Tiny Salutations

Tiny Salutations

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Thursday, January 15, 2015

Encouraging Development


We have worked very hard with our son to try to encourage his development, as he has been late for most developmental milestones. This being said, now he is ahead on some milestones and behind on others. He has had therapies and we work on things at home. So I figured I would share what has worked for us to help with developmental delays.

First, be patient. Kids do things when they are ready, no sooner. You can support and encourage them to be ready, but they will not do it until they feel ready. Second, keep at it. Just because your little one didn't respond the first 50 times doesn't mean they won't ever. We used sign language for about a year and a half before our son picked it up.

For gross motor skills:

Running!

L learned to walk at 18 months. To learn how to walk, we built L an obstacle course. We put several table-like toys in a row staggered across the house. At first, he could reach each table toy without taking any steps. Then, I moved them just a little farther apart to where he had to stretch to reach a little, then one step, then two, etc. Eventually he could walk between the table toys easily.

L has only recently learned to jump (at about 2 years 9 months). To learn to jump, we had him jump on the couch and on the bed (Yes, jumping on the furniture! If it makes the difference in his leg strength, I'm all for it). He could hold on to the side of the bed or on to our hands. He started by just kind of wiggling up and down.

La has also just learned to walk up and down the stairs (at 2 years 9 months). We practiced stairs a lot. What finally clicked was that he had toys in both hands and didn't want to put them down to crawl up the stairs. Favorite toys can be good motivators.

Tummy time
L didn't learn to roll over until about 9 months, learn to sit up until about a year, and learn to crawl until about 14 months. Lots and lots of tummy time is what worked here. No he didn't like tummy time, but I would let him be upset for short periods of time often while doing tummy time.

I would also like to point out that he did not use his left side much for a long time. This, interestingly enough, was due to a nerve palsy in his eye. He had to tilt his head to see, and his body followed suit. He had an eye surgery to correct this. So if you see something abnormal in development, the doctor can be a good resource in addition to the therapists. I'm not sure if it is a state or federal program, but there is a program that will pay for a free eye exam to babies (I think between 6 months and 1 year). It is called InfantSee. I highly suggest everyone take advantage of it.


For language:

L didn't say any words- or understand any words- until about 27 months. Last February, he was evaluated at 9 months in language skills. He was evaluated again 8 months later at over 32 months (they stopped the testing there). The first thing he learned was sign language (“more”). Some people are skeptical about sign language, but I swear by it. My son would not be talking so well if we had not started with that. You don't just use the sign, you also say the word, and they eventually connect the two. First, I would show him the sign and say the word at the time he would need to use it. Then, later, I would request him to say it. Eventually, he would need to use the sign to get what he wanted from me. Once he had that down well, he would need to use the word with it to get what he wanted. 
 
First book- day 2 of life

Read all the time. Seriously. All the time. We started reading to L the day after he was born (I only got to see him for a few minutes the day he was born, and I was in no state to read). Reading to him everyday in the NICU made me feel a connection to him, even during those long days when I couldn't hold him. I read to him everyday and continued to do so until this very day. Until he became mobile, I would read to him many times throughout the day. After he learned to crawl around, he just couldn't sit still for a whole book- even a tiny board book. Although it felt frustrating, patience paid off. I would read to him until he crawled off. Some days it would take all day just to get through a couple of simple board books. That's okay. The more exposure they get, the longer they will be able to listen later. Now at 2.75 years, we read about 1-2 hours per day. We read for about an hour before bed and a few books throughout the day. And he actually listens the whole time, and we have moved on to some books without pictures (still reading books with pictures as well). Sometimes he still gets ants in his pants, and we have to set the book down and come back later. And that's still okay. L learns nearly everything about the world through books. He takes delight in pointing out things he remembers from his books throughout the day. He quotes his favorite parts during the day when he sees something relevant. And at under 3, he is just beginning to read. He knows all the letters and can point out a few words that he recognizes.

Homemade book

Make your own books. Sure there are wonderful kids books out there, but your child will better recognize and make connections if the pictures are from their very own little world. All of L's first words were in a book I made him. I put together a book (a binder with sheet protectors and simple photos with words printed below) of family members, pets, and things I wanted him to learn how to say, like “drink”, “book”, “car”, etc. He learned all of these words, with their accompanying signs, first. Then, after those were accomplished, he began saying new words that he found in other books.

Keep books everywhere. We have books everywhere- L's room, the living room, the bathroom, the car, my backpack.

Silly fun while reading

Surprised by a book
Reading a book



Don't limit yourself to baby books. We have board books for the sturdiness needed in the car and plastic books for the waterproofing needed in the bathtub (yes, he even reads in the bathtub!). These are good and serve their purpose. However, we also read more advanced books to L and just don't expect him to fully understand. Challenging him is the best way to push development a little further, as long as he is showing interest. At bedtime, we start out with whatever book he chooses. Then, we read a few with good pictures and a fun story (usually Dr. Seuss or a similar level). Generally, last we will read one that has few or no pictures for a while to settle him for sleep. During the day, we read some children's books and some “family” books. “Family” books are longer chapter books that we all can enjoy- and are appropriate for everyone- and generally take a few days or weeks to read ( some of my favorites are Lois Lowry books, Dear America books, American girl history books, etc.- there are so many more, but that gives you an idea).

Another technique we used to get L talking was imitation. He has had a hard time grasping turn-taking ideas, which is essentially what talking is, verbal turn-taking. So, to get him to understand this concept, we imitated whatever he did. We would make the same movement or sound. After a long time of imitating him, he finally started imitating us. Then, we would go back and forth in this way. Even though he speaks quite well now, using full sentences with prepositions and all, I repeat what he said back to him before giving him my answer. For example, he might ask “Where is my Barracuda?” (he knows tons of car models- the Barracuda being his favorite), and I would respond “Where is your Barracuda? I'm not sure. Let's go look for it in the living room.” This shows him that I am hearing him, acknowledging him, and showing him the proper way to form the sentence. This is especially helpful in situations where I cannot help him, but want him to know I heard him, such as “Can we have fruit treats (aka, dried fruit)?” when we are all out.


For sensory skills:

My son continues to have quite intense sensory problems, but we are progressing in the right direction. This section will be more individual and require some experimenting. What works for L, may not work for your child.

There are three other important points to make here. First, pick opportune times to try sensory challenges. What I mean is, don't try to stimulate his sensory system when he is already in a bad mood or overwhelmed. It won't work, and you will both be unhappy. Second, use baby steps. Adjusting to sensory stimulation is slow and steady. Sometimes you have to move forward in increments so small it seems like you aren't doing much. Remember, patience. Sometimes, you even have to take a step backwards. That's okay. Keep at it, and find what works for you. Third, find what will calm him down quickly. We went through agonizing months where we could not find what would calm him down quickly and effectively. This was during his most challenging period too. He was in constant meltdowns that would last for hours for seemingly no reason. We finally found a perfect solution for L. We put him in a blanket and swing him in it like a hammock. Within a few minutes of rocking he has calmed down. If there is only one person, pulling him around on a blanket is the next best thing. So find what works. It will take trial and error, but when you find it, it is so worth it.

Jumping in puddles

sensory rice bin


Tactile sensory: Give them lots of different textures to play with. Start out with things you know they will tolerate and slowly introduce more textures. Some good things to use here are shaving cream, paint, rice, beans, and bird seed. We made a home made rice bin by filling a large shallow storage tupperware about half way with rice. It is shallow enough that he can step in and out with minor assistance, but large enough that he has room to play. Since it is a tupperware, the lid snaps on so that we can store it in the shed and not worry about animals getting into it. Some animals love sandboxes, or anything similar, so I suggest using something you can keep closed tightly unless you keep it indoors. We give him opportunities to get messy. We let him play in a mountain of shaving cream in the bathtub before a bath. Or we let him paint with his hands. Or get covered in mud or sand.

Movement sensory: This has been one of L's biggest challenges. He is very sensitive to movement and can become overwhelmed easily. A moment of wrestling can lead to hours of meltdowns from being too overstimulated. We do something that is not stimulating for a while and every once in a while mix in something stimulating. For example, we will swing him back and forth in our arms, then spin him in a circle (the stimulating part), then let him crash (like a mild and safe toss) into a pile of blankets and pillows on the bed. He can do this a long time. It is important to remember that toddlers often can't tell right away when they have had too much, so use your best judgment here.

Visual sensory: This is another of L's challenges. We have not sufficiently found much to help here yet. I think he may have some eye problems left from being premature (he started to develop ROP , which is where the retinas don't attach properly due to high oxygen levels in the NICU) and eye surgery. Often, when one piece of development is really out of whack, there is a physical problem behind it, particularly with L. I highly suggest any medical reasons be ruled out for any developmental challenges. The one thing that we have noticed is that television is terrible for this issue. If he watches any TV, he loses control of himself. It is like supercharging stimulation for him. We have recently been suggested vision therapy, so I will keep you updated on that. He also has an appointment with the ophthalmologist to assess his current vision challenges coming up.

Sound sensory: L has recently turned a corner with sound sensory. Before having his ear tubes placed, he would scream until you turned off all music. He still does this if he is in a bad mood. If you catch him in a good mood though, sometimes he will even try to sing or dance. The other day I was listening to Billie Holiday while tidying in the kitchen, and L came in and said “This is a cool song!” It just melted my heart to see how far he has come with this sensory challenge. Don't get me wrong, there are still times where he screams like a banshee until you turn it off, but now there are some times where he likes music. It's all about recognizing the little victories!

I certainly don't have all the answers, and we are constantly learning, but I hope this has helped any of the parents out there facing challenges with developmentally delayed kids. Or given parents with typically developmental kids more ideas to help bolster learning in their child!