Educational Archives | Page 3 of 3

How to help children on the spectrum develop friendships

Clinic, Educational, Speech Therapy, Stories | Mar 07, 2022 5 min read

In my high school, a peer known for his social awkwardness greeted me in a monotone voice, “Pratt, do you have anything to say to me?” I replied, “Yes, good morning. How are you doing today?” Satisfied with the exchange, he nodded and walked to class. He did not return the greeting, nor did I expect him to. He also never asked me how I was doing.

There is an expression that “the only way to have a friend is to be one.” But what if you struggle to read facial expressions, body language, and tone of voice? For children on the autism spectrum, making friends can be challenging. From the young child who sits alone on the playground to the high schooler who chooses to stay in the computer lab rather than interacting with their classmates at lunch, it may appear that these children have no interest in pursuing friendships. Unfortunately, this is a common misconception held by neurotypical people (not on the autism spectrum).

The child on the playground and the teenager in the computer lab may be overwhelmed by the noise and chaos of the children around them or the location where social interaction occurs. Other behaviors of children on the spectrum include lack of eye contact, fidgeting, and repetitive movements (arms flapping, rocking, etc.). Many of these actions help limit overstimulation, manage anxiety or help with focus, but they can be perceived as a lack of interest by their neurotypical peers. Neurotypical children may conclude that their counterparts with autism are disinterested. But appearances can be misleading.

Children on the spectrum often long for friendships but do not know how to develop them. The importance of peer relationships is well understood. Friendships can provide opportunities to learn important social and emotional skills, including empathy, cooperation, problem-solving, and similar prosocial skills. Unfortunately, the opposite is also true; negative peer relationships involving bullying, rejection, and manipulation result in feelings of isolation, anxiety, depression, and confusion about relating to others.

Luckily, there are many ways to support children on the spectrum. Here are some steps you can take to support your child in making a new friend:

1. Explain what a friend is:

For young children, keep things simple. For example, explain to them that “a friend is someone who is nice to you and likes to spend time with you.” Understanding abstract concepts can be difficult for young kids on the spectrum. It helps to discuss characters in a movie or tv show that the child enjoys. Ask questions such as, “Is Character X being nice to Character Y? Do they like playing together?”

2. Social Stories

Children with autism often learn better when they are provided with visual support. Social stories lead a child through specific situations using pictures and words. Each story can be tailored to the child. For example, writing a script or drawing out the course of a conversation can help children understand the basics of how to talk to a friend. ***Carol Gray is a good resource.

3. Practice is Key

The best way to try something new is to explore it first in a safe and familiar environment. Have your child practice social skills (greeting others, asking and answering questions, self-advocating, suggesting ideas for play) among people the child already knows and is comfortable with (siblings, cousins, neighbors, and other adults). Through practice and repetition, you and your child can problem solve challenges he might have before encountering them at school or on the playground.

4. Finding Your Tribe

To build friendships, children must first share common interests. Find what your child is good at or enjoys, and then find a community based on that interest. For example, if your child loves board games, find a gaming group. If your child plays an instrument, get them into the band at school. Finding a shared activity is key, and it provides the groundwork for children to further grow friendships by sharing their feelings or by sharing a positive emotional experience.

Sometimes, however, it’s not about what groups children with autism join; it’s about getting other children to join them. Some schools implement a playground ambassadorship program, where neurotypical students are tasked with engaging students who tend to remain on the periphery of the playground. These children look for peers who are not engaged and reach out to them/ask them to play. Parents may want to ask their schools if this program is already in place or can be implemented. You are your child’s best advocate.

SmallTalk wants your children to “find their tribe” and make long-lasting connections with peers. Therefore, SmallTalk offers small social skills group sessions at each clinic location to help teach your children the foundations of social skills and offer guided practice of engaging in different social scenarios with peers. If you are interested, please call us at (619) 647-6157 to schedule an appointment.

Feeling the LOVE

Activities, Educational, Speech Therapy, Stories | Feb 03, 2022 3 min read

February is here! And so are our themed therapy activities. We love thematic learning – it is relatable and helps kids make meaningful connections within their everyday lives.
Here are some of our favorite ideas to try incorporating at home:

Books about Feelings and Love

Themed books are a great way to teach vocabulary, encourage early literacy, and promote positive relationships and acceptance. When reading books with your child, we recommend using the “PEER” approach.

P: Prompt your child with a question about the story. Prompting your child focuses attention, engages the child in the story, and helps the child understand the book.
Point to something in the picture, for example, a balloon. “What is that?”

E: Evaluate your child’s response.

“That’s right! That’s a balloon.”

E: Expand on what your child said.

“That’s a big, red balloon! We saw one of those in the grocery store yesterday.”

R: Repeat or revisit the prompt you started with, encouraging your child to use the new information you’ve provided.

“Can you say big, red balloon?” Each time the book is reread, the expanded vocabulary words are verbalized again.

Here are some books worth checking out:

Froggy’s First Kiss, by Jonathan London
The Day it Rained Hearts, by Felicia Bond
Guess How Much I Love you, by Sam McBratney
Love Splat, by Rob Scotton
Love Monster, by Rachel Bright
Love You Forever, by Robert Munsch
The Giving Tree, by Shel Silverstein
Llama Llama I Love You, by Anna Dewden
No Matter What, by Debi Gliori

Making Valentines

Arts and crafts activities are a great way to work on making choices, requesting and describing during play. Here are some useful strategies to incorporate during the craft at home:

Provide two choices during card-making: “Do you want the heart or the lip sticker?” or “Do you want the purple or red crayon?”
Model the use of adjectives: “Ooo, I pick the sparkly, red and white heart!” or “I’m going to draw a big chocolate candy.”
Teach location concepts: “Do you want to put the sticker in the middle or on the side?” or “Let’s write your name on the front.”
Practice “who” questions by asking who your child wants to make the card for.
Sabotage. Give your child an unsharpened pencil or a glue stick with the lid still on it so that they need to ask you for help.

Trip to the Post Office

Once your Valentines are complete, we recommend taking your kids on a trip to your local post office. Here are some ideas on how you can incorporate speech and language skills into the outing:

Teach related vocabulary: stamps, envelope, delivery, etc.,
Model comments: “I see a mail truck!” or “Wow, look at all of those mailboxes!”
Verbally sequence the steps to mailing a package: “First you fill the box, then you tape the outside, next you write the label…”
Take turns dropping mail into the mailbox and discussing who the mail is for.
Practice ordering stamps at the counter.
Bonus: Let your therapist know if you went on the outing, that way it can be a topic of conversation in their speech session. :)

We wish you a Happy Valentine’s Day and look forward to hearing how your activities go! We LOVE meaningful activities, making connections, and all of our wonderful families at SmallTalk.

Author: Julia Navarra, M.A., CCC-SLP, Speech-Language Pathologist

Does my child need Occupational Therapy?

Clinic, Educational, Speech Therapy, Therapy | Jan 03, 2022 3 min read

What is Occupational Therapy? Does that help my child get a job? No! “Occupations” are daily activities, so that means playing and learning for your child. Children develop daily living and self-care skills through actively exploring their environments and playing with others. Occupational therapy addresses sensory processing, motor delays, and social-emotional components that may be impacting your child’s ability to develop independence at home and school. If any of the following characteristics resonate with you, your child may benefit from occupational therapy!

Sensory Processing

Overly sensitive or heightened reactivity to sound, touch, or movement
Under-responsive to certain sensations (e.g., high pain tolerance, doesn’t notice cuts/bruises)
Constantly moving, jumping, crashing, bumping
Easily distracted by visual or auditory stimuli
Emotionally reactive
Difficulty coping with change
Inability to calm self when upset

Social Interaction Skills

Difficulty interacting socially and engaging with family and peers
Difficulty adapting to new environments
Delayed language skills
Overly focused on one subject (e.g., space, universe, dinosaurs, trains)
Can’t cope in the school environment

Play Skills

Needs adult guidance to initiate play
Difficulty with imitative play
Wanders aimlessly without purposeful play
Moves quickly from one activity to the next
Does not explore toys appropriately
Participates in repetitive play for hours (e.g., lining up toys)
Does not join in with peers/siblings when playing
Does not understand concepts of sharing and turn taking

Oral Motor/Oral Sensory

Excessive drool
Chews food in the front of the mouth, rather than on the molars
Difficulty using a cup at an age-appropriate time
Difficulty with drinking from a straw at an age-appropriate time
Lengthy bottle or breast feedings
Tiredness after eating
Baby loses excessive liquid from their lips when bottle or breastfeeding
A child loses excessive liquid or food from his or her mouth when drinking or chewing
A child appears to be excessively picky when eating, only eating certain types or textures of food
A child excessively mouths toys or objects beyond an age-appropriate time

Fine Motor Skills

Manipulating toys and puzzles
Holding a pencil
Using silverware or straws at an age-appropriate time
Using scissors
Using zippers, buttons, shoelaces
Coloring, drawing, tracing, prewriting shapes
Poor handwriting, letter/number formation
Not developing a hand dominance at an age-appropriate time
Avoiding tasks and games that require fine motor skills

Gross Motor Skills

Going up and down stairs at an age appropriate time
Coordinating both sides of the body
Understanding the concept of right and left
Poor ball skills
Poor balance
Fear of feet leaving the ground
Not crossing the midline of their body during play and school tasks
Avoiding tasks and games that require gross motor skills

Visual Processing

Difficulty with the spacing and sizes of letters
Difficulty with recognizing letters
Difficulty with copying shapes or letters
Difficulty with visual tracking and crossing midline
Difficulty finding objects among other objects
Difficulty with copying from the board or another paper
Difficulty with the concept of right and left

Learning Challenges

Unable to concentrate and focus at school
Easily distracted
Difficulty following instructions and completing work
Tires easily with school work
Poor impulse control
Hyperactivity or low energy
Not keeping up with workload at school
Difficulty learning new material
Makes letter or number reversals after age seven

Do you feel like your child has difficulty in any of the areas as mentioned above? Are you questioning whether an Occupational Therapist should see your child? If so, our SmallTalk therapists are here to help strengthen these skills and answer any questions through structured and unstructured table and gym activities with weekly/bi-weekly therapy sessions. Please call to schedule an evaluation today!

Authors: SmallTalk Occupational Therapists

SmallTalk’s gifts for goals!

Educational, News, Speech Therapy | Dec 01, 2021 3 min read

The Holidays are upon us, and we’ve heard the question…. “What toys do we recommend?!” We LOVE all questions, but this one, in particular, is FUN to answer! In general, most novel items or toys are a great way to teach your child new skills! Like all other moments of the year, FAMILY TIME is the best gift. Break out a family photo album, cut back on screen time, make a “family dance party” playlist, bake together (recipes are great for reading comprehension and following directions), or go explore the great outdoors (play “I spy” on a walk to work on visual-motor integration and describing).

Get Retro!

Think back to a toy that you received as a kid to share with your mini-me! Ditch the expensive electronic light-up toys and go for “old school” blocks, train sets, or pretend musical instruments. Bring back family game nights; with Pictionary, you can work on fine motor skills and labeling. Board games that you played as a child, like Candyland or Hungry Hungry Hippos, are awesome to work on taking turns, following directions, and fine motor skills.

Get Building!

We already know many of our SmallTalk family loves Legos, but did you know how great they are for therapy goals? To work on therapy targets, you can talk about what you’re building, give directions, or give only a few blocks and have your child ask for more. Try larger blocks Lincoln Logs, or magnet building sets if Legos are too small. Puzzles are also a go-to, working on fine motor skills, picture matching, and labeling.

Get Creative!

Hands-on activities and craft sets are awesome for all kids! We recommend Play-Doh, sticker books, puppet theaters, Kinetic Sand, water tables, or make your own jewelry activities. You can work on verbs in all of these activities and following directions. Costumes or dress-up items are fantastic to work on making narratives (telling stories) and pretend play. Make reading more interactive with books that have craftivities.

Get Moving!

Gifts to get our bodies moving are always wonderful, especially for our sensory-seeking friends or if gross motor skills are a challenge. We’d recommend small trampolines, swings, sports equipment, Twister, or Spike Ball. A simple ball can be used to roll back and forth to work on turn-taking, use to work on saying names, or can be thrown at a hoop to work on coordination. For our smaller movements, check out the 50 Piece Fidget Popper set on Amazon or stretchy toys like Goo Jit Zu characters.

Before you buy…

Before buying a new toy, think about your child’s specific way of PLAY! For example, avoid small pieces if your kiddo is still exploring with their mouth often, and avoid toys with gel or slime inside if they may love to bite, squeeze, or stomp.

Prepare for Changes in Routine!

As always, it is important to talk about changes in routine, such as visitors or traveling to new places.
Discuss how your child is feeling about changes in routine and ask how you can help them (i.e., bring a familiar toy to new places or show pictures of where you are going or who is coming over).
Remind family and friends about how best to greet your child- do they prefer high-fives or big bear hugs?

If this year has been hard on your family, like so many, check out this link to see local resources to help with the holidays.

We wish you and your families a fun and festive holiday season!

Kendall Harrington, M.S., CCC-SLP

Surviving the holidays with picky eaters

Activities, Educational, News, Speech Therapy | Nov 01, 2021 2 min read

The holidays are times of family and traditions, many of which involve food and eating. However, when your child eats very few foods, the holidays can bring frustration and stress as you navigate the changes in routine, new foods and the expectations of eating them, and the abundance of desserts and sweets.

We’re sharing some recommendations to help you decrease stress surrounding mealtime so that you can enjoy the holidays with your loved ones.

Limit changes in routine. Holidays can often mean traveling, time changes, and lots of familiar and new faces. These changes can be overwhelming. Try to keep your child’s mealtime routines, including the time of day they eat and any cleanup routine, the same. If possible, bring familiar plates, utensils, and cups too!
Have your child eat a typical meal or snack before the big meal, especially if the big meal is later than the child’s usual mealtime. Then, keep a preferred snack at the ready for your child to eat with the whole family. The focus of the holiday meal should be family, not a struggle to explore new and tricky foods. If available, you can always bring some leftovers home for food exploration at a later time.
Prepare your child and set expectations. Explain to your child what activities may be happening and show pictures of who they can expect to be there. If there is going to be food present that may be tricky for your child to tolerate, try exploring the food through play the weeks before the holiday at home, where they will likely feel the safest.
Limit sweets! The holidays are filled with desserts that are sometimes hard to resist. Sugar can suppress appetite limiting consumption of nutritious foods. Try to keep sweets until the end of a meal; however, avoid making the availability of dessert dependent upon how they ate the rest of their meal.

Try these suggestions so you can focus on enjoying your time with loved ones.

The SmallTalk family wishes you and yours a very Happy Thanksgiving!

Lauren Fong

SmallTalk’s spooktacular Halloween tips and tricks!

Activities, Educational, News, Speech Therapy | Oct 01, 2021 4 min read

October has officially arrived, triggering a return to school, apple picking, frolicking in the pumpkin patch, tractor rides, and the delicious aroma of pumpkin spice coffee. Of course, fall also stirs up the ghosts, goblins, and witches of Halloween!

While Halloween can be a memorable and exciting time for children all over the country, it is also a time of uncertainty, confusion, and stress for those who experience communication and sensory challenges. For these children and their families, Halloween can prove to be a difficult and overwhelming experience to navigate.
At SmallTalk, parents and families often ask how we can help prepare their children for the holiday seasons.

Below is a list of tips and tricks to help our families and emphasize the treats as opposed to the tricks of Halloween.

Prepare for Unexpected vs. Expected Situations

If Halloween brings discomfort to your child, discuss what they might expect to see, hear, or feel around or on that costume-filled night.

Read a non-threatening Halloween book/social story, watch a fun Halloween movie, listen to upbeat Halloween music or make a trip to a Halloween store.
Prepare and practice a written script for how and what to say for trick or treating interactions with neighbors and friends.
Review with your child a Halloween social story or sequence of events that will occur on Halloween while trick or treating.
Share your trick or treat route and script with your neighbors before Halloween night.
Discuss how your child is feeling about Halloween- excited, scared, happy, etc.
Anticipate and talk about some unexpected situations that could occur.
Reassure your child that friendly faces will be by their side throughout the night.

Augmentative/Alternative Communication

Create a Halloween page on your child’s AAC device with various Halloween icons and answers to possible Halloween questions such as “What is your costume?” “Are you having fun?”

Practice using the device’s Halloween page with your child, so they feel comfortable using it on Halloween night.

Articulation/ Phonological Delays

Suggest Trick or Treating in a small group of familiar people.
Consider a group costume with friends/family (i.e., Ninja Turtles, Power Rangers, circus, etc.) to help your child feel more included.
If Halloween trick or treating is too overwhelming for your child, many communities, local churches, and schools provide Trick or Treating options.
Encourage your child to attend/participate in a Halloween party at school or local community.
Try an alternate Halloween plan.
- Allow your child to hand out candy to trick or treaters and practice asking “Wh” questions to trick/treaters (i.e., What is your costume? Where did you get that?).

Sensory Challenges

Provide a Halloween craft or carve a pumpkin to expose your child to different textures.
- Create a Halloween sensory bin.
Trick or treat before it gets dark.
Before Halloween night, walk around your trick/treating route and observe your neighbors’ decorations and lights.
Schedule sensory breaks while trick or treating or at Halloween festivities to avoid possible overstimulation and provide distance from foreseeable stressors.
Bring headphones to block out overwhelming/loud noises.
Try tasty candy alternatives if you have a “picky” eater.
Allow your child to pick a costume that makes them feel comfortable.
- Try on the costume on several different occasions before trick or treating to make sure it is comfortable.
- Allow it to hang in a visible spot days before Halloween to familiarize your child with the costume.
- Create your own costume out of preferable fabric if a store-bought costume cannot be tolerated, and invite your child to be a part of the process.

We wish you a fun-filled and SPOOKTACULAR Halloween season. We cannot wait to see your costumes and hear your children tell us about their experience!

by Pamela “PJ” Baragona, MA CCC-SLP

COVID-19 and your child’s development

Clinic, Educational, News, Psychology | Aug 30, 2021 5 min read

SmallTalk is listening to you! In the last year and a half, we’ve heard you express your child’s needs, your own fears and frustrations, and the COVID-19-related obstacles you have encountered.

We empathize with you and understand the difficulties in juggling a little one’s developmental progress as you simultaneously deal with the concerns of a pandemic.

Can you relate to these challenges expressed by some of our clients?

We knew our child needed help, but COVID concerns were confusing and worrying, so we stopped seeking services until now.
We had a pandemic baby. So, we felt the need to stay safe at home with our child.
We didn’t go out much because of COVID.
School speech/language or occupational therapy via ZOOM at school did not work for our child, so we discontinued this until the pandemic was over.

If so, keep reading.

The Effects of a Pandemic

Over the past 18 months, the global effects of the COVID-19 pandemic rocked our society. Our country experienced a significant financial and human loss, and, as a result, many of our children suffered considerable speech/language, emotional, physical, or feeding delays. In addition, the temporary suspension of schools, parks, playgrounds, amusement parks, and other outlets limited their ability to embrace a sense of fun and learning. And travel restrictions forced a feeling of stagnation that further added to our children’s loss of opportunity to build important functional communication skills.

On top of all that, as safety concerns and the need to protect family health grew, most playdates, extra-curricular, and family outings were abruptly halted, decreasing our children’s exposure to building critical developmental milestones.

Learning how to develop meaningful in-person interactions with peers, understanding body/facial language and feelings, throwing a ball, balancing on a swing, holding a pencil, or exploring various sensory experiences are all crucial to a child’s development. They learn from experiencing different lights, sounds, smells, and textures that exist throughout our communities. Learning by example is vital. That phenomenon is stifled when, for example, the ability to explore new foods at restaurants is not permitted or the natural mimicking of peers, as they try different foods, is no longer happening.

SmallTalk’s Response

Our therapists have been proactive in working with our current families and addressing specific and individual situations. For the Speech-Language Pathology team, the lockdown caused a significant increase in referrals for children under three years who are experiencing a delay in functional expressive language such as verbalizing basic needs and wants. This team also helps children who have trouble being in groups and sharing. They assist little ones with their ability to play appropriately with toys and other children, as well as understanding age-appropriate language and guiding them to learn to follow directions.

For our school-age children, we are seeing an increase in the need for social groups as children have not had significant opportunities in school or extra-curricular activities to engage and bond with their peers.

Some families seeking extra support for their children found that virtual school therapy was inconsistent, ineffective, or not individualized. Others recognized that due to the severity of their child’s delays, engaging or participating in Zoom school/therapy seemed fruitless, resulting in the cessation of further attempts at treatment until clinics and schools once again provided in-person opportunities.

Our Occupational Therapy team is also providing increasing support to help children with sensory/regulation issues, exploring new foods/textures, attachment/separation anxiety concerns, and lack of core body strength.

At SmallTalk, we have the strong desire and expertise to help children with any speech/language or occupational therapy needs by providing an optimal environment for learning. We are here for you. In addition to working with your child at one of our three locations, we are also passionate about supporting you and your family by sharing ways that you can reinforce and practice the learned skills at home.

Here are some helpful tips that can target missing or delayed skills:

Early Intervention Language

Promote child-led play: allow your child to pick their preferred play object and narrate their play. Tell them what they are doing, label objects.
Keep the language simple – if your child speaks only in 1-word responses, narrate their play in no more than 2-3 words. Ex: child says “ball,” parent/sibling can say “big ball” or “go ball.”
Limit the noisy toys, which limit a child’s ability to be imaginative and/or create their own sounds for the toys.
Emphasize using cause/effect toys like blocks, stacking cups, cars, and ramps.
Encourage requesting words in play like “more,” “help,” “want,” or “open” to help your child express wants, needs and limit frustrations.
Daily routines such as bath time, snack, or mealtimes, are excellent language opportunities. Talk with your child about the activity, the whys, the hows, the sensations, or any related topic that promotes positive communication.

Social Skills

Encourage a playdate.
Consider enrolling them in daycare/pre-school.
Encourage them to participate in a sport.
Join a music or story-time class at a local library.
Visit a playground/park with other children.

Feeding

Have fun with new foods! Create fun, creative, and colorful displays.
Give your child food choices- have them look fun and good.
Get messy! Play with your food- kids may want to explore new foods before putting them in their mouths.
Give new foods creative and silly names.
Use fun books/apps to explore new foods.

Motor Planning, Cognitive and Sensory Skills

Use everyday household objects to build a themed obstacle course like pillows, boxes, rolled towels, or packing peanuts.
- Walk on uneven surfaces –balance and sensory needs.
- Push/pull heavy items- strengthening.
- Walk like different animals – coordination.

Smalltalk’s message to our families is that you are not alone. We hear you. We understand. We can help your child reach their greatest potential. Let’s talk. Call us today to learn more at 619–647-6157 ext. 1.

by Pamela “PJ” Baragona, MA CCC-SLP

Power of play

Educational | Mar 12, 2013 1 min read

We’ve often heard that “play is a child’s work”. Research shows that 75%
of brain development occurs after birth. So, what can we do to nurture that
development? Play. Play is the way that toddlers learn basic turn taking,
imitation and problem solving skills. Language develops through play.
Play is how older children learn social skills, creativity, as well as fine and gross motor skills.

At SmallTalk, we attempt to harness the power of play by inserting our therapy goals into a variety of toys and activities. We get down on the floor, follow our clients lead, and play. Our clients are developing, learning, and refining language and motor skills while having fun. In cases where a child doesn’t really know how, we model play skills with virtually irresistible activities and get them to join in on the fun.

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