If you are a parent or professional working with typically developing young children or children who are challenged, you have probably been introduced to the notion of using sign language with them. As a pediatric team of professionals, we find sign language to be the one of the most exciting skills children learn and grow from using. We use sign language with our late talkers, our children who have signs of Childhood Apraxia of Speech, Down Syndrome, Autism, and many other developmental and genetic disorders. Here are some do’s and don’t of using sign language with young children.
Do introduce sign language as a way to give them a way to communicate their wants and needs. Some of the first signs we teach are milk, cracker, more and cookie! We find both the Wee Hands Online Dictionary and the Lifeprint websites to be invaluable! If a client is frustrated or expressing an extreme desire for a given object, we can quickly plug in the word and see a picture or video of the sign. While the Wee Hands Dictionary is good for the most useful toddler and children’s signs, some of our children might love grapes and this sign hasn’t quite made it to the dictionary and the Lifeprint dictionary is more exhaustive.
Don’t teach words that aren’t useful or don’t mean anything to them. If you are interested in learning specific words from a local professional here in the Midlands of South Carolina, we recommend the Signing Time Instructor – Jill Eversmann. Click this link to learn more about the classes she offers!
Do hand over hand demonstrate how to sign a word. Take their hands and do it with them and then stand in front of them and sign it again so they can see you doing the sign. It might take you doing it with them 7-10 times before you see them attempt to do it but then again, if it’s a highly motivating food, we have seen boys sign “candy or cookie” after one demonstration!
Don’t think they won’t sign if you have been trying for several months and not getting any results. Toddler’s need to be sitting up independently and be able to bring hands to mid-line to do many signs, so if you begin before these motor skills are possible, you may frustrate yourself.
Do clap and praise them as they begin imitating and using the signs spontaneously! When toddlers begin using signs spontaneously, care givers and parents can begin expanding their vocabulary to words like: stop, mine, please, thank you and night night! These powerful words give them a voice in their day to day lives and parents often report seeing their toddlers less frustrated. If they do continue to pitch a fit or whine, encourage them to use their words. Model the sign for what they want and make them sign so they can begin to see the usefulness. If you had a typically developing 3 year old, you would not allow them to cry and whine but would expect them to talk to you. Expect no less from a child who can sign, just adjust the talking to signing.
Don’t put them on display and have them perform for grandparents and friends. Allow them to show what they know as they request and use it naturally.
Do verbally say the word you are signing and expecting your baby to sign. As your baby begins to sign more and more and develop a vocabulary of 15-20 words, you will begin to hear some verbal approximations for the words they use most often or hear most often. They may say “muh” for more or “bah” for ball. Some later word approximations might include “op” for stop, “peas” for please and “tan too” for thank you! One of the common questions we get is “Will they ever talk if we teach them signs?” Absolutely! Sign language is just a visual and kinesthetic way to help facilitate your baby’s language skills. Teaching your baby to sign won’t keep them from talking any more than teaching them to crawl will keep them from walking!
Don’t discourage signing or verbal approximations! Toddler’s and young children often do not have the motor skills to precisely sign or say words, but accept their effort and know that they will get better and more articulate.
Take a look at this video and watch this two year old girl with Down Syndrome show you all the signs she knows on command! It’s difficult to hear but she signs grapes, please, milk and stop!
A few other useful signs we encourage through therapy are: help, open, close, book, on, in, dog, bird and music!
From parks to grocery stores,these little faces are everywhere! With 1 in every 691 babies in the United States born with Down Syndrome, chances are you come in contact with a person with Down Syndrome. As more research is done, this 400,000 plus population is becoming more self sufficient and we are learning their possibilities are endless! So as a parent, how do you help your baby with Down Syndrome have a chance to excel and use all of their potential? We recently had the opportunity to shadow one of our very own at the Palmetto Health Down Syndrome Clinic – Columbia.
While you may be referred by your physician to the clinic, it is important to know every child with Down Syndrome should receive three very important evaluations as soon as possible. If your community does not have a clinic like the one described here, you can create your own team of therapists and gain the information critical for not only optimizing your baby’s development, but maintaining necessary reflexes and skills.
This clinic is set up in a round robin fashion. Each family has an opportunity with each specialist and every 20 minutes rotate to another until each family has had an opportunity to meet with each specialist for an evaluation and specific recommendations for further tests and therapy plans are created. On this particular day, our client was happy and oh so spunky! Here’s Steven, 2 years old, waiting his turn to meet with the Geneticist from Greenwood Genetics Clinic. Steven and his family met Dr. E.J. Prijoles and were able to ask any question they had about Down Syndrome. Gathering information from knowledgeable professionals about development and issues related to this particular population is empowering. Since this was their second time, basic information was not necessary, but they were able to ask about current research and find out of any findings were relevant to Steven.
Second, Steven went to be evaluated by the Occupational Therapist, of Rehabilitative Care Center. The OT’s generally watch the child play with small toys and evaluate their fine motor skills as well as how well they sit up and use their upper body. They may refer you to have an occupational evaluation or a sensory evaluation. Each of these areas are very important to your baby using their hands and trunk appropriately so they begin to play with toys and puzzles and later have the muscle strength to self-feed and eventually to write! Steven already has an Occupational Therapist but mom was interested to hear what they thought of his Sensory Integration and what they would recommend additionally in this area. Both of the OT’s confirmed he seemed to have sensory aversions to soft items, and because of his low tone probably would benefit from deep pressure for ultimate proprioceptive input. (The body’s ability to know where it is in space.) A sensory motor screening can be done, but they confirmed an ongoing relationship with an OT who is trained in this area is best as they are always doing diagnostic assessments through therapy sessions. OT’s are able to make better recommendations and work with the team assembled for your child.
Next Steven headed over to meet Ms. Bethany Clark, the Physical Therapist with Rehabilitative Care Center. Bethany is young but passionate about helping families with children who are challenged. She quickly got busy evaluating Steven’s skills to determine why he isn’t doing more crawling and walking yet. His Physical therapist has been seeing him two times a week and he has had steady progress, but before one years of age, enjoyed taking it all in and was not very actively engaged motor wise. After looking at Steven’s skills and how he ambulates, Bethany recommended some type of trunk support system. A Thera Tog or a Spio suit is designed to give support, stability and tactile stimulation for children who need a little boost in this area. These suits are available online or locally at Brace & Boot. It is our hope that with this type of steady input and stability, Physical Therapy will be more productive and Steven will begin to crawl and walk more and more over the next 6 months. It is important to note that many toddlers with Down Syndrome learn to walk without a product of this kind. Even still, other children who have had access to these suits have not seen any benefit through them. Therefore it is important that the team continue to work to explore every possible strategy to encourage physical skills.
Finally, the last therapist to evaluate Steven was Ms. Mandi Madden who is a Pediatric Speech Language Pathologist with Rehabilitative Care Center. Mandi specializes in feeding disorders and is a wealth of information for therapists like ourselves. It is important that you seek an evaluation as early as possible by a SLP who specializes in feeding and oral motor skills if you have a baby who has Down Syndrome. There are many reflexes and skills a qualified therapist can identify and help you maintain as they continue to grow and develop that first year. While babies are not the same, the low tone, tongue protrusion, GI issues are common with toddlers who have Down Syndrome. Steven has had several swallow studies that determined he aspirates on liquids and has reflux. With this knowledge and a first hand knowledge of what current therapy consists of, Mandi was able to give oral motor exercises as well as feeding tips for his SLP to try for continuing to tolerate textures and begin eating table foods.
Last stop was with Dr. Hawn, who is a Clinical Professor with the USC School of Medicine. He was able to look over all the results from the team of therapist’s and discuss the findings with Steven’s mother. As a result of the team’s evaluation, he also was able to give mom a prescription for a Spio suit and to have another scope done to look at Steven’s esophagus. Each of these recommendations was a result of the team’s evaluation. While most families participate in something like this clinic in the first year of their babies life, Steven’s mom chose to take advantage of the clinic again because he is growing and developing and she had areas of concern she felt might could be addressed with a separate set of eyes reviewing his case. This ongoing ability to advocate for Steven and leave no “stone un-turned,” is what every parent of a child with special needs must be encouraged to do.
Steven’s team welcomed the recommendations and is actively implementing new strategies for his benefit! It is our desire that you will find this information useful and seek to take advantage of the Down Syndrome Clinic here in Columbia, South Carolina or find one in your area.
Program note: This clinic, beginning in June 2014, is evaluating only children who do not already have services in place. The OT, PT and Speech Evaluations are now done at the Rehabilitative Care Center and the doctor’s evaluation is done on a separate day for billing purposes.
The concept of wellness has many applications in our society but for the sake of this blog, it is defined as physical activity that results in a level of fitness that impacts immediate quality of life, health over the long term and recreational benefits. Getting children involved in sports and exercise early in life is critical. As the old adage goes, many life skills, such as a healthy lifestyle is likely “caught rather than taught.” In a study by Rimmer, Braddock and Marks (1995) it was noted that less than 10% of adults with developmental disabilities engage in physical activity a minimum of three days a week. So parents and caregiver’s need to get out and get moving early and often to break this mindset. Taking family walks or biking outings are a great way to get everyone off the couch and outdoors breathing fresh air and getting much needed vitamin D! Here are a few links to local parks and trails that are fun and unique!
Palmetto Trail – Hike the entire trail or just the Peak to Prosperity trail and get to cross 11 different train trestles!
Sesquicentennial State Park – Hike or bike the trails and enjoy the slides and canoeing!
Congaree National Park – Become a junior ranger! Print this book and walk and learn about all kinds of native animals.
Just because a child has a physical disability, parents and others may feel as though the child can’t play organized soccer or baseball but what studies have shown, is that while the goals of sports participation and exercise may need to be individualized for a child with a disability it can result in equal benefits compared to the general population. Take time to find out about leagues in your area that cater to children with developmental disabilities. Important benefits of sports and exercise include the development of self-esteem, social integration, and the learning of social and team skills. All greatly beneficial to the child with a disability.
Friendships and a sense of community are forged and developed in the process of becoming well and is an unintended benefit to exercising together with peers. If you are struggling to find organized sports leagues, why not gather up neighbors to throw frisbee with or play some relay games with on a Sunday afternoon!
Waving, pointing and nodding are some of the first ways our little ones learn to communicate.
By encouraging them to wave,
we teach them the importance of social skills and acknowledging someone’s presence.
By teaching them to point,
we teach them to connect with their surroundings, comment on things around them and identify objects in books!
By modeling nodding,
we teach them to agree or disagree with something being asked.
Even if a child is non-verbal, they can communicate their intent and most of the time they say, “No!” before they say yes. Keep talking but don’t think nonverbal communication isn’t beneficial too!
Beginning in 1995 with only 17 Walks, the National Buddy Walk Program continues to grow and this year is set to sponsor more than 250 Walks!
The Buddy Walk for the Midlands of South Carolina is in it’s 14th year of existence and is scheduled for Sunday, October 20th, 2013. To see an actual video and schedule of the days events, click here to connect with Family Connection of South Carolina. Event Video & Registration.
Because last year’s walk was so well attended, the organizer’s have chosen to have this year’s Buddy Walk at Sequicentennial State Park just off Two Notch Road on the Northeast side of town! Plan to come from 1-5 pm and be prepared for a 1.5 walk to show your support for all the children and their families who live with Down Syndrome! Last year The University of South Carolina sent everyone’s favorite mascot “Cocky” to mill around and visit with all the children and adults who attended.
The Buddy Walk was begun to promote acceptance and inclusion of people with Down Syndrome in their local communities. Many participants will be wearing their “team” shirts to support the specific child they are walking to endorse and countless families have set up pages to raise funds to donate to the National Down Syndrome Association. If you do not live in the Columbia area, you can find a walk near you by looking at this resource. “Buddy Walks by State.”
The resources raised by each participating family and team are used both Nationally and locally to continue research and the development of awareness to allow these children to reach their highest potential. Come join the fun celebrating these children and their milestones. It is a day filled with joy and love as we celebrate each of these individuals.