Featured Archives | SmallTalk

Handwriting Readiness

Activities, Educational, Featured, General, Occupational Therapy | Aug 29, 2024 2 min read

Handwriting readiness is a crucial part of a child’s development, involving fine motor and visual motor skills, which are essential for writing and dressing skills, like buttoning and zipping, that support their overall participation in school and activities of daily living.

Fine Motor Skills

Fine motor skills involve the small muscle movements in the hands and fingers that allow children to hold and manipulate writing tools effectively.

Children’s grasp of writing tools will change as they grow. By 4-5 years old, most children should be using a more mature grip. Here’s a timeline:

1-2 years: Fisted grip (holding with their whole hand).
2-3 years: Digital pronate grasp (holding with fingers pointing down, thumb up).
3-4 years: Static tripod grasp (holding with three fingers, but using the whole hand to move the pencil).
4-5 years: Dynamic tripod grasp (using three fingers with wrist and fingers moving independently for control).

Visual Motor Skills

Visual motor skills are essential for using scissors and making pre-writing lines, as they involve coordinating what the eyes see, with how the hands move.

Children typically begin using scissors around 2-3 years old, starting with simple snipping. Here’s a timeline:

2-3 years: Snipping paper and cutting along straight lines.
3-4 years: Cutting out simple shapes like circles and squares.
4-5 years: Cutting more complex shapes

Practicing pre-writing lines is crucial before learning handwriting because it helps children develop the fine motor skills and visual motor coordination needed to form letters and write neatly. Here’s a timeline:

2-3 years: Scribbling and imitating horizontal lines, vertical lines, and a circle
3-4 years: Copying simple lines, a circle, and imitating a cross
4-5 years: Copying a square, cross, triangle, diagonal lines, and an ‘X’

Fun At-Home Activities to Boost Your Child’s Visual and Fine Motor Skills

Practice drawing pre-writing lines, shapes, and letters in sensory bins filled with rice, shaving cream, or sand
Use playdough or wikki stix to create different shapes, lines, and letters
Use broken crayons when coloring/drawing to help initiate a proper grasp
Use large or small beads to string on a shoelace, pipe cleaner, or string
Rip paper to make crafts at home and practice opening and closing markers and glue sticks

By Allie Calcagno, OTR/L

OMG, it’s an OMD!

Educational, Featured, General, Speech Therapy | Jul 26, 2024 2 min read

What is an oral motor disorder?

Difficulty with the function of the muscles and structures involved in speech and feeding

May be the result of:

A physical, structural issue such as cleft palate or tongue-tie
Prolonged pacifier or sippy cup use, which interferes with natural oral development
Injury
Fetal Alcohol Syndrome
A neurological condition such as cerebral palsy and Down syndrome which includes issues with muscle tone, resulting in dysarthria

Signs of an oral motor disorder include:

Droopy or “long” face with mouth that frequently hangs open
Drooling past the age of 18 months
Speech which is difficult to understand
Lisped speech
Difficulty sticking out tongue or moving it from side to side
Difficulty producing certain consonants or deleting them past age 3
Refusal to eat certain foods, especially meat or other tough foods to chew
Frequent gagging when eating
Open-mouth breathing (may be only when sleeping) and/or snoring

Key components affected by oral motor disorders include:

Articulation: Difficulty in coordinating and controlling the movements of the lips, tongue, and jaw which can lead to reduced intelligibility
Chewing: Challenges chewing and manipulating food in the mouth
Swallowing: Difficulty with coordinated and sequential movements required for safe and effective swallowing
Facial Expression: Limited control over facial muscles, impacting facial expressions and non-verbal communication

If you suspect that your child may have an oral motor disorder which is impacting articulation and/or feeding, it is important to seek treatment with a speech-language pathologist and/or occupational therapist. We are here to help!

By Kathleen Winger, M.S., CCC-SLP

My child was just diagnosed with autism spectrum disorder… Now what?

Educational, Featured, Therapy | Sep 02, 2022 3 min read

Step 1: Take a deep breath!

Learning that your child has been diagnosed with Autism Spectrum Disorder, or ASD,
can understandably flood parents and caregivers with a range of overwhelming emotions.
It’s easy to feel trapped or condemned by a label. When the “what ifs” start to invade,
remember that this new information does not change who your child is or who you
already know them to be. It is simply an identification of a root cause for various
symptoms and the first step to helping your child reach their full potential.

Step 2: Free your child (and yourself) from expectations

Following a diagnosis of ASD, it is common for parents and caregivers to experience a
period of mourning for “normality” and feelings of uneasiness when thinking about the
future. However, the new diagnosis is not a predictor of the future, let alone a sentence to
a life of failure or unhappiness. Taking one day at a time and celebrating any progress,
no matter how small, is key in cultivating both acceptance and a sense of hope.

Step 3: Advocate for your child

With a new diagnosis comes a plethora of recommendations from medical and school
professionals. Always remember, though these recommendations are backed by research
and have been proven to help, you have the final say in your child’s treatment. Though
30 hours of therapy per week might be recommended, you may feel that is too much. Go
with your instinct! Your child’s team of professionals will work with you to ensure the
best possible treatment to match your child’s individual needs.

Step 4: Find community

No one has to face the journey alone! Consider joining a virtual or in-person support
group for parents and caregivers of children with Autism, or an online forum. Sometimes
well-meaning family and friends can misunderstand and unintentionally cause more pain,
so it can be important to connect with people who do understand. Autism Society San Diego offers both support groups for parents/caregivers and fun events for the entire family. Military families can take advantage of the Exceptional Family Member Program
(EFMP) for a range of family support. When in doubt, meetup.com is a great place to
start!

Step 5: Take care of yourself!

Self-care is often placed on the backburner when caring for a child who has an ASD
diagnosis. However, burn-out is not only emotionally draining for you, but is also
unhelpful for your child. It’s important to seek Respite Care services if you don’t have a
friend or family member to babysit while you take time for yourself to recharge. In
addition, pick your battles with your child. Rome wasn’t built in a day, so anticipating
immediate results and/or perfection can contribute to high stress levels.

Checklist, in no particular order:

Developmental evaluation (medical) through your doctor or San Diego Regional Center. It is important to get a medical diagnosis, not just an educational label
through the school district. This is not the same as a formal diagnosis.
Speech therapy (medical/outpatient)
Occupational therapy (medical/outpatient)
Behavioral therapy (e.g., ABA) (in home or in facility)
Apply for school services at age 2 and 10 months to begin at age 3. This will determine eligibility for services through the school district such as, speech
therapy, occupational therapy, and behavioral therapy. Your child can receive these therapies in both the medical and school setting, as medical and educational
services are autonomous from one another.

Written by: Kat Winger, MS CCC-SLP

What is Pediatric Occupational Therapy and how would I know if my child would benefit?

Educational, Featured, Psychology, Speech Therapy, Therapy | Apr 04, 2022 6 min read

Occupation refers to functional tasks or activities that bring meaning to your life. And our children’s main activity is PLAY. Did you know that kids play to learn and that play requires motor, sensory processing, cognitive, and social skills? All these skills work together for learning. However, when the necessary skills for play are observably difficult, it can make grasping new competencies challenging for kids.

Occupational therapy addresses all the skills needed for play. It works on strength, coordination, and control to support their movement. OT also helps with sensory processing difficulties by identifying the way your toddler receives or responds to sensory input and teaching fun ways for you to support your child. And finally, Occupational Therapy promotes executive function skills building on motor, attention, and regulation foundations for learning.

Though play can look different and vary from child to child, there are general toddler development skill ranges necessary for learning to happen. When these are not progressing or missing, they can inhibit engaging in and learning through play.

The development of sensory processing and motor skills begins immediately at birth. The brain is where all the magic happens. Newborns take in sensations, but their body is unable to organize them—their reflexes are neurological responses to stimulation, including the senses of light, sound, touch, or pressure input such as stroking and vestibular sensory input with sudden movement.

The sensory processing and motor skill development looks random and clumsy at first with the baby’s initial kicking of their legs or trying to find their mouth with their hand. As they continue to be exposed to the sensation and repeat the movement, it becomes more purposeful.

Babies are holding, pulling, pushing, and dropping toys as they learn about cause and effect. More and more skills work together to explore and learn through play.

For your toddler, the years from 1 to 3 are very busy. They are essential years of curiosity, trial and error, and learning about what they can do. At age one, toddlers are very active. Give them a container, and everything comes out; maybe a few things go back inside. Set something on the table, and they pull up to see if they can get it. They make sounds and babble and may tug on your heart with Ma Ma or Da Da words!

Toddlers are in a transition of building more independence. During the terrible twos, a stage that everyone stresses about, they continue to learn about their environment, manipulate things, and communicate their experiences. Their development takes all the work that the baby’s brain and body did and uses it in play to build confidence, control movement, and explore new sensations. Toddlers experience big emotions. They must learn about these feelings and how their body responds to them. How we react and support them is important.

They also learn to transition from one activity to another, even when they don’t want to.
For example, two-year-olds usually can stack a few blocks, string a few large beads on a shoelace, feed themselves with a spoon, drink from an open cup or a straw, remove/pull on clothing, brush teeth, help wash their body at bath time, jump, run, and walk up and down a few steps. They can also throw a small ball toward a target, help clean up, and put toys away. Though the terrible twos try on parents and toddlers, they don’t last long. And both parents and kids learn a great deal!

As we strive to develop more patience during these times, our toddlers are growing far more in their quest for independence. Two-year-olds should be able to attend and learn a new play activity for 4-6 minutes. Some research even suggests that this age group should be able to focus on a task for 10 minutes.

Though many toddlers can sit and play for extended periods of time with preferred toys or activities they have initiated themselves, a better learning opportunity is to give them a new task to work on to develop manipulation skills like using a tool to scoop, fill a container, feed themselves with a spoon or fork, stack or build with blocks, lace beads on a string, or roll a ball back and forth.

Notice how your child works through activities. When development is not smooth, there will be clues in how your child moves, plays, speaks, or acts. See if you observe any of these challenges:

unable to manipulate toys in play, they continue to dump, empty containers, or throw them around the room
difficulty using tools to scoop, squeeze, hammer, draw
unable to demonstrate repetitive play activities. May run around, only roll the car back and forth
moves between many play activities quickly, not engaging in any of them
requiring or demanding your attention and unable to initiate or engage in play by themselves for short periods
difficulty imitating actions in movement, imitating mouth or tongue movements, silly faces, or being unable to throw a ball at a target. Difficulty moving from sitting to moving under structures, crawling through a tunnel
unable or very clumsy with jumping, climbing, moving between different level surfaces, climbing ladder to slide
unable to take turns in play activities such as rolling ball back to you, stacking blocks
seems fixated on the television, tablet, or phone and unable to engage with other toys in play
difficulty putting things together such as connecting blocks, lacing, and beads
unable to tolerate play on a swing, on a slide
unable to play near or with other children
unable to tolerate tactile messy play or engagement with media like play-doh, finger paint, or shaving cream
difficulty removing pull on clothing from dress-up activities

Play is one of the most significant areas that can provide clues about your toddler’s development. As we’ve outlined, there is so much growth happening during this time. If you see your child struggling in any of the areas we mentioned, occupational therapy can help develop and strengthen the skills needed for learning.

Occupational therapists are experienced experts and can help identify the areas inhibiting your child’s primary occupation and introduce fun activities for successful skill development.

Children are tiny individual humans with varied interests and gifts. We embrace and work together with parents to help children reach their greatest potential.

Come in and check us out in April for Occupational Therapy month!

Author: Pamela Vasiloff, OT