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10 Signs of Auditory Processing Disorder

What is Auditory Processing Disorder?

Auditory processing refers to what we do with the messages we hear. An auditory processing disorder occurs due to an auditory deficit that is not the result of other cognitive, language, or related disorders. However, children with an auditory processing disorder may also experience other difficulties in the central nervous system, including learning disabilities, speech-language disorders, and other developmental disorders. Auditory processing disorder may also co-exist with other diagnoses, such as ADHD or Autism. Blog-Auditory-Processing-Disorder-Main-Landscape

10 Signs of Auditory Processing Disorder

  1. Difficulty understanding speech in noisy environments
  2. Inability to consistently and accurately follow verbal directions
  3. Difficulty discriminating between similar-sounding speech sounds (i.e., /d/ versus /t/)
  4. Frequently asking for repetition or clarification of verbally presented information
  5. Poor performance with spelling or understanding verbally presented information
  6. Child typically performs better on tasks that don’t require or rely on listening
  7. Child may not speak clearly and may drop ends of words or syllables that aren’t emphasized
  8. Difficulty telling stories and jokes; the child may avoid conversations with peers because it’s hard for them to process what’s being said and think of an appropriate response
  9. Easily distracted or unusually bothered by loud or sudden noises
  10. Child’s behavior and performance improve in quieter settings

How is Auditory Processing Disorder Diagnosed?

An initial diagnosis of auditory processing disorder is made following a comprehensive audiological evaluation, which is completed by a licensed and ASHA accredited audiologist. Following the diagnosis, the speech-language pathologists at NSPT work closely with the audiologist and collaborate on an ongoing basis. Children with an auditory processing disorder benefit from working closely with both speech-language pathologists, as well as occupational therapists. Professionals at NSPT can collaborate with teachers and other professionals to provide recommendations to help set up a successful learning environment for your child. Therapy will include activities to increase auditory closure skills, vocabulary building, discrimination skills, grammatical rules, and auditory perceptual training.

Resources:

 Bellis, Teri James. Understanding Auditory Processing Disorders in Children. American Speech-Language-Hearing Association. Retrieved from http://www.asha.org.

www.understood.org

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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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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Helping Your Child with Word Finding Difficulties

We’ve all had that feeling where our word or thought is on “the tip of the tongue.”  However, when this is recurring and interrupts communication with your child, then it becomes a problem.  Word finding difficulties (also called “word retrieval difficulties”) are not a vocabulary disorder.  Your child understands the definition of the word(s) and has used them before.  Word finding difficulties are the result of difficulties accessing the vocabulary they already have in their repertoire.  Imagine that your child’s vocabulary is like a library.  All the books are there, but your child just may not know where or how to get them.  Word finding difficulties are common in children with ADHD, learning disorders, and language disorders.

Common Signs of Word Finding Difficulty:

  • Using many filler words in place of specific vocabulary: “Where’s my, ah, um, my, um, you know….my backpack?”
  • Whole word/phrase repetition: “Do you know where, where, where my…. backpack is?”
  • Delayed responses: “Where’s my……………..backpack?”
  • Nonspecific language: “It’s on the thing.”

Strategies and Activities to Help Your Child:

  • Give your child time: It is easy to interrupt and fill in your child’s language during moments of word finding.  However, it is important to avoid this and give your child time to think about what he/she wants to say, and independently utilize word finding strategies.
  • Discuss attributes:  ‘Attributes’ are the common features that describe vocabulary – category, function, location, parts, and physical descriptions such as color, shape, and size.  During moments of word finding, encourage your child to describe the common attributes. For example, if your child cannot recall the word “cow,” he/she can provide attributes such as “it’s a big animal that lives on a farm, says moo, and gives us milk.”  As a communication partner, you can prompt your child by saying, “Tell me what it looks like; tell me where you find it.”
  • Sound/Letter cues:  Sometimes providing the initial letter or sound is as helpful to the child as providing the entire word.  As a communication partner, if you know the word your child is thinking of, use this strategy.  When you are unsure, encourage your child to give you the first letter or sound.
  • Word finding games: Word finding games such as Scattergories, Last Word, and Outburst are great games that target word finding skills.  If your child is having word finding difficulties, encourage him/her to use strategies such as identifying the category or function, describing what it looks like, or drawing a picture.

Feel free to share any of your word finding strategies below.  If you think your child has word finding difficulties, contact North Shore Pediatric Therapy and set up a speech-language evaluation.

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Acquisition of Speech Sounds by Age

Speech sound development varies greatly between boys and girls as well as between ages. Below are two charts that provide information about age of acquisition of speech sounds.  Speech Pathologists have researched the age of acquisition of consonant sounds in Standard American English for many decades. Each study found slightly different results regarding the age of mastery. I have provided the norms listed from the Goldman Fristoe Test of Articulation, 2nd Edition (GFTA-2). The GFTA-2 has been a widely-used articulation assessment for over 30 years. The age of mastery was determined by 85% of the sample population having the target sound mastered in the initial, medial, and final position of words. You can view a chart below with each sound and the typical age of mastery.

These charts should be used as a reference, not as a definitive means of determining if speech services are warranted. If your child is difficult to understand or is experiencing challenges with pronunciation of sounds, please contact a licensed speech language pathologist for a full evaluation.

Male

By Age Children should be able to say
2 ½ m n h w
3 p b g
3 ½ k t
4 f
4 ½ -ing y (yellow) d
5 j (jumping)
5 ½ s “ch” (chair) “sh” (shovel)
6 r l
7 v z “th” (this)
8 “th” (thumb)

Female

By Age Children should be able to say
2 m h
2 ½ n p
3 f w b T
3 ½ k g
4 d
4 ½ -ing y (yellow) r j (jumping) “sh” (shovel)
5 l s “ch” (chair)
5 ½ z
6 “th” (this) v
8+ “th” (thumb)

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References:

 Goldman, R., Fristoe, M., & Williams, K. (2000). Goldman fristoe test of articulation supplemental developmental norms. (2 ed.). Circle Pines: American Guidance Service.

Reading: It Comes in Stages

Child reading

Reading can sometimes appear to be an overnight skill, and there are even children who “teach themselves” to read before they reach the first grade. Often, it is a wonder that kids enter one grade with minimal letter knowledge and leave reading books on their own. It has been my experience that the skill of reading is often taken for granted. I was a quick reader (one of those annoying overnight type learners), but my sister struggled every step of the way. Now, as I work with children in early elementary school who are having difficulty with this skill, I have learned more and more to appreciate how tricky it is and how many skills go into the act of reading.

To better understand the process of learning to read, and to appreciate the lengths we’re pushing children every time we sit down with a story, I have listed the multiple steps of reading below:

  • First, kids see symbols and associate a symbol with an item- in simple terms, it’s like all of us recognizing those “golden arches” as a potential snack, drink, or rest break while driving on the highway.
  • Next, letters are identified.
  • Then, not only are  letters  identified, but they are also associated with the sounds they create in words (if we’re talking vowels, that list is LONG, whereas for consonants it’s typically only two or so- the hard and soft ‘g’ for example). Children at this stage are called “decoders.” That means they’re taking every letter and painstakingly identifying it, associating a sound, and blending one to the next and so on. I imagine the inner monologue of a six year old learning the skill to be something like this: “oh, that’s a B, b makes buh, ok and next is u, u can be you or uh….let’s see what comes next, g, ok g can say jee or guh, let’s put it together, boooj…no, buuug, no BUG, that’s it.” It’s no wonder that kids at this stage can sometimes get through a whole page, without a clue as to the meaning of the words. Their full attention was on decoding, not comprehending.
  • Some kids are wonderful decoders from the beginning; they have great sound and letter awareness and quickly make the leap to the next step, which involves “chunking” sounds together. Most importantly, kids must learn to chunk vowels which commonly occur together (like the ‘oa’ in boat and the ‘oo’ in boot). They also learn to recognize common words on sight, rather than expending effort fully decoding every word. At this stage, children sound much more fluent and less halting, and their intonation begins to match the meaning of sentences. This is because they are able to spend less energy on decoding and more energy on comprehension.
  • Even beyond this stage of an apparently competent reader, demands are increased – most notably in third grade. Children in third grade are expected to make the switch from “learning to read” to “reading to learn.” That is often why children who fared well in early grades bump into difficulty in third and fourth grade “out of nowhere.” It is likely that their reading skills just have not developed to the point where they are now a tool to support learning, as opposed to a developing skill.

Support your kids’ reading skills- practice makes perfect and support makes practice bearable! Seek out assistance or evaluation if you feel your child could benefit. I feel (and I hope many agree) that it’s better to be proactive than reactive in literacy learning, so that reading can be a pleasurable pastime rather than a dreaded task.

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Speech and Language: What is the Difference?

At a time when families are seeking treatment for their children, they may hear terms like “speech” or “language” and wonder, what’s mother and daughter talkingthe difference?  Many children will struggle with both speech and language aspects of communication, and it is important that families understand the distinction.

Speech:

“Speech” can be thought of as verbal communication. It is the set of sounds that we make (using our voice and our articulators) that comprise syllables, words, and sentences. Speech alone carries no meaning; it is merely sound.

There are three main components of speech:

  • Articulation (how we make each sound)
  • Voicing (using our “vocal cords”)
  • Fluency (intonation and rhythm)

Speech sounds emerge at different ages, and most children have all sounds mastered by age 9. Common speech errors occur when a child omits sounds (ex. “ba” for “ball”)  or substitutes one sound for another (ex. “wabbit” for “rabbit”). If you have questions about typical speech milestones, please see this blog

Language:

“Language” encompasses how we use speech to formulate sentences in order to communicate.  Language also consists of three parts:

Children may have difficulty with one or more components of language, as indicated by children choosing the wrong word, having a difficult time understanding ideas and concepts, and struggling with appropriate grammar when speaking or writing. Many older children may have difficulty decoding social language such as irony, sarcasm, or hidden meanings, which can negatively affect their ability to make and maintain friendships.

Communication is comprised of speech and language. Children struggling in one or more areas of communication may have difficulty being understood by both familiar and unfamiliar communication partners, making it more difficult for their wants and needs to be met. These difficulties may also create problems in school, both academically and socially.

Intervention can help children with difficulties in these areas. Speech-language pathologists can conduct evaluations and create plans that help to reduce both short-term and long-term effects of speech and/or language disorders. At NSPT, we want to see your children blossom, so please contact us if you have any questions about your child’s speech and/or language development!




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Encouraging Language Skills during Family Board Games

One of the most impactful ways a child can make progress toward their speech and language goals is through home practice.  I compare it to working outFamily playing a boardgame at the gym; one day a week counts for something, but you’re unlikely to see noticeable results.  Instead, three or four days a week is the best way to build muscle and endurance and notice tangible changes.  Speech and language development functions in a very similar way. To help children maintain and make further gains between speech sessions, we assign home practice activities.  To kids, this often translates to “more homework!”  So how can we encourage children to practice throughout the week?  Try choosing fun and engaging activities that mask the speech and language goals

Here are some board games recommended for school age and adolescent students:

7 favorite games that encourage language skills:

Outburst Junior. This fast-paced game encourages the use of categories and vocabulary.  Players are given a word or category, and asked to name as many category members as possible before the time runs out.

Scattergories Junior. This fun game also encourages the use of categories.  Players are given a specific letter (e.g., “F” or “G”) as well as a list of categories.  Each player must think of various category members that begin with that letter.

Guess Who. This silly game encourages players to ask questions and group pictures together based on similarities and differences.  Players have a board filled with faces (or in the new version, animals, appliances and even monsters) and have to guess which face belongs to their opponent.

Headbanz. This engaging game encourages children to verbally describe objects, ask questions, and remember clues.  Players are each given a secret word to wear on their headband.  Players can look at other players’ headbands, but cannot see their own.  Each player must ask questions about their word, and give others clues for theirs (e.g., “Is my word an animal?’).

Catch Phrase Junior. This high-energy game encourages the use of vocabulary, verbal descriptions, categorization, synonyms, and word definitions.  Players are given a word and must try to get team members to guess what it is without actually stating the word.

Cranium Junior. This entertaining game also encourages the use of vocabulary and word meanings while tapping into the various senses.  Players are given a question card and must act, hum, draw, or sculpt the answer to help their teammates guess what it is.

Apples To Apples Junior. This interactive game encourages the use of vocabulary, word meanings, synonyms, and categorization.  Players are given a stack of cards, each with a different word (a person, place or thing).  A descriptive word is then placed in the center of the game and players must choose a card from their stack that best fits the description.

5 modifications for kids with language difficulties:

Each of these games relies heavily on language skills. Therefore, a child with language difficulties might find these games challenging.  To help, here are a few ways to modify each game so that your child feels more successful.  I advise using the modifications for all players, instead of singling one child out.

  • Extend the time allowed for each turn. Instead of using a sand-timer, use your own timer on a smartphone or stopwatch to allow each player more time to complete tasks.
  • Eliminate timing altogether.  If you notice your child crumbling under the time pressure, just eliminate timers altogether.  After your child has had practice with the game and feels more confident, you can slowly reintroduce the timer.
  • Adjust the vocabulary words. If your child seems unfamiliar or overwhelmed by the vocabulary in the game (e.g., Apples to Apples), create your own playing cards with more suitable vocabulary for your child.
  • Encourage note-taking. Games such as Guess Who and Headbanz rely on memory.  If your child seems to have difficulty remembering clues, encourage him/her to write things down during the game (e.g., my headband is an animal, it lives in the zoo, it has stripes, etc).
  • Provide lots of encouragement. Discourage any negative comments from players, while encouraging positive comments instead (e.g., “good try” or “nice job!”).  Give your child positive and descriptive praise for anything they are doing well (e.g., “Wow, you are showing great sportsmanship” or “That was an excellent question to ask.”)

Above all, have fun!  Games provide an excellent avenue for learning, but more importantly, they provide a fun and engaging way to spend time together.  By incorporating your child’s speech and language goals into games, your child will learn and practice without ever hearing those dreaded words, “more homework.”  Ask your child’s speech-language pathologist for more fun activities to address their speech and language goals at home.

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Sample Activities to Increase Oral Awareness!

Development of oral facial muscles is important for a child to accurately produce speech sounds. Poor coordination and strength of articulators can adversely affect skill development for speech sound production. When looking at oral development it is important to ensure the child is provided a variety of movement opportunities to build a variety of oral skills. Movements should include movements of the jaw, tongue, and cheeks to build strength and coordination.

Father practicing oral awareness with child

Below are sample activities to do at home to increase oral awareness and movement

  1. Gather two sets of 5 items varying in size, texture, shape, and temperature. For example; ice, a tongue depressor, straw, teething toy, and straw. Encourage your child to use each of the objects in oral-exploratory play. Imitate your child’s movements and comment on what your child is doing and how it makes the mouth feel.
  2. Mirror play! Have your child sit with you in front of a mirror. Explain that you will be playing a “clown” game. Feel free to dress up in silly hats or clothes to play the game! Instruct your child that you will be taking turns making silly faces in the mirror and copying each other. With your models, make sure you do a variety of tongue movements. Stick your tongue out, move it side to side, lift up the tip up to touch your nose. Have your child practice the movement 2-3 times before it is his or her turn to put the clown hat on.
  3. Play musical “chairs”. Choose objects around the house that include a target sound. For example if the target sound is “b” you could find a book, bear, bottle, bread, and bowl. Place pieces of paper on the floor, with the item on the paper, in a circle. Have the child walk from sheet to sheet until the music stops. Once the music stops, have your child say the target word they land on. You can also write the word on the pieces of paper to increase print sound awareness.
  4. Cut an egg carton in half lengthwise, turn it upside down, and color or paint each of the 6 protruding sections a different color. Next, find a puppet or an animal with a large mouth. Find small “food” items to feed the puppet. These could be marbles or pretend food. Tell your child that you are going to sing silly songs to help feed the very hungry animal! Model a sequence of three sounds varying in intonation tapping the egg cartons to pace each sound as they are sung. Different intonation patterns can include rising/falling pitch or increase/decreased loudness on individual sounds. For example, “ ba BA ba”. Think of the NBC studio signature tone. Once the silly song is imitated you can feed the hungry animal! Using rhythm and a singsong voice has been proven to help facilitate speech output.

These activities will encourage oral motor development in a fun and exciting way. Your child will be learning and exploring and improve his oral awareness in the process!




Smartphone Technology and Language Development: Pros and Cons

iPads, iPhones and apps.  Today’s buzz is all about Smartphone technology and what “apps” will benefit development and academic skills in children.  Parents frequently request recommended apps to best address their child’s speech and language skills.  After all, we want to take advantage of the latest learning tools and most cutting edge technology to help our kids succeed.  However, use of Smartphone technology should be approached with caution.  Like all good things, moderation is key.

Here are a few important points to consider before integrating Smartphone children on phonestechnology into your child’s daily routine:

Pros: What are the positive benefits of Smartphone technology?

  • Smartphone apps provide excellent “drill” style activities to teach specific skill sets, such as vocabulary building, phonologic awareness, articulation skills, and learning new concepts.
  • Devices such as tablets, Smartphones and iPads expose children to modern day technology, improving their computer literacy and ability to navigate such tools.
  • Smartphone apps provide a fun and entertaining activity for children. This can be excellent choice for breaks from homework, rewards or car-rides.

Cons: What are the negative effects of Smartphone technology?

  • Smartphone apps promote passive learning and provide little opportunity for creativity, social interaction, problem-solving, sustained attention, ideation, and make-believe. All of these skills are foundational to development in children by promoting motor skills, language learning, problem-solving, and social skills.
  • While Smartphone apps may encourage children to talk or practice sounds, they do not encourage children talk to an actual person. Language is a reciprocal social system, intended for communication between people. It’s critical that children learn to communicate with others in a reciprocal context.
  • Smartphone apps do not promote the use of novel language.  A critical part of language development includes the ability to arrange words into combinations, building sentences to communicate their thoughts and ideas.
  • Smartphone applications offer little opportunity to learn social skills. Social skills include interpreting nonverbal cues, making eye-contact, initiating conversation, and responding to others.
  • When it comes to learning, practicing skills in context is critical. So even though Smartphones might teach children new skills, they do not offer opportunities for children to generalize these skills in a real-life context.

So what can parents do?

Here are a few practical steps as families navigate their child’s use of tablets, Smartphones and iPads:

  • Think moderation. Limit your child’s use of electronics, and set boundaries ahead of time so your child knows what to expect.
  • Encourage activities that encourage creativity, social interaction, problem solving, sustaining attention, ideation, and make-believe. A few good choices include blocks, dress-up, play-doh, books, pretend food, and baby dolls.
  • Spend face-to-face time with your child every day. Encourage your child to participate in play with you and encourage their use of their language, facial expressions, eye-contact, and engagement.

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