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Rehabilitation Center Pediatric Rehabilitation Services

Staff Blog
Let’s Play- I Mean Have Some Fun!

A child makes sense of her world through play. When we play with our young children, we stimulate talking and learning. A child will learn best when he feels no pressure to communicate; and you, as a mom or dad, can both observe and feel delight as your child communicates what he knows about the world so far during a play scheme. Here are some tips for having a fun, relaxed play session with lots of social interaction and learning going on:

Your 2 to 3 year old wants to “ play cars” with you: you say “ ok, that sounds fun” (you have allowed your child to lead, you are learning what your child likes, and you are giving him confidence.)

You sit down so you are face to face with you child. ( you and your child learn from each others’ facial expressions and you are really sharing a moment together)

You imitate your child’s sounds, words, and actions in play (again you are learning about child by observing and your child feels you are really interested in him - he may imitate you.)

You say what your child might say if she could; for example, child is pushing car fast, and you comment, “your car is going fast!” (you are giving child words to express what is happening but you are not quizzing her and putting pressure on her with, “Is that car going fast or slow.”)

You wait to see what your child will do next (again following her lead) and she has an idea to “go to the store”; you ask a question to keep this conversation going: “what do we buy?”- you might have some pretend food nearby for your child to choose from. Then its your turn to introduce an idea, “I know, after we buy our food, lets drive to the park; we can have a picnic.” (turn taking is a building block for cooperative play and effective communication; it can be encouraged early-on by waiting for a response from your child (verbal or nonverbal) and making sure you provide a response to you child’s communicative bids to you, even a giggle he shares with you.)

“Playing cars” is now a special play routine for your child and you which he will remember and which can be elaborated on. Just remember, you are a play partner not a director or teacher. You will be surprised at how much fun you have when you remember how to play.

For more information on how to play like you were a kid again, refer to following resources:
It Takes Two to Talk and You Make the Difference in Helping Your Child to Learn at

Help With Handwritng

Now that school is underway, handwriting demands have increased for our children along with frustration for some. Handwriting is a fundamental skill used daily to communicate with others. The following is a list of tips that can lead to success in handwriting:

Our hands need a stable base to work from when writing. Many children especially those who did not crawl on hands and knees have some upper body weakness and benefit from strengthening and stability activities such as: donkey kicks, crab walking and wheel barrow walking.

Propping on forearms on the floor to draw or color is helpful in promoting forearm/wrist stability which is necessary for the fingers to control a pencil.

Having your child work at a vertical surface promotes the development of proper hand and wrist position for handwriting and fine motor skills. Paper can be taped to a wall; a dry erase board, chalkboard, easel, slant board or a large three ring binder can be used as a writing surface. Other benefits of using an angled or vertical surface include encouraging upright posture and visual regard for work.

Younger children can use magnets on the refrigerator, foam shapes and letters on shower wall or sides of bathtub, or play and draw in shave cream or colored soap foam on tub sides at bath time.

Using short broken pieces of chalk or crayons encourages a tripod grasp used in a functional pencil grasp.

Coins or marbles can be hidden and found in play dough, modeling clay, or therapy putty to improve strength and control of fingers and hands.

Proper positioning of the body during writing activities includes: feet flat on floor with ankles, knees, and hips bent at 90 degrees. A small stool or phonebook can be placed under the child’s feet. Table height should be no higher than the child’s elbow when sitting.

Tilt paper to the left for right handed students and to the right for left handed students.

“Pinch” the pencil for writing with pads of index finger and thumb and side of middle finger. Sometimes a special pencil grip, a shorter pencil, or other adaptations are necessary to achieve a more functional pencil grasp.

Handwriting skills can be practiced at home by having your child add items to a grocery list, using a family message board, writing down a desired dinner menu, writing thank-you notes, and sending postcards when on vacation.

Keep writing tools such as paper, pencils, and markers within easy reach. Colored pencils, scented markers, glitter crayons, gel pens, and paints may assist in motivation.

Maze and dot-to-dot activities assist with eye-hand coordination.

Talk to your child’s doctor if your child exhibits significant difficulties with fine motor and /or handwriting skills. An occupational therapy evaluation may be indicated.

Helpful Handwriting Websites:
Handwriting Without Tears
Zaner-Bloser Handwriting
Make your own handwriting worksheets

What You Should Know about Your Newborn’s Head Shape and Position

If you have a newborn or an infant, you should know about torticollis and plagiocephaly. Sometimes infants develop a “favorite” head position with the head tilted to the side while inside the uterus. When placed to sleep on the back (as all babies should to comply with the “Back To Sleep” recommendations), this preference can continue.

The baby cannot lift and turn the head enough by his or herself to change the head position and stretch out that tighter side of the neck. Because the infant spends so much of the first few weeks and months sleeping, sometimes a change occurs in the head shape due to the pressure of gravity on that “favorite” side of the head. The head often becomes flat and then it is difficult to move out of that position, even when the neck muscles are stronger. If the head shape is left unmanaged, it can become so altered that facial features can become uneven.

Also, as the infant is learning to lift his or her head, the head will continue to tilt to that “favorite” side if those tighter neck muscles are not stretched out and if the looser and weaker muscles are not strengthened. The head is often tilted to one side, but turned towards the other side. This can cause problems with developing head control and slow gross motor development, and the tilted/rotated position can persist if not addressed.

Torticollis and plagiocephaly can also occur for other reasons. If you suspect that your baby has a “favorite” side or has similar symptoms to those described, see your pediatrician for clarification. The following is a guideline for positioning you newborn to help prevent these problems:

Tips for Positioning Your Baby:
  • Always follow the “Back To Sleep” Program recommendations to place your baby on his/her back to sleep.
  • Alter the way his/her head is turned during his naps and night-time sleep so that he/she “faces” both directions equally.
  • Notice if he consistently moves to a “favorite” position during his/her sleep or awake time. If you notice a “favorite” position, try to help him/her to have more time “facing” the other side during sleep and stimulate him\her to look in that direction when awake.
  • Remember to give your baby short, but FREQUENT, periods of tummy time exercise every day! Even if your baby fusses, let him/her practice pushing up for a few minutes at a time. Your child will get stronger and fuss less with practice
  • Also note the amount of time your baby is on his/her back and facing upward either in his/her crib, cradle, infant carrier, or other positioners. Remember that spending too much time in any one position can change the shape of your baby’s head.
  • Support your baby’s head when he/she is in semi-reclined positions such as the car seat, swing, bouncy seat, etc. Do not allow his/her head to turn to face one side more than the other or TILT over to one side or the other.
  • Don’t position your baby in upright positions such as the swing, bouncy seats, or exersaucers before he/she is ready. This leads to problems with the neck as babies try to hold their head up before they have enough head control.
  • Position your baby on his/her side to “play” as a break from so much time on his back.
  • By three months, your baby should be happy playing on his/her tummy and lifting his/her head well for 20 minute periods several times per day.

Talk to your doctor if you are concerned about your baby’s head shape, neck movement, or head control.