Child & Family Development Child & Family Development

November 1, 2020

Ask the Experts: Q&A Roundtable

By: Jessica DeLing

A main priority of ours at C&FD, is taking a multidisciplinary approach to treat the whole child. By providing comprehensive and integrated services, we are able to support our clients and their families with efficiency. Parents and caregivers often have many questions about their child’s development. Throughout the month of November, our therapists will answer commonly asked questions and share ideas for supporting development in a number of areas.

Speech Therapy

Q: My toddler isn’t talking yet… is that normal?

By: Kelly Conner, CCC-SLP

We get many questions regarding what is “normal” and what isn’t. The reality is, speech and language development is a broad spectrum and every child develops at their own pace. Some children can be late talkers without having a speech or language delay. With that being said, there are some guidelines to follow that can help you figure out if your child’s development is on the right track, or whether you should reach out for a speech and language evaluation. Here are some milestones to help you gauge your child’s development.

  • Most children begin saying their first word around 12 months.
  • At around 18 months, most children start putting 2 words together and say around 50 words.
  • At 3 years of age, most children can put 4 word sentences together.

Some children may reach these milestones early, while some kids may reach them later. It is important to look at your individual child and their progression.

Physical Therapy

Q: Why isn’t my child crawling yet?

By: Abby Morton, DPT

Crawling is a big milestone as it requires major proximal strength at our core, shoulders, and hips. A typically developing baby begins to crawl on hands and knees around 9-10 months. However, many things are accomplished before the big crawl!

From the start with tummy time and rolling, your baby is continuously building skills while developing core, arm, and leg strength. Typically, your baby will first accomplish and master skills of movement with sitting and tummy time positions as this indicates he has the strength and control to stabilize himself on hands and knees. If you notice your little one has a hard time balancing while playing in sitting or does not move around much while on his belly, this may indicate some weaknesses causing difficulty to move on to crawling and more.

Crawling is a skill that incorporates much more than being able to move from point A to point B. It enhances core strength, balance, strength, coordination, and learning development. As a check-in, consider whether your baby may have some challenges with earlier milestones. That may be a clue to what is limiting crawling support.

Occupational Therapy

Q: My child is having difficulty sitting still during virtual school…HELP!

By: Sam Develli, OTR/L

As task demands increase (which often happens at this point in the school year), we often see children experience increased restlessness and decreased attention. With virtual school, and the added complexities of technology and limited peer interaction, we are seeing even more challenges surrounding sustained attention, working memory, and self-regulation.

Sustained attention, working memory, and self-regulation are all aspects of a larger concept called executive functioning. And executive functioning is not learnt overnight, it’s a multitude of skills that are built from typical developmental experiences. Unfortunately, nothing is typical right now!

So how can you help my child in building these skills and increase their ability to learn in a virtual medium? Here are some tips to try:

  • Ensure your child has ample movement breaks throughout the “school day”. Ordinarily, these are structurally built into the school day as children change classes and go about their schedule. But with everything happening in one “room”, these often become forgotten. While all children are able to sustain attention and sit for varied amounts of time, a good rule of thumb is to embed a 2-3 minute movement break (even if this means getting a drink or going to the bathroom) after 25 minutes of seated, table work. It’s also helpful to provide a longer break after significant seated time.
  • Allow your child to stand or lie on his/her stomach to complete school work, or sit on an exercise ball to engage the postural muscles and provide some input while focusing. It should be noted that this is not appropriate for children with low muscle tone (our “floppy” kiddos), as this will require too much energy focused on remaining upright and prevent learning.
  • Look closely at your child’s work space- are they appropriately positioned to engage with their teacher and classmates? The goal for optimal participation is to ensure your child’s hips, shoulders, and head are aligned with each other. To achieve this, try to position their knees at a 90 degree angle with their feet flat on the ground or on a stable surface, such as heavy books or a stool. Their head should be located in midline (or neutral), and they should be able to easily see their hands and the surface they are working on. For the computer/ipad, try to position it at eye level. This can be achieved through specific stands or simply stacking books to elevate and prevent pain due to neck and visual strain.
  • Implement heavy work/proprioceptive input throughout your child’s day. This can be activities such as running or playing outside, or incorporated into chores/exercise. See the following chart to determine which chores might be appropriate for your child to help out with- a win-win for all involved!

Heavy Work Activities (the goal is providing deep pressure to our muscles and joints)

  1. Exercise- wall push-ups, squats, bear walks, yoga poses
  2. Helping with chores- carrying laundry basket, taking the trash out, bringing groceries in from the car, making bed or stripping sheets, pulling a sibling/friend in a wagon, pushing a sibling/friend on a swing, washing car, cleaning mirror/windows, using watering can to water plants
  3. Cooking- stirring/mixing thick batter or mashing potatoes
  4. Play- kneading play-dough, pillow fight, obstacle courses, jumping on trampoline

We are Open

Child & Family Development remains open under normal business hours and operations, but we are taking many steps to keep our clients and staff healthy and prevent the spread of COVID-19. We are offering Virtual Office Visits for some services, please reach out to our office for more information.