Dr Annie's Free Resources for Parents

The team of experienced professionals at Annie's Centre have put together these Information and Tip Sheets for Parents and Professionals.

If you missed hearing Dr Annie's Parenting segment on Radio 2GB, then you can still read through some of her Parenting tips below.

The team at Annie's Centre have also prepared some useful resources on language and motor development in children.

• Parenting the Anxious Child
• How Does Communication Develop in Children? What to expect from 6 months to 2 years
• Communication Risk Factors
• What are the Early Warning Signs of a Communication or Language Difficulty?
• Tips to Develop Your Child's Language and Communication Skills
• What are the Early Warning Signs of a Motor Development Difficulty?
• Tips for Developing your Child's Motor Skills
• What is an Occupational Therapist?
• What is Sensory Integration Therapy?

Parenting the Anxious Child

Encourage Courageous Behaviour

• Deliberately pay extra attention to non-anxious ("brave") behaviours. Find the behaviours where your child is confident and pay attention to them (e.g. I want to spend time watching you get into the pool all on your own because I know how well you can swim" OR "I'd love to spend time with you while you do your spelling practice because I know how hard you try to learn the words!")
• Reward "bravery" to help increasing the likelihood of courageous behaviours. Try to work out "what is my child currently doing that is brave for them?" Then, reward and praise these existing brave behaviours. Be careful not to bribe the child. Rewards are for efforts e.g., hugs/ kisses/ praise/ special treat for efforts a child makes to be confident (e.g., you put so much effort into speaking in front of the class today during news time so I think we should go and get a milkshake on the way home to celebrate!").
• Use proportional rewards (not bribes). Reward in proportion to the degree of the brave behaviour.
• Try and model brave behaviour - both parent and peers (e.g., if you are worried about being late for an activity talk through your own ways of coping in front of the child..."I'm worried about being late for the party so I'm going to have to take some deep breaths to help stay calm ...can you help me do that. I'll also need to think of some helpful thoughts to boss away my worries like, "We'll be ok, it's not the end of the world if we're late").
• Encouraging independence and reduce over-protective/ controlling parenting. Allow the child to make his/her own mistakes. Ask yourself, "if I did not help my child in this situation, what is the worst outcome that could occur?". (Avoid questions like: "Do you want me to come with you?", "Are you sure that's what you want?", "Will you be ok?")
• Reduce reassurance (gently play down anxiety, then ignore and/or re-direct the child) (e.g., "you don't need my help to walk into the classroom with you, I'm too old for school now...you'll do it better without me"). Speak confidently to the child.
• Ensure that each parent has consistent expectations for the child (make sure you are all working on targeting the same brave and anxious behaviours at the same time.

Discipline for Anxious Children

• Be calm and use self control - sometimes anxious children can be frustrating
• Aggression from your child is not acceptable under any circumstances and should have immediate and substantial consequences e.g., time-out.
• Look at your child's motivation for avoiding a task -> is it disobedience or fear? Will they do it at other times or do they always try to avoid the task?

How Does Communication Develop in Children?
What to expect from 6 months to 2 years

 All babies and young children develop at different rates. Following are some general guidelines to help you identify when to be concerned about your child's development. If you think your child has difficulty with the following steps of development please contact Annie's Centre, Specialists in Child Health and Development.

At six months does your baby:

• Often look around for speakers?
• Follow a moving object with her eyes?
• Copy the sounds that you make when you talk to her?
• Make babbling sounds with a consonant and a vowel (e.g. 'pa' or 'goo').
• Make any sounds apart from crying.

At nine months does your baby:

• Recognize his name or those of close family members?
• Makes sounds to people as if he wants to talk to them?
• Use strings of babble like 'mama mama', 'baba baba'?
• Enjoy intereactive games like 'Peek-a-boo'?
• Show interest in noise-making toys?

At twelve months does your baby:

• Look around for familiar objects, such as her hat, when she hears you talk about them?
• Turn towards a speaker when her name is called?
• Use lots of tuneful babble?
• Initiate games like 'patacake'?
• Follows your finger as you point?

At sixteen months does your baby:

• Take turns with you in making sounds to each other?
• Respond by looking in the right direction to questions like 'Where's your hat?'
• Babble with lots of different sounds so it sounds like he is talking?
• Show interest in starting lots of games with you like 'patacake'?
• Maintain his attention on one thing for a few seconds?

At twenty months does your baby:

• Use any single words?
• Understand and follow directions like 'your shoes are in the kitchen'.
• Wants lots of attention from you and wants you to play with her?
• Often look around to see where sounds are coming from?

Communication Risk Factors The following risk factors may affect a child's ability to learn language and/or speech. A poor model of speck from others within the child's environment. Parents and significant others using long and complicated sentences which the child cannot understand and is unable to imitate. Lots of competing noise and distractions from television, radio or other children. Little motivation to speak due to others talking for him/her and others predicting his/her needs and and wants. History of birth trauma or prematurity (low birth weight). Extra quiet or irritable baby. Delayed motor milestones History of feeding problems such as poor sucking or chewing. Family history of speech/language problems. History of ear infections. Home environment is bilingual of lacking in stimulation. Frequent hospitalization. Poor concentration. Poor coordination (poor motor skills, poor motor planning)

What are the Early Warning Signs of a Communication or Language Difficulty?

A child with a language problem may have difficulty with:

• Following instructions;
• Attending, listening and concentrating;
• Social skills;
• Answering questions;
• Asking questions;
• Learning new vocabulary;
• Sequencing words and ideas;
• Problem solving

Tips to Develop Your Child's Language and Communication Skills

1. Encouraging them to listen to:

• music
• noises
• sounds in the environment
• familiar voices on the phone

2. Talking with your child about what they are doing and about every day activities. Describe your observations using detailed descriptions of their behaviour

E.g., 1. "Wow, you are painting a flower using the long paint brush and the yellow paint. You are making the brush go up and down on the page" etc
Or
E.g., 2. While you wash up, name all the objects in the sink. Describe their shape, colour and size. Talk about what they are used for.

3. Reading stories, singing songs and watching TV with your children and then talk about what happened in the program.

4. Talking slowly and clearly with your child. Trying to match your language level to your child's skills. This will help develop their comprehension skills. Your child will also feel encouraged to try and copy what you are saying.

5. Modeling good listening to your children and showing them that talking and listening are enjoyable by:

• making eye contact with them when you speak
• stopping what you are doing and listening to what they say
• adding additional comments and information to keep the conversation going

6. Encouraging conversational turn taking with the whole family. This will ensure that everyone has a turn and will develop your child's communication confidence.

7. Encouraging contact with other children. This will give your child the opportunity to extend their language and play skills

What are the Early Warning Signs of a Motor Development Difficulty?

It is important to remember that children all develop at their own speed.

However here are some signs that might indicate a sensory processing or physical development delay:

• Bumps into things/people frequently
• Unable to sit and focus on activity for adequate amount of time
• Likes to spin or play on outside equipment more than other children
• Has a strong need to touch others or be touched
• Seems to avoid using hands
• Avoids some clothes or food textures
• Appears to run or walk in an clumsy or awkward way
• Slumps or sits with poor posture
• Has poor ball skills
• Appears to have difficulty grasping items
• Has difficulty using scissors or paintbrush/pencil
• Appears to have a difficulty with handwriting/written tasks
• Seems to avoid crossing the midline
• Avoids assisting in dressing
• Appears to have difficulty feeding himself/herself

Tips for Developing your Child's Motor Skills

• Give your child toys that are made with various material, make sounds, move to stimulate sensory systems
• Take your child to the park and play on the swing and slide to also stimulate sensory systems
• Messy play such as finger-painting, playing with goo, playing in the sandpit, water play with bubbles to also stimulate sensory systems
• Playing with toys on the floor (lying on back and stomach) to strengthen core stability muscles
• Lots of outdoor play such as playing with the ball, bike riding, trampoline, running, skipping to help develop gross motor skills
• Table top activities such as play dough, drawing, construction activities, cutting to help develop fine motor skills
• Alphabet games and colouring in to help develop pre-writing skills
• Puzzles to help develop visual perception
• Quiet activities to promote attention and concentration

Just about any game or activity you play with your child from an early age and throughout childhood is beneficial and help promote skills!!

What is an Occupational Therapist?

"An Occupational Therapist is a health professional trained to help people who are ill or disabled learn to manage their daily activities"

Children participate in many daily activities. Some of these activities can include:

• Eating
• Dressing
• Organising themselves for school and within the classroom
• Socialising with others
• Participating in outside games that involve ball skills, running, jumping, skipping, hopping etc.
• Participating in floor or desktop activities that involve handwriting, drawing, cutting, construction
• Play and other actitivities such as watching Television
• Chores around the house

In order to be able to perform these activities successfully and independently children require:

• Sensory processing (touch, smell, vision, hearing, taste, balance, joint awareness)
• Postural and trunk stability
• Body awareness and laterality
• Co-ordination (whole body)
• In-hand manipulation skills and well developed grasps
• Visual motor co-ordination
• Visual perceptual skills
• Attention/Concentration
• The ability to listen and follow instructions
• Cognitive skills such as problem solving, motor planning, organization and sequencing

An Occupational Therapist's role when working with a child is to help develop and strengthen these components in order for the child to be able to perform tasks successfully, which will have an overall impact upon SELF ESTEEM AND SELF BELIEF.

What is Sensory Integration Therapy?

Sensory Integration is necessary to:

• Relate to people in a meaningful way
• Move our bodies through space in a co-ordinated manner
• Focus and attend to the things in our environment in order to work, play and learn effectively

But what exactly is Sensory Integration?
"The ability to take in information through the senses (touch, movement, smell, taste, vision and hearing), to put it together with prior information, memories, and knowledge stored in the brain, to make a meaningful response" (Stephens, 1997).

Our nervous systems operate on an 'excitation' and 'inhibition' process. Excitation occurs when neurons (information carriers to the brain) are activated or more likely to respond. Inhibition occurs when the chances of response are decreased or responses are blocked. We all require a balance of the two in order to function optimally, this balance is called 'modulation', and enables the nervous system to respond to some senses and ignore others. When this occurs it provides us with our optimal level of arousal for learning, performance of self cares, productivity and leisure activities.

What are our senses again?
We all are aware of the following five senses:

• Hearing (Auditory) Receptors located in the ears
• Sight (Visual) Receptors located in the eyes
• Touch (Tactile) Receptors located in the skin
• Smell (Olfactory) Receptors located in the nose
• Taste (Gustatory) Receptors located in the mouth

But there are two other senses that not everybody is aware of:

• Movement and gravity information (Vestibular) Receptors located in the inner ear
• Body position and awareness (Proprioception) Receptors located in the muscles and joints

How do I know if my child has a Sensory processing difficulty?
There are some children who avoid activities that provide them with certain types of stimuli. For example, Johnny avoids any type of messy play or walking
barefoot in the playground. He also has difficulties with people standing close to him and the teacher always finds him refusing to stand in a line with his classmates. This would suggest that Johnny could be avoiding (over responsive) to tactile stimuli.

Children who are sensation avoiders often engage in disruptive behaviours such as withdrawal or engaging in emotional outbursts that enable them to get out of the threatening situation. From a behavioural perspective the child may appear as controlling or stubborn.

There are other children who seek activities that provide them with certain types of stimuli. For example, Sarah rocks back and forth on the mat at story time and has difficulty sitting still or staying in one position for a period of time. She has also been noted to spin a lot and seems to take excessive risks on the playground equipment. This would suggest that Sarah could be seeking (under sensitive) to vestibular stimuli.

Children who are sensation seekers are active and continuously engaged in their environments. They make noises while working, fidget, rub or explore objects with their skin, wrap body parts around furniture or people as a way to increase sensory input during tasks. From a behavioural perspective they appear excitable or seem to lack consideration for safety when playing.

What are some telltale signs that may indicate a sensory processing difficulty?

• Bumping into things/people frequently
• Unable to sit and focus on an activity for adequate amount of time
• Appears to fidget constantly during activities
• Likes to spin or play on outside equipment more than other children
• Has a strong need to touch others or be touched
• Seems to avoid using hands
• Avoids some clothes or food textures
• Appears to run or walk in an clumsy or awkward way
• Slumps or sits with poor posture

What should I do about it?
If you have any concerns about your child's behaviours or notice your child does any of the above more than other children, the best thing would be to consult with an Occupational Therapist and undergo a sensory assessment. The Occupational Therapist can then develop a therapy program to address sensory processing difficulties.