Why Recess is so Hard-Can we help?
by Deborah Luetkenhoelter, M.A./CCC-SLP
Jacksonville Speech and Language Center
In my previous article I discussed reasons why recess may be hard for some of our children. Open, fluid, social situations can be unnerving to all of us at times, but if our child is faced with other learning and social challenges, the demands at recess can be daunting!
As a quick review- recess is a social time that is dynamic and somewhat unpredictable. Kids often move from place to place, play to play, and play partner to play partner. If a child is unable to enter and exit play, to shift with the unspoken rules, to read peers faces, emotions and actions, he may become very lost in the milieu.
So how can we help our child deal with the unpredictability of recess? We want him to have success on the playground and we want him to forge friendships. Let me make a few concrete suggestions.
- Rehearse the games with your child. If he isn’t good at bouncing, tossing or catching a ball-practice. If he is afraid of the jungle gym go to Doc Griffin Park when only a few children are there and get on the gym with him.
- Play games that involve competition. Have a foot race. Pick teams. Practice being first, second or last. Talk about being second, being a good sport.
- Practice congratulating the winner. Role-play: make it fun and silly.
- Practice entering play. Role-play walking up to another person, getting their attention and asking to play.
- Practice varying states of readiness and unpredictability. Talk about watching your play partner-making unexpected changes in a game. For example, begin a race to the garage and halfway there turn around and head back. Laugh about it. Did he see you? Now it’s his turn.
- Play a game, such as two-square according to hard and fast rules a few times. Then talk about changing the rules. Make one change. “We can agree on changing this rule. Let’s decide together.”
- Practice watching for emotion. Emotion tag. Tag only the child who looks happy. Emotion ball. Toss the ball only to the child who has a smile. Use other facial expressions. Let the kids pick. Laugh about it. Talk about what a frown might mean. What a confused look is telling us.
- Teach your child to listen. “When I say ‘go’, you run to the slide” “Ready, set, ‘stop’” (ha- ha, funny, laughing) “Ready, set, ‘go-pher’”. Again have fun with it. Finally, “Ready set, go”.
- Set play dates with a child that she might actually play with on the school playground. Play a game or two that your child will actually play when she gets to school. Again, practice going first, last-winning, losing, congratulating. Invite a different peer next time.
- Talk about recess with your child. Find out what is easy and what is hard for him. Share an “I story”. “When I was in 2nd grade, I wanted to play 2-square. It was hard for me, but I went up to the kids, watched the game for a little bit, then said, ‘excuse me, can I play too?’
- Write a story using words or pictures to represent the “I story” above. Make it your child’s story. End the story with a statement that encourages without placing your expectations upon your child: for example, “Sometimes it is hard to ask to join a game, but that’s okay, I can try to ask to join 2-square when I am at recess today. Lots of kids are learning to play at recess”.
- Ask an adult to observe your child at recess, to let you know what situations seem easy or difficult. Most children need help on the playground from time to time. Your child isn’t an exception, I promise.
My Child is not the same as Other Children
“I always knew there was something amiss. She never really cuddled. You know how some babies are. You pick them up and they just Velcro themselves right into your chest, laying their head in the crook of your neck. Melissa never did that. She would stiffen when I picked her up. She seemed to cry a lot. The doctor said it was colic, but I don’t know. It seemed different. She didn’t look at me in the same way as my son had. She didn’t seem to respond to my smiles, wouldn’t play patty-cake, or engage in playful vocalizations like my first child. She walked early, though. And she moved! She was into everything. But nothing really held her interest. She started talking; saying some words-then all of a sudden, language development seemed to stop. Now at age 3, she makes sounds and says some words, but I usually don’t know what she wants. She seems to be getting more and more frustrated. I don’t know what to do”-written by Melissa’s mom.
Does this story sound familiar? Is it your story? What do we do as a parent when we see our child struggle in ‘typical’ development or have so much trouble fitting into the social scheme? How do we advocate for our kids? How do we prepare them for life? That’s our responsibility as a parent isn’t it? -And a seemingly overwhelming one at that! First of all it is important to absolutely KNOW that a caring parent is already doing the best he or she can. That’s what LOVE is and by definition- ‘Love Never Fails’.
Melissa’s mom has clearly noticed unusual behaviors in her preschooler. Should she wait for her to outgrow it? Or should she begin to investigate possible reasons for what she has observed. In my opinion, it is always appropriate to ask questions, to seek answers. One has nothing to lose and possibly everything to gain. In this case, since language development seems impacted-an evaluation by a qualified Speech Language Pathologist (one who is familiar with pediatric neurological and developmental delays) would be of paramount importance, as would a visit to a pediatrician. The Speech Pathologist may refer Melissa to a pediatric audiologist for a hearing test. Her pediatrician may give Melissa’s mom a referral to a Specialist to consider possible medical or neurological reasons for Melissa’s apparent delays and behaviors.
As a preschooler, is Melissa too young for therapies? Absolutely not. Speech Therapy, Occupational Therapy (for fine motor skills and sensory issues) and Physical Therapy are often essential for helping young children move through developmental clogs. A pre-school program that includes both social and therapeutic opportunities may also be a good avenue. Speech Therapy, such as delivered at Jacksonville Speech and Language Center, includes fun and playful teaching of speech and language skills, supportive language-such as signing and the use of picture cues, teaching parents to teach, and participation in small group settings where a child’s social/language skills can be practiced. If you feel that your child has a problem, continue your quest until you get the answers you need. Don’t stop asking questions until your child gets the help he/she needs. You know the problems. You are the parent.
And if we can be of any assistance, please call us at 899-7000. We are here to help you and your child and can offer a ½ hour free initial consultation.
Back to School-Exciting or Stressful?
Joan can’t wait for school to start again. Dan dreads it. John is excited to see his buddies: Anne is overwhelmed. As summer vacation draws to a close, there is a somewhat ambivalent anticipation in heading back to school. What makes school a fulfilling place for some and a place of stress and anxiety for others?
School can be a place where kids reunite, stories are told, and new experiences are shared. It can be stimulating, social, energizing, and fun. But what if new experiences are over whelming? What if “social” is difficult? What if “energizing” is frenetic over-stimulation? And what if verbal ‘sharing’ is in the realm of the unknown?
Nine years ago, my husband and I moved from the Rogue Valley to Upstate NY. At that time, statistics for incidence of Autism (now more commonly referred to as ASD-Autism Spectrum Disorders) was 1 in 2000. We are back in Jacksonville and now the incidence of autism is known to be 1 in 155 nationally. May I repeat that? 1 in 155 children have an Autism Spectrum Disorder. And in Oregon, the incidence is about 1 in 89. I guess we can do the math!
As your kids head to school this fall, will they be the ones that are stimulated and energized; the ones having fun socializing, talking, paling around? Or will your child be the one who feels awkward and excluded-overwhelmed by the change, the new teacher, an unfamiliar classroom, tables instead of desks, and unfamiliar peers? How can you help?
· Prepare your child for the changes in the new school year by taking him to visit his new classroom; to meet his new teacher, to sit at his new desk. (This of course needs to be pre-arranged with the school).
· Write a story or make a list describing upcoming changes as a way of preparing her for something different. Keep it factual and positive and short.
· Be willing to address his/her concerns and help him come up with options for dealing with the challenges that may wait. (Writing the scenarios and options for older children is helpful. Using pictures for younger might be more functional.) Review the stories, lists and scenarios several times.
· Circle the date school starts on a calendar. Be sure to include one or two fun outings before and after that highly anticipated day.
· Start a ‘school routine’ a week before school starts, if at all possible.
· Keep in mind that social language skills may need to be directly taught.
2. Is it a Speech and Language Delay-or will he outgrow it?
Your son is 2 years old and still isn't talking. He says a few words, but in comparison to his peers, you think he's way behind. You remember that his sister could put whole sentences together at the same age. Hoping he will catch up, you postpone seeking professional advice. Some kids are early walkers and some are early talkers, you tell yourself. Nothing to worry about...
This scenario is common among parents of children who are slow to speak. Unless they observe other areas of "slowness" in the early development of their child, parents may hesitate to seek advice. Some parents may excuse the lack of talking by reassuring themselves that "he'll outgrow it" or "she's just more interested in physical things."
Knowing what's "normal" and what's not in speech and language development can help you figure out if you should be concerned or if your child is right on schedule.
Understanding Normal Speech and Language Development
It's important to discuss early speech and language development, as well as other developmental concerns, with your child's doctor at every routine well-child visit. Although it may be difficult to tell whether your child is just immature in his or her ability to communicate or if your child has a problem that requires professional attention, the following developmental norms may provide clues:
Before 12 months
It's important for kids of this age to be observed for signs that they're using their voices to relate to their environment. Cooing and babbling are early stages of speech development. As babies get older (often around 9 months), they begin to string sounds together, incorporate the different tones of speech, and say words like "mama" and "dada" (without really understanding what those words mean). Before 12 months, children should also be attentive to sound. Babies who watch intently but don't react to sound may be showing signs of hearing loss.
By 12 to 15 months
Children this age should have a wide range of speech sounds in their babbling and at least one or more true words (not including "mama" and "dada"). Nouns usually come first, like "baby" and "ball." Your child should also be able to understand and follow single directions ("Please give me the toy," for example).
From 18 to 24 months
Children should have a vocabulary of about 20 words by 18 months and 50 or more partial words by the time they turn 2. By age 2, kids should be learning to combine two words, such as "baby crying" or "Daddy big." A 2-year-old should also be able to follow two-step commands (such as "Please pick up the toy and bring me your cup").
From 2 to 3 years
Parents often witness an "explosion" in their child's speech. Your child's vocabulary should increase (to too many words to count) and he or she should routinely combine three or more words into sentences. Your child's comprehension should also increase - by 3 years of age, he or she should begin to understand what it means to "put it on the table" or "put it under the bed." Your child should also begin to identify colors and comprehend descriptive concepts (big versus little, for example).
What's the Difference Between Speech and Language?
Speech and language are often confused, but there is a distinction between the two:
- Speech is the verbal expression of language and includes articulation, which is the way words are formed.
- Language is much broader and refers to the entire system of expressing and receiving information in a way that's meaningful. It's understanding and being understood through communication - verbal, nonverbal, and written.
Although problems in speech and language differ, they frequently overlap. A child with a language problem may be able to pronounce words well but be unable to put more than two words together. Conversely, another child's speech may be difficult to understand, but he or she may use words and phrases to express ideas. Another child may speak well but have difficulty following directions.
What Are Some Warning Signs of a Possible Problem?
If you're concerned about your child's speech and language development, there are some things you can be on the lookout for.
An infant who isn't responding to sound or who isn't vocalizing is of particular concern. Between 12 and 24 months, reasons for concern include a child who:
- isn't using gestures, such as pointing or waving bye-bye by 12 months
- prefers gestures over vocalizations to communicate by 18 months
- has trouble imitating sounds by 18 months
For the child over 2 years, you should seek an evaluation if he or she:
- can only imitate speech or actions and doesn't produce words or phrases spontaneously
- says only certain sounds or words repeatedly and can't use oral language to communicate more than his or her immediate needs
- can't follow simple directions
- has an unusual tone of voice (such as raspy or nasal sounding)
- is more difficult to understand than expected for his or her age. Parents and regular caregivers should understand about half of your child's speech at 2 years and about three quarters of your child's speech at 3 years. By 4 years old, your child should be mostly understood, even by people whom your child doesn't know.
What Causes Delayed Speech or Language?
There are many reasons for delays in speech and language development. Speech delays in an otherwise normally developing child are rarely caused by oral impairments, such as problems with the tongue or palate (the roof of the mouth). Being "tongue-tied" (when the frenulum - the fold beneath the tongue - is too tight) is almost never a cause of delayed speech.
A number of children with speech delays have oral-motor problems, meaning there's inefficient communication in the areas of the brain responsible for speech production. The child encounters difficulty using the lips, tongue, and jaw to produce speech sounds. Speech may be the only problem or may be accompanied by other oral-motor problems such as feeding difficulties. A speech delay may also indicate a more "global" (or general) developmental delay.
Hearing problems are also commonly related to delayed speech, which is why a child's hearing should be tested by an audiologist whenever there's a speech concern. If a child has trouble hearing, he or she may have trouble understanding, imitating, and using language.
Ear infections, especially chronic infections, can affect hearing ability. Simple ear infections that have been adequately treated, though, should have no effect on speech. But it's important to note that current recommendations suggest that, in certain situations and depending on the child's age, ear infections can be observed without immediate treatment because most will resolve without treatment.
What Will the Speech-Language Pathologist Do?
If you, or your child's doctor, suspect that your child has a problem, early evaluation by a professional (called a speech-language pathologist) is crucial. Of course, if there turns out to be no problem after all, an evaluation can ease your fears.
Although you can seek out a speech-language pathologist on your own, primary care doctors will frequently refer you to them.
In conducting an evaluation, a speech-language pathologist will look at your child's speech and language skills within the context of his or her total development. Along with observations of your child, the speech-language pathologist will use standardized tests and scales, as well as his or her knowledge of milestones in speech and language development. The speech-language pathologist will also assess:
- what your child understands (called receptive language)
- what your child can say (called expressive language)
- if your child is attempting to communicate in other ways, such as pointing, head shaking, gesturing, etc.
- your child's oral-motor status (how a child's mouth, tongue, palate, etc. all work together for speech as well as eating and swallowing)
If the speech-language pathologist finds that your child needs speech therapy, your involvement will be very important. You can observe therapy sessions and learn to participate in the process. The speech therapist will also show you how you can work with your child at home to improve his or her speech and language skills.
Of course, the result of an evaluation by a speech-language pathologist may indicate that your expectations are simply too high. Educational materials that outline developmental stages and milestones may help you look at your child more realistically.
What Can Parents Do?
Like so many other things, speech development is a mixture of nature and nurture. A child's genetic makeup will, in part, determine intelligence and speech and language development. However, a lot of it depends on the child's environment. Is the child adequately stimulated at home or at child care? Are there opportunities for communication exchange and participation? What kind of feedback does the child get?
When speech, language, hearing, or developmental problems do exist, early intervention can provide the help your child needs. And when you have a better understanding of why your child isn't talking, you can learn many ways to encourage your child's development of speech.
Here are a few general tips you can employ at home:
- Spend a lot of time communicating with your child, even during infancy - talk, sing, and encourage imitation of sounds and gestures.
- Read to your child - starting as early as 6 months. You don't have to finish a whole book, but look for age-appropriate soft or board books or picture books that encourage your child to look while you name the pictures. Try starting with a classic book such as Pat the Bunny, in which the child imitates the patting motion, or books with textures that your child can touch. As your child gets older, let him or her point to recognizable pictures and try to name them. Then move on to nursery rhymes, which have rhythmic appeal. Progress to predictable books, such as Eric Carle's Brown Bear, Brown Bear, in which your child can anticipate what happens. Your little one may even start to memorize his or her favorite stories.
- Use everyday situations to reinforce your child's speech and language. In other words, talk your way through the day. For example, name foods at the grocery store, explain what you're doing as you cook a meal or clean a room, point out objects around the house, and as you drive, point out sounds you hear. Ask questions and acknowledge your child's responses (even when they're hard to understand). Keep things simple, but never use "baby talk."
Whatever your child's age, recognizing and treating problems early on is the best approach to help with speech and language delays. With proper therapy and time, your child will likely be better able to communicate with you and the rest of the world.
Reviewed by: Mary L. Gavin, MD, and Anne M. Meduri, MD
For an evaluation or more information, contact:
Debby Luetkenhoelter, M.A./CCC-SLP
Jacksonville Speech and Language Center
541-899-7000 www.jacksonvillespeech.com
