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This website offers a multitude of information on cognitive and brain development, and readers can sign up for a free bi-weekly newsletter about the brain.

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This website offers a multitude of information on cognitive and brain development, and readers can sign up for a free bi-weekly newsletter about the brain.

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Brain Games & Brain Education - Brain Connection by BrainHQ

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Brain Connection, powered by BrainHQ, is dedicated to providing accessible, high-quality information about how the brain works and how people learn. Many discoveries are being made in areas that relate to the human brain, including language, memory, behavior, and aging, as well as illness and injury.

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A thorough checklist that includes information on memory, means-end, object concept, and pre-academic skills.

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By: Learning Disabilities Association of America

Developmental Milestones

The course of children's development is mapped using a chart of developmental milestones.

These milestones are behaviors that emerge over time, forming the building blocks for growth and continued learning. Some of the categories within which these behaviors are seen include:

Cognitive Milestones

By one:

follows moving object with eyes

recognizes differences among people; responds to strangers by crying or staring

responds to and imitates facial expressions of others

responds to very simple directions

imitates gestures and actions

puts small objects in and out of container with intention

Between one and two:

imitates actions and words of adults

understands and follows simple, familiar directions

responds to words or commands with appropriate action

is able to match two similar objects

looks at storybook pictures with an adult, naming or pointing to familiar objects on request

recognizes difference between you and me

has very limited attention span

accomplishes primary learning through own exploration

Between two and three:

responds to simple directions

selects and looks at picture books, names pictured objects, and identifies several objects within one picture

matches and uses associated objects meaningfully

stacks rings on peg in order of size

recognized self in mirror, saying baby, or own name

can talk briefly about what he/she is doing; imitates adult actions

has limited attention span; learning is through exploration and adult direction

is beginning to understand functional concepts of familiar objects and part/whole concepts

Between three and four:

recognizes and matches six colors

intentionally stacks blocks or rings in order of size

draws somewhat recognizable picture that is meaningful to child if not to adult; names and briefly explains picture

asks questions for information: why and how questions requiring simple answers

knows own age

knows own name

has short attention span; learns through observing and imitating adults and by adult instruction and explanation; is very easily distracted

has increased understanding of concepts of the functions and grouping of objects and part/whole

begins to be aware of past and present

Between four and five:

plays with words: creates own rhyming words, says or makes up words having similar sounds

points and names four to six colors

matches pictures of familiar objects

draws a person with two to six recognizable parts, such as head, arms, and legs; can name or match drawn parts to own body

draws, names, and describes recognizable pictures

rote counts to five, imitating adult

knows own street and town

has more extended attention span; learns through observing and listening to adults, as well as through exploration; is easily distracted

has increased understanding of concepts of function, time, part/whole relationships; function or use of objects may be stated in addition to names of objects

time concepts are expanding; can talk about yesterday or last week, about today, and about what will happen tomorrow

Between five and six:

retells story from picture book with reasonable accuracy

names some letters and numerals

rote counts to ten

sorts objects by single characteristics

is beginning to use accurately time concepts of tomorrow and yesterday

uses classroom tools meaningfully and purposefully

begins to relate clock time to daily schedule

attention span increases noticeably; learns through adult instruction; when interested, can ignore distractions

concepts of function increase as well as understanding of why things happen; time concepts are expanding into an understanding of the future in terms of major events

Learning Disabilities Association of America (1999)

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Early Identification - Cognitive Milestones

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LD OnLine is the leading website on learning disabilities, learning disorders and differences. Parents and teachers of learning disabled children will find authoritative guidance on attention deficit disorder, ADD, ADHD, dyslexia, dysgraphia, dyscalculia, dysnomia, reading difficulties, speech and related disorders.

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Based on the work of Jean Piaget, information is presented in an easy to read chart and includes a section devoted to how parents can increase their child's cognitive development through play.

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This page presents an overview of the development of intellectual abilities. Children are not little adults. Until they reach the age of 15 or so they are not capable of reasoning as an adult. The following information is based on the work of Jean Piaget. He was not a psychologist. He was a developmental biologist who devoted his life to closely observing and recording the intellectual abilities of infants, children and adolescents.

The stages of intellectual development formulated by Piaget appear to be related to major developments in brain growth. The human brain is not fully developed until late adolescence or in the case of males sometimes early adulthood. We often expect children to think like adults when they are not yet capable of doing so. It is important that parents know what to expect from their child as they develop and to be sure that the expectations they may have for their child at a given age are realistic.
[CLICK HERE to learn more about intellectual and cognitive development along with suggestions on how to encourage and guide your child's or teen's development]
Piaget's Stages of Cognitive Development

Primary Circular Reactions(2-4 months)
Reflexive behaviors occur in stereotyped repetition such as opening and closing fingers repetitively.

The Preoperational Period (2-7 years)

Period of Concrete Operations (7-12 years)

Characteristic Behavior:

Evidence for organized, logical thought. There is the ability to perform multiple classification tasks, order objects in a logical sequence, and comprehend the principle of conservation. thinking becomes less transductive and less egocentric. The child is capable of concrete problem-solving.

Some reversibility now possible (quantities moved can be restored such as in arithmetic:
3+4 = 7 and 7-4 = 3, etc.)

Class logic-finding bases to sort unlike objects into logical groups where previously it was on superficial perceived attribute such as color. Categorical labels such as "number" or animal" now available.

Period of Formal Operations (12 years and onwards)
Characteristic Behavior:
Thought becomes more abstract, incorporating the principles of formal logic. The ability to generate abstract propositions, multiple hypotheses and their possible outcomes is evident. Thinking becomes less tied to concrete reality.

Formal logical systems can be acquired. Can handle proportions, algebraic manipulation, other purely abstract processes. If a + b = x then a = x - b. If ma/ca = IQ = 1.00 then Ma = CA.

Prepositional logic, as-if and if-then steps. Can use aids such as axioms to transcend human

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They Learn Fast! Understand Your Kid's Intellectual Development

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This page presents an overview of the development of intellectual abilities. Children are not little adults. Until they reach the age of 15 or so they are not capable of reasoning as an adult. The following information is based on the work of Jean Piaget. He was not a psychologist.

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This website gives information on the advantages of signing, and provides resources, news, updates, products and videos.

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Baby Sign Language lets babies, as young as six months old, communicate their needs so they don't need to cry. Your baby will learn how to tell you:

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Provides a chart listing language skills from 6 months to 8 years, as well as links to more detailed information about each stage.

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Language and communication skills are critical to a child's development. Good communication makes them better able to engage in socialization and to learn from their environment and from formal classroom instruction. When we talk about communication we are talking about both speech which is the verbal means of communication and language which is using shared rules to put words together to express thoughts and feelings as well has to understand the meaning of language through both spoken and written communication. Since parents are a child's first teacher, knowledge of language development in children improves their ability to interact with their child to stimulate and guide them in their ability to understand and communicate with their environment.

There are four main components of language:

Phonology involves the rules about the structure and sequence of speech sounds.

Semantics consists of vocabulary and how concepts are expressed through words.

Grammar involves two parts. The first, syntax, is the rules in which words are arranged into sentences. The second, morphology, is the use of grammatical markers (indicating tense, active or passive voice etc.).

Pragmatics involves the rules for appropriate and effective communication. Pragmatics involves three skills:

using language for greeting, demanding etc.

changing language for talking differently depending on who it is you are talking to

following rules such as turn taking, staying on topic

From birth on, children are programmed to develop speech and language. The first five years are most critical but language development continues throughout early childhood and on into adolescence. During the first five years stimulation of language development is important as the brain is both developing new nerve cells as well as multiple connections between nerve cells to serve the function of language both expressive and receptive. Lack of stimulation during this time could result in a child making slower progress or end up with poor communication skills. Later, we provide some tips for parents on how to help with language development but the basic suggestions are to spend lots of time talking, singing and reading to your child.

In the early stages of language development, the brain is programmed to attend to speech sounds and begin to mimic them. Early on babies like to make sounds up on their own. Later they attempt to repeat sounds/words that they are exposed to from their environment.

Children usually say their first words between nine and 18 months old. The most common first words are either "mama" or "dada'. What's kind of interesting is no matter what language children are raised in, the first words usually reference either mother or father. By the age of 18 months a child usually has a vocabulary of 50 to 150 words.

By two they can probably use over 300 words and understand about 1,000 words. By about 18 months children begin to put a couple of words together to form a sentence sometimes referred to as "telegraphic speech" such as "Mommy ball" or "Mommy throw ball".

Around 3 years of age, children begin to use language for all kinds of things. They are not only trying to get things by asking they are talking about past experiences and even beginning to use it to pretend. By preschool (4 ½) they are beginning to understand and use the rules of language to express possession of something, connect thoughts and quantify. There language is becoming more like that of adults.

In elementary school children continue to expand their use of oral language but are also learning to read a write. As children progress through middle school and high school they continue to expand their vocabulary and refining their grammatical skills and write in more complexities as well as continue to develop reading comprehension skills.

The tables below describe specific skill development for each stage of development through age 8. Below the developmental time line you will find information on how you can stimulate and encourage language development as well as information on how to recognize lagging development and what to do about it.

Recommended Books for Parents

Videos on Language Development

Language Development Time Lines:

Birth to 6 Months
Six to 12 Months

12 to 18 Months

18 To 24 Months

Two to Three Years

Three to Four Years

Four to Five Years

Five to Six Years

Six to Seven Years

Seven to Eight Years

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Look Who's Talking! All About Child Language Development

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Language and communication skills are critical to a child's development. Good communication makes them better able to engage in socialization and to learn from their environment and from formal classroom instruction.

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Provides information about early speech development, examples of speech sounds that children produce before they say words on a regular basis, and easy interventions parents and professionals can use to increase communication skills.

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Preschool kids do better when they talk to themselves

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Preschool kids do better when they talk to themselves

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According to a recent study, parents shouldn't worry about young children talking to themselves, in fact, 5-year-olds perform better on motor tasks!

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from research organizations

Parents should not worry when their pre-schoolers talk to themselves; in fact, they should encourage it, says Adam Winsler, an associate professor of psychology at George Mason University. His recent study published in Early Childhood Research Quarterly showed that 5-year-olds do better on motor tasks when they talk to themselves out loud (either spontaneously or when told to do so by an adult) than when they are silent.

"Young children often talk to themselves as they go about their daily activities, and parents and teachers shouldn't think of this as weird or bad," says Winsler. "On the contrary, they should listen to the private speech of kids. It's a fantastic window into the minds of children."

In the study, "'Should I let them talk?': Private speech and task performance among preschool children with and without behavior problems," 78 percent of the children performed either the same or better on the performance task when speaking to themselves than when they were silent.

The study also showed that children with behavioral problems (such as those diagnosed with Attention Deficit Hyperactivity Disorder, or ADHD) tend to talk to themselves more often than children without signs of behavior problems.

"Given that kids with behavior concerns need more direction and control from adults, teachers may unnecessarily ask children to be quiet in classrooms out of fear that such speech coming from difficult-to-manage kids will lead to problem behavior," says Winsler. "Yet non-disruptive private speech would actually help these children as they develop. Therefore, teacher training and professional development efforts should suggest that teachers increase their tolerance level for this kind of private speech."

Winsler says that private speech is very common and perfectly normal among children between the ages of 2 and 5. As children begin talking to themselves, their communication skills with the outside world improve.

"This is when language comes inside," says Winsler. "As these two communication processes merge, children use private speech in the transition period. It's a critical period for children, and defines us as human beings."

Winsler also conducted the first-ever study looking at private speech in children with autism. He found that high-functioning autistic children talk to themselves often and in the same ways that non-autistic children do. Talking aloud also improved their performance on tasks.

"Children with autism have problems with their external social speech, so psychologists assumed that their private speech would also be impaired," says Winsler. "But this study shows that it is not the case-that autistic children use their private speech very effectively as a tool to help them with tasks."

The study, "Private Speech and Executive Functioning among High-Functioning Children with Autistic Spectrum Disorders," was just published in the Journal of Autism and Developmental Disabilities.

Cite This Page:

Below are relevant articles that may interest you. ScienceDaily shares links and proceeds with scholarly publications in the TrendMD network.

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children's health; attention deficit disorder; infant's health; epilepsy research; learning disorders; child development; child psychology; add and adhd

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Preschool Kids Do Better When They Talk To Themselves, Research Shows

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Parents should not worry when their pre-schoolers talk to themselves; in fact, they should encourage it, says a new study. The study shows that children do better on motor tasks when they talk to themselves out loud than when they are silent.

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Physical development chart that is broken down in months beginning with birth then in years from 1 to 5 years of age.

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The Whole Child - ABCs of Child Care - Physical

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A baby begins learning the basics of self-movement and begins to master the skills needed for hand-to-mouth coordination and holding objects.

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Everyone talks about how tall -- or short -- a child is; this article discusses whether size really matters.

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Such Great Heights

Ronnie Andren

Eight-year-old Sam Merritt can jump on his bed without worrying about hitting his head; he can squeeze into tight spaces during hide-and-seek; and he figures he'll never have to duck when he gets off the school bus. But he does have to listen to endless comments from strangers, classmates, and even relatives about his size. At 3'10", Sam looks more like a kindergartner than a third-grader. To make matters worse, his 4'2" twin sister, Amanda, is tall for her age. "People make the most insensitive remarks like, 'No, they can't be twins -- he looks like the little brother,'" says their dad, Scott, of Loganville, Georgia. "It bothers me, so it must get to him."

Four-year-old Veronica Meyer, however, has inches to spare. The 4-foot-tall preschooler from Brooklyn is the same height as many 7-year-old girls. Her 2-year-old sister, Natalie, is tall too. "People ask what I feed them, like there's some super food for height," says their mother, Julie. "I'm nearly 6' and my husband is 6'2". Our daughters obviously inherited our tall genes, but people still feel the need to point out their size."

Kids come in all shapes: tall or short, round or pencil thin. And they all want to fit in and be accepted. But when you're dwarfed by classmates -- or you tower above them -- fitting in can be more of a challenge. "Kids get teased about physical differences like height, weight, having a big nose, or wearing glasses. Unfortunately, people make a lot of judgments -- and a lot of thoughtless comments -- based on appearances," says Meredith Dreyer, PhD, a pediatric psychologist at Children's Mercy Hospitals and Clinics, in Kansas City, Missouri.

Measuring Up

This fixation on size begins moments after your baby's born. Everyone wants to know his height and weight stats. From then on, the pediatrician will measure him at every checkup. While inches and pounds are important, growth is key. First developed 30 years ago, government growth charts gauge how his measurements compare with those of other kids of the same age and gender. "We don't worry as long as a child grows steadily, but an unusual jump in height or a sudden falloff in growth can be a sign of a health problem," says Elizabeth Littlejohn, MD, a pediatric endocrinologist at the University of Chicago Comer Children's Hospital.

During his first year, your baby grows up to 10 inches in length. However, his early size isn't very predictive of his final height or weight. He'll add about five inches during his second year, and then starting at age 3, he'll grow about two and a half inches per year until a final growth spurt kicks in during puberty. Girls reach their adult height around 15 (the average American woman is 5'4"), while boys don't top out until 16 or 17 (the average American male is 5'9"). A school-age child who falls below the 5th percentile for height is considered to be of "short stature," a clinical term meaning he's shorter than 95 percent of kids his same age and gender, whereas a child who's in the 95th percentile is taller than all but a few of her peers. Average height is anywhere between the 40th and 60th percentiles. You can look at your family tree to figure out your child's future potential: Height is about 80 percent genetic. A child whose parents are both 6' is likely to be the tallest kid in kindergarten. If both parents are unusually short, their children probably will be short too. But even kids who have average-height or tall parents may inexplicably stop growing -- a condition known as idiopathic short stature (ISS). These children are significantly shorter than 99 percent of their peers, and will remain small as adults. "Boys generally won't grow to be more than 5'4", while the girls might hit 4'11"," says Dr. Littlejohn. Late bloomers, on the other hand, are small for their age but still growing at a normal rate and will eventually have a growth spurt and catch up to their peers.

Short Stuff

People often presume that short kids -- especially boys -- aren't as popular as tall kids and are often teased, bullied, or depressed about their size. However, one study of almost 1,000 middle- and high-schoolers found that height made little difference in how much classmates like each other. "Short kids tend to be well-adjusted and to have just as many friends as taller classmates," says study author David E. Sandberg, PhD, a pediatric psychologist at the University of Michigan Medical School, in Ann Arbor. "If these older kids are faring okay at a time when height differences are most noticeable and bullying is more of an issue, then younger kids who are short are probably fine too."

Although the study's findings are encouraging, it can still be tough to be little -- particularly if you're a boy. "It's more socially acceptable for a girl to be small than for a boy to be short," says Dr. Dreyer. After all, girls are referred to in flattering ways -- petite, cute -- while boys tend to be called shrimp, shorty, or peewee.

Even parents would rather have tall sons. One study at the Children's Hospital of Philadelphia found that boys are taken to growth specialists twice as often as girls are, even though boys aren't more prone to shortness. "Society views tall men as being strong, confident, and desirable, and parents of small boys don't want their sons to have a disadvantage in life," says study author Adda Grimberg, MD, a pediatric endocrinologist.

If your child's on the short side, it can be difficult for you to watch other kids, and even tactless adults, treat him differently because of his size -- especially if you had a similar experience when you were a kid. But if you're overly fixated on his height or get defensive when people comment about it, he could get the message that being small is bad or that his size defines him, says Dr. Grimberg. Instead, give your child the tools he needs to feel good about himself inside and out.

Find areas where he can shine. Small kids can excel at lots of sports, including soccer, gymnastics, and martial arts. But if your child wants to play basketball or volleyball, encourage him to try it. Of course, there are also plenty of nonphysical activities he can get involved in, such as playing a musical instrument or acting in the school play.

Problem-solve. If your child is being picked on, brainstorm solutions together and practice responses so she feels confident sticking up for herself. "Bullies want to get a rise out of their victim. When you don't react or you react unexpectedly, it takes away their fun," says Dr. Dreyer. Some deadpan replies for pint-size taunts: "Thanks a lot, I didn't know I was short" or "Wow, you're really observant."

Encourage him to speak up. When people mistakenly assume that Ethan Udell is only 6 years old, the fourth-grader from Dix Hills, New York, quickly corrects them and gives them something else to talk about. "He tells people, 'I'm actually 9 1/2, and I'm a really good hockey player,'" says his mom, Stacey. Other upbeat responses to try: "Shortness is only one of my great qualities" or "I take after my grandfather."

Respect her age. Don't say that your child is younger than she really is to get discounted tickets to movies or amusement parks. It might save you a few dollars, but it'll cost her self-esteem.

High Anxiety

Tall kids might seem to be on top of the world, but height has its downsides. Because they look older than their years, adults -- and even peers -- often expect them to behave more maturely. When Marissa Cooper, then 3, had a perfectly age-appropriate meltdown in a mall in Greenwood, Indiana, her mom, Heather, got snippy comments from strangers who assumed the girl was at least 5. "A woman said loudly to her friend, 'Isn't she a little old for tantrums?'" says Cooper. Now 6, Marissa is as tall as many 9-year-old girls, and that complicates playdates. Kids her age assume an "older" child won't want to play with them and are intimidated by her size, while kids her height find her too immature. "It's tough being a tall girl, and it just gets worse during the dating years," says Cooper, who's 5'8" and knows from her own childhood experience.

Life's not a slam dunk for tall boys either. Adults generally expect that they're great at sports, but that's not necessarily true. Answering nonstop inquiries about his athletic abilities can be stressful for a child who's already tired of being singled out for his size.

And then there's bullying. "When you're 8 but look 10, older kids like to challenge you. They'll say, 'So I bet you think you're as tough as me. Prove it,'" says Carleton Kendrick, a family therapist in Boston who was the tallest kid in his class. Still, tall kids have been known to throw their height around. A study at the University of Southern California found that both boys and girls who stand a mere half-inch taller than their peers at age 3 tend to be more aggressive by age 11. Experts speculate that tall boys and girls have higher testosterone levels, which contributes to aggressiveness. Or it could also be that tall kids learn early on to use force to get what they want. When your child gets sick of all the bean-stalk remarks, try these tactics.

Take it as a compliment. Encourage your child to be proud of her height. Your daughter might say: "Thanks for noticing. I take after my dad," or "My grandma is tall too."

Tell your own tall tales. Know what it's like to stick out in a crowd? Share what you liked about being a tall child: You could sit in the back row and still see over classmates' heads. You could ride anything at the amusement park.

Rebound from stereotypes. Your child doesn't have to explain that he's not into basketball or other sports. He can just say, "No, I don't play," and mention what he does like to do: "I love to ride my bike," or "I'm really good at math."

Whether your child is tall or short or somewhere in between, remind him that all kids are teased for some reason or another, suggests Dr. Dreyer. And try to help him see his height isn't such a huge deal. Where bigness really counts -- in terms of kindness, generosity, intelligence, and love -- is on the inside.

Shots for Short Kids?

About one in 3,500 children have growth-hormone deficiency, meaning they don't produce enough growth hormone for normal development and need daily injections of synthetic growth hormone to achieve something close to a normal height. In 2003, the FDA expanded approval for growth-hormone therapy to include the 1 percent of kids with idiopathic short stature (ISS). With treatment, children with ISS can gain an average of two to five inches depending on the cause of the slow growth and how many years they're in treatment. Studies have found that growth-hormone therapy is very safe for children. Side effects are rare and may include ear infections, muscle or joint pain, headaches, nausea, breast growth, and skin rashes. However, the treatment costs about $20,000 per year, with some kids needing it for five years or longer, and insurance doesn't always cover the cost. For more information, visit the Human Growth Foundation at hgfound.org or the Magic Foundation at magicfoundation.org.

Copyright © 2007. Used with permission from the October 2007 issue of Parents magazine.
All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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Eight-year-old Sam Merritt can jump on his bed without worrying about hitting his head; he can squeeze into tight spaces during hide-and-seek; and he figures he'll never have to duck when he gets off the school bus. But he does have to listen to endless comments from strangers, classmates, and even relatives about his size.

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Discusses how to tell whether your child is growing properly and provides information on how to help your child achieve optimum growth.

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What Factors Really Matter?

6 Factors That Affect Growth

1. Heredity Your child's genetic history is the number-one influence on her growth, says Lynne Levitsky, M.D., chief of the pediatric endocrine unit at Massachusetts General Hospital, in Boston. Look to Mom and Dad's height, shape, and rate of growth to predict how your child will turn out. Need proof of the power of genes? Studies show that identical twins grow to within an inch of each other in final height.

2. Nutrition "Without a good diet, kids won't grow normally," says Jo Anne Hattner, R.D., a pediatric specialist at the American Dietetic Association. Be vigilant about making sure your kids consume wholesome calories. Even well-meaning parents can derail a child's healthy diet. Common problems? Incorrectly mixed infant formula, not getting enough calories when you're breastfeeding or weaning, or even efforts to keep an infant from getting "fat." (Babies, no matter how plump, should never be put on diets.) Too much juice or soda can also can interfere with a child's appetite for nutritious foods.

3. Medical Conditions Some children are born with or develop serious medical conditions that can stunt growth if not treated. The most common: gastrointestinal disorders such as celiac disease; food allergies; thyroid problems; hormone deficiency; heart, kidney, or liver ailments; and certain chromosomal abnormalities. Medications for common childhood conditions should also be monitored closely. For instance, Ritalin and other stimulants prescribed for ADHD have been found to affect growth. The problem is often dose-related and is usually easily fixed, says Barry B. Bercu, M.D., head of endocrine, diabetes, and metabolism at All Children's Hospital, in St. Petersburg, Florida.

4. Exercise Regular physical activity promotes growth by strengthening bones and muscles. But beware of getting your child involved in high-impact sports such as gymnastics and running, which -- when done excessively -- can impede growth and even cause trauma to developing bones.

5. Sleep Make sure your child snoozes soundly each night. About 70 to 80 percent of growth hormone is secreted during sleep, says Paul Saenger, M.D., a pediatric endocrinologist at Children's Hospital at Montefiore Medical Center, in New York City.

6. Emotional Well-Being Kids reach their full growth potential when they're in a loving, nurturing, and supportive family environment, says Thomas Moshang, M.D., director of the growth center at Children's Hospital of Philadelphia. Emotional neglect and excessive tension or anxiety can interfere with growth. The condition -- called "psycho-social growth failure" by doctors -- is extremely rare, but its consequences are as real as malnutrition.

Reading the Chart, Rules for Good Measure

Print Out a Copy of the CDC's Growth Charts

How to Read the Childhood Growth Chart

The most important tool in understanding and tracking your child's growth is a simple piece of paper: The childhood growth chart. There are charts for height, weight and head circumference for infants and for children. But how to decipher all those lines and numbers? And what is a percentile, anyway? To find out where your child falls on the chart for height, for example:

1. Find his measurement in inches on the left or right side of the chart, and his age along the top or bottom.

2. Move your fingers along those lines until they intersect.

3. Make a mark at that point.

4. Find the curve closest to this intersection. (Each curve represents a different percentile -- or the number of children out of 100 who would measure in at that height.)

5. Follow the curve up to the right to read which percentile it represents. (A 15-month-old boy who is 31 inches long would be in the 50th percentile, or exactly average in size.)

Rules for Good Measure

Careful tracking on the growth chart is critical to spotting problems and treating them quickly. Here's how to get the most from the childhood-growth grid.

Be an advocate for your child. See that he is measured for height and weight at every doctor's visit and that each measurement is carefully plotted on the grid.

Make sure your doctor has up-to-date charts. The latest growth charts from the Centers for Disease Control and Prevention make statistical adjustments for breastfed and formula-fed babies and for ethnic variations. They also include a body-mass index that flags weight problems.

Compare growth from one visit to the next. Make sure your child is measured in the same way at each visit. For height, your child should be standing erect with her shoes off. Babies and toddlers up to age 3 should be measured for length while lying down and should be weighed without diapers or clothing.

Keep your own records. Ask your doctor for a copy of the chart, or print one of your own right now: Growth Chart for Boys or Growth Chart for Girls.

Don't read measurements out of context. Doctors don't worry about occasional blips on the chart; instead, they look for trends over time. Bouts of flu or other illnesses may set your child back at a checkup. "Seasonal growth" (kids sometimes grow three times faster in the spring months) and age-related growth spurts could briefly bump them ahead. And don't get hung up on numbers. As long as your child grows at a steady rate and stays within the range of his established percentile -- regardless of his size -- he's growing well.

Know the warning signs. You should be concerned if your child crosses two or more percentile curves, say from the 50th to the 10th, or if he moves into extremes -- either below the 5th or above the 95th. A child whose weight is in the 95th percentile is considered obese. A score below the 5th percentile might mean your child has a chronic illness.

Related links:

Can I Make My Short Child Taller?

If your child is below the 5th percentile in height, he could be deficient in growth hormone (GH). Doctors can prescribe a synthetic version to promote growth in children whose bodies don't produce enough of the hormone naturally or who suffer from certain diseases that impede growth. GH won't make basketball stars out of short kids, but it can help an abnormally small child gain some height.

What if a child is short but otherwise healthy? Most doctors won't prescribe GH to kids who are not hormone deficient, but new research suggests it could add up to two inches to a healthy child's final height. The growth comes at a high price, however. GH involves daily injections and can cost about $20,000 a year. Side effects in healthy kids are still unknown.

Baby Myth, Predictions, Expectations

Big Baby Myth
Q: Does a baby's size at birth offer any clues into what he'll look like as an adult?
A. No. In utero size is determined by how well the mom eats, as well as by the health of the placenta. That's why a petite woman can give birth to a ten-pound infant.

But once those babies are out of the womb, all bets are off. Big newborns who defied genetic odds will likely drop a couple of curves on the growth chart -- say from the 75th to the 25th percentile. It's also not unusual for small or average-size babies whose parents are big to grow rapidly and gain percentiles in the first two years of life. To get a fix on your how big your child will be, look at the pattern he establishes after he turns 2.

How to Predict Adult Height

In boys: Add five inches to the mother's height, and keep the father's height constant. For example, a boy born to a mother who is 5'3" and a father who is 6'2" will likely grow to between 5'8" and 6'2".

In girls: Subtract five inches from the father's height and keep the mother's height constant. The daughter of the couple above would grow to between 5'3" and 5'9".

Growth Spurts

Children grow in fits and starts. Here's a look at what to expect.

0-12 Mos. Most moms notice times when their babies just can't seem to get enough to eat. Increased hunger is the usual sign of a growth spurt. During the first year, there are plenty of them. Expect a lot of growth at 10 days to 3 weeks, 6 weeks, 3 months, and 6 months. By age 1, a typical baby will have tripled her birth weight and grown ten inches.

1 Year Growth slows a bit, but your baby will add an average of four to five inches and gain about a half pound per month.

2 Years Expect your toddler to grow three to four inches and gain three to four pounds. By the time they turn 3, most kids have grown to about 50 percent of their ultimate adult height. But soon the rapid pace of growth will slow down and become more subdued until puberty.

3 Years By the end of this year, your child will add another two to three inches, doubling his birth length.

4-10 Years Your child should grow about two inches and gain about six pounds per year. Some kids may experience a small spurt between 6 and 8 years.

Puberty Puberty in girls usually begins between ages 8 and 13. She'll grow two to ten inches and gain 15 to 55 pounds before reaching her final adult size. Puberty in boys starts between ages 10 and 15. He'll grow anywhere from four to 12 inches and gain 15 to 65 pounds.

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6 Factors That Affect Growth Heredity Your child's genetic history is the number-one influence on her growth, says Lynne Levitsky, M.D., chief of the pediatric endocrine unit at Massachusetts General Hospital, in Boston. Look to Mom and Dad's height, shape, and rate of growth to predict how your child will turn out.

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Encouraging Physical Development of Toddlers 

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Encouraging Physical Development of Toddlers 

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Fine and gross motor activities are discussed along with developmental milestones and suggestions for parents.

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These practical play ideas will help to boost your toddler's developing physical skills, and are easily fitted into your daily routine. You'll find there's enough here to keep even the most active toddler happily occupied.

Last reviewed: November 2016

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How to encourage your toddler's physical development

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These practical play ideas will help to boost your toddler's developing physical skills, and are easily fitted into your daily routine. You'll find there's enough here to keep even the most active toddler happily occupied. Last reviewed: November 2016

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Provides information on gross and fine motor development for birth to age 6 in a checklist format useful for parents and early childhood professionals.

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Early Identification - Motor Skills Milestones | LD Topics | LD OnLine

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LD OnLine is the leading website on learning disabilities, learning disorders and differences. Parents and teachers of learning disabled children will find authoritative guidance on attention deficit disorder, ADD, ADHD, dyslexia, dysgraphia, dyscalculia, dysnomia, reading difficulties, speech and related disorders.

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Activities to help children develop fitness and body/spatial awareness are presented along with a chart that focuses on promoting locomotion, manipulation, and stabilization.

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This article and resource site on teaching self-care skills to children includes information on toileting skills, guides to healthy eating habits, and developmental delays.

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Gross motor skills are one of many of the amazing milestones for your 3 year old. While your child's physical rate of growth will likely slow down this year, each week may bring a change in what she can do and what she understands.

In other words, you'll likely see the development of the following:

Gross motor skills

Fine motor skills

Intellectual or cognitive skills

Verbal skills

Social and emotional skills

That said, don't be alarmed if your child isn't able to accomplish all of the skills listed below. Every child develops at his or her own rate.

Gross Motor Skills

Motor skills are related to how your child uses his body. Gross motor skills use large muscle groups and are related to active play. Milestones at this age may include:

Run several yards without falling

Climb up low furniture and jungle gyms with ease

Walk on tiptoes

Walk a straight line

Walk up and down stairs alternating feet

Kick a ball

Jump up with both feet

Pedal a tricycle

Throw a large ball

Yes, all that running, climbing, jumping and non-stop moving is hard to keep up with. It may be tempting to tell your 3 year old to "stay still." But allowing him the freedom to move is essential. Given the time and space to practice his physical skills, he will develop better balance and confidence. While he will inevitably suffer some spills and scrapes, this phase can help him avoid major falls and injuries in the coming years.

Fine Motor Skills

Tasks that rely on fine motor skills are those that use the hands and small muscle groups. Fine motor skills milestones you can expect your child to achieve by age 3 include:

Feed self (although, you can still expect messes)

Turn pages in a book

Hold and write with a crayon

Wash and dry hands

Put on shoes (but not tie laces)

Dress self with some help

Build a balanced block tower

Open and close twistable lids

One of your child's major accomplishments this year will be learning to "draw," although pictures will mostly be scribbles and lines on the page. To encourage your budding writer and artist, provide lots of paper and age-appropriate writing tools (crayons, washable markers, finger paints). Show her how to use the tools by coloring and drawing with her. Teach her what is ok to draw on (paper) and what is not (the white couch), but you might also want to invest in washable paint just in case it gets on the walls and furniture for the inevitable mishaps.

Intellectual or Cognitive Skills

Your child's mind and imagination will blossom this year. As he develops his memory and starts to understand more about the world around him, he'll be filled with questions. It can be a challenge to know what your child actually does understand and what still needs to be learned, but these are some of the milestones you can expect him to achieve by the end of the year:

Identify basic colors

Count to five

Say the alphabet (but may not be able to identify each written letter)

Play make-believe with dolls, toys or other people

Sort objects by shape and color

Identify basic shapes

Match objects

Complete simple puzzles

Understand the concept of two

Recognize everyday sounds

Understand "before," "after," "now," "soon" and "later"

Remember what happened yesterday

Know where playthings belong

Laugh at silly ideas or jokes

Understand some important safety rules (don't touch the hot stove; stay away from the window)

Follow one- or two-step commands

Pay attention for about three minutes

At this age, it's important to also understand your child's intellectual limitations. He hasn't learned to separate fantasy from reality, so he may believe what he sees on television or in books is real and may not understand hyperbole such as statements: "If you eat more carrots you'll turn orange." He also believes that everything is related to something he has done.

For this reason, if something "bad" happens he may blame himself or ask what he did wrong.

Even though he's come a long way, his reasoning skills are very limited. Sticking with clear-cut facts will help you manage behavior ("put the trucks in the box and you can eat your snack" versus "be good and we'll get something").

Verbal Skills

Follow one- or two-part commands

Use names for family and friends

Name common objects

Understand most of what you say (everyday conversation)

Speak five word sentences

Uses pronouns (I , you, me, we, they ) and some plurals

Speaks clear enough for strangers to understand most words

Begin to enjoy rhymes and silly plays on language (putting wrong words into favorite songs

Understand "mine"

Use "me" and "you" appropriately

Tell stories

Carry on a conversation of two to three sentences

Enjoy books and stories

Ask simple questions

In many ways the development of speech marks a significant change for your entire family. As your little one is able to express her needs and wants, you may be able to avoid those behavior meltdowns that often occurred because she couldn't tell you want she wanted. Some of the advances in language you may see this year include:

According to the American Academy of Pediatrics, there is greater variation in language development among children of this age than in any other area of development. There is a wide range of "normal" and some common variations. For instance, girls' language skills often develop earlier than boys. Some young children are also naturally chatty while others are quiet. A child may have extremely well-developed language skills, but she may choose not to speak much. While being aware of language delays to watch out for, try not to compare your child's verbal skills to others.

Social Skills

Take turns in games

Become more independent

Show interest in trying new things

Invent fantasy games

Cooperate with other children

Show a range of emotions

Copy other people's behavior (adults and peers)

Show affection for others on his own (without you suggesting he give a friend a hug)

Know first and last name

Realize when some actions are wrong and feel sorry

Try to make others laugh

Play with a group of children

Show interest in potty training

Around your child's third birthday you may notice a change in how he interacts with other children. This is the point where many children begin moving away from parallel play (where kids play near each other) to group or interactive play (where he actually cooperates and plays with others). This means he'll begin needing to learn how to navigate those relationships. It's a period when he will develop essential skills such as:

Although your child is looking for independence and new experiences, he may get upset when separated from you. While it's hard for parents to see a child upset, providing opportunities for your child to socialize without you is important for his development. This also means that you should try not to hover when your child is playing with others and not to interfere in conflicts unless you're truly needed.
CDC.gov. "Important Milestones: Your Child at Three Years." Web. "Developmental Milestones: 3 to 4 Year Old." Healthycihldren.org. Web. Powell, J. and Smith, C.A. "Developmental milestones: A guide for parents." Manhattan, KS: Kansas State University Cooperative Extension Service. Web. Shelov, Sreven P. M.D., M.S., F.A.A.P., et. al. Caring for Your Baby and Young Child Birth to Age 5. Banatam Book, 2009. Print.
Someone gets upset because a toy was grabbed or another child didn't get a turn? A simple "let's share and play together" followed by an encouraging nudge to return to each other can be more effective than stepping in to resolve the situation. Keep in mind, your child and his friends need to learn to play with each other, not with each other's parents.

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Gross Motor Skills You Can Expect From Your 3-Year-Old

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Gross motor skills are one of many of the amazing milestones for your 3 year old. While your child's physical rate of growth will likely slow down this year, each week may bring a change in what she can do and what she understands.

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Teaching Your Young Child Specific Self-Help Skills

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Teaching Your Young Child Specific Self-Help Skills

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This article gives fun interactive ways to teach self-help skills using picture cues, rhymes and song, and motor activities.

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Children with disabilities of every kind need to learn hygiene and self-help skills as soon as they are able. These skills should be taught from the time the child is very young, because the sooner and in more ways the child can become independent, the happier he will be. The child who has developed sufficient self-help skills is more likely to be integrated into a regular classroom setting and have better experiences with peers.

There are various methods you can use to teach your child everything from grooming, getting dressed, brushing teeth, bathing, etc. Choose a method based upon your child's learning style.
Picture Icons
Often, picture icons can help children remember the routine. Break the task into small parts. Then create a schedule of visual reminders, and post it close to the location where the action will be performed. Here's an example of a picture icon chart:

Prior to each step, ask the child, "What do we do next?" See if the child can remember, and if not, point to the visual clue on the schedule. State each task simply and use the same phrasing each time. As the child becomes proficient, play games where you cover one of the steps with your finger, asking the child to recall it. Soon you can "hide" the entire schedule, seeing if the child can remember the whole routine. Give positive reinforcement (Give a big hug, cheer, or simply say "good job." Provide time with a favorite object, etc.).
Songs and Rhythm
You can use rhythm or songs as a mnemonic. Rhythm and rhyme can aid memory. For example you could sing, "This is the way we brush our teeth, brush our teeth, so early in the morning...."
Backward Chaining
Backward chaining is another teaching method which helps some children learn to do multi-step tasks. Start with the last task on the list, and when the child has mastered it, move to the task just prior to it. This method only works with particular skills.
Create Motor Memories
Often children with autism or other neurological disorders have a difficult time getting their muscles to move in the way they are supposed to. The child may need to develop a "motor memory" of what the experience "feels" like. This may require you to physically manipulate the child's arms or legs into the appropriate position, for example, grasping the child's hand and positioning it to brush his teeth. It may take several (or even many) experiences where you place the child's body in the appropriate position before the motor memory is developed.

Although special education teachers may provide your child with some instruction in self-help skills, the primary responsibility certainly falls on you as the parent. With a special needs child, your role as "teacher" in the home is even more important. Be creative and do what works best for your child.

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Teaching Your Young Child Specific Self-Help Skills

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Children with disabilities of every kind need to learn hygiene and self-help skills as soon as they are able. These skills should be taught from the time the child is very young, because the sooner and in more ways the child can become independent, the happier he will be.

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Provides self-help milestones for ages birth to 6 and includes information on eating, drinking and dressing.

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Early Identification - Adaptive Milestones | LD Topics | LD OnLine

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LD OnLine is the leading website on learning disabilities, learning disorders and differences. Parents and teachers of learning disabled children will find authoritative guidance on attention deficit disorder, ADD, ADHD, dyslexia, dysgraphia, dyscalculia, dysnomia, reading difficulties, speech and related disorders.

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This article defines self-help skills and offers parents of preschoolers activities and suggestions for developing those skills.

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Self-Help Skills : Parenting 24/7 | University of Illinois Extension

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Preschool children grow and learn at an amazing pace. They can't wait to feel busy, successful, grown-up, and independent. They begin practicing self-help skills at age two during the "me do it myself" stage. Even though this is annoying to adults at times, it paves the way for their development of essential skills for school success.

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This is hard for some parents and easy for others. If it is hard for you, try not to make your child worried or afraid by your behavior - be cheerful, say good-bye at the preschool or child care center, and go out looking happy even if you are sad inside.

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Written in family-friendly language, the tools may be used by families and child development professionals in a range of disciplines, including health, education, child care, and family services. The companion Referral Tool and the guide to Locating Community-Based Services to Support Children and Families are tailored to help providers and families connect with the specific resources they need.

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Articles on Social Development of Children

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Hot links to articles on social development of children

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Early Identification - Social Skills Milestones | LD Topics | LD OnLine

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LD OnLine is the leading website on learning disabilities, learning disorders and differences. Parents and teachers of learning disabled children will find authoritative guidance on attention deficit disorder, ADD, ADHD, dyslexia, dysgraphia, dyscalculia, dysnomia, reading difficulties, speech and related disorders.

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Promoting Social and Emotional Development

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Promoting Social and Emotional Development

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Children’s early development is greatly affected by the mental health and well-being of the adults who care for them.

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Infant-Toddler Social Emotional well being

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Infant-Toddler Social Emotional well being

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NCCP | Promoting the Social-emotional Wellbeing of Infants and Toddlers in Early Intervention Programs

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The strategies used by communities highlighted in this brief are illustrative of ways to promote the social-emotional wellbeing and healthy development of infants and toddlers through supports provided by the Part C Early Intervention Programs. These efforts represent both state policy choices, including funding decisions and state eligibility criteria, as well as community level innovation and cross-systems collaboration.

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This article describes oral language development in young children and offers parents and teachers suggestions to foster communication.

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Young Children's Oral Language Development

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The development of oral language is one of the child's most natural – and impressive – accomplishments.

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Language Development in Internationally Adopted Adopted Children

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Language Development in Internationally Adopted Adopted Children

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Working with Internationally Adopted Children

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ASHA policy documents, Leader articles, and online resources about working with internationally adopted children

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The ability to hear is essential for proper speech and language development. Hearing problems may be suspected in children who are not responding to sounds or who are not developing their language skills appropriately. The following are some age-related guidelines that may help to decide if your child is experiencing hearing problems.

It is important to remember that not every child is the same. Children reach milestones at different ages. Talk your child's healthcare provider if you are suspicious that your child is not developing speech and language skills correctly. The National Institute on Deafness and Other Communication Disorders and other experts list the following age-appropriate speech and language milestones for babies and young children.

Milestones related to speech and language

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Age-Appropriate Speech and Language Milestones

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The ability to hear is essential for proper speech and language development. Hearing problems may be suspected in children who are not responding to sounds or who are not developing their language skills appropriately. The following are some age-related guidelines that may help to decide if your child is experiencing hearing problems. It is important to remember that not every child is the same.

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Discusses toddlers' use of language and presents activities for encouraging language development and pre-reading skills

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Toddlers learn many new words and begin to form simple sentences. The number of words in a toddler's vocabulary expands rapidly. By 2 years of age, children typically begin to connect words, such as "go" and "bye, bye" to make the simple sentence "Go bye-bye." By 3 years, many toddlers are able to form a variety of sentences with three or four words.

Young toddlers both babble and use real words. Parents and caregivers will be able to understand a toddler some of the time, but they may have difficulty understanding the child on other occasions. People outside the toddler's family may also have difficulty understanding all of his words.

Toddlers can use language to imitate and to talk about pretend things and past experiences. As your toddler engages in pretend play, she thinks out loud and talks to herself. She also develops an ability to talk about past experiences in one or two sentences. This is important because it is the beginning of your child's understanding and production of stories.

Not all toddlers develop language in the same way or at the same rate. For example, some children tend to develop language in spurts, while others show more slow, steady growth. Not all children learn to talk in the same way. Some learn to speak by learning words one by one. Others pay less attention to individual words, but learn to speak in phrases, saying, "Gimme cup of juice," for example.

Toddlers are developing an awareness of the power of words. At this age, your toddler is learning that he can use words to get attention, get his needs met, and express his feelings.

Encouraging Your Toddler

Pretend with your toddler. Help your child move beyond the "here and now" in her play with toys. Help create worlds with words as you play together. For example, if your toddler says "Truck up!" you might reply "That truck is going way up to the moon!".

Help your toddler tell a story about a special event. To support your toddler's emerging storytelling abilities, you might pose questions such as, "And what was on top of your birthday cake?" or elaborate on what your child says. For example, if your toddler says, "Big doggie!" you might say, "Yes, Bruno was a very big doggie, wasn't he?" Supporting your child's ability to tell stories helps develop her language skills as well as her appreciation of stories.

Talk about family photos. Talking with your toddler about photographs of family events is a great source for stories and will stimulate not only his memory, but his language as well. Constructing photo albums or homemade books about a particular event, such as a child's birthday, is a wonderful way of being able to revisit special events over and over again.

Give your child words for feelings. This is a great time to introduce specific words that map onto specific feelings. When your child is frustrated, you can introduce words such as "mad", "angry", and "frustrated". You can also offer your child specific phrases he can use to get your help and attention.

Next: Learn about toddlers' reading milestones.

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Toddlers learn many new words and begin to form simple sentences. The number of words in a toddler's vocabulary expands rapidly. By 2 years of age, children typically begin to connect words, such as "go" and "bye, bye" to make the simple sentence "Go bye-bye."

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This site offers a language milestone chart for children birth to age 6, and includes activities and strategies to encourage language development.

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Speech and Language Milestone Chart | LD Topics | LD OnLine

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The course of children's development is mapped using a chart of developmental milestones. These milestones are behaviors that emerge over time, forming the building blocks for growth and continued learning. This article provides information about these milestones, as well as activities to encourage your child's language by age.

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National Center for Pyramid Model Innovations NCPMI

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The goals of the National Center for Pyramid Model Innovations (NCPMI) are to assist states and programs in their implementation of sustainable systems for the implementation of the Pyramid Model for Supporting Social Emotional Competence in Infants and Young Children (Pyramid Model) within early intervention and early education programs with a focus on promoting the social, emotional, and behavioral outcomes of young children birth to five, reducing the use of inappropriate discipline practices, promoting family engagement, using data for decision-making, integrating early childhood and infant mental health consultation and fostering inclusion.

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Here are some ideas for fun activities you can do with your child at home to promote early learning.

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Activities and resources for parents of young children

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Developing self care skills doesn't always come naturally. Here are ideas for helping your child develop independence in this area.

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Practical ideas for teaching impulse control in young children.

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Impulse control can be a challenge-and developmentally appropriate-for many kids, particularly little ones. However, it is a vital skill that can be nurtured and improved upon at any age. This is important as a lack of impulse control is at the root of many behavior problems. Without effective intervention, impulsive behaviors can become normalized, habitual, and worsen over time.

For example, impulsive 5-year-olds may hit or have tantrums when they don't get their way, while impulsive 14-year-olds may share inappropriate content on social media or engage in risky behaviors like drinking alcohol without thinking about the potential ramifications.

However, you can help your child learn to improve their impulse control as they grow. In fact, studies show that interventions to improve impulse control (and other elements of executive function) can be very helpful in bolstering these skills.

Research shows that poor impulse control is linked with impaired decision-making and the development of mental health conditions. So, the more impulse control your child gains, the less likely they'll be to do or say something that can harm others and themselves-and they'll be more likely to have positive mental health.

Consider Whether Your Child has ADHD

Teach Your Child to Label Feelings

Kids who don't understand or know how to effectively communicate their emotions are more likely to be impulsive. A child who can't say, "I'm angry" may hit to show they're upset. Or a child who can't verbalize, "I feel sad," may throw themselves to the floor and scream.

Teach your child to recognize their feelings so they can tell you-rather than show you-how they feel. Start by teaching your child how to label their emotions, such as angry, sad, excited, surprised, worried, or scared. Then, talk about the difference between feelings and behavior.

Make sure they know it's okay to feel angry, but it's not okay to hit, kick, or yell at someone when they're angry. When they're able to talk about their emotions in a meaningful way, they'll be more likely to feel heard and supported-and less likely to feel the need to act out.

Ask Your Child to Repeat the Directions

Sometimes, kids behave impulsively because they don't listen to directions, this is particularly true of kids who have ADHD. Help them stay on track by making sure they're actually listening. Otherwise, before you've finished your instructions, they may sprint into action without any idea what you said.

Teach your child to listen to directions by asking them to repeat your instructions before taking action. Before you start your instructions, say, "Before you move, I want you to explain the directions back to me." And once you've finished, you can ask, "OK, what did I just tell you to do?"

Only after they're able to repeat back what you said-whether it's to clean their room or to put away their homework-should they be able to take action.

Additionally, aim to make directions simple, easy-to-follow, and with as few steps as possible. Consider your child's developmental readiness to follow multi-step directions as well. You can also try writing down directions so that they have a reference if they forget what they need to do.

Teach Problem-Solving Skills

Although brainstorming solutions sounds simple, problem-solving can be one of the most effective impulse control techniques.

Teach your child that there is more than one way to solve a problem and that it is helpful to evaluate several potential solutions before springing into action. So, whether your child is trying to fix the chain on their bicycle or trying to figure out a math problem, encourage them to brainstorm at least five possible ways to solve a problem before deciding what to do.

After identifying possible solutions, help them evaluate which solution is most likely to be effective. With practice, they can get used to thinking before they act.

Teach Anger Management Skills

Low frustration tolerance may cause impulsive outbursts. Teaching your child anger management skills can help them deal with their emotions in a healthy way.

Show them specific strategies, like taking a few deep breaths or walking around the house to burn off some energy. You can even create a calm-down kit filled with tools that will help them relax. It's best to teach children how to calm down, make more appropriate choices, and/or place them in a calm-down space before impulsively reacting.

Establish Household Rules

Create clear rules and explain the reasons behind your rules. Providing your child with structure and expectations can help improve impulse control because they know what behavior is desired from them. In fact, research shows that kids tend to thrive with the routine and structure offered by family rules.

Make your expectations known before your child enters new situations. When they understand the need to use an indoor voice in the library or walk in the grocery store, they'll be less likely to misbehave.

Explain the negative consequences of breaking the rules ahead of time, as well. Then, they'll be able to make better-informed decisions about their behavior.

Provide Structure and Be Consistent

Keep your discipline consistent and your child's routine the same. Less chaos reduces impulsive behavior.

Offer reminders like, "You need to hold my hand in the parking lot when we get out of the car," every time you go to the store. With enough practice, your child will grow accustomed to your rules and the consequences of breaking them.

Create a Reward System

Kids need opportunities to practice delayed gratification. Make delayed gratification fun by creating a reward system. A token economy system can be a fun way to do this. Reward your child's good behavior with tokens. Then, allow them to exchange tokens for bigger rewards, like a trip to the park.

Create small incentives that only require one or two tokens as well as big rewards, that require 20 tokens. Then, encourage your child to save up their tokens for bigger ticket items, like going to the movies. Saving up for bigger rewards will teach them how to wait, an essential skill that will help them resist temptations that may lead to impulsive choices.

Be a Good Role Model

Your child will learn a lot about impulse control by watching you. Model appropriate ways to wait patiently and tolerate delayed gratification. Point out impulse control techniques that you're using by saying things like, "I'd really like to buy that new laptop but I'm going to save my money for our vacation next summer."

Talking to yourself out loud will teach your child how to develop an internal dialogue that will help them manage their impulses. Researchers at the University of Toronto found that self-talk plays a major role in helping kids manage their impulsive behavior.

Encourage Physical Activity

Encourage your child to play outside and ensure that they get plenty of exercise. A child who has had an opportunity to run, jump, and climb will be better equipped to be more self-disciplined.

Limit your child's screen time and encourage them to be physically active whenever possible. Look for opportunities to play outdoor games together as well. Tossing a ball, playing hopscotch, or playing tag will get direct their energy into positive actions rather than impulsive, inappropriate ones.

Play Impulse Control Games

Games such as Simon Says, Red Light Green Light, and Follow the Leader will give your child opportunities to practice impulse control. And your child will likely enjoy playing them while they learn.

With practice, your child can train their brain to have better self-control. But make sure you make practice fun. If you force them to sit still or pay attention to boring tasks too long, your efforts may backfire.

A Word From Verywell

It's normal for young children to be physically impulsive. Hitting, jumping off furniture, or running in the grocery store are common impulse control problems.

By the tween and teen years, most kids have gained control over their physical impulses but they may still be verbally impulsive. Your child may blurt things out without thinking about how their words may be perceived or may say unkind things when they're angry.

With practice and consistent discipline, impulse control should improve over time. If, however, you have concerns about your child's ability to make healthy decisions or your child seems to be struggling more than other children their age, talk to their pediatrician. Underlying conditions, like ADHD, may interfere with your child's ability to manage impulsive behavior, but treatment can be a big help.

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10 Fun Ways to Help Your Child Gain Better Impulse Control

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Kids can be impulsive by nature. But you can help your child gain self-control by teaching specific impulse control techniques.

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Starfall.com has fun, interactive games and activities for a variety of ages. A portion of the activities are free but, a subscription is required for full use.

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Starfall Education: Kids Games, Movies, Books & Music for K-5 and above

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At Starfall, children have fun while they learn - specializing in reading, phonics & math - educational games, movies, books, songs, and more for children K-5 and above.

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This website offers a wide selection of child oriented, fun learning games and videos.

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Educational games and videos from Curious George, Wild Kratts and other PBS KIDS shows!

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Games, printables, stories, stickers, and apps!

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85% of brain growth occurs in the first three years of life. Babies need to have exposure to many positive, loving words to help develop their communication skills.

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The number of loving words a baby hears in the first three years of life makes a big difference.

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The chart specifies at which age most children typically will have mastered specific speech sounds.

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Speech and Language development resources.

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Speech and Language development resources.

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SoundStart is led by Pathways Health Centre for Children 1240 Murphy Road Sarnia, Ontario N7S 2Y6 Phone: (519) 542-2074

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Early Learning News & Resources

New Guide to Social and Emotional Learning Programs
The Collaborative for Academic, Social, and Emotional Learning released their 2013 publication that identifies well-designed, evidence-based social and emotional learning programs for the pre-K and elementary grades. It's downloadable and free!...READ MORE "

Implementing RTI in Early Childhood Settings
RTI Action Network recently debuted "Implementing Response to Intervention in Early Childhood Settings: National, State, and Program Perspectives." This 80-minute webcast features key experts on the role RTI can play in child development throug...READ MORE "

Early Learning Observation and Rating Scale (ELORS)
Check out this valuable free resource for early childhood classrooms. The Early Learning Observation and Rating Scale (ELORS) is the perfect companion to your early childhood classroom programming. It is designed to assist educators with their obse...READ MORE "

Find Free Children's Books Online
If your child loves to read, visit the International Children's Digital Library website, where you'll find nearly 5,000 books in more than 50 languages, all available for free in a digital, child-friendly format. Search books by language, award...READ MORE "

Transitioning to Kindergarten:
A Toolkit for Early Childhood
Educators Index

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New Guide to Social and Emotional Learning Programs The Collaborative for Academic, Social, and Emotional Learning released their 2013 publication that identifies well-designed, evidence-based social and emotional learning programs for the pre-K and elementary grades. It's downloadable and free!...READ MORE " Implementing RTI in Early Childhood Settings RTI Action Network recently debuted "Implementing Response to Intervention in Early Childhood Settings: National, State, and Program Perspectives."

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This article gives some reasons why a child may bite and some strategies to prevent them from doing so.

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Biting is a typical behavior often seen in infants, toddlers, and 2-year olds. As children mature, gain self-control, and develop problem-solving skills, they usually outgrow this behavior. While not uncommon, biting can be an upsetting and potentially harmful behavior. It's best to discourage it from the very first episode. This article will help you to understand the reasons young children bite and give you some ideas and strategies for responding appropriately.
Why do young children bite?
Some children bite instinctively, because they have not developed self-control. For example, when 3-year-old Marcus grabs a doll from his 2-year-old sister Gina, her first response is to bite him and grab the doll. She doesn't stop to think about other ways to act or the result of her actions. But there are many other reasons why children may bite.
A child might bite to

Relieve pain from teething.

Explore cause and effect ("What happens when I bite?").

Experience the sensation of biting.

Satisfy a need for oral-motor stimulation.

Imitate other children and adults.

Feel strong and in control.

Get attention.

Act in self-defense.

Communicate needs and desires, such as hunger or fatigue.

Communicate or express difficult feelings, such as frustration, anger, confusion, or fear ("There are too many people here and I feel cramped").

What can families do to prevent biting?
There are a variety of things that families can do to prevent biting. It helps to

Have age-appropriate expectations for your child's behavior based on his or her current skills and abilities.

Make sure your child's schedule, routines, and transitions are predictable and consistent. At meal and bedtimes, try to do things in the same way and at the same times. Young children thrive when they know what will happen next.

Offer activities and materials that allow your child to relax and release tension. Some children like yoga or deep breathing. Offer playdough, foam balls, bubbles, soft music, and other stress-reducing items.

Use positive guidance strategies to help your child develop self-control. For example, offer gentle reminders, phrased in a way that tells them what behaviors are expected. "Be sure to hang up your coat on the hook." "You can each have a bucket to use in the sandbox." "Put a small dot of toothpaste on your brush. You won't need much to get your teeth clean."

Provide items to bite, such as teething rings or clean, wet, cold washcloths stored in the refrigerator. This helps children learn what they can bite safely, without hurting anyone else.

How should I respond when my child bites?
While every situation is different, here are some general guidelines for responding when a child bites.

Infants
Infants learn about the world around them by exploring it with their hands, eyes, and mouths. But infants often need help to learn what they should and shouldn't bite.

If your infant takes an experimental bite on a mother's breast or grandpa's shoulder, stay calm and use clear signals to communicate that it is not okay for one person to bite another. A firm "no" or "no biting!" is an appropriate response.

Toddlers and Preschoolers
Toddlers have many strong emotions that they are just learning to manage. Toddlers may bite to express anger or frustration or because they lack the language skills needed to express their feelings.

Biting is less common in preschoolers than toddlers. When a preschooler bites, it may be due to something at home or at their child care program that is causing the child to be upset, frustrated, confused, or afraid. A preschooler may also bite to get attention or to act in self-defense.

Follow the steps below with both toddlers and preschoolers.

1. If you see the biting incident, move quickly to the scene and get down to children's level. Respond to the child who did the biting. In a serious, firm tone make a strong statement: "No biting. Biting hurts. I can't let you hurt Josie or anyone else." Next, offer a choice: "You can help make Josie feel better, or you can sit quietly until I can talk with you." Help the child follow through on the choice if necessary.

2. Respond to the child who was hurt by offering comfort through words and actions: "I'm sorry you are hurting. Let's get some ice." Perform first aid if necessary. The child who did the biting can help comfort the bitten child-if both parties agree. Help the child who was hurt find something to do.

3. Finally, talk to the child who did the biting. Maintain eye contact and speak in simple words using a calm, firm tone of voice. Try to find out what happened that led to the incident. Restate the rule, "Biting is not allowed." Model the use of words that describe feelings: "Kim took your ball. You felt angry. You bit Kim. I can't let you hurt Kim. No biting." Discuss how the child can respond in similar situations in the future.

What if biting becomes a habit for my child?
If biting becomes a habit for your child and ongoing positive guidance is not effective, it is time to set up a meeting with your child's teacher(s). Together, you can plan an approach for addressing the behavior that can be applied consistently at home and at the program. Together, you can discuss and define the behavior and find the cause behind it. Next, you and the teacher(s) can develop a plan to address the causes and help your child to replace biting with acceptable behaviors. Try the plan for several weeks, but be patient. It takes time to change behaviors that have become habits. Keep in touch with your child's teacher(s) to share information about changes in behavior. After several weeks, evaluate the plan's effectiveness and make changes as needed.
What strategies can I use to help my child overcome a habit of biting?
Here are some strategies for addressing a child's biting habit.

Observe your child to learn where, when, and in what situations biting occurs. Sometimes an adult may need to stay close to the child to prevent biting.

Pay attention to signals. Stay close and step in if your child seems ready to bite.

Suggest acceptable ways to express strong feelings. Help your child learn to communicate her wants and needs ("Amy, tell your sister you were still playing with the truck").

Use a reminder system to help your child learn to express strong feelings with appropriate words and actions ("Tell Manuel that you don't like it when he gets that close to you").

Reinforce positive behavior by acknowledging child's appropriate words and actions ("You didn't like being tickled so you used your words to ask me to stop").

Provide opportunities for your child to make choices and feel empowered.

Be sure your behavior expectations are age-appropriate and individually appropriate for your child. Expecting a child to do something he or she is not able to do can cause children to feel stress. Stress can lead to biting.

Offer foods with a variety of textures to meet your child's sensory needs.

Teach your child words for setting limits, such as "no," "stop," or "that's mine."

What strategies are not helpful?
These strategies should not be used to address a child's biting habit.

Avoid labeling a child as a "biter." Negative labels can affect how you view your child, and even affect the child's feelings about him- or herself.

Never bite a child back to punish or show him how it feels to be bitten. Biting a child sends the message that using violence is an acceptable behavior that can be used to solve problems.

Avoid getting angry, yelling, or shaming a child.

Avoid giving too much attention to a child who bites after an incident. While this is usually negative attention, it can still reinforce the behavior and cause a child to repeat it.

Do not force a child who bit and the child who was hurt to play together.

Do not punish children who bite. Punishment does not help children to learn discipline and self-control. Instead, it makes children angry, upset, defiant, and embarrassed. It also undermines the relationship between you and your child.

For further reading
Banks, R., & S. Yi. 2007. "Dealing with Biting Behaviors in Young Children." Clearinghouse on Early Education and Parenting. http://ceep.crc.uiuc.edu/poptopics/biting.html.

The Center on Social and Emotional Foundations for Early Learning (CSEFEL). "Responding to Your Child's Bite." www.vanderbilt.edu/csefel/documents/biting-parenting_tool.pdf.

Crisalli, L. 2008. "All about Biting." Exchange 184: 61-63. http://www.ccie.com/library/5018461.pdf.

University of Maine Center for Community Inclusion and Disability Studies. "Ouch! That hurts! - Biting." (Growing ideas tip sheet). http://umaine.edu/ccids/files/2009/12/biting120309.pdf.

Zero to Three. "Why Do Toddlers Bite? Finding the Right Response." www.zerotothree.org/child-development/challenging-behavior/chew-on-this-resources-on-biting.html.

Source: Adapted from D. Koralek, "Understanding and Responding to Biting," In Classroom Strategies to Promote Children's Social and Emotional Development, 135-138. Lewisville, NC: Kaplan Press, 1999. © 1999 The Devereux Foundation, Villanova, Pennsylvania.

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Understanding and Responding to Children Who Bite

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This article will help you to understand the reasons young children bite and give you some ideas and strategies for responding appropriately.

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This article gives ideas and suggestions for activities geared towards developing self control in young children.

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When asked about school readiness skills, many teachers say children who succeed in kindergarten know when and how to control their impulses. Here are a few ways families can help children learn self-control.

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Communicating with Baby: Tips and Milestones from Birth to Age 5

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As young children grow, their communication skills become more complex. They learn to understand and use language to express their thoughts and feelings and to connect with others.

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This article gives some easy activities to help build fine motor skills in children

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There are lots of activities that can increase muscle strength and coordination, preparing children for more advanced skills, from writing with a pencil, using a computer mouse, or playing a musical instrument.

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PreK age readiness skills and printables

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PreK age readiness skills and printables

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PreKinders: Ideas & Resources for Pre-K & Preschool Teachers

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PreKinders is a resource site for teachers of Pre-K and Preschool with teacher-created activities, lesson ideas, printables, and themes for your classroom.

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This information is from the Center on the Social and Emotional Foundations for Early Learning.

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CSEFEL: Center on the Social and Emotional Foundations for Early Learning

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The National Center for Effective Mental Health Consultation (CEMHC) addresses the needs of Early Head Start/Head Start (E/HS) staff and families for practical guidance on effective ways to promote young childrenís social and emotional development and reduce challenging behaviors.

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Building motor skills in Preschool and PreK age childrenn.

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Building motor skills in Preschool and PreK age childrenn.

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This post contains affiliate links. As an Amazon Associate I earn from qualifying purchases.
Looking for simple gross motor activities you can do indoors? This is the mega list!

I know how the winter goes - whether you're experiencing it now, or you're in the southern hemisphere and looking forward to it in a few months. You need things for your learners to get those wiggles out, or you're going to go a little crazy!

Here's a list to keep on hand! These are perfect for both the home and the early childhood classroom.
1 - Toss bean bags into baskets
Provide laundry baskets. Then get your learners in several rows, and have them take turns tossing bean bags into the target.

2 - Move on paper plates

Buy some colored paper plates. Then get creative! Place them in a row (red, green, red, green) and have students step on just the red ones. Or have them get down on all fours and "skate" with a plate under each hand. Put the plates in a row to get your students moving around the classroom. Put the plates far apart for biiiig steps. Or put them close together for tiny steps.

3 - Learn with a ball toss

If your learners are able to catch a simple toss, put them in a circle. Then think of a way to incorporate learning with a ball toss. For example, you can throw a ball to a student and name a word. Then s/he names a rhyming word and tosses the ball back to you. Toss it to another student with a new word for him/her to rhyme.

4 - Play "f ind and tag it"

This is a versatile game that can be used to review many different skills. Just tell your learners to find something and tag it. For example, "Find and tag something blue." Or "Find and tag something that starts with /s/."

5 - Move like an animal

You'll need some open space, but this is a great way to get kids using new muscles. Here are some ideas:

Move like a bird (run with arms outstretched)

Move like a snake (wiggle on tummies on the floor)

Move like a bear (walk on all fours)

Move like a frog (get down on haunches and hop)

Move like a kangaroo (take big leaps with arms in front of chest)

Move like an elephant (with heavy stomping)

Move like a penguin (waddle with ankles close together and arms pinned to sides)

Need more ideas? Check out 15 animal walks for sensory input, from Lemon Lime Adventures

6 - Have f un with painter's tape

Painter's tape is one of the best inventions ever. It goes on (and comes off) easily - whether you've got a smooth floor or a carpeted one (but be sure to test it first just to be sure). And there's so much you can do with it! Put it on the floor like a ladder. Then have students see how many rungs they can jump. Can they jump farther with a running start?

See how many rungs they can stretch - or how far they can go on one foot. Need more ideas? Check out this post at Hands on As We Grow.

7 - Play indoor hopscotch

I really think painter's tape is the way to go on this one. Create a simple hopscotch board with numbers. Then have students toss a bean bag on a space and jump to get there. Another idea is to use cardboard squares that you can pull out at any time.

Tip: Change the skill that learners review with hopscotch; instead of putting numbers on the squares, consider letters, shapes, or sight words.

8 - Use balloons

Blow up enough balloons for each of your learners (plus extras, because you know you'll need them after the inevitable popping). Have them put a balloon between their knees and walk like a penguin. Or they can toss the balloon and catch it so that it never hits the floor.

Can they balance the balloon on a part of their body (like an outstretched arm) and walk a few steps - or across the room?

9 - Alphabet action cards

Print our free alphabet action cards - then get active while reviewing the alphabet one letter at a time.

10 - Copy me!

This is where you can get in your workout for the day. Simply do a series of exercises or silly actions, and have your students copy you. Jump like a kangaroo. Scratch like a monkey. Run in a place. (Whatever it takes to get that heart rate up!)

11 - Create a wiggle jar

Print action cards and place them in jar. When your students need a movement break, pull a few cards for everyone to do. Here are some ideas for a preschool wiggle jar:

Jog in place while you sing the alphabet.

Touch the sky and then your feet five times in a row.

Pretend you're playing the drums.

Fly around the room like a bird.

For wiggle jar ideas, visit Homeschool Share.

12 - Tape balance beam

This is ultra simple, but surprisingly fun! Grab several rolls of colorful painter's tape, and set it on the floor in different lines; make the lines zigzag, curvy, straight, or shaped like a circle, square, or other shape.Then challenge your learners to walk each colored line from beginning to end.

13 - Dance like this

If your learners like to dance, put on some music - but give them instructions to dance a particular way. They can dance slow, fast, in a circle, silly, etc.

14 - Roll and move

Grab a large soft die (like this one), and write a list of simple exercises on cards. Have one learner draw a card, and another roll the die. The die tells you how many times to do the exercise. Here are some ideas for the exercise cards:

Touch your toes

Do arm circles

Run across the room

Hop on one foot

Jump forward

Take big steps

Take tiny steps

15 - Be an athlete

Have your learners pretend to do one of these sports. Think of it as heart-pumping charades!

16 - Be the weather

Children can use their bodies to be different kinds of weather, such as:

17 - Learning scavenger hunt

Write things your students are learning on sticky notes - they may be letters, numbers, shapes, sight words, etc. Put the sticky notes in various places around the room (some hidden and some obvious), and see how many your learners can find and identify.

18 - Sing active songs

Sing one of these classic songs, and add some actions!

I'm a Little Teapot

If You're Happy and You Know It

The Hokey Pokey

Ring around the Rosie

Head, Shoulders, Knees, and Toes

Teddy Bear, Teddy Bear, Turn Around

Here We Go 'Round the Mulberry Bush

19 - Do alphabet yoga

If you have nap mats or towels, pull them out and challenge your learners to do a yoga pose for various letters of the alphabet.

A - Airplane (hold still and move arms to the side)
B - Bicycle (lie on your back and pedal your feet)
C - Cat pose (get on all fours; then round your back while tucking in your chin; release)

For a list of yoga poses from A-Z (and how to do them!) visit Pink Oatmeal.

And for even more gross motor ideas, check out 3 Dinosaurs' gross motor printable list.

We hope this list gets your learners moving and saves your sanity at the same time!

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Indoor gross motor activities for preschool and kindergarten - The Measured Mom

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It's hard to know what to do with active kids on a rainy day! Thankfully, this post has a huge variety of indoor gross motor activities for preschool and kindergarten. No more crazies! #grossmotor #preschool #kindergarten #rainyday #largemotor

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These movement exercises help with focus and skill development.

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10 Must Do Brain Gym Exercises for Children

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You can boost your child’s cognitive skills with a few exercises. Read further to know the brain gym exercises that young child must do for mental growth.

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This article explains what Sensory Processing Disorder is and has a checklist indicating red flags for possible concern.

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"Parents are the adults in the best position to know when their child has a sensory problem but, too often, their observations are discounted because they are 'just the parents.' If the family's health care provider isn't familiar with SPD, the clues that triggered the parents' alarm may be overlooked, misinterpreted, or dismissed.

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FDLRS NEFEC Child Find Screening Registration

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FDLRS NEFEC Child Find Screening Registration

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Have daily simple, brain building tips for your child sent to your phone.

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Science-backed early learning for children from birth to age 5.

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Vroom helps you add science-backed early learning moments to mealtime, bathtime, bedtime or anytime. By helping your child learn now, you get them ready for school, friends and life.

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Are you concerned that your child may have difficulty with sensory processing? This article provides helpful information on what a sensory processing disorder looks like and suggestions for addressing the concerns.

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About the Author

Amanda Morin is a parent advocate, a former teacher and the author of The Everything Parent's Guide to Special Education.

Reviewed by

Vanessa Pastore, M.A., OTR/L, is a pediatric occupational therapist who specializes in sensory integration. She has a private clinic in New York City.

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I'm Concerned My Child Might Have Sensory Processing Issues. Now What?

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About the Author Amanda Morin is a parent advocate, a former teacher and the author of The Everything Parent's Guide to Special Education. Reviewed by Vanessa Pastore, M.A., OTR/L, is a pediatric occupational therapist who specializes in sensory integration. She has a private clinic in New York City.

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TATS.UCF.EDU website resources

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TATS.UCF.EDU website Resources

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This website provides information on developing fine motor skills in fun, creative ways.

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Published: · Modified: by · This post contains affiliate links.

It's no secret that fine motor development plays an important role in a child's development and success at school. When I was teaching Preschool and Kindergarten, I saw many kids who had weak fine motor skills. I created a variety of fine motor skills activities to use in the classroom for students of all skill levels, as everyone can use a little help. Many parents wanted to work on fine motor skills at home too and they often asked me for ideas. The cheap fine motor activities for preschoolers that I will be sharing today will help kids strengthen their skills while incorporating learning from various parts of the curriculum. I just love sneaking in some learning wherever I can, don't you?

Jump to:

Why are fine motor skills important?

Fine motor skills are important for young children and they affect everything from self feeding to using scissors to writing with pencils. As children grow, there will be a greater demand placed on their motor skill development. They will be expected to dress themselves and use zippers and buttons. Drawing and writing will be easier if your child has strong fine motor skills.

What items are helpful for practicing fine motor skills for preschoolers?

Stickers

Tweezers - pinching these and picking up objects with them is a great activity.

Pipettes or droppers - use these to draw up and release water in a cup.

Ice cube tray - for sorting

Lego toys - helps to work the pincer grasp while kids are pulling them apart.

Lacing cards - they are great to keep in a car for road trip or to take to a restaurant.

Paper clips - attach them and take them apart.

Fine motor skills activities for 3-5 year olds
Please supervise children while they are doing these activities.

I just love easy fine motor activities! This one requires 2 supplies and is pretty easy to take anywhere. It really works on those small muscles! You can find the cheese shakers here.
Fine Motor Work with Golf Tees
This fine motor exercise will help kids to gain hand strength as they push golf tees into foam. Even a toddler can do it! We use these golf tees for lots of activities.

In addition to fine motor practice, you can use this activity with pom poms to help with color recognition. These tongs are a great size for kids and you will use them again and again.
Play Dough and Beads
What kid doesn't love play dough? Take advantage of that by adding some beads for fine motor practice. Try making this oatmeal play dough recipe with kids. It works great for this activity.
Patterned Bead Snakes
Stringing beads on a pipe cleaner is a great way to work on fine motor skills. Add some fun by creating a snake. You can also use this as a way to teach colors and patterns.
Fruit Loop Towers
Raid your pantry for this yummy activity that will have kids reaching and grasping for more. When you are done, you can make this cereal rainbow craft with the leftover cheerios.
Making Straw Jewelry
Fun for little fingers! This is another activity that my preschoolers and toddler both enjoyed. When they are done threading the straws on to the pipe cleaners, they will have colorful pasta jewelry to wear and incorporate into pretend play.
Woven Paper Place mats
Small hand muscles get quite the workout as they weave paper under and over to create a pretty place mat. You can laminate these when they are done and use them for meals.
Fine Motor Work with A Colander
Love this new use for a strainer or colander! In addition to being a great fine motor activity, this unleashes imagination and keeps kids busy. Win!
You Can Count on Me
Math combined with fine motor work? Count me in (pun very much intended)! This is another one of those activities that just use a few items you probably already have.
Fine Motor Skills for Preschoolers Pasta Play
Fine motor skills for preschoolers are so important. Here is a fun game you can make using dyed pasta. Directions to dye pasta included.

Color Drop Game
You can make this game yourself and it helps kids learn their colors in addition to fine motor skills.This is a great activity for developing hand-eye coordination.

Find out how to make dyed q-tips and use them for a fine motor color matching activity like placing them in clay.
Fine Motor Skills Activity with Dyed Oatmeal Marshmallow Sculptures Counting Bead Fun Fine Motor Skills Water Art

Related posts

More Fine Motor Skills Activities

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18 Fine Motor Activities for Preschoolers - Mess for Less

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18 Fine Motor Activities for Preschoolers. Love how lots of these ideas use stuff you already have around the house.

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This website provides information on developing fine motor skills in fun, creative ways.

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Here are ideas for improving fine motor skills in Pre-K/ Preschool children. Find additional fine motor activities here.

Find more fine motor ideas on the Fine Motor Skills Resource Page

Fine Motor Skills is one of the main areas I sought to improve in my Pre-K classroom this past year (2008-09). I think fine motor is an area which is often overlooked, yet it is so important. Fine motor skills are the foundation children need before they learn handwriting, in order to have proper pencil grasp and control of a writing instrument.

My goals were to increase the fine motor materials available in our classroom environment, and to plan activities and materials that are interesting and fun so that children would be motivated to use them and would choose them during their free choice time. Most of these activities use "found materials" that can be borrowed, donated, or purchased inexpensively, rather than commercially produced and sold in an educational catalog. Below are several of the fine motor skills activities my class did this year. A few of these ideas were borrowed from Montessori (and I've noted those below).

Water Drops with Suction Cups

The little suction cups on the bottom of these bathtub shapes become mini bowls when turned upside down and used in this activity. (These were purchased at the Dollar Tree.) Children use a finger grasp to squeeze one drop of colored water into each little bowl on the dish. [Idea borrowed from Montessori]

Beads with Suction Cups

These are the same bathtub shapes as in the above activity. Children use their thumb and forefinger to grasp each little bead and place it on a bowl on the shape. The beads are pony beads purchased from a craft store. [Idea borrowed from Montessori]

Clothesline

Children use their fine motor muscles to squeeze the clothespins to clip each piece of clothing to the clothesline. I tied a piece of thick string to the handles of a wooden tray to make the clothesline, and used mini clothespins (although the regular sized clothespins can be used as well). The clothes are Barbie doll clothes purchased at a dollar store. As an alternative, you could cut out shapes of shirts and pants from felt.

Clothespins on a Box

Children squeeze the clothespins and clip them to the sides of the box. To make the activity more interesting, I wrote letters on dot stickers and placed the dot stickers around the sides of the boxes. I wrote letters on the clothespins so the children would match the letters on the clothespins to the letters on the boxes. Other skills could be used, e.g. colors, numbers, beginning sounds. This is similar to activities where children clip clothespins to a paper plate or cardstock circle; however, in my experience, those were flimsy and awkward to use, which is why I like the box better. Any sturdy box could be used (shoe box, postal box). The boxes in this picture were stacking gift boxes that held chocolate covered nuts (a Christmas gift), and they worked out perfectly.

Nuts & Bolts

These larger nuts and bolts can be purchased individually at hardware stores. The cost is usually no more than $0.40 to $0.50 each. Children use their fingers, hands, and wrists, coordinating both hands while grasping and twisting the metal nuts onto the bolts.

Sewing/Lacing Cards

These can be purchased or made with poster board and a hole puncher. Use shoe laces or plastic lacing. Tie one end of the lace to one hole of the card. Children lace the string through each hole. These can be made to match different themes or holidays.

Plate Sewing

Tie lengths of yarn to plastic yarn needles, and knot the end. Children "sew" the yarn on a styrofoam plate by pushing the needle in and out through the plate.

Stringing Cut Straws

Cut plastic drinking straws into small pieces, about 1-inch. (Cutting the straws is another great fine motor activity for kids.) Tie yarn to a plastic needle, or use plastic laces, and knot the end. Children string the straws onto the yarn or lace.

Stringing Beads

Children string pony beads onto pipe cleaners.

Bean Gluing

Children draw a simple picture on a piece of construction paper with a pencil. They trace the pencil lines with glue and glue the beans onto the design. Gripping the beans with their fingers is good fine motor practice.

Seeds and Tweezers

Children pick up different types of seeds with tweezers and sort them by type into the cups.

Unifix Cubes or Interlock Cubes

Children push the cubes with their hands to hook them together. Unifix cubes connect on one end and can make a long "train". Interlock Cubes connect on different sides and can make different things, for example the dogs the children were making in the photo.

Mosaic

In advance, cut construction paper into 1-inch long strips. Children "snip" the strips into smaller pieces and glue them onto their paper to make a mosaic. This activity is great for children who are not yet skilled with scissors, but need cutting practice because they can snip the paper with one cut.

Eyedropper Art

Children use eyedroppers to drop liquid watercolor onto a coffee filter or paper towel. (I use Colorations Liquid Watercolor from Discount School Supply.) If liquid watercolor is not available, you can color water with food color. Also see my blog post for adapting this activity for holidays or themes.

Paper Clips

The children in my class are always wanting to use paper clips because they see me use them, so I set up this activity in the fine motor center. I cut squares of colored construction paper and placed them on the tray along with colored paper clips. Children stack the papers (all of the same color) and clip them with the matching colored paper clip. This was challenging for some children to manipulate the paper clip, but they loved doing it, and it gave them an opportunity to use paper clips with permission.

Dot to Dot

I printed out the Geoboard Dot Paper from the Math Their Way website for this activity (I used the size on the second page). I added Pip Squeak markers, which are great for young children because they are short. Children draw lines with the markers to connect the dots on the paper.

Toothpick Punch

To do this activity, cut squares of construction paper (I cut mine 6×6 inches). Draw a numeral, letter, or simple shape with a Sharpie. I placed a stack of these papers in the fine motor center, along with toothpicks and a carpet square. Children place the paper on the carpet square and use the toothpick to punch holes all along the black lines. When they are done, they can hold their paper up to the light and see the light shining through the holes. Kids enjoy it and it's great fine motor practice!

Pinching Sand

Sand art is a great fine motor activity because children can pinch the sand with their fingers to apply it to their art work. Provide a simple outline (or have the children draw one), a small bowl of white glue, a small bowl of colored sand, and a "glue brush". I buy the cheap paintbrushes with stiff bristles that are sold in a package for $1 at dollar stores. These brushes are not a good enough quality for painting, but they make great glue brushes. Children paint the glue on their paper with the brush, pinch some sand with their fingers, and sprinkle it over the glue. Place a pan, tray, or paper plate on the table for children to shake off the excess sand.

Insect Wrapping

Children wrap the plastic insects with pieces of white yarn ("spider webs"). When they are finished wrapping all of the insects, they unwrap them and place the yarn back in the bowl. We do this activity during a study of bugs and spiders.

Birds Eating Worms

Cut pipe cleaners into smaller pieces and shape them to make several "worms". Place the worms on a brown carpet square (this represents the dirt). Children use a clothespin as a bird beak and catch the worms with their beak. As they catch worms, they place them in a basket until all of the worms have been collected.

Marbles and Melon Scoops

Children scoop the marbles with melon scoops and place them in the ice cube tray. This ice cube tray was found at a kitchen discount store. Also posted at Fine Motor in the Sensory Table. See my blog post for a Halloween adaption to this activity.

Pouring

Children pour something from one bottle to another. I started out having them pour popcorn seeds. They can later try pouring sand, and then water.

Color Mixing

Children mix primary-colored water to make secondary colors. The bucket in the middle is for dumping the water when finished, or to start over. Also posted on the Sensory Table page.

Knobbed Puzzles

Children exercise the fingers used for a pencil grasp when picking up puzzle pieces that have knobs or pegs.

Legos

A bit obvious, but should not be forgotten.

Play Dough

An old stand-by. Also see my webpage for more play dough activities.

Peg Boards

Another old stand-by.

Additional Fine Motor Posts

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Here are ideas for improving fine motor skills in Pre-K/ Preschool children. Find additional fine motor activities here. Find more fine motor ideas on the

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TATS.UCF.EDU website information and resources

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Addressing Communication in the Classroom - correlations to BDI-2NU and FELDS
Links below: Using Augmentative and Alternative Communication (AAC) in PreK classrooms and Resources for Core Vocabulary

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"Rock Your Classroom" - Focus on Communication and Language

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Addressing Communication in the Classroom - correlations to BDI-2NU and FELDS Links below: Using Augmentative and Alternative Communication (AAC) in PreK classrooms and Resources for Core Vocabulary

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This website has well known individuals reading popular children's books.

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The SAG-AFTRA Foundation's Daytime Emmy-nominated, Storyline Online, features celebrated actors reading children's books to inspire a love of reading in millions of children worldwide.

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This site has information about getting your child ready to enter Kindergarten. It includes an interactive book to read to your child.

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The following materials were created by the Ready Freddy Team for parents and children to use at home.

Listen to and download the songs that appear on the inside cover of the Ready Freddy Activity Calendar.

Follow Freddy as he gets ready for his first day of school!

Take a look at some of Freddy's favorite books about getting ready for kindergarten!

Parents know their child best. This worksheet helps parents introduce important information to their child's new teacher.

This child/parent activity helps introduce a child to the teacher from the child's perspective. Pages can be filled with drawings or text, depending on the skill level and interest of the child. Parents should help talk through and think about pages, but what is on the page should be the child's work (not done by the parent's hand).

Additional Resources

Pennsylvania's Promise for Children offers a free resource to help your child learn and build skills. To access, click on the link above to create a personal map for your child. Your child's information will remain confidential. As you answer questions, you can save tips and resources to your child's map. You can also follow your child's milestones, save activities to build your child's skills, and compare child care/early learning programs.

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The following materials were created by the Ready Freddy Team for parents and children to use at home. Listen to and download the songs that appear on the inside cover of the Ready Freddy Activity Calendar. Follow Freddy as he gets ready for his first day of school!

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Ideas to help teach Self-Regulation to children.

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Ideas to help teach Self-Regulation to children.

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How can you support the development of self-regulation in your child? Check out some of our best activities and ideas here!
*This post contains affiliate links. Read more.
What is Self-Regulation?

When we talk about self-regulation in kids, we're referring to the ability to maintain an arousal level that is appropriate for any given situation. Self-regulation also involves having the ability to generate appropriate behavioral and sensory responses to the input in different situations and daily routines and the ability to demonstrate self control: to monitor and control behavior, attention, motor output, emotions, and social interactions.

Self-regulation skills might include a child maintaining his composure and problem-solving or asking a caregiver for help or guidance when another child takes his toy or being able to self-monitor, control their impulses, and keep their voice quiet in the library. Self regulation in the classroom or school might include a child being able to attend and stay at his desk while the classroom teacher is talking or being able to stay with his class and walk in line in the hallway.

It sounds like a lot, doesn't it? That's because self-regulation is extremely complex. It involves cognition, the sensory systems, behavior...and so much more! Many children struggle with one or more of these areas, making self-regulation challenging. Children who are autistic, who have ADHD, or who need more sensory processing supports may struggle with self-regulation skills more than other kids. Toddlers and kids in the preschool years are still actively developing the ability to regulate themselves and may demonstrate outbursts and tantrums as part of typical development. But all of us - adults and children alike - can have difficulty with managing our own emotions and behaviors when faced with basic daily stressors like tiredness or hunger.

The Self-Regulation Handbook

Here at The Inspired Treehouse, we're so passionate about the topic of Self-Regulation that we finally decided to write a book about it! The Self-Regulation Handbook is an ebook that's packed with tools, activities, strategies, and information that are perfect for supporting self-regulation in kids at home, in the classroom, or during therapy sessions. Click here to learn more!

How Can You Tell if Your Child is Struggling With Self-Regulation?

Recognizing when kids have self-regulation concerns involves recognizing different patterns of behavior. Kids who are having difficulty with self-regulation may:

-Act overly silly or "out of control"

-Have tantrums or meltdowns

-Struggle with transitions between activities

-Have difficulty waiting or taking turns

-Struggle with being in close proximity to others (e.g. circle time)

-Demonstrate problems and frustration during social interactions (e.g. talking too loud, standing too close, touching others)

-Have difficulty walking or waiting in line

-Move too quickly or with too much force

-Grab or touch objects impulsively

How to Help Kids Develop Self-Regulation

Even though self-regulation can be a challenging skill for many children, research has shown that games and fun activities can be effective in promoting better self-regulation and for children who are struggling.

It is also so important for kids to have caregivers who are able to maintain perspective, coach them through difficult situations, demonstrate empathy when kids are struggling with self-regulation, and form responsive relationships that foster kids' self-regulation capacities and self-esteem.

Games and therapy tools that support planning and problem solving, patience, memory, attention, motor control, and sequencing can help kids develop the ability to self-regulate despite challenging situations and circumstances. Calming techniques, self-awareness exercises, and mindfulness activities can also be effective in supporting the development of self-regulation.

The following 30 games and activities can be great ways to introduce self regulation strategies with kids!

Games and Activities for Self-Regulation

The following 30 games and activities can be great ways to introduce and practice self-regulation skills with kids and can even be used as self-regulation interventions during therapy sessions. Click on the linked titles for more information!

1 || Red Light, Green Light

Spice it up with these fun light buzzers! And be sure to check out our post about variations on this classic game to promote self control in kids!

2 || Simon Says

Try this Simon Says parachute game for a different twist on this old classic.

This fun obstacle course for kids is a great way to encourage teamwork and social skills while also working on gross motor skills like balance and coordination!

4 || Duck Duck Goose

A great old classic for working on social interactions, waiting, and more!

5 || Freeze tag

This is an awesome one for working on self-regulation because kids have to wait perfectly still until their friends come to "unfreeze" them.

Cooperative art activities for kids like Partner Painting are perfect for getting little ones to work together while also targeting visual motor and fine motor skills.

7 || Hide and seek

Can kids wait quietly in their hiding spots while their friends try to find them?

Group games for kids like Wacky Relay are a great way to focus on social skills, teamwork, and gross motor skills!

Freeze Dance is so perfect to use in the classroom or at home to practice regulating movements and behavior.

10 || Musical Chairs

We love this idea for working with kids on coping when it's their turn to be "out". It can be a big challenge, but a good way to practice.

The Mirror Mirror game can be as simple, or as challenging as you make it and is a super fun way to address controlled movements and attention.

Working together on controlling the parachute to play different games is awesome for working on self-regulation. Grab our favorite parachute here!

13 || "Counting Down" or Anticipation Activities

Try setting out a beanbag chair and helping the child wait by counting down - "3...2...1...JUMP!" and then jumping onto the bean bag chair. And then repeating the activity so the child knows to wait before jumping)

Bilateral coordination, memory and cognitive skills, and cooperative play are all packed into these fun hand clapping songs and games - and they'll also take you for a little stroll down memory lane!

Hedbanz is another fun game for working on self-regulation because kids have to resist the urge to yell out the picture on their friends' headbands!

16 || Dancing

Kids love practicing their favorite fast and slow dance moves to different types of music - great for regulating speed of movements.

Suspend game is a great fine motor challenge and also challenges kids to regulate the force of their movements.

18 || Balloon volleyball

When kids play balloon volleyball, they have to learn how to slow their movements down in order to control the balloon and not let it go flying!

Slow, careful movements are the name of the game in Jenga and you can modify the blocks to include fun questions and other prompts to boost social interaction.

We like the simple game of Operation for working with kids on coping with turn taking when they hit the buzzer on the pretend patient.

Simon is great way to work on visual attention and memory, this old game is a great one for your classroom or therapy bag.

22 || Sequencing Motor Tasks

For example - do 3 jumps, then 2 hops, then stand on one foot for 3 seconds)

Like Simon, Bop It is great for working on memory, but also includes an auditory processing challenge and an opportunity to learn how to remain calm when kids make a mistake.

Spot It is a perfect game for addressing visual processing skills and also offers kids a chance to cope with "losing" because the rounds go fairly quickly so they can get back "in the game".

These calming deep breathing techniques for kids are great strategies for supporting self-regulation and calm behavior at home, in the classroom, and beyond! Grab the free printable breathing cards too!

These 10 meditation resources are the perfect place to start if you want to try mindfulness activities and guided meditation for kids!

Mindful movement and mindful breathing are a great combination for supporting self-regulation. Try some yoga for kids in your classroom or during your next therapy session!

One of the most popular curriculums on the market for working on self-regulation, Zones of Regulation offers visual supports and practical activities for working on the skills kids need most to regulate themselves.

You'll want these calming techniques in your toolbox for addressing behaviors in the classroom setting.

And these awesome ideas are perfect for taking out into the community to practice self-regulation on the go!

Other Resources About Self-Regulation

1 || Developing Young Children's Self-Regulation Through Everyday Experiences, National Association for the Education of Young Children. Ida Rose Florez

2 || Self-Regulation: A Cornerstone of Early Childhood Development. Linda Groves Gillespie and Nancy L. Seibel. National Association for the Education of Young Children.

3 || Executive Function & Self-Regulation. Center on the Developing Child, Harvard University.

4 || How Can We Help Kids With Self-Regulation? Child Mind Institute.

5 || Strategies for Teaching Kids Self-Regulation. PBS.
6 || Self-Regulation Research: A Simple Overview
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How to Help Kids With Self-Regulation: 30 Games and Activities - The Inspired Treehouse

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How can you support the development of self-regulation in kids? This huge resource is full of self-regulation games, information, books, and more!

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As toddlers and preschoolers become increasingly verbal, they may begin to stumble over their words-raising concerns about stuttering. As a parent, how do you know when disfluencies are a normal part of development and when to be more concerned? Read on.

What are Typical Disfluencies?

It is not uncommon for young children to have disfluencies in their speech (e.g., word or phrase repetitions). In fact, about 5% of all children are likely to be disfluent at some point in their development, usually between ages 2 ½ and 5. It is also very typical for a child to go back and forth between periods of fluency and disfluency. Sometimes, this can occur for no apparent reason, but often this happens when a child is excited, tired, or feels rushed to speak.

Learning language rules:

During this time, children are expanding their vocabularies rapidly and learning complex language rules. These rules allow children to change simple messages ("Mommy juice") into longer, more complicated sentences that require more motor coordination to produce smoothly ("Mommy put the juice in the blue cup"). It's only natural that there may be some disruptions along the way.

Is It Truly Stuttering?

For most toddlers and preschoolers, most disfluencies go away on their own after a short period of time. In other cases, disfluencies persist and the signs of stuttering become more obvious. Getting professional help early offers the best chances for reducing stuttering. But how can parents tell the difference between typical disfluency that will go away and the early signs of non-typical disfluencies that may indicate stuttering?

Here are some ways to differentiate typical disfluency from stuttering:

​

If your child is truly stuttering, he or she may hold out the first sound in a word, saying "Ssssssssometimes we stay home," or repeat the sound, as in "Look at the b-b-b-baby!" In addition, children who stutter often develop other mannerisms such as eye blinking, tense mouth, looking to the side, and avoiding eye contact.

Risk Factors for Stuttering:

There are other risk factors that can help predict whether fluency problems will continue for longer than a few months.

Family history is the biggest predictor of whether a child is likely to stutter.

Gender. Young boys are twice as likely as young girls to stutter, and elementary school-age boys are 3 to 4 times more likely to stutter than girls.

Age of onset. Children that start having difficulties at age 4 are more likely to have a persistent stutter than those who begin stuttering at a younger age.

Co-existing speech and/or language disorders increase the likelihood a child may stutter.

Getting Help:

If you are concerned about your child's speech, talk with your pediatrician about getting a speech and language evaluation. A complete evaluation from a certified speech-language pathologist can help you to better determine if the stuttering is likely to persist.

Speech-language pathologists will help parents determine the best course of action (e.g., closely monitoring the child's fluency, enrolling in treatment services, and/or parent education). The American Speech-Language-Hearing Association (ASHA) offers a searchable database of these professionals. In addition, a list of clinicians who specialize in stuttering can be found here.

Treatment Approaches for Stuttering:

Early treatment for stuttering is very important, as it is more likely to be eliminated when a child is young (before entering elementary school). There are two main treatment approaches for stuttering:

Indirect treatment is when the speech-language pathologist helps the child's parents on how to modify their own communication styles. Indirect approaches are effective at reducing or even eliminating stuttering in many young children.

Direct treatment involves the speech-language pathologist working with the children themselves either one-on-one or in small groups, giving them specific speech strategies for easing into words and reducing tension during stuttering events. In addition, direct treatment may involve helping the child to differentiate between smooth (fluent) and bumpy (stuttered) speech.

After age 7, it becomes unlikely that stuttering will go away completely. Still, after age 7, treatment can be very effective at helping a child effectively manage stuttering-helping develop skills necessary to handle difficult situations (e.g., teasing and bullying) and participate fully in school and activities. For older children, speech treatment is still beneficial, encouraged, and effective in helping to reduce the severity and impact of stuttering.​

What Parents Can Do:

Here are some ways parents can help:

Reduce communication stress. There are different techniques to put less pressure on a child in a speaking situation. Rephrasing questions as comments (using " You played outside today at school. It must have been fun!" instead of "What did you do at school?") is one effective approach. Parents can also do their best to reduce situations that trigger their child's stuttering.

Talk about it. When children are aware of their stuttering, it is best to be open and talk about it in a positive way. Let them know it is okay to have "bumpy speech." If a child does not seem to be aware of the problem, there is no need to bring it up until you are seeing a speech-language pathologist.

Practice patience. Give children time to finish what they are saying. Don't rush or interrupt them. Don't tell them to "slow down" or "think about what you want to say." Phrases such as those are generally not helpful to children who stutter.

Model good speech habits. While telling a child how to talk is generally not helpful, parents can model speech habits that help with stuttering, such as slowing down their own speed when they talk, putting in more pauses between sentences, and speaking in a relaxed manner.

Seek a professional. There are many ways to find a speech-language pathologist. A child's pediatrician can provide a recommendation. Children younger than 3 can receive a free evaluation through their local Early Intervention Program. If a child is older than 3, parents can contact their local public school for a free evaluation. Parents also have the option to seek out a private speech-language pathologist with a child at any age. A searchable database of these professionals is available here. A list of stuttering specialists is available here. ​

Follow Your Instincts:

If you continue to have concerns about your child's speech, ask for a reevaluation or referral for additional formal testing.

Additional Information & Resources:

Copyright © 2015 American Academy of Pediatrics and American Speech-Language-Hearing Association

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stutter~ stuttering~ preschool language~ stumble over words~ toddler language~ trouble talking~ getting words out~ stumble over words~ speech development~ slp~ speech therapist~ disfluency~ disfluencies in children's speech~ is it stuttering~ genetics

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Stuttering in Toddlers & Preschoolers: What's Typical, What's Not?

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As toddlers and preschoolers become increasingly verbal, they may begin to stumble over their words-raising concerns about stuttering. As a parent, how do you know when disfluencies are a normal part of development and when to be more concerned? Read on. It is not uncommon for young children to have disfluencies in their speech (e.g., word or phrase repetitions).

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Strategies to Help With Sensory Processing at Home

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Strategies to Help With Sensory Processing at Home

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When your child has sensory processing issues, it can affect every part of his life-and yours. But there are ways you can help your child cope. Here are strategies that may help with different kinds of sensory experiences.

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Sensory Processing Issues: Strategies You Can Try at Home

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When your child has sensory processing issues, it can affect every part of his life-and yours. But there are ways you can help your child cope. Here are strategies that may help with different kinds of sensory experiences.

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This website has information as well as activities for parents and children.

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Do2Learn began in 1996 through a National Institutes of Health Small Business Innovative Research grant. Our team searches out the most talented and creative teachers and clinicians across the world. These gifted individuals work with our technical experts to transfer their knowledge into formats that we can make available to you.
Since beginning, we have grown into a world-wide resource with over 11 million hits a month. While based in North Carolina, approximately half of our users are from outside of the U.S. Thousands of sites link to us and we can be easily found on most search engines using topics such as 'picture cards', 'facial expressions', and 'job tips'. We hope you find our resources helpful and pass on our link to others.
We believe that simply telling busy teachers, parents, and professionals what they should be doing is not enough. If we explain how to devise a visual communication system using picture cards, we provide free cards to get you started.

When we present the Teacher Toolbox on how to adapt a classroom for children with special needs, we provide resources for behavior management plans, literacy tools, and the materials to create everything in your classroom.

Our approach is to use the latest technology and expert guidance to create innovative and usable solutions.

Learn about DiagnoseFirst, our newest project to help teachers and clinicians recognize the symptoms of ASD.

Pre-employment screening assessments are online or paper tests that some companies require applicants to complete during the application process. Read more about JobTIPS Student Version!

JobTIPS Toolbox PRO is filled with resources to help you coach your students through the challenges of assessing their skills, finding and applying for jobs, and practicing the social skills needed to do well in the workplace.

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picture exchange communication system cards

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Do2Learn: Educational Resources for Special Needs

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Do2Learn began in 1996 through a National Institutes of Health Small Business Innovative Research grant. Our team searches out the most talented and creative teachers and clinicians across the world. These gifted individuals work with our technical experts to transfer their knowledge into formats that we can make available to you.

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TATS has put together a wonderful collection of fun activities you can do with your child this summer.

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Information from TATS on development of math concepts

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Does your preschooler talk at home but won't talk in school or other social settings?

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Selective Mutism Anxiety & Related Disorders Treatment Center | SMart Center

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Selective Mutism - A Comprehensive Overview

PH: (215) 887-5748 | E: SMartCenter@SelectiveMutismCenter.org

Selective Mutism is a complex childhood anxiety disorder characterized by a child's inability to speak and communicate effectively in select social settings, such as school. These children are able to speak and communicate in settings where they are comfortable, secure, and relaxed.

More than 90% of children with Selective Mutism also have social phobia or social anxiety. This disorder is quite debilitating and painful to the child. Children and adolescents with Selective Mutism have an actual FEAR of speaking and of social interactions where there is an expectation to speak and communicate. Many children with Selective Mutism have great difficulty responding or initiating communication in a nonverbal manner; therefore, social engagement may be compromised in many children when confronted by others or in an overwhelming setting where they sense a feeling of expectation.

Not all children manifest their anxiety in the same way. Some may be completely mute and unable to speak or communicate to anyone in a social setting, others may be able to speak to a select few or perhaps whisper. Some children may stand motionless with fear as they are confronted with specific social settings. They may freeze, be expressionless, unemotional and may be socially isolated. Less severely affected children may look relaxed and carefree, and are able to socialize with one or a few children but are unable to speak and effectively communicate to teachers or most/all peers.

When compared to the typically shy and timid child, most children with Selective Mutism are at the extreme end of the spectrum for timidity and shyness.

Why does a child develop Selective Mutism?
The majority of children with Selective Mutism have a genetic predisposition to anxiety. In other words, they have inherited a tendency to be anxious from one or more family members. Very often, these children show signs of severe anxiety, such as separation anxiety, frequent tantrums and crying, moodiness, inflexibility, sleep problems, and extreme shyness from infancy on.

Children with Selective Mutism often have severely inhibited temperaments. Studies show that individuals with inhibited temperaments are more prone to anxiety than those without shy temperaments. Most, if not all, of the distinctive behavioral characteristics that children with Selective Mutism portray can be explained by the studied hypothesis that children with inhibited temperaments have a decreased threshold of excitability in the almond-shaped area of the brain called the amygdala. When confronted with a fearful scenario, the amygdala receives signals of potential danger (from the sympathetic nervous system) and begins to set off a series of reactions that will help individuals protect themselves. In the case of children with Selective Mutism, the fearful scenarios are social settings such as birthday parties, school, family gatherings, routine errands, etc.

Some children with Selective Mutism have Sensory Processing Disorder (DSI) which means they have trouble processing specific sensory information. They may be sensitive to sounds, lights, touch, taste and smells. Some children have difficulty modulating sensory input which may affect their emotional responses. DSI may cause a child to misinterpret environmental and social cues. This can lead to inflexibility, frustration and anxiety. The anxiety experienced may cause a child to shut down, avoid and withdraw from a situation, or it may cause him/her to act out, have tantrums and manifest negative behaviors.

Some children (20-30%) with Selective Mutism have subtle speech and/or language abnormalities such as receptive and/or expressive language abnormalities and language delays. Others may have subtle learning disabilities including auditory processing disorder. In most of these cases, the children have inhibited temperaments (prone to shyness and anxiety). The added stress of the speech/language disorder, learning disability, or processing disorder may cause the child to feel that much more anxious and insecure or uncomfortable in situations where there is an expectation to speak.

More studies are necessary to fully assess speech/language abnormalities and Selective Mutism as well as processing disorders and Selective Mutism. It is important to note that there are many children with Selective Mutism who are early speakers without any speech delays/disorders or processing disorders.

Research at the Selective Mutism Anxiety Research and Treatment Center (SMart Center) indicates that there is a proportion of children with Selective Mutism who come from bilingual/multilingual families, have spent time in a foreign country, and/or have been exposed to another language during their formative language development (ages 2-4 years old). These children are usually temperamentally inhibited by nature, but the additional stress of speaking another language and being insecure with their skills is enough to cause an increased anxiety level and mutism.

A small percentage of children with Selective Mutism do not seem to be the least bit shy. Many of these children perform and do whatever they can to get others attention and are described as professional mimes! Reasons for mutism in these children are not proven, but preliminary research from the SMart Center indicates that these children may have other reasons for mutism. For example, years of living mute and therefore have ingrained mute behavior despite their lack of social anxiety symptoms or other developmental/speech problems. These children are literally stuck in the nonverbal stage of communication. Selective Mutism is therefore a symptom. Children are rarely "just mute." Emphasis needs to be on causes of the mutism and propagating factors of mutism.
Studies have shown no evidence that the cause of Selective Mutism is related to abuse, neglect or trauma.

What is the difference between Selective Mutism and traumatic mutism?
Children who suffer from Selective Mutism speak in at least one setting and are rarely mute in all settings. Most have inhibited temperaments and manifest social anxiety. For children with Selective Mutism, their mutism is a means of avoiding the anxious feelings elicited by expectations and social encounters.

Children with traumatic mutism usually develop mutism suddenly in all situations. An example would be a child who witnesses the death of a grandparent or other traumatic event, is unable to process the event, and becomes mute in all settings.

It is important for parents and teachers to understand that the physical and behavioral symptoms are due to anxiety and treatment needs to focus on helping the child learn the coping skills to combat anxious feelings.

It is common for many children with Selective Mutism to have a blank facial expression and never seem to smile. Many have stiff or awkward body language when in a social setting and seem very uncomfortable or unhappy. Some will turn their heads, chew or twirl their hair, avoid eye contact, or withdraw into a corner or away from the group seemingly more interested in playing alone.

Others are less avoidant and do not seem as uncomfortable. They may play with one or a few children and be very participatory in groups. These children will still be mute or barely communicate with most classmates and teachers.

As social relationships are built, and a child develops one or a few friendships, he/she may interact and even whisper or speak to a few children in school or other settings but seem to be disinterested or ignore other classroom peers. Over time, these children learn to cope and participate in certain social settings. They usually perform nonverbally or by talking quietly to a select few. Social relationships become very difficult as children with Selective Mutism grow older. As peers begin dating and socializing more, children with Selective Mutism may remain more aloof, isolated, and alone.

1. Temperamental Inhibition: Timid, cautious in new and unfamiliar situations, restrained, usually evident from infancy on. Separation anxiety as a young child.

2. Social Anxiety Symptoms: Over 90% of children with Selective Mutism have social anxiety. Uncomfortable being introduced to people, teased or criticized, being the center of attention, bringing attention to himself/herself, perfectionist (afraid to make a mistake), shy bladder syndrome (Paruresis), eating issues (embarrassed to eat in front of others).

3. Social Being: The majority of children/teens with SM have age appropriate social skills and are on target developmentally, although some do not. Most children on the autism spectrum struggle with speech/language skills, social skills and have developmental challenges.

4. Physical Symptoms: MUTISM, tummy ache, nausea, vomiting, joint pains, headaches, chest pain, shortness of breath, diarrhea, nervous feelings, scared feelings.

5. Appearance: Many children with Selective Mutism have a frozen-looking, blank, expressionless face and stiff, awkward body language with lack of eye contact when feeling anxious. This is especially true for younger children in the beginning of the school year or then suddenly approached by an unfamiliar person. They often appear like an animal in the wild when they stand motionless with fear! The older the child, the less likely he/she is to exhibit stiff, frozen body language. Also, the more comfortable a child is in a setting, the less likely a child will look anxious. For example, the young child who is comfortable and adjusted in school, yet is mute, may seem relaxed, but mutism is still present. One hypothesis is that heightened sympathetic response causes muscle tension and vocal cord paralysis.

6. Emotional: When the child is young, he/she may not seem upset about mutism since peers are more accepting. As children age, inner turmoil often develops and they may develop the negative ramifications of untreated anxiety (see below).

7. Developmental Delays: A proportion of children with Selective Mutism have developmental delays. Some have multiple delays and have the diagnosis of an autistic spectrum disorder, such as Pervasive Developmental Disorder, Aspergers, or Autism. Delays include motor, communication and/or social development.

8. Sensory Integration Dysfunction (DSI) symptoms, Processing Difficulties/Delays: For many children with SM, sensory processing difficulties are the underlying reason for being 'shut down' and their mutism. In larger, more crowded environments where multiple stimuli are present (such as the classroom setting), where the child feels an expectation, sensory modulation specifically, sensory defensiveness exists. Anxiety is created causing a 'freeze' mode to take place. The ultimate 'freeze mode' is MUTISM.

9. Common symptoms: Picky eater, bowel and bladder issues, sensitive to crowds, lights (hands over eyes, avoids bright lights), sounds (dislikes loud sounds, hands over ears, comments that it seems loud), touch (being bumped by others, hair brushing, tags, socks, etc), and heightened senses, i.e., perceptive, sensitive, Self-regulation difficulties (act outing, defiant, disobedient, easily frustrated, stubborn, inflexible, etc).

10. Common symptoms within a classroom environment: Withdrawal, playing alone or not playing at all, hesitation in responding (even nonverbally), distractibility, difficulty following a series of directions or staying on task, difficulty completing tasks. Experience at the Smart Center dictates that sensory processing difficulties may or may not cause learning or academic difficulties. Many children, especially, highly intelligent children can compensate academically and actually do quite well. MANY focus on their academic skills, often leaving behind 'the social interaction' within school. This tends to be more obvious as the child ages. What is crucial to understand is that many of these symptoms may NOT exist in a comfortable and predictable setting, such as at home. In some children, there are processing problems, such as auditory processing disorder, that cause learning issues as well as heightened stress.

11. Behavioral: Children with Selective Mutism are often inflexible and stubborn, moody, bossy, assertive and domineering at home. They may also exhibit dramatic mood swings, crying spells, withdrawal, avoidance, denial, and procrastination. These children have a need for inner control, order and structure, and may resist change or have difficulty with transitions. Some children may act silly or act out negatively in school, parties, in front of family and friends. WHY? These children have developed maladaptive coping mechanisms to combat their anxiety.

12. Co-Morbid Anxieties: Separation anxiety, Obsessive Compulsive Disorder (OCD), hoarding, Trichotillomania (hair pulling, skin picking), Generalized Anxiety Disorder, Specific phobias, Panic Disorder.

13. Communication Difficulties: Some children may have difficulty responding nonverbally to others, i.e., cannot point/nod in response to a teachers question, or indicate thank you by mouthing words. For many, waving hello/goodbye is extremely difficult. However, this is situational. This same child can not only respond nonverbally when comfortable, but can chatter nonstop! Some children may have difficulty initiating nonverbally when anxious, i.e., have difficulty or are unable to initiate play with peers or go up to a teacher to indicate need or want.

14. Social Engagement Difficulties: When one truly examines the characteristics of a child with Selective Mutism, it is obvious that many are unable to socially engage properly. When confronted by a stranger or less familiar individual, a child may withdraw, avoid eye contact, and 'shut down,' not only leaving a child speechless but preventing him/her from engaging with another individual. Greeting others, initiating needs and wants, etc., are often impossible for many children. Many shadow their parents in social environments often avoiding any social interaction at all. The common example given is; 'A child in grocery story can sing, laugh and talk loudly, but as soon as someone confronts him/her, the child freezes, avoids and withdraws from social interaction.' As the child ages, freezing and shutting down rarely exist, but the child remains either noncommunicative or will respond nonverbally after an indeterminate amount of warm up time.

MUTISM is just one of the many characteristics that children with Selective Mutism portray.

When are most children diagnosed as having Selective Mutism?
Most children are diagnosed between 3 and 8 years old. In retrospect, it is often noted that these children were temperamentally inhibited and severely anxious in social settings as infants and toddlers, but adults thought they were just very shy. Most children have a history of separation anxiety and being slow to warm up. Often it is not until children enter school and there is an expectation to perform, interact and speak, that Selective Mutism becomes more obvious. What often happens is teachers tell parents the child is not talking or interacting with the other children. In other situations, parents will notice, early on, that their child is not speaking to most individuals outside the home.
If mutism persists for more than a month, a parent should bring this to the attention of their child's physician.

Why do so few teachers, therapists and physicians understand Selective Mutism?
Studies of Selective Mutism are scarce. Most research results are based on subjective findings based on a limited number of children. In addition, textbook descriptions are often nonexistent, or information is limited, and in many situations, the information is inaccurate and misleading. As a result, few people truly understand Selective Mutism. Professionals and teachers will often tell a parent, the child is just shy, or they will outgrow their silence. Others interpret the mutism as a means of being oppositional and defiant, manipulative or controlling. Some professionals erroneously view Selective Mutism as a variant of autism or an indication of severe learning disabilities. For most children who are truly affected by Selective Mutism, this is completely wrong and inappropriate!

Research at the SMart Center indicates that children who seem oppositional in nature often have parents, teachers, and/or treating professionals who have pressured them to speak for months, perhaps years. Mutism not only persists in these children, but is negatively reinforced. These children may develop oppositional behaviors out of a combination of frustration, their own inability to make sense of their mutism, and others pressuring them to speak.

Because Selective Mutism is an anxiety disorder, if left untreated, it can have negative consequences throughout the child's life and, unfortunately, pave the way for an array of academic, social and emotional repercussions such as:

Worsening anxiety

Depression and manifestations of other anxiety disorders

Social isolation and withdrawal

Poor self-esteem and self-confidence

School refusal, poor academic performance, and the possibility of quitting school

Underachievement academically and in the work place

Self-medication with drugs and/or alcohol

Suicidal thoughts and possible suicide

Anxiety disorders are the most common mental illnesses among children and adolescents. Our main objective is to diagnose children early, so they can receive proper treatment at an early age, develop proper coping skills, and overcome their anxiety. According to the US Surgeon General, our country is in a state of emergency as far as children's mental health is concerned. 10% of children suffer from mental disorders, but less than 5% of these children are actually receiving treatment.

If parents suspect their child has Selective Mutism, what should they do?
Parents should initially remove all pressure and expectations for the child to speak, conveying to their child that they understand he/she is scared and it is hard to get the words out and that they will help their child through this difficult time. Praise the child's efforts and accomplishments, support and acknowledge the difficulties and frustrations.

Parents should speak with their family physician or pediatrician and/or seek out a psychiatrist or a therapist who has experience with Selective Mutism. However, please note that having experience with Selective Mutism does not guarantee that the treatment approach and understanding is correct. In fact, a clinician with less experience, yet who has an excellent understanding of Selective Mutism may be an ideal choice for your child.

What are the key questions to ask a potential therapist or physician?
Do your homework! You will have a much better idea what to look for if you understand Selective Mutism. Educate yourself as much as possible before seeing any professional. Parents should read as much information as they can about Selective Mutism. The Selective Mutism Association website has countless pages of information and it is updated on a regular basis.

Key questions to ask include:

What are your areas of expertise?

Have you ever treated a child with Selective Mutism? If so, how many and what are your success rates?

What are your views on Selective Mutism? In other words, what are some of the reasons a child manifests mutism?

What is your treatment approach to Selective Mutism?

What will be my role as a parent? What is the teacher's role?

What is your opinion on medication in treating Selective Mutism and when do you consider medication?

Can you supply me with references of families you have worked with?

How will you work with my child to help him/her progress communicatively?*

*Children do not progress communicatively without learning coping skills. Simply lowering anxiety is NOT enough to enable the child to begin engaging socially, learn to progress to verbal communication and feel comfortable in an environment. Skills must be taught.

Caution: When speaking to potential treating professionals, please be cautious of those who see Selective Mutism as a controlling/manipulative behavior. Treatment approaches based on discipline and forcing a child to speak are inappropriate and will only heighten anxiety and negatively reinforce mute behavior.

How is a child evaluated for Selective Mutism?
Social Communication Anxiety Treatment® or S-CAT® is an evidenced-based program created by Dr. Elisa Shipon-Blum and implemented at the Selective Mutism Anxiety Research and Treatment Center (SMart Center). Presently, the SMart Center is the ONLY Center in the world that implements S-CAT®.

Dr. Elisa Shipon-Blum's S-CAT® Program is based on the concept that Selective Mutism (SM) is a social communication anxiety disorder that is more than just not speaking. Families in the S-CAT® Program are provided with structured, individualized, step-by-step treatment.

Dr. Shipon-Blum has created the SM-Stages of Social Communication Comfort Scale© that describes the various stages of social communication possible for a child suffering from Selective Mutism. Children suffering from Selective Mutism (SM) change their level of social communication based on the setting as well as the expectations from others within a setting. As a result, social comfort and communication will change from setting to setting and person to person. The Social Communication Bridge® illustrates this concept in a visual form.

For example, a child may be "chatting up a storm" with their friend or family member in one setting, yet meet that same person in another setting (such as at school or perhaps at a family function) and the child may have difficulty socially engaging, communicating nonverbally and perhaps the child cannot communicate at all!

For some children, they appear very comfortable and mutism is the most noted symptom. This usually means they are able to engage nonverbally with others via astute nonverbal skills (professional mimes!) in most, if not all settings. These children are stuck in the nonverbal stage of communication (Stage 1) and suffer from a subtype of SM called Speech Phobia.

Although mutism is the most noted symptom of SM, the inability to speak merely touches on the surface of our children. A complete understanding of the child is necessary to develop an appropriate treatment plan for home and in the real world, as well as in school by developing accommodations and interventions, e.g. IEP or 504 Plan.

According to Dr. Shipon-Blum's work, after a complete evaluation consisting of parent and teacher assessment forms such as the Selective Mutism Comprehensive Diagnostic Questionnaire (SM-CDQ)© and the SM School Evaluation Form©, and parent and child interviews, treatment needs to address three key questions:

1. did this child develop (including influencing, precipitating and maintaining factors)?

2. does Selective Mutism persist despite past treatment and/or parent/teacher awareness?

3. can be done at home, in school, and in the real world to help the child build the coping skills needed to overcome his/her social communication challenges?

To help a child suffering in silence, an understanding of which stage the child is in during particular social encounters must be developed. The Social Communication Anxiety Inventory (SCAI©) can be used to determine the stage of social communication on the Social Communication Bridge®. Treatment is then developed via the whole child approach under the direction of the treatment professional, the child, parents, and school personnel working together.

Dr. Shipon-Blum emphasizes that although anxiety lowering is key, it is often not enough, especially as children age. Over time, many children with Selective Mutism no longer feel anxious, but their mutism and lack of proper social engagement continue to exist in select settings.

Children with SM need strategies and interventions to progress from nonverbal to spoken communication. This is the Transitional Stage of Communication, an aspect missing from most treatment plans. In other words, how do you help a child progress from nonverbal to verbal communication?

Strategies and interventions are developed based on where the child is on the Social Communication Bridge in a particular setting and are meant to be a desensitizing method as well as a vehicle to unlearn conditioned behavior. Time in the therapy office is simply not enough. The office setting is used to help prepare the child for the school and real world environments by developing strategies to help the child unlearn his or her conditioned behavior. Then, in the real world and within the school setting, the strategies and interventions are implemented.

The S-CAT® Program incorporates anxiety lowering techniques, methods to build self-esteem, and strategies and interventions to help with social comfort and communication progression. This may include bridging from shut down to nonverbal communication and then transitioning into spoken communication via the Verbal Intermediary®, Ritual Sound Approach®, and possibly the use of augmentative devices.

Children with SM need to understand, feel in control, and have choice in their treatment (age dependent). These are critical components of Social Communication Anxiety Treatment® strategies, which provide the child with choices and help to transfer the child's need for control into the strategies and interventions.

S-CAT® games and goals (based on age and where the child is on the Social Communication Bridge®) are used to help develop social comfort and ultimately progress into speech via the use of ritualistic and controlled methods. Strategy charts are used to help develop social comfort and progress into speech. Silent goals (environmental changes) and active goals (child directed goals based on choice and control) are some of the other tools used within the S-CAT® Program.

Every child is different and therefore an individualized treatment plan needs to be developed to incorporate home (parent education, environmental changes), the child's unique needs, and school modifications (teacher education, accommodations and interventions). By lowering anxiety, increasing self-esteem, and increasing communication and social confidence within a variety of real world settings, the child suffering in silence will develop necessary coping skills to enable for proper social, emotional, and academic functioning.

A trained professional familiar with Selective Mutism will have a parental interview. Emphasis will be on social interaction and developmental history, other manifestations of anxiety, behavioral characteristics (shy temperament), home life description (family stress, divorce, death, etc.) and medical history. From the results of the initial interview, the professional will often see the child. Children with Selective Mutism may or may not speak to the diagnosing professional. Whether or not a child speaks to the evaluating physician does not really matter. An astute professional should be able to assess interpersonal communication skills and build rapport quite easily and, if given at least one session and possibly viewing videotapes from home, can rule in or out Selective Mutism as a diagnosis.

1. Consistent failure to speak in specific social situations (in which there is an expectation for speaking, e.g., at school) despite speaking in other situations.

2. The disturbance interferes with educational or occupational achievement or with social communication.

3. The duration of the disturbance is at least 1 month (not limited to the first month of school).

4. The failure to speak is not due to a lack of knowledge of, or comfort with, the spoken language required in the social situation.

5. The disturbance is not better accounted for by a Communication Disorder (e.g., stuttering) and does not occur exclusively during a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder.

Associated features of Selective Mutism may include excessive shyness, fear of social embarrassment, social isolation and withdrawal, clinging, compulsive traits, negativism, temper tantrums, or controlling or oppositional behavior, particularly at home. There may be severe impairment in social and school functioning. Teasing or goading by peers is common. Although children with this disorder generally have normal language skills, there may occasionally be an associated Communication Disorder (e.g., Phonological Disorder, Expressive Language Disorder, or Mixed Receptive- Expressive Language Disorder) or a general medical condition that causes abnormalities of articulation. Intellectual disabilities, hospitalization or extreme psychosocial stressors may be associated with the disorder. In addition, in clinical settings children with Selective Mutism are almost always given an additional diagnosis of Anxiety Disorder, especially Social Phobia is common. (DSM-V-TR) (APA, 2018)

Authors note: The above criteria are quite vague/nonspecific and should not be used alone to rule in or rule out the diagnosis of Selective Mutism. As mentioned earlier, children with Selective Mutism manifest many behavioral characteristics other than mutism. In addition, since children with Selective Mutism often have difficulty responding and/or initiating nonverbally, Selective Mutism can be viewed as a communication disorder. In addition, children with autism, PDD-NOS, Aspergers and other developmental disorders can manifest mutism that is selective in location.

How is Selective Mutism treated?
The main goals of treatment should be to lower anxiety, increase self-esteem and increase social confidence and communication. Emphasis should never be on getting a child to talk. All expectations for verbalization should be removed. With lowered anxiety, confidence, and the use of appropriate tactics/techniques, communication will increase as the child progresses from nonverbal to verbal communication. Treatment approaches should be individualized, but the majority of children are treated using a combination of:

1. Social Communication Anxiety Therapy® (S-CAT®): This is the philosophy of treatment implemented at the Selective Mutism, Anxiety, and Related Disorders Treatment Center (SMart Center). This treatment includes development of an individualized treatment plan that focuses on the whole child and incorporates a TEAM approach involving the child, parent, school personnel, and treating professional. Recommended therapeutic tactics and techniques are implemented to build social comfort and progression of communication comfort (nonverbal and verbal) in various social settings (in and out of school). Because anxiety levels change from situation to situation, and often from one person to the next, methods often change from one social situation to another. Therefore, by lowering anxiety, increasing self-esteem, as well as increasing communication and social confidence within a variety of REAL WORLD settings, the child suffering in silence will develop necessary coping skills to enable for proper social, emotional, developmental, and academic functioning.

2. Behavioral Therapy: Positive Reinforcement and Desensitization techniques are the primary behavior treatments for Selective Mutism, as well as removing all pressure to speak. Emphasis should be on understanding the child and acknowledging their anxiety. Introducing the child to social environments in subtle and non-threatening ways is an excellent way to help the child feel more comfortable, i.e., Parents can take the child into school when few people are around to get the child to practice speaking. Eventually, bring a friend or two to school and allow the children to play when other children are not present. Small groups with only a small number of children are helpful, as well as allowing parents to spend time with the child within the class. After the child is speaking quite normally, the teacher, and then the students are gradually introduced into the group setting. Positive reinforcement for verbalization should be introduced when, and only when, anxiety is lowered and the child feels comfortable and is obviously ready for some subtle encouragement.

3. Play Therapy, Psychotherapy, and other psychological approaches: These can be effective if all pressure for verbalization is removed and emphasis is on helping the child relax and open up. Confronting mutism in a non-threatening way is important. These children are SCARED, and the focus should be to help them identify their level of being scared' in a particular situation. Helping them to realize that you understand and are there to help them relieves tremendous pressure.

4. Cognitive Behavioral Therapy: CBT trained therapists help children modify their behavior by helping them redirect their fears and worries into positive thoughts. CBT needs to incorporate awareness and acknowledgement of anxiety and mutism. Most children with Selective Mutism worry about others hearing their voice, asking them questions about why they do not talk and trying to force them to speak. The focus should be on emphasizing the childs positive attributes, building confidence in social settings, and lowering overall anxiety and worries.

5. Medication: Studies indicate that the most effective approach to treatment is a combination of behavioral techniques and medication. Often behavioral techniques are used for an indeterminate amount of time prior to the addition of medication. If children are not making enough progress with behavioral therapy alone, medication may be recommended to reduce the anxiety level. Serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil, Celexa, Luvox, and Zoloft are very effective in the treatment of anxiety disorders. Similar to the SSRIs, there are other drugs that affect one or more neurotransmitters such as serotonin, norepinephrine, GABA, and dopamine, etc. which are also proving to be affective. Examples are Effexor XR and Buspar. Both classes of drugs work well in children who have a true biochemical imbalance. This seems to be the case in the majority of children with Selective Mutism. Very often, we have seen positive effects in as little as a week! Medication is used as a jump start with the hope that, as we lower anxiety via medication, we can implement behavioral techniques more easily and successfully! Goals for the duration of treatment with medication are usually 9-12 months.

6. Self-esteem boosters: Parents should emphasize their childs positive attributes. For example, if your child is artistic, then by all means show off the artwork! Have a special wall to display your childs masterpieces; perhaps you can even have a special exhibition! Have them explain their artwork to family members and close friends. This promotes more verbalization practice, as well as helps with confidence!

7. Frequent socialization: Encourage as much socialization as possible without pushing your child. Arrange frequent play dates with classmates or even small group interactions with individuals the child knows well. The goals is for your child to feel comfortable enough with the classmates so that verbalization will occur. Most children with Selective Mutism will talk to friends in their own home. As the child gets increasingly comfortable speaking to one child, invite another child over, and then have two or three children at a time! Transfer speaking into the school via set tactics/techniques. For some children, Social Skills therapy is necessary and often helpful in accomplishing increased communication.

8. School involvement: Parents need to educate teachers and school personnel about Selective Mutism! You must be an advocate for your child. The school needs to understand that children with Selective Mutism are not being defiant or stubborn by not speaking, that they truly CANNOT speak. Explain to the teacher that a child needs to feel that it is alright for them not to speak. Nonverbal communication is acceptable in the beginning. As the child progresses with treatment, the teacher should be involved in the treatment plan with verbalization being encouraged in subtle, non-threatening ways. An Individualized Educational Plan (IEP) or 504 Plan may be necessary to help accommodate your childs inability to communicate verbally and to help the child progress communicatively as well as build social comfort.

9. Family involvement and parental acceptance: Family members must be involved in the entire treatment process! Very often changes in parenting styles and expectations are necessary to accommodate the needs of the child. Remember, never pressure or force your child to speak this will only cause more anxiety. Convey to your child that you are there for them. Spend one on one time, especially at night, when all pressure is off and engage your child in discussions about their feelings. Allowing your child to open up helps relieve stress. A parents acceptance and understanding is crucial for the child!

It is important to realize that with proper diagnosis and treatment, the prognosis for overcoming Selective Mutism is excellent!

Author: Dr. Elisa Shipon-Blum is President and Director of the Selective Mutism, Anxiety, & Related Disorders Treatment Center (SMart Center). She created CommuniCamp™, an intensive group treatment program for Selective Mutism, and is also Founder and Director Emeritus of the Selective Mutism Association and a Clinical Assistant Professor of Psychology and Family Medicine PCOM. Dr. Shipon-Blum's initial interest in Selective Mutism was personal. Her experience trying to find help for her daughter made the need for research, development of appropriate/effective treatment strategies, and dissemination of information about this social-communication disorder abundantly clear. Many of these findings are based on research from treatment at the SMart Center of hundreds of children with Selective Mutism.

Contributors: Christine Stanley, Lori Dabney, Laurie Gorski

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WHAT IS SELECTIVE MUTISM? Selective Mutism - A Comprehensive Overview BY DR. ELISA SHIPON-BLUM PH: (215) 887-5748 | E: SMartCenter@SelectiveMutismCenter.org Selective Mutism is a complex childhood anxiety disorder characterized by a child's inability to speak and communicate effectively in select social settings, such as school.

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Guide

In this guide we explain what SM looks like in the classroom and offer tips and strategies for teachers.

Selective mutism (SM) is an anxiety disorder that affects children in school, where they find themselves unable to speak, though they speak comfortably at home. In this guide we explain what selective mutism looks like in the classroom, and advise teachers on how to approach parents if you are concerned a student might have the disorder. We also offer tips for encouraging kids with SM to participate and verbalize, strategies for handling testing and advice on what to do if you learn you will be getting a student who has struggled with SM in the past.

What Is Selective Mutism?

Selective mutism (SM) is an anxiety disorder in which a child is unable to speak in certain settings or to certain people. The most common setting for children with SM to struggle in is school. The disorder can be confusing to adults and painful for children, who experience so much anxiety that they actually feel unable to speak in certain situations, even though they can speak easily and comfortably other times, such as when they are at home with their parents. Children with SM don't necessarily look anxious; they may stare back or look frozen when asked a question or prompted to engage.

The disorder often isn't discovered until a child first starts going to school and his teacher notices that something is wrong. Parents might not realize their child has trouble speaking around other people since talking is not a problem at home. Or they may think that their child is shy, but not realize just how impairing their child's anxiety really is.

Kids who have selective mutism might only be able to speak in a whisper to teachers or peers. Others might not even be able to manage a whisper, and might go the entire school year without speaking once. Children with SM may not be able to answer questions in class, even when they know the correct response, and they may struggle to ask for help or initiate conversations. Many children with SM cannot ask to use the bathroom, and may go hours or the whole day without using the bathroom (or may have accidents).

Signs a Child Might Have SM

Signs a child might have selective mutism include:

Being freely verbal and even gregarious at home, but completely or mostly nonverbal at school or around strangers

Seeming "paralyzed" with fear, or "shut down" when unable to speak

Using gestures, facial expressions and nodding to communicate. (Note some children with SM struggle even with nonverbal communication and will not do this.)

The disorder may look slightly different from child to child. Sometimes children with SM will be able to talk to peers but unable to talk to their teacher. Others will stay silent around peers, too. Many kids with SM enjoy school and have friends (or want to); they may interact nonverbally during playtime. Some children with SM are able to speak to their classmates in their own homes, but many cannot. Although they're normally able to talk with their parents, some might stop being able to once they are in their classroom (or even on school property). Some children with SM will be able to smile and point to things that they want, while others will struggle even with this, developing a completely flat facial expression and not being able to use gestures.

While warming up to a new classroom environment can take time for many children, and being quiet in the first few weeks of school isn't uncommon, a student who is nonverbal for more than a month may be cause for concern.

Selective mutism can sometimes be mistaken for other things (and vice versa). Here are some of the most common issues SM can be confused with, and how to differentiate between them.

Oppositional behavior: Selective mutism is sometimes mistaken for oppositional behavior because a child with SM might seem to be refusing to answer questions. In reality, children with SM are extremely anxious and experience SM as an inability to speak even when they want to. In other words, a child with SM is unable to speak, not refusing to speak.

Autism: Because autistic children and children with SM both struggle with socialization, the disorders can sometimes be mistaken for each other. However, even when kids with SM are in situations where they can't speak, they can still pick up on nonverbal cues and emotional subtleties. Their socialization skills when they are at home with family look very typical. Autistic children, on the other hand, will struggle to interpret social nuances and the limits of conversation even when they are at home or in other comfortable surroundings.

Trauma: There is a misconception that children with selective mutism have been traumatized. While it is possible for a child to become mute after a traumatic experience, usually the child avoids talking about aspects of the trauma itself, rather than becoming completely silent. Post-traumatic stress disorder (PTSD) also has other symptoms like difficulty sleeping, nightmares and recreating the traumatic event during play, which makes it look quite different from SM.

Second language: When a child speaks a different language at home, care should be taken before diagnosing her with SM. Children should not be diagnosed with SM if their failure to speak can be explained by difficulty understanding or using a second language. Additionally, bilingual children commonly experience a "silent period" while they are acquiring their new language, so it is important not to mistake this stage of learning for SM.

However, bilingual children can still develop SM, and in fact the disorder is more common among children who are multi-lingual, although being bilingual doesn't cause SM.

It is very important that bilingual children who are suspected to have SM have a thorough assessment that takes into account their language development and the history of their symptoms.

Social anxiety disorder: Also called social phobia, children with social anxiety disorder are afraid of being judged negatively by others. Speaking can be anxiety-provoking for them, as can writing in front of others, eating in front of others and performing. Social anxiety disorder frequently occurs along with SM. A thorough evaluation should be able to determine if a child has social anxiety disorder.

Sharing Concerns With Parents

If you think that one of your students might have selective mutism, you should share your observations with his parents. What you have to say may come as a shock, since parents are used to their kids being chatty at home and might not have seen the behavior that you are seeing at school. So make your observations specific enough that parents get a clear picture of their child's struggle, and what he's missing out on.

For example: "I'm really glad he speaks at home, but I want to make sure you know what we're seeing at school. Your son comes to circle time, but isn't able to participate. When it's his turn to tell us what the weather is, he clams up. He looks like he wants to respond but can't."

Parents might need time to process what you are sharing or want to give the child more time to see if he will become more verbal. These are both totally normal and reasonable reactions. However, if the child continues not making progress and his parents aren't being open to what you have to say, you might want to bring in the school psychologist or another member of the school staff or administration who can meet with the parents and discuss again what is happening in the classroom.

After a careful diagnostic evaluation, children who have been diagnosed with selective mutism should begin working with a mental health provider, ideally a psychologist who has experience treating selective mutism. Treatment consists of specialized behavior therapy with techniques that prompt speech and then reinforce successful speaking experiences with lots of labeled praise and small incentives.

Part of the treatment involves helping children with SM face the situations that make them anxious instead of avoiding them. This will help their anxiety fade away over time. However, children with selective mutism should never be coaxed or pushed to speak. The pace of treatment should be very gradual and children shouldn't be asked to do something that is too difficult for them. The goal of treatment is to help build the child's confidence by accumulating more successful speaking experiences. Pushing a child to do something more than she can handle can have a negative effect if she fails to be able to meet the expectation.

Because children with SM are often young, treatment should also involve direct work with parents, caregivers and other adults who support the child so that they learn how to help the child speak and engage. The child's treatment provider should also teach caregivers to avoid "rescuing" the child by answering for her or accepting an overreliance on nonverbal communication. It is common for very well-intended adults to automatically do this, but it can actually reinforce the child's SM.

Knowing when - and how - to ask a child with selective mutism to participate in class can be difficult. That's why it is extremely important that teachers know what a student is working on in therapy and get guidelines about how best to support and reinforce the progress she is making. Experts who treat selective mutism have found that children have the most success when their teachers, parents and therapist all partner together to form a team, sharing goals, tips and feedback. This partnership is essential because even if the child is making progress in the clinician's office, if her gains aren't translating into progress in the classroom, her treatment is missing the mark.

Tips for Helping Kids Talk

Be a sportscaster: Do a play-by-play recap of what the child is doing: "You're drawing a flower" or "I see you're pointing to the picture in the book." This helps convey interest in what the child is doing and is a good technique to fall back on when he is nonverbal.

Wait 5 seconds: When we ask a question, we often don't give kids enough time to respond. Waiting five seconds without repeating the question or letting anyone answer for a child is a good rule of thumb. It also helps kids learn to tolerate their anxiety.

Use labeled praise: Instead of just saying "Great job!" be specific: "Great job telling me you want juice!" This way kids know exactly what they're being praised for, and they feel motivated to keep doing it.

Rephrase your question: Instead of asking questions that can be answered with a yes or no - or, more often, nodding or shaking his head - ask a question that is more likely to prompt a verbal response. Try giving him choices ("Would you like a puppy sticker or a star sticker?") or asking more open-ended questions ("What should we play next?").

Practice echoing: Repeat or paraphrase what the child is saying. This is reinforcing and lets him know that he's been heard and understood. For kids who speak very quietly, repeating what they say also helps them participate in bigger groups.

Strategies for the Classroom

Here are some of the strategies that teachers report finding helpful:

Nonverbal communication: If the child is able to use gestures and hand signals (like pointing, nodding, giving a thumbs up or down), nonverbal communication is a great way to help kids participate in class. The goal is for her to eventually move beyond relying only on nonverbal communication, but in the meantime it is still an effective way for her to get her needs met and for you to show her that her participation is valued.

Pairing with a buddy: If a child has a particular friend that she is already verbal with, or who she is on very good terms with, arranging for them to sit next to each other may decrease her inhibition and increase the chance she'll speak up.

Small group work: Some children feel less anxiety when they are doing activities inside of a smaller group, and may be more likely to speak up.

Building on strengths and areas of interest: Children feel more excited and confident (and less inhibited) when they get to explore things they are interested in, or use their talents so that they feel good about themselves.

Warm up time: Kids with SM benefit greatly from being able to come to the classroom with parents and "warm up" before anyone else is there. This allows the child to practice being verbal in that environment without the pressure of having the teacher or peers there. Ideally, after time with parents alone, a teacher may be able to "fade in" to the classroom, while still giving space to the student and her parents.

Outside support: Depending on how impaired a child is, having her therapist or another person trained in selective mutism treatment strategies spend some time inside the classroom to provide individualized support can be very helpful.

Children with SM may qualify for accommodations under Section 504 or be eligible for special school services under an IEP.

It can be difficult to understand where a child's comprehension is if he isn't able to participate in class. Reading out loud, answering questions and contributing to discussion might be impossible.

A good way to judge achievement levels is to have parents make a recording of their child reading out loud or doing a lesson at home that couldn't be done in class. For things like group spelling activities that need to be done in class, maybe the child could write his word or spell it out with magnetic letters. All of these accommodations should be temporary and part of a specific plan with the eventual goal of verbalizing directly. The therapist working with your student may also be able to recommend other creative ways children can display their ability and understanding of class material.

Would Switching Classes Help?

Parents sometimes wonder if switching classes or schools will help their child start talking. It is true that it can sometimes be hard to get a child with selective mutism to talk in front of people she has a history of not talking around. The more she is used to not talking around her teacher, for example, the more ingrained it will be. However, pulling a child out of one class and putting her into another can also sometimes be disruptive without being helpful - particularly if the child isn't currently receiving treatment or her new teacher hasn't been prepared to work with a child who has SM.

If your student feels comfortable with you and you are following the recommendations of her treatment provider, then it is certainly worth trying to make progress in her current classroom. If the child's parents prefer to switch classes, it will be important for them to put strategies and techniques to help her in place before she enters the new class. Otherwise they may be risking introducing her to yet another class she feels unable to speak in, which might reinforce her anxiety. The next section in this guide gives advice for working with a new student who has SM.

Helping a New Student Already Diagnosed With SM

If you learn that a new student in your class has struggled with selective mutism in the past, helping him learn to feel comfortable with you is important. Here are some ideas that might help:
Schedule a Visit
Many experts recommend that a student with SM meet his new teacher before school starts so that he gets to have a one-on-one interaction, before other kids are around.

You could arrange for the child's parents to bring him by the classroom in the days before school starts so that you could introduce yourself and give a tour of the classroom. He doesn't need to speak to you during this first meeting if he isn't ready, but he might be able to have a conversation with his parents so that he starts building successful speaking experiences inside the classroom.

If there are toys in the classroom, you might give him the chance to play for a few minutes. After he's gotten comfortable, you could be a "sportscaster" and do a play-by-play recap of what he's doing ("I see you're moving the cow into the barn" or "Wow, you're making that car go fast!"). This is a great way to connect with him even if he isn't ready to speak.
Make a Video
Another good way to break the ice is to have the child record a short video for you at home. This way he can introduce himself in an environment where he feels comfortable and you can see how chatty and confident he can be. If he's able to, it would be good if he could show you the video himself during the family visit before school begins. This is one way for him to start communicating with you and thinking of himself as a speaking person at school.
Arrange Plan Bs
Try to have a Plan B for situations where the child is being asked to do something he can't do yet. For example, rather than asking your student what job he wants in the classroom that day, your Plan B might be to say, "Jack, come and point to the job you want today."

Likewise, if you learn that a student isn't ready to ask you to use the bathroom, work out a plan in advance. If he can use hand signals, arrange for a signal he can use when he needs to go to the bathroom. If he's not able to use signals, maybe for now there can be an understanding that he is allowed to use the bathroom when he needs to without asking permission. Make sure he knows where the bathroom is, too. For other children, simply taking them to the bathroom and saying "time to go to the bathroom" may be needed.
Talk to the Treatment Team
If the child is receiving treatment for his selective mutism, ideally you would be able to speak with his therapist or his parents to learn more about what he is doing in treatment and how you can support that in the classroom. For example, they might be using a star chart to reward him when he follows through with a particular behavior he's been working on, and you can help reinforce that. Likewise, he might be responding well to certain techniques that you could try to use. It's important for the treatment team to make sure you're on the same page, because any advances made in the clinician's office need to be able to transfer into the classroom for them to be a true success.

This guide was last reviewed or updated on February 23, 2023.

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In this guide we explain what SM looks like in the classroom and offer tips and strategies for teachers.