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Play Based Therapy – 5 Things to Consider When Playing at Home

  1. Choose toys and activities a child likes.blog-play-therapy-main-landscape
    • Use toys or objects the child enjoys to increase the likelihood that they will pay attention.
    • Read the child’s cues to determine when or if the attention is waning and provide them with options of other preferred items.
    • It is okay to have them complete “one more turn” before having them clean up.
    • Create a regular clean up routine after play time. Create or use a fun clean up song!
  2. Allow a child to take the lead in choosing toys- but this doesn’t mean you need to give them free rein all the time!
    • Offer acceptable choices- this is a happy medium between letting the child do what they want all the time and the adult determining what the child plays.
    • By providing choices, it gives an opportunity for the child to respond and communicate (and they feel like they are in control!).
    • If possible, choose activities that the child is able to move and does not have to sit still or at a table the whole time moving helps the child to be more attentive or focused!
  3. Imitate a child’s actions and use specific labels to address what the child is doing or attending to at the moment.
    • Over time, it is hoped that the child enjoys the repetition of the words and actions, then will begin to repeat an action he sees you complete (i.e. “Jump, Jump!” “You are jumping!)- Make sure you are face-to-face with the child, so that they know that you are talking about exactly what they are doing.
    • Simply state an object or an event name during the child’s play (i.e. “Ball” or “You found a ball”).
    • Try to stay away from talking too much or narrating too much information (i.e. It looks like you found something. What are you going to do with it? Are you going to bounce or throw it?) Depending on the child’s age, this kind of narration is likely above the language-level for the child.
    • Try to avoid asking the child questions!
  4. Use prompts to elicit attention with verbal visual cues (i.e. Look!)
    • Point to where you want the child to attend or focus.
    • Gaining the child’s attention is the first thing that needs to occur before they are expected to learn anything.
  5. Reinforce attention either naturally or artificially.
    • Pick reinforcements that are motivating for your child!
    • Reinforcing a child’s communicative attempts may include allowing them to play with a toy or finish eating a snack that he/she requested.
    • Depending on the child, stickers or suckers may be just the perfect reinforcement as well!

Reference

Mize, L. (2011). Teach Me To Talk! Shelbyville, KY: Teachmetotalk.com

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 and speak to one of our Family Child Advocates!

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The Do’s and Don’ts of Play: A Parent’s Guide to Helping Your Child Develop Better Peer Interactions

Imagine that you go to work in the morning and spend your entire day not knowing how to navigate thePlay Skills parameters of your workplace. You’re unsure of your job description, title, and workplace culture….and no one will give you any answers. By the end of the day, you feel utterly exhausted merely as a result of attempting to navigate a world with no structure or boundaries. Now, imagine you’re a child.  This is how children with limited play skills might feel as they are expected to respond to situations for which they don’t have the skillset each time they come in contact with a peer.

Play is the single most important mechanism children utilize to learn about their universe.  Play provides a framework to explain imaginative and real events in a child’s world. It allows them to learn about independence, manners, and character, as well as build confidence and practice new skills. Yet, some children have difficulty learning how to properly navigate these interactions.

The good news? You can help.

Play at Any Age

Play skills are developed in a progression.  Although there are times in which a child may fluctuate between all levels of play, the following indicates the age-appropriate development of peer interactions.

Solitary play (ages 0-2): Child is completely captivated with play and does not seem to notice other children.

  • Learns through trial and error
  • Copies other children and adults
  • Looks at other children playing but does not join in the play
  • Likes playing with adults as well as by himself/herself

Onlooker play (2-2 ½): Child is interested in other children’s play but does not join in. He/she may ask questions.

Parallel play (2 ½- 3):   Child shares the same space with peers but doesn’t actively engage with them.

  • Begins to use symbols in his play, such as using a stick as a sword
  • Starts to show some reasoning skills… may still learn by trial and error.
  • Copies other children and adults’ behaviors and language

Associative play (3-4): Child is interested in pursuing social interactions with peers while they play.

  • Shows more reasoning skills
  • Begins to ask “why” and “how” questions
  • Plays imaginatively, for instance, dress-up

Cooperative play (4+): Children play in groups of two or more with a common goal in mind; they often adopt roles and act as a group.

  • Shows understanding and uses reason related to experience
  • Begins to understand simple rules in games
  • Plays cooperatively, taking turns

Should I Be Concerned About My Child’s Play Skills?

Typical play:

  • Spontaneous
  • Flexible: child can add onto others’ play schemas*, play story** can change throughout, child does not become distraught if a peer/parent adds their ideas
  • Creative
  • Voluntary
  • Internally Reinforcing
  • Functional
  • Age-Appropriate

Atypical or Disordered Play:

  • Ritualistic: child engages with toy in the same order/manner, every time he/she plays with toy
  • Difficulty with Generalizations: child has difficulty accepting new patterns or rules, attempts to utilize one general rule for all similar events (i.e. “I know the youngest person goes first in Sorry, so I expect that the youngest person goes first in all games.”)
  • Non-functional
  • Repetitive: child performs the same action repetitively with a toy that doesn’t suit its purpose, ie. flipping, stacking, ordering items or repeats the same phrase over & over again while engaging
  • Limited Interests: child frequently finds a way to steer play story to a few favorite interests
  • Rigid: may accept when parents and peers join his/her play schema, but only by child’s rules and with his/her interests
  • Difficulty “bouncing back” from unexpected events in play: may recoil when a peer introduces a dinosaur, for example, when child expected story to progress in a certain direction. May become upset at changes or quit altogether
  • Avoids eye contact, or eye contact may be fleeting
  • Often requires prompting for basic communication, i.e. saying hello when approached by peer
  • Often includes non-reciprocal language: response frequently does not match question
  • Difficult for child to enter into an already-developed play scheme: two peers are pretending to be firemen, third child wants to join but can only talk about/pretend to be a doctor

*Play schema: diagrammatic presentation; a structured framework or plan 

**Play story: the story that is told through the play schema

Parent How-To Guide

If your child has underdeveloped play skills, here are some ways to assist in his/her development to encourage parallel, associative, and cooperative play:

  1. Provide Opportunities
  • Allow your child time for free play with same-aged peers
    • Don’t “helicopter” parent during free play, but provide modeling if necessary
    • Provide plenty of materials to encourage imaginary play, i.e. dress-up clothes, pretend food, cash register
    • Encourage symbolic play: child engages in imaginary play with an item and calls it something else, i.e. uses a banana as a telephone
  1. Model Feelings & Behavior to Encourage Problem-Solving
  • Provide your child with words to explain feelings
    • “Jimmy, it looks like you’re sad because Sally isn’t sharing her toy with you. Let’s tell Sally how you’re feeling together.”
    • If your child is old enough, encourage him to use the words himself. “Jimmy, you can say, ‘Sally, I am sad because I want to play with that toy too.’”
    • Starting your modeling sentences with the phrase “you can say…” is a very powerful way to neutrally provide your child with the words he/she may not know how to express
  • Provide your child with options for independent problem-solving
    • “Jimmy, do you want to wait until Sally is done with the toy or ask her if she can share it with you?”
    • This allows the child to choose between 2 options and learn to find solutions independently
  1. Set Expectations. Especially if your child demonstrates rigid behavior!
  • Be sure to set expectations before engaging in task
    • “Jimmy, we are going to the playground. At the playground, I expect you to play properly with friends. That means sharing the equipment, speaking nicely, and waiting your turn.”
  1. Give Positive Reinforcement
  • Encourage proper behavior and play skills by offering both natural consequences and praise.
    • Consequence, stated before engaging in task: “Jimmy, if you don’t follow the rules we discussed at the playground, we will need to go home immediately.”
    • Praise, stated after task is completed: “Jimmy, way to go! You followed all the rules by taking your turn and speaking nicely to your new friends. I’m proud of you.”

Seek Outside Help

If your child doesn’t seem to improve with these at-home tips, seek the assistance of an occupational or developmental therapist for hands-on support for both you and your child.

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 and speak to one of our Family Child Advocates!

References:

  • Parten, M. (1933). Social play among preschool children. Journal of Abnormal and Social Psychology, 28, 136-147.
  • http://www.child-development-guide.com/stages-of-play-during-child-development.html
  • http://brighttots.com/teaching_playskills.html
  • http://www.erinoakkids.ca/ErinoakKids/media/EOK_Documents/Autism_Resources/Teaching-Play-Skills.pdf
  • http://childdevelopmentinfo.com/child-development/play-work-of-children/pl2/

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5 Reasons Free-Time is a Good Thing

Free-time is a good thing. Parents spend a lot of time encouraging their children to participate in recreational activities during the school year. There is nothing wrong with having your child participate in different activities and helping them to figure out what they are passionate about; however, over-scheduling your child with too many activities can often lead to increased stress in children and their parents. It is important for parents to be cautious about how much they are scheduling their children and to encourage more free time.

Here are 5 reasons why it is important not to over-schedule your child:KidsFreeTimeFall

  1. Over-scheduling can create increased stress and anxiety for both parents and children. Over the last several years there has been an increase in anxiety related disorders due to the stressors involved with over-scheduling.
  2. It creates less time for children to complete their homework and can cause them to have less sleep at night due to staying up later to complete their homework.
  3. It decreases the amount of quality time a children can spend with their family.
  4. Over-scheduling can cause a child to have less time for free-time and with you. Quality time doing imaginative play with your child is important in order to encourage creativity and to help develop independence in children.
  5. It can also cause children to have difficulty maintaining with peers due to not having enough free time to spend with them and to build their relationships.


 Is over-scheduling or homework creating stress? Read here for 8 Tips to Ease Homework Time Stress.




Navigating the Playground with a 2-Year-Old

Summer is a great time to explore the playground with your child. Playgrounds provide a fun and exciting playground with toddlerenvironment that gets your child outside and active. Children of all ages can enjoy a playground in many different ways.

Read on for specific tips to navigating the playground with a two-year-old:

  • Choose the right time of day to play.  Pick a time of day when peers of a similar age will be at the park. Older kids play differently, and it’s best to have your little one playing with children his own age.
  • Climb the stairs and uneven surfaces. A two-year-old is expected to be able to climb stairs independently and walk over uneven surfaces without losing balance. The park is a great place to practice these skills. If your toddler is a little unsteady on the wobbly bridge, hold their hand to increase confidence.
  • Go down the slide. Depending on your toddler’s confidence and the size of the slide, you can either hold them on the way down, or let them slide down by themselves. Many parks have smaller slides that are good for beginners.
  • Play in the sand. This will help to develop your toddler’s fine motor skills and tactile sensory processing. If you can, try and build a castle or mountain to help develop spatial skills.
  • Ride the spring-animals (the kind you sit on that wobble). This will help improve your child’s balance and strength while having fun!

Parks are a great environment to encourage your kids to get outside and play. In addition to the benefits mentioned above, playgrounds help to foster social skills, build friendships, and support a healthy lifestyle.

7 Developmental Steps To Teaching Your Child To Catch

Children learn at a very early age how to roll a ball.  As they grow into toddlers, they can begin to understand the basics of playing girl playing catchcatch.  As with any other skill, catching a ball is something that takes practice. Below is the developmental sequence for teaching your kiddo how to catch.

7 Developmental Steps To Teaching Your Child To Catch:

  1. Push a ball across the floor.  Encourage your child to receive the ball between their outstretched legs and then push it back to you. This teaches your child the concept of reciprocal play as well as turn-taking. It also teaches them about the concept of cause and effect (push ball and the ball will roll).
  2. Catch a ball with both hands. Use an underhand toss to throw a large playground-sized ball to your child’s chest. When first learning to catch, encourage your child to catch the ball by wrapping their arms around the ball and cradling it to their chest. When their accuracy to catch the ball against their chest improves, encourage them to use only the palms of their hands and fingers.
  3. Catching a ball with one hand. Ask your child to put one hand behind their back or in their pocket. Again, toss a tennis ball to your child’s chest. Encourage them to catch the ball using only the hand that is free. Another technique that you can use is to put a baseball mitt on your child’s non-dominant hand. Encourage them to catch the ball in the mitt, transfer it to their other hand and toss it back to you.
  4. Dropping and catching a ball with two hands. The next step is to drop a tennis ball and catch it using both hands. The biggest trick for catching the ball after bouncing it on the floor is to start the drop at waist height, as opposed to at the level of their chest or higher. This will provide a smaller and more manageable bounce.
  5. Dropping and catching a ball two hands. Once your child can drop and catch a tennis ball with two hands, challenge them to do the same action with one hand.
  6. Bounce and catch with partner. Once your child can drop and catch a tennis ball by themselves, try to stand about 10 feet away from them and play catch by bouncing the ball back and forth with your child. Start by throwing it to the mid-line of their body. Once they’re able to consistently catch the ball, you should throw the ball to their sides.
  7. Over/Under: The next step in the ball-catching process is the trickiest game of catch yet. It requires two balls. Designate one partner as the “over” and one as the “under.” The person who throws over will throw their ball  in the air to their partner. The one who throws under will bounce the ball on the floor to their partner. Count to three before each bounce and see how many times you can simultaneously pass between each other without dropping either ball!

Depending on your child’s skill level, there are ways in which you can alter the game in order to make it easier or more challenging for your child. For example, you could use a larger or smaller ball. Smaller balls are more difficult to catch. In addition, you could increase or decrease the distance between you and your child. The closer you stand to them, the easier the task will be. You could also give your child a carpet remnant or draw a shape on the floor. Direct your child to stand on that designated spot while playing catch. This will help them define their space so that they only need to worry about catching and throwing, rather than their body positioning.

Practicing catch also works on a variety of skills that will transfer to other functional activities. These skills include bilateral coordination, convergence of eyes, projected action skills and visual motor skills.

You’ve got the steps. Now, get out there and play ball!

How Does Play Help Meet a Child’s Therapy Goals?

Occupational therapists often use play as a means of helping achieve our clients’ goals. Many times, it may not look like our sessions are working on your child’s areas of need; however, when we are working with children, we often try to adapt play activities in order to help your child meet his goals. Play is a very motivating activity for a child to engage in with the therapist and work on some of his goals. Play may also mask the fact that children are working on a difficult skill by introducing fun into the activity. For example, if one of the child’s goals is to improve his handwriting skills, you could play a game that involves writing, such as Boggle, Scattergories, or crossword puzzles.

Therapist and child at Gym

Here are some play activities that OT’s use to help your child meet his goals:

  1. If your child needs to work on balance and coordination, we may play basketball while standing on top of a bosu ball (imagine standing on the rounded part of a ball cut in half).
  2. A child who needs to work on core and upper extremity strength could meet these goals by playing a game while lying on his stomach over a therapy ball, while balancing with his arms on the ground.
  3. In order to improve self-regulation for a child who has sensory concerns, we may start our session by playing on the gym equipment in order to help regulate his nervous system.
  4. To work on bilateral coordination and fine motor skills with a child who does not like drawing, we often use play-doh and have him trace shapes and cut them out with scissors.
  5. Another way to work on gross motor coordination is to practice climbing a rock wall, climbing a ladder, or swinging on the monkey bars.

Sometimes, however, it may be difficult to adapt the activity and make it fun for the child. In this case, the therapist may have the child participate in an activity to work on the skills he needs to improve, but use a play activity as a reward.  From the first example in which the child’s goal is to improve handwriting, the child may still not want to play the games that involve handwriting. Then, the therapist may tell the child that after handwriting, he can do an activity of his choice.

Hopefully, this blog provides a bit more insight into the therapist’s mindset while working with your child. The therapist is constantly thinking and problem solving about how to make an activity therapeutic and how to make it easier or harder based on the child’s ability to succeed at the tasks. If the therapist is successful, the child will not even realize the activities are working on their areas of need and will want to come to therapy every session!

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Learning Through Play Time with Your Toddler

Play time provides a natural context for early language learning and is also important for the development of social communication skills. Childrentoddler playing learn through play and often practice newly acquired language skills and words during play time.

There are three stages of play development:

  1. The first stage is referred to as “self-related” symbolic play. This type of play can be observed between 12-18 months. This type of pretend play mimics daily activities using real objects. A child at this stage of developmental play typically plays alone. For example, a child will pick up a cup and pretend to drink.
  2. From 18-24 months, a toddlers’ play progresses to “other-related” symbolic play. The child is still using real objects, but will perform the action on multiple play toys. For example, the child will use the cup to give a drink to a doll, offer a sip to the bear, and finally have a drink herself.
  3. The final stage of play development is “planned” symbolic play. This stage of developmental play emerges between 24-30 months of age. Play behaviors include using one object to represent another, such as using a stick for a spoon. At this stage, the child has also begun to plan out play sequences by gathering all necessary props prior to engaging in a play routine. She might use a doll or other play toys as the agents of the play action. For example, the child will have the doll give the bear a drink.

Suggestions for Toys:

  • 12-18 monthstoy kitchen set, toy garage set, zoo animals. All of these toys provide multiple opportunities for parents to sequence a variety of play time routines for the child to imitate. This is where we as parents and caregivers must dive into our inner child and start using our imagination!!
  • 18-24 monthspuzzles, farm set, pretend painter’s/doctor set. These toys provide the child with multiple opportunities to start acting out and initiating their own play routines and to use their own imagination, as well as allowing for multiple play partners and toys to be used. Be prepared to clean up a big mess!

Following these guidelines should  help you use age-appropriate play with your child. Developing play skills will expand your child’s language and social communication.

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How to Maximize a Playdate for a Child with Speech Delays | Pediatric Therapy Tv

In today’s webisode, a pediatric speech pathologist explains ways to help a child with speech delays play well with others. She provides useful strategies to encourage communications and respect between the children. For speech game ideas read our blog “5 Board Games That Promote Speech-Language Skills

  • The right timing for a playdate
  • How to introduce a speech delayed child to a regular child
  • What signs to look out for as the playdate progresses

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV, where we provide experience and
innovation to maximize your child’s potential. Now, your host, here’s
Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host, Robyn
Ackerman, and I’m standing here today with Megan Grant, a Pediatric Speech
and Language Pathologist. Megan, can you give our viewers some tips on how
to maximize a play date with a child with delayed speech?

Megan: Sure. A play date for a child with delayed speech and language
skills isn’t going to look that much different than that of a play date for
a child with typically developing skills. However, there are some key
things to keep in mind. Make sure that you time it right. Make sure that
the play date is scheduled after naptime and after mealtime, so that the
kids are well rested, their bellies are fully and they are ready to play
and interact with each other.

Also you want to make sure to keep it brief. Sometimes, 45 minutes to an
hour is only what the kids will tolerate in the beginning, so don’t worry
that the play date should be three or four hours at a time. You definitely
need to make sure that you keep it short, especially in the beginning. Kids
will work up that way. Also, introduce a friend who’s familiar to your
child. That’s definitely going to be a key as well. Someone who is from
music class or from school is going to be more accustomed to interacting
with your child, and your child is likely going to be able to interact with
them much better than if you introduce someone who is entirely new to them.

When you do have a child who has delayed speech and language, you can pre-
teach the other child and say, “You know, Billy’s still learning how to
talk.” And let them know that that’s OK. Sometimes, kids are very
receptive and they pick up very easily on the nuances of other children, so
that’s definitely going to help as well. Keep in mind that you are going to
have to provide models, more so than with kids who are typically
developing. Kids who have delayed speech and language aren’t necessarily
going to initiate and maintain play as easily, so you’re going to have to
jump in there and let them resolve some conflicts, but definitely give them
the support that they’re going to need. And just have fun. Watch for signs
of frustration. If your child starts to break down, you definitely want to
jump in there and you can feel free to end the play date sooner than later.

Robyn: All right. Well, thank you so much, Megan, and thank you to our
viewers. And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of mind
to your family with the best in educational programming. To subscribe to
our broadcast, read our blogs, or learn more, visit our website at
learnmore.me. That’s learnmore.me.

Developing Hand-Eye Coordination

Hand-eye coordination is the synchronization of eye and hand movements. It involves proprioception (knowing where your body is in space) combined with processing visual input. Any task that requires the coordination of vision and hand movements involves hand-eye coordination. Examples of hand-eye coordination include grasping objects, catching and throwing a ball, playing an instrument while reading music, reading and writing, or playing a video game.

Hand-Eye Coordination in Infants

There are many ways to encourage development of hand-eye coordination in a child. Just like any other skill, the more time spent doing activities that involve hand-eye coordination, the easier the skill will become. In infants, reaching and playing with objects and toys are great ways to foster development of hand-eye coordination. As they get older and are able to sit independently, you can play with balls, encouraging the baby to roll and corral them. Playing with blocks and other toys that involve putting something in or taking something out are also great ways for an infant to develop this skill.

Hand-Eye Coordination in Toddlers

With toddlers, continue to play with various sized and textured balls to develop hand-eye coordination. By the age of three, a toddler should be able to “fling” a ball forwards and catch a ball against their chest. To help develop his aim, you can practice tossing balls into hula-hoops or targets on a wall (start with big targets and get smaller as the child progresses and gets older). To practice catching with only the hands, start with bigger and softer balls (like koosh balls or bean bags). Progress to smaller and harder balls (like a tennis ball) as the child gets older.

Hand-Eye Coordination in 4 Year Olds and Older

Coloring and creating crafts is another fun and great way to develop hand-eye coordination. Some fun crafts to do include stringing beads or macaroni, finger painting, or playing with play-dough. When a child is four years or older, games that involve slight hand movements can also further facilitate growth in this area. Examples of these games are Jenga, Honey-Bee Tree, or Topple (all available at any toy store). Complex puzzles, Legos, or building blocks are other great hand-eye coordination activities.

Children who have poor hand-eye coordination often refuse or choose not to participate in activities that involve this skill. The activities mentioned above can be very beneficial in assisting these children in improving their hand-eye coordination. Some children struggle immensely with every-day activities due to poor coordination skills. These children may require extra assistance from an occupational therapist or a physical therapist.

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What to do when your Child Doesn’t Play with Toys Appropriately

One exciting thing about being a child is all the cool and fun toys you get to play with. However, some children struggle with playing appropriately, and can be too rough and unsafe with toys. Parents sometimes have difficulty getting their children to use toys appropriately.

To help you gain better control during playtime, and keep your child and others safe, try the following strategies with your children:

  1. Model. When your child gets a new toy, model how the toy should be used. You should provide lots of prompts and hand-over-hand assistance to teach and encourage your child to appropriately play with the new toy.Infant girl playing with toys
  2. Practice. Have your child practice appropriately playing with the toy. If your child starts to get too rough with it, show them the appropriate way to use it and then have them repeat it back to you.
  3. Praise. When your child is appropriately playing with their toys, provide them with praise and let them know they are doing a great job. For example, you can say, “Suzy, I love how nicely you are playing with your dolls!” or “Josh, you are doing a great job of racing your cars and not throwing them!”
  4. Take It Away. If your child continues to play with toys inappropriately (i.e., throwing them, hitting others with them, trying to break them), immediately take the toys away. Let your child know that this is not how one plays with the toys. Talk to your child about why it is unsafe (i.e., someone can get hurt, you can break the toy or other items that are nearby, others might not want to play with you). You can then reintroduce the toy and show your child how to appropriately play with it. Let your child know that if they do not play the right way with the toy, then they will not be able to play with it for the rest of the day.
  5. Make a Story. You can also create a story about how we should and should not play with our toys. Within the story, identify the appropriate ways to play with toys and why we should play with them that way. Your story can also illustrate inappropriate behavior with the toys, highlighting again why we do not want to use toys in that manner. Review the story with your child before they go on a play date or start playing with toys. In addition, you and your child can reread the story after they misbehave with a toy.
  6. Just Not Ready. Some children just may not be developmentally ready to play with a specific toy, despite the age limits listed by the manufacturer. If this is the case, pull the toy out every now and again and see if your child is at the right stage. The toy will be much more fun for both of you when they can use it appropriately.

To keep your child playing safely with toys, always remember to model, practice, and praise; and if you have to, do not be afraid to take the toy away until your child can appropriately play with it.

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