On Thursday, November 20, 2008, we’ll continue our series on autism. Our colleague pediatric psychologist Dr. Lisa Powell will be joining us to talk about the specific diagnostic criteria for autism spectrum disorders. We’ll also ask her to tell us what research is telling us about the most promising treatment protocols for children with autism. We’ll also get her perspective as a clinician on what she’s seen be most helpful for families.

By far this is the most searched topic on this website. The current statistics are staggering. 1 in 150 children are now being diagnosed with autism. If you’re a boy, the odds are 1:99.

If you are concerned that your child MAY have autism, don’t miss these shows!

Just so you know, in the month of December, we’ll be focusing on TREATMENT STRATEGIES for toddlers and young preschoolers with autism. We’re planning a show specifically on introducing PECS (Picture Exchange Communication System) as well as a discussion about the benefits of Floortime and other social and play-based interventions. We’ll also have an entire show dedicated to echolalia.

We will likely not be discussing the CAUSES of autism or biomedical treatments for autism since this is not our area of clinical practice or expertise.

You can listen live by clicking this icon.

Our call-in number is 1-718-766-4332. We’d love to hear your questions!

If you can’t join us live, you can always listen later anytime using the blogtalkradio icon in the right hand column or on the home page.

Our show is also available for FREE download on itunes. Visit the itunes store and search “Teach Me to Talk with Laura and Kate.” For you itunes novices, choose subscribe, and the show will download so you can listen later with your ipod.

I hope you’ll join us! Laura

Websites:

www.autismspeaks.org

www.actearly.org

www.floortime.org

www.zerotothree.org

Books:

Engaging Autism   Stanley Greenspan and Serena Wieder

The Child with Special Needs  Greenspan and Wieder

More Than Words   Fern Sussman

Giggle Time - Establishing The Social Connection     Susan Aud Sonders

It Takes Two to Talk   Ayala Manolson

Therapy Programs/Manuals:

The Affect-Based Language Curriculum - An Intensive Program for Families, Therapists, and Teachers Greenspan and Lewis

Teach Me To Talk the DVD  - Strategies for Parents to Improve Expressive Language Skills in Toddlers    (Order on this site from logo link on the right) 

Checklists to help parents in the initial diagnostic process:

Checklist for parents to fill-in that MAY predict if your child is likely to receive a diagnosis of autism/PDD -http://www.childbrain.com/pddassess.html

Plain English Version of DSM IV Criteria for Diagnosing Autism - http://www.bbbautism.com/vol_6_iss_2_autism_pdd_pddnos.htm#dsmiv_eng_6_2 

If you have other resources you’d like to share, please do so!  Laura

On Thursday, November 13, 2008, we’ll continue our series on autism.  

By far this is the most searched topic on this website.  The current statistics are staggering.  1 in 150 children are now being diagnosed with autism.  If you’re a boy, the odds are 1:99. 

We’re going to discuss the HUGE behaviors (or lack of social or language skills) that indicate a referral for speech-language therapy for infants and toddlers.  

We’re also going to continue to talk about the diagnostic process and initial treatment recommendations.

This week we hope to also begin to recommend our favorite resources for families who are in the process of seeking an initial diagnosis.   

I want to give you a big heads-up about next week’s show too. On Thursday, November 20 our colleague pediatric psychologist Dr. Lisa Powell will be joining us to talk about the specific diagnostic criteria for autism spectrum disorders.  We’ll also ask her to tell us what research is telling us about the most promising treatment protocols for children with autism.  We’ll also get her perspective as a clinician on what she’s seen be most helpful for families.  

If you are concerned that your child MAY have autism, don’t miss these shows! 

Just so you know, in the month of December, we’ll be focusing on TREATMENT STRATEGIES for toddlers and young preschoolers with autism.  We’re planning a show specifically on introducing PECS (Picture Exchange Communication System) as well as a discussion about the benefits of Floortime and other social and play-based interventions. We’ll also have an entire show dedicated to echolalia. 

We will likely not be discussing the CAUSES of autism or biomedical treatments for autism since this is not our area of clinical practice or expertise. 

You can listen live by clicking this icon.  

Our call-in number is 1-718-766-4332.  We’d love to hear your questions! 

If you can’t join us live, you can always listen later anytime using the blogtalkradio icon in the right hand column or on the home page.  

Our show is also available for FREE download on itunes.  Visit the itunes store and search “Teach Me to Talk with Laura and Kate.”  For you itunes novices, choose subscribe, and the show will download so you can listen later with your ipod.     

I hope you’ll join us!  Laura

I think about new professionals hungry for information to help them with a new client, or I think about grad students who will read anything they can get their hands on!  I even regularly hear from what I’ve come to appreciate as ”seasoned” (NOT OLD!!) professionals who thankfully aren’t so cynical or so tired that they are on auto-pilot and actually still care enough to try to track down new ideas. 

But I have to say, I never think about grandparents reading my stuff.  

That doesn’t mean that I don’t talk to grandparents.  I see a few grandmas pretty regularly during visits with my own little friends on my own caseload.  I also talk to my own mother nearly everyday, who at any given time, is very worried about one grandchild or another in our own family. 

Until recently, I had heard from only a handful of grandmothers on this site, but lately it seem like they’re coming out of the woodwork!  Here are a couple of examples of ones I’ve received -    

“My grandson just moved to our hometown. He is four years old and still struggling with speech. I do have to say that I have searched the Internet far and wide for suggestions to help him. I have to tell
you that your website has been the most helpful to me. My grandson has had an explosion of words, complete setences, and questions in the last two months…… I am so afraid that he is not getting what he needs. I feel like I should do my best to keep language alive. When I pick him up from daycare, we sing songs. He likes for me to read Go, Dogs, Go by Dr. Suess. He has started to even repeat words in the book. We blow bubbles, play horns, and drink from straws. I’m not a speech therapist, but I can’t just sit back and wait while nothing happens. Since, I have tried some of your suggestions, my grandson is “picking up and running with words.”    

One thing you might want to offer after the evaluation is to assist the parents in researching and exploring treatment options. Helping a stressed mom wade thru websites and books for useful information would always be welcomed IF your advice and offers to help are given knowing that a parent has the right to take it or leave it. 

The best result of all of this independent research is that you yourself will become educated in what’s going on with your grandchild. Information makes us all more useful, even if you just become the sounding board for a mom and dad who could use extra reassurances that they are doing all they can, and someone who will firmly, but lovingly, remind them when they are not.    

Another great thing I’ve heard from many grandparents lately is that they taken on some of the “treatment” themselves.  If your grandchild is language delayed, read the articles on this site and learn the techniques from the DVDs to start your own “grandma” therapy sessions. My own mother tries to do this with all of her grandchildren who are toddlers and young preschoolers.  She recognizes how important language skills are for future academic success, and she’s made the most of visits to Mimi’s house.   

If you can help financially with the extra expense of costly therapy, by all means, do so.  Sometimes I notice that my own older clients’ therapy sessions have been funded by grandparents when I read their names on the check.  

Support can come in all kinds of non-financial ways too!  If you can’t help pay, offer to drive your grandchild to sessions, or babysit any other children at home so that mom and dad can fully participate instead of chasing around a young (or older) brother or sister.  

If you aren’t available during the week, go and pick up the other grandchildren on the weekends so that mom and dad have uninterrupted time to do all of the “homework” they need to do with the child who needs focused therapy time at home in order to make progress.  

One wonderful idea the mother of a little girl on my own caseload shared with me today is that instead of buying her grandchild a toy or clothes for her birthday, the grandmother purchased a session of classes at a local baby gymnastics facility for her language-delayed granddaughter.  The grandmother picks up the grandchild for the class one morning every week so that they can spend one-on-one time together, just “GG” and grandbaby.  This is win-win for everyone in this family since this is child #4, and her busy mother needs the break! 

Lastly, I want to encourage you to NOT make this grandchild any less special because of whatever issue this may turn out to be.  I’ve seen so many grandparents (and their own grown children!) struggle with very difficult toddlers during very difficult developmental patches.  Some children do get better and “grow out of it” (with the help of therapy and whatever else their committed parents do!)  Unfortunately, some children do not. Grandparents sometimes have to grieve too when it becomes obvious that a child may not ever be what you’ve dreamed and hoped.   

My hope for you as a grandparent is that you can rise to the occasion and love and support your family and this child come-what-may.  A grandparent’s attention and devotion may be what helps pull this child, and his or her parents, through a very traumatic time for all of you. But as the grandmother above pointed out, your life experiences alone uniquely qualify you to be able to help not only your grandchild who deserves it, but your grandchild’s parents, who most likely desperately need it!  

Laura             

On Thursday, November 6, we’ll be beginning a new series on autism.  By far this is the most searched topic on our website.  The current statistics are staggering.  1 in 150 children are now being diagnosed with autism.  If you’re a boy, the odds are 1:99. 

For the next two weeks, 11/6/08 and 11/13/08, we’ll start to talk about the ”red flag” behaviors of autism that children who are diagnosed with autism exhibit at ages 1-3. 

We’re also going to discuss the HUGE behaviors (or lack of social or language skills) that indicate a referral for speech-language therapy for infants and toddlers.  If you’ve been on the fence wondering if your child should be referred, this show is for you!   

On Thursday, November 20 our colleague pediatric psychologist Dr. Lisa Powell will be joining us to talk about the specific diagnostic criteria for autism spectrum disorders.  We’ll also ask her to tell us what research is telling us about the most promising treatment protocols for children with autism.  We’ll also get her perspective as a clinician on what she’s seen be most helpful for families.  

If you are concerned that your child MAY have autism, don’t miss these shows! 

Just so you know, in the month of December, we’ll be focusing on TREATMENT STRATEGIES for toddlers and young preschoolers with autism.  We’re planning a show specifically on introducing PECS (Picture Exchange Communication System) as well as a discussion about the benefits of Floortime and other social and play-based therapeutic approaches.  We’ll also have an entire show dedicated to echolalia. 

We will likely not be discussing the CAUSES of autism or biomedical treatments for autism since this is not our area of clinical practice or expertise. 

You can listen live by clicking this icon.  

Our call-in number is 1-718-766-4332.  We’d love to hear your questions! 

If you can’t join us live, you can always listen later anytime using the blogtalkradio icon in the right hand column or on the home page.  

Our show is also available for FREE download on itunes.  Visit the itunes store and search “Teach Me to Talk with Laura and Kate.”  For you itunes novices, choose subscribe, and the show will download so you can listen later with your ipod.     

I hope you’ll join us!  Laura

Promote Participation and Attention at Circle Time by:

1.  Using developmentally-appropriate activities.

Too often I go into toddler classrooms to work with a child who is language-delayed and having difficulty participating in the circle time routine, and I cringe at what the teacher is trying to pass off as an activity interesting enough to hold the attention of 10 two-year-olds.  

HINT - HINT - If 8 of the 10 children are not able to participate and pay attention, you’re doing the wrong kind of activity!  

Naming flashcards, reciting the alphabet, days of the week, or months of the year, and saying the Pledge are NOT appropriate for this age group! For 4 & 5-year-olds yes (well, maybe), but 2- and 3-year-olds, forget it!

What activities are developmentally-appropriate for younger children? 

• Sing simple songs with hand motions, or better yet, songs with lots of whole body activities (think Hokey-Pokey, London Bridge, If You’re Happy and You Know It, Itsy Bitsy Spider, The Wheels on the Bus, etc…)  Try to mix 1 or 2 old favorites with one newer song that’s related to your weekly/monthly theme.  Sing the same songs for a week or two to build familiarity, then move on to new ones to match your theme.  
• SHORT Flannel Board Stories or SHORT Stories told with Props  OR 
• VERY SHORT stories from books with lots of pictures related to your theme read with LOTS of enthusiasm.  By short, I mean 2 minutes tops!  By enthusiasm, I mean using your voice and your facial expressions to convey the meanings of the words.  This is sooooo important for children with language delays who may not understand all of the words, but can follow the plot pretty well if you’re giving them other visual and verbal cues to help them.     
• Include only activities that the children obviously enjoy.  If you’re losin’ ‘em, lose the activity!
• Build routines into circle time such as singing the same opening or closing song so that children know what to expect. 

My favorite opening circle time song for toddlers is letting the children take turns hiding under a blanket and singing:

“Where, oh where, oh where is (child’s name)?,

Where, oh where, oh where is (child’s name)? ,  

Where, oh where, oh where is (child’s name)?,

Where can (name) be?” 

Then help the child uncover and everyone says, “Boo.”  This has been a big hit with every class I’ve ever introduced it to from about 15 months all the way through 3 year olds.  It also helps children learn their friends’ names.   

2.  Making the length of circle time match your group’s attention span.

In the beginning of the year, circle time may need to only be 5 minutes long and then expand to no more than 10 minutes for 2 year olds and 15 minutes for 3 year olds.  Why?  Because you may lose the attention of even the best-behaved and brightest young children after this amount of time.  Very complaint children may still remain seated longer than this, but if they’re not actively participating and learning during this time, why bother?

3.  Scheduling circle time AFTER a gross motor activity.

So many preschools schedule circle time for the very first activity of the day.  This is GREAT IF your children have been given the opportunity to run, jump, kick, catch, throw, and play rambunctiously for the first 10 or 15 minutes they have been in the classroom, but often this is not the case. 

If you don’t have the luxury of planning your own schedule or the facilities to do this, then always begin circle time with a 2 minute dance to “get the wiggles out.”  Or you could have the kids ”march” around the room or “hop like bunnies” to pick up and put away toys before beginning circle time.    

Many teachers are afraid to do this thinking that it will hype the kids up.  Actually, it’s the opposite.  After kids spend some time moving around, their little brains and bodies are more ready to attend.

I love it when circle time is after children have been outside or have had gym time.  Not only have kids gotten to move around, they’ve also walked to and from the other location between activities.

4.  Providing better seating arrangements for younger children.

Toddlers need to know where and how to sit for circle time.  Using an arrangement that promotes visual boundaries is the best way to make sure children stay where they should, instead of wandering around the room or invading the space of their friends.      

Many programs use colored shapes taped to the floor as a guide, but often times the shapes are too small to serve as a boundary for where sprawling legs and wiggly feet should stay. I prefer carpet squares or bean bags.  Toddlers with sensory processing disorders will also get a “sensory bump” from using either of these since it provides much more tactile feedback than sitting on floor.       

I know storage is a problem for some facilities, but most every room has an empty corner.  If you have the children retrieve them from a stack in a corner as the beginning activity for circle time and then stack them back in the corner when you’re finished, you’ve also provided a movement activity PLUS established another “routine” for your classroom.  You’ve also extended circle time by at least 5-10 minutes for children with even very limited attention spans since most 2 year olds can be taught to get and return their carpet square or bean bag just by following the examples of other children.                 

I place mimimally verbal children and highly distracted children directly across from the teacher so that they can SEE what’s going on.  I also like to place less verbal children between other more verbal kids so that they hear better language “models” BEFORE it’s their turn to respond if we’re going around the circle to answer a question, and so that they can see a peer seated next to them who is (hopefully) on track.  

5.  Giving kids who can’t participate yet enough support to make them successful, AND a way out. 

If the length of your circle time is too long for him, a child could be allowed to sit for the first song/activity of circle time, then be allowed to go to a quiet or calming spot (definitely better than time out for not participating OR disrupting the activity fo the rest of the group!)  You could gradually extend it so he sits thru the first 2 activities, then he can opt out.  Still make the child return for the clean up part if you are putting carpets away since I know from personal experience that most all children CAN learn to do this part. 

One other way to help a young child learn to sit and attend is to provide “fidget toys” so that they can get some tactile feedback while being expected to continue to sit.  You can provide small squishy toys (think small koosh balls, smushy or stretchy animal toys, or even a Hot Wheels car).  You may want to buy several options and put them in a special box so that once a child is sitting he can choose from the box every day. 

You can gradually extend the time so that the child has to sit for a minute or two BEFORE he gets the toy in circle time, then he can sit and “fidget” through the next little portion of circle time.  When he gets up, the toy has to go back in the box. This works well for kids who are tactile or visual seekers because they want to sit to get the ”treat.”  If you know there’s something he loves, try to find it in a little toy appropriate for holding during this time, and I’d give it only during this time for him. 

Other items that work great for me when I lead this activity are attaching ribbons to the edges of the carpet squares.  I also purchase and wear cheap bracelets that I can give to a kid during circle time if he needs it, or let him “fiddle” with it while he sits in my lap. 

I do think it’s okay to hold a child who needs it through circle time, either while I’m seated on the floor or even between my legs if I’m fortunate enough to get a chair! Some teachers balk at this saying it’s not fair to hold one and not all of them, but rarely will you have more than one or two who need to be held until he can do the routine (unless it’s a special needs classroom).  Use the laps of other staff members too!  If you have a kid who really needs the support, recruit a volunteer to be there specifically for circle time.           

Another thing I have done if I have a child with behavioral issues (rather than truly sensory ones) who won’t sit is to give everyone who is sitting a treat like a Skittle (or even a sucker if I think I need a “bigger” incentive) or let everyone who is sitting have a special turn doing something I know this kid likes to do.  Some teachers ”stamp” kid’s hands or give stickers for this too, but I usually see children who need more of a prize than that!  I am pretty generous with this initially.  I go ahead and give a child like this the prize too to get him “hooked” into doing this even if he initially he just comes over and sits and waits for the prize while the other kids are getting theirs.  Then I might up the ante and remind him that he has to sit through the most of the closing song to get the prize, then all of the closing song, etc…  (Often these are the children who get up after the opener, then they come back for the closer.) 

——————————————————————————-

You really can use these activities to “shape” behaviors for circle time, but gradually over several days, weeks, or even months, depending on how well you pick your reinforcers, how entrenched the child’s behavior is, OR how his little sensory system is affected.  It will likely not happen in a week unless your issues are pretty mild, but it can happen over time for most children.

Be sure to leave a comment if you have other great circle time ideas to share!  Laura    

OUCH! Being a pediatric SLP who specializes in early intervention, this hit a little too close to home.

My heart sank as I read her story.  She had just finished the initial evaluation with her state’s early intervention team, and they told her they suspected that her son has autism. 

As she typed the post, there she was right smack in the middle of those first stages of grief, bouncing back and forth between denial, isolation, and anger, all there in black and white for the world to see. 

I felt so badly for her.  Even though I’ve never met her, I know her. I’ve been on the other side of the table from her for years, sitting right across from her, trying to swallow the lump in my throat, gripping my well-worn test manual with white knuckles, and trying my best not to tear up as I deliver the words that would confirm her worst fears.  It’s not easy being a dream killer.  

Since I originally read her blog, I’ve thought about her often.  Sometimes it’s because I’ve told a mom the truth, and I could see all over her face how much my words hurt her.  Sometimes I’ve thought about it when I’ve opted to save a hard conversation for another day.  In recent years there have been a few times when I’ve decided that life-changing news can wait a week or two.  The truth is that sometimes you’re never ready to hear what might need to be said about your child. 

Just this week I ran across that same blog, again while doing research for this site.  At least 6 months have passed since I read her thoughts, and my how things have changed.  This mom has blossomed into a wonderful resource of realistic hope and practical information for other parents.  Her words are not the kind of too-good-to-be-true “cure” that you read about in supermarket magazines or hear from a celebrity on Oprah.  As she shares her story, you read about the hard work of one family doing everything they can to help their young son.                           

When I contacted her to see if she’d mind if I posted a link to her blog here at teachmetotalk.com, I wrote that I’d thought about her original post often since reading it, especially when having those initial difficult conversations with parents.  

She sent me back this comment, “I wish I could give you advice as to how to soften that blow, but I have none. But think of it this way: the “blow” is an essential part of the journey. You can’t skip that step, and the anger and irrationality that comes with it.”

The next time I’m feeling queasy about the news I have to share, I hope I remember that.  

 ———————————————————————–

You can read this mom’s blog “A Little Big Autistic” from our new blogroll. 

If you want to hear the complete discussion, please listen to the show #13 by clicking the blogtalkradio link from this page or the home page.

For those of you who would like to review the entire list we found at  www.sensory-processing-disorders.com here goes:  

Gross Motor

If a child is…

Possible visual problems may exist if the child…

Does not make eye contact with others or holds objects closer than 3-4 inches from one or both eyes

 THESE ARE THE FOLLOWING LANGUAGE MILESTONES THAT A CHILD SHOULD HAVE MASTERED BY THESE AGES FROM THE ARTICLE ON THIS SITE TITLED “WHEN TO WORRY”

This week and next week we’ll be finishing up our discussion about sensory issues in toddlers and preschoolers.  

On Thursday, October 23 we’ll be focusing on how play skills can be affected by sensory processing disorder AND we’ll be talking about red flags that warrant a referral for toddlers for developmental, occupational, and speech therapy.    

On Thursday, October 30, we’ll be talking with our colleague Carey White, who is a pediatric occupational therapist and a specialist in sensory processing disorders.  She is going to discuss listening therapy, the brushing protocol, and other more skilled OT treatment modalities.  Join us for what I know is going to be an informative show! 

If you’re a parent who has a child with “quirks,” or one who is described as a “puzzle,” sensory processing disorders may help your child’s issues make sense to you.

You can listen live by clicking this icon.  

Our call-in number is 1-718-766-4332.  We’d love to hear your questions! 

If you can’t join us live, you can always listen later anytime using the blogtalkradio icon in the right hand column or on the home page.  

Our show is also available for FREE download on itunes.  Visit the itunes store and search “Teach Me to Talk with Laura and Kate.”  For you itunes novices, choose subscribe, and the show will download so you can listen later with your ipod.     

I hope you’ll join us!  Laura