fbpx
Pragmatic Language

The Power of Pragmatic Language

Social Language Milestones

Pragmatics is the way we use our language in social settings. For example, how to start a conversation, interpreting body language, understanding different perspectives, and using sarcasm. Pragmatic language is typically learned incidentally (learned through experience) but with some children, it may need to be directly taught. Pragmatic language begins to develop as an infant and continues to grow and form until the high school years. Below is a list of “milestones” to expect along with activities/strategies to enhance social language. 

Infant (3-12 months)

  • Starts making eye contact
  • Reaching 
  • Participates in parallel play (playing next to caregiver, sibling) 
  • Participates vocal turn taking
  • Uses vocalizations to request, protest, express feelings 

Activities: Peek-a-boo, stacking blocks, waving, songs, nursery rhymes

Toddler (12-36 months) 

  • Imitates routines
  • Imitates other children
  • Uses words (12 months)/phrases (18 months)/sentences (30 months) to request, protest, express feelings
  • Asks questions
  • Begins at 18 months
  • Initiates pretend play (ex: playing in toy kitchen, pushing trucks/cars, playing with baby doll)
  • Begins at 18 months
  • Takes two turns in conversation
  • Begins to describe/retell events 
  • Begins to return/initiate greetings by waving 

Activities: Ask questions during pretend play (“What’s baby doing? Where are they going?”), “sabotage” by putting toys out of reach, shared reading activities, scrapbooks to encourage retelling 

Preschool (3-5 years)

  • Uses language for teasing, joking, fantasies 
  • Starts to share with others
  • Joint play with peers (participating in others play schemes, including self in play) 
  • Theory of Mind: Understanding that others have different beliefs 
  • Begins at 4 years
  • Produces narratives as “chain”
  • Takes 4-5 conversational turns 
  • Improves describing skills to repair communication breakdowns
  • Begins to inference/predict 
  • Participates in turn-taking games

Activities: Sequence 3-4 pictures and retell story, give simple riddles (i.e., “This is an animal that lives on the farm and says ‘Moo’”), play “Go Fish” or “Bingo”

School age (5-11 years)

  • Invites others to play 
  • Initiates conversations with familiar topics (ex: school, weather, weekend) 
  • Problem solving (individually and in a group) 
  • Begins 6-8 years old
  • Gives and responds to compliments 
  • Tells and understands jokes of greater complexity 
  • Politely interrupts 
  • Responds to and uses facial expressions (ex: smiles, frowns, looks of surprise) 
  • Recognizes spatial boundaries 

Activities: Practice multiple meaning words, Apples to Apples, Emotion charades, Red Light Green Light 

Middle/High School (11-18 years)

  • Recognizes if listener is interested or bored 
  • Shifts topics during lulls in conversation 
  • Understands difference between friends/acquaintances
  • Engages in collaborative discussions 

Activities: Would You Rather questions, book club, Let’s Talk Conversation Starters

If you notice delays in the way your child is using social language such as having difficulty making friends, understanding body language, or maintaining age-appropriate conversations, schedule a screening with an SLP at BDI Playhouse today!

 

toy

Tis the Toy Season- Toy Guide

‘Tis that time of year again! And all your kids want are toys, toys, toys! This can feel overwhelming when adding to an already large pile of toys in the home setting. Especially when the kids don’t even seem to play with the toys already available!  

Below are some tips and ideas for bringing new toys in this Holiday season. 

1. Balance of educational and choice toys; balance of seated and movement activity gifts

    • Teach your kids from a young age that they may not get everything on their wish list.
    • Provides them with opportunities to learn about toys they may have never seen before.
    • Encourages seated attention or physical activity. 

2. Hide toys and rotate them

    • Hide old toys before new toys come out.
    • When child appears bored of toys that are available, switch toys out with the hidden box of toys. Children will forget about some toys they have, making them feel new and exciting again!
    • Continue this toy rotation as child displays readiness with multiple boxes as options. Allow child to peek into boxes and choose box, if they wish.

3. Incorporate multiple skills per toy

    • Challenge the child to create different ways to use the toy.
    • Model your own creative ways to use the toy
    • Encourage exploration of new toy.

4. Use toy in obstacle course

    • Toys that appear more challenging for a child are great to incorporate into a fun movement activity. This helps break up the challenge and decrease frustration.
    • Great for toys with multiple pieces.
    • Encourages physical activity, especially in those cold months!

5. Keep toys simple

    • Simple toys encourage creativity and imagination!
    • Toys don’t need to have a lot of lights or songs to be fun. These can actually become over-stimulating for a child.
    • Allow child independence for exploring toys with only interrupting activity if unsafe.

6. Favorite educational toy companies

    • These websites allow you the ability to choose toys based on age range so you know what activities are developmentally appropriate for child

If you want some more ideas check out our website or amazon idea page!

 

Reflex

Primitive Reflexes

Primative Reflexes- The Good, The Bad, The Better!

Have you ever tripped and simultaneously reached out your hands to stop the fall? That is your primitive reflexes at work! They are essential as the first line of defense to protect ourselves but they can also be detrimental to our development.

What are primitive reflexes? 

Primitive reflexes are involuntary motor responses present at infancy that facilitate survival. Pediatricians check these reflexes at wellness visits to ensure the nervous system is working properly. It is important that these reflexes are present but it is just as important that these reflexes mature or integrate in early childhood. 

The Good: 

REFLEX

GOOD

Moro Reflex

The startle reflex

A fear response to sudden movements or noise
Hands PullingHead control reflex and the ability to contract our muscles to sit up
Hands SupportingOur falling reflex. Ability to reach out and catch yourself.
Tonic Labyrinthine (TLR)Develops balance and spatial awareness
STNRHead, limbs and balance system connection
Asymmetrical Tonic Neck Reflex (ATNR):  Differentiates our left and right side.
Spinal GalantConnects the trunk and lower body
AmphibianActivates nerves between both hemispheres of the brain
Babinski:Supports mature walking and balance
BabkinTongue and mouth coordination for eating and speaking
PlantarProtective response to provide stability
PalmarAdvances fine motor movements of fingers.
Landau Promotes ability to control head in tummy time

Why do reflexes need to integrate?

We unconsciously use these reflexes everyday, but what happens when we are unable to consciously control them? That’s what happens when reflexes don’t integrate. It’s like being in a self driving car and not being able to take control of the wheel, which can be very scary. Sometimes our reflexes do not mature because of abnormal movement patterns in utero or infancy, neurological deficits, or just unknown reasons. These primitive neuro connections are powerful and can inhibit our ability to voluntarily control our body and mind if they are retained.

How do reflexes affect development?

A retained reflex can present in strange ways causing possible behavioral, emotional, sensory and physical deficts. Not all reflexes present the same way in every person but they do have common patterns. The infant’s movements work together in sequence during development. If one reflex does not integrate it can cause others to also be retained. It is not uncommon to see two, three, or almost all the reflexes present during a primitive reflex evaluation. The following are common traits you might see if reflexes are retained.   

The Bad- Unintegrated Primative Reflexes

REFLEX

GOOD

BAD

Moro Reflex

The startle reflex

A fear response to sudden movements or noise
  • Anxiety
  • Difficulty sleeping
  • Insecure
  • Sensitive to light
  • Sound and/or touch
  • Emotional
  • Common in toe walkers 
Hands PullingHead control reflex and the ability to contract our muscles to sit up
  • Poor muscle tone
  • Poor hand, eye, and mouth coordination
  • Delayed gross and fine motor movements 
Hands SupportingOur falling reflex. Ability to reach out and catch yourself.
  • Clumsy
  • Poor personal boundaries
  • Aggressive
  • Avoids interactions
  • Difficulty processing information
Tonic Labyrinthine (TLR)Develops balance and spatial awareness
  • Motion sickness
  • Poor sense of time and organizational skills
  • Coordination difficulty
  • Spatial and balance problem
STNRHead, limbs and balance system connection
  • Crawling difficulty
  • Low muscle tone
  • Slumps while seated
  • Difficulty copying tasks
  • Poor attention
  • W sits 
Asymmetrical Tonic Neck Reflex (ATNR):  Differentiates our left and right side.
  • Challenged with crossing midline
  • Difficulty catching
  • Focus and memory difficulty
  • Auditory challenges
  • Dyslexia
Spinal GalantConnects the trunk and lower body
  • Postural deficits
  • Hip rotation effecting gait
  • Hyperactive
  • Fatigues with cognitive functions
  • Bed wetting
AmphibianActivates nerves between both hemispheres of the brain
  • Rigid movements
  • Limited stride length
  • Poor coordination
  • No rotational movement
  • No hand dominance
Babinski:Supports mature walking and balance
  • Tripping
  • Stabilizes with tongue
  • Oral motor and articulation deficits
  • Flat feet
  • Walks on toes or sides of feet 
BabkinTongue and mouth coordination for eating and speaking
  • Open mouth posture
  • Poor mouth coordination
  • Lacks facial expression
  • Speech delay
  • Sensory chewer 
PlantarProtective response to provide stability
  • Grasping hands
  • Poor running/jumping
  • One sided crawl
  • Standing delay
  • Fight/flight response to loss of balance.
PalmarAdvances fine motor movements of fingers. 
Landau Promotes ability to control head in tummy time
  • Poor posture
  • Clumsy
  • High tone in legs
  • Visual challenges
  • Depression and fears
  • Poor focus and balance

 

The Better: 

It is extremely common to have one or more reflexes present and you might even identify some of these traits in yourself. That does not mean it needs to be treated unless the reflex is so dominant that it interferes with the ability to learn, be safe and thrive. Reflex therapy helps to identify and create an individualized reflex exercise program to promote integration. The brain responds by taking the wheel and improves control over it’s own mind and body. Now that’s better!

 

If you think your child may have primitive reflexes present we can help! Free primitive reflex screenings are available via Zoom or in person at our Orland Park or Naperville/Aurora locations. 

Bedtime routine

Bedtime Routines

Bedtime routines are essential for getting the appropriate amount of sleep each night. Lack of sleep within children can disrupt the important cycles their bodies go through to help with development, attention and so much more. Creating a bedtime routine doesn’t have to be difficult, just utilize these tips and your child will be snoozing in no time.  

Consistency

Whichever tip you decide to implement, the most important is consistency. Providing a predictable bedtime routine that is consistent allows your child to understand the sequence of events that lead up to the point of going to sleep. Utilizing verbal reminders, prompts or a visual schedule of the tasks that need to be completed before bed, help with active engagement as well as relieving anxiety. 

 

Calm Down Time

Relaxation is an important step in falling asleep. Provide a time before bed where your child is away from alerting stimuli like a TV, iPad, or phone screen. Reading books, picking up toys, or listening to calming music is much more appropriate for a bedtime routine. 

 

Meditation

Meditation is a great way to clear the mind to decrease anxiety before going to sleep. Here are some examples to implement within your bedtime routine:

  • Deep breathing
  • Progressive muscle relaxation
  • Guided imagery

 

Environmental Changes

Changes to your child’s sleep environment is an easy and great way to make your child comfortable enough to fall asleep and stay asleep.

  • Weighted blanket/compression sheets: Utilizing a weighted blanket or compression sheets can provide the proprioceptive input children crave as they sleep. This simple change can decrease anxiety and provide a calming effect to better facilitate a good night’s sleep. 
  • Light level: Utilize curtains to block out light. A dark room helps the body recognize that it is time to sleep.
  • White noise: Static noise can block out other sounds within the environment that may be disruptive.
  • Soothing Scents: Scents like lavender or other calming smells can help relax your child before bedtime. 

 

If your child has difficulty following a bedtime routine or has continued trouble falling asleep, please do not hesitate to contact the office at BDI Playhouse Children’s Therapy to receive a free occupational therapy screening

Written by Kiersten Robertson, MOT, OTR/L

Girl refusing tomato

Feeding Fiasco

For some families, meal time can be the most challenging part of the day. Parenting a child who is having difficulty with eating can be tough for the entire family! Some kids are picky for a short time, or avoid only a few specific foods, and some kids may outgrow a food challenge. Some children maintain a difficult relationship with food for an extended period of time, seem to be regressing in skill, or make meal time a complete disaster with no end in sight. 

The Battle Field

When the preparation of food, the presentation of food, and/or the act of coming to the table is just the beginning of the mealtime battle, getting your child to eat nutritious and delicious food can be tough. If you are having to frequently pull out your sword and shield in preparation for a mealtime battle, it’s time to seek help from feeding therapists!

Too Tiny

If your child’s eating is impacting their growth, or your child is requiring supplements for weight or growth, our therapists can assist in food expansion strategies to enhance your child’s food intake and overall well being. 

  • Flee the Scene

Some children are overwhelmed by specific foods or the mealtime experience and will run away. Others require parents to strap them in, bribe them, pull out the tablet, or chase them down just to get to the table. If your child is having trouble coming to or staying at the table, feeding therapists can help make food more approachable, assist in attention enhancement, and provide strategies to remain at the table for the entire meal!

  • Tantrum Time 

When your dinner is thrown on the floor, smeared on the table, or screamed about in protest, your little one is struggling with food. Anxiety and frustration look different on each child, and tantrums can be one of the many responses to complex feelings food may be causing. Your therapist can help determine what abilities your child is struggling with that make the meal so difficult, and assist in developing skills to engage in meals and manage big emotions throughout the eating process.

  • The Picky Eater

A child is defined as being a “picky eater” when their food intake/variety is limited, but they are able to eat 30 or more food items. This number includes being able to eat the same food item prepared in a variety of ways! A picky eater may avoid an entire food group, or limit foods to a specific consistency or flavor. A feeding therapist can help picky eaters develop a meaningful relationship with their food and help the number and types of food accepted increase.

  • The Problem Feeder

A “problem feeder” is a child that eats 20 foods or less. This child may be brand specific in the foods they tolerate, they may have eliminated entire food groups, or they may avoid all foods that are a specific color, texture or consistency. Problem feeders may have underlying difficulty with oral motor or sensory processing skills resulting in gagging/vomiting, choking, coughing, or drooling. Our therapists are trained to assist in assessing the areas of challenge and increase the types of foods a child is eating to improve their nutritional intake and overall health/wellness.

  • Social Skills Suffer

Eating is a social activity. Families and friends sit down to share a meal, go out to eat meals together, bond over coffee dates, celebrate milestones with food, and more! If a child is having difficulty remaining at the table or tolerating being around others eating food, a feeding therapist can step in before social skills and meaningful events are impacted!

If your child falls into any of the above categories, bring your worries to BDI Playhouse feeding therapists! Set up a free consultation to get more information, and put your worries to rest!

Written by: Maggie Lord, MS, OTR/L

Potty Accidents

Potty Accidents

Why is my child having potty accidents?

Potty accidents aren’t fun for anyone. It can impact a child’s relationships with their family and friends.  Here are 5 common reasons children have accidents

Constipation 

Chronic constipation is the main cause of pee and poop accidents in children that have been potty trained. This is a great handout to see if your child has any of the main signs of constipation. Did you know that pooping every day doesn’t mean they aren’t constipated? “The Poo in You” is a video with a great explanation of what happens inside the body. 

Lack of Awareness 

Many kids may not have any idea that they have to go. They may not realize that they have to use the bathroom until it’s too late, or until they’ve already gone. Knowing what is happening inside the body can be a hard concept for kids with difficulty with sensory awareness. 

Poor Potty Posture 

Poor potty posture makes it hard to clear out the bladder and bowels. The Squatty Potty  or other step stool helps support the feet which lets the pelvic floor muscles relax. Therapists can also help with postural awareness and strength to help with the proper potty posture for successful toileting.

Scary Bathrooms

The bathroom can be a scary place for kids! Sitting with dangling feet, the noise, and the smell can all make kids avoid the potty. Many children avoid public bathrooms because of these fears. 

Medical Reasons

There could be a medical reason your child is having accidents. If you have concerns about your child’s accidents talk to your pediatrician. They can help decide if a referral to gastroenterology or urology is needed.

 

Who can help my child?

If you think your child might have constipation or is struggling with accidents, please reach out for a free screening! Sometimes, you may need the help of a physical, speech, or occupational therapist to help identify the reasons for your child’s accidents and/or constipation. 

Pediatric Therapists

Therapists trained in pediatric incontinence can provide treatment with:

    • Core strengthening
    • Biofeedback
    • Bladder re-training
    • Behavior and diet strategies
    • Body awareness to help realize the urge to go 
    • Posture training
    • Increasing fiber rich food intake 
    • Increasing variety of foods
Introducing foods to baby

Introducing Foods to Babies

Introducing foods to your baby is an exciting time!  You have your highchair and your pediatrician’s green light to introduce solids.  As you start out on this food filled adventure, here are a few ideas to keep in mind!   

Expression is Everything 

  • When you are introducing foods to your baby, make sure you share the same facial expression/excitement for each food, no matter how YOU feel about that food.  Your baby is extremely observant and will notice your dislike before it even hits his/her lips!  

 

Not for Nutrition 

  • Whether you choose to go the BLW or puree route, your purpose should be about exposure and experiences with food, not quantity or nutrition.  This is the time your baby is learning how to eat and experiencing new tastes and textures.  If, after a few bites, your baby indicates he/she doesn’t want anymore, let your baby be done!  You want your baby to ENJOY this experience so he/she will want to do it again and again!

 

Messy Mayhem

  • Put down the towel!  The messier your baby gets now, the less likely they will become overly sensitive to food spills (on his/her body or surroundings).  As your child’s feeding skills progress, the messes will naturally decrease!
  • Did you know that the sippy cup is the same oral motor pattern as drinking from a bottle/breast?  It was invented with the sole purpose of reducing spills.  When introducing the “next step” to an infant, we should be introducing the straw and open cup!   

If your baby is having difficulty transitioning to solids, BDI Playhouse Children’s Therapy offers free screenings to give you the tools to help your baby “eat” their way to a healthy toddlerhood.

Written by: Jessica Keenan, MA, CCC-SLP/L, CLC

Infant Massage

Infant Massage

Benefits of Infant Massage

Massage has benefits at any age, but for babies it can be extra helpful! The best time to massage your baby is when they are awake, but alert. It doesn’t have to last long to get these benefits. You don’t need much, a comfortable room, something soft to place baby on, and some oil (here are some suggestions to pick out what works for you)!

Improved development 

Massage can improve circulation, improve muscle tone, and provide increased awareness of a baby’s body parts. It’s also a great time to talk to your baby which will help their speech and language.

Improved sleep

Daily massage can help babies build tolerance to handling and different input. This can help them learn to calm and relax their bodies on their own which can help them The relaxation linked to massage can help baby fall asleep on their own. 

Improved digestion

Babies occasionally experience difficulties with pooping or have increased gas. There are specific massage techniques that can help move gas bubbles and poop along. 

Parent and child bonding

Massage is a great way for parents, caregivers, and grandparents to bond with their baby. Babies respond differently to different strokes. It’s a great way for parents to pick up on the babies cues. It’s also a great excuse to get some 1:1 quiet time with baby. What a great way to break up that witching hour!

Improved body awareness

Body awareness helps babies start interacting with their environment. They get input when they recieve massage. This can help improve their awareness of where their body is in their environment. If your baby has a preference for using one side more than the other it can be a great way to help them be more aware of the side they don’t use as much

 

If you would like to learn how to massage your baby , BDI Playhouse offers Infant Massage classes in clinic and virtually. Trained therapists will help you find the best way to ready your baby’s unique cues to get the most out of massage! 

 

 Written By: Andrea Turnell, PT, DPT

 

Engorgement

Breast Engorgement

What is the best way to prevent engorgement while breastfeeding?  Frequent feedings!  Feeding your baby 10-12 times per 24 hours and making sure your breasts are emptied each feed should reduce your risk of experiencing engorgement.  However, if you are experiencing that painful fullness here are a few tips

Strategies to reduce engorgement

Before Breastfeeding

  1. Hand express or pump the breast for 1-3 minutes prior to feeding
  2. If you can get milk to flow use moist warm compresses to increase milk flowing
  3. If you cannot get milk to flow use cold pack on breasts
  4. Warm shower with back to water, taking a “breast bath” in warm water, and/or applying wash cloths that are moist and warm

While Nursing

  1. If the breasts or areola are too swollen for baby to latch pump or and express for 1-3 minutes to soften breast before feeding. 
  2. Apply light to moderate pressure (REVERSE PRESSURE SOFTENING) to move fluid around nipple and to make it more latchable.

Between Feedings

  1. Use cold compresses, over a protective layer of fabric, on your breasts, chest, and under arms to help decrease swelling.
  2. Wear bras that are not too loose and not too tight.

Engorged breasts can make your breastfeeding experience tough.  The best way to treat engorgement is to prevent it!  However, if you are experiencing persistent engorgement and would like additional help, schedule a free screening with one of our lactation counselors.

Written by Jessica Keenan, MA, CCC-SLP/L, CLC

Mom's breastfeeding

Benefits of Breastfeeding

What are the benefits of breastfeeding babies?  Many moms are faced with familial and societal pressure of deciding whether they want to breastfeed or formula feed.   Before making the decision based on others experiences or the latest baby marketing trends, read on to find out how breastfeeding benefits baby, mom and your community!

Benefits of Breastfeeding

Baby

  • Decreases risk of mortality 
  • Reduces risk for asthma, upper respiratory infections, allergies, ear infections
  • Less risk for colic, reflux, gas, diarrhea, constipation, GI pain
  • Decreases risk for obesity, type 1 diabetes, Autism, ADHD
  • Increases intelligence scores
  • Reduces risk for narrow facial development

Mom

  • decreases risk of unwanted shorter pregnancy intervals
  • Satisfies baby’s emotional needs and increases bonding between mother and baby
  • reduces risk of PPD
  • Helps mom to lose ‘baby weight’
  • reduces risk for high blood pressure
  • decreases risk for ovarian and breast cancers
  • increases work attendance due to healthier baby

Community

  • More bonding opportunities for parents/children
  • Higher IQ subgroups
  • Do not have to worry about dangers of manufacturing errors/formula recall
  • Reduced financial strain without costs of formula
  • decreased waste production to make formula
  • reduced health care costs
  • decreased work absenteeism of parents due to infant/toddler illness

When making the decision between breastfeeding and formula feeding, it’s important to consider how it will effect mom, partner, baby, and your community!  Research shows that breastfeeding comes with increased health benefits for both mom and baby, mentally and physically.  Exclusively breastfeeding reduces the workload and financial burden on your partner.  Finally, it reduces the carbon footprint in your community!  Want to learn more?  Join us at our Breastfeeding Basics class!  Already in the thick-of-it and needing some support?  Reach out and schedule a free screen with one of our certified lactation counselors and infant feeding specialists!

Written by: Jessica Keenan, MA, CCC-SLP/L, CLC