Finding the right preschool when your child has delays

U.S. Air Force photo by Senior Airman Destinee Sweeney.

For any parent, sending your child to school for the first time can be overwhelming and a little bit scary. But when your child has delays (speech, language, developmental), finding a preschool that is the right fit for your child and your family can seem even more daunting.

To make navigating the process of finding the best preschool feel less intimidating, I compiled a list of five important things to look for and ask about to ensure the best learning environment and support for your child.

  1. Parent/Teacher communication. Understanding how communication is handled and what to expect from the start will be of utmost importance. How will you find out about your child’s day? Will you have the opportunity to communicate with your child’s teacher at pick-up and/or drop-off, or will the teacher send home daily notes with information regarding what happened at school that day? Will you have the chance to ask questions regarding your child’s progress in person or does the teacher prefer email or scheduled phone calls? Will there be conferences to communicate how your child is progressing throughout the school year? All of these questions are important to have answers to prior to enrollment so that both the teacher and you as a parent have clear guidelines and expectations regarding communication. Make sure you are comfortable with the amount and means of communication promised by the preschool. This will set your family up for success, a positive parent/teacher relationship, and make sure you have clear, thorough information about what’s happening in your child’s classroom.
  2. Student to teacher ratio and classroom size. Making sure there are enough helping hands in the classroom is crucial to ensuring that each child in the classroom gets the support he/ she needs. The lead teacher can only be so many places at once, so knowing that there are other qualified adults in the room is important. A 3:1 child to adult ratio is ideal, especially if you feel your child will require more individualized attention. When thinking about student to teacher ratio, you also need to consider class size. Children with any sort of delay will likely benefit from being in a preschool classroom with smaller class sizes. Smaller classes allow for more one-on-one teacher instruction, provide a less overwhelming sensory environment, and create more opportunity for teachers to facilitate social/play interactions.
  3. Willingness to communicate with outside service providers. If your child has speech, language, and/or developmental delays, he or she is likely receiving outside services and working with a team of therapists. When looking for the best preschool for your child, don’t be afraid to ask if the classroom teacher is willing to communicate with outside service providers and join the team of professionals supporting your child. Your child’s teacher will have access to your child for the longest period of time of any of the therapists/professionals on the team. Making sure the teacher is willing to learn more about your child’s goals in therapy, what strategies are most effective/beneficial, and how he/she can incorporate and support generalization of your child’s treatment goals into their school day will be essential for a successful preschool experience.
  4. Visual supports and schedules. We all benefit from the use of visual supports throughout our day. Whether it is a “to do” list, a grocery list or a calendar, visuals make navigating our day more concrete and help to eliminate stress even as adults. For preschoolers, especially preschoolers with developmental delays, a classroom with strong visual supports and schedules is equally (if not more) beneficial. A classroom visual schedule creates routine, predictability, and comfort in what to expect and what is coming up next. Visuals help guide our thinking and make abstract concepts more concrete. This is vital when helping children understand and make sense of a new environment. Look for pictures labeling items in the classroom, photographs of peers for “checking in” or saying “hello,” social stories, and of course, the visual schedule.
  5. Movement breaks/play. Knowing how long your child will be expected to sit for a given time throughout the school day is important to know. Preschool-age children need to move their bodies to be accessible to learning and to soak in the important information being presented during structured activities. They need to “shake their sillies out.” Making sure that movement breaks are embedded in the classroom routine is imperative. This can be achieved by dancing, playing with equipment (e.g., scooters, balls, balance beams, slides, etc.), structured gross motor activities, and more. We also want to make sure that your child has the chance to play! Play unlocks language and builds social skills. Play helps create imagination and develops problem solving skills. Children need to play. Ask how much time in your child’s day will be dedicated to play. Make sure there will be the opportunity to explore new toys, engage in play, and develop foundational social skills that will serve your child forever.

So look for these important things as you explore options for your preschooler. Don’t be afraid to ask questions, to go on visits, to observe, and to make sure you feel comfortable with what the program has to offer. Of course, a teacher who will love your child for exactly who he/she is and make learning fun is key to a positive first school experience as well.

If you have any questions or would like assistance on your journey to finding a preschool that will best fit your child’s unique needs, do not hesitate to reach out to the Beaumont Children’s Speech and Language Pathology department, we would love to help.

– Ali Pettit, M.A., CCC-SLP, Speech and Language Pathologist, Children’s Speech and Language Pathology Department, Beaumont Health

Understanding childhood trauma and Adverse Childhood Experiences

image credit: Kat Jayne, Pexels.

Childhood trauma is a growing public health crisis for children today. Research shows that traumatic childhood experiences are increasingly common. It also shows that these negative experiences have a profound impact on the function and development of children. Children exposed to parental substance abuse and domestic violence rarely have secure childhood experiences. The symptomatology tends to be complex and multi-dimensional.

A natural response

Children learn to regulate their behavior by anticipating their caregivers’ responses to them. A caregiver’s response encourages that child to develop an attachment to the caregiver and the environment. Attachments can be both secure and insecure, resulting in a child’s ability to form and engage in relationships for the rest of his or her life. Children’s attachments also impact their ability to regulate their own emotions and senses, as well as adapt to their environment.

Children who experience developmental trauma are often stuck in the “primitive brain,” which is responsible for automatic body functions (breathing, heart rate, and temperature control) and protects us by switching us to survival mode. Survival mode requires an immediate response (fight, flight or freeze) to all possible harmful stimuli. Children who are stuck in their primitive brain due to Adverse Childhood Experiences (ACE) will respond with one of the survival responses and will require co-regulation. These children will require co-regulation much longer than their typically developing counterparts.

Also, children who experience developmental trauma cultivate coping strategies that aid in ensuring safety. However once the child is removed from the unsafe environment, those coping strategies become unhealthy. They inhibit healthy growth and the development of daily life skills that are important for managing impulses, problem solving, and learning and developing higher level thinking and planning skills. These skills take place in higher levels of the brain that are often “offline” and inaccessible due to the quick response of the primitive brain. This limits the ability for information to pass into the higher levels responsible for attachment, relationships, learning, thinking and language. Often these children are misdiagnosed and misunderstood by professionals, friends and family. These misdiagnoses and misunderstandings tend to reinforce the already disorganized patterns of attachment and regulation.

Trauma at an early age

Many professionals and individuals who aren’t educated in the effects of early childhood trauma believe if the child experiences the trauma as an infant or toddler, then the child doesn’t remember the trauma and therefore won’t be affected by it. However that is not the case.

Because language hasn’t developed at that young of an age, memories of the trauma aren’t stored in language, so the child cannot necessarily describe or recall the event in words. Instead it is stored “physically” in sensations and sensory memories.

Infant brains function mainly in the brainstem, the primitive brain, therefore their experience of trauma is held in primitive responses (heart rate, temperature, respiration rate). The child’s sensory system develops with limited ability to effectively filter sensory input due to its over or under response for survival. As a result, the child grows up re-living the trauma through natural body functions, without the ability to put words to the trauma. The child also has difficulty telling the difference between danger or natural body responses to safe experiences that cause activation of the automatic brainstem (aka primitive brain).

Trauma in infancy causes disturbances to the sensory system, which often brings the children challenges in making sense of the world through their senses, including knowing how much pressure their body is exerting, differentiating differed textures, and understanding where their or her head and body are in space (balance and coordination). It also makes it difficult for the child to manage his or her own emotions and regulate responses. Often there may be an increase in anxiety and depression, with the child expressing this through behavioral issues and anger outbursts.

Treatment is available

Beaumont’s Trauma Regulation Treatment team uses a multidisciplinary approach within a medical model for children who have experienced abuse, neglect, peri- and post-natal substance exposure, invasive medical treatments, and/or exposure to community trauma. Our goal is to provide education and support to aid parents and caregivers in understanding the impacts of trauma on their children. Our team is composed of an occupational therapist, a behavioral health therapist, and a physical therapist who work closely to address underlying issues caused from trauma exposure. This interdisciplinary approach supports a combination of bottom-up (occupational and physical therapy) and top-down (behavioral health) treatment to calm the response of the child’s primitive brain and encourage increased access to the relationship and executive functioning parts of the brain. This lets the child develop use of all parts of the brain for neurological growth and development while addressing attachment, regulation, sensory motor challenges, and natural processing of trauma experiences. Our treatment approach values the efforts and inclusion of the caregiver into the treatment team to provide education and resources, empowering the caregiver’s efforts to better support their children through daily growth and development.


The information above is derived from pioneers in the areas of trauma and child trauma: Bessel van der Kolk M.D. and the National Child Traumatic Stress Network, Bruce Perry M.D. Ph.D and the Child Trauma Academy, and Vincent Felitti M.D. and his work with the Adverse Childhood Experience (ACE) study.

For more information on childhood trauma and treatment options refer to:

– Sara Gariepy, MS OTRL, CATP and Kristin Rosales, MSW, CATP are with the Beaumont Center for Children’s Rehabilitation team in Macomb.

Improving your child’s motor skills in a winter wonderland

smiling girl making snow angel

Photo credit: Loadmaster (David R. Tribble) at Wikimedia Commons.

Michigan winters are cold and snowy. When the family has cabin fever, an outside snowy day is the perfect place to play. Not only is it a fun change, did you know it’s also a perfect way to improve fine and gross motor skills?

Getting ready for snow fun can be both challenging and rewarding. Putting on snow pants then adjusting the straps, pulling on the boots, zipping up a coat, placing on a hat, and finding just the right spot for your thumb in the mittens are all fine motor and body awareness skills children can achieve when given the time and the incentive. The youngest ones will still need a little help.

Once out the door all bundled up, a whole snow-filled playground awaits in the yard! Running with boots on is hard work! Check out the snow; is it soft, crunchy, wet, flaky, good for packing, or powdery? Make a footprint path in the snow for your friends and parents to follow. Take big steps, small steps, and jump with two feet. Making a snow angel is exercise; now try to get up without squashing the angel! Does it look like you?

Ready to build a snowman? Pack a snowball tight, now roll and roll. Keep pushing it, using all of your arm, core and leg strength. Make two more each smaller than the last. Kids can ask mom or dad to help stack the snowballs on top of each other to make the snowman.

Time to go sledding! Younger children enjoy being pulled on a sled while the older kids seek the hills. Sledding down and climbing back up over and over builds great strength and endurance. No hills in your yard? Children can pull each other on sleds or pack some snow and make their own hill – let their imaginations take over. Building a fort, shoveling a path and looking for animal tracks are all ways to enjoy being outside.

Are you ready for one more adventure? Go ice skating! Many rinks have open skate with rental skates available; some rinks offer plastic PVC walkers for children to help with balance. Bring your own helmet (bike or hockey) with you. Ice skating is fun and challenging. It incorporates balance, coordination, and strength. Children about 3 years old can really start to enjoy skating; they don’t have far to fall and they enjoy the quick progress they make.

Well that was fun! The kids will climb out of the layers of clothing, pile up the boots, and are ready for a snack. Soup or hot chocolate are just perfect to warm up all over. This was an exhausting day, so expect the kids to go to bed early tonight.

– Amanda Froling, PT, C/NDT, CKTP, is a physical therapist within the Beaumont Center for Children’s Rehabilitation in West Bloomfield.
– Carol Julien-Buell, PT, MPT, C/NDT, PCS is a board-certified Pediatric Clinical Specialist. She is physical therapist at the Beaumont Center for Children’s Rehabilitation in Beaumont Health & Wellness Center, Royal Oak.

How music can be a key to improved children’s literacy

young girl hands on piano keys

Parents and teachers often promote learning music when it comes to encouraging children to enjoy a thorough, well-rounded education. However, did you know music can specifically influence children’s reading and writing? Here is important information for educators, moms and dads on the link between music and literacy.

How does music help?

Participating in music — whether in the form of song, dance, or playing a musical instrument — helps children learn to follow instructions and listen for comprehension. According to Science Daily, there are several studies supporting the idea that music helps children with language development, with many theories as to why. Some researchers believe the overlap of brain circuitry is at the heart of the matter, that children are learning to use a similar part of the brain for music as for language. Others believe it relates to the timing in a child’s development. No matter how or why it works, the evidence in favor of engaging children with music is overwhelmingly positive.

Home and budding musicians

Adding music to a child’s homelife can be a boon to their literacy. Any family can encourage children toward music through song, and as Scholastic points out, even parents who are not gifted in singing can participate. Children enjoy the musical aspects and interaction, and they really don’t care if family members or friends are “good” singers. Dancing is in the same category, making learning easy and fun for kids who can participate with mom, dad or siblings.

When it comes to learning a musical instrument, you might want to engage a tutor or participate in group lessons. There are also free online music lessons available for various ages and abilities. Some families decide to set up an area at home dedicated to practicing an instrument, apart from the rest of the household so your child doesn’t disturb anyone. You should expect to pay an average price of $1,757 to soundproof a room in your home.

Naturally turning to music 

Many parents naturally gravitate toward music when it comes to raising their children. They sing lullabies when it’s time for sleep and soft songs to soothe children when they are anxious or afraid. When hitting the road, songs provide entertainment on long car trips or an opportunity to learn the alphabet in anticipation of school. In addition to these traditional tools, Bright Horizons points out that music can be a specific resource to child development as well, helping children toward improved literacy and overall learning. You can use music to connect children with particular communication skills, such as learning to form and understand words, speak in sentences, and read. Teaching children tongue-twisting songs, alliterative songs, or songs with foreign words and phrases can build language skills directly.

Examples and specifics

Music naturally engages children, helping them to get excited about whatever they are doing. It is also a way to keep them connected and interested in learning. One of the many ways music helps children in their language development is the learning of rhythms, rhymes and patterns. The repeated sounds, words, and actions that are part of traditional children’s music help give better understanding of what is meaningful, and teach emotional connections to words. Songs we might describe as “sing-songy” are an example, such as “Over the River and Through the Wood.”

Musical activities such as finger plays, which is singing songs with coordinated finger movements, appear to enhance children’s vocabulary and help them learn to pronounce words more clearly. An example of a finger play is “Itsy Bitsy Spider.”

Songs that incorporate dance and body movement can also reinforce understanding of words, rhythm, emotion and meaning. You can connect children with fun music and dance videos on websites like YouTube. Playing a musical instrument appears to further enhance children’s language and comprehension skills, as they learn to read notes and understand the variances in soft sounds, short sounds, loud sounds, and smooth sounds.

Every educator and parent aims to help individual youngsters become his or her best. By including music in a child’s life, you can build important language-related skills and abilities. Ensure children have access to music for improved literacy.

­– Charles Carpenter created He believes in the power of music and sound as a healing tool. He is based in San Antonio, Texas.

Fun indoor activities to keep kids moving all winter

young kids doing Zumba

Altered image. Lori Yerdon, USAG Humphreys Public Affairs, Flickr. CC license.

Much like adults, children need regular physical activity, an hour a day, to reap numerous health benefits including improved cardiovascular health, strong bones and muscles, positive self-image, decreased stress levels, and improved sleep. Achieving an hour of exercise in the winter time can be a challenge due to the cold weather and shorter days. Here are some ideas and tips to keep kids moving all winter long.

Use what you have and what your child enjoys

Board games, puzzles, balls, arts and crafts all can be used as motivation to perform exercises. A familiar position we use as therapist is tall kneel and one-half kneel. These are great positions because they strengthen the hips and core muscles while working on balance, coordination and endurance. Once the child is in either position, he or she can play a board game, draw a picture, or play catch with a sibling, friend or family member.

tall kneel, one-half kneel


Yoga is for everyone and you don’t need to leave the comfort of your home. Simply do an internet search for “storytime yoga” to locate kid friendly stories and themed yoga poses to go along with the stories. There are YouTube videos to follow along with or once you get the hang of it you can make up your own yoga poses to go along with some of your child’s favorite books. Ask your child to make up yoga poses as well. It’s great opportunity to be creative and silly. There are also kid friendly yoga pose cards that you can purchase or make your own from Pinterest. Take turns picking cards and performing the selected pose. Mix them up and create a yoga flow.

Play tag in a small space to improve agility

Do you have an area in your house that is pretty open, maybe a basement or play room? Create a “Tag Court” by sectioning off a small space, approximately 10′x10′ (smaller or larger if you choose), with use of masking tape. Play with two players at time and players cannot go outside the taped lines. Use stickers or football flags, if they are handy, to create a game of tag and keep track. This game is great fun and works on speed and agility. You will be surprised how quick this game gets your heart rate up. Variations of this game can also be used such as jump tag, playing tag while jumping, playing tag while crab walking, bear crawl tag and so on.

Have a dance party!

Time to be creative with your moves and get your heart rate up. Pick songs that your child enjoys, clear a space and have fun. You can keep it simple or decorate by putting up streamers, having balloons, different colored lights, flash lights, and microphones for singing. Invite friends over to work on dance routines and have a recital or just have fun. Want to change it up? Try a “freeze dance,” where dancers must freeze the music stops playing. This is a great activity to improve agility and direction following. You may want a theme dance: dance like your favorite underwater creature, favorite animal, cartoon character, etc. Try a dance in the dark with flashlights or incorporate instruments.

Turn screen time into activity time

Have you heard of Go Noodle? It’s an interactive website designed to get kids moving. Many classrooms are using this site and children are responding positively with improved attention and test scores. Sign up for the home version for free at There are limitless fun and catchy songs that incorporate academic content. There is also a section of mindfulness with calming activities.

I hope this gives you some more ideas on how to have fun and sneak in some exercise when stuck indoors over the winter. Imaginative play is limitless. Keep moving to stay healthy and stay warm!

– Christina Paniccia, pediatric physical therapist and pediatric supervisor at the Beaumont Neighborhood Club in Grosse Pointe, Mich.

Infant safe sleep

safe sleep, baby with pacifier

NICHD, Flickr. Public domain image.

Did you know that Governor Rick Snyder declared September 2018 as Infant Safe Sleep Awareness Month in Michigan to highlight the importance of preventing sleep-related infant deaths?

Here are some fast facts:

  • Sleep-related deaths are those where the sleep environment likely contributed to the infant’s death, including those ruled SIDS, SUID, suffocation, and other causes.
  • In Michigan, a baby dies nearly every other day due to sleeping in an unsafe sleep environment. That’s over 150 babies each year.
  • Sleep-related infant deaths are the leading cause of death for infants between 1 and 12 months of age.
  • Sleep-related infant deaths in Oakland and Macomb counties are lower than the average rate in Michigan, but Wayne county deaths are higher.

Help protect the infants in your life

The American Academy of Pediatrics (AAP) recommends:

  • Placing baby on his or her back for every sleep time (i.e., nap time or bed time).
  • Putting baby to sleep in a safety-approved crib, bassinet, or portable crib (pack-and-play) with a firm mattress and tight-fitting sheet.
  • Keeping items out of baby’s sleep area. That means no blankets, pillows, or toys. Use a sleep sack if baby is cold.
  • Offering a pacifier when putting baby to sleep.
  • Baby sleeping on a surface separate from adults or other children.
  • Room sharing (not bed sharing) for at least the first six months. Pull baby’s crib, bassinet or pack-and-play next to the adult bed for quick and easy feeding and comforting.
  • Keeping baby’s sleep space free from smoke.
  • Breastfeeding if possible; it is associated with reduced infant deaths.
  • Practicing supervised tummy time to build strong neck and shoulder muscles.
  • Ensuring everyone caring for the infant knows how to keep baby safe while sleeping.

For more information on infant sleep, visit the American Academy of Pediatrics’ sleep sectioncheck out the resources from the Michigan Department of Health and Human Services, or learn more about the Safe to Sleep campaign from the National Institute of Child Health and Human Development.

Digital diet for your family

little boy using phone

Children are growing up in media-rich environments that include television, computers, phones, tablets, video games, and other mobile devices. Although these technologies open doors to a wide range of education and fun, there are risks associated with overuse, especially for young children.

Researchers found that increases in media use during childhood led to increases in BMI; fewer minutes of sleep per night; delays in cognitive, language, and social development; and poorer executive functioning.

The American Academy of Pediatrics (AAP) recommends that children younger than 18 to 24 months have no screen time at all. At around 18 months, the possible exception becomes video chatting with relatives and friends. From about 1½ to 5 years, the AAP recommends allowing no more than one hour of screen time. After age 5, the recommendation is that screen time decisions be made factoring in the educational value and interactive quality of the activities, and that screen time doesn’t interfere with sleep or exercise.

Under the age of 2 years, children’s brains are developing fast. They need communication, hands-on exploration, and social interactions to help develop cognitive, language, motor, social and emotional skills. They are not able to generalize images from a TV or iPad to a real-life experience.

Preschool-age children are developing higher-level skills, including task persistence, impulse control, emotion regulation, and creative, flexible thinking. These skills are best taught through unstructured play and parent-child interactions.

Remember that all children are learning from their family members’ examples, so think about your own screen use. Increased use of mobile devices by parents is associated with fewer verbal and nonverbal interactions with their children. Over 40 percent of parents report that their children ask them to put down their devices, and about half indicate that screen time takes time away from reading and other activities.

Of course, tablets and phones are a good way to calm your child in the airport or while checking out at a store, but try to avoid using media as the only way to calm your child. Finding the right balance of real-life interactions and technology is important for children to learn and grow.

When you do use screens in your home, make them interactive:

  • Pause a video and talk about what you see.
  • Use the same toys, or do the same activities as what is on screen.
  • Apply information to real life.
  • Sing songs from shows during those routines at home.

Experts recommend a Digital Diet for children, customized to your family. Consider the following ideas for creating rules and sticking to them:

  1. Earn screen time by completing a non-screen activity:
    • Worksheet/summer homework page
    • Real play with siblings for 20 minutes
    • Exercise or outdoor play for 20 minutes
    • Completing a household chore
  2. Require siblings to agree on a show before watching.
  3. No screens before or after certain times (e.g., not before breakfast, not after dinner, etc.).
  4. Avoid screens in the evening, as this is related to poorer sleep.
  5. Create media-free zones in your home (e.g., no technology at the dinner table).
  6. Don’t leave the TV on in the background.

For the American Academy of Pediatrics Policy Statement on Media and Young Minds, visit:

Additional information can be found here.

– Kellie Bouren, M.A., CCC-SLP, Speech and Language Pathologist, Children’s Speech and Language Pathology Department, Beaumont Health