Making Food Fun!

5 Playful Ideas to Try When Presenting a New Food to a Child with a Limited Diet

Heather Celkis, OTR/ Capital Area Speech & Occupational Therapy www.capitalareaspeech.com

Making Food Fun!

Reasons Tolerating New Food is Difficult

There are many reasons a child may have difficulty tolerating new foods. These reasons may include but are not limited to difficulty swallowing, difficulty moving the food efficiently within the mouth (oral motor skills), gastrointestinal issues, swallowing difficulties, poor postural control, respiratory difficulties and poor sensory processing. A child who has a very limited diet should be assessed by his or her pediatrician and referred for further testing by a specialist and/or therapy by a professional such as an occupational therapist or speech therapist.  It is important to rule out medical issues that may impact a child’s ability to eat.

Steps to Introducing New Foods

For many children with difficulty with sensory processing and tolerating novelty, the first step to trying a new food is interacting with it, tolerating it on a plate, smelling and playing with it. Yes! We should be encouraging these kids to play with their food!

The following are a few helpful and playful ideas for introducing new foods:

1. Place just a few bites of food on the plate. If the child has a whole plateful of novel food they may become overwhelmed and feel that they will be pressured to eat all of the food presented.
2. Use the food to paint a paper plate with sauce. For example, use a piece of broccoli to brush cheese sauce on a plate. Make patterns with the sauce by using the broccoli as a stamp.
3. Use some familiar foods with a few pieces of novel food and arrange them to make a picture such as a smiley face. Take turns making the face as silly as you can.
4. Stack the food like blocks then knock them down. Bread cubes, crackers and carrot slices are great for stacking.
5. Have a pretend tea party and feed the animals and dolls the novel foods. This is a great way to encourage a child to interact with a new food while not expecting them to eat the new food yet.

Children are more likely to try a new food if they are allowed to explore it at their own pace so be patient and above all have fun!

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Handwriting

This blog post was written by one of our outstanding occupational therapists.

Occupational Therapists frequently receive referrals to work on handwriting. But why does handwriting matter? Simply put, it’s been an important method of communication for thousands of years, and continues to be important for everyday life. In school, at work, when completing application forms, and planning our days, people often pick up their pens. However, in these times of increasingly advanced technology some people wonder if handwriting is becoming obsolete. In some ways perhaps, but there are many reasons that it shouldn’t. For one thing, the simple act of writing helps with brain development. Increased brain activity occurs whenever we use this complex skill in a way that does not happen when we type. This is because writing involves fine motor skills, spatial skills, eye-hand coordination, memory, and planning. As a child, the development of neural connections through writing is incredibly important. Secondly, studies have shown that when we write things down (think classroom notes, grocery lists, and to-do lists) we are more likely to remember them. Additionally, for purposes of safety, writing can also be important. If for some reason, we become unable to communicate verbally (in incidences of injury, for example) writing can become a primary form of communication.

What does it mean to have “good” handwriting? Generally speaking, it means that the writing is legible, and there are several pieces to the puzzle when it comes to legibility, including motor skills, visual skills, and the combination of the two. Let’s take a look at this through different age groups.

Preschool and Kindergarten

At this age:

• Kids are playing fine motor games and doing simple eye-hand coordination tasks like drawing pictures, learning to color within the lines of a shape, trace simple lines and shapes, learning to use scissors. By age 5 or 6 they are using one hand predominantly, with the other hand as a helper. In kindergarten they are learning how to write letters and draw more challenging shapes.

Things to look out for:

• A fisted or otherwise awkward grasp on crayons or markers, from age 3 and up.
• Difficulty copying simple shapes (lines and circles) or starting to draw features of people and common objects.

What you can work on:

• To get little hands ready to hold a pencil (down the line), have them pick things up with tweezers, bread tongs, or clothespins; play with finger puppets; fingerpaint with a different color on each finger; play crawling games to help develop the muscles in their hands; and color with small pieces of crayon or chalk (like one-inch long).
• To get them ready for more precise eye-hand coordination, have them put stickers onto designated spots as part of arts and crafts activities, do simple mazes, string beads with holes of different sizes, and play with constructional toys.
• To help establish hand dominance, never force them, but have them play with games that involve using both hands together, such as toy nuts and bolts, wind up toys, and grinder or crank toys (like some play-dough toys).

Elementary school

At this stage:

• Writing becomes an increasingly important skill, and by the upper grades the majority of the child’s work is likely to be handwritten. Kids complete worksheets, journals, answer questions about reading assignments, and later on write paragraphs on notebook paper.

Things to look out for:

• Difficulty with letter formation, letter size, spacing between letters and words, and letters that float or sink below the baseline.
• Messy but fast writing; or neat but slow writing.
• Difficulty learning cursive.
• Hands getting tired easily.

What to work on:

• Perceptual tasks such as puzzles, spot-the-differences, and hidden pictures.
• Precision tasks such as mazes, dot to dots, mirror image drawings, and grid drawings.
• Adaptations to the type of paper/lines your child is using; adaptations to the pencil/writing tool

Middle school and high school

At this stage:

• Your kids are taking notes in class, and often have worksheets to complete as well as longer written assignments.

Things to look out for:

• All of the same signs as in the elementary age group.
• Teachers and other people having difficulty understanding what the child has written.
• Avoidance of work.

What you can work on:

• Talk to an occupational therapist about adaptations that can be made to the tasks, setting, or materials used if writing is posing a significant challenge.
• Depending on the child’s strengths and needs, it may be helpful to revisit cursive as an alternative to printing.
• Children should start becoming more proficient with typing at this stage.

If you have concerns about your child’s writing, talk to his or her teachers about school strategies, and consider an occupational therapy screening to find out more information about what can be done to help.

References:

Handwriting Without Tears (2013). Research Review. Retrieved January 23, 2015 from http://www.hwtears.com/files/HWT%20Research%20Review.pdf

Handwriting Without Tears (n.d.). Importance of Handwriting. Retrieved January 23, 2015 from http://www.hwtears.com/hwt/why-it-works/handwriting-standards/importance-handwriting

Konnikova, M. (2014, June 2). What’s lost as handwriting fades. New York Times. Retrieved February 5, 2015 from http://www.nytimes.com/2014/06/03/science/whats-lost-as-handwriting-fades.html?_r=0

Mueller, P. A. & Oppenheimer D. M. (2014). The pen is mightier than the keyboard: Advantages of longhand over laptop note taking. Psychological Science, 25(6), 1159-1168.

The University of Stavanger. (2011, January 24). Better learning through handwriting. ScienceDaily. Retrieved January 23, 2015 from http://www.sciencedaily.com/releases/2011/01/110119095458.htm

What Does a Speech Pathologist Know About Language and Literacy?

Jamie Putnam, speech language pathologist and owner of Capital Area Speech Therapy, has been providing in-service opportunities to preschool/kindergarten programs around our area. The following is information gathered from Jamie’s lectures.

Speech pathologists are often portrayed as the ones who “fix the sounds”. There is no doubt we spend time working on the “r” sounds, a lisp, or a number of other sounds. Those sounds, however, are only a small percentage of our qualifications. 

What about language and literacy? Are they related? What do speech pathologists know about language and  literacy?

Language and literacy is a symbiotic relationship. These skills develop together. Research shows  that children who enter school with strong oral language skills learn to read and write easier and excel in school related to their peers who struggle with language skills.

Language disorders are seen in as many as 1 in every 5 children. Research indicates that the majority of children with language disorders will go on to having reading difficulties or disorders. 

What does early language and literacy development look like?

AGE	LANGUAGE DEVELOPMENT	LITERACY DEVELOPMENT
12-18 mos.	Rapid language acquisition & word explosion	Enjoys books as toys Likes to turn pages Loves predictable stories Points out familiar objects in pictures Likes the same book over and over
18-24 mos.	Rapidly expanding word base and word combinations	Chooses books Knows that books go front to back and right side up-will orient a book Loves predictable repetitive stories Will fill in words
24-36 mos.	Awareness of sentence structure and vocabulary continues to explode	Will correct adult if story is read differently Will fill in words or attempt to tell story Likes repetition and predictability in stories
3-4 years	Uses complex sentences & understands word structure (tense)	Understands that words may be changed and manipulated Rhyming and word play Recognizes name in print Recognizes environmental symbols
4-5 years	Clearly communicates about remote events	Simple sound letter correspondence Letters have meaning Experimental writing, spelling, and story telling

There are five predictors of literacy success.

1. Oral Language

2. Alphabet Awareness

3. Phonemic Awareness

4. Concepts About Print

5. Early Writing With Inventive Spelling

A professor in early childhood education describes these predictors in detail in this You Tube video.

 

 

 

 

What Does An Occupational Therapist Do?

Our OTs Miss Farah and Miss Kelsi put together this informative brochure about occupational therapy.
Occupational Therapy Services
Thank you Farah and Kelsi!

What Can OT and a Sensory Gym Do For Your Child?

Occupational Therapy in the Sensory Gym
written by Kelsi Knife, M.S., OTR (Occupational Therapist)

We are extremely excited about our new sensory gym. It is big, bright, and full of fun equipment! What’s not to love? However, you might be wondering how all of this will help your child meet their occupational therapy goals.

In therapy, we use the gym equipment to improve the fundamental skills that children need to be successful in their everyday lives. With a little bit of creativity, we can use the same activity to address many, many skill areas! Below, I have given some examples of how the sensory gym can help your child reach their OT goals.

Swings: With so many swings to choose from, the therapeutic possibilities are endless! The movement of the swing provides input to the vestibular system, which can be calming or alerting, depending on the child. This can help your child to focus on fine motor activities during therapy. The swings can also be used to build upper body and core strength, improve balance skills, and encourage your child to use both sides of the body in a coordinated manner.

Slide: Like the swings, the slide is wonderful for providing vestibular input. It can also be helpful for children with a fear of heights. Sometimes, we like to change things a little and climb up the slide! This is great for improving full body strength and coordination.

Monkey bars and rings: The monkey bars and rings are great for building upper body strength, endurance, and coordination which are very important skills for fine motor and handwriting development. By having a child pull up their legs while hanging from the bars (to kick over objects, for example) we can also address core strength and, as a result, improve balance and posture.

Zip line: Like the monkey bars, the zip line is awesome for building strength and endurance in the upper body and core. It also helps us teach children to be aware of and regulate their strength and speed.

Rock wall: The rock wall is perfect for working the entire body at the one time! It also requires your child to think about their end goal and create a plan to achieve it. This really exercises their sequencing and problem solving skills.

Obstacle Courses: By combining several pieces of gym equipment we can create an obstacle course that works on a ton of skills at once! Obstacle courses are also great for teaching your child to plan and sequence motor activities. Participating in this type of activity can really improve your child’s self-esteem and enable them to approach new activities with confidence!

These are just a few of the ways that our sensory gym can benefit your child. We look forward to helping them learn and grow, all while having a blast!

Phonological Processing Skills of Children Adopted Internationally – Research Says…

I am joining fellow speech pathologist bloggers in reading and blogging about a recent research related to our field. For more information or to see more research reviews, check out this blog.

I have several amazing friends who have recently adopted or are in the process of adopting children internationally. Over the past couple of years, I have also worked with a few children who have been adopted internationally. For these reasons, I found this study about certain language skills of children adopted internationally to be a great one to review.

Phonological processing skills are very important for oral language and literacy development. Phonological skills include phonological awareness, phonological memory, and rapid naming. Phonological processing skills are referred to as the decoding component of reading. These skills as well as comprehension are essential for reading success.

The children who participated in the study were adopted from China before 25 months of age. The study was performed when the children were between 6 years, 8 months – 9 years, 3 months. They were individually given a formal phonological processing test. Some of the children were receiving speech therapy for articulation or language impairment.

The researchers wanted to find whether children who were adopted internationally had difficulties with phonological processing skills at the school-age when compared with a normative sample of children their age. After formal assessments, the study noted that these children preformed within the average range of scores to the tests’ normative sample.

They also examined whether age at time of adoption had an impact on phonological processing skills at school-age. The results indicated that age at time of adoption was not correlated with reading comprehension or phonological processing skills. It should be noted that this particular study only examined children who had been adopted before 25 months old. Previous studies have found that age of adoption is correlated with later school language skills. These previous studies may have studied a broader age range of adopted children.

Scott, K., Pollock, K., Roberts, J., and Krakow, R. (2013) Phonological Processing Skills of Children Adopted Internationally. American Journal of Speech-Language Pathology, 22, 673-683.

What is Phonological Awareness

Have you heard the term phonological awareness? This term refers to the understanding that language is composed of smaller units including words, syllables, and sounds. Children with good phonological awareness skills are able to hear and manipulate these words and sounds.

Phonological awareness skills are very important for reading success. Speech pathologists work on phonological awareness skills when children have difficulty hearing rhyming words, learning sound/letter recognition, and have difficulty learning to read.

Phonological awareness skills include the following:
-Hearing and producing rhyming words
-Segmenting words in sentences
-Blending, segmenting, and deleting syllables
-Identifying sounds in words
-Blending sounds to make words
-Segmenting sounds in words
-Deleting sounds in words
-Adding sounds in words
-Manipulating sounds in words

Ideas to boost your child’s phonological awareness skills:
-Sing songs or recite nursery rhymes that have rhyming words
-Ask your child to name words that rhyme
-Clap for every word you hear in a sentence or for every syllable you hear in a word
-Ask what sounds he/she hears at the beginning, middle, or end of words (What sound do you hear at the beginning of ‘Saturday’)
-Ask him/her to say a word then say it without a certain sound (Say ‘ball’, now say it without ‘b’)
-Ask him to say a word then change a sound in the word (What would the word ‘cat’ be if you change the ‘c’ to ‘b’)

You can look back to our post on language and literacy here.

SuperDuperInc has easy to read information here

Reading Rockets has good detailed information and more ideas for how parents can help at home too.

Can a Pacifier Hinder Speech Development?

I recently read a blog post about giving your baby a sippy cup on ASHA’s blog. I really enjoyed this post. If you have the chance, I recommend checking it out. The writer is a speech pathologist who works with children with feeding problems.

The blog post discusses why a sippy cup isn’t the best choice when weaning your baby from a bottle. The writer discusses that a sippy cup can cause problems with speech development. Along with sippy cups, pacifiers and bottles can contribute to speech problems if used too frequently or too long.

First of all, pacifiers are a controversial topic. I personally don’t think they are bad when used with an infant. In fact, I think it can be a lifesaver for a tired mom or dad. A pacifier is a great way to help soothe and relax an infant. Some babies will sleep better with a pacifier. It has also been reported that the use of a pacifier at night can reduce the risk of SIDS in newborns.

One problem with a pacifier can be if the baby uses it all the time. This could interfere with opportunities for babbling. Babbling is an important part of speech development.

Another problem with bottles, pacifiers, and sippy cups comes when a child uses them for too long. The baby uses an immature suck/swallow pattern when using a bottle, pacifier, or sippy cup. This can interfere with developing the proper the tongue placement for a normal swallow and for producing some speech sounds.

Ideally by the time a baby is 12 months, he should be weaning from the bottle or pacifier. If your infant uses a pacifier, remember to give her plenty of time to explore her voice.

For more information about this topic check out Mommy Speech Therapy.

Do Speech Pathologists Just Play?

Speech pathologists love to play. A large portion of my time at work is spent crawling on the floor playing and playing board games.

If you peeked in a window during therapy, you may think “why are they just crawling on the floor playing with cars?” Although it looks like all fun and games, there is a plan hidden in all the fun. While we are playing with the pop up toy or racing cars around a mat, we are constantly thinking about what words we will use next and how we will say them.

Each child has an individual set of goals for speech and language. The words the speech pathologist uses in therapy depends on the goals for that child.

The following videos are examples of ways to use toys to encourage words with a 14 month old.


Things to keep in mind when trying to encourage your little one to talk:
*use short phrases
*use words to label items (that’s a banana)
*use words to tell what things do (throw the ball)
*use words to describe items (big block, red shoe)
*model different types of utterances (make comments and ask questions)
*describe where things are (the ball is UNDER the chair)
*GIVE YOUR CHILD TIME TO TALK
*DON’T BE TOO PUSHY

When you model words for your child, give them plenty of time to talk back. Parents often say “Say ball, say it, say ball, come on, say ball.” This does not give the child an opportunity to try. They need time to process the information and attempt to say the word. Instead, try to model the word and wait a while for a response.

How to Use Toys to Build Language Skills

How to Use Toys to Build Language Skills
By Ashley Ward, B.A., SLPA

With the holidays right around the corner, you are likely thinking about which toys and gadgets you will surprise your children with this year. Almost every toy imaginable can be used to build language skills while playing. In imaginative play with dolls or cars, engage in pretend dialogue with your child. This helps build their imaginations while working on vocabulary and sentence structure. Ask your child for descriptions of what is going on during the play session, like what certain characters are wearing and how they are feeling. Below, I have created a brief list of specific ways you can work on language skills with common toys.

Baby Dolls:
In addition to imaginative play with the dolls, you can talk about the different body parts and use accessories (baby bottle, cradle, clothes, etc.) to talk about the baby’s needs and feelings. Use “wh” questions (who, what, where, when, why) to expand conversation. For example, “Why is the baby crying?” “When do you need to feed the baby?” “What is the baby doing?” You can also use these accessories to work on prepositions: “Put the baby under the blanket,” “The baby is in her bed.” If the doll comes with an array of baby clothes, use these to teach the names of these items (hat, bib, pajamas, socks, etc.)

Play kitchen:
There is so much you can do with a play kitchen. If possible, set up a mini grocery store with inexpensive fake food products or even use some of your own. This allows you to teach your child names of all different types of food. While cooking, ask your child to describe how they are preparing the food. Again, this is a great opportunity to work on prepositions: “Put the meat in the oven,” “The pan is on the stove,” and verbs such as stirring, mixing, pouring, opening/closing containers, etc.

Doctor Set:
Go through the doctor set with your child and have them try to describe what each item is used for. What is a stethoscope used for? Why do doctors use a thermometer? Why would a patient need a cast/sling? Your child may have some trouble with this depending on their age, so they may need you to help them explain. Doctor sets are great for social/pragmatic play with turn taking. Your child can play the doctor first, asking you for your symptoms using “wh” questions and using the play tools appropriately based on their function. Then, switch roles and have your child play the patient by having them describe how they are feeling: “How do you feel when you’re sick? Tired, grumpy, nauseous?”

These are just a few ideas of ways you can incorporate and promote language development with play. We at Capital Area Speech wish you and your family a wonderful holiday!