5 Things You Didn’t Know a Speech-Language Pathologist Can Help Your Child With:

The title “speech-language pathologist” can be a difficult one to discern. In addition, the shortened “speech therapist” can also be slp reading with a childmisleading. Speech-Language Pathologists work with children and adults on a wide variety of skills that may surprise you. Speech sounds are not the only skill that SLPs work on! The following list is, by no means, exhaustive of the broad scope of practice SLPs are qualified to provide service in, but rather a list of lesser-known areas of expertise for SLPs. It should be noted that, although all SLPs are trained to treat each of these areas, individual therapists do have areas of expertise, therefore, it behooves you, as a parent or educator, to seek out a therapist with training in the specific areas you seek assistance with.

5 Things You Did Not Know A SLP Works On:

  1. Reading
    1. Reading is a cornerstone skill on which academics become progressively more demanding as a child moves on from elementary through high school. Reading is a Read more

3 Reasons Your Child Needs A Meal Schedule

Today, there is the great debate among parents to whether or not put their kids on a schedule. Should I give my child a daily routine or Family eatinggo with the flow of what they want, when they want it? In terms of feeding, schedules are very important for kids that are over 6-12 months old. Prior to 6 months old, feeding really should not be done on a schedule, but rather on demand. Breast or bottle feeding on demand helps infants learn to respond to hunger and satiety cues. In addition, it allows them to eat what they need to grow to their potential. At this age, eating is very instinctual and babies know best how much to eat and when to eat, with the exception of some cases of medical or developmental issues.

During the transition to solids, between 6-12 months of age, I advise parents to introduce a routine of “meals” from the beginning. Feed the infant at the same time as the rest of the family’s mealtime(s) every day. Then, as the child gets older, continue sticking to regularly scheduled family mealtimes and snacks that occur around the same time each day.

Below are three reasons why a meal schedule is crucial for children:

  1. Teaches good mealtime habits. Ask any parent and they will say that they have experienced mealtime struggles at some
    point. One way to eliminate mealtime struggles is to have set expectations from the beginning of introducing solids. Teach your young child that when it’s time to eat, we come to the table, sit in a high chair or booster seat and have a variety of healthy foods to eat. It makes the connection for them from the very beginning that sitting at the table means that it is time to eat.
  2. Prevents “grazing”. Grazing happens when we eat randomly all throughout the day. This can lead to over-eating unhealthy foods for older kids and it may actually lead to under-eating for younger kids. When children eat little amounts here and there, they fill up just enough to decrease their appetite for well-rounded meals.
  3. Promotes healthy digestion. Eating on a schedule means that we are filling up the gut at meals and then giving it time to empty before filling up again. The rhythmic filling and emptying of the gastrointestinal tract is the ideal pattern to stimulate regular bowel movements. Furthermore, a regular pattern of meals helps keep blood sugar balanced throughout the entire day, which helps to improve energy, concentration and moods.

If your family struggles with implementing mealtime schedules or routines, contact one of our registered dietitians to schedule an appointment. A registered dietitian can help you implement ways in which you can get your family back on track and address any nutrition concerns.


3 Easy Alternatives for Tummy Time

Every parent knows how important tummy time is for their baby. Most parents also know how difficult it is to get the necessary infant on tummyamount of tummy time into each day. This is only made more difficult when babies dislike tummy time and cry whenever placed on their belly. Here are some simple alternatives to laying your baby flat on their stomach as well as provide the benefits of tummy time and keeping baby and parent happy.

3 Alternatives for Tummy Time:

  1. Front Carry: Hold baby facing away from you, supporting him/her around their rib-cage  With their bottom tucked into your belly, tilt their trunk forward so that it is parallel with the ground. This will encourage the baby to look forward, strengthening the muscles in the back of the neck and along the spine. The more horizontal the baby is, the more difficult it will be for them to lift and hold their head. Lift the baby’s trunk up every 30-60 seconds to give them a break.
  2. Baby on Shins: Lay on your back with your legs bent so that your shins are parallel to the ground. Lay the baby on your shins with their head hanging off your knees and holding onto their hands. This is a great alternative as you can look at the baby as well as move your legs to entertain the baby (similar to airplanes). This is also a good core exercise for mommy!
  3. Baby on Lap: Sit on the floor with your legs straight out in front of you (support your back on the wall if necessary) and lay your baby across your legs with their head hanging off one side of your thigh. This is an effective exercise because you can easily move a toy with one hand to encourage them to look around and strengthen the baby’s neck muscles.

Tummy time is vital for a baby to grow and learn new gross motor milestones. The goal is to have the baby be on their bellies 50% of their awake time. If a baby does not spend enough time on their stomachs, future gross motor skills, such as crawling, may be delayed. There may be specific reasons, such as weakness, low muscle tone or torticollis, that can cause your child discomfort during tummy time. If you have any questions or concerns regarding your baby’s tummy time, please click here to request a meeting with a physical therapist or speak with your pediatrician.

What is Down Syndrome?

Down Syndrome is thought to be the most common genetic etiology of mental retardation. This condition has been found to occur in down syndromeapproximately 1 in 800 live births. The genetics of the condition are such that the individual has an extra copy of chromosome 21.

Physical Features Associated with Down Syndrome:

  • Decreased muscle tone seen at birth
  • Excess skin at the nape of the neck
  • Flattened nose
  • Small ears
  • Small mouth
  • White short hands with short fingers

Cognitive Features Associated with Down Syndrome:

  • Moderate mental retardation
  • Weakness with grammatical aspects of language
  • Relative strength with spatial reasoning tasks
  • Verbal short term memory is more impaired than visual memory
  • Weakness with daily living skills (self-care skills)
  • Relative strength with social skills

Interventions for Children with Down Syndrome:

  • Speech and language therapy with possible addition of sign language
  • Visually-based interventions for teaching, reading and vocabulary
  • Occupational therapy for sensory integration and motor development

What are Metalinguistic Skills and What Do They Look Like in My Child?

Metalinguistic skills involve the awareness and control of linguistic components of language. Simply put, it implies the ability to thinktoddler clapping and discuss language. These skills require an awareness of others as listeners and an ability to recognize significant details that indicate changes in speech. For example, you do not usually speak to a teacher in the same way you would speak to a friend. In addition, you do not typically speak in a restaurant the same way in which you speak in a museum. Noticing what kind of speech is appropriate in various environments with various speakers is also reflective of metalinguistic skills.

These metalinguistic skills start to develop as early as one year as your child learns to monitor their own utterances and begin to repair their breakdowns in communication when they are misheard. Before the age of two, children typically learn how to adjust their speaking to different listeners: louder vs. softer, simpler vs. complex, demanding vs. requesting and peer vs. adult. Before the age of four, children should know how to recognize signals indicating that their listener understood the message spoken (i.e., such as a nod for assent and a frown signifying confusion). Children also learn to correct their own speech as well as their conversation partners’ speech. At this age, children spend a significant amount of time exploring new sounds, new words and new speech styles. As they reach their academic years, metalinguistic development continues to improve as children gain an understanding of the specific meaningful units that are associated with language (i.e., sounds, syllables, words, sentences). As a child’s mastery of language components grows, they learn to play with humor by telling jokes, riddles and puns (e.g., “What’s black and white and red (read) all over? A newspaper!”). This indicates a desire to control the use of language that was not present in the early language of children. This manipulation of language is significantly correlated to the development of pragmatic skills or the use of language.

Development of these metalinguistic skills are essential to a child’s ability to be successful in creating enlightening conversations that will serve as foundations for further learning in their lives.

Is Your Child Just Disorganized, or Is It a Bigger Problem?

Do you find that your evenings and mornings are primarily spent helping your child track down missing work or lost items andmessy child generally trying to help them get organized enough to manage their school day and extra-curricular activities? Is assisting your child too much interfering with family time and leisure time? Is this causing your family and your child stress? This scene is common in many families with middle and high school children that should be starting to manage their own lives. These problems are often caused by a weakness in Executive Functioning Skills: the skills that allow us to manage ourselves and our time with the resources we have. These skills are critical when it comes to being successful in school, but these skills are not often not taught in the classroom.

 The following are the Executive Functioning skills:

  • Emotional Control:  The ability to regulate emotions in order to stay productive and complete a task
  • Initiation: The ability to start a task independently
  • Planning/Organization: The ability to plan and organize one’s time, assignments and activities effectively
  • Shift: The ability to move from one task to another
  • Working memory:  The ability to hold information in the mind for completing a task
  • Inhibitions:  Stopping impulses at the right time in order to stay focused and accomplish the task at hand

Executive functioning coaching addresses weaknesses in executive functioning skills. Executive functions develop throughout childhood and continue to develop into early adulthood. Often, executive functioning difficulties become apparent for the first time during adolescence (although they may reveal themselves earlier). Poor or underdeveloped executive functioning skills may result in several difficulties for children, including emotional difficulties, risk-taking behavior, compulsive behaviors and attention problems. All of these may ultimately cause many issues in the self-esteem and functioning of the child and family, both in and out of school.

If executive functioning weaknesses are suspected, a neuropsychologist will be able to diagnose specific areas that need to be improved. A directed, executive functioning coaching program designed to address these challenges will result in a marked improvement in the current and future functioning of the child. North Shore Pediatric Therapy offers both individual executive functioning coaching programs and intensive workshop experiences to teach these vital skills. Contact us to schedule your appointment today.

*Cooper-Kahn, Joyce, Dietzel, Laurie. Late, Lost and Unprepared: A Parent’s Guide to Helping Children with Executive Functioning: Woodbine House Inc: 2008.
Rush University Executive Functioning Curriculum Training
https://www.aboutkidshealth.com.ca/En/News/Series/Executive Function/Pages/Executive Function

Food Journaling 101

Food journaling involves writing down everything you (or your child) eat and drink over a certain period of time. I often ask parentsfood journal and children to do this and they are often not thrilled about the “assignment”. The detailed record keeping of foods and beverages consumed may provide a lot of useful information and can be a great tool to direct the nutrition plan of care.

Below are five situations when food journaling may be helpful:

  • For weight management: Writing down everything you eat and drink during weight loss cases provides two benefits: First, you are accountable and aware of everything you are eating and drinking in a new way. You are seeing it listed on paper. Second, you don’t forget about the foods you consumed when asked about it during the visit a few days later.
  • For picky eaters: Again, recording everything a child eats throughout the day serves a few purposes. It helps me to identify the “gaps”- what nutrients are falling short and which nutrients are being met. It may also help you as a parent to reflect on how many things your child is actually consuming, especially if you review it over the course of a week. Finally, seeing the pattern and timing of what your child eats is very important. Adjusting or creating a structure around meals and snacks is very beneficial for picky eaters.
  • For suspected food allergies or sensitivities: If a child is having physical symptoms that I suspect are correlating with food, food journaling is one tool that can decipher whether the symptoms are food-related or not. In these cases, in addition to the foods and beverages consumed, it is also helpful to write down the times of a day. Through the course of the day, it can be difficult to remember every detail of what your child consumed. For example, you notice a rash on your child in the bath tub before bed and are trying to remember if it was the vanilla granola or oatmeal she had for breakfast? Or was it eggs today? Wait, was that yesterday? Did I send lunch to school or did she get hot lunch? Did she trade and eat something else at school? The goal of the food log is to provide clearer information.
  • For underweight kids: Similar to picky eaters, it is beneficial for a parent to keep a food log for the underweight child once in a while. The parent may be able to focus on whether the child is eating well and then troubleshoot with me on how to maximize calories and protein; however, I do not advise children that may be at risk for having an eating disorder to record everything they are eating, nor should parents of these kids keep a food log for them. The reason is because this can easily become a tool to control and restrict the diet further.
  • For general healthy eating goals: Any of us can benefit from doing food journaling every so often. If you find an area of your health that you would like to improve, start with a food journal. Examine what exactly you eat over the course of a few days. Establish where there are gaps, strengths and areas for improvement. Do you need more variety? Are you not actually eating as many fruits and vegetables as you thought? Do you eat more in the evening than in the morning? Is your calcium intake low?


If you would like a registered dietitian to do a food journaling exercise for your child, contact NSPT at 877-486-4140. One of our nutrition professionals can meet with you to create a food log template, guide you through the process and then analyze the nutrition for you.

Plan Ahead this Easter and Passover For Your Special Needs Child

Easter and Passover are special times during the year in which friends and families get together for a form of celebration. For many easter and passover families, these are happy times in which the event is eagerly anticipated; however, for families with children who have special needs, this can serve as a time of increased stress and potentially fear. These parents often worry about how their children will behave and react to these situations.

Below are some helpful tips that parents may utilize to make the special occasion as stress-free as possible:

  • Let the host know in advance what to expect and what behaviors the child may display. If the host has children, provide information in a kid-friendly manner so that they will be prepared.
  • Prepare your child by creating a social story or script in which the day’s events are planned and sorted out. Utilize visual schedules to help reinforce the child about what the day will look like.
  • Pick battles. Many children with sensory needs will refuse to wear a suit or dress. Plan ahead basics, such as clothing.
  • Set a time limit to the visit. If you know your child is unable to handle social situations or environments in which there is a high amount of action for more than an hour, plan on leaving within an hour of arriving. If you, as a parent, want to stay longer, anticipate this and have a babysitter or caregiver prepared to pick up the child.

Family get-togethers and religious celebrations do not necessarily need to be a fearful or anxiety-provoking event. Remember, you know your child best. If you believe that the situation may be problematic, it most likely will. Anticipate this and create strategies to ensure success for more enjoyable events

Happy Easter and Happy Passover!

Risk Factors Associated with Prematurity and Low Birth Weight

As previously described in a prior blog, prematurity and low birth weight are commonly found in 2-8% of live births in the United States.  There pregnant ladyare numerous neuropsychological and cognitive concerns that were reported in the previous blog.  There are many risk factors that parents need to be aware of that can be a contributing factor in premature delivery.

Medical risk factors that are associated with low birth weight are:

  • Previous preterm delivery
  • Family history of infertility
  • Multiple gestation
  • Placental abnormalities
  • Uterine abnormalities/infection
  • Preeclampsia

Cultural risk factors associated with low birth weight include:

  • Preterm birth more than 2x as common in African Americans
  • Higher in single mothers
  • Higher in low socioeconomic status families

Because of the possible long term concerns with low birth weight, it is important to be preemptive and knowledgeable about medical and cultural factors that might contribute to the condition.

Sleep Deprivation in Children and 5 Tips on How to Get Your Child to Sleep

Sleep is one of the most important activities in your child’s day but it is often overlooked as such. It is as essential as food, water, and child sleepingsafety and vital for adequate physical and cognitive development.

How much sleep does your child need? Often more than we typically expect, school-age children need 10-12 hours, with younger children needing the most, and adolescents needing 9-10 hours of sleep per night to function optimally. If your child is not getting this on a regular basis, they can become sleep-deprived. When this is prolonged, a number of problematic issues can arise, including problems focusing, mood dysregulation, and risk for falling behind in school.

How do you know if your child is sleep-deprived? Some of the signs include:

  • Excessive daytime sleepiness (e.g., falling asleep in the car, wanting to take naps)
  • Needing to drag your child out of bed in the morning
  • Waking up irritable and unrested
  • Problems falling asleep at night (more than 30 minutes)
  • Sudden change in emotions or behavior

Here are some tips to help your child sleep and for your entire family to get the rest they need:

  • Dim the lights: Our sleep cycle is regulated by light so try turning off or dimming lights around the house 30 minutes before bedtime.
  • Avoid the “second wind:” Tune into your child in order to find the time when they begin to slow down and become tired. If this opportunity passes, children may become more hyperactive and difficult to settle.
  • Routine is key. Keep it simple and short (less than 30 minutes)
  • Oftentimes children will need help settling down. When other strategies have not worked, you may want to talk to your pediatrician about Melatonin, an over-the-counter supplement.
  • And finally, make bedtime a time in which to look forward. Use it as an opportunity to unwind from the day and bond with your child.

If you suspect that your child may not be getting enough sleep, and your attempts to alter the problem have not helped, talk with your doctor or schedule an appointment with one of our behaviorally-trained social workers and experts.