: This area is aimed to assess the control and coordination of the body that is involved in body movements, more specifically movements engaged through recreational and competitive sports.

Written by Amie Li – Occupational Therapist for De Silva Kids Clinic.