A child may avoid eye contact for a number of reasons, but it’s something to really pay attention to because it’s one of the earliest indicators of autism spectrum disorder (ASD). Infants who avoid eye contact with their parents – something that can be observed in a baby as young as 3 months – need to carefully monitored and assessed if the problem persists. Most babies start making eye contact no later than 6 months of age. If this is something you’ve noticed, it’s imperative to talk to your pediatrician about a potential referral for ADOS testing. If you already know your child is on the spectrum and is struggling socially, our Fort Myers OT (occupational therapy) team has some strategies that may help improve eye contact.
When Should My Baby Be Making Eye Contact?
Babies start using eye gaze to regulate behavior at around 5-6 months of age. By around 7-9 months, they use eye gaze to initiate joint attention. Joint attention is when a person purposefully coordinates his/her focus of attention with that of another person. In other words, two people are intentionally paying attention to the same thing for social reasons. If you say to your child, “Look at that big ball,” and the child looks to where you have pointed to see the ball. You’ve just engaged in joint attention. Kids on the autism spectrum struggle with joint attention, as it’s considered a social skill. Difficulty with joint attention can lead to or at least be closely correlated with developmental language delays.
As our Fort Myers OT professionals can explain, most toddlers will pair eye contact with their gestures at least half the time when they’re communicating. When kids struggle to pair their gestures or words with an eye gaze, it could be a red flag. For a child with social-communication deficits, consider that it can be really difficult to listen to someone talk, understand what they are saying and look at them at the same time.
Even as they get older, kids with autism may be apprehensive about establishing eye contact because they don’t have the ability to communicate. Some kids on the spectrum require a great deal of concentration to make and sustain eye contact. It’s important for parents not to force their kids to have eye contact, as this could result in frustration and anxiety. Instead, there are tactics we as occupational therapists can use in sessions and teach you for carryover.
Fort Myers OT Tips for Encouraging Eye Contact
With patience, positivity, and encouragement, you can help your child make and maintain eye contact. It can be difficult at first, but know that working on this skill is something that is not only going to help them in the short term, but long term when it comes to making friends and succeeding throughout life.
Some kids are “language late bloomers.” A percentage will catch up to children their same age on their own. Others, however, will continue to struggle with language learning. We call this a developmental language delay. If these difficulties persist beyond the earlier stages of development (past the age of 5), it can significantly impact their reading, writing, math, reasoning, and social skills later on.
Kids whose language troubles can’t be explained by some other cause (such as a disability, syndrome or physical impediment) and continue until they’re in school are typically diagnosed with Developmental Language Disorder.
Some indications of a language delay may include:
- Not babbling by 15 months.
- Not speaking by the age of 2.
- Inability to speak in short sentences by the age of 3.
- Trouble following directions.
- Difficulty putting words together in a sentence.
- Leaving words out of sentences.
If you suspect your child may be struggling with language comprehension or expression, you do not need to wait until they are school age to have it addressed. In fact, you should have it assessed and treated much sooner, if possible. As noted by the American Speech-Language Hearing Association (ASHA), early intervention (before age 5 and preferably before age 3) can have a substantial impact on the long-term implications of a speech-language disorder or developmental language disorder.
Our early intervention speech therapy team at FOCUS Therapy can help your child struggling with language skills to catch up to their same-age peers, specifically targeting skills like:
- Cognitive thinking (problem-solving, thinking, learning).
- Communication (listening, talking, understanding, gesturing).
- Physical/sensory skills (seeing, hearing, crawling, walking, climbing).
- Social-emotional skills (playing, understanding feelings, making friends).
- Adaptive/self-help skills (eating, drinking, bathing, dressing, etc.).
If you think your child may need some extra help in the area of language development, here are four things to know:
Kids’ recreational screen time more than doubled in the U.S. during the COVID-19 pandemic, according to a recent study by the Journal of the American Medical Association Pediatrics. This is concerning news because, as a Fort Myers speech therapist will tell you, excessive use of screen time can have numerous adverse impacts. In particular, these include:
- Unhealthy weight gain.
- Reduction in social skills.
- Delay in speech-language development (particularly for younger children).
The researchers looked at a group of more than 5,400 kids. Their average daily screen time prior to the pandemic was about 3.8 hours (still pretty high!). (The data was initially gleaned to study how cognitive development is impacted by screen time.) Then during the pandemic, kids’ use of electronic screens doubled to 7.7 hours daily. It should be noted that figure excluded school-related screen time, which many kids engaged in on-and-off, either in virtual school or some hybrid. Here in Southwest Florida, many schoolchildren are also assigned a set number of weekly minutes through a reading-math program called iReady. This too would have been excluded.
Analysts were solely looking at recreational screen time. That would include the use of electronic devices (phones, iPads, gaming systems, etc.) for things like:
- Multiple-player gaming.
- Single-player gaming.
- Social media.
- Video chatting.
- Browsing the internet.
- Watching streaming movies, videos, or television shows.
Speech and language skills are critical to a child’s ability to learn and interact in the world around them. When speech-language delays are identified and treated right away, there are exponential benefits for their social-emotional and academic growth. The early years are the most important for building strong speech and language skills. In this stage, your child’s brain is growing extremely fast in the first five years of life. During this window, kids are more open to learning than they’ll ever. To minimize the long-term negative impacts of a speech-language delay or disorder, our Fort Myers speech therapy team recommends early intervention – starting before age 3, if possible.
Communication is one of the most critical developmental tasks of early childhood development. It’s the way children start to form their understanding of the world. When a child has trouble communicating (being understood and/or understanding others), it can hinder their ability and confidence to express their ideas and observations of the world around them.
Kids who struggle with communication in earlier stages of development may struggle with:
- Low frustration tolerance.
- Emotional outbursts.
- Excessive shyness.
They may also appear less academically advanced than their peers. That’s because reading, writing, and verbal assertions are essential to the learning process. The foundation for these skills starts very early – from birth. Your child may be too young yet for school, but if you notice they aren’t on pace with their peers in terms of speech and language skills, it’s a good idea to act promptly. The sooner you can address it, the less chance they’ll fall too far behind academically.
Also by the time kids get to school, their speech and language delays or difficulties may become markedly obvious, sometimes even to them. This realization can be a blow to their confidence, leading to lower class participation and performance. The earlier they can start working on it with a licensed speech-language pathologist (SLP), the less the deficit is going to impact them later on.
A child’s inability to express themselves or understand what’s being expressed to them has an undeniable negative impact on their ability to fully enjoy and participate in daily life. The earlier we can intervene with speech therapy, the less difficulty they’ll have as they get older.
Our Fort Myers speech therapy team has many strategies to help children learn important speech and language skills.
So much of it is creating opportunities and encouraging practice in a fun, play-based atmosphere. Some examples include:
- Putting things just out of reach, to encourage the child to ask for it.
- Provide only part of a game to play with, and encourage them to ask for other pieces.
- Pretend to be forgetful. Let the child “catch us” being forgetful or getting an answer wrong – the love to be helpful so we can get it right!
- Pause during an activity that is predictable. It could be singing a favorite song or game and just pause. This encourages them to retrieve and use their vocabulary.
If you ask any parent of young kids whether they’re game for a product that is affordable, reduces spills and messes, and is super convenient, of course you’re going to hear: Yes, Please! Unfortunately, convenience for parents isn’t always what’s best for children. Case-in-point: The sippy cup. Speech therapists who study feeding and swallowing development and speech-language development will tell you: You really should ditch the sippy.
It’s really made more for parents than for kids. Someone got tired of their toddler spilling all Tang on the carpet and the rest is history. Sippy cups are marketed to parents as a necessity. But our Fort Myers speech therapists will beg to differ.
Some things to consider:
- Overuse of the hard sippy cup spout impedes swallowing development. During the baby’s first year, he or she will primarily use a front-to-back tongue movement to pass liquids and soft solids to the back of their mouth so they can swallow them. Speech therapists call this pattern suckle-swallow. But by the time they get to be about 12 months, their swallow pattern will mature. The tip of the tongue will rise to the bumpy, gum line ridge (where you make the /d/ sound) and begin using wave-like motions. This is what allows them to swallow a greater variety of textured foods. If your child is drinking solely from a sippy cup or bottle, this development milestone can be delayed.
- “Paci-mouth.” Yes, this refers to the damage that can be caused by overuse of a pacifier, but something similar can occur with sippy cups. If the tongue isn’t able to go up during swallowing, it will generally come to rest in a forward position in the mouth. This can potentially impede speech-language development. If your child only uses a sippy cup very occasionally, this likely won’t be a problem. But for lots of kids, sippy cups are constant companions. Speech-language skills can be stunted for kids who don’t get past that suckle-swallow pattern by the time they’re 1.
- Facial development delays. There is a muscle in the face called the genioglossus. Heavy use of a sippy cup can impede its development, which can lead to mouth-breathing. Mouth-breathing is associated with slowed facial development.
Some parents note when filling out our Fort Myers speech therapy intake forms that we inquire as to whether their child had a low birth weight. You may wonder what this has to do with speech therapy. The answer, as noted in research published by the National Institute on Deafness and Other Communication Disorders, is that compared to babies with a birth weight in the normal range, those with low birth rate:
- Were more likely to have a communication disorder.
- Were more likely to have used speech-language, occupational, and physical therapy services.
- Had weaker motor abilities.
- Had lower school performance.
- Had higher incidence rates of pneumonia.
- Were three times more likely to repeat a grade.
In short, while some babies with low birth weight are perfectly fine, some are at high risk for communication and developmental problems that can extend well into childhood. Our Fort Myers speech therapy team at FOCUS Therapy can help.
Your child has autism. You know it. The rest of the family knows it. His teachers and therapists know it. Maybe even a few of his classmates know it. But when should HE know it? And how should you tell him?
It’s something many of our FOCUS Therapy families grapple with at some point, and answers really depend on the individual. Some parents opt to tell their child when they’re very young, hoping an early understanding of why they struggle more with certain things might make it all less confusing. Other parents wait until their child becomes aware of their differences and starts asking questions. A few parents wait until their child is older with a better ability to fully grasp what their diagnosis means. Our FOCUS speech, occupational and ABA therapists know there isn’t a singular right answer, but we’re here to support our patients and help guide families in these discussions.
Recently, a patient’s mother asked about the best way to handle some of the questions her 7-year-old son on the spectrum was asking. Christie Lawrence, a registered behavior technician (RBT) with our Fort Myers ABA therapy team and herself the mother of a teenager with autism, offered her thoughts.
“I would say the most important part of informing your child of their autism diagnosis is to empower them,” Lawrence said. “Autism can bring many gifts, and it’s so important to teach our children to find and focus on their strengths and build confidence from their success.”
Many people think of the role of speech therapists as being limited to speech and language. However, we also play a key role in pediatric feeding therapy evaluation and treatment.
Our Fort Myers speech-language pathologists are experts in oral mechanics – all the way down to the esophagus. We’re specially qualified to support individuals with feeding and swallowing difficulties.
Most people don’t put a ton of thought into the process of feeding and swallowing, but but both actually involve dozens of steps and systems working in conjunction. Feeding is what it takes to get food off the plate and into the mouth. Swallowing involves all the steps it takes to chew and then move food down the throat while protecting the airway leading to the lungs.
A child may have a feeding AND swallowing disorder, or just one or the other. For example, a child on the autism spectrum may have a feeding disorder wherein their food intake is extremely limited due to sensory processing difficulties. They may only need feeding therapy. A child with tracheostomy tubes or dysphagia (difficulty swallowing) or odynophagia (pain while swallowing) may only need swallowing therapy.
When your child is hard to understand, it can be stressful for you, your family, friends, educators – and perhaps most especially, your child. Of course, nobody enters this world speaking perfectly, and each child has their own timeline for proper pronunciation. However, it’s also important not to wait too long if you notice your child is more difficult to understand than his or her peers. The sooner a Fort Myers speech therapist can intervene, the faster your child can catch up to where they need to be. That can be critical to ensuring they don’t fall too behind socially and academically. Speaking skills mastered before pre-K and kindergarten can significantly impact the ease with which your child will be able to read and write.
Although every child develops at their own rate, knowing what key milestones to watch for is a good idea. In general, as noted in a recent Parents.com article, you should understand:
- At least 50 percent of what your child says by age 2.
- At least 75 percent of what your child says by age 3.
- About 100 percent of what your child says by age 4, even if all the sounds aren’t perfect.
By the time your child is about 6 or 7, he or she should produce all sounds correctly most of the time. If you can’t, it is well past time to reach out to a Fort Myers speech therapist. Ideally, we like to start treatment of children with speech and language delays and disorders as soon as possible – the earlier the better. At FOCUS, we are big proponents of “early intervention,” which starts between ages 2 and 5.