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Everything Tummy Time

Parents of infants all know that they should be working on tummy time every day from an early age. However, most parents also experience difficulty consistently working on tummy time, since babies are often initially resistant to this position.Blog-Tummy Time-Main-Landscape

Below is a list of reasons why tummy time is so important, even if your child does not initially enjoy the position:

  1. Strength: When a baby is placed on her stomach, she actively works against gravity to lift her head, arms, legs and trunk up from the ground. Activating the muscle groups that control these motions and control the motor skills that your child will learn in tummy time allows for important strengthening of these muscle groups that your baby won’t be able to achieve lying on her back.
  1. Sensory development: Your child will experience different sensory input through the hands, stomach, and face when she is lying on her stomach, which is an integral part of her sensory development. When your baby is on her stomach her head is a different position than she experiences when on her back or sitting up, which helps further develop her vestibular system.
  1. Motor skill acquisition: There are a lot of motor skills that your child will learn by spending time on her stomach. Rolling, pivoting, belly crawling, and creeping (crawling on hands and knees) are just a few of many important motor skills that your child will only learn by spending time on her stomach. Along with being able to explore her environment by learning these new skills, your baby will also create important pathways in the brain to develop her motor planning and coordination that impact development of later motor skills, such as standing and walking.
  1. Head shape: Infants who spend a lot of time on their backs are at risk for developing areas of flattening along the back of the skull. It is recommended that babies sleep on their backs to decrease the risk of sudden infant death syndrome, and since babies spend a lot of time sleeping, they are also already spending a lot of time lying flat on the back. Spending time on the tummy when awake therefore allows for more time with pressure removed from the back of the head, and also helps to develop the neck muscles to be able to independently re-position the head more frequently while lying on the back.

It is important to remember that your child should only spend time on his or her stomach when awake and supervised. Many infants are initially resistant to tummy time because it is a new and challenging position at first. However, by starting with just a few minutes per day at a young age and gradually increasing your child’s amount of tummy time, your child’s tolerance for the position will also improve.

For more tips on how to improve your child’s tummy time, watch our video!

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Occupational Therapy’s Role in Improving Self-Care Performance in Children

The role of the occupational therapist, when working with clients of any age, is to support participation and daily functioning. For a child, one of the primary occupations is self-care. Self-care Blog-Self-Care-Skills-Main-Landscapeskills, which include feeding, toileting, dressing, bathing and grooming, are classified as Activities of Daily Living (ADL’s), because they are a critical part of a child’s overall health and participation each and every day. In order to participate in self-care, a child must have component skills within a variety of performance areas, and delays in any of these areas can make seemingly simple tasks feel nearly impossible.

During an initial evaluation, an occupational therapist will help you determine which performance deficits or barriers within the child’s environment are causing your child to struggle with self-care. The OT will first obtain information by asking you questions about your home setup, your family’s routines, what kind of assistance your child currently needs to perform age-appropriate self-care skills, and what your goals are in terms of self-care independence.

These questions will help the therapist obtain a snapshot of your child’s current self-care performance and provide more information about the home environment in which your child is performing. The therapist will also complete a comprehensive evaluation of your child’s underlying skills through clinical observation and standardized testing to determine potential causes of delayed self-care skills.

Below are a variety of performance areas an occupational therapist will assess that could contribute to self-care performance:

  • Motor performance: A child’s physical ability to perform the motor tasks required for a self-care skill is dependent on his or her strength and endurance, range of motion, body awareness, grasp, manual dexterity, and bilateral coordination. In addition, a child may have decreased motor planning, or difficulty generating an idea for and executing a specific movement pattern.
    • Example: A child may be unable to tie his shoes because he cannot maintain a pincer grasp on the shoelaces.
  • Executive Functioning and Attention: A child may have difficulty sustaining attention to a self-care task, sequencing the steps of a task in an efficient order, or remembering when and how to do the task at all.
    • Example: A child may not be able to remember or mix up the order of steps to tying shoes.
  • Sensory Modulation: A child may have decreased sensory modulation, or ability to filter out irrelevant sensory stimuli. Children with poor sensory modulation may be hypersensitive to input, which can often make children very uncomfortable in their own skin, easily distractible, or easily upset and overwhelmed. Other children may be hyposensitive and not notice certain important sensory input. You can read more about how sensory processing impacts self-care and hygiene in one of our other blogs, “Horrible Haircuts and Terrible Toothpaste” http://nspt4kids.com/occupational-therapy/horrible-haircuts-and-terrible-toothpaste-helping-your-child-with-sensory-processing-disorder-tolerate-hygiene/
    • Example: A hypersensitive child may be bothered by the feeling of their socks and refuse to wear tie shoes; a hyposensitive child may not notice that his shoes feel or look funny when on the wrong feet.

Once the evaluation is complete, the occupational therapist will be able to determine if the child would benefit from ongoing occupational therapy. Future treatment would focus not only practicing specific self-care skills, but also engaging in activities that facilitate the overall development of underlying motor, sensory integration, and executive functioning abilities. In addition, the therapist will work with you to adapt your child’s environment through the use of home modifications, visual supports, and adaptive equipment to support performance. Through all of these modalities, the occupational therapist will be able to increase your child’s participation in self-care activities, thereby increasing his or her independence and overall development.

Check out one of our previous blogs on self-care written by a Board Certified Behavior Analyst: Self-Care Skills for Children with Autism

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Tips and Tricks to Boost Your Toddler’s Speech and Language

When your child enters into this world, he is immediately exposed to his new environment. Speech and language development begins right away, as your child begins to explore the environment around him. The early years of your child’s life is a crucial period for speech and language development. Blog-Toddler Speech and Language Main-Portrait

As you interact with your child, there are various ways that you can help to boost his speech and language:

  • While you are playing with your child, talk about the actions that he is doing and what you are doing. For example, if your child is throwing a ball, say “throw the ball” as he throws it. This will help him match spoken words to actions.
  • Label objects for your child. As you are engaging with your child, tell him what it is that he is holding, looking at, etc. For example, if your child is holding a ball, say “you have a ball” This will help to increase his ability to identify and name various objects.
  • Expand on your child’s utterances. As your child is acquiring language skills, he will start to speak using short utterances before he can use full sentences. When your child produces one word or short multiword utterances, take his utterance and use it in a full contextual sentence. For example, if your child points to a ball and says “ball,” you can respond with “yes, I see the red ball!”
  • Use natural sounding speech with appropriate intonation when talking to your child. As your child is being exposed to language, not only is he listening to the words, but he is also listening to your tone of voice and looking at your face. Therefore, to help him understand what you are saying, it is important to match your tone and facial expression to your spoken words. For example, if your child is throwing toys inappropriately, tell him “no throwing” with a more stern tone of voice. If you say “no throwing” with a “happy” tone of voice and a big smile, your child may have a difficult time understanding the concept of “no” since the tone of voice and facial expression did not match the meaning of “no.”
  • Sing familiar songs with your child. Engaging in song is a fun way to encourage language development. At first, you will be doing most of the singing while your child closely watches and listens. While you sing, you can use gestures to match words in the song. As your child gets multiple exposures to you singing the song, encourage him to engage in the song by gesturing along with you. For example, when singing “head, shoulders, knees, and toes,” start by singing the song while you touch each body part matching the words in the song. Then to engage your child more, you can sing the song while you help him move his hands to touch the body parts from the song. Another tip you can do with songs is pausing at certain words for your child to say. For instance, you can pause before “toes” each time it occurs in the song to allow your child to say it. Not only can this help to increase language production, but it can also help your child identify and name objects, items, or in this example, body parts.

NSPT offers services in Bucktown, Evanston, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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10 Common Household Items to Develop Fine Motor Skills

The building blocks for fine motor success begins on day one. Skill development is commonly observed when the child becomes explorative in their environment and increasingly independent. Independence in age appropriate tasks is often a great measure of where they are developmentally. Specifically, the common influencing skills for fine motor development are strength, coordination, visual perception and motor planning. To assist in maturation of these skill areas you can engage your child in simple activities with things you may already have around the house! Blog-Home Fine Motor Skills-Main-Landscape

10 great tools you may find around the house to develop fine motor skills:

  • Broken crayons– Don’t get rid of those broke crayons! Coloring with these can assist with precision, hand strength and grasp maturity.
  • Q-tips– They can be utilized for painting, dotting and erasing from a chalk or white board. Fine motor precision and grasp maturity are challenged in activities with Q-tips.
  • Clothes pins– Transferring small items while playing different games such as matching, minute to win it, and relay races. Clothes pins also assist with motor planning, strength, and coordination.
  • Tweezers– This is another great tool for transferring small items while playing different games that addresses motor planning, strength, and coordination skills.
  • Child safe scissors– Begin with snipping construction paper and progress into more complex activities such as cutting shapes. To start, make a fun fringed edge for a picture they drew or advanced beginners can make a snowflake with parental assistance. Cutting activities can be difficult, but it significantly addresses coordination, strength, visual motor, and motor planning skills.
  • Legos– These small pieces may hurt when stepped on, but they are great for coordination, precision, visual attention, and strength.
  • Small blocks– Blocks can be used in many ways. A few suggestions would be to stack, string, and build various structures. Blocks are wonderful tools for coordination, visual perception, and grasp maturity.
  • Play Doh– Great way to mature manipulation, coordination, strength, and creativity skills.
  • Shaving cream– A fun way to practice their drawing skills in a non-traditional pencil and paper way. This can assist with precision and motor maturity as well.
  • Spray bottle– Clean up from the shaving cream and painting activities with a spray bottle filled with water. This can really test as well as develop the child’s grasp strength and endurance.

**All activities should be closely supervised and supported by an adult.

NSPT offers services in Bucktown, Evanston, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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How to Use Visual Supports at Home for Language Development

For children with receptive and expressive language disorders, visual supports can be powerful tools when communicating. Visual supports are beneficial to aid in not only the comprehension of language, but also to improve expression of language. These visuals can provide a child with information they are missing when comprehending language or speaking. Visual supports are so universal and easily to utilize that they can be implemented seamlessly in the home environment.

How to use visual supports to improve language comprehension:

For children that experience deficits in language comprehension, visual aids are a great way to improve their ability to comprehend instructioVisual Supportsns, rules of an activity, and expectations. Here are some examples of ways to create visual aids for receptive language tasks.

  • Visual schedules can be pictorial, written or both. It is important to tailor the schedule to the child’s abilities. For children with receptive language deficits, hearing their schedule for the day can be confusing and maybe, even a little scary. By presenting a visual schedule, paired with a verbal description, a child will receive the information via two avenues of communication, which will likely improve comprehension of what to expect.
  • A Listening Chart, as shown below, visually depicts the components to being a good listener. When expectations or rules are presented only verbally, information is often forgotten. By using a visual to depict expectations, the child will be more successful and can easily remind him or herself of what actions need to be completed.
  • Presenting choices visually can be a powerful tool for children who have receptive language deficits. For example, if there are two choices for snack (e.g., pretzels or grapes), you can present two pictures of these food items when asking the child what he or she would like to eat.

How to use visual supports to improve language production:

The use of visual aids for language production is slightly more diverse than those utilized for language comprehension. Visual aids for language expression are often used to help a child initiate communication, participate appropriately in a conversation, and to expand utterances. Here are some examples of visual aids used to improve expressive language skills.Smash Mats

  • Smash mats are a great tool to use to expand a child utterance length (e.g., from two word to three words). As shown here, a smash mat can be as simple as three dots on a page. When modeling a sentence, you can touch a dot as you say each word (e.g., Girl is swinging or I want goldfish). You can make smash mats even more enticing by adding a playdoh ball to each dot. Smash mats are also great, because as your child continues to progress in their expressive language skills, you can continue to increase the length of their utterance by adding additional dots to your mat.
  • A Topic Tree is one of many visual aids that can be used during conversations. The topic tree is specifically for topic maintenance (i.e., staying on the same topic of conversation with your
    communication partner). For example, if you are talking about Christmas with your child, each time that you make a comment, ask a question or appropriately respond on the topic of Christmas, you put a leaf on the tree. This is an easy DIY visual aid you can make at home!
  • A Yes/No Board is a great visual aid for an emerging communicator. It is a simple visual depiction of the concepts of “yes” and “no.” Yes/No boards can be visually Y-N Boards2displayed in a variety of ways as shown below. When asking a child a Y/N question, by presenting the child with this visual, you are not only cueing the child that you are asking a question, but also providing the child with the appropriate response choices.Y-N Board

All of these visual aids will not only increase a child’s engagement in a daily activity, but also aid in making transitions smoother. Visual aids can be implemented at any age and in any environment.

NSPT offers services in Bucktown, Evanston, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Help! My Child is Wetting the Bed

Wetting the bed is a very common issue that occurs with many children. Below are some preventative and reactive strategies to help decrease bed wetting from occurring. Blog-Wetting the Bed-Main-Portrait

Preventative Strategies for Wetting the Bed

Liquid Intake

It is important for children to drink liquid throughout the day to stay hydrated, but it is best to stop drinking liquids before bed time. This may prevent the bladder from having to be emptied while the child is asleep.

Bathroom Schedule

Scheduled bathroom breaks help empty the bladder when it may need to be emptied. Many times when children are engaged in a preferred activity they choose to not use the bathroom when it is needed. Bathroom breaks/schedules throughout the day can prevent other issues like infection or wetting pants during other parts of the day. Using the bathroom multiple times or at least one time right before bed may help the child from needing to empty the bladder while he or she is sleeping. Parents can also wake their children up when they are getting ready for bed and have them use the restroom one more time.

Reactive Strategies for Wetting the Bed

Waterproof bedding

When a child does wet the bed, use waterproof bedding, blankets, and padding to prevent any damage to mattress. Clean up will also be easier.

Alarms

Sometimes children are in such a deep sleep that the signal of wetting the bed does not wake them up. There are alarms that can be bought to help signal/wake the child when he or she needs to use the bathroom in the middle of the night.

Open Communication

It is important to not embarrass your children or make them feel bad when they wet the bed. This can be a sensitive topic and it is important for open communication and to make you child feel comfortable when it happens.

NSPT offers services in Bucktown, Evanston, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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What is Orton Gillingham?

What is Orton Gillingham?

Orton Gillingham is an approach designed to target reading, spelling and writing skills. It is an evidence-based approach frequently recommended for students who demonstrate challenges in these areas, particularly students with a diagnosis of dyslexia or a reading disorder. Blog-Orton Gillingham-Main-Landscape

Orton Gillingham is phonetically based, meaning that it educates students on how letters are linked to certain sounds, and in what context (e.g. when a “c” followed by “e,” “i” or “y” it says the /s/ sound). The approach is systematic, structured and repetitive, so that each lesson builds on previous knowledge and has a predictable routine.

It is also multi-sensory, in order to target all pathways of learning: visual, verbal, auditory, and tactile/kinesthetic. The instruction is customized to fit the student’s individual needs related to literacy.

How does Orton Gillingham work?

The Orton Gillingham approach is comprised of five levels. Upon initiation of therapy, a pre-test will determine which level best suits the needs of the individual. Each session includes a review of the phonetic rule learned in the previous session, through a variety of multi-sensory exercises. These activities include letter and sound identification, blending of sounds to create non-sense words, reading and spelling both words and sentences, reviewing of sight words, and oral reading practice.

The student must demonstrate mastery of the target skill (90% or greater on both reading and spelling tasks), before learning new material. Upon completion of a level, a post-test is given to determine the student’s understanding and retention of the knowledge for that level, before moving on to the next.

Orton Gillingham is typically provided by a Speech Language Pathologist, Reading or Academic Specialist. It is most effective when the student participates in sessions at least twice a week.

Click here to learn more about North Shore Pediatric Therapy’s Orton-Gillingham Reading Center.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Why Isn’t My Baby Walking?

The walking stage is a huge milestone for every child. It’s an exciting new time when your baby officially becomes a toddler. Most babies learn to walk between 12 and 15 months. A baby isBlog-Walking-Main-Landscape considered delayed in walking once they turn 18 months old. When a child is delayed in a certain gross motor skill, parents are always curious why this delay is happening.

Here are some reasons that your baby may be delayed in walking:

  • Muscle weakness and/or low muscle tone. This is the most common reason. A child who has weakness or low tone in their core and hip muscles may have difficulty with walking. Sometimes this weakness affects the earlier milestones such as crawling, pulling up to stand, and cruising. If your baby had difficulty learning early milestones, they are more likely to have difficulty with walking. A physical therapist can do exercises with your child to strengthen their muscles and help them learn to walk.
  • Orthopedic concerns. This involves the bones and joints in a child’s legs and how they are aligned. An example is hip dysplasia. These concerns are diagnosed by an orthopedic surgeon and are treated in a variety of ways.
  • Neurological concerns. This involves the nerves, muscle fibers, and nervous system of the body. An example is diplegic cerebral palsy. These types of concerns are diagnosed by a neurologist.

Orthopedic and neurologic concerns can be very scary to parents. It is important to understand that a delay in walking does not automatically mean that your child has an orthopedic or neurological disability. If you think your child is delayed in walking, speak to your pediatrician. A pediatric physical therapist can evaluate red flags for causes of delayed walking, as well as help your child to learn this skill.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Why Crossing Midline is Important for Development

As babies grow and develop certain milestones are often celebrated, such as rolling, sitting, crawling, and walking. As a pediatric occupational therapist, one of the milestones I always celebrate might not be visible to the untrained eye. Crossing midline, defined as the ability to reach across the body’s invisible midline with your arms or legs to perform tasks on the opposite side of the body, is a required skill for many higher level coordination activities. Blog Crossing Midline Main-Landscape

This skill typically develops around 18 months of age. Oftentimes when children are referred for occupational therapy due to poor fine motor skills, handwriting, or coordination, they are not crossing midline efficiently.

Some ways to observe whether or not your child is crossing midline efficiently include:

  • Watching to see if your child switches hands during drawing tasks. Do they switch from left hand to right hand to avoid their arm crossing over when drawing lines across paper?
  • Evaluating hand dominance: by age 6, children should have developed a hand dominance. Children with poor midline integration may not yet have developed a hand dominance.
  • Tracking an object across midline: this can be observed during reading, as decreased midline integration can lead to poor ocular motor skill development required for scanning.
  • Observing ball skills: children who are not yet crossing midline may have a difficult time crossing their dominant leg over their non-dominant leg to kick a ball forward.
  • Assessing self-care skills: putting on socks, shoes, and belts may be extremely difficult as these are activities that require one hand to cross over to assist the other in the process.

Children who have difficulty crossing midline may not be able to keep up with their peers, which may cause increased frustration during participation at school and in social situations. In addition, crossing midline is a required skill needed in order to complete more challenging bilateral coordination activities, such as cutting with scissors, using a fork and knife to cut food, tying shoe laces, writing out the alphabet, and engaging in sports.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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How to Help a Child Who is Struggling with Self-Esteem

As children get older and start spending more time with peers, it is natural that they begin comparing themselves to others. It’s healthy for children to want to excel and do their best, but itBlog-Self-Esteem-Main-Landscape becomes problematic when it comes at the expense of their self-esteem. Self-esteem can take time to develop and strengthen, but there are some things you can do to help enhance it during the earlier years.

What to Look for in a Child with Low Self-Esteem

If you notice your child making a lot of negative self-statements, this is indicative that he or she may be struggling with self-esteem. Negative self-statements are self-deprecating and tend to represent black and white thinking patterns. An example of a negative self-statement would be “I am dumb” or “I will never be good at this.”

It is very healthy for children to develop interests or hobbies and to spend time around others who enjoy similar things. Explore a variety of activities with your child and try to provide him/her with options. Whether it’s a cooking class or swimming lessons, your child is bound to show interest in something. Listen to your child and give him/her the autonomy to choose something that really interests him/her. Check out your local park district or community center to see what programs they offer. The Chicago Park District has dozens of wonderful programs and activities that may interest your child.

Each child has their own strengths, talents, and qualities that make them unique. That being said, it is great to point them out when you notice them! It is human nature to enjoy hearing that others are noticing the things we are doing well. At the same time, it is important to help your child understand that they are not defined by their achievements. Think about some adjectives that describe your child (i.e. compassionate, kind, caring). These intrinsic qualities are really what makes someone special – not the amount of trophies or ribbons on their shelf. Plant Love Grow is a wonderful website that has lots of self-esteem boosting activities that you and your child can do together.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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