Messy Play with Food

As early as 4 months of age, Pediatricians are encouraging parents to expose children to baby foods. This milestone is pivotal in staging the rest of the child’s feeding experience. The main goal of this exposure is not for ingestion, as calories are still predominantly from breastmilk or formula, but for exploration.

Encourage your child to get messy! Show them how to smash their food, touch it with both hands, and smear it on their highchair tray. Is in in their hair? No problem! What you are encouraging is learning about the foods! Is it soft or hard? Can it break? Is it warm or cool? Does it have a big flavor or a small one? How can the child manipulate the food? Provide opportunities for children to use their fingers, a tool (such as an infant spoon), or a celery rod. The opportunity to be creative are endless!

Suggestions for messy play at home:

  • Mix baby cereal with preferred breastmilk/formula
    • Can be mixed with more or less milk to alter the consistency
    • Can mix with water as an alternative
    • Can be warmed in the microwave
    • Can be cold from fridge milk
    • Can put in freezer for a few minutes before serving
  • Stage 1 purees (can mix different flavors once introduced one at a time and checked for allergic reaction- consult your Pediatrician before mixing textures)
  • Smashed banana
  • Smashed avocado
  • Smashed sweet potato
  • Celery rod (at least 6 inches long)
  • Carrot rod (at least 6 inches long)
  • Cooked then pureed squash (Acorn squash, Butternut Squash)

Learning to Eat with “Hard Munchables”

What are Hard Munchables?

Hard Munchables are rod shaped food items that a child can hold independently and when inserted into the child’s mouth, it does not break apart and is long enough that a portion of the food remains outside of the mouth. The goal of hard munchables is NOT to eat, but for the child to explore the inner surfaces of their mouth and learn about this food texture. Exploring hard munchables is extra important for teaching the tongue to put foods to the back of a child’s mouth, thus enabling the child to eat more complex foods in the future, such as steak and baby carrots. Hard munchables are also useful in moving the gag reflex towards the back of the mouth as well as teaching the mouth how to accommodate for different size food objects.

When to introduce hard munchables?

– Child is mouthing toys without prompting.

– Child has neck and head control to sit independently.

– Number of teeth are not a prerequisite….. it is preferred to introduce hard munchables BEFORE children have teeth!

What are examples of hard munchables?

– Raw carrot rod

– Raw celery rod

– Raw jicama rod

– Beef jerky stick

– Hardened pizza crust/bread stick

– Hardened Twizzler stick

– Rib without meat on it

– Frozen French toast sticks

As always, only expose your child to foods under direct and constant supervision. Feeding skills vary and change frequently, so be mindful that one day a celery stick does not break apart and a few weeks later, the child is shredding pieces off!

Once your child’s molars protrude and jaw strength increases, the hard munchables are no longer used for exploration and become a food for ingestion purposes.

Happy Exploring!

Mom Guilt

Mom guilt. Such a familiar term these days. But where does mom guilt come from? Why do so many moms fall victim to it? Is it worse now than it was when our mothers were raising children?

For me, the internet is a blessing and a curse. It helps me answer the question of how much medicine I can give to my coughing child at 2 am. It reassures me that a quotient really is the answer to a division problem while I’m helping my child study for math. But the downside of the internet is it shows me what moms all around the country are doing. It depicts gorgeous back drops for a pre-k class party. Articles on Google or social media share dietary tricks , multi-vitamin do’s and dont’s, how to make sure your house is the cleanest it can be, how and when you should get your baby to sleep through the night….  it’s all informative…and exhausting! So not only do we have to figure out how to keep these little people alive, but we have to make sure they have a wonderful, well-adjusted childhood where they get the best education so that they can become citizens of this hustling, bustling world and start to raise well-adjusted children of their own! Whew!!

Enter mom guilt.

Mom guilt is the feeling that you’re not meeting the expectations of what a mom should be, therefore disappointing your future adult child by not affording him/her of the best childhood experience available. And we all do it! Do I work too much? Do I spend enough quality time with my child? Do I not spend enough time away from him? Do I have a stronger bond with one child over another? Do my kids watch too much TV? Do they spend too much time on electronic devices? Are they getting enough physical activity? Is he getting the best nutrition from his diet? Does my daughter have the basis for a good body image? Is my son learning how to treat women with respect? Do I savor these crazy moments that everyone tells me I will one day miss? So many questions…so few answers.

What complicates this story more is having a child with disabilities. There are thousands of other moms out there to compare how you should be being a mom when you have a neurotypical child, but who do you look to when you have a child with special needs? These moms are special people, because unfortunately for them, mom guilt gets amped up even higher! I am  this child’s mom! What did I do to cause these problems my child now has to endure? How and what can I do to make this child’s life easier? How can I be frustrated with this child that needs extra help??

Moms, you are not alone!!!! We are all guilty of not cutting ourselves enough slack. The ironic thing is that there are moms who question every stage of their pregnancy, examining what they did wrong to perhaps cause their precious baby to struggle so, and then there are women who become pregnant and don’t receive prenatal care, stop drinking or using drugs, and they go on to deliver healthy, full term babies in the back of a taxi. Some things we just don’t have that much control over, and even when we do everything right, watch everything that goes into our mouths, take every prenatal vitamin prescribed, receive the best prenatal care, have a well-designed delivery plan…things still may not happen as we expect.  Yet, we guilt ourselves that WE, the MOTHER, are responsible for things going off plan!  Why do we do that to ourselves?

Our expectations of OURSELVES is astounding and disproportionate to what we are capable of doing and what we have control of. I write this not just for you moms out there with mom guilt but for myself as well, because I am just as much a victim of inflated expectations that no one should hold themselves to. Let’s ask ourselves this question when we get in our loop…what will happen if I don’t worry about this today or if this doesn’t get done?  Will it negatively impact my child or our family if this doesn’t happen?  How much extra value does this add to my child’s life or to my family’s life?

Because in the end, we all have fond memories and memories we wish to forget…those from our childhood and those from our parenting experiences!  The truth of the matter is that our children will also have fond memories and memories they wish to forget.  None of us is perfect, and being a mom is hard work! Let’s all take some of the pressure off ourselves and reduce the expectations…because, as I humbly admit, none of us will EVER be perfect. So let’s release the guilt, support each other as moms, recognize the fluff for what it is, and just do the best job we can of loving our sweet angels!

To all those moms out there that are trying to give their babies, both big and small, the best life there is, always remember YOU are one of your child’s most treasured gifts.  Even with all your imperfections, you will always be their one and only MOM.

Why Does a Non-Verbal Child Need Speech Therapy?

photo5 (1) “You are a speech therapist.  How can you help a child who does not speak?” When speech therapy is recommended for a non-verbal child, many people who are not familiar with the role of the speech-language pathologist (SLP), aka “speech therapist,” wonder why this recommendation was made.

In order to answer this question, it is important to understand that SLPs are communication specialists and that communication is not just verbal.  Imagine the messages you send with just a look to your loved ones.  Think about how you know what other people might be thinking or feeling, even if they don’t say anything.  How often do you point or gesture throughout the day to communicate?  Now imagine what it would feel like if you had none of these ways of communicating.  Not only is your voice silenced and your mouth motionless, but you also can’t use your hands or your facial expressions to convey meaning to others.  Try it.  You might get a sense of the frustration that some of our non-verbal or low-verbal children experience.

As SLPs, specifically those trained in DIR/Floortime, we start with the most basic form of communication, which is back and forth emotional signaling with a trusted partner. This could be in the form of eye contact and smiling—a basic human connection.  We then use techniques to  help the child explore his sound system, as well as use his body and face to gesture.  We help the child and his/her family communicate in continuous circles, even if not a word is spoken.   When children achieve this level of communication and they still can’t talk, we can introduce alternative communication devices that will give them a voice while theirs continues to develop.

“Speech therapy” is crucial to the overall communication development of a non-verbal child.  If any professional tells you that speech therapy can’t help, they are misinformed.  If an SLP tells you that he/she can’t help your non-verbal child, thank them for their honesty and find one who can.


Autism Awareness: An Onlooker’s Perspective of the Parent’s Journey

photo4 (2)Because I am a parent, I automatically have respect for the emotional, physical, and spiritual energy it takes to raise any child.  All parents who care or who try to do the right thing have my respect, because I know that just dealing with life’s normal stressors can make for a rocky journey. I am in particular “awe” of parents with kids on the autism spectrum or with other potential lifelong disabilities.   Their challenges are far greater than any I have faced as a parent.

I felt compelled to talk about parents as part of Autism Awareness month, because they have been the greatest force behind improving the understanding and care of their child(ren).  These are people that have pushed me and my colleagues to always be striving to know more, be more, and do more for these children and their families.   Complacency is just not an option.    After well over a decade  (well, almost two decades really) of working with children and their parents,  I have made a few observations about these unstoppable warriors.

  1. Parents react very differently to the diagnosis or potential diagnosis, as well as to the treatment journey.  Some parents are embarrassed or angry, some feel guilty, many are hopeful, and many are overwhelmed.   Some seem to cycle through all of these emotions at one point or another.   During the course of a child’s treatment, parents react differently toward us as professionals.   If they are going through a hard time, they may convey anger or blame. If their child is successful, they show appreciation and gratitude.   There is no way we can completely understand what they are going through, but we have a great deal of empathy for them and work hard to ride the waves with them.
  2. We hear stories of isolation.  If a parent isn’t part of a community (and sometimes even if they are), they report feeling isolated.  If your child screams or bites other children when he or she is overwhelmed, he/she is often not a party favorite.  We also hear that finding a babysitter can be difficult, because it can be hard to find someone who you can trust with your child during a meltdown or someone who will be vigilant enough to keep your wandering child safe.
  3. We watch parents find comfort in others who are fighting the same battles.  I watch moms who ordinarily may have never been a part of each others lives, but have bonded given their special circumstances.  They cheer each other on, pray for each other, cry with each other and share words of encouragement.  They share resources and experiences.  We are delighted when we see friendships bloom in the waiting room of our office.
  4. Watching parents progress in their understanding of the disorder and acceptance of their child’s challenges is almost as rewarding as watching the child make progress.  It seems that after a while, many are either relieved that their child will likely live a fairly typical life, or they have accepted their child’s challenges and delight in small markers of progress.  Some situations are particularly tough and these parents remain in a state of hypervigilance for many, many years.
  5. We notice over time that  societal norms have less influence over parents’ emotions as they grow in their understanding of their child.  Parents at this level of acceptance seem to have a realization that they care much less about what others think of them, as parents, or of their child’s actions or behaviors. They are much less embarrassed or upset by their child’s perceived “unusual” behaviors in public and they seem more sure that the autism was not their fault.  They seem to know that if anybody does blame them, it is out of ignorance, not truth.
  6. I feel this underlying sense of relief and quiet joy,  when I realize that a parent is slowly moving away from a life in which autism is all-consuming to a somewhat “typical” life that includes autism. These parents start doing things for themselves again or participating in sibling activities that bring them joy.  My assumption is  that initially it has to be all about autism. Autism has invaded their lives and their families and they are in a battle to fight it off. They do more than I would think is humanly possible and they fight with all of their strength. It’s not that I see them stop fighting, but more that they reach a satisfying level of success.  It is not as all-consuming, because they see their hard work and advocacy for their child paying off.  They may reach a comfort level for an extended period of time with their child’s placement in educational and therapeutic settings, and can rest before the next big battle may need to be waged.

Over the years there have been so many parents whom we have grown to respect and admire.  They have taught us so much about perseverance and strength.  Thank you for sharing the joy and pain of your journey with us.

What does it take to play a game?

blaise game 2Games are wonderful developmental learning tools for children.  They challenge many developmental areas simultaneously, requiring communication among different areas of the brain. So which skills need to come together to effectively play a game? Here are at least 6 of the things we observe/ work on when helping children learn how to play games:

  1.  Understanding game etiquette.   This means you have to know when to take your turn and when to wait,  accept losing, maintain your “cool” when things don’t go your way, be gracious when your friend gets lucky and joke/have fun in a non-offensive manner.
  2. Following multiple steps.    Setting up a game usually requires at least 3 steps, and even the simplest games require at least 2-3 steps to play, all at different levels of difficulty.  Some games might require picking a card and putting your token on the matching color square (i.e., Candy Land). Others might require spinning a wheel, determining the rule that is associated with that spin, then acting out that step (such as in Hi-Ho Cherrio!).
  3. Working with contingencies and being flexible.    Even simple games like Chutes and Ladders or Candy Land require players to deviate from the standard of counting and moving, if certain things happen.  More complex games like The Game of Life and Monopoly require decision-making and a variety of money transactions, in addition to spinning, counting, and moving.
  4. Sustaining attention and remaining in one spot.  Two-(or more)-player games are only fun for all parties if each person is invested in the game and can sustain attention.  An inability to sustain attention to the game could be related to the difficulty level of the game, the child’s impulse control, their need to move around, or a host of other reasons.
  5. Making precisely graded movements.  Games often have small pieces that need to be put in precise locations in order to maintain order in the game. When kids have difficulty grading the amount of pressure they put on something or lack precision in their movements, they may inadvertently mess up the whole game board, upsetting themselves and others.
  6. Exercising Cognitive and Language Skills.  Some of these skills include one-to-one correspondence, quantity concepts, counting, matching, reading for meaning, following directions, communicating with play partners, remembering, and many, many more!

Games are a wonderful way to support your child’s development, but can be frustrating if your child struggles with any of the skills above.  Modifications can be easy and fun and can support your child in their challenge areas.  In future blogs, we will discuss modifications for a variety of games. Meanwhile, take a look at some of our favorite games by clicking here, and scrolling about half-way down the page.


Disclosure:  Our company has signed up as an Amazon affiliate, which means that when a reader makes a purchase through one of our product links, we may receive a small commission.  We are committed to allocating any commissions received to a scholarship program for children who cannot afford our services.   We are also committed to only providing honest reviews and opinions about books and products that we believe our readers will benefit from or enjoy.

Book Review: Engaging Autism

outsideThe truth is all children need the principles on which DIR/Floortime® is based. It is a way of interacting with your child that improves their ability to engage, relate, communicate, and think logically and flexibly. All children (actually, all people)  can become better communicators, given coaching by a more competent communication partner.  Children with sensory-based communication impairments need particular focus and coaching in these areas of development by their parents, instructors, and caregivers.

The vast majority of the children we see in our clinic have sensory-based communication impairments. This means that their ability to engage, relate, communicate, and think logically and flexibility has been limited, at least in part, by sensory system challenges.  Engaging Autism is one of our most frequently recommended books to parents and caregivers. It is also a good introductory book to DIR/Floortime® for clinicians, teachers, and caregivers who are not trained in the approach/technique.

Here are the reasons we think you should read Engaging Autism by Stanley Greenspan, M.D., and Serena Wieder, Ph.D. (even if your child doesn’t have an autism diagnosis):

1. The book is easy for non-professionals to read. Drs. Greenspan and Wieder use language that is easy to relate to and give interesting examples to make the principles understandable.

2.  It is inspiring.  When  reading this book,  parents are often relieved because they realize that someone is actually addressing the real concerns they had for their child’s development, and that the approach makes sense intuitively.  It is an approach that parents can learn and implement themselves.  It gives parents a way to better understand their child.  With that increased understanding,  Floortime users learn that behavioral approaches can be limiting because they don’t always reach the child in his/her place of joy or understand the biological needs that may be limiting their child’s functioning.

3. Engaging Autism helps you become a better advocate for your child by giving insight into developmental steps that are not on a standard developmental chart.  Most people are familiar with developmental milestones which include when a child should roll over, sit, babble, and say their first words.   Fewer people have had exposure to developmental stages such as 1) Shared Attention and Regulation, 2) Engagement and Relating, 3)Purposeful Emotional Interactions, and 4) Shared Problem-Solving.   Understanding these stages described in this book will help you to advocate for your child when standard measures done by physicians and/or school systems say “Let’s wait and see.”

4.  This book can be read many times and the reader will learn something new each time.   As their child overcomes challenges and moves up the developmental ladder, parents can continue to refer to Engaging Autism to help them address higher level needs. Also, the person engaging with the child may refer back to the book to continue to hone his/her skills.   I, personally,  often look back at chapters in this book to help me refocus.  Also, I may refer parents, teachers, or clinicians to a specific chapter in this book.

5. There is a special section devoted to  “Overcoming Difficult Symptoms.”  This section gives insight into scripting/echolalia, self-stimulation, sensation craving, overactivity, avoidant behavior, activities of daily living (such as eating or toileting), behavior problems, coping with feelings, meltdowns and regressions.  Although there are no easy answers to these difficult symptoms, readers can understand what may be going on in their child’s brains and bodies in order to support them.

The emotional well-being of children and families is a huge priority when choosing how symptoms should be addressed.  Being able to understand our children at a deep level plays a huge role in the way we respond to situations, and the way that the child ultimately learns to see and value himself.  Engaging Autism will help you learn many wonderful things about your child and the immense value you can add to his/her life.



5 Reasons PTLC Chooses DIRFloortime®


  1.  DIR® parents and therapists don’t have to force children to perform tasks that are unnatural, unmotivating, or lack meaning for the child.

DIRFloortime builds on the intrinsic motivation of the child. We look for the “gleam in the eye” and when we find it, we use it to motivate the child to move forward in all aspects of his/her development.  Supporting the child’s emotional health and well-being, while improving engagement, communication, and problem-solving are key elements of this model.

  1. DIR® looks at the child as an individual.  

We as providers are highly motivated and obligated to understand the nuances of each child’s development and outward behaviors. We look for patterns that help to understand how they communicate, why they communicate, what motivates them, what increases their connectedness and level of joy, and what overwhelms them.  We need to understand when a child needs a break and when the child needs to be pushed.   Every child’s sensory profile is different and every child’s threshold is different.   It is our job to work with parents so that together we can identify those patterns and understand what those patterns mean in terms of everyday life functioning and intervention options for each child.

  1.  Our DIR® kiddos learn to think and solve problems.

Imagine being stuck in sameness because you know if you deviate from your normal patterns, you will have no idea how to get back on track or how to get out of a “sticky” situation.  Many of our children are rigid. The may not like the ball pit because they don’t know how to get out of it.  Or maybe they are scared of new situations, such as ordering their own food at a restaurant, because if something unfamiliar happens, they won’t be able to adapt and solve the problem.  Change brings too many unknowns and our kiddos often lack the skills to come up with new ideas or solve problems.  

DIRFloortime, along with sensory integration theory, guides us in helping children to improve their thinking and independent problem-solving in meaningful and fun situations.  This improves their flexibility and helps support a strong foundation for academic or vocational learning.   

  1.  We can help children from a very young age, when parents begin noticing something different, but pediatricians may not yet be concerned.  

Sometimes a child technically meets all milestones, but parents know that something is different.  DIRFloortime gives us an intimate understanding of development from a very young age.  We can observe a child’s interactions with other people and with his/her environment to know if he or she is at risk for developmental challenges.

  1. “DIRFloortime® has the strongest research of any intervention to support its effectiveness in improving the core challenges of autism including relating, interacting, and communicating while decreasing caregiver stress and improving parent-child relationships. “  (Quote taken from

DIR positively affects things that are hard to measure, but that are arguably the most important things in life–connecting to others, thinking flexibly, and solving problems.  It’s hard to measure how happy a child is , how connected he feels to others, or how empowered his family feels because they understand their child better.  But parents and children feel these changes deeply.  


Sharing our Passion!

DSC_0379If you were a fly on the wall in PTLC’s office area, you would probably hear a lot of chattering.  You might conclude that we are obsessed with our jobs.  And you would be right–well almost.  We prefer to say that we are PASSIONATE! We think about and talk about your beautiful children (aka “our kiddos”) throughout the workday, trying to problem-solve  issues, both big and small. We celebrate our kiddos’ smallest victories.   During our time off, we read books in hopes of getting additional insight into specific behaviors or to gain an even deeper understanding of therapeutic theories and methods.  We travel the country so we can take the best courses available.   So it’s no surprise that we are interested in sharing our obsession (I mean PASSION) with others.

As part of our goals and mission statement, Pediatric Therapy and Learning Center wants to reach out to the community to provide information and education about childhood development and the disorders which often affect that development.  In this blog, we hope to provide helpful tips for parents, information about treatment approaches, reviews and suggestions for books and other products, as well as our thoughts and responses to questions parents may ask.  If you have any suggestions for a blog post, please feel free to comment here or send us a message on our Facebook page.

We are very excited and optimistic about what 2016 will bring for our kiddos!

Disclosure:  Our company has signed up as an Amazon affiliate, which means that when a reader makes a purchase through one of our product links, we may receive a small commission.  We are committed to allocating any commissions received to a scholarship program for children who cannot afford our services.   We are also committed to only providing honest reviews and opinions about books and products that we believe our readers will benefit from or enjoy.