Monthly Archives: December 2014

Healthychildren.org Has AAP Tips And An E-zine For Parents

There are so many sites out there, and busy parents aren’t sure what to look at first when researching health issues.  The American Academy of Pediatrics (AAP) has a website with a newsletter and an e-zine that can be a place to start.  They write a monthly newsletter on a wide range of subjects, and the e-zine is published much less frequently but goes into more depth on the issue’s theme.  Their advice sounds like the responses you would receive from your seasoned pediatrician, if they had the time to answer all of your questions.  Sometimes with a fussy child you just need to get in and out before things get truly ugly.

Do not expect in-depth research or much of a mention of alternative health ideas.  This is mainstream medicine.  But they do a nice job of organizing their information and the pieces are short and to the point.  When you have a quick question, that can be enough!

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Peekaboo Apps: Fun Learning Choices for the Toddler Techies

One of the best app designers for very young children (for whom short periods of screen time with an interactive adult is always the way to go) are the folks who make the Peekaboo series.  They have created a handful of apps (Peekaboo barn, vehicles, fridge, ocean) that use sharp but simple graphics, sound effects that entertain but do not overwhelm, and these apps can be used by very young children or developmentally delayed children with ease.  You can select a continuous shuffle, or have the app end when your child has viewed all the pages.  I have not downloaded the zoo app, but I just might have to do so.  The others are that good!

Each app is designed slightly differently, and I review them below based the level of physical ability needed to activate the screen and the interactive demands of the game.

Peekaboo Vehicles is a strong winner for boys who love cars but have difficulty with accurate hand control (or for very young gear heads).  Your child sees a cloudy screen and hears the quiet roar of a vehicle.  Tapping once will reveal the hidden vehicle, and another tap with drive it away, bringing back the clouds.  That’s it, nothing more.  Sometimes you don’t need more activity on the screen to stimulate learning.  You can talk about the picture, name all the items and colors, and stimulate language by pairing the reveal and the send-off with target words such as “open, go, bye”,etc.  You can chose an American or a UK pronunciation.  The sound effects are simple and familiar to most children, and the visual complexity is moderately stimulating.  The focus is on the vehicle.

Peekaboo Barn and Peekaboo Fridge show either a red barn or a kitchen, and your child hears the animal or the animated food make a noise to entice them to open the centrally placed doors.  Peekaboo Fridge shakes the fridge door slightly, for a nice visual cue.  Touching the screen outside of the target will not activate the screen, leading the child to aim carefully and reducing random tapping. When the door(s) open, you see the animal and hear his bark/moo/oink, or see the food with a funny little sound. The app allows a few seconds for the child to identify the item, then speaks the name of the animal or food.  Tapping the screen again will close the door.  A new sound/movement will entice your child to tap again.  The barn animals make realistic sounds, but some children with auditory sensitivity have been startled unless the sound level is low.  Peekaboo Fridge sounds are  very subtle and quiet.  Again, plenty of opportunities to promote language with familiar animals and foods. The graphics are simple and colorful, making it easy for a young child to identify familiar details such as the sun or the clock. Your child cannot close the doors until the app has said the name of the animal or food, which again avoids the overstimulation that occurs when a young child wildly taps the screen without control or focus.  During the holiday season, the animals in Peekaboo Barn are wearing colorful hats and the barn has holiday lights and snow.

Peekaboo Ocean is more complex, but also more entertaining.  An object is just peeking above the waves, and only a direct tap on that object will reveal it.  All of the target items have an interactive component, so touch the full object when it appears.  The jellyfish are the least active (if you have met one, then you know that is a good thing!) and the mermaid actually speaks.  It is adorable when the child speaks back to her!   Not all of the other animals and objects in each screen will respond.  The expanding sea star and the spinning octopus and her brood are a delight to young children.  Most (but not all) sound effects are subtle but engaging.  Children with sensory processing issues or ASD can be startled by sounds that are not familiar, such as the submarine horn or the whale.  They may prefer to have the sound muted.  Your child progresses to the next page by tapping the arrow at the top right hand corner of the screen.  It is not very obvious to the youngest children, so an adult may need to advance it.  This can be an advantage if you would like to keep a child focused and interactive for longer periods.

Enjoy the look on your child’s face as they navigate the land of peekaboo!

Color With Melissa and Doug: Your Child Won’t Know He Is Getting Ready to Write!

Tear off these large sheets of sturdy paper so it lies flat for easy coloring.

Tear off these large sheets of sturdy paper so it lies flat for easy coloring.

One of my favorite toy makers (sorry, Santa!) is Melissa and Doug.  Their well-designed toys are entertaining to children and satisfy the esthetic and educational needs of parents.  But did you know that you can use their fabulous coloring pads to develop pre-writing skills in your preschooler?

Their jumbo coloring pads come in a wide range of themes.  You can buy a vehicle, princess or animal theme, or go all-out with a blue/pink combo pack that either has dinos/vehicles/sports and hearts/princesses/fairies.  I know it is not totally PC, but I have had specific requests from little clients for themes that speak to them.  You like what you like.   I used the “blue” coloring pad for my illustration since my caseload is about 75% boys, and they are usually less likely to want to color.  I have to work harder to engage the guys in fine motor play.  The animal-themed book appeals to all children.

Now….you get the best results when you color together.  How YOU color, and what you demonstrate and say about your coloring will make all the difference!  When you know what will build their skills,  coloring turns into a fun learning opportunity for a preschooler.  I use Handwriting Without Tears in my private practice.  Their preschool workbooks are designed developmentally to bring your child through the stages of pre-writing all the way to writing uppercase letters.  They have a nice coloring section, and each page has some coloring opportunities with each letter.  But some children need more practice with controlling a crayon.  Enter Melissa and Doug and you.

Preparation:  Select your sheet for maximum interest (your child’s) and target pages that have a variety of vertical, horizontal, and circular shapes.  If you know that your child loves cars and is not making a circular scribble yet, then you really want a picture of cars, a sun, or an animal sheet with lots of little animal heads to color in.  You are going to color upside down, with your paper directly above your child’s.  He can see the compelling details of your picture, and can more easily mimic your strokes.  Feel free to ad-lib.  Who says you cannot add circular clouds, vertical blades of grass, or a horizontal road?

Step 1:  Identify what stroke (vertical, horizontal, circular) your child is commonly using.  Commonly, young children exclusively use a vertical stroke.  Older child with some fine motor delays will turn her paper to fill in shapes rather than alter her crayon stroke.

Step 2:  Demonstrate a new stroke, and mention that grown-ups and older kids use their fingers in different ways to color in shapes depending on the shape they want to fill in.  Mention that kids who are learning may have to go slower to control their crayon.  You can offer to work on part of their sheet, or on yours.  You might say that you tend to use too much force when you are trying something new, so you will be making an effort to press lightly and not break the crayon.  Small people like to hear that adults make mistakes too.

Step 3:  Reward and reinforce all sincere effort.  Some cautious children are hesitant to try something new in front of you to avoid a witness to their failure, but will practice on their own.  Some kids need more help and support from an occupational therapist.  But everyone loves the Melissa and Doug pages!

Autism and the Happiest Toddler Approach: Why Does It Work?

All children on the autism spectrum have two things in common:  they have difficulty with communication and less social skills than would be expected for their age.  Many, but not all, children with ASD struggle with sensory processing.  The level of struggle is so unique that these kids look very different from one another most of the time.  But when they get frustrated, they all can break down into aggression, avoidance and tantrums that last and last.  I recently attended a professional training where the presenter remarked that those meltdowns were not only a sign of autism but inevitable, and “you just let the child have his tantrum”.   I think that abandons the child when he needs the most support, but is the least available for traditional talk-based or token strategies.  I have also spoken with behavioral-managment clinicians who go straight through to a time-out warning when a child begins to resist or complain.

So why does The Happiest Toddler (THT) strategy work well for children on the ASD spectrum?

At first glance, it seems that it would be less successful than standard behavioral approaches, as it relies on reflecting back feelings and supporting social and self-control skills.  Initiating and sustaining direct verbal give-and-take is often the greatest limitation of these children.  Kids on the spectrum really benefit from the emphasis on non-verbal messages, the repetition, and the indirect teaching that occurs using Dr. Karp’s techniques.  The adult matches the child’s language level at the time of the tantrum, and social interaction matches a child’s skill level as well.  If a child with ASD is able to function above an 18-month level, at any chronological age, then this approach can be very effective in helping him achieve a calmer state and learn self-control skills.

I modify the program to assume that a child will need more opportunities to practice and fewer distractions to use techniques such as Gossiping and Patience-stretching. My target level of repetition, voice volume and language complexity may have to be very fine-tuned for each child.  I may need to select words that he commonly uses, or words that have previously shown a positive response.  I will strive for consistency in my delivery once I have created a plan, and accept that generalization of using THT (expanding this to other situations, or even to the parents and nannies) is going to take longer.

This strategy works more effectively with a “floor-time” model than with an ABA model, but it can be used with any program.  The definitive measure of whether this approach will work is the willingness of adults to adapt their response to a child’s unique emotional and communication needs.

Take a look at the technique demonstrated on a “Good Morning America” segment to give you an idea of what it looks like in action. http://youtu.be/lrxBKvV1p-A

Toddler Apps That Make Tiny Hands and Tiny Minds Work Together!

One of my favorite app designers are the folks at Tiny Hands.  They have a suite (but you can buy apps separately and get free mini trials) of apps for the 2-5 set that are progressive in challenge but consistently high in fun.

Since I am always looking for positive (read: active) tablet use, I like the way these apps require matching, categorization, counting or visual-percpetual skills to be rewarded at the end with a cute character suspended on pop-able balloons.  The graphics are very simple, and an over-excited toddler cannot tap themselves through.  They have to think.  Themes reflect topics that toddlers can recognize and nothing controversial.  There are no warring ninjas or exploding bombs.  But there are plenty of animals, vehicles, and even some music.  Levels of play are indicated, but the child is not restricted from trying higher levels.

As an occupational therapist, I love using the app crayon or the app stylus for these games.  The drag-and-drop function builds hand strength and control without a child realizing that they are doing so.  It is just so much fun.

Tiny hands gets tiny minds working too!

Elf on the Shelf Controversy: Let’s Try Positive Gossiping to Santa

The recent discussion surrounding the popular toy “Elf on the Shelf” has been more heated than one might expect for a holiday tradition.  For every family that finds him charming and motivating, there is another family that sees him as a creepy little elf, holding the threat of tattling to Santa over toddlers.

I suggest that if you think he is cute, and your children like the magical elements to the story,  you could alter the “backstory’ as they say in Hollywood.  What about giving the elf the responsibility of only sharing a child’s positive behavior with Santa?  He might watch for sharing, cooperation, and patience.  Just like the Gossiping technique in Happiest Toddler on the Block, you can tell the elf (well within your child’s hearing) what wonderful things he has done each day.

If a child has already heard the standard version, simply explain that the elf’s job description has been changed due to your child’s maturity.  New holiday season, new plan.