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Attention Span in Toddlers and Preschoolers

2/27/2018

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What is a normal attention span in toddlers and preschoolers? A while ago I found an article from day2daparenting.com that gave a nice, specific details age by age. There were no specific references, and I was hesitant to share it at first.  I dug a bit deeper and found studies (Gaertner et al., 2008; Conejero and Rueda, 2017)  that aligned nicely with the information in this article, so I am sharing it here:
 
         
Average Attention Span By Age Group:


8 – 15 months
Any new activity or event will distract your child, but they can usually attend for one minute or a little longer to a single toy or activity.

16 – 19 months
Your child might be restless, but is able to sustain attention to one structured activity for 2-3 minutes. Your child might not be able to tolerate verbal or visual interference.

20 – 24 months
Your child is still easily distracted by sounds, but can stay attentive to an activity either with or without an adult for 3-6 minutes.

25 – 36 months
Your child can generally pay attention to a toy or other activity for 5-8 minutes. In addition, he/she can shift attention from an adult speaking to him/her and then back to what he/she was doing if he/she is prompted to focus her attention.

3 – 4 years
Your child can usually attend to an activity for 8-10 minutes, and then alternate his/her total attention between the adult talking to him/her and the activity he/she is doing independently.

5-6 years
Children typically can attend to one activity that is of interest to them for around 10-15 minutes at a time and should generally be able to filter out small distractions occurring simultaneously in the environment. They may only be able to attend to an assigned classroom activity for only 5-10 minutes particularly if they find it uninteresting or difficult for them and do not have adult guidance to stay on task. Small groups of children may be able to play together for 15 minutes or up to a 1/2 hour if they are engaged in novel, interesting play activities.

http://day2dayparenting.com/qa-normal-attention-span/
https://www.omicsonline.org/open-access/early-development-of-executive-attention-2375-4494-1000341.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2607062/#R62
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Good Night Sleep-Why It is Important

2/10/2018

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​On importance of HEALTHY BREATHING and GOOD NIGHT SLEEP.

Below are some interesting points from an article recently published in one of professional publications.

-EVEN SMALL DISTURBANCES in breathing can have substantial (and negative) effects on a child's functioning, health and behavior.

-AIRWAY FUNCTION DISORDERS  can interfere with language, learning and academics, executive function skills, socialization, self-regulation, and behavioral and emotional health in children.

- such issues as INCREASED FIDGETING AND HYPERACTIVITY, DECREASED ATTENTION,  POOR MEMORY, IMPAIRED EXECUTIVE FUNCTION SKILLS, POOR ACADEMIC PERFORMANCE, DECREASED SELF-REGULATION, and  INCREASED AGRESSION may be associated with underlying airway function disorders

-SLEEP-DISORDERED BREATHING (SDB) can lead to reduced oxygenation of the brain, change in neural physiology and function, and a lack of restorative sleep essential to optimal daytime functioning.

-RED FLAGS that may indicate sleep-disordered breathing: 
Cessation of breathing and/or gasping for air—this warrants immediate attention from a physician.
Snoring.
Audible breathing.
Open mouth posture.
Grinding teeth (nocturnal bruxism): a micro-arousal that alerts the body to breathe.
Frequent arousals leading to fragmented sleep.
Restless sleep.
Night terrors, sleep walking.

-THE ABILITY TO BREATHE EFFORLESSLY AND QUIETLY THROUGH THE NOSE  with the tongue suctioned up and the lips gently closed is essential to optimal craniofacial growth and development. Healthy nasal breathing supports proper chewing, swallowing, speaking, and overall body posture.

- Appropriately trained and experienced SPEECH-LANGUAGE PATHOLOGIST is an important part of an interdisciplinary team and can provide key management of abnormal breathing patterns and oral functions within orofacial myofunctional treatment programs.

Adapted from: leader.pubs.asha.org/article.aspx?articleid=2671816

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Tempt Your Child to Talk

10/8/2017

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      Today I want to talk about some ways to help your child begin to talk.  

      For a child to become an active participant in communication, there must be a need, an opportunity, and a reward for their efforts.  Creating a reason to communicate is one of the most important things we can do to help children develop communication skills. In other words, we DO NOT have to anticipate their needs! I know, it sounds harsh, but think about it… By not anticipating, we give a child an opportunity to show and tell us what he or she wants or needs. When a desire is fulfilled, this is rewarding for a child, and there is a great chance that he or she will try the communication method again.

        Creating Communicative Temptations (this term was formalized by Wetherby & Prizant in 1989) is one way to create a need for communication. This is exactly what it sounds like: setting up the environment in such a way as to tempt a child to communicate with us.

     Here are some ways to tempt your child to request:
  • Give your child a toy that requires your help to operate and wait.
  • Give your child a coloring book, but nothing to color with. Hold a crayon out of reach and wait.
  •  “Forget” to give your child a spoon for her yogurt and wait
  •  Put him in the swing and wait.
  •  Give a favorite book to her, and wait.

     Here is an example:
  • Give your child a hard to open container of bubbles or a tub of playdough. DO NOT OPEN IT.  WAIT…  
  • Waiting is an important part of this process. We want to give a child a chance to communicate first, to initiate the communication.
  • When he communicates (through a gesture, a grunt, a point, a sound, a word)
          - provide a MODEL of what you want him to say: “Open” or “Open bubbles” or   “Mommy open bubbles” or “More bubbles please”.  Say it as a statement, not with a rising intonation of a question
         - Give him what he wants
         -and cheer him on!
  • Next time wait just a little bit after you provide a model and see if your child will repeat. Don’t wait too long (we want to give him opportunity to communicate, not become upset and distressed).
 
Here is another one:
  • Have a favorite snack visible, but in out of reach place (put it in a clear hard to open box or on top of the refrigerator).
  • When your child indicates that she wants a cookie (maybe she points or reaches),
         -Provide a model (“Cookie”, “Want cookie”, “I want cookie”),
         -Wait for her response just a bit before giving her the treat.
         -Cheer her on!
 
A model you are going to provide for your child depends on his or her level.
  • if your child is not saying words yet, model one word (“open”),
  • if he uses single words, model two words (“open bubbles”),
  • if she is combining 2 words together, provide 3 words phrase (“green play dough”)
 
Do not get discouraged if he or she does not repeat on your first attempt to implement communicative temptations. Be persistent and it will work.
 

Here are a few more ideas
(
from http://childdevelopmentprograms.ca/elearning-modules/the-power-of-play/story_content/external_files/Communication%20Temptation%20Ideas.pdf):
  • Hold a ball as if to throw or roll it, and wait.
  • Pour only a little water in your child’s cup let him drink it all and wait.
  • Give your child a little bit of food at a time let her eat it all and wait.
  • Put the food in large family style serving bowls on the table, give your child an empty plate and wait.  
  • Give your child food in a package he cannot open on his own, and wait.
  • If your child likes toys in his bath, let her get into the water with no toys, and wait.
  • Play with a puzzle. After your child has put in 2 or 3 pieces, offer your child a piece that does not fit and wait
  • Initiate a familiar and an unfamiliar social game with your child (like "peek-a-boo") until she expresses pleasure, then stop the game and wait.
  • Engage your child in an activity with a something that can be easily spilled (or dropped, broken, torn, etc.). Suddenly spill some of the substance on the table or floor in front of your child and wait.

Remember, you are not being mean! You are creating the environment for your child to become an excellent communicator!
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Ten Ways to Enrich Your Child's Language While Apple Picking

9/8/2017

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Going apple picking this weekend?  With the apple picking season upon us, why not use this opportunity to enrich and develop your child’s language? These are ten things I came up with. Feel free to share yours!​
​1.  
Who can come up with most words to describe apples? Red, smooth, juicy, round, smooth, tart, crunchy, cold, rotten…     you got the idea.

2.  What can we do with an apple? Eat, slice, peel, core, bake, pick, bite, chew…

3.  Where do apples grow? On the apple tree! Talk about parts of the tree: trunk, branches, leaves, roots, bark. Find these parts on different trees.

4.  What parts does an apple have? Skin, core, seeds, stem, flesh. Which part do we eat? Or don’t?

5.  You can talk about apples that grow high or low on a tree, or fell on the ground, or grow near/far from the trunk.

6.  Talk about what food you can make with apples: apple pie, apple sauce, caramel apples, apple juice. Did I miss something? 

7.  If you decide to actually make a recipe, this is an excellent opportunity 
-to discuss what ingredients and equipment you need to make it
-to talk about HOW you will make it (what the steps are)
-to help your child recall and describe the steps after you are done
- to enjoy the shack


8.  Count the apples. Who has more? Less?

9.  Find the biggest/smallest one. Compare the apples: big-bigger-the biggest, small-smaller-the smallest.

10.  Don’t forget to talk about the hay ride, lots of vocabulary there too.  
 ​
As always, if you have questions or concerns about your child's speech, language, play, or communication, talk to the speech therapist www.slp4u.com/contact.html
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What is Early Intervention?

9/4/2017

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Let's talk about Early Intervention (EI) programs.

We know now that the earlier the child receives the services, and the earlier the family receives the support they need, the better the outcome is. Every state in the United States has an Early Intervention program for children from birth to three years of age. Through these programs children who qualify for services can receive speech, occupational, and physical therapy, as well as developmental intervention and other services. After three years or age the the preschoolers may continue receiving services through the school districts.

An important thing to know about Early Intervention program is, that anyone can refer a child to an evaluation: a parent, a guardian, or a doctor. You, as a parent, can call the state’s early intervention program and request an evaluation. One way to start the phone call is: “Hello, my name is so-and-so, I want to refer my child for speech and language evaluation. I have concerns about my child’s development”, or “I have concerns that my child [is not speaking yet] [is not saying words correctly] [does not seem to understand what is said to her]”. The EI program representative will walk you through the next steps.
In the State of NJ, Early Intervention evaluations are free, however therapy is not, and the cost is based on the family income. If your child indeed qualifies for early intervention, a speech therapist (or a another professional, depending on your child’s needs) will come to your home and work with both you and your child, set up specific goals, and give you specific strategies and advice tailored to the needs of your child and your family.

If you think that your child may have problems with speaking, understanding, or hearing, trust your instinct and get evaluation through the early intervention program. Many times the advice you hear from friends, family, and even pediatricians is to wait and see, but if you feel that something is off, it may be worth checking it out. Pediatricians have checklists and questionnaires that they use to determine whether or not a child is developing appropriate skills, but they do not provide as comprehensive and detailed information as what a speech-language pathologist would be looking for. A speech therapist can give you a clear picture of what your child’s skills are now, what you should expect to see next, and how to get there.

You can find the links to NJ Early Intervention Questions & Answers as well as to developmental milestones here: http://www.slp4u.com/helpful-links.html
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Speech Sound Development

8/19/2017

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My friends with young children often ask me to listen to their kids’ speech: “Anna doesn’t say /r/”, “Matthew says “top” instead of “stop”. Is it time to see a speech therapist?”   
Today, let’s talk about speech and sound development.
 As very young children learn to speak, they simplify the adult speech. They do this because their young brains, lips, and tongues are not mature enough to process and produce adult-sounding speech. They just cannot put correct sounds in correct places in words and sentences yet.   Most of the times the mistakes in the young children’s’ speech are not random and follow the certain predictable patterns, which are called Phonological Processes. All kids use phonological processes as they begin to speak.  When your toddler says “tup” instead of “cup”, she is using a phonological process of fronting, when a child says “cap” instead of “clap”, he is using cluster reduction, and when you hear “too” instead of “shoe”, you hear stopping.
As children mature, their mastery of language increases, phonological processes gradually disappear, and the young child’s speech becomes clearer and more adult-like.  Many of the phonological processes disappear by the age of three, and all of them are expected to resolve by the age of 5.
A typically developing 4-year-old is fully intelligible, but still makes some speech sound errors.
 
Here is a guide to speech intelligibility (how clear a child’s speech is to others):
  • By the 2nd birthday, parents should understand at least 50% of what their toddler is saying.
  • By the age of 3, 90-100% of what a child is saying should be completely intelligible to the parents, and 75% - to strangers.
  • By the age of 4, strangers should understand most of what the child is saying (90-100%)
 
Here are some (but not all) examples of phonological processes and ages by which they are expected to be eliminated:

Disappearing by the age of 3:
Unstressed syllable deletion is omitting a weak syllable (banana = nana)
Final consonant deletion is omitting a consonant at the end of a word (Cat=ca)
Fronting is substituting a front sound for a back sound (Can = tan)
Reduplication is repeating phonemes or syllables (Water = wawa)
 
Disappearing after the age of 3:
Cluster reduction is omitting one or more consonants in a sequence of consonants (Clean = keen) 
Gliding is substituting /w/ or /j/ for another consonant (Run=wun, Lego=yego)
Stopping is substituting a stop consonant for a fricative, liquid, nasal, or glide (Zoo = doo, chair = tair, shoe = too)
 
For a complete list of the phonological processes, their descriptions, and ages by which they should disappear go to
http://www.speech-language-therapy.com/index.php?option=com_content&view=article&id=31:table3&catid=11:admin&Itemid=117
 
Here is a quick look at sounds and ages at which 85% of the kids master them. Note that many children may and will learn to produce these sounds correctly earlier. (This information is adapted from Goldman-Fristoe Test of Articulation, 2-nd edition)
2 years old:
Beginning of the words: b, d, h, m, n, p,   
Middle: b, m, n   
End: m, p

 
3 years old:
Beginning of the words: f, g, k, t, w
Middle: f, g, k, ng, p, t,   
End: b, d, g, k, n, t

 
4 years old:
Beginning of the words: kw    
Middle: d   
End: f

 
5 years old:
Beginning of the words: ch, dz, ts, sh, j, bl
Middle: ch, dz, ts, sh, j, bl
End: l, ng, ch, s, sh, dz, r, v, z

 
6 years old:
Beginning of the words: r, v, most consonant clusters such as br (break), fl (fly) and others  
Middle: r, v   
End:

 
7 years old:
Beginning of the words: th   
Middle: th  
End: th

 
Talk to a speech-language pathologist if your toddler
  • Cannot pronounce vowel sounds (a, o, u, i, y) by the age of three
  • Omits many consonant sounds in the beginning of words (oo instead of shoe) by the age of three
  • Produces back sounds k,g, h in place of other sounds (kiger instead of tiger) in any age
  • Continues to omit final consonants past the age of three.

For more about speech sound development, go to:
http://teachmetotalk.com/2009/08/31/speech-sound-development/
 
If you are concerned about your child’s speech and language development, talk with a speech-language pathologist:
http://www.slp4u.com/contact.html
​
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Bath Time Fun and Language

8/11/2017

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Bath time is an excellent time to connect with your child and to enrich and encourage your child’s language development.  It is repetitive and familiar, so you can discuss the steps: “First we poor water in the tub, then we take the clothes off, then get into the tub, etc”.  Talk about all actions you are doing and ask your child what happens next. 
Many parents use bath time to read books and sing songs with their children.  Here are some more things you can do to make bath time even more fun. (Think about all the wonderful words you can teach your child while playing):

1. Wash a baby doll. The doll may happen to have dirty hands, nose, tummy, back, toes, etc. You could wash the doll using soap, shampoo, washcloth. Rinse it with water, poor water over the doll, dry with the towel. And now your baby doll has clean toes, fingers, hair, knees, elbows, eyes

2. Play with the wash cloth. Wash it, twist it, watch the water drip, wring it, squeeze it, pull it.  Hide your face behind it and play peek-a-boo. Hide the little toys under/inside it. Use it to wash the toys

3. You could poor water in/out of cups and containers of different sizes and colors. The cups will be dry/wet, empty/full, have more/less/some water

4. Toy fish could swim in/out of the cups, splash, jump high/low, in/out of the water, swim up/down, side to side, backwards and forward, fast and slow

5. Other animals could also jump and splash in the water. You could catch them with the net, put them in a toy boat, count, wash, and hide in the soap bubbles.

What games do you play with your child during bath time?
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Play games - Practice language skills

7/14/2017

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We are busy!  Things get hectic!  Here are a few games that you can play with your preschooler-kindergartner child while driving, waiting for an appointment, or at home on a rainy day. Play games, have fun, practice language skills.

  1. Categories. Select a category (farm animals, white foods, furniture, funny things, etc.). Take turns naming an item in a category.
  2. Rhyme Time: Practice creating rhymes for things children see from the car window or in the environment around them. (hat-cat, knee-me, house-mouse).   
  3. Match the sound. Decide on a sound (not a letter, as some sounds are made by two letters: ch, sh, th). Take turns naming words beginning or (to make it more challenging for older kids) ending with that sound.
  4. Guess that word. Say simple words sound-by-sound. Have your child guess the word (d-o-g = dog, m-a-p=map, s-a-n-d=sand).  
  5. Mind Reader. One player chooses a familiar object and gives three clues about it (it’s sweet, it’s cold, it comes in a cone).  Other players try to guess what it is.  Variation can be other players ask yes/no questions in order to guess the item (do you eat it with the spoon? Is it soft?)
  6. Cities and Syllables:   As you pass through different towns, cities, or states, children can practice counting the number of syllables in that city or state’s name. For example, when passing through Idaho, the child counts or claps out three syllables. When passing through Tallahassee, the child counts/claps out four syllables. 
  7. Can You Find Them?. Ask your child to look around and name all round things in the room, then all red, square, soft, smooth, etc. For the younger kids use simple characteristics (color, simple shapes). For older kids use more advanced features (smooth, rough, wooden, plastic, soft, etc)
  8. Opposites. Say a word, ask your child to say a word with the opposite meaning (big-little, white-black, good-bad). 

​

Adapted partially from:  “Practicing Language Skills in the Car?” by Erica Zollman, M.Ed., CCC-SLP,  Handy Handouts® # 402 www.handyhandouts.com • © 2016 Super Duper® Publications • www.superduperinc.com

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Tongue Thrust

6/10/2017

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What is Tongue Thrust?
​

Tongue thrust is a habit of pushing the tongue against or between the front teeth during swallowing and/or speaking, and, sometimes, at rest. Every time a child swallows, his teeth are pushed forward by the pressure of the tongue. This habit can cause problems with dentition, biting, chewing/eating, and speech.

Tongue thrust swallow is normal in infancy, but it usually decreases and disappears as the child grows and begins to eat solid food.   If this does not happen, a trained speech language pathologist (SLP) can help re-train the muscles to a normal swallowing pattern. In a normal swallow, the teeth usually come together, the lips are closed and relaxed, and the tongue is held against the roof of the mouth behind the upper front teeth.


Causes of Tongue Thrust

Tongue thrust can be caused by several  factors:

Allergies, enlarged tonsils and adenoids: Allergies and enlarged adenoids can make it difficult to breath normally through the nose.  When the tonsils are enlarged and the nose is blocked at the same time, the back of the tongue has no room, and has to come forward (otherwise the child can't breathe). The child develops open mouth posture and forward placement of the tongue during speaking, swallowing, and at rest. 

Excessive thumb/finger sucking, prolonged use of bottles and pacifiers  also  encourage forward placement of the tongue and immature swallowing pattern.

Family heredity
  is another causes of tongue thrust. 

Consequences of Tongue Thrust

Speech: Some children produce sounds like S, Z, SH, ZH, CH, J incorrectly with the tongue tip protruding between the front teeth.  “Sun” may sound like “thun” and “shoe” – like “thoo”. Also, the sounds T, D, N, and L may be distorted because of weak tongue tip muscles. However, in some cases speech may not suffer at all.

Dentition: The pressure of the tongue against the front teeth may result in malocclusion or misalignment of teeth, such as open bite. Open bite occurs when  the upper and lower front teeth do not come together when the mouth is closed. The result is a gap or opening between the rows of teeth when the jaws are closed.  

Tongue thrust can reverse orthodontic work that has already been done.

Eating:  Tongue thrust swallow may cause messy and noisy eating.  A child may chew food with his/her lips open, take large bites, and swallow before completely chewing the food. This may also cause an upset stomach from swallowing too much air while eating.

How can tongue thrust be corrected?

A speech language pathologist will develop a treatment plan to remediate tongue thrust. The tongue thrust therapy is different from articulation therapy and will include goals such as:
​
• decreasing unhealthy oral habits (e.g., thumb sucking)
•  improving swallowing pattern and eliminating open-mouth posture
• improving muscle coordination and strength
• improving articulation skills

For success in this therapy, consistent exercise every day is necessary until the correct swallowing and muscle pattern becomes a habit.   

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