Sunday, February 27, 2011

FAQ #2 GET THAT BABY ON THE TUMMY - BUT WHY?

You have a baby and one of the first things you hear from the pediatrician, your mother, your grandmother,  and your mother in law is "MAKE SURE THAT BABY GETS ENOUGH TUMMY TIME!"

While this is a great point (and a frequently asked question for us as Early Intervention therapists) did you ever wonder WHY?

Tummy time, or time resting or playing on a firm surface is important for plenty of reasons, but here are a few of the most important. Tummy time....
* Strengthens your baby's anti-gravity muscles, or the muscles that help eventually lift your baby off the ground..lifting their head to look around, shoulders to roll, torso and limbs to crawl and to sit up, and eventually their whole little self to come to stand and walk. Think of this as an equivalent to your own workout. You know without the crunches you won't get the abdominal muscles you want. Without the practice on the tummy, these muscles won't get strong enough to help baby explore and meet milestones.
* Improves visual strength and hand eye coordination by allowing practice focusing on gazing at the hands while pushing the belly off the floor at the same time. 
* Facilitates a well shaped head. Your baby's skull is still pliable. Too much time resting against a surface can actually flatten the skull and shift one side more forward than the other.
* Helps develop muscular arches in the hand important later on for picking up small objects and for accuracy and success with handwriting.
* Can aid in digestion.

The Back to Sleep Program was implemented to reduce the risk of infant deaths from SIDS. This program has been very successful and is extremely important.  Babies should sleep safely on their backs following guidelines reviewed with a pediatrician, but during their waking hours it's our responsibility as parents to get them on their tummies to reap the benefits listed above.  Think about it this way, before this program, babies slept on their tummies and we saw fewer cases of "developmental delay" or "late walking" because children got strong from exercising those anti-gravity muscles while on their tummies. I am in no way suggesting that we put babies on their tummies to sleep. The risk is just too great, however, we can and should make up that lost tummy time during the day and through play. There are numerous children receiving school based Occupational Therapy for "handwriting" issues.  I can't help but think that lack of exposure to tummy time has played a role in this increased occurrence as well.  I went to a continuing education course where the speaker recommended that we educate parents that babies spend 80% OF THEIR WAKING HOURS ON THEIR TUMMIES! I can confess that I did not do this with daughter #1. I put her on her tummy, She cried. I picked her up. We repeated this routine with a little more tummy time each week. I did change my game plan when it came to #2 and did notice she picked up milestones more quickly.  My point is, that even a little time each hour will go a long way for your child.

Here's some advice to make the tummy tolerable in your home:
1) ALWAYS be present during tummy time and ALWAYS use a firm surface for safety.
2) If your baby dislikes being on the tummy, try a rolled towel or Boppy Pillow under the arms, or placing your baby on your chest instead of the floor.
3) Hang motivators overhead (soft toys or rattles in a play gym are great) or in front (mirror or you!) of your baby.
4) Place your baby on his/her tummy each hour and increase the time by one minute each try.
5) Avoid what I like to call "container syndrome." People give great baby gifts and we tend to use them and move baby from the bouncer seat to the swing to the stroller to the car seat to the exersaucer and back to the bouncer seat. Great, right? WRONG! Where's the floor? Babies can't learn to crawl or roll if they don't practice. Think your floor is dirty? Use that beautiful pack-n-play!

Friday, February 25, 2011

FAQ #1

As early intervention therapists there are some questions we get from parents quite frequently.  These common questions may be ones that you need answers to also.  Today's blog entry is the beginning of our FAQ series that we hope you will find helpful!

FAQ #1 - Is my toddler/preschooler developing a stuttering problem?

Answer:  Probably not.  It is very common for children between the ages of 2 1/2 to 5 years to stumble over their words (repeat the first word of a sentence, repeat the beginning syllable of a word).  At this stage in their development, they are experiencing more complex thoughts and may have a little trouble formulating and speaking in sentences as quickly as their little brain is thinking!  Most children outgrow these normal dysfluencies by the age of 5, however if your child is stuttering for more than six months or if you notice that the stuttering becomes more severe (prolonging the beginning sound of a word "ssssssssnake", opening their mouth to say a work and getting "stuck", tension in their face when trying to talk, blinking their eyes or stomping their feet in an effort to get the words out) you may want to consult a speech-language pathologist for an evaluation.

Here are some tips on how to react to your child when they are "stuttering":

-Stay calm and be patient.  Show your child that you are interested in what they have to say and will wait as long as they need to get their thoughts out.  Do not finish their sentences for them, this may only frustrate them more and make them feel like you are talking for them.
-Model slow, easy speech (think Mr. Rogers).  Hearing this style of talking may encourage your child to speak more slowly and reduce their dysfluent speech.
-Do not call attention to or point out to your child when they stutter.  Increased awareness in your child will only increase their stuttering by making them feel poorly about their speech.

Some helpful websites for any other questions you may have:

www.nsastutter.org/
http://www.stuttersfa.org/
http://www.westutter.org/index.html
Monday, February 21, 2011

Your Own Parent Performance Review

A few weeks ago, while snuggling with my 4 year old, she started one of those silly but wonderful conversations.

"I love you so much Mommy."
I answered: "I love you too."
"No I love you so much you can't count it."
I answered. "I understand cause I love you that much too."
"No I love you all the way to the moon."
"Or to Heaven."
"Which is farther Mom?"

Hmmmm....

I said Heaven and that I loved her that much too, but then I took a turn to be silly and decided I see what she loved about me and maybe what she didn't...a performance review for parents if you will.

She gleefully replied I gave the best hugs and was really good at cooking. She said the rule I made them follow most was not to touch a hot stove (What?! What about the share-treat others as you'd be treated-clean up your stuff before you get other stuff out-how did that make you feel mantra that spills out of my mouth multiple times a day?) and that when she was a mom one day she might do things differently by allowing ice cream before dinner occasionally, but she wasn't quite sure yet.

It hit me then. Of all the rules I try to make them follow, all the meetings and appointments I often have to drag them to, and all the work I do from home while diverting them to other activities, she holds on to two things - that I want her to feel LOVED and SAFE. I took a deep breath and let out some stored up Mommy guilt. Thinking back briefly to my own childhood, I understood her in that moment. Sure there is one or two unjust teenage rules that I still debate with parents, but for the most part, those are the two things I remember the most as well. I never doubted that I was loved and felt very safe - what a gift! I thought I'd share because parents today have plenty on our plates. Our society moves faster than before and for employment reasons many are not living near strong family support systems. Most families don't have the luxury of one parent staying home and even if they do, that parent is often stressed with so much work in the home, that they too feel the guilt creep up. None of us is alone in feeling like we want to be more present or do more for our children who we love all the way to heaven and back. Take your own deep breath this morning, hug your child, play one game with them, and do your best to make your home one that helps them know they are safe. I promise if you do that, you'll pass your performance review with flying colors! Who knows, maybe you'll even get a raise!
After being forced to use my desktop (free advice keep coffee away from laptops, they don't get along), I was looking through some old photos and found this one of our now 4 year old. It made me smile and think of this entry :-) No matter what the age, our children feel our love!


Wednesday, February 16, 2011

Please Mommy Don't Go!

You will never feel more loved then when your child cries for the first time at the sight of you leaving.  In their eyes, at this stage of their development, YOU are their greatest love.  And because of their uncertainty that you will return, they are heartbroken to see you walk away.  The first time it happens is heart wrenching.  Some parents aren't able to leave when they hear their baby calling out for them.  Your child's cries affirm their love for you, and this  is one of the first ways they expresses it.
Separation anxiety begins around the age of 10 months and peaks by 18 months.  It usually subsides between 2 1/2 to 3 years of age.  It is a natural stage of development in your child's social-emotional skills.  Your leaving and returning helps your child to learn object permanence;  even when you aren't with them you are somewhere else.  Another reason why separation anxiety occurs is because at this young age your child has no concept of time.  Whether it be one minute or 8 hours, your child just knows that you are gone and they want you back!  With practice, your child will eventually learn that you will return and their anxiety will resolve.


Here are some tips to help ease the transition of when you have to leave your child's side:


-Make your goodbye quick and try distracting your child with a toy or object of interest.
-Verbally reassure them that you will be back.  Provide them with a picture of you to hold while you are away.
-Creating a picture schedule may be helpful for older children.  The schedule will help them to understand what  happens next in their day and reassure them that you are returning.
-Usually the child stops crying within minutes of your departure.  Give your babysitter/family member a call to make sure that your child has calmed down, then let go of the guilt!!


Your reward for the pain of leaving them is seeing their smiling face when you return.  Just as their cries made you feel loved when you left them, their excited, smiling face when you return...well there is nothing like it!  It reminds you that THEY are your greatest love too!
Sunday, February 13, 2011

Making SENSE of SENSORY INTEGRATION= something we all need to undertstand

As I've mentioned before, we want our blog to meet many goals but one is to educate.  A topic we get frequent questions about involves the word "sensory." I guarantee you have or know of a child with "sensory needs," so I thought I'd use this entry to provide a GENERAL understanding on this topic.  Please keep in mind that this is just that, general. This topic is very detailed and you could research and read for months and go to uncountable conferences on this subject, so this entry is not meant for those who have a good grasp on sensory needs and want detailed information.  

Who has "sensory issues?" It is true that children on the Autistic Spectrum have sensory integration issues, however people who are not on the spectrum also can have issues in this area.  In fact, we all have "sensory needs," what makes them concerning is if they interrupt our daily function.

When you hear the word sensory you think back to 1st grade science, right? Taste, touch, smell, sight, sound! While these are certainly senses and important ones at that, our nervous systems also process other senses such as deep pressure, light touch, vestibular movement (like swinging or spinning), and gravitational position/proprioception (where your body is in space) to name a few. Our nervous systems were made to take in all these senses, process them, and organize our bodies in response to them in order to function.  For example, if a child is sitting in class around mid day, his or her nervous system is processing the temperature of the room, the smell of cooking lunch, the sound of the train outside, the glare of the overhead light on his or her page, the feeling of the tag inside a sweater, and the pressure of the desk he or she has been sitting in for 90 minutes.  In a properly functioning nervous system, this child would be able to take in all these senses, organize them, and allow him or her to pay attention to what is being taught.  Imagine one of those areas is not integrated properly. For example - if sound is not processed appropriately, that child will hear that train like a bull horn in his/her ears, making attending to the lesson impossible.

Our bodies seek out the input we need and avoid the input that is too much to function in any situation.  Every person is either a sensory seeker (you know who you are out there, you roller coaster riding-barefoot walking-toucher of every object as you walk through a store) or sensory avoider (don't even think about having the TV and radio on at the same time while having a conversation, and forget that deep tissue massage!)  Truth is, most of us are a combination of these things during our day to help our body meet it's various needs.  Chewing the end of a pen keeps you alert in a lecture the same way shifting in your seat does. I shake my foot as I fall to sleep - always have - and most people on my mother's side of the family do. I now know, this is my own way to calm my nervous system down.   This is why we rock babies to sleep!

So what do you do if a child you love or you yourself have issues integrating sensory information? If the issues are severe and are affecting learning, sleep, and social interaction, you should seek the assistance of a physician and/or a sensory trained therapist in your area.  Occupational Therapists are most commonly the ones in our field with the most training in this area and there are some that are what we call SIPT trained.  This stands for Sensory Integration Praxis Test, meaning these folks have had extensive training in recognizing, administrating a detailed examination to determine needs, and prescribing appropriate treatment.  Treatment usually comes in the form of a general or very specific "sensory diet," and no this does not mean food!  A sensory diet details the amount, type, and frequency of certain sensory activities to help your nervous system come to an optimal state allowing your body to fully function. For sensory avoiders or those low on a sensory threshold, this may mean "revving up" the system and for those who are already to revved up, this means calming it down.  

What does this mean for a "typically" (who is really typical, right?) developing child or adult? Feel that your child is not sitting through dinner? Make it part of your routine to run 5 laps around the house and jump off the bottom steps 5 times.  Do you have a student that fidgets or a child that can't sit through story hour? Give them a stress ball to squeeze while paying attention.  The goal no matter how significant is not to ignore or stifle the sensory needs of the individual but to help them meet the needs their body is seeking out in an appropriate manner. This is why recess and P.E. and learning through movement are essential and successful components to learning. Children can acquire what their sensory system needs in this way!

Keep in mind that with the growing number of Autistic children in our society today we are also seeing a huge number of children with Sensory Processing Disorder.  These children and families often avoid fun community activities because their child's different reaction to certain stimuli is frequently greeting with negative reactions.  If you keep in mind that these kids are not misbehaving but simply trying to regulate their nervous systems, we could all be more supportive to these families.


Observe your child today. What sensory activities are they avoiding or seeking? Do they crave deep pressure and find it through toe walking, jumping, or climbing? Do they seek vestibular movement through swinging or spinning? Are they finding visual input by running quickly as their world flies by them? Use what they need to help them get to the optimal sensory level to learn and play and enjoy knowing that you know something more about how your child is wonderfully made!


 Here's our youngest having fun - and seeking out some sensory seeking behavior!
Tuesday, February 8, 2011

A Story for Parents




A friend recently shared this story with me and I want to share it with all of you.  Sometimes life gives us blessings but they are packaged a little differently then we imagined.  But they are blessings just the same!  Enjoy!


Welcome to Holland



I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this...... 

When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting.
After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland." 
"Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy."

But there's been a change in the flight plan. They've landed in Holland and there you must stay. The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place.
So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.
It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandts.
But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned."
And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very very significant loss.
But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.

Emily Perl Kingsley  1987

Thursday, February 3, 2011

Night Night! Sleep Tight! Your Child WILL EVENTUALLY SLEEP - it's alright!

For this entry, we decided to try and start a discussion about a topic that was proposed by a friend on our face book page: SLEEP! In particular, how to get your child to sleep so you can get some as well!

Remember in my last entry, I admitted that sleep was not a subject that was passed with flying colors on the parenting report card in our house? Well, I can share with you what we learned from our mistakes along the way!

I want to start by saying that there are many theories on sleep and many different methods and schools of thought. My BFF (and co-owner of Milestones & Miracles) handled sleep beautifully with her children.  The ease that her infants would fall asleep on their own and stay asleep left me in my own state of shock and awe compared to my finicky, non-sleepers. Her "go-to" reference is Healthy Sleep Habits, Happy Child by Marc Weissbluth, so if you are a person who likes to have a reference book handy, we thoroughly recommend it. In particular, it is a great source of recognizing and responding to early signs of sleepiness, resulting in restful sleep for your child. Also The No -Cry Sleep Solution by Elizabeth Pantley is a great resource.

In addition, I have found from talking with friends and observing daily routines in patient's homes for years that sleep habits and practices, like most parenting skills, are very individualized and affected by tradition, culture, how you were raised, and your emotions.  Only you can decide what is right for your family and your child. That being said, restful sleep for yourself and your child and the ability to fall asleep and go back to sleep independently are skills every child needs to learn, regardless of when you decide the time is right for your child.  Think of it this way. Falling asleep and maintaining quality sleep is a life skill.  Place the same importance on it for your child as you would self feeding, dressing, or toileting.

Here are some tips I can share from our experience:

~ It is really important for your baby or child to fall asleep in their bed drowsy but awake.  We all sleep in a cyclical pattern of deep and light sleep periods. Between these periods, we open our eyes briefly and look around. If we are in the same environment that we fell asleep in, we usually fall right back into deeper sleep without realizing it. However, if we are not, we are aware of it and become fully awake.  Wonder why if you fall asleep on the couch, you usually wake up during the night? This is why! If your baby falls asleep in your arms or feeding or your child in your bed and then you move them, they will at some point in the night also become alarmed and possibly afraid.

I know what you are thinking (because trust me, I was there)..."great, but how do I get them to fall asleep on their own?"
Try one or more of the following:
~ Include the same evening routine every night. 
~ Chose activities that calm versus excite the nervous system. Avoid "screen time" (TV, videos, handheld games) at least 2 hours before bedtime.  The brain needs this "down time" to relax and wind down.
~Try a warm bath, a baby massage (or foot or hand massage for older children), a good amount of cuddling and reading, a familiar song, and/or prayers (if you are a praying person).  Whatever you choose, do a similar routine every night. Children feel safe with familiarity and knowing what to expect.  Keep the lights dim and limit noise. Swaddling a small baby or rocking your child also helps calm their nervous system.
~ It might be helpful to hold the reading and cuddling in the child's bed vs. yours if transition is difficult.
~ Try a special or favorite plush animal or blanket, reserved "just for bedtime" as an incentive.
~ Around the age of 3 (and often later) children start to process their day at nighttime (just like we do).  Their concerns or worries might seem trivial to us but are very real to them.  It is not uncommon for night terrors (think nightmare on steroids) to appear at this age. To attempt to avoid them, allow your child to share something about their day.  This comforting part of their day, when snuggled close to you, might be the chance for them to share these feelings or anxieties.  Have you ever played "roses and thorns?'  We do this at dinner - sharing the high and low points of our day, but bedtime might work as well.
~ If your child is hesitant for you to leave, try one or both of these options (they were both suggested by friends who are professionals and working like a charm for us!):
* Reassure you child that you are just in the next room and are available if they really need you.  Let them know that you will come back to check every so many minutes as long as they are quiet.  Doing this rewards the positive behavior (staying calm and quiet, alone in their room) that you are desiring with the reward they are seeking (you!)  You can start with 1 or 2 minutes and build up to longer periods. If you decide to give this idea a try, be very consistent to not go into the room when your child is screaming as you will be rewarding the undesired behavior.
* If your child seems to need a distraction at night, try a book or several stories on CD or MP3 player in their room.  This is often the stage where a parent splurges for the kiddo TV but the visual stimulation is not helpful in allowing the brain to "relax" and for your child to get quality sleep.  With a story, they can become distracted in listening to the words (vs. worrying about sleeping), and practice their receptive learning skills while flexing that imagination muscle all at the same time!

This was a life saving move for us! After weeks of sleepless and highly emotional nights (for our daughter and for us), these two options finally helped.

Remember to look at your child's overall state in regard to their success with sleep. If they are hungry or actually overtired, they are unlikely to sleep well.  Adjusting mealtimes and nap times (or making sure they get a nap) might be necessary.

If your child is fearful of those good old monsters, I've heard monster spray (air freshener or hairspray) works beautifully!

Like most stages, I've found that consistency is key and leads to a quality result faster.  I remember how painful it was when we broke our eldest of the habit falling asleep in our bed with me. I used to stay busy cleaning up and would eventually end up with the pillow over my head crying myself! One of the hardest tasks for me as a parent, was not to comfort my crying child.  But I realized it was my "job" to teach our daughters to be good sleepers.  Once I wrapped my tired, frazzled, emotional brain around that fact, we all started resting better!

Here's wishing you all a great night's sleep!
Wednesday, February 2, 2011

Curbing Cabin Fever

Not only do adults get cabin fever children do too!  With snow storms spreading across the nation over the past couple of weeks I thought it would be a good time to share some fun activities to help you entertain your little one(s) when stuck inside.  As a mother of two "active" children I've had to get creative.  And after this past weekend, when they were nearly climbing the walls, I started scouring the internet for fun things for them to do indoors. Here are some of the things I found and have tried:

-Fill the bathtub or kitchen sink with snow and let them play in it 
-Make snow ice cream
-Put towels down on your kitchen table or the kids' table, fill up some containers with water and let them have a "tea party"
-Make a hopscotch board by painting squares and numbers on an old sheet
-Put some masking tape down on the floor to make a balance beam
-Stick them in the tub, no water, and let them draw with shaving cream
-Make mini muffins together by filling a mini muffin pan with muffin mix and then letting them decide what to mix into the muffins.  Put their choices in a regular muffin pan (chocolate chips, dried fruit, sprinkles, coconut., etc) and let them mix with a toothpick.
-Make a fort.  Line up the dining room chairs and drape a blanket over them to create your child's own playhouse.
-Play games with your child like Simon Says, Hide and Seek and I Spy.
-Clean out the garage, bundle up the kids and let them go out there to jump rope, hula hoop and ride their bikes.
-Exercise with your kids.  I dusted off my old "Tae Bo" dvd the other night and my kids were entertained just watching me and then joined in to get a little exercise themselves.


If you have any suggestions to curb cabin fever please share them with us.  The good news is Punxsutawney Phil didn't see his shadow, so before we know it Spring will be here and we can get back to the playground and swimming pool!

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Welcome to our blog! As longtime friends, we recently decided to combine our professional experience (as a speech-language pathologist and physical therapist) and "Mommy Experience" to create a company dedicated to something we are both extremely passionate about - letting kids be kids! Milestones and Miracles, LLC was formed in 2010. Our mission is to empower parents in understanding the natural progression of their child's development (and not rush it along and skip stages). We develop and provide developmental products to support this learning process, bonding families through engaging, fun, and meaningful experiences! We are thrilled to share that our first product, 1 2 3 Just Play With Me is available for sale. Visit www.milestonesandmiracles.com to learn more and order a unique product for yourself & your child or as a gift! We will continue use this blog to share about topics that interest and excite us. Stay tuned!

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