Tag Archives: child development

It All Starts With Play…

Rebecca Siomra



Children need the freedom and time to play.
Play is not a luxury. Play is a necessity.
– Kay Redfield Jamison

When I came across this quote, it made me stop and think.

Play is a necessity. Interesting. Necessary for what? The importance of play for everyone has gotten a lot of attention in research and literature in recent years. In adults, play means something different to different people – playing hockey, painting a landscape, singing show tunes, training dogs, going for a morning run or even building a deck! In childhood, play has a very special and important role. Play affects just about every area of a child’s development, and impacts brain development. Play makes us feel good and it can motivate us and help us learn.  In discussing play in children, I’m not talking about the need for mountains of trendy, expensive toys or electronics, but just ‘play’, pure and simple.

Why would I care about play? I specialize in speech and language. Speech-Language Pathology isn’t only about talking and understanding, it’s about communicating and interacting with others, and those skills begin to develop from day one through daily routines, and through simple play.  The way we bounce, rock, tickle or sing to a baby are all early play activities. When we see how babies do (or don’t) respond to these activities, we start to know more about their personalities, or how they might be feeling that day. The way that we respond in turn helps that little one to learn that what they do (or don’t do) has an effect on others. They learn that making a noise or smiling will bring on another tickle, or round of ‘Twinkle Twinkle’, and so communication begins.

In my practice, the first step in a therapy program for a young child often starts with very simple interactions. I want the parents that I coach to really understand that play is a child’s work; encouraging play and joining in play is a parent’s work. Play allows a child to learn about themselves, their environment, other children, adults and how they should and should not behave with other people. In a wonderful coincidence, when we play with a child, we also learn about them and, if we’re lucky, about ourselves too.

I think it’s incredible that so many important
life-skills can be learned through play.

When we use the term ‘child’s play’, we usually mean something that is ‘easy to do’, or ‘without significant challenge’. I have the opportunity to work with very young children every day, and my experiences lead me question that generalization. A child’s play is fun, absolutely, but without challenge? I’m not so sure the little ones would agree with that!  Remember, this is their work, and they take it very seriously!

Boy working with building blocks

Watching a toddler tackle stacking blocks or a shape sorter for the first time, or try to sort out how to make a toy bus sing its song again, reminds me just how important it is to reset my perspective. So many skills are second nature to me as an adult, but are brand new to the children I work with. Every little step in developing early play skills requires patience… practice… learning. Think about it, when babies are really little, they learn to grasp something in their hand, then to lift it up, then their hand gets tired and, oops, it falls out.  Now what?

They try again, and again, and again. Perseverance is a life-skill; how amazing is it that it can begin to develop at such a tender age. As an adult, our role may be to stay close by and to let them keep trying, to allow them the opportunity to learn. Babies and young toddlers may dump anything and everything out of containers, but putting something back into a container requires hand-eye coordination and control of grasp and release. What happens when the task becomes too frustrating?

The child needs to figure out how to communicate so that someone will know to come and help; one more skill to add to the to-do list. Wow, this ‘child’s play’ stuff is a lot of work!  Fortunately, it’s also a lot of fun, which encourages these little ones to keep practicing.  They certainly are motivated to learn!

Over the years, I’ve collected charts and lists detailing developmental milestones. What I find fascinating is watching the points from those lists coming to life, first in what children do in their play, and then  in their everyday routines.

A baby who has been putting her fingers, then toys, in her mouth comes to realize that she can also put bits of cookie in her mouth – brilliant. One big step to independence!! The young toddler who has been playing peek-a-boo with his parents realizes that when they disappear around the corner to answer the phone they’re still there and will come back, and he doesn’t need to be sad – marvelous!

In Auditory Verbal Therapy, we coach parents to make ‘Learning to Listen Sounds’ for their babies while playing with toys, singing or looking at books. The big moment comes when, one day, that little one looks at the airplane and says ‘ahhhh’, without even realizing that she has learned how to attach a label to an object. Even more astonishing, all of that practice of making those funny sounds back and forth with any adult who will play, one day turns into first words!!

Play gives children a chance to practice what they are learning.
– Fred Rogers

Ah, those first sounds… first words. Music to every parent’s ears.  What comes next?  We want to hear those words again, and again of course! As adults, we can create endless opportunities for young children to practice new sounds and words through games or books.  We want them to feel confident and to want to try again. When we build all of this ‘work’ into play, a child will be motivated to keep trying, to keep learning.

The repetition of songs can help children learn about body parts, actions, animals or even what the parts of a bus do!  They learn how to listen and wait for the pause in a song when they can happily fill in the ‘E-I-E-I-O’ with gusto! They learn how to take turns by pushing a car or ball back and forth.  They learn how to ask for help by handing the container of bubbles to a parent while looking between the two expectantly. The countless rounds of peek-a-boo, driving that blue train around the track one… more… time. So many opportunities for children to learn from us, and all we have to do is have fun – really? Amazing!

As a Speech-Language Pathologist, I may guide a parent in how to adjust play routines, or the language they use, to match their baby’s learning needs, but it really still boils down to play.

Laying the ground-work for early play and communication development opens so many doors… like the one to the land of make-believe, but that’s a thought for another day!

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Realizing the Potential of Group Therapy

Margot Pukonen bio

Many administrators and clinicians think of group therapy as a means of increasing the number of children in service.  This is true to a point but it will not increase numbers exponentially.  There is a limit to the number of children a clinician can effectively treat at any one time due the planning and documentation requirements associated with service delivery.  After many years of running speech and language therapy groups at The Speech and Stuttering Institute, we’ve come to the conclusion that the value and power of group therapy lies in the quality of service it offers.

Group therapy provides a very rich therapy environment and offers learning opportunities that are not present in individual therapy.  Groups provide peer learning opportunities.  Clinicians do not have to directly teach and reinforce all the skills a child may need to develop since the children learn by observing each other.  Group activities also provide opportunities for children to practice new skills in more naturalistic conversational exchanges which support generalization into contexts outside the therapy room.  An additional benefit is that children learn how to participate in a group setting.  They develop skills such as maintaining a group focus of attention, taking and waiting for turns, responding to questions and comments, sharing information and asking questions.  This experience will serve them well in school since most teaching occurs within groups.

Group therapy is a good intervention option when children have developed the behavioural and self regulation skills to wait for turns, delay gratification and follow adult directions.  If these skills are not established, the clinician will spend more time supporting the child’s participation rather than addressing actual speech/language targets.  Children in junior and senior kindergarten are typically ready for a group therapy approach.  A group of two is an excellent starting point for clinicians who have not run groups before.  Groups of three are ideal since there are enough children to create group dynamics yet children don’t have to wait too long for their turn.  At this stage of development, children lose attention quickly if they have to listen and wait for any length of time.  In terms of the child’s skill development, his/her therapy goals should be emerging and can be elicited through verbal or visual models or requests to imitate.  Individual therapy is a more appropriate option when skills need to be established and the child requires consistent clinician support to elicit an appropriate response.

Clinicians may be intimidated at the thought of running groups because of concerns about behaviour management and/or the ability to meet each child’s individual needs within the group context.  These challenges can be managed when clinicians understand two key concepts about group therapy: “the group” is a client and groups evolve.

Clinicians should view “the group” as one of their clients.  For example, if there are three children in the group, “the group” is the fourth client and the clinician needs to plan for and support its functioning when planning and running therapy sessions.  In fact, “the group” should be viewed as the primary client because when the group doesn’t function, it is challenging to meet the needs of the individual children.

An understanding of how groups evolve will provide clinicians with a set of strategies they can employ to support group development as well as an understanding of their role in facilitating the process.  Children’s therapy groups undergo the stages of forming, storming, norming, performing just the same as adult groups (Tuckman, 1965).  Children’s needs and abilities are different at each stage of the process so the clinician needs to provide the appropriate supports in order to guide the group to higher and more productive levels of group functioning.

Realizing the Potential of Group Therapy

At the forming stage, children are new to the group.  They don’t know the others in the group, what to expect or what will be expected of them.  The clinician’s role is to provide them with information about what will happen, when and how as well as what they are expected to do.  This is achieved by providing a well-organized environment so the children know where to focus their attention, where to move and where to keep or find materials.  Visual schedules help them understand and predict what will happen next and when the group session will end.  Desired group behaviours or “rules” such as waiting for a turn, making transitions and positive peer interactions also need to be clearly explained, demonstrated  and reinforced.  Providing visual cues that can act as reminders of the target behaviours as well as reinforcing group members who demonstrate the behaviour facilitate the process.

Once children become more comfortable in the group they often start “storming” and push boundaries and challenge the clinician.  This is when all of the structures and visual supports introduced in the forming stage become very helpful.  The clinician’s role at this stage is to remind children of the rules and expectations or negotiate by referring to visuals and group rules (e.g. first we ….., then you can…..).

During norming, the children come to understand and accept the boundaries and expectations.  As a proactive measure, clinicians continue to review rules, refer to visuals and reinforce desired behaviours.

The group is performing once children are managing their own behaviour fairly independently and the focus of the group shifts to working on specific speech-language goals within the group activities.   These goals may have been introduced earlier but were often of secondary importance as the clinician focused on developing the group structure and processes.

It takes time for a group to reach the performing stage and it is natural for groups to move between storming, norming and performing within and across sessions.  If the therapy block is too short, clinicians will spend most of the time guiding the group to the performing stage and then disband just as it reaches its maximum potential.  Based on our experience with junior and senior kindergarten children, we recommend a ten to twelve week block at a minimum.  It often takes at least 6 to 8 sessions to reach the performing stage and then children can focus their attention on practicing and generalizing individualized targets during weeks 8 to 12.

Groups are a rich and motivating intervention context for children.  For clinicians, they are a more complex form of service provision because they require planning for several children as well as the group.  By establishing a predictable group structure, routine and rules and guiding children through the process of learning how to participate and learn within a group, the potential of group therapy can be realized more consistently and successfully.

Reference: Tuckman, B. (1965). Developmental sequence in small groups. Psychological Bulletin 63 (6): 384-99.

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We appreciate your interest in this blog post. The text contained in it is copyrighted by SoundIntuition as of the date of publishing. Contact us by leaving a comment on this post if you would like to use this text elsewhere. When used, we would ask that you cite this page, using the full URL (http://soundintuition.com/blog/realizing-the-potential-of-group-therapy), as being the originator of the content.