Category: Talk

Screen Time for Babies and Toddlers

There has been some new information recently published regarding the use of screens to help parents teach their young children. Let me start by saying, all information is valuable whether we agree or disagree. The purpose of this post is not to argue or debate the information, but rather provide parents additional information from the perspective of a professional who helps families teach their little ones.

With over 20 years of experience, I have seen many shifts in how children learn. Also, I have seen shifts in how their caregivers learn. While I come from a generation that did not have constant access to screen time, or information in the palm of my hand at any given moment, I can see how it can be a useful source for parents. However, especially over the last 10 years or so, in some situations a screen has replaced very important face to face interactions between young children and their caregivers. There are a ton of shows out there that have wonderful teaching/learning opportunities. It is crucial to remember that young children learn best through PLAY. This means, they are exploring their environments utilizing all of their senses. If a screen is always on, what senses are they using? Vision and hearing. Two senses. Common sense should tell you, this is not a good thing.

Children need social interaction. Guess who the first people that provide this are? You, the caregivers. Learning faces and non verbal language is a crucial part of development. They need to learn not only about their own feelings, but the feelings of others. How do we typically show our emotions? Through our facial expressions. An excess amount of screen time can not replace this.

Look, I get it. Parenting is hard, it’s exhausting at times. Sometimes, we need to get things done without a tiny human hanging on us. It is entirely possible to have a balance. When you feel like you need to use it, just be sure to limit the amount of time they are watching it alone. When you need to veg out, try talking with your little one about what is happening in the show. It is also important for them to learn to disconnect from the bright vibrant colors and fast moving images to attend to you and then go back to what is happening on the cartoon, and back to you, and back to the show. So on and so forth.

Overall, a screen should not be used as a replacement for you or the primary way they are learning. It has been a proven fact for many, many years. Children learn best through play and exploration. Also, you are the most important play partner in their lives and their first teacher. Make the best of learning to be a kid again with your kid(within reason, haha!).

EMOTIONS

Over the last 19 years working in pediatrics, mostly Early Intervention, I have experienced many parents/caregivers who have difficulty navigating their child’s emotions. Since I am there to help parents/caregivers help their child communicate, naturally we usually end up talking about the frustration their kiddo(s) are demonstrating. Inevitably, a huge part of my job comes down to teaching families to navigate and/or manage behaviors.

So, many parents ask, “When should I begin teaching my child(ren) about emotions?”. Most scholars believe that teaching children the “feeling words” and how to use them should begin around the age of 3. They believe this is when children begin to more fully understand their own and other people’s facial expressions and can use the words to identify emotions. This may be true, however, after working in this field for so long, I believe we can begin the teaching of them earlier.

Why not talk about those feelings they are having(or that you’re having) when they begin to demonstrate frustration, excitement, sadness, etc.? The earlier they hear these words and begin to see emotions on other people’s faces, maybe the earlier they will begin to identify emotions. Could this also lead to them learning to navigate how to manage emotions a little earlier on? Possibly. If anything, it may teach us adults how to navigate our emotions in order to demonstrate healthy ways to manage them. As parents/caregivers, we are the biggest source of influence for them in most situations.

Besides labeling emotions as they are feeling their big feelings or watching others demonstrate emotions, there can be other ways to begin teaching feeling words at a young age. You can point out characters in books while readying short stories, look through photos, or while they are watching their favorite shows. This can be as simple as pointing to faces and describing the emotion very simply, such as, “Oh, he’s sad”, or “Look how happy she is!”. Nothing too complicated. The least amount of words the better when they are little. You can show them those emotions on your own face and change the tone in your voice as you describe. I truly believe it is never to early to begin using feeling words while you talk to your toddler or preschooler!

WHY IS MY BABY NOT TALKING?

Are you asking yourself, “Why does my child not talk but understands everything I say?”? This is one of the most common questions Speech Language Pathologists(SLP) hear. There are many answers to the question. The most important thing is, is that you have an evaluation by a SLP. If your child is under 3 years old, look into your local Early Intervention program for infants/toddlers. In many states it may be free! What are some reasons your child isn’t using words to express themselves, but has become a master communicator with gestures?

*It may be awareness and lack of confidence that they can produce the words so you understand them. Many children try word approximations at a young age and we as “perfect speakers” miss it. We get “Mama” and “Dada” but what about when they only use “Ma”à”Mama”? We still get it don’t we? So, think about “ba”. This can represent “bottle”, “ball”, “bubble”, “bath”, etc. When we don’t make associations, they lose confidence and motivation to keep trying. Pay close attention to the sounds they make along with the gestures. The words take time to fully develop. Also, they may have decreased awareness of their mouth and how to make different sounds(didn’t mouth objects when they were infants, too much time sucking on a pacifier or bottle if they were fussy, slow to develop hand to mouth connections, etc).

*It may be structural: high palate, enlarged tonsils and/or adenoids, undetected tongue tie, small jaw but large tongue, protruding top teeth, etc. Seek the advice and evaluation with a SLP. EARLY is best, and especially if your pediatrician isn’t familiar with these abnormalities.

*Opportunities to practice “talking” back and forth is limited. In the busy society we live in these days, we often forget how many opportunities we have during daily routines to help our children practice. Talking doesn’t always com naturally for some children. As parents, we need to ensure we give them time and multiple opportunities to practice skills in a loving, fun way. Just like it takes practice to walk, it takes practice to talk. Talking is a motor act also! It also requires our respiratory system to work in coordination with our sensory motor system and voice! It’s more complicated than most of us think.

These are a few reasons but again, I stress the importance of seeking a SLP early on to determine the best course of treatment for your child. Here are a few tips to get you started:

  1. Imitate your baby’s early vocalizations and babbling, creating back and forth vocal play or early “conversations” between the two of you.
  2. Play in the mirror and make silly faces and sounds as often as possible.
  3. Label pictures and objects frequently while pointing or gesturing.
  4. Model sounds that may be associated with these pictures/objects(woof-woof, beep-beep, etc).
  5. Sing songs, especially those that have actions along with them(Itsy Bitsy Spider, Wheels on the Bus)
  6. Use open ended phrases while you play or go through your routines(Ready, Set,….., Up and…..)

Most importantly, if or when you, as the parent, feel something doesn’t seem right, seek help. It may only take a few tweaks to what you’re already doing to make a difference. You can find more info about typical development, along with additional tips and tricks, throughout my website. Message me any time with questions!

WHY ARE ROUTINES IMPORTANT IN EARLY INTERVENTION?

First, let’s start with the question, “What is Early Intervention?”. Early Intervention(EI) is a multi-disciplinary service and support system provided to families and caregivers for children found eligible, presenting with a developmental delay or disability. It may include: Physical Therapy(PT), Occupational Therapy(OT), Speech and Language Therapy, or Specialized Instruction(SI). Additional services may include, Vision, Hearing, or Nutritional supports. Why is it important? It provides families and caregivers resources, information, and support to assist their child with developmental skills so they can participate in their family’s routines and activities. EI can help families and caregivers embed learning opportunities throughout the day. By doing so, their child grows in their abilities to engage and become independent within their family, as well as the community. Why are the family routines and activities critical for children to learn and participate in?

  1. Children learn best in their natural environments. Whether they are at home, in a child care setting, or at a family member’s house, learning opportunities happen almost every moment of the day when they are awake!
  2. When a child become eligible for EI, this means there is an area of development that is delayed. EI is designed to assist and support families to practice strategies that improve/enhance the skills that are or are not already occurring. They teach families and caregivers how to provide multiple opportunities to practice.
  3. Practicing a certain strategy or skill becomes a naturally occurring process through out the day instead of, setting aside only a specific amount of time to practice. This can lead to the child not generalizing the skill. For example, if you only practice the word “more” with your child to ask for more blocks, they may not use that same word to meet their need of more to eat or drink. Imagine the frustration that may occur!

Whether you think we you are a person who is a “free spirit”(not routine oriented) or a person who lives and breaths structure/schedule(routine oriented), “routines” do occur every day for every one of us! Think about it this way: We all wake up, get dressed, eat, go to bed. What else do we ALL need to do during the day? There is so much opportunity to practice a LARGE variety of skills every day. Also, this gives us as parents and caregivers, the ability to help our children learn the skills they need for every day life.

COMMUNICATION TEMPTATION

Are you noticing that your child is using a lot of gestures but not many words to communicate? Are they beginning to show some frustration when you’re not understanding what they want? One way to assist your child with indicating what they want, while decreasing their frustration, is to provide choices. For example, they gesture to the snack cupboard and you know there are a couple of snacks they prefer. Bring the box/container down to their eye level and simple ask, “Do you want crackers or goldfish?”. Even if they can’t imitate those words at the moment, they can show you which one by touching or pointing to it.

Another strategy to try is a “communication temptation” or “environmental sabotage”. What is that?? You can implement this in a few different ways. If they choose a food that is in a small package or container that they can’t yet open, give it to them anyway before opening it. When they give it back to you, you can model “open” or “help”, or the name of the food. Model it first as if you are asking a question so they also have an opportunity to give you a “yes” response by shaking their head or attempting a vocalization similar to “yes”. As you open the package or container, model the word you’ve chosen again. Once again as you give them the food, model the same word. They have now heard it 3 times. If they do not try to imitate that word after trying this MANY times and throughout MANY routines, you may need to contact additional assistance through your local Early Intervention program. Another way to practice this is by placing a favorite toy or favorite cup in sight but out of reach. When they gesture toward it, you know for sure what they want. Utilize the same strategy of modeling the word 3 times, giving your child plenty of time to at least attempt to imitate the word(3-5 seconds based on how frustrated they become waiting).

Sometimes our children need extra time to process the expectation or extra opportunities to practice and become confident to imitate the word so they eventually use it spontaneously. There will be frustration if this is something new for them. It’s important to provide opportunities for our children to navigate through the steps of spontaneously and confidently expressing themselves, while providing assistance when needed. This also means they will need time to feel and process their emotions.

LEARNING THROUGH ROUTINES

Whether you have a set schedule/routine for your day or you are better operating on a moment-by- moment basis, there are “routines” that occur daily. Based on years of research, routines-based interventions are now considered an evidence-based practice. Why are routines the best way to “teach” children? No one even realizes what is actually happening(which can be a good thing)! It can become an easy way to incorporate practice naturally into the day. There is no “special time” to set aside to practice certain skills/strategies in your already busy day. There is no planning or special preparation. Your children will be learning and they will only be thinking about engaging with parents/caregivers, building their participation(and autonomy) in daily activities.

What routines happen during everyday life with your children? The big routines are of course: eating, playing, and sleeping. What can we teach children during these routines? For the purpose of this article, I will focus on speech and language, but keep in mind, ALL developmental skills can be learned during everyday routines.

During meals, vocabulary can be expanded as children learn what they are eating and drinking, as well as, the objects needed to participate in meals. You can easily present opportunities to make choices and requests by giving smaller portions at a time so your child asks for more. During play, there are a ton of action words to learn, names of toys, and how to play with others using words. Again, there are many opportunities to incorporate making choices and requests. What can a child learn while sleeping? Well, they need rest to rejuvenate their ability to soak up all the things happening around them. There is much to learn surrounding the process of going to sleep! What pajamas to wear, did we brush teeth, we have to tell everyone “Night-night”! You can find more ideas to build speech and language skills throughout this site. Additional routines include, but are not limited to: bath time, dressing, looking at books, riding in the car, etc. Language can be learned all day long!

Teaching language skills during your everyday activities will make it easier to practice certain skills. Always speak to your pediatrician with any concerns regarding your child’s development. Send me a message with any specific questions!

SIGN LANGUAGE

“If I teach my child signs, will they still talk?”. Probably the first question on all parent’s minds if sign language is suggested, whether a friend or relative mentions teaching their baby signs early on, or an early intervention therapist. Parents want to know what’s the deal with baby signs? As an early intervention speech therapist, I have always used sign language as a part of therapy sessions. Research has shown that pairing a gesture(such as a sign)with the word provides the child an alternative way to communicate wants/needs. As long as the child can hear, they will imitate the word along with the sign in time. For some children, sounds and words can be challenging. There are a variety of reasons this can be the case. Using sign language is a way to bridge the gap until they are confident to imitate the word.

We all communicate with gestures sometimes. Babies begin to imitate actions and gestures before they imitate words. If imitating a sign(or gesture) can help them communicate their wants/needs before intense frustration sets in, we should provide them that alternative. Once they are comfortable using the word, they will, and the sign will disappear on its own. I began modeling signs with my own child around the time he began to really use his voice. That lovely stage babies go through around 8-10 months that they are screaming all the time😉 When they are excited, upset, or just impatient. Fun times, haha. We started with “eat”, “more”, and “all done”. Mostly because he was extremely impatient as I prepared his food and when was done with the meal(mostly just done sitting for it). Before a year old, he was using “more” spontaneously and functionally. His daycare was also great about teaching and using signs with the babies. Many childcare centers incorporate baby signs into their day.

Again, signs will not hinder spoken language in a child that can hear and is intentionally communicating with you in other ways(gestures, actions, vocalizations, etc.). Speak with your pediatrician or local Early Intervention program if you are concerned about your child’s speech and language development. Click on the Resources tab for more information regarding milestones and development. You can also find me on Instagram to see demonstrations for simple baby signs: @eattalkplays

MIRROR PLAY

Have you ever walked into a child care and notice mirrors on the walls? In some infant or young toddler rooms, they are placed at ground level. Why is this? As infants, it is important for babies to see their own reflections, as well as, the reflections of those that care for them. This is a great way to teach them they have a name and so do the other people around them(Hi Joey, Hi Daddy – as you wave). It is also helpful for them to see their actions, giving them the visual feedback as their movements are giving them proprioceptive and vestibular feedback.

Mirrors can be helpful to begin teaching body part identification, for both themselves and on other people(Joey’s nose, Mommy’s nose). Also, it’s a fun way to give them awareness of how their mouth moves and sounds they can make.

 For those children that are delayed in their speech and language skills, this can be helpful. However, some may avoid looking in the mirror and resist when it’s introduced. In my experience, these are the kiddos that also resist imitation for a long time. Anecdotally, there seems to be a connection in their perception of potentially failing at the task. They avoid at all costs until they feel confident that the attempt will be a perfect imitation.

If you have a child that does not enjoy looking in the mirror and making silly faces, try setting up a mirror where he/she plays the most. They may end up watching themselves play periodically, learning about how their bodies move. This could aid in less resistance to watching themselves, and you in the mirror. Once they realize watching themselves move their bodies(including their mouths)can help them to imitate more accurately, you can begin to teach them new sounds and words. Have fun and provide a lot of reinforcement as they try new things outside of their comfort zone!

PACIFIERS AND SPEECH DEVELOPMENT

One of the most common questions I get as an Early Intervention Speech Pathologist is about pacifier use. Pacifiers certainly have their use for our babes. Not just to help soothe those fussy babies! It has been linked with decreased risk of Sudden Infant Death Syndrome(SIDS) and can help babies learn to self soothe. Some studies have shown pacifiers can be helpful for babies who may have trouble sucking or have an underdeveloped sucking reflex. Sucking is a reflex for newborn babies. Newborn reflexes do disappear as babies grow. We should see our babies decrease their need for sucking. They grow and take the bottle or breast less frequently. They begin to eat purees and transition to cup drinking(which I will have more information on).

There is much debate when your baby should no longer have the pacifier. In my experience, “cold turkey” may be more trouble than it’s worth. If it can be slowly decreased, it will be easier(for everyone!) when it suddenly “disappears”. Once your baby begins to show joint attention and imitation, he/she should begin to have it less often during the day. They can begin to explore how their mouths move and all the sounds they can make using toys, teethers, and even foods as they begin venturing through the feeding stages. As they get older, their awareness and memory begin to grow as well. Strategies to decrease pacifier use when they are in toddler stages will be more difficult because of this. In addition, the longer they use the pacifier, the structure of their mouth will begin to be affected and dentition shape will impact speech production.

 If you have found yourself with a toddler attached to their pacifier, there are a few things to try to replace the soothing comfort it has provided them. Some children do truly have an oral sensory need for more input to help them feel regulated. Currently, Occupational Therapists(OT) and Speech Language Pathologists(SLP) are recommending use of straw cups over sippy cups. There are many reasons for this shift. One of them being the input your child receives with sucking liquids through a straw. If your child seeks oral input, a straw to drink form is a great alternative and provides regulation to the sensory system. In addition, there are many tools that can be a good substitute throughout the day when they are looking for something to chew on or put in their mouth. When they are teething, these tools can serve double duty! Some of these can also be used to assist with feeding difficulties. It is important to always seek the assistance of a professional pediatric OT or SLP in this case. Contact your pediatrician to inquire about your local Early Intervention program. This is a process. It may happen more slowly than you would like, but it CAN happen with a plan.  Please see link below for more information if you would like to explore some alternatives to decrease pacifier use.

https://www.arktherapeutic.com/oral-motor/?aff=59

DIAPER CHANGES

Not always the most pleasant routine of the day, but diaper changes can be a great learning opportunity for your baby! During this time, you are usually face to face. This gives your baby the perfect view of your mouth. As your baby watches you move your mouth, and hears the sounds/words you make, they will begin to imitate(as long as hearing is in tact). Not only are they imitating the motor actions of your mouth, but their tiny brains will make new connections, and the output will be imitation of sounds! So, as many times as you change diapers all day, will be the number of times you are teaching them speech and language!

This is a great time to make silly faces and sounds(raspberries, ooooh, ahhhh, etc). Talk about what you are doing(up, lay down, pants off, wipe, all clean, socks!, etc). Sing songs to your baby and gain eye contact with them. So many ways to engage with them and teach them during this routine! As they get older and begin to wiggle, protesting the process, any of these strategies can work to distract them from their protest.

Diaper changes can be a perfect time to gain interest and increase imitation for those kiddos who are not imitating or using sounds and words. Watching your mouth as they listen can be helpful to their ability to imitate. See developmental milestones in the resources tab for more information regarding when and what you should expect.

*If you have concerns that your baby is not reaching speech and language milestones, speak to your pediatrician or reach out to your local Early Intervention program.

Sounds/words to include: diaper, shirt, pants, socks, up, down, on, off, ooooh, yuck, stinky, wet, dry, all clean, all done, eye, nose, mouth, ears, head, arms, legs, feet, make “raspberries”, pop lips, click tongue, make any silly sound