How do I help my child at home? Answers from your school OT

hand skills HolgersFotografie pixabayHow do I help my child at home?

by Marie Toole, MS, OTR/L

on the School Tools From Your Pediatric   Occupational Therapist Blog

 

Happy November!  By now the school year is off and running and routines have been established (we hope!).  Parents are coming into our school this month for parent-teacher conferences for first quarter report cards.  When I meet with parents, the most common question I get asked is “How can I help my child carry over therapy techniques at home?”  My answer almost always is “Make it fun and it won’t seem like homework!”  Carryover activities should not appear to be one more thing to do in a long list of many homework assignments.

 

One of my favorite home program activities is our school’s Handi-Tool Kits.  I had always envisioned my students having a type of lending library of therapy toys. I wanted them to be able to borrow toys or activities for the weekend and bring them back after showing mom and dad how awesome they were to play with.  They never knew that they were improving their hand skills at the same time!  So, I contacted our town’s Men’s Club, a local charitable group, and met with them to review my proposal for funding.   Then, I put together a kit of hand tools and toys to help improve  fine motor control.  We put together a content list and wrote out directions for accessing and using each toy.  After we purchased items for a number of kits,  we put them together in lunch box sized cases and started reviewing how to use and play with the items in our therapy sessions.  When we were ready to start sending the kits home, we sent a letter to the parents beforehand to make sure that particular weekend would be a good time for them to explore the Handi-Tool kit with their child.  My students love taking the Handi-Tool kits home and parents get to see some therapy items and become more familiar with hand skills when they read the cards  included in each kit.  This is a win-win for all of us!

Handi Tool Kits Toole
Handi-Tool Kits —— Click on the picture for a larger view!

 

Core and upper body strengthening are two other developmental areas that I always encourage parents to work on at home.  I emphasize that at home they need to make sure that their children are sitting properly when they work at a table and are eating meals.  Their backs should be straight and resting against the back of the chair with their feet flat on the floor and their head and eyes positioned forward.  I point out that it is not acceptable for children to hold their heads up with their hands or to have their heads lying on the table or desk when they are writing.  Step stools or books/boxes for footrests are helpful to maintain correct posture.  During writing activities, the non-dominant hand needs to stabilize the paper at all times.

 

Local children tug of war during a community park festival

To help increase core or upper body strength and stability, I suggest that parents try some of these activities:

  • wheelbarrow walking around the house or yard:  Have them measure how far they can go.
  • crab walk forward, backward, and sideways
  • tug-o-war
  • knee or wall push ups:  have them keep count of how many they can do.
  • climb the jungle gym or monkey bars at their public or elementary school playgrounds
  • work on their tummies when watching TV, drawing, or writing:  have them lie on the floor on their stomachs holding themselves up using their elbows and forearms propped on the floor.  Do not allow them to hold their heads up with hands.
  • write/draw/paint on a chalkboard or easel or any vertical surface such as a wall or window
  • complete household chores such as carrying in groceries or yard work

 

Another area to focus on is hand skills.  Parents should encourage their children to hold pencils and utensils correctly.  Constant reminders are needed for those who have difficulties. At school, we encourage children to “pinch” the pencil at the tip with thumb and index finger.  This is the most mature and efficient position for handwriting and tool use.  For students who tend to have difficulty with this, we recommend the following fun activities:

 

  • use an eye-dropper with colored water for painting or coloring activities
  • use tweezers to pick up macaroni, goldfish, cheerios, rice, or pasta and place them in a cup –or in their mouth!spintoy janerella pixabay
  • spin tops by pushing the thumb and index fingers in opposite directions to make them spin
  • flick coins, ping-pong balls, tiddily winks, or cotton balls with their thumb and pointer fingers:  make this a game of hockey or try to aim for a target
  • snap fingers:  start with the dominant hand and then both hands
  • use a spring clothespin to pick up small objects and place them into a container
  • play with clay, play dough, or theraputty:  hide small items such as buttons or coins for them to find

 

Even in today’s computer world our children still need to learn to write legibly.   It is extremely important that they form the letters in the correct direction.  I encourage parents to remind their children to take their time when writing and forming letters.  They should ask their child’s teacher or OT for a visual model from the handwriting program they use in school to encourage carryover at home.

 

To improve letter formations parents can:

  • write letters on the wall with a flashlight
  • write letters in a tray or pan filled with salt, sand, shaving cream, whipped cream, or pudding
  • write on the shower walls with shaving cream, soap, or tub paints
  • mystery writing:  One person holds a piece of chalk or a pencil and then closes their eyes.  The other person moves their hand to write a letter or word.  Or one person can write a letter with their finger on the other person’s back or palm of their hand.
  • rainbow writing:  Write a word or letter on the paper or chalkboard and have their child trace it several times in different colored chalk or crayons.
rainbow writing toole
————Rainbow Writing————-
letter formations Toole
Letter Formation Practice Using Different Media Forms

 

 

 

 

 

 

 

 

I stress to parents that they should always remember that these activities should not be viewed as “homework” but rather as games that are fun and can help to increase skills critical to classroom success.  They should think of the outdoor games such as tag, kick the can, hopscotch, or jump rope that they enjoyed as a child and teach them to your children.  We never knew that having all that fun was good for us!  The best piece of advice I have for parents is “Have fun “working” with your child!”

 

 

Marie TooleMarie L. Toole, MS, OTR/ L, is a pediatric occupational therapist with 28 years experience in NICU, Early Intervention, and private practice with the last 20 years spent working in public schools. She is NBCOT and SIPT certified as well as a member of AOTA and NHOTA.  She lives in southern New Hampshire and can be reached at toolem@sau25.net.  Follow her on Twitter @MarieTooleOTNH, on Pinterest marietooleNHOT, and on School Tools for Pediatric Occupational Therapists  where she tweets, pins, and posts about OT, education, autism, and sensory integration, as well as other school related topics.

 
 Disclaimer: The information shared on the Go-To-For-OT Blog or affiliated Twitter, Facebook, or Pinterest sites, and shared on social or public media or as links on other sites is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the authors and administrator of these posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.  
Photos are the property of the author or contributors on other sites.  Their use should include the link provided to the contributor’s source.  

 

How do I help my child at home? Answers from your school OT

Choosing Great Toys for Your Little Ones

Choosing Great Toys for Your Little Ones

by Marie Toole, MS, OTR/L

on the School Tools From Your Pediatric Occupational Therapist Blog

 

wooden train jgojtan pixabayThe holidays are fast approaching and you might be trying frantically to find developmentally appropriate toys and games for the little ones on your list.  Or maybe a friend or coworker is having a baby and you want to purchase the “right” toy for a present.  Toy stores can be overwhelming with their size and stock and you may have found yourself having difficulty selecting from among the toys and technology when you got there.  Parents often ask me to recommend toys or games that will help their children improve their hand skills, eye-hand coordination skills, or cognitive skills.  They question how to choose with so much technology and so many games, toys, and activities out there.  They wonder how I as a parent and therapist choose, as well as help the grandparents decide on appropriate toys and games.  The questions are many.  But, let’s take a look at some answers, shall we?

 

Toys in our household did double duty.  I was always looking for that unique and different toy that had some therapeutic value to it.   At first, they were toys for my three children to use.  But when they outgrew them, the toys went into my therapy bag for me to use on my visits in Early Intervention.  I am not saying that we did not buy the newest, hottest toys on the market.  We did.  But guess what? Those toys got broken or were discarded quickly, the pieces were lost, or the toys were simply forgotten.  There are some toys, however, that retain their value.  Those toys I still have and use in my therapy practice today because of their many fine qualities.  When it comes to toy and game suggestions, I am not going to tell you what to buy; but, instead, I would like to guide you in the process and give you some things to think about when purchasing them.

 

Here are a few questions you should ask yourself when considering that new toy or game:

  • Does it have small parts that babies and toddlers might swallow? Is it toxic?  Remember, babies and toddlers often put things in their mouths  or use them for teething so be cautious.  Can it be washed or disinfected easily?  Toys harbor germs in nooks and crannies.  They need to stand the test of time and be durable and easily washed.
  • Is it messy?  Am I willing to live with the results of that messy play?  Young children love to get wet, dirty, and messy.  Do you have enough space to let them fully explore and enjoy these added sensory elements in their play?  Children learn best when they are playing and are able to freely explore to make noise, create a mess, and figure out the many different ways to use an item.  Give them time and the space to do so and you will have happy children.
  • Can your child manage this toy independently or with a bit of guidance?  There are age pegs AlexasFotos pixabayranges on most toy packages.  Use them as a guideline and imagine your child playing with that toy. Are your child’s little hands ready for it? Can he or she pick it up and manipulate it independently? If you buy a toy or game that is not developmentally appropriate, you are asking for frustration not enjoyment.  It might be the hot toy on the market; but if your child is not ready for it, it may become quickly discarded.
  • Does it help improve hand or motor skills?  Little children’s bodies are growing in myriad ways and we want to assist that growth by encouraging the improvement of both small-motor and large-motor skills.  Children move to learn.  They are active and busy and like lots of change.  Games and activities that encourage balance, that discriminate between left and right, and that get kids moving and cooperating with others are always great choices.

 

Games, toys, and activities that encourage the use of two hands to manipulate them begin to help make the transition to more refined grasp and later on to pencil control in school.  Using two hands to make a toy work helps children realize that they have a hand that does the work and a hand that stabilizes. When we ask children to use pencils and crayons in school, we hope that they have good hand strength to allow proper pencil grasp and endurance for writing and coloring tasks. We have two sides of our hands, one that stabilizes (pinky, ring, and tall man) and one that does the work (index finger and thumb).  We don’t want to put crayons or pencils in little hands too early but chunky chalk or finger paints certainly can lay the foundation for good hand skills. Squeezing and rolling playdoh helps to improve hand strength and coordination.

 

Does the toy assist with visual perceptual skills?  Do they have a component for matching like items?  Do the children need to know colors?  Figuring out puzzles, creating designs with pegs, or making other visual patterns help to stimulate cognitive pathways and assist with spatial skills.  Deciding if the blue peg goes in the hole on the left or the right to match the picture can be the precursor to math and spatial skills in the kindergarten or first grade classroom.

 

Does the toy encourage socialization?  Is it a group game?  Children learn so much when they play games with others.  They learn to wait their turn and be patient and come to understand what it is to win and lose.  All life’s lessons that are best learned are done in a fun and safe environment.  Once they get to school, being a member of the class will have challenges of its own.  But those children who have pro-social behaviors and have learned to navigate winning or losing at CandyLand tend to fare better.

Lots of great questions and things to think about when choosing appropriate toys.  One suggestion I will give you is to move away from the big-box stores.  Supporting small businesses is always a good idea but this time it is purposeful.  Local craft fairs often have wooden toys that are well made and durable.  Look in your local, independent, small toy stores.  They often have toys and games that are unique and different. These are often well-crafted toys that will last and are creative and colorful and inspiring.  I often found toys from European countries that are so well made that I still have them today.  I use them in my therapy regularly and notice the children I work with thoroughly enjoy them to this day.

grandmother toys tooleThere are certain toys that I like to call “Grandmother Toys.”  These are ones I have kept in the basement and will pull out when I have grandchildren of my own someday.  They stand the test of time and will be different and unique in an ever-changing world.  I have kept a few childhood favorites from each of my children’s younger years. They are toys that each of my children loved for different reasons. Think “classic” toys…think about the toys you loved as a child and why they stick with you.  You made memories with those toys and they are special to you. The memories your little ones will make using the toy or game you buy will be priceless.  Choose wisely and your gift will be a winner!

owl clock toole

 

I rarely suggest electronic toys, games, or apps.  I much prefer hands-on learning.  Let me leave you with a few suggestions for games or toys that foster that:

  • Play doh or theraputty (hand strengthening)
  • Large pegs and pegboards (eye hand coordination)
  • Matching games (memory, visual perception)
  • Finger paints/watercolors/bingo dabbers used on an easel (encourages proper hand positioning)
  • blocks bethL pixabayBlocks (creative play)
  • Twister (body movement, left/right)
  • Sidewalk chalk/bubbles/balloons (outdoor play)
  • Lite Brite (eye hand coordination, visual perceptual)
  • Card games (Crazy 8’s, Skip Bo, Old Maid) (turn taking, social  skills)
  • Simon (visual and auditory memory)
  • Jump ropes/chinese jump ropes/Skip It (balance and coordination)
  • Pick up Sticks/Connect Four/Toss Across (eye hand coordination)

 

Marie TooleMarie L. Toole, MS, OTR/ L, is a pediatric occupational therapist with 28 years experience in NICU, Early Intervention, and private practice with the last 20 years spent working in public schools. She is NBCOT and SIPT certified as well as a member of AOTA and NHOTA.  She lives in southern New Hampshire and can be reached at toolem@sau25.net.  Follow her on Twitter @MarieTooleOTNH, on Pinterest marietooleNHOT, and on School Tools for Pediatric Occupational Therapists  where she tweets, pins, and posts about OT, education, autism, and sensory integration, as well as other school related topics.

 
 Disclaimer: The information shared on the Go-To-For-OT Blog or affiliated Twitter, Facebook, or Pinterest sites, and shared on social or public media or as links on other sites is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the authors and administrator of these posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.  
Grandmother’s Toys photos are the property of the author and their use should have her approval.  All other photos are the property of the contributors of Pixabay and their use should include the link provided to the photographer’s source.  
Choosing Great Toys for Your Little Ones

So….What is wrong with W-sitting?

 

So…. What is wrong with W-sitting?

by Marie Toole, MS, OTR/L

 

 

 

This is a question I often hear from both parents and teachers alike.

           “My child always sits like that.  What is so bad about it? What can I do to help?”  

 

What is W-sitting and why does my child do this?

Movement RX, Dr. Theresa Larson, DPT*

W-sitting is often a position that young children choose to use when sitting on the ground or the floor.  Children will place their knees close together and their ankles splayed out along side their hips so that their legs look like a “W” when their bottom is on the floor.   Often this is due to low tone, joint laxity (movement in the joints), or poor trunk/core strength.  Sometimes it is just a habit, one that we do not want to continue.  By having this large base of support under them, many children have more support for those weak core muscles, therefore making it easier to sit upright without having to do too much work.  Hence, this is why it is often their  “go-to” sitting position, and can become a tough habit to break.   

 

Why is it so bad for my child?

Trunk Rotation EME pixabayW-sitting may lead to hip tightness or possibly hip dislocation.  Young children who continually sit in this position for extended periods of time are asking for long-term trouble in the ankle, knee, and hip down the road.  W-sitting inhibits trunk rotation (twisting and turning to get a toy or play with something) and shifting their weight side-to-side.  Twisting and turning the trunk promotes crossing the midline their hands and balance skills throughout the trunk.  Shifting weight assists in balance and core stability.  Often times, poor coordination and clumsy movements develop due to the limiting factors of this poor posture.  

 

How can I help my child?

The best way to prevent W-sitting is to discourage it from the beginning.  Encouraging other sitting positions such as criss-cross, long sitting, side sitting, half kneeling or even using a small chair if the hips are tight are all good alternatives.  Being consistent with Criss Cross Seating Posture Ben_Kerckx pixabaycorrecting as well as suggesting alternative sitting postures will only help your child to develop proper sitting postures that promote growth, flexibility, and  appropriate development.  In the classroom, teachers will monitor this and suggest seating alternatives.  Being consistent and doing the same at home will enhance your young child’s growth and development.  

 

Marie TooleMarie L. Toole, MS, OTR/ L, is a pediatric occupational therapist with 28 years experience in NICU, Early Intervention, and private practice with the last 20 years spent working in public schools. She is NBCOT and SIPT certified as well as a member of AOTA and NHOTA.  She lives in southern New Hampshire and can be reached at toolem@sau25.net.  Follow her on Twitter @MarieTooleOTNH, on Pinterest marietooleNHOT, and on School Tools for Pediatric Occupational Therapists  where she tweets, pins, and posts about OT, education, autism, and sensory integration, as well as other school related topics.

 
*Movement RX, Dr. Theresa Larson, DPT http://www.movement-rx.com
 Disclaimer: The information shared on the Go-To-For-OT Blog or affiliated Twitter, Facebook, or Pinterest sites, and shared on social or public media or as links on other sites is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the authors and administrator of these posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.  
Photos are the property of the contributors of Pixabay and their use should include the link provided to the photographer’s source.  
 
So….What is wrong with W-sitting?

“School Tools” from your Pediatric Occupational Therapist – Tips for Typical Development

Marie Toole, OTR/L

“School Tools” from your Pediatric Occupational Therapist

Marie L. Toole, MS, OTR/L

 

 

In this new blog, I plan to share some of the teachings I have done over the years for parents in hopes of providing you with information that is timely and relevant.  As a school-based occupational therapist with over 20 years experience, I have seen lots of children …and counseled lots of parents… on what to expect from their toddlers through first graders.  With the pressure of “high-stakes testing” looming before them, many parents want their child to exceed expectations and may set unrealistic hopes and dreams for him or her.  Today’s blog will help you sift through the details of developmental milestones and remind you that they are children first, and that they will reach those milestones when they are ready.  If we expect them to do too much, too soon, we are asking for frustration.  It is okay to slow down and enjoy the journey of childhood.  It is not a race to the top.  We need to remember to let them be kids.  If we could only convince the makers of those high-stakes tests that they are little children and not widgets coming off the assembly line, we might have much happier children and parents!.  No two children learn alike nor will they do every activity at exactly the correct age or time frame.  The activities I will share today are meant to be guidelines to help all of us remember how these baseline skills will affect future school performance.   Try some of them out with your children today!

 

Typical Development of the 2-6 year old:  The Importance of Play

Preschoolers and kindergarteners should be playing more.  The benefit of fine motor play helps build wrist stability, aids in the development of the arches and web space of the hand, helps with separation of the sides of the hand, and builds an understanding of delicate touch when needed.  The benefits of gross motor play help increase endurance, increase core strength, and improves mobility, as well as wards off childhood obesity.  

Terrific Two’s Fine Motor Skills include:

  • Developing wrist stability, as well as the small muscles and arches of the hand, by picking up small objects like cereal or feeding self with a spoon.
  • Beginning to use both hands at midline where one hand holds the object and the other hand manipulates it, such as opening containers and popping hand-shaping iwanna pixabaybeads.
  • Repeatedly “dumping” and “filling” cups or buckets to build wrist stability and grasping skills.
  • Beginning to use playdough or clay by rolling and shaping with help to build finger and hand strength.
  • Stacking blocks starting with large blocks and moving to one-inch to build grasping and visual-motor skills.

Gross Motor Skills include:

  • Walking forward, backward, and up steps.  It’s fun to try marching or Simon Says to make it interesting!
  • Walking down steps with both feet, one step at a time.
  • Running without holding on.
  • Kicking a ball.
  • Throwing a ball into a box.
  • Moving pedal-less riding toys.
  • Walking up and going down a slide.

Thunderous Three’s Fine Motor Skills include:

  • Stringing one inch beads.  Begin with pipe cleaners and move on to shoelaces.
  • Folding paper.  Try making easy Origami shapes with tissue paper, foil, or wrapping paper.
  • Building a tower of 6-9 blocks then making trains and bridges out of blocks.origami DevilsApricot pixabay
  • Snipping with scissors.  Start with play dough logs and work up to different types of papers, such as construction or plain bond.
  • Tracing and copying basic shapes with large crayons or sidewalk chalk.
  • “Painting” the house or wall with water using large strokes and brushes.
  • Creating easy pegboard designs with large or fat pegs.
  • Using glue to complete simple art projects such as a collage.

Gross Motor Skills include:

  • Walking a straight line.  Try using a jump rope or chalk line as a guide.
  • Walking upstairs with alternating feet.
  • Walking tip-toe for 10 steps.  Playing games like “Mother May I” is fun!
  • Balancing on each foot for 2-4 seconds.  Yoga poses work well for this activity.
  • Throwing a ball overhand.  Start with playground balls and move towards tennis balls.
  • Catching a 9-inch ball using both arms and the body for support.
  • Jumping up with both feet together in games like Jumping over sticks, ropes, or cones.
  • Hopping 1-2 times on one foot.  Dancing to music can be exhilarating!
  • Pushing and pulling a wagon or similar type object 10 feet.
  • Riding a tricycle.

Fearless Four’s Fine Motor Skills include:

  • Using a four-fingered grasp on hand tools such as large crayons or chalk.
  • Stringing ½ inch beads.
  • Completing simple puzzles, first those with peg handles and then moving on interlocking puzzles.puzzle Efraimstochter pixabay
  • Drawing simple designs using a circle or a square.  Paint, chalk, or shaving cream are excellent mediums!
  • Coloring a simple picture such as a house, an animal, or simple basic shapes.
  • Cutting on a straight line. Remember:  thumbs up for cutting!
  • Picking up small objects or toys like paper clips or small pegs with finger tips.

Gross Motor Skills include:

  • Walking down stairs using alternating feet.
  • Balancing on each foot for 4-6 seconds.
  • Completing a broad jump.
  • Hopping 5 times on one foot.
  • Galloping.

Fabulous Five’s Fine Motor Skills include:

  • Refining grasp (3 or 4 fingers) on tools such as pencils, crayons, or paintbrushes.
  • Cutting more precisely with scissors using pictures or designs with more intricate details.
  • Completing mazes and dot-to-dot activities.
  • Playing target games such as bean bags or velcro toss.
  • Using Magna Doodles, Etch-A-Sketch, or iPad apps for fine motor control.

Gross Motor Skills include:

  • Walking on a straight line using heel-toe action.  Try a balance beam or a line of tape on the floor!
  • Balancing on each foot for 8-10 seconds.
  • Catching a 9-inch ball with hands only.
  • Jumping backwards 6 times.  Try jumping rope!
  • Hopping on one foot 2-3 yards.
  • Skipping with alternating feet.
  • Hanging from bars using an overhand grip for 5 seconds.
  • Running and avoiding objects on an obstacle course.

Sensational Sixes’ Fine Motor Skills include:

  • Using a mature 3-fingered grasp for tool use on pencils or crayons.
  • Picking up and sorting small objects, such as coins, pegs, or marbles.large pegs alexas_Fotos Pixabay769283_1280
  • Using tweezers to pick up objects such as small blocks or play dough balls.
  • Using a paper punch to make designs and pictures.
  • Snapping fingers.
  • Using squeeze bottles to create art. Try colored water on the snow or driveway.
  • Sorting and turning over playing cards.

 

Gross Motor Skills Include:

  • Completing one full sit up and one push up.  Family work out time!
  • Carrying objects down stairs.
  • Beginning to ride a 2-wheeler with training wheels.
  • Learning to swim.
  • Throwing and catching softball-sized balls.
  • Climbing trees, pumping high on swings, crossing monkey bars, or participating in acrobatics or gymnastics.

 

Understanding each developmental stage will help you as a parent to support your child’s learning.  When you know what your child is capable of and what is developmentally appropriate, you can set realistic expectations for skills and behaviors.  If you are concerned about your child’s development, please consult with your healthcare provider for additional supports and services.  Your local school system can assist with services once your child turns 3 years old.  

 

Marie L. Toole, MS, OTR/ L, is a pediatric occupational therapist with 28 years experience in NICU, Early Intervention, and private practice with the last 20 years spent working in public schools. She is NBCOT and SIPT certified as well as a member of AOTA and NHOTA.  She lives in southern New Hampshire and can be reached at toolem@sau25.net.  Follow her on Twitter @MarieTooleOTNH, on Pinterest marietooleNHOT, and on School Tools for Pediatric Occupational Therapists  where she tweets, pins, and posts about OT, education, autism, and sensory integration, as well as other school related topics.

 

 Disclaimer: The information shared on the Go-To-For-OT Blog or affiliated Twitter, Facebook, or Pinterest sites, and shared on social or public media or as links on other sites is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the authors and administrator of these posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.  
Photos are the property of the authors and administrator and are not to be used in any fashion except as links to the appropriate blog without the expressed, written permission of the author and/or administrator.
“School Tools” from your Pediatric Occupational Therapist – Tips for Typical Development