Monthly Archives: October 2020

The Three Stages of Color Recognition in Toddlers and Preschoolers

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Although this is not officially an OT issue, I field questions about when and how to teach color recognition to young children.  Like many of my other posts, I am writing this one so that I have something I can send parents; they can read about the concepts we discuss.  There is so much going on in a session that it is hard for the average parent to retain everything I “throw” out in a 30-45 minute session!

Color recognition doesn’t usually emerge before 14-16 months, and typical children can be struggling to match primary colors for months after that age.  But the progression, delayed or on-time, follows a fairly standard pattern.   Expecting stage 3 responses when your child is still at stage 1 is simply asking for frustration from your child, and creates unnecessary concern for parents.  These stages aren’t seamless, meaning that one day a child will consistently be at stage 2, and the next, they are functioning at stage 1.  This is also normal, because a young child that is ill, tired, distracted, upset or even hungry cannot perform skills consistently.

Color identification generally happens with primary colors first, and progresses to secondary and tertiary colors.  This  means that a child often can distinguish red and blue  before they know purple and gray.  There are children over three that are totally confused about brown, gray and beige…..that is completely normal.

Stage 1:  Your child is able to match colors shown to them without being able to respond to a request for a specific color or to name the color.  You hold up a blue block, and ask your child to give you another block that is the same color.  You may even find one and say “HERE it is!  The same! I found another block!”  Your child clearly looks at a few blocks, and hands you the blue one.

Stage 2:  Your child is able to respond to a request to find a block of a specific color.  You say to your child “Please give me a BLUE block”, and without showing them which block is blue, they find one and give it to you.  This requires receptive language, as a child interprets your words and assigns labels to the objects they are seeing.

Stage 3:  Your child is able to correctly answer the question “What color is this block?”  This level of skill means that they know the names of colors and can state them on demand.  This requires expressive language, and anyone who has learned another language will know the internal Rolodex as you search for the right name for the color you are viewing.

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How The Pandemic is Affecting A Toddler’s Learning: Parents Are Their Child’s Best and First Social Models

The New York Times ran a ridiculous piece today about the effects of the pandemic on early learning.  It had quotes from staff at programs for music class about the amazing motor and cognitive benefits of clapping in time to a song and imitating animal sounds.  It had quotes from parents in wealthy NY suburbs, concerned that not learning turn-taking and social skills in class would affect their children’s performance at preschool.  And of course, it showed stills of music class on Zoom, with toddlers looking at a split screen with the adult singing and the other children visible in little boxes.

Do not fear:  very young children aren’t losing out.  Their social skills won’t be permanently crippled by being at home with their parents.

The parents of typically-developing very young children are the original and best source of socialization and language skills.  There is no substitute.  Parents are MORE than capable of providing the right stuff.

Parents might be missing the benefits of having someone to share the long hours of childcare, and the opportunity to connect with other parents, but very young children under 3 without any developmental delays are able to do just fine without their movement or activity class, AS LONG AS THE ADULT(S) CARING FOR THEM ARE WARM, INTERACTIVE, RESPONSIVE, AND FOCUSED ON THEIR NEEDS.

As a therapist working in Early Intervention programs, my job has been to instruct parents in how to promote development, and how to manage behaviors that arise from delayed development or disabilities.  But it also has been about teaching some parents how to play with children under 3, how to pick out toys that match their current skills, and how to deal with the typical tantrums and defiance that come with the territory.

 Many parents have no idea what to do, and a few, frankly, really don’t want to deal with the sometimes boring and tedious job of caring for and playing with very young children.  I see a fair amount of outsourcing parenting when people can afford to do so.    And I understand it rather than condemn it.  This is real work, and not everyone wants to do it.  For generations, the wealthy have hired people to raise their children, because they could.  Why vilify middle class modern parents for the same thing?  But don’t think that a very young child is missing out on important social skills when they can’t go to music class.  The owners of the class are missing their income.  The babies will be just fine.

Very young children are wonderful, but they require a tremendous amount of energy.    It can be draining, in a way that getting out a project update is not.  Raising children is work.  Hard work.  There aren’t that many professionals willing to state the obvious:  young children take much more than they can give in those very early years.  They can’t converse.  They can’t joke.   They can adore you, but they can’t reciprocate cognitively or socially in the way an adult needs.  Regardless of how much you adore them, it is work.  Rewarding and important work, but hard work.  Done alone in a pandemic, while a partner is focused on earning a living, it can be isolating and exhausting.

Enter infant music classes and Mommy-and-Me groups.

These are terrific for breaking up the long days of childcare and getting adults together, but most 14-month olds don’t socialize with peers.  They don’t have the mental ability to do so.  The adults do.  This has real value for adult mental health, but please don’t lie about who is getting the most out of the class.  Accept that raising very young children is hard work, and make sure that caretaking parents are able to take care of their own needs.

But do not buy the idea that without going to music class, a young toddler is risking a loss of social, emotional, motor, or cognitive skills.  But their parent might be.

Is Your Child Bright or Gifted? Spot the Differences

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One of my posts, Why Gifted Children Aren’t Their Teacher’s Favorite Students….  gets a lot of interest.  Parents are surprised that having a gifted child doesn’t reap enthusiasm from the average educator.  The general characteristics of a gifted person (intensity, drive, and complexity) can be downright disruptive in a general classroom.  It often isn’t any easier at home.

So if you are wondering if your child is gifted, and you haven’t started searching for a psychologist to perform the WISC-R yet….here are a few differences between the bright kids and the gifted kids:

  1. Bright kids learn quickly.  Gifted kids can learn lightening fast.  Show a bright kid something new and after 5-8 repetitions, they have it down.  A gifted kid can have it down in 1-2 demonstrations.  Think Shirley Temple.  The could teach her a dance routine by simply showing her the steps once.  That is a gifted dancer.
  2. Bright kids are great listeners.  They sit and wait for you to finish.  Gifted kids will interrupt with questions, argue points you never saw coming, and have a strong need to examine the materials that you are holding.  They almost want to inhale your props to learn more about them.  
  3. Bright kids make friends easily.  Gifted kids can struggle to find true peers, and often prefer to be alone so that they can pursue their interests and control the outcome of their play.  A gifted athlete may be competing with children much older, and a child that is able to expertly play an instrument or read at an advanced level has to find common ground with other kids while having uncommon skills.  
  4. Bright kids really ARE a joy to teach.  They have great memories, know how to fill in the blanks, and follow your instructions.  Gifted kids have their own strong passions, and rarely have enough space on a worksheet to fill in their complete answer to a simple question.  They want to express their unique viewpoints, and see many sides to a situation, so “yes/no” responses don’t really work for them.  Take a gifted kid on vacation, and you could have someone who has no interest at all in going to the beach, or someone who won’t leave the beach because there is still so much more to see.  
  5. Bright kids win awards, get elected for school offices, and are often group leaders.  Gifted kids may or may not accomplish these things.  Their performance may be driven by their desire to explore rather than excel, so they may be accused of not living up to their potential.  Gifted kids will not always be found in the top reading group or in the honor classes.  They aren’t driven by other’s agendas.  Their own internal sense of drive will prevail.  The perpetually daydreaming or laser-focused gifted child may have an agenda that hides their gifts.  Gifted children can be interested in and talented in many things, and have difficulty staying with one passion long enough for mastery, and they may not care about mastery anyway.  Their passion is the journey.  

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Is It Sensory Treatment…Or Sensory Stimulation? How To Know The Difference

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I have spent the first part of my career in pediatrics convincing parents, teachers, and other therapists that sensory processing is important for development, and that sensory processing disorders are a real “thing”.  I am spending the latter part of my career trying to explain to the same groups that using a sensory-based activity does not constitute sensory treatment.

Why?

Results.  You will not get good results to any treatment if the underlying principles aren’t understood and used correctly.  This requires more than a therapy ball and a brush.  A local school district uses general sensory activities for the whole class, rather than sensory-based treatment for kids with sensory processing disorders.  I get a lot of private practice referrals from this neighborhood.  The district’s refusal to address children’s needs in the classroom, while telling parents that they are “sensory-aware”, is frustrating to everyone, including the therapists in the district.  They don’t seem to stick around…..

Therapy for sensory processing disorders requires an evaluation.  Assessing the problem and identifying a rationale for the related behaviors or functional deficits is essential.  Tossing out a sensory-based activity because it is fun, easy, or has worked for another child is the hallmark of a well-meaning provider that wants to help a child but doesn’t have the training of a licensed therapist.

A good example would be to offer teething toys to a child that chews their shirt.  Sounds like a solid plan:  oral seeking equals oral stimulation.  But wait! What if the child is using oral seeking to address severe sound sensitivity?  Isn’t it better to deal with the cause of the problem rather than the end-point behavior?  You would need an evaluation to know that their greater problem is poor modulation and sensitivity.

Treatment techniques follow a pattern that is based on the brain’s neurological response to sensory input.  I didn’t take courses in neuroscience because I liked looking at brain sections.  I took those courses so that I could understand the structure and function of the brain!

The right intervention (movement, pressure, etc.) uses intensity, duration, specificity of sensory input, location of contact/input, frequency, and timing to achieve results.  This sounds like a lot to consider, and….it is!  The way OTs create a sensory diet isn’t by looking at what worked for another child.  We look at what we observe, what we assess, and what the child’s performance demands are.  Only then can we identify what should be used, how and when it should be used, and how to determine our next steps in treatment. 

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A great treatment that isn’t used at the correct level of frequency or used when it is most needed is going to fail.  So will the right frequency of treatment used vigorously rather than with skilled observation.  Non-therapists can be taught a treatment intervention, but it takes training and experience to create a treatment program.  This is no different from any other type of therapy.  Psychotherapists aren’t just talking to you. Speech therapists aren’t simply teaching you how to pronounce the “r” sound.  If it was that easy, we wouldn’t need licensure or even a degree.   

It would be a lot more fun.  We make it look easy, and that is the art of OT.

 I have just explained (some of) the science.

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How to Help Toddlers Prepare to Write

Ian, Lila, and Tom aren’t writing. They are drawing!

Contrary to the ideas of some preschool teachers, most three year olds don’t write their names.  In truth, most young fours don’t either.  I refuse to count the kids who “draw” their names like the photo above.  That isn’t writing.  That is drawing, the same as if I copied my name in Mandarin.  I would be drawing the characters, not writing.  Writing requires that I know the correct start and sequence of strokes.

So…What can you do to help late twos and the threes prepare to write?

The mom of a toddler brother of a private client asked me, and I know this child uses his fist to hold a crayon.  Improving his grasping skills should be one big goal, and there are a bunch of fun toys that can support this.  Read Water Wow: Summer Pre-writing Fun on the Road  and read LEGO Duplo My First Car Creations: Putting Together Cars, Building Hand Coordination for two great toys that kids in this age group will love.

 Another way to prepare a young child for handwriting is to build a child’s skilled use of spoons and forks for self-feeding.  I wrote a post on this  How Using Utensils To Eat Prepares Your Child To Write  , and I don’t think parents always fully understand that offering finger foods isn’t going to build hand skills after age 2, unless your child is very physically delayed.  Once they can pop a chicken nugget into their mouth, finger feeding isn’t building hand control.  It certainly isn’t enhancing grasp!  Getting a child the right utensils seems to be an issue in many homes.  Pre-pandemic, I did live EI sessions, and regularly asked parents to throw out those infant feeding spoons (they have a tiny bowl and a super-long handle) because they DO NOT HELP YOUR CHILD SELF-FEED.  THEY MAKE IT HARDER.  Read Which Spoon Is Best To Teach Grown-Up Grasp?  and Teach Spoon Grip By Making It Fun And Sharing a Laugh With Your Child   to find good utensils that support hand control.

The use of a vertical easel, the kind found in any preschool classroom, can build hand control and prevent the development of an awkward crayon grasp.  Stabilize the paper with clips or tape, because young children will not hold loose paper while coloring.  Using a screen stylus builds finger strength and makes drag-and-drop screen time into a hand exercise.  

Crayola’s PipSqueak markers and their My First Crayons are great choices for pre-writing.  ColorWonder paper and markers will not make a mess.  They will save your MIL’s couch at the same time!

Enhancing bilateral assembly skills will prepare a child for the visual-perceptual and midline awareness needed for handwriting.  I love MagnaTiles and DUPLO blocks, but there are other ways to build.  A great variety of building materials will support a typically-developing child.  Sitting passively in front of a screen will not.  Safety scissors should be offered.  The kind that really work: Lakeshore Scissors for Toddlers That Only Cut the Paper, Not the Toddler

Finally, young children need to see adults and older siblings drawing and writing.  If your older kids are addicted to screens, you will have to be the one coloring and drawing.  During stressful times, this might help you relax as well.

Remote Learning Strategies for Special Needs Students

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Remote learning isn’t easy.  Helping a special needs student navigate it isn’t easy either. Here are some strategies to improve outcomes and reduce everyone’s stress about it:

  • If your child’s OT has created a sensory diet for them, this is the time to use it.  A sensory diet is a series of activities and actions that support the brain’s ability to regulate alertness and emotional arousal. How To Remember to Do A Sensory Diet With Your Child If there every WAS a time to get serious about a sensory diet, it is now.  Your child needs every advantage to stay calm and focus.  If you never drilled down and tried it, ask for a review of the techniques, and don’t be shy about admitting that you don’t use it as often as recommended.  We know you are overwhelmed.  We are too!
  • Your learning environment matters.  Take a look around, and remove distractions.  Remove things that don’t distract you, but could distract your learner.  This may mean that you put up a tension rod and a drape that blocks a window, another room where a sibling is learning, or even the view to the snack cabinet.  It may mean that cheerful signs go down.  It may mean that the room you are using is the wrong room because it is too bright, too warm, too noisy, etc.  Kids with learning differences don’t get motivated by lots of decorations; they get distracted.  Teachers get enthusiastic about decorating their classrooms, but they don’t have sensory processing or learning issues.  Don’t make things harder for your child.
  • Positioning matters.  The chair height and desk/table height will affect your comfort and attention span, so you have to think about how it affects your child.  If your OT is virtual, you can send photos and videos of your set-up and get feedback.  This may not require a purchase.  We can help you use the materials in your home to make your equipment work better.
  • How much sleep is your child getting, and how much rest, play, and fun?  Some kids are way over scheduled, even with COVID, and some aren’t getting a chance to be creative.  Make sure that you have puzzles, art supplies, crafts, and other ways for your child to explore.  You might find that you can throw off some stress by painting or crafting as well.
  • Consider therapeutic listening.  I am using Quickshifts Quickshifts: A Simple, Successful, and Easy to Use Treatment For Regulation, Attention, and Postural Activationwith almost all my private clients, and it is helping them focus on Zoom sessions.  Even parents that were skeptical of this treatment have come on board.  They see the difference it makes!