ConnectABILITY Homepage

What are Tube Feedings?

Some children cannot meet their nutritional needs by oral feedings alone. Due to medical complications or growth difficulties, these children are unable to take in enough calories by mouth for proper growth, nutrition, and development. Tube feeding supplements are often required.

There are several types of tube feedings that can be used to supplement nutrition. A doctor will recommend one that is specific to the child’s needs.

Nasogastric Tube

The nasogastric tube or NG tube is a soft tube that runs through the nose and into the stomach. Surgery is not required for placement. This tube is designed to be used for several months to provide the child with extra nutrition and calories. The NG tube still allows the child to eat by mouth. Therefore, oral eating skills can continue to develop and prepare the child to eventually eat without the tube.

The NG tube is considered a short-term help for babies with poor growth. It is generally not used when babies have long-term feeding difficulties.

Orogastric Tube

The orogastric or gavage tube is run from the mouth to the stomach using a tube similar to a NG tube. Surgery is not required for placement. The orogastric tube is usually pulled out immediately after each feeding and replaced before the next one. This irritates the throat and makes swallowing difficult. It is only used, therefore, on a short-term basis in very young infants as it is difficult to eat by mouth with the tube in place.

Gastronomy Tube

A gastronomy tube infuses food directly into the stomach. A surgical procedure or a special procedure called endoscopy (PEG) is required for placement and daily skin care is necessary. Children are at risk of developing reflux of stomach contents with this tube.

Some advantages to this tube are that it is placed directly through the abdominal wall and is not seen most of the time as is the NG tube. When the tube is no longer necessary, it can easily be removed. Because the tube bypasses the mouth completely, irritation to the throat does not occur and food can be taken orally if the child is medically able to eat. This type of tube can be used on a long-term basis and due to its larger size, thicker formulas can be used.

Jejunostomy Tube

The jejunostomy tube is placed surgically through the abdominal wall into the jejunum (the beginning of the small intestine past the duodenum). It bypasses the stomach and helps stop the risk of reflux feedings. If permitted by the doctor, the child may still eat by mouth. Care for this tube is similar to the gastronomy tube. This tube requires a continuous drip feeding, meaning the child is connected to a feeding pump most of the time. Special predigested formulas may also be required.

How is it diagnosed or detected?

Children that require tube feedings usually have a pre-existing condition or disability such as Failure to Thrive, Down Syndrome, Cleft Palate, Cancer and/or other disabilities that may present the child with severe oral-motor difficulties.

In infants and young children, common signs that tube feedings are necessary are:

  • lack of, or very little, weight gain
  • weight loss
  • slow growth
  • severe crying during feedings/refusing to feed
  • inability to swallow
  • evidence of aspiration

The goals of nutritional intervention are to prevent or reverse nutritional deficits, to promote normal growth and development, and to maximize quality of life.

The information on the specific types of tubes has been adapted from, Therapy Skill Builders, a Division of Communication Skill Builders; Feeding and Nutrition for the Child with Special Needs, Klein and Delany.

Additional Resources:

THE HOSPITAL FOR SICK CHILDREN www.sickkids.ca/dietitians/
The Department of Clinical Dieticians is composed of 33 registered dieticians and four breastfeeding Support Nurses. Each dietitian works within their respective program to assess the nutritional status and needs of paediatric patients at risk of less than optimal nutrition to support their growth and well-being. They develop, implement, monitor and adjust nutritional care plans based on this assessment and each child’s on-going medical condition.

THE OLEY FOUNDATION www.oley.org
The Oley Foundation is a national, independent, non-profit organization that provides up-to-date information, outreach services, conference activities, and emotional support for consumers, their families, caregivers and professionals.

Toy Shop

Photo parent and child paintingCreating and using powerful teaching tools for the development of language, social, motor, sensory, and cognitive skills.

Every Toy Has A Number of Teaching Tips, in Five Distinct Areas

Language

Language development has two main parts: receptive and expressive

Receptive language is the understanding of language. Example: If you ask your child “Where’s the ball?” and she looks at the ball. She has received and understood your message.

Expressive language is communication, using language to express thoughts. Most people use a combination of speech, written symbols or pictures and gestures for communicating.

Social

Social skills are life long “people skills” that focus on learning appropriate ways to interact with, and to respond to, others.

Before being able to do this, children must learn to view themselves as individuals who are separate from others.

Motor

Motor skills fall into two basic groups: fine and gross motor.

They allow children to explore and manipulate their environments.

Gross motor involves large muscles such as those in your arms, legs and stomach.

Fine motor skills use smaller muscles such as those in your eyes, mouth, hands and face.

Cognitive

Cognitive refers to the ability to understand concepts, pay attention, reason and remember. These skills help your child to understand and organize the world.

Sensory

Our senses include vision, hearing, touch, taste and smell.
These are used to give information about our bodies and the environment.

The largest sensory system, touch (tactile), is responsible for receiving critical information about texture, temperature, touch pressure as well as pain.

Toys

Bowling top

photo of bowling set made from plastic bottles

This is a great way to teach turn taking, and it sure can promote physical activity!

Materials

  • One litre clear plastic bottles, coloured plastic tape.
  • If you want to make a ball, you’ll need a sock, some lentils, and a needle and thread.

Step-by-Step

  1. Ring 5-10 clear plastic bottles with coloured plastic (PCV) tape.
  2. Pour one cup of lentils into the sock. Shake lentils to the bottom. Twist sock tightly just above the lentils.
  3. Holding the twist, sheath the top back over the filled portion of the sock. Repeat twist and sheath until ball is formed. Sew top closed.

Teaching Tips

Motor:

Bowling activity will help develop your child’s large motor skills as she learns to throw the ball to knock down the bottles, and then to pick them up to repeat the process.

Learning to aim also promotes hand/eye coordination.

Social:

This is a great opportunity to learn turn taking.

Start by having your child assist you in setting up the bottles. Indicate you will begin by taking your turn. “Model” by tapping your chest, stating “my turn” before you throw the ball. Set up again, and repeat for “your turn”.

Encourage other kids to join in, observing the “taking turn” rule.

To help your child be as successful as possible.
Accomplishment builds self-confidence.

  • Use a bigger ball
  • Add bottles
  • Get closer

Cognitive:

The concepts of “spatial relationships” is advanced as a child throws the ball and monitors where it lands.

Concentrationtop

Photo of lids with pictures on them

You’ll be surprised at how many times you come back to this game. It fits a wide range of purposes, and its as challenging as you want to make it!

Materials

  • Lids from frozen juice containers
  • Stickers
  • magazine photos
  • colouring book shapes
  • textured materials
  • glue

Success is in gathering the pictures.

Draw and glue letters for letter recognition.

Photo of magazines and lids

Step-by-Step

Grab your camera (make two prints of great photos) and teach toilet training (pictures of toilet, paper, flush, etc.) or use photos of facial expressions to teach emotions (happy, sad, mad, frightened).

Teaching Tips

Language:

To help develop vocabulary, always verbally “label” pictures for your child. When you’re ready, add written labels to picture disks. Finally try losing the pictures!

Social:

Model how to play the game by taking turns with your child. If your child has difficulties waiting for a turn gently hold her hand while quickly taking your turn. This game, in all its variations, can really help increase a child’s attention span.

Cognitive:

To develop matching skills place two different pictures on the table. Present your child a picture identical to one on the table. Help your child to make a match. Increase the number of pictures on the table as your child’s skill level grows.

For simple “concentration”, begin with 2 pair pictures face down on the table. Encourage your child to make matches by turning pictures over one at a time. Increase the number of hidden pairs as skill level improves.

To develop visual memory, sow your child two different pictures. Remove one picture, and ask your child to describe it. Increase the number of pictures.

Drums!top

photo of tin can drums and wooden spoon

Improve your child’s sense of rhythm, increase appreciation of movement and music, enhance language and social skills.

Materials

  • coffee tins or metal cans
  • shiny wrapping paper
  • construction paper
  • tape or glue
  • scissors

Step-by-step

  1. Decorate drums using shiny paper or coloured plastic (PVC) tape.
  2. Glue different materials around some drums to provide tactile stimulation (sandpaper, bubble-wrap, corrugated cardboard).

Tips for Teaching

Language:

  • Use this activity to help your child understand simple directions such as “slow”, “fast”, “brush”, “hit softly”, “beat loudly”.
  • Give clear directions. Use simple language. Position yourself in front of your child at eye level.
  • Provide hand over hand assistance to help your child follow through.
  • Encourage your child to imitate you with her own drum.
  • Sing a familiar melody, chant or song to the beat of the drum.
  • Sing slowly. Using clear language. Be at eye level.
  • Later, pause between lines to encourage her to initiate the next line.

Motor:

  • Let your child watch your hand movements as you play the drum. Give her the drum and encourage her to imitate the same hand movements.
  • Model more than once or provide physical assistance if needed.
  • The drum will help your child develop strength and endurance through her hands and arms.
  • This activity will also enhance hand/eye coordination.
  • The drum will help improve both large and small muscle control depending on how it is used.
  • Encourage your child to use it in different ways and incorporate it into various daily routines. For example – outdoor play – bring the large drum and sticks to be played loud – indoor – set up a small drum for tapping on with hands.

Sensory:

  • Drums stimulate the sense through touch and hearing.
  • Beating on the drum with both hands will help develop body awareness and promote freedom of expression. This will also encourage creativity and spontaneity.
  • Use drums to help your child learn to discriminate sounds and tempos.
  • Use various sizes or materials (a tin can or plastic container).
  • Beat on one drum then the other. Allow her to imitate you and repeat until she’s able to take notice of the different sounds they make.
  • Establish a beat pattern (two fast beats, on slow beat or loud beat, soft beat). Encourage your child to imitate you or develop a pattern between the two of you. (For example, a small soft drum for her and a loud big drum for you).
  • Take turns beating to produce loud and soft pattern sounds. Use other materials to beat on the drum producing different sounds (a brush, a pencil, a small rolling pin).

Social:

  • Take turns beating on one drum. Indicate whose turn it is by tapping your chest and saying “my turn” or “your turn”.
  • Initially your turn should be very brief so the waiting time for your child is not so frustrating.
  • Using two drums, take turns playing your own and developing a rhythmic pattern together.

Feed the Clowntop

Photo of clown and balls

Learning to aim and throw.

Materials

  • Large box
  • White shelf paper (similar)
  • Markers/crayons/paint
  • Exacto-knife
  • Masking tape
  • Glue

Step-by-step

  1. Draw a face on the paper to fit the box. Tape it to the box with masking tape.
  2. Using the knife cut the opening for the mouth. Tape around the mouth to reinforce the opening.
  3. Decorate with markers/crayons/paint

Tips for Teaching

Language:

Teach names of facial features. Reinforce concepts “in” and “out”.

Motor:

Throwing activities can be great for kids who are learning to stand on their own.

Position your child with her back against the wall.

The act of throwing will encourage her to move away from the wall briefly, and to balance in the standing position.

Gradually, move farther away from the wall.

Feed the Clown will help your child learn to throw with more control and direction and to coordinate hand and eye movements.

Cognitive:

Be creative! Give your clown a name. Make up stories about feeding your clown favourite food (and not so favourite, too).

Guitartop

photo of homemade guitar

Strumming on the guitar stimulates the senses, refines fine motor skills, and builds appreciation for music.

Materials

  • Kleenex box
  • paper towel roll
  • Elastic bands
  • Exacto-knife
  • Tape

Step-by-step

photo of cutting the box to insert the paper towl roll

  1. On one end of the Kleenex box, trace around the end of the empty paper towel roll.
  2. Cut a hole in the box
  3. Inert the towel tube into the opening. Stretch elastics. Tape elastics at bottom of the box.

Tips for Teaching

Language:

Using this instrument to accompany a familiar song that incorporates words and actions will promote both receptive and expressive language skills. Encourage your child to imitate you as you sing or have her strum the guitar according to your tempo. This will improve listening skills. Learning the words to simple songs helps to enhance language skills and concepts especially when the words relate to specific movements.

Motor:

If your child has difficulty, adapt this activity by using fewer rubber bands or thicker ones.

Have your child play her instrument in front of the mirror so she can have a different view of herself strumming.

Sensory:

Playing the guitar and dancing or singing to the rhythm, your child’s senses will be stimulated in many ways. This exposure will increase body awareness as well as sense of rhythm.

When first introducing this toy, show your child how to hold it and play it. Sing a familiar simple song as you play and move your body to the rhythm. As your child takes her turn, sing along to her sounds or dance making it a fun and enjoyable experience for both of you.

Juice Lid Gamestop

Photo of Juice Lid games

Simple to make, simple to use, juice lid games are as powerful as they are simple.

Materials

  • Lids from frozen juice containers
  • Containers with lids
  • Stickers
  • Magazine photos
  • Photos
  • Colouring book shapes
  • “Mactac”
  • Glue
  • Scissors
  • Exacto-knife

Step-by-step

  1. Cut out slits in container covers wide for beginners.
  2. What do you want to work on? Glue pictures, drawings, shapes on each lid.
  3. Use clear adhesive shelf liner over pictures for durability.

Teaching Tips

Language:

  • This toy can be used to help your child understand simple directions such as “put in”, “take out”, “open” and “give me”. Give directions once using clear, simple language. Provide hand over hand assistance, if necessary, to help your child to follow through. Reduce assistance as your child learns to understand the instruction.
  • For the beginner, use this activity without the lid on the container to practice “in” and “out” concepts.
  • You can teach picture names as your child places the lids in the container.
  • Use single words and keep them consistent each time you do the activity.
  • The juice lid game can also be used to teach shape, colour and/or names of animals.

Motor:

  • For children who are learning to grasp and release, this is a good activity.
  • Using hand over hand assistance grasp the juice lid and assist your child to release into the container.
  • Larger openings in the lid will make this easier. Later you can reduce the size of the hole.
  • Wrist rotation is taught by helping your child to fit the lid into the opening.
  • This toy promotes hand/eye coordination as your child learns to grasp and move the juice lid towards, and into, the opening.

Social:

  • This activity is great for teaching turn-taking.
  • Initially, keep all the lids.
  • Hand your child one lid at a time.
  • After she has put the lid in, take a turn. Say “My turn”, and gesture to indicate when it is your child’s turn.
  • Later share turns by dividing the juice lids into a pile for each of you.
  • Once mastered, include other children and be certain to enforce the “my turn” rule!

Cognitive:

  • For the beginner, use this activity without any pictures on the lids to make it solely a “drop-in” game.
  • Focus on placing the lids through, and listening to the sounds they make when they hit the bottom.
  • Here’s a chance for your child to problem solve.
  • Use juice lids with pictures or drawings of animals, people, fruit, numbers, transportation, etc.
  • Provide containers with pictures of the categories you decided to use. Have your child sort lids into the appropriate containers.
  • Name the pictures on the juice lid as your child puts them in.
  • To work on learning number concepts, count as your child inserts items. You can also ask her to “put one more in” or “give one more”.

Lacing Arttop

photo of noodles colored and used as beads

A simple game that requires your child to use both hands cooperatively, encouraging good hand/eye coordination.

Materials

  • Noodles
  • Spools
  • Pipe cleaners
  • Yarn
  • Shoe laces
  • String
  • Food colouring
  • Masking tape

Step-by-step

  1. Place slightly damp noodles into a zip lock bag add food colouring and shake.
  2. Wrap end with masking tape.

Teaching Tips

Language:

Your child will learn to understand simple directions such as “in” and “pull”. Give these directions once using clear, simple language.

Provide hand over hand assistance, if necessary, to help your child to follow through. Reduce assistance as your child learns.

Motor:

  • Stiffen the end of the lace or string with tape.
  • At first, you may have your child practice putting beads on a thin dowel, pencil or pipe cleaner.
  • To start with, choose a small number of thin “beads” with large holes. Noodles are good.
  • Increase the number of beads and decrease the size of the hole as your child becomes more skilled.
  • Demonstrate how to pull the tip of the lace out of the bead before sliding the bead down the string.
  • Provide assistance if necessary.

Cognitive:

Lacing art can be used to extend attention span and to teach the concept of finishing a specific piece of work before moving on to the next activity.

Start with a small number of “beads”. This will depend on your child’s attention span and the difficulty of the task. Add more as your child learns to sit for longer periods of time.

Lacing Boardtop

photo of lacing board

Fun to do, and a powerful tool to teach the concept of “finishing” before moving on the next activity.

Materials

  • Construction paper
  • Marker
  • Crayons
  • Hole punch
  • Scissors
  • Mactac
  • Shoelaces or pipe cleaners or yarn

Step-by-step

photo of punching holes in board

  1. Draw a character or use large photos or colouring book art cut out. Apply “mactac” to both sides. Cut out.
  2. Punch holes around the edge.

Teaching Tips

Language:

Lacing boards can provide a focus for talking with your child. Comment on the character on the board as well as what your child is doing.

Your child will learn to understand simple directions such as “in” and “pull”. Give these directions once using simple language.

Provide hand over hand assistance, if necessary, to help your child to follow through. Reduce assistance as your child learns.

Motor:

For children who are just learning to hold the lace, choose fatter or stiffer materials. You may even want to wrap the end with masking tape, to make it easier to grasp.

Assist your child to grasp the lace, insert it into the hole and pull through the hole.
The process is actually harder than it seems. For some children it may be helpful to have them practice one step at a time, like just pulling the lace through the board. This allows them to feel successful rather than being overwhelmed by the complexity of the task.

Try using simpler designs for your board, spaced further to start with.

Add more holes closer together as your child gains confidence.

Cognitive:

Start with a small number of holes on the lacing board. Make sure the number in manageable for your child. This will depend on your child’s attention span and the difficulty of the lacing task. You want your child to enjoy and come back to it. Add more holes as your child learns to sit for longer periods of time.

My Housetop

photo of house made from box

A fun way to help children understand daily routines and situations.

Materials

  • Large box
  • Paint
  • Exacto-knife
  • Brushes
  • Sponge blocks
  • Masking Tape
  • Marker

Step-by-step

  1. Draw arch shaped doors on two sides of the box. Cut the openings for doors using an exacto-knife. Draw a window on one side and cut out.
  2. Tape around the openings. Decorate using paints with brushes and sponge blocks.

Teaching Tips

Language:

Each week, choose a different set of household items (sleep-time pillow and blanket, meal-time small table, chairs and kitchen utensils) to play different scenarios.

Each scenario, introduce new words or concepts.

During kitchen activity, label “stirring, pouring, mixing”. Encourage your child to request items by with holding props. Give simple directions while playing (e.g., “pour tea”, “put the baby in bed”)

Social:

When playing with your child make the play as realistic as possible by using all the necessary props. For “sleep time”, use your child’s favourite blanket, pillow, pajamas, teddy bear and book.

It is lots of fun to change roles with your child. You be the baby and your child can pretend to be the parent.

If your child has difficulty with a daily routine (e.g., meal time) use the appropriate props to play out a positive scenario. Pretend to feed each other, or feed a doll.

Cognitive:

This activity may enhance children’s understanding of daily routines. First we cook, then we wash dishes. It’s also a fun way to practice self-help skills (e.g., dressing and undressing with play clothes).

My House may be used to help children understand different people and situations in the community and to anticipate upcoming event.

Set up a “Doctor’s Office” to help your child feel comfortable. Use a “play” doctor kit, and a white shirt as a lab coat.

Peg Boardtop

photo of pegboard

Making a Peg Board is an hour invested in lifelong motor and cognitive skills.

Materials

  • Cardboard
  • Coloured tape
  • Round clothes pins
  • Pick up a new Styrofoam meat tray in various sizes from your supermarket.

Step-by-step

photo of making holes in pegboard

  1. Pressure mark lines of holes on the tray with the top of a marker pen. Cut out with an exacto-knife.
  2. Place the tray over a larger piece of cardboard. Tape lightly at corners to hold in place. Trace lines of holes onto cardboard. Trace tray shape onto cardboard and cut out.
  3. Cover lines or holes drawn on cardboard with strips of coloured tape. Secure tray to cardboard with tape around edges and decorate.
  4. Add colour to the tops of clothes pegs matching the tape used on the cardboard.

Teaching Tips

Language:

Help your child understand simple directions such as “put in”, “take out”, and “give me”.

Give directions once using clear, simple language. Provide hand over hand assistance to help. Reduce assistance as your child learns.

Say the word “more” as you hand the peg to your child. As the routine becomes established pause to allow your child to gesture for more, or to request more using a sound or word.

Motor:

Peg Board can improve hand/eye coordination as your child learns to grasp and move the peg towards, and into, the opening.

If your child has difficulty grasping small objects you may choose to enlarge the peg by wrapping it with tape, or adding foam tubing. The kind used for plumbing insulation is very handy and cheap. Just cut it to size.

Using hand over hand assistance grasp a peg together.

Assist your child to release it into the matching hole.

You may wish to make a Peg Board with spacing for the holes further apart.

Social:

Take turns placing pegs. Indicate ‘turn’ by chest tapping saying “My turn” or “Your turn”.

Initially, your turn should be very brief so the waiting time for your child is not too frustrating.

Cognitive:

Teach colour matching with Peg Board. Starting out, use two colours to match. Make sure that the colours you choose are different enough from each other (yellow and blue rather than orange and red).

Label colours of pegs using single words. Ask your child to give you a specific colour. To make this a little easier, you might start with tow colour options. Place the correct peg closer to your child. As your child becomes successful with this task place the two colour choices the same distance from your child.

When you are confident that she knows one colour introduce the second colour in the same way and then alternate requests for specific colours.

To work on learning number concepts count as your child inserts pegs. You can also ask her to “put one more in” or “give one more”.

Photo Cubetop

photo of photosubes

This is a wonderful toy, and a powerful teaching tool. It can be used to increase language skills, encourage communication and socialization, and develop cognitive abilities.

Materials

  • Cube box (3” to 4”)
  • Photos of familiar people, food, events
  • Labels
  • Mactac, glue

Step-by-step

photo of putiting photo on cube

  1. Glue top and bottom of the box together if necessary. Glue photos to all sides.
  2. Label photos using lower case letters.
  3. Cut and apply mactac to all sides.

Tips for Teaching

Language:

If you’re working on increasing your child’s vocabulary this toy can help!

Place simple, clear pictures of different objects on each side of the cube.

Name the pictures for your child. Encourage her to imitate your words. Place the picture cube close to your face as you say the word.

Discuss and describe each picture.

For example, an apply is “A shiny, red apply! Mmm! Crunchy and Juicy!” If she’s able, let her tell you about the pictures, too. Ask questions and comment to elicit communication.

Use the cube to expand your child’s receptive language by asking questions. “where is the dog?” or “Show me the cat”. You can also use this activity to teach body parts. Use pictures of different body parts (from magazine pictures or drawings) on each side of the cube.

As your child, “Where is the nose?” or “Show me the eyes”.

If your child has difficulty expressing what she wants, this activity can help address this concern.

Use real photos, magazine pictures, and drawings of things you want your child to communicate to you. Stick them on the sides of the cube. For example, food items (she can tell you what she wants to eat or drink), or home routines (she can let you know if she needs to use the toilet or id she’s tired and wants to go to sleep).

Initially show the cube photo and point out how it will be used. Choose one of the pictures e.g., juice (when you know she may be thirsty). Point and label “juice” using clear, simple language with animated voice tone and expression to attract her attention. Go get the juice and say “juice!” and “You want juice!” Show her the juice cup beside the picture on the cube then give her the juice and repeat the naming.

Social:

To promote elf-awareness and self-confidence make your child’s hand print and foot print (by painting and stamping, or tracing).

Take a photo of your child. Have her draw a picture on a 4’x4’ sheet of paper. Take a photo of your house, and a family photo. Glue and mactac each item onto the cube. Point, name, and discuss each item with your child as you play with cube.

You can use the cube to teach your child about different emotions and feelings.

Make drawings of faces depicting various emotions to place around the cube. Label and discuss each. Encourage her to point to, or label, feelings when asked. You can make it a game by taking turns tossing the cube and imitating the expression of whatever comes up.

If your child has difficulty with transitions (moving from one activity or routine to another) you can use the cube to help her understand daily routines and smooth transitions.

Use photos, drawings or magazine pictures representing your child’s daily routines.

Place on each side of the cube.

Initially you will need to show her how the cube will be used. Before each transition, show your child the photo of what he or she will be doing next.

Label the photo using clear, simple language. Be at eye level. Move on to that routine promptly so he can learn to associate the photo with the activity.

To promote social interaction, use the cube to help your child learn turn taking during a game of “toss the cube.

Take turns tossing the cube and naming the picture that faces up when the cube lands.

If you have several cubes take turns stacking them to make a tower.

Cognitive:

The photo cube can be used to teach numbers, colours, shapes, letters, words, size and names of objects, people and places.

Use photos, drawings, magazine pictures or computer drawings that depict concepts.

Cut out the different coloured shapes to place on the sides of the cube. Label and name the colours and shapes.

Ask your child to find certain shapes and encourage her to name them. If she’s not able to, encourage her to imitate you.

You can make two identical cubes and use this as a matching game, too.

Play Doughtop

photo of playdough

Making play cookies and pizza promotes fine motor skills.

Materials

  • 1 cup of flour
  • 1/2 cup salt
  • 2 teaspoons cream of tartar
  • 7/8 cup of boiling water
  • 4 teaspoons of vegetable oil
  • Food colouring
  • Add something smelly, like vanilla or coffee
  • Add some glitter

Step-by-step

  1. Mix flour, salt, cream of tartar. Gradually add boiling water and add food colouring and oil.
  2. Knead the dough until smooth. Add water or flour for consistency. Store in an air tight container.

Tips for Teaching

Language:

Help your child to understand words such as “squeeze”, “poke”, “push”, “touch” and “roll”.

Comment on what your child is doing, using clear, simple language.

Motor:

Play dough promotes fine motor skills in activities like rolling, patting, poking, grasping, squeezing, and pinching.

Sensory:

photo of playdough and various cutters

Play Dough stimulates the sense through touch and smell. To add to the texture, bury objects in the dough or use scented variations. Start with familiar scents and work towards using stronger smells.

If your child has difficulty tolerating different textures Play Dough can be used in plastic bags.

Later it may be explored with the feet or on other parts of the body.

Social:

Develop turn-taking routines by sharing cookie cutters and rolling pins. Work cooperatively to make shapes such as pizzas or stacked birthday cakes.

Encourage other family members or friends to participate.

Cognitive:

Play Dough may be used to develop imaginative play skills. Your child will love to make cookies birthday cakes, hot dogs, pizza and more. Use cookie cutters, rolling pins, plastic knives and plates to add to the experience.

A variety of shaped cutters can be used to teach shape concepts.

Scarf-in-a-Bottletop

photo of scraf ina bottle

If refining your child’s fine motor skills is a high priority, this is a wonderful activity.

Materials

  • A scarf
  • A clear plastic water bottle
  • Beads with large holes OR if your child puts things in their mouth use clothes pegs or spools.

Step-by-step

It’s important to remember for some children beads are a choking hazard.

Instead of beads, you can clip a clothespin on the end of the scarf.

It works the same way.

Tips for Teaching

Language:

Help your child understand and follow simple directions such as “put in”, “take out”, “poke”, “pull up”.

Give directions once using clear, simple language. Provide hand over hand assistance.

Reduce assistance as your child learns.

Help develop vocabulary by talking about the details of the scarf (Long, red, shiny, soft).

Motor:

Help your child to practice proper grasping and releasing techniques.

Provide hand over hand assistance as she grasps the toy to place it into the bottle, and then grasping the end of the scarf to remove it.

As your child places the scarf into the bottle mouth she is expected to poke continuously until it is fully inserted.

In doing this, she is learning to poke and point using her index finger. Encourage her to continue this task until the end.

Help your child to use both hands in midline (in the centre of her body).

Encourage her to hold the bottle with one hand and poke the scarf into the bottle with the other.

Social:

This can be a great “turn taking” activity.

Take turns poking the scarf into the bottle and then pulling out.

Provide a lot of praise and encouragement as your child cooperates and complete this task.

Cognitive:

Here’s a great opportunity for your child to problem-solve.

They’ll need to figure out how to place the entire scarf in the bottle (perhaps using another tool instead of her finger). Once it’s in, she may invert the bottle expecting the scarf to fall out.

Provide assistance if she appears frustrated in her attempts.

Sensory Blockstop

photo of sensory blocks

Increase sensory awareness develop fine motor skills.

Materials

  • Foam blocks
  • All purpose glue
  • Lots of textured stuff:
    • Foil paper
    • Scouring pads
    • Pasta
    • Sandpaper
    • Bubble wrap
    • Fur fabric
    • Beans
    • Cotton balls
    • Pipe cleaners
    • Non-slip pads

Step-by-step

  1. Trace around blocks on textured materials and cut to size.
  2. Apply glue to blocks.
  3. Press materials onto surface set aside to dry.

Tips for Teaching

Language:

Label the texture and feel of the blocks using single words (rough, soft, furry).

Blocks can be used to help your child understand directions such as “put on”, “pick up” and “give me”.

Give directions once using clear, simple language. Provide hand over hand assistance. Reduce assistance as your child learns.

Motor:

This is a good activity for children who are learning to grasp and stack. Initially, you may need to help. Reduce assistance as your child gets better.

Grasping and moving the blocks towards the tower promotes hand/eye coordination.

Sensory:

Sensory blocks stimulate the sense through touch.

In addition to fingers and hands let your child experience textures on an arm or leg or foot.

Social:

Take turns building block towers.

Hands your child one block. After she has put the block on top, take a turn. Say “My turn” and gesture to indicate when it is your child’s turn.

Take turns knocking down the block towers.

Cognitive:

Have your child copy block towers that you’ve made.

To work on number concepts, count as your child piles blocks. You can also ask her to put on “one more” or “give one more”.

Sensory Boxtop

photo of sensory box

Stimulate the senses. Promote hand/eye coordination. Fun to make!

Materials

  • Empty Kleenex box
  • Textured materials
    • Brush
    • Feather
    • Sponge
    • Fur fabric

Step-by-step

You’ll want to reinforce the opening of the box with masking tape.

Cut textured materials into pieces of various sizes and shapes.

Be on the lookout for new materials.

Tips for Teaching

Language:

Name the textures, colours and shapes of the materials. Use single words to describe each texture such as “soft” and “rough”. Comment on what your child is doing (scratching, patting).

Help your child understand simple directions such as “put in”, “take out”, and “give me”. Give directions once using clear, simple language.

Provide hand over hand assistance to help your child follow through. Reduce assistance as your child learns to understand the instruction.

Motor:

For children who are learning to grasp and release toys, this is a good activity.

Using hand over hand assistance grasp the textured materials and assist the child to release into the hole.

Also assist the child to retrieve the pieces from the box.

This toy promotes hand/eye coordination as your child learns to grasp and move materials towards, and into, the opening of the box.

Sensory:

Sensory Box provides an excellent opportunity to stimulate the sense through touch.

Cognitive:

This activity will help to teach the concept of textures, size and colours. Use single words to describe each texture (soft, rough).

To work on learning number concepts count as your child puts-in and takes-out items. You can also ask her to “put one more in” or “take one more out”.

Allow your child to classify textures such as soft/hard, rough/smooth.

Have your child close her eyes and identify textured materials by feeling them.

Shape Sortertop

photo of shapesorter

Encourage socialization.

Promote motor and cognitive skills.

Materials

  • Container
  • Knife
  • Marker
  • Decoration items
  • Sorting “shapes” form around the house

Step-by-step

  1. Trace shapes gathered from around the house on lid.
  2. Cut and outline.
  3. Decorating Tips.

Teaching Tips

Cognitive:

Help your child understand simple directions like “put in”, “take out”, “open” and “give me”.

Give directions once using clear, simple language. Provide hand over hand assistance to help your child follow through. Reduce assistance as your child learns.

To encourage your child to request more keep all the shapes out of your child’s reach. Say “more” as your hand a shape to your child. Gradually, hold the shape a little longer and wait for your child to gesture, attempt to say the word and, eventually, say the word.

You can teach object names as your child places the shapes in the sorter. Use single words and keep them consistent.

The shape sorter can also be used to teach shape and colour names.

Motor:

For children who are learning to grasp and release this is a good activity. Using hand over hand assistance grasp a shape and assist your child to release into the matching hole.

Larger openings in the lid will make this easier to begin with. Later you can add more shapes.

Wrist rotation is taught by helping your child to fit the shape in the opening.

This toy promotes hand/eye coordination as your child learns to grasp and move the shape towards, and into, the opening.

Social:

The shape sorter is great for teaching your child turn taking.

Initially, keep all the shapes. Hand your child one item at a time. After she has put a shape in, take a turn. Say “My turn” and gesture. Indicate when it is your child’s turn.

Later, share turns by dividing the shapes into piles for each player.

Try to include other children at this point and help them to understand whose turn it is.

Cognitive:

Help your child problem solve.

Initially, she’ll use a trial and error approach, trying to put shapes into any opening. Later she will learn to scan openings and choose the appropriate one.

Name the properties of the shape as your child puts them in (“blue square”).

To work on number concepts, count as your child inserts items. You can also ask her to “put one more in” or “give one more”.

Smelly Jarstop

photo of smelly jars

Enhancing sense of smell.

Materials

  • Plastic jars with lids,
  • Film canisters
  • Stuff that smells
    • Coffee
    • Jell-o powder
    • Pot pourri
    • Cinnamon sticks
    • Lemon grass
    • Vanilla beans
    • Cardamom pods
    • Chocolate
    • Hay

Step-by-step

Punch holes in the lids. Use coarse smelly materials to prevent leaking.

Teaching Tips

Language:

Name the scented materials using single words such as “vanilla”, “lemon”. Ask your child which one she would like to smell as your hold two jars with different scents. Name the colour of the jar.

Sensory:

This activity will enhance a child’s sense of smell especially children who have difficulty tolerating certain smells. At the beginning, offer your child a jar that contains a scented material that your child likes. Then introduce additional scent. Place the jars on a tray so your child can easily reach and smell each of the contents of the jars.

Cognitive:

After your child is familiar with a variety of scents, make a duplicate set of smelling jars and put them on a tray. Let your child pair the matching jars.

Squeeze Bagtop

photo of squeeze bag

Simple sensory experience.

Materials

  • Duct tape
  • Heavy-duty freezer bag
  • Hair gel OR
    • Jello
    • Play dough
    • Shaving cream
    • Whipped cream
    • Cornstarch and water
    • Pudding

Step-by-step

Fill heavy-duty freezer bag with gel, close the bag and seal with duct tape.

Teaching Tips

Language:

Help your child understand simple directions such as “squeeze”, “poke”, “push”, “touch” and “roll”.

Give directions once. Provide hand over hand assistance to help your child to follow through. Reduce assistance as your child learns.

Name the texture and “feel” of the bag using single words such as “cold”, “soft”, “gooey”.

Motor:

Grasping and squeezing the bag increases strength in the hands.

Sensory:

Squeeze bag stimulates the sense through touch and smell, and enhances body awareness.

Encourage your child to place the bag on different parts of her body.

Use the bag to play hiding games.

Squeeze bag can be used at a variety of temperatures, but be careful not to make it too hot.

Stacking Ringtop

photo of homemade stacking ring

Hand/eye coordination motor development and problem solving.

Materials

  • Paint (and paint brush)
  • Small, sturdy box
  • Paper towel roll
  • Rings from sponges
  • Empty masking tape rolls
  • Cut-out container lids
  • Preserving jar lids

Step-by-step

photo of homemade stacking ring

  1. Trace around the paper towel roll in the middle of the top of the box.
  2. Cut out the hole and tape the box top to the box. Insert the paper towel roll.
  3. Decorate if you wish.

Teaching Tips

Language

Encourage your child to request more. Keep all the rings out of your child’s reach. Say “more” as you hand a ring to your child. Gradually, hold the ring a little longer and wait for your child to gesture, attempt to say the word and, eventually, to say the word.

You can teach object names as your child stacks the rings. Use single words and keep them consistent.

The stacking ring can also be used to teach size and colour names.

Motor:

For children who are learning to grasp and release this is a good activity.

Using hand over hand assistance, grasp a ring and assist your child to release it onto the pole. Wrist rotation is taught by helping your child to place the ring on the pole.

This toy promotes hand/eye coordination as your child learns to grasp and move the ring towards, and onto, the pole.

Social:

Teach your child turn-taking.

Initially, keep all the rings. Hand your child one item at a time. After she has put a ring on, take a turn.

Say “my turn” and gesture. Do “your turn” and gesture.

Later, share turns by dividing the rings between the players. Try to include other children at this point and help them understand “whose turn” it is.

Cognitive:

Initially, your child will stack the rings in any order. Later, teach her to scan the rings and choose the appropriate size starting with the largest and stacking the smallest last.

Teach your child about colour and size as she plays with this toy. Name the properties of the rings as your child stacks them (“large yellow ring”).

To work on concepts count as your child stacks items. You can also ask her to “stack one more” or “give one more”.

Stacking Toystop

photo of stacking toys

Powerful problem solving.

Materials

  • Plastic containers of various sizes (with lids)
  • Boxes
  • Wrapping paper paints to decorate

Step-by-step

The secret is being always on the lookout for a wide variety of container sizes, and keeping the toy together in a box.

Teaching Tips

Language:

To encourage your child to request “more” keep all the containers out of your child’s reach.

Say the word “more” as your hand the container to your child. Gradually, hold the container a little longer and wait for your child gesture, attempt to say the word and, eventually, to say the word.

Use words and phrases such as “put in”, “put on”, “take out”, “take off”.

Teach size and colour names (“small”, “big” or “small blue box”).

Motor:

To strengthen your child’s grasp encourage her to take the lid off and put it on again…

This activity will enhance your child’s hand/eye coordination as she stacks containers.

Social:

Take turns nesting or stacking containers.

Take turns knocking down stacks.

Cognitive:

Have your child stack the boxes or containers 9with lids on) in any order, to see the consequences. If a small box is on the bottom the stack will fall over.

Assist your child to stack with the largest container or box on the bottom.

Allow your child to attempt to nest containers (fitting one into another without the lids) through trial and error.

If the child is having difficulty give hand over hand assistance. Reduce assistance as your child understands the nesting concept.

Tactile Booktop

photo of tactile book

Lots of sensory stimulation

Materials

  • Photo album
  • Textured stuff
    • Fur fabric
    • Cotton balls
    • Sponges
    • Scouring pads
    • Non-slip pads
    • Foil
    • Sand paper
    • Bubble wrap

Step-by-step

  1. Cut textured materials to fit pages and insert.
  2. Place cardboard between material and plastic. Cut opening to allow material to be touched.

Teaching Tips

Language:

When “reading” this book name the textures, colours and shapes.

Use single words to describe each page (soft, rough). Comment on what your child is doing (scratching, patting, turning pages).

Motor:

The tactile book is great for children who are just learning to turn pages. The stiffness of the pages helps.

To make page turning even easier you can use “page fluffers”. These can be made from a small block of foam ½ to 1 cm thick. Stick to the upper right hand corner of the pages using two-sided tape.

Sensory:

As we promised, lots of sensory experiences are in the book.

Remember to experiment with “how things feel” on arms, legs, cheeks and even feet.

Cognitive:

Teach textures, colours and shapes. Use single words to describe each page such as soft, rough, rougher.

Talking Sockstop

photo of sock puppets

Puppets teach creative and imaginative play.

Materials

  • You’ll need some glue
  • Pipe cleaners
  • Needles and thread
  • Socks
  • Buttons (don’t use buttons if your child “mouths” things)

Step-by-step

  1. Draw facial features on the sock.
  2. Glue or sew yarn as hair. Sew pipe cleaners as nose and mouth. Sew (strongly attach) buttons as eyes.

Teaching Tips

Language:

Help your child learn words of songs and body parts (eyes, nose, mouth).

Puppets can also help your child to express moods (happy, sad).

Cognitive:

Be creative. Give your puppets names.

Bring them to life. Give them personalities. Pretend to feed the puppet. Comb its hair.

Allow your child to experiment with putting the puppet on his hand. You can use the puppet to explain concepts such as “above” and “below”.

Using puppets with mood features can help your child to express how he feels.

3-D Puzzletop

photo of 3-d puzzle

Powerful problem solving!

Materials

  • Styrofoam meat tray (new from grocery store)
  • Hard sponges
  • Coloured paper
  • Cardboard
  • Marker (pen)
  • Knife
  • Scissors
  • Glue

Step-by-step

  1. Draw and cut out sponge shapes.
  2. Trace and cut out shapes in tray.
  3. Trace tray on cardboard, cut out glue coloured paper to cardboard and tape cardboard backing to tray.

Teaching Tips

Language

Help your child to understand simple directions such as “put in”, “take out”, “open” and “give me”.

Give directions once using clear, simple language. Provide hand over hand assistance to help your child to follow through. Reduce assistance as your child learns.

To encourage your child to request “more” keep all the containers out of your child’s reach. Say the word “more” as your hand the container to your child. Gradually, hold the container a little longer and wait for your child gesture, attempt to say the word and, eventually, to say the word.

Use single words to name each shape and keep them consistent.

Motor:

Puzzles promote eye-hand coordination as your child learns to grasp and move the shape towards and into the opening.

For children who are learning to grasp and release, this is a good activity. Using hand over hand assistance grasp the shape and assist your child to release into the matching hole.

Social:

Puzzles are great for teaching turn taking.

Initially, keep all the shapes. Hand your child one item at a time. After she has put a shape in, take a turn. Say “my turn” and gesture. Repeat for “your turn”.

Cognitive:

The 3-D Puzzle will help your child to learn the concept of matching.

Allow your child time to explore each shape and then provide assistance to place the objects in the corresponding openings.

Initially, your child is likely to use the trial and error method to find the correct opening. With time, your child will learn to look at the shape of the object and to scan the board to find the corresponding opening. You may wish to prompt correct responses by pointing to or tapping the correct opening.

The circle is usually the first and easiest shape to learn since it will fit no matter which way it is turned.

The square is usually taught second and the triangle third. You can make this activity a little more challenging by turning the tray so that the shapes are in different places.

Thunder Rolltop

photo of thunder roll

How a plastic bottle and coloured water can help teach language, motor coordination and cognitive skills. Neat.

Materials

  • Large plastic bottle
  • Sparkles
  • Marbles
  • Beads
  • Soap
  • Oil
  • Ribbon
  • Food colouring

Step-by-step

Fill 2-litre bottle 2/3 with water. Add food colouring. Add marbles. Blue the top of the bottle to prevent spilling.

Teaching Tips

Language:

This activity will help expressive and receptive language skills. As you and your child roll the bottle back and forth, talk about what’s happening (“catch the bottle!”, “here it comes!”).

Help your child understand simple directions. State directions clearly, using simple language such as “roll bottle”, “pick it up”, “give it to me”, “faster”, “slower”.

If your child requires support in rolling the bottle, provide hand over hand assistance.

Make one goal of this game to direct the bottle to another person. Involve a third person and help facilitate the rolling as needed.

Reduce the assistance as your child learns.

Motor:

This activity is a great way to improve hand/eye coordination.

As your child rolls the large bottle using both hands, encourage her to follow the bottle with her eyes as it rolls.

When it tops encourage her to go get it and try again.

Make it a turn taking game, rolling it back and forth. This will give her a specific target to aim for.

Playing with this toy will help build strength and endurance. This will improve both small and large muscle groups.

Social:

Encourage interactive play between you and your child. She will learn to follow simple rules (waiting her turn, or staying between boundaries). She will learn how to play cooperatively and share one toy.

Help facilitate play with another child by stating and modeling the rules of the game and providing hand-over-hand assistance if needed. dxEncourage turn-taking by clearly stating and gesturing whose turn it is.

Toy Shop as written and produced by Fatima Kediye, Raffi Marinuzzo and Margaret Howard of the Early Childhood Services Team at Community Living Toronto.

Talking To The Family About Your Concerns

Developing a partnership with the family is very important when we share the care of their child. We communicate with parents on a daily basis. We often talk about their child’s achievements, friends, or the things he particularly enjoyed doing. We talk about how their child is settling in, our program, and the philosophy and goals of our service.

But, how do we tell the family about our perception that their child may be experiencing difficulties with their behaviour or development?

Remember, what we see as a problem may not be viewed this way by the family. This has significant implications for:

  • what concerns we raise
  • when we raise concerns
  • how we raise concerns with the family

Once a concern has been identified, it is important to consider both the needs of the family and all the members of the teaching team, including yourself. It is possible that neither party may want to talk about the concern – both staff and family can be reluctant to discuss areas of difficulty.

Understanding the family’s reluctance to hear the message

A family can react quite differently than expected to information about their child.

  • You may have observed your areas of concern for some time, while it may be the first time the family has considered these concerns. The family may not feel “ready” to consider these issues about their child.
  • A family may also go into “threat” mode when approached about their child. The parents may see it as a criticism of their parenting skills.

Understanding staff reluctance to deliver the message

Why is it difficult to move from discussing what the child ate and with whom they played, to raising what you believe is an area of concern? Here are some possible reasons:

  • Staff can feel threatened, too.
  • We may not feel comfortable about the information we are reporting or we may not have had enough time to build a good rapport with the family before we need to raise concerns.
  • We may feel under-resourced and are not sure where to refer the family, or are afraid of a negative reaction from a defensive parent.
  • We may even feel so concerned about the possible feelings of a family that we avoid the issue entirely.

If we really do have concerns about a child, we need to try talking to the family for the benefit of the child.

Raising Concerns

Before you raise concerns with the family, consider the following suggestions:

  • Talk to colleagues about your concerns. You may want to discuss the issue with your Supervisor and/or inform yourself about the centre’s protocol for communicating with parents.
  • Determine who would be the appropriate person to talk with the family – perhaps the Supervisor, another team member, or you.
  • Talk to the family as soon as possible. If there are two parents/guardians, try to see them together.
  • Find a time to discuss your concerns with the family WITHOUT the child being present.
  • Demonstrate an attitude of respect towards the family’s particular culture, religion, socio-economic, and linguistic background.
  • Timing is important:
    • While the child is clinging to his mother’s leg, not wanting her to leave, or as she is hurrying off to work, is not the best time to approach a parent.
    • Likewise, at the end of the day, a few words about how the day went is good, but it may not be the best time for informing a parent about a concern.
    • Allow adequate time for the meeting and provide a location that ensures privacy.

When meeting with a family consider the following suggestions:

  • Be positive, supportive, and honest about the child when raising concerns.
  • Give the family examples of the child’s strengths or areas that have shown improvement. Remember the importance of a positive approach when talking to a family.
  • Plan ahead and think about what you are going to say. You may even wish to write it down before meeting with the family.
  • Acknowledge that your concerns are based on your observations in only one setting and that there are many reasons for behaviour.
  • Be prepared:
    • Have concrete examples of your concerns
    • make sure they are objective.
    • Have a list of different services and appropriate support groups (with the names of relevant people), to which the family can be referred.
    • Develop an action plan with the family about what to do next. Have some ideas ready to suggest to the family.
    • Be prepared to consider what the family suggests, even if it is quite different from what you had in mind.
  • Reassure the family that staff members are happy to work with them to achieve the best outcome for their child.

Though breaking the news can be difficult, it is important that the issue be raised as soon as possible. This may allow for earlier intervention, which could provide the support necessary for their child to reach his/her potential.

References:

Managing Challenging Behaviour (2003). New South Wales Department of Community Services.

Sharing and co-operating

“It’s MINE!” We have all heard children scream this at one point or another. Young children often feel that a toy belongs to them just because they want it to. Children who are learning to share may become angry and frustrated when they cannot “get what they want.” They may show these feelings by grabbing items from other children or refusing to let go of toys.

Some children need extra support from adults when learning to share. As a parent, teacher or early childhood professional, you can do this by teaching your child which play materials belong to him, showing him how to share, and coaching him during play with other children. One of the best ways to show your child the benefits of sharing and working together is to have him participate in fun and co-operative activities he can enjoy.

Make Sharing Easier

Sharing Rules

Here are some simple sharing rules that can be put on a poster with pictures:

  • Ask when you want to use something.
  • Wait until someone is finished before you start using something.
  • Help each other.

Introduce these rules by using puppets or dolls. You can also create a simple story involving a favourite cartoon character and how they share. Here is an example using “Bert” and “Ernie” from the television show “Sesame Street”:
Bert is using the scissors to cut a picture from the newspaper. Ernie wants to use the scissors. “Bert, can I use the scissors?” asks Ernie. “I am using the scissors right now. You can use the scissors when I am finished,” answers Bert. Ernie waits until Bert is finished. Bert hands Ernie the scissors and says, “Ernie, I am finished now.” “Thank you, Bert”, says Ernie.
You can replace the word “scissors” with a toy that your child likes. Praise him when he follows the sharing rules during activities with you or other children.

Special Toys

Your child may have a special stuffed animal that goes everywhere with him. He may rely on this toy for comfort and get very upset if another child shows interest in it. Most young children find it difficult to share their favourite toys. It may be a good idea to put away special toys in a specific place. At home he can put it in a bin in his room before friends come over to play. At the classroom or child care program, he can be encouraged to put the special toy away in the cubbie when coming in. It will be there when it’s time to go home.

Plan Activities

You can involve your child by allowing him to choose two or three activities that he would like to share with his friends.

Show him how to ask for, and pass, materials to another person. Here are some expressions you can teach him:

“I want”

  • Point to object and show person the palm of his hand.
  • Point to a picture of the object.
  • Point to ‘want’ picture.
  • Touch the object and say, “want”.

“Give”

  • Pass object to person.
  • Hold object in front of person and say “take” or “here”.

“Wait”

  • Hold hand up like a stop sign.
  • Point to “wait” picture.

 
“Finished”, or “All Done”

  • Gesture finished by brushing hands together.
  • Point to “finished” picture on visual schedule.

Here are some activities that are designed to help children share. Start by doing the activity with your child, then invite a friend to join in.

Sharing Bins

Sharing bins is a good way to structure activities for children who are beginning to share. It works best with activities where children need to share the materials, but can play on their own. Some examples include lego, blocks, cars, crayons, and clay or playdoh. Provide each child with a bin or small box with their photo or name on it. Put all the toys to be shared on the table or floor and allow the children to take turns adding toys to their bin. Each child plays with the toys in his bin. If they want to, they can trade toys with each other.

Paper Plate Pals

Provide each child with a paper plate to decorate. Place decorative craft materials such as feathers, pom poms, and yarn on several small plates for the children to share. To encourage children to pass items to each other, you can place the pom poms closer to one child and the yarn closer to the other. Glue, crayons, and markers can be placed in between the children. Providing only one of a particular material such as one glue bottle, or a limited amount of scissors also creates a situation where children need to wait to use the item. It also provides an opportunity for the children to ask each other for the item when another child is using it.

Better Together!

Here are some everyday activities that will encourage your child and the children he is playing with to co-operate and work together. If the children have trouble sharing, you can support them by reminding them of any rules you have created. Praise and encourage them when you see them sharing and co-operating. Here are some examples:

“Liz, I like how you are helping Juan make a tunnel.”
“Sherry, it was nice of you to give Billy a napkin.”
“Chris and Matt, I like how you are sharing the cars.”

Cooking

Cooking is an excellent way to promote sharing and have fun. Children can help create the snack, eat, and clean up! You can set up the activity like a production line so each child has a special job to do. For example, if you are making a pizza your child can spread the sauce, his friend can add the cheese and both can add the vegetable toppings. At the child care program you can provide each child with their own bowl and wooden popsicle stick for mixing. Have a separate “teacher” bowl for the main mixture. While their hands are busy you can invite each child to have a turn mixing the teachers bowl.

Gardening

This is a great way to teach children about science and gives them a chance to get messy! You will need a few plastic pots, some soil, seeds, and a few spoons or toy shovels. Try growing plants such as beans that sprout quickly indoors. One child can make a hole in the dirt while the other puts the seed in. As the plant grows, children can take turns watering it.

Sandbox

Playing the sandbox provides a great deal of opportunity for sharing and cooperating. Encourage your child to play in the sandbox and share the
pails, shovels, balls, and toy cars while they build castles, roads, or whatever they dream up together!

Tips for Parents:

Label Toys

You can teach your child the concepts of “mine”, “yours”, and “ours” by clearly showing what belongs to him, what belongs to other people and what is shared. An easy way to do this is to buy a sheet of identical stickers and stick one on each of your child’s toys. Name each toy as you go along. You can say, “This truck belongs to Ishmael,” or “Ishmael’s truck”. Encourage your child to join in by attaching stickers and repeating your words. If your child takes toys to a friend’s house, school or child care program, the stickers will remind him which ones he can take home with him and which ones he must leave behind.

If you have more than one child at home, you might have a rule that some toys are for everybody to share but some toys belong to just one person. In the play area, put the shared toys together on several shelves. Place each child’s toys in a separate box or bin labeled with their name and photograph. Toys can be labeled with each child’s name or a small sticker to avoid arguments. For example, Nina’s toys have a red sticker on them and Freddy’s toys have a yellow sticker on them. The child needs to ask his brother or sister before using a toy that does not belong to him.

Prompting and Fading

Prompting and fading are two important teaching techniques that can (and should) be used in everyday activities such as tidying up after play, learning self-help skills like brushing teeth, and appropriate social skills. These techniques can be used at home as well as in the classroom.

What do the terms mean?

A Prompt is a cue or hint meant to help a child to perform a desired behaviour, skill, or part of a skill. Prompts can be as permanent as stop signs that signal our need to decelerate our car, to gradually fading prompts such as reducing the amount of hand over hand assistance used to teach a child to cut with a pair of scissors. Hand over hand assistance is essentially your hand over your childs hand shadowing the desired behaviour that they are to complete. PROMPTING just means “using prompts”.

Like crutches for a person with a broken ankle, prompts serve only to support your child while developing the new skill. Weaning your child off prompts quickly will ensure that the skill will develop and that he will not become dependent on the “crutch”. This is FADING. It is a process of gradually reducing the need, strength or level of the prompt. Using the example “tying shoe laces”, you might gently touch your child’s wrist to encourage him to pull the lace loops apart to create the knot (rather than using a higher degree of assistance such as hand-over-hand assistance).
The prompts (cues and assistance) given to help a child do all, or part of, a new skill range from the strongest and hardest to fade (get rid of) to the weakest and easiest to get rid of.

The following is a guide to the different levels and types of support or prompts that can be used to teach new skills.

1 (most or strongest ) → 5 (least or weakest)

  1. Full Physical – hand over hand
  2. Partial Physical – touching your child’s elbow, wrist, shoulder etc. to prompt movement
  3. Modeling – demonstrating the action or skill desired and tapping into your child’s imitation skills
  4. Gestural – pointing, nodding, or gazing at an item to provide a cue as to the action wanted
  5. Positional – either placing your child where learned cues in the environment prompt the behaviour. (e.g., placing him in front of the washroom door to prompt using the toilet) OR – positioning an item related to the skill in view of your child to prompt action (e.g., bringing shoes over to him may prompt him to go to his cubby to begin dressing to go home.)

When teaching a new skill you will use the MOST AMOUNT OF PROMPTING NEEDED to ensure learning the steps of the skill. If the skill is new to your child, you may need to provide full physical assistance initially to get the job done. If your child can do part of the task already or uses a similar skill, you may find a visual prompt, such as the picture of the next step, is enough to teach the step. Helping too much can sometimes be a problem. It is important to find the right balance.

How do you get started using prompting and fading?

There are five simple steps to remember:

  1. Define target behaviour (action, skill, or partial steps). Through TASK ANALYSIS, the steps to performing a skill to be taught are determined.
  2. Identify suitable prompts. Go through the steps of the task analysis with the child and determine the most amount of prompting (cues, assistance) needed to get through each step. It may be that different steps of the skill need different levels of prompting. Prompts will change as your child begins to learn the steps.
  3. Prompt, reinforce, and fade. The reason for prompting behaviour is so that you can reinforce it using praise or any other reward that will motivate learning. Give your child time to respond. Unless you are using direct hand-over-hand assistance, after presenting a lesser prompt (e.g., Modeling), it is best to wait a few seconds before prompting again. The reason for waiting is to see whether he will attempt a correct response. That will let you know what prompt level to use. As your child begins to demonstrate the action you want, begin to fade the prompt by being less “hands on” with your assistance and provide more subtle cues such as gestures etc.
  4. Monitor results. This is essential to know if you are progressing satisfactorily. Keep a log of which prompts are being used at each step of the task analysis so that you don’t accidentally provide too little or too much prompting the next time you instruct your child on that skill.
  5. Return to a stronger prompt when necessary. Sometimes you might think that a step has been learned and then discover the next day that your child is struggling. At these times, it is OK to give a previous, stronger level of prompting until your child is showing that he can do that step proficiently again. Remember to quickly move to a lesser prompt as soon as possible.

It sometimes takes a little practice to feel comfortable using these techniques, but making prompting and fading part of your daily teaching toolkit is a useful way to help all children learn new skills.

Definitions of speech and language terms

There are several methods of testing a child’s Communication – anything that can be understood by another person that includes talking, gestures, facial expression, laughing, crying, use of pictures, etc.

  • Language – a systematic means for expressing and understanding thoughts.
  • Receptive Language – the ability to understand another person.
  • Expressive Language – the ability to get one’s ideas across to another person.
  • Cognition – the process or act of knowing. It involves perception, memory, conceptualization, and problem-solving.
  • Concept – an expression of a rule that organizes information in one’s experiences. Verbal concepts enable individuals to classify and retrieve information. For example, knowing the concept of size allows children to classify anything in their environment as big or little.
  • Auditory Discrimination – the ability to differentiate between and among various sounds and to hear likenesses and differences.
  • Auditory Memory – the ability to recognize and/or recall information presented orally.
  • Visual Discrimination – the ability to differentiate between and among various shapes, sizes, colours, numbers, and/or letters.
  • Visual Memory – the ability to retain and recall information that has been presented visually.

Additional Resources:

Visit the Toronto Preschool Speech and Language Services at https://www.toronto.ca/community-people/children-parenting/pregnancy-and-parenting/parenting/speech-language-vision-hearing/speech-and-language/

Programming for children with Visual Impairments

Children with visual impairments often require physical and programming adaptations to be made to their educational setting. Children should be encouraged and provided with opportunities to be independent. Repetition and routines can help a child to understand their visual environment, and if changes are needed they should be made slowly to allow the child to adjust. In order for children to maximize their skills, they must feel comfortable, safe, and secure within their surroundings. Consistent arrangement of the environment can support children with a visual impairment.

Physical Space

  • edges of steps should be highlighted with contrasting paint or plastic nosings (plastic protectors that fit on to corners of furniture)
  • slanted floor surfaces should be highlighted in contrasting colours
  • windows should have blinds that are effective in reducing glare
  • sitting in areas of bright sunlight should be avoided
  • furniture should be kept in the same place as a predictable environment is necessary

Accessibility

  • equipment should be kept in one place for consistency and be clearly marked
  • frequently used equipment should be at the child’s level

Visibility

  • wall displays should be uncluttered, clearly presented, and positioned at the child’s eye level
  • signs indicating different rooms (e.g., “washroom”, should be positioned at the child’s eye level)
  • doors and walls should be painted in different colours to provide a contrast
  • door knobs and light switches should be highlighted in different colours
  • equipment pieces in the playground area should be different colours
  • different floor finishes should be used to identify separate areas (e.g., carpet in classrooms or tiled flooring in corridors, mats at door entrances, and exits to buildings)
  • corridors should be free of obstacles (e.g., chairs, tables)
  • “diffused strip lighting” is preferred

Programming Recommendations

  • children with visual impairments rely on auditory information for some part of their learning. Books on tape or CD, spoken output from the computer, and use of tape recorders provide a quick means of access that has the advantage of being meaningful to sighted peers.
  • low vision optical and video aids enable many partially sighted, low vision, and blind children to participate in regular class activities.
  • large print materials and Braille books are also available.
  • provide contrast in colour between an object and its background.
  • children with visual impairments need opportunities for direct experiences with materials and objects because they do not gain information from pictures. The opportunity to pat an animal, to stand in sand, or touch paint will be more valuable than only relying on verbal descriptions.
    Children with visual impairments vary in their learning abilities and needs. Educational support from a professional in visual impairment is beneficial to assist in the development of appropriate programming for the child.
  • As the child grows older, it is important for him to have contact with adults who are visually impaired and to have the opportunity to participate in regular work experiences. Not only must education provide information access, but it must also help him develop the skills needed to make decisions and experience the results of these decisions. Educators and families should resist the temptation to provide assistance where it is not needed; only through initiative and experience will a child understand his own capabilities and develop a realistic plan for his future.

Programming for a child with a Hearing Impairment

A hearing loss ranges from mild (hard of hearing) to profound (deaf). Specialists (audiologist, speech and language pathologist) can assist Early Childhood Educators in understanding the degree to which development of communication skills will be affected by the child’s hearing impairment. Parents should be consulted to determine how much hearing capacity the child does have and which teaching methods and communication system is best suited for the child. Early developmental milestones will be similar to those of the hearing child. The impact of a hearing impairment is most obvious in language development. Actual cognitive ability is hindered only to the extent that performance depends on language comprehension and use.

Strategies:

  1. Seat the child up close for good visibility of teacher, activity, or other children.
  2. Experiment to find out or ask parents how close a speaker must be in order for the child to hear.
  3. Provide the child with experiences that make residual hearing (auditory acuity of a child after an impairment without amplification).
  4. Speak at normal speed and volume without exaggerating lip movements.
  5. Avoid speaking with your back to the child or with a bright light behind you. Don’t inadvertently cover your mouth when speaking. Lipstick may enhance visibility.
  6. Use normal vocabulary and sentence structure. Be prepared to repeat, rephrase, point out, or demonstrate if the child does not understand.
  7. When seeking the child’s attention, be certain to use his or her name. Teach the child to attend to your face and do not give any directions until the child is obviously attending.
  8. When teaching the child, use visual and tactile aids. Model the desired behaviour whenever possible.

Principles Guiding the Delivery of Specialized Supports in Child Care Settings


“Children with special needs and their families have access to child care and appropriate supports in the neighbourhood where they live.”

Inclusion:
Children with special needs have the same opportunity to attend and actively participate in child care programs as their peers.

Quality:
Child care programs and Special Needs Resourcing Agencies strive for responsive, timely evidence based best practices in the area of inclusion.

Partnerships:
A successful partnership between parents, childcare staff, and specialized services is essential in order to meet the individual needs of each child within a group setting. Participation of Parents/Guardians is recognized as integral to the successful inclusion of children with special needs in child care.

Accessibility:
Children with special needs and child care staff have access to supports which facilitate high quality inclusive early childhood experiences.

Integration:
The delivery of specialized supports in child care is embedded within a broader strategy for a system of childcare where all children can maximize their potential.

Equity:
Specialized supports are assigned based on the general population base and the rate of prevalence for special needs.

Flexibility:
Specialized supports are delivered in a way that allows service providers to adjust services based on current needs and agency’s expertise.

Capacity Building:
Inclusion is a process not a product, and there are issues of capacity that will take time for the community to respond to appropriately. Training is valued as an important contributor to quality and inclusion and will be available and coordinated by the child care and special needs resourcing communities to meet staff needs and build capacity.

Accountability:
Funded services are governed, delivered and accounted for, in a way that is transparent to the user and local taxpayer.

Michael at the Playground

Michael is a four-year old boy in the preschool classroom. During outdoor playtime, Michael usually plays with a ball or goes on the slide. The teachers have noticed that he frequently pushes and hits other children who are engaged in play. The other children often get upset and move off to play in another area or tell the teacher what happened.

Does the story about Michael at the playground sound familiar to you – perhaps you have a child like Michael in your classroom?

If so, then you’ve actually taken the first step of identifying a problem behaviour that may be putting a child at risk. In this case, Michael’s problem behaviour is also interfering with his social, emotional and intellectual development.

Deciding what to do next may be difficult. Here’s the 3-step approach we followed in Understanding and Changing Behaviour.

Step 1: Decide Where to Start

We’ve identified a problem behaviour. Let’s take a moment to describe what we see or hear. Describing the behaviour will help us to be consistent when gathering information a bit later.

Michael pushes and hits other children with an open hand or clenched fist.

Michael moved into our preschool classroom just two weeks ago. In order to better understand his behaviour, we’re going to use the Functional Assessment Interview by O’Neill. This functional assessment tool will help us to record our observations of Michael’s behaviour, and gather information from his parents and previous teachers.

Now let’s move on to the next step.

Step 2: Gather and Analyze

Here is some information we gathered from the Functional Assessment Interview which includes: what happens before the behaviour; the setting and time when the behaviour occurs; and what happens afterwards.

  • There are no medical concerns or changes in medication.
  • Michael’s eating and sleeping patterns have not changed.
  • The behaviour happens more often in the playground and indoors less frequently.
  • The time of day was usually in the morning during outdoor play. Michael does not attend child care in the afternoon.
  • The behaviour occurs with peers, and happens at home with children of extended family members.
  • The behaviour does not happen with adults, siblings, or while he was in his previous classroom.
  • The behaviour is most likely to happen when other children are engaged in gross motor activities or in the block/transportation area.
  • When Michael hits or pushes a child he stays very close to them and does not run or move away.
  • We also noticed that Michael is removed from the situation after the behaviour occurs which leads to him screaming “no”. He often approaches the same child again even after being removed.
  • Sometimes children run away from Michael after he hits or pushes them.

We also considered Michael’s communication skills and noted that he speaks in two to three word sentences and uses gestures to make requests.

The results from the Functional Assessment Interview suggest that the function of the problem behaviour is to obtain attention. The problem behaviour serves a communicative function: Michael is using the behaviour to express his desire to join other children in play.

Now it’s time to move onto the next step and plan for change.

Step 3: Plan for Change

Planning for change involves making the behaviour irrelevant, inefficient and finally ineffective.

Making the Behaviour Irrelevant

We can make the behaviour irrelevant by preventing or controlling the things in the environment that happen before the behaviour.

Let’s take a look at some ways to prevent the behaviour from happening by promoting social interaction through group activities, and setting clear rules.

Activity
During outdoor play time, we will lead group activities and games like, “Duck, duck goose”, “Mr. Wolf” and “Red light, green light”. We will encourage Michael to participate and become acquainted with the other children in the class.

We will facilitate play between Michael and another child with games or toys that he is most interested in. For example, playing “catch” with the large bouncing ball in the playground or playing with the car ramp but using only one car.

Setting clear rules
We will also create a rules board that emphasizes positive ways to interact with others including all the “good” things we can do with our hands (e.g., pat on the back, shake hands). We can discuss these rules at circle time every day and reward children when we see them following the rules. Keeping class rules very clear and simple will assist Michael to understand what is expected of him.

Making the Behaviour Inefficient

To make behaviour inefficient, we might choose to teach specific adaptive, educational and social behaviours. By teaching these types of behaviours, we eliminate the need for the problem behaviour.

At other times, we may teach an alternative behaviour. An alternative behaviour serves the same function as the behaviour being replaced but is seen to be more appropriate by other children, adults and the general public. To be successful, it requires equal or less physical effort and complexity but results in the same type of pay-off for the child.

In this case, we are going to teach Michael how to “ask a friend to play”. We will create a social script that describes what Michael can do to ask a friend to play.

For more details on the strategies and teaching techniques we used to help Michael learn how to “ask a friend to play” visit our “Teaching New Skills” section.

Making the Behaviour Ineffective

The last step is to make problem behaviour ineffective, meaning that it no longer works for the child. Keeping in mind that the behaviour may not change right away – we are aware that it is very common for problem behaviour to increase before it decreases when implementing changes. The key is to be consistent with our plan.

Since this behaviour is really a request for peer attention, we have decided that when Michael hits or punches another child, all teachers will physically redirect him to a new activity without paying any attention to the behaviour.

Another important factor in making the behaviour ineffective in our environment means changing a behaviour in all the places a child finds himself including at home. Our partnership with parents is the key to success.

Throughout this process we spoke to Michael’s parents about our concerns, and shared our strategies. Michael also had some difficulty with social interaction at home, so we provided the family with the same strategies we are using and created a social script to use at home. Changing a problem behaviour that continues to be rewarded in other settings is confusing to the child and frustrating for everyone.

If the problem behaviour persists then we will have to re-assess but it is important for us to give our plan time to work. Be patient! Some behaviours can take a couple of weeks to change.