Picky Toddlers

food healthy red summer

As any parent of a toddler will tell you, picky eating is pretty common between 18 months and 3 years of age. Some experts suspect that little sensory systems are developing and kids are figuring out what textures and tastes feel best. Other professionals think that toddlers crave predictability during this period of rapid development, and as a result, they tend to gravitate towards the same foods. My personal observation is that toddlers are learning to use communication to control their environment- since meals happen 3-5 times a day, this is a logical time to voice an opinion! The good news? It is usually just a phase. The bad news? That doesn’t make picky eating any less frustrating! Here are five strategies to help ease the stress of having a picky eater in your house:

*Offer Choices

Rather than saying “Do you want _____?”, try offering a choice of two items. Your child will feel that she has some control. I also like to offer options for presentation (“do want big strawberries or cut strawberries?”)  as well as options for utensils/dinnerware. (“do you want a blue plate or a red plate?”).

*Model Good Habits

Children are always paying attention! Make sure that you are modeling the eating habits that you want to see your child adopt. Talk out loud about the choices you are making, and make a point of trying new or different things with your child. (ex: “I had red bell peppers yesterday, so I am going to try yellow peppers today. I wonder if they will taste the same or different?”)

I also encourage parents and caregivers to eat with their child. Even if you are just munching on a few carrot sticks while your little guy eats lunch, you are sending the message that meal time is a fun, relaxing time to spend together, as well as to enjoy food.

*Serve Variety

It is easy to fall into the trap of “I know she isn’t going to eat that, so why bother putting it on the plate?“. The problem with that mentality is that you are sealing your child’s fate as a picky eater! I like to serve my daughter 4 items at every meal- 2 items that I know are a sure thing and 2 that are new or different.

I also make sure that I am switching things up with leftovers so that she isn’t eating the exact same dish three nights in a row. For example, I will throw some frozen peas in her mac and cheese one night, and the next, I will stir in some diced chicken. Not every variation is a smash hit, but I am gently nudging her to step outside of her comfort zone.

*Reduce Pressure

If you have ever had the pleasure of engaging in a power struggle with a two-year-old, you know that the more you push, the deeper they will dig their heels in. With the under three crowd, you will have way better success with a more subtle approach. Avoid saying things like “Take a bite” or “Eat this“.  Instead, present the plate to your child and let him decide what he wants to eat first.  Don’t hover over him as he scopes out his plate. Instead, dig into your own food and chat about a preferred topic.

Beware of making threats or doling out punishments for not trying foods. This can make the child feel more anxious about the meal time process, and result in bad behavior in the future. Don’t let your child see that you are feeling stressed or frustrated- you don’t want his eating habits to have power over the family dynamic.

*Make It Fun

Unless your child has specific concerns about gaining weight or getting the right nutrients, the goal of meal time is really to learn to eat a variety of foods and to learn to participate in the social aspect of eating. You want your child to associate meals with comfort, nourishment, and happiness. Focus on connecting with your child over a meal- play music, tuck away your cell phone, and be playful. Leave the table manners for later years and encourage your child to get messy, explore the foods, and try things in the way that feels most comfortable to them.

It is also really important to keep in mind that toddlers have tiny little stomachs! The average toddler’s stomach is about this size of his clenched fist. Think about how tiny that is! We want our children to learn to listen to their bodies and recognize signs of both fullness and hunger. Consider your own eating habits- do you eat large quantities at every meal? Or do you tend to graze throughout the day? We tend to adjust our intake based on how we feel, our mood, and how much energy we need for that day’s activities. Teaching our kids to do this now will help foster life-long healthy eating habits.

What if this isn’t your “run of the mill” picky eating? 

There most certainly are kiddos whose picky eating habits are beyond the realm of “typical”. It can be hard for parents to know when to power through and when to seek professional help. I use these criteria to differentiate a “picky eater” from a “problem feeder”:

*Eats less than 3 foods in each major food group (vegetables, fruits, proteins, grains, dairy).

*Visible signs of distress or anxiety when presented with new or non-preferred foods (crying, screaming, etc).

*Frequent gagging, vomiting or choking during meals.

*Interference with an ability to participate in normal daily activities (birthday parties, family dinners, etc.)

*”Jagging” on preferred foods by eating them too often to the point of never wanting to eat that food again.

If you think you might need support with your child’s eating habits, contact our office to schedule a feeding consultation. Our feeding team will be happy to help.

Elizabeth Clark McKenzie, MS, CCC-SLP

adorable baby bowl child




Tummy Time



If you are a new parent, it won’t be long before you start hearing people talk about “Tummy Time”.  This catchphrase was coined in the 90’s when the Back to Sleep Campaign was launched and babies were no longer spending much time in the prone, or face-down, position. While instances of SIDS (Sudden Infant Death Syndrome) decreased dramatically, babies were missing out on time to develop foundational developmental skills. Child development professionals and pediatricians began to educate parents on the importance of placing infants on their tummies for short periods of time throughout the day. Currently, the AAP recommends that young infants spend about 90 min on their tummies per day, and research shows that babies who spend time on their tummies while awake are more likely to achieve certain motor milestones.

Most parents assume that means you put the baby on his tummy and that is the end of that, right? For many of us, the whole tummy time experience wasn’t as simple as it sounds. My daughter HATED tummy time and would scream her head off when we tried to do it. Luckily, I was able to rely on some colleagues of mine to give us some pointers. Here is the lowdown on why Tummy Time is so important, and some tips for ways to make it easier (and more enjoyable for everyone involved)!

What does Tummy Time do?

  • Develops muscles of the head, neck, shoulders and back
  • Helps to prevent motor delays and conditions, including plagiocephaly and torticollis
  • Allows for visual exploration of the environment
  • Encourages isolation of limbs from trunk
  • Allows for babies to discriminate between items that are close and items that are far away
  • Builds up strength in the upper body and hands that will lead to development of fine motor skills (such as handwriting!)
  • Helps develop the vestibular system (important for balance!)


Tips and Tricks

  • Ease into tummy time– start by holding your baby upright on your shoulder. Once she is comfy with that, try lounging back at an incline and let her try tummy time on your chest. From there, you can try to lie flat on your back and see how she tolerates that. My daughter grew to love doing tummy time on my lap, laying across my legs. I allowed her to get used to gradual position changes so that being prone on the floor didn’t feel like such an extreme change.
  • Use a prop – Some babies respond better to tummy time when using an exercise ball, rolled up towel or nursing pillow. (Do not leave baby unattended when propped up)
  • Join the fun! – You try lying on your tummy too! Face your baby and softly talk or sing to him. This might calm him, but will also prompt your little guy to work those neck muscles to better see your smiling face!
  • Set up some entertainment –  Place a couple of toys in a rainbow arc in front of your baby. Items in close proximity will be more motivating to look at than items far away, which might keep baby’s attention for longer. Down the road, she can reach and grab at toys, or even scoot towards them! I also love propping up books to look at!
  • Use a mirror – Not only are babies motivated by their own reflections, but you will also encourage some valuable social and language skills as well. Baby can work on recognizing facial expressions, imitation, and cause and effect- all while getting those tummy time minutes in!


My Favorite Tummy Time Tools:


Here is a great blog post, written by Wendi McKenna who is a pediatric physical therapist. She takes you through the progression of tummy time from birth to seven months, and does a great job illustrating all of the important skills gained along the way!


Do you have burning questions or hot topic suggestions for our blog? Send them my way at ElizabethM@skillbuildersllc.com. 

-Elizabeth Clark McKenzie, MS, CCC-SLP


Summertime Anxieties

Summer does not equate to relaxation and fun for everyone.  Even though kids with anxiety may experience less overall stress during to the break from school, these months can pose some new challenges. I asked local clinical social worker, Rebecca Goldberg,  to weigh in on some common areas of concern from children and parents regarding the summer break. She gave me some wonderful strategies that might help:

Boredom– Let it happen!

Summer is intended to be unstructured but not all kids do well with little to do.  A common concern from both parents and kids is the need to be entertained or having a short attention span.  Like any new skill, leisure skills need to be learned, expanded and practiced, especially for anxious kids.  Kids are used to instant gratification and constant inbound stimulation in our digital world and school environments.  Even though protesting (“I can’t do it!”) may occur, letting boredom happen is important. Boredom has been touted as an important skill in childhood that leads to expanded creativity, problem-solving skills and benefits to overall mental health as we age.

Try these ideas:

–      Work with your child to create a leisure, quiet, solo activity list. This can include art projects (be specific, take the trip to a craft store and buy a few kits or find some projects online), listen to music, read, garden, color, draw, journal – to name a few. Put these items in a central location. 

–      Make a visual list and have it posted somewhere in the house where your child is most likely to engage in the activities.  A common space in the house may be best.

–      Have quiet time near one another.  This allows for connection and closeness even if you aren’t engaging with one another directly.  This also models these skills for your child and shows that you too make leisure a priority and can practice what you preach.

–      Have your child practice solo skills for a few minutes a day and build up as they go; it can be a good practice for the whole family.  Start with 5 minutes and stick with it; don’t save them no matter how much they complain!

–      Praise your child for spending quiet time on their own. Notice if they seem calmer or accomplished and reflect on that specifically.  Help kids see the merit in quieting their mind, disconnecting and trying new activities.

–      Explain the why.  Lots of kids do better knowing “the why” behind something.  Let kids know how important it is to explore and come up with creative ways to spend their alone time.  When kids don’t want to try it, frame it is as an “experiment” to see how it goes.  This strategy can often feel less overwhelming to an anxious kid who thinks their whole world is now going to change.


Vacation– Always relaxing?

Not for everyone!  Vacations involve leaving your job, house and other responsibilities which is bound to cause stress on parents.  We all want to get the most out of our time away so it’s important to plan ahead and manage the stress proactively.  Your children will absolutely feel your stress around getting out the door, unless you plan accordingly.

Try these ideas:

–      Make sure you have enough time to plan, prepare and talk with your partner well in advance to make the transition out of town as smooth as possible. Let kids know what they will be responsible for, i.e. packing their own bag, preparing a car/plane/train activity bag, etc.

–      Get acclimated to the vacation spot beforehand. If this is a new place you are vacationing to, do some online searches together as a family and look at photos, activities and start to generate ideas, and excitement, for the trip.  Even if your child gets nervous about going, remind them that even though the travel time or leaving their friends may be hard, it will be worth the vacation experiences. 

–      Set expectations ahead of time.  Allow everyone to have ideas about activities to do while away and write them ALL out, everyone’s ideas matter.  Vote on these activities as a family and plan accordingly.  Set up a calendar of the vacation so kids know what to expect and on what days; post this somewhere central like the kitchen.

–      Not everyone vacations the same.  If you are traveling with another family, be cognizant of the differences in what each family may need.  Make sure you set time aside for your own family’s needs to be met.  Additionally, some kids and their parents vacation differently!  By allowing the needs of your children to be met, the vacation will ultimately will be more enjoyable for you too, so take that trip to the arcade, bowling alley or have a quiet board game day.


Camp & Sleepaway Camp– A big step for any child, let alone one with anxiety!

Whether it’s down the street or across the country, going to camp can be a hard thing to do for some kids.  Once signed up and registered, kids often experience increase anxiety and may refuse to go.  My typical response is “let’s try to find a way to work through it, even though it’s hard”.  Establishing that even though camp may feel scary, it is not a reason not to go – just a reason to get more prepared.  

Try these ideas:

–      Amplify being brave.  Focus on how this is scary AND your child can be brave.  We want to teach children that we can do something, even when we think we can’t at first.

–      Remind your child of other times they have been successful. Has your child been afraid of doing something before and then tried it, and it turned out fine?  Remind them of that and be specific, “Remember when you did swim team for the first time and it was so scary and you thought everyone was going to be a better swimmer than you? Do you remember what happened? You were able to face your fear and now you love to swim.  You would have really missed out on something awesome if you listened to your worry that time and let’s not let worry control us this time either.”

–      Bring an item to camp that helps them remember you, home, or whatever helps them feel calm, safe and grounded.  This can be something small like wearing a piece of jewelry of Mom’s, bringing an item from home (photos, small pocket item), a favorite fidget or squishy, etc.  Sensory based items can also help with grounding a child when they become dysregulated with anxiety – try something soft (rabbits foot, etc.), something that smells good (essential oil cotton ball, wearing Mom’s perfume, etc.), or something special to eat for lunch.  It’s always nice to get a note from a loved one in your lunch or in your camp backpack, too – it is the little things!

–      Wear a watch or create a count down.  Help kids know that even things that feel uncomfortable do come to an end.  

–      Reward your child for being brave.  Give your child tons of positive feedback, make it bigger and use a reward after camp to help them stick with it, ice cream is a good one for the summer or a trip to the pool for a night swim.  

–      Make a backup plan.  If camp is hard, let the child know you will be available to help them work through it. The camp can call you and you can talk with them but the goal is to stay at camp – do not swoop in to rescue your child and manage your own anxiety around your child’s distress.  We only beat anxiety by facing it.  Your child is in control, not their worries.

–      Stick with it and don’t cave.  It may be easier for both of you not to push through something like camp, which creates so much distress, but it is worth it.  If you don’t do it now, it will keep happening.  Don’t teach your child that when its hard, we stop or give up and that you also, don’t believe they can do it.  It may take hours to get your kid out that door but stick with it.  Take care of yourself in the process and if you need a break or the conversation is going nowhere, let your child know it’s time to pause and you will come back to this issue later.

–      What are the mini steps?  If your child is not able to make it through a full day at school, setting up the expectation for a full day camp can be a set up for failure.  If this is new, try the mini steps to get there – having a parent stay there for the first hour (you can sit in the car if the camp does not allow parents to stay), staying for the morning, morning and lunch, and then working up to the full day.

–     What are the stuck thoughts?  Anxious kids have stuck thoughts that maintain the anxiety.  “No one will play with me” or “There will be too many bugs” or “What if my parents don’t pick me up?” are all thoughts hear.  Talk through these with your child and help them see that these stuck thoughts are worry talking to them and are not true. Counter these with evidence and work to reframe the thought to something more accurate and helpful.  Make these visual and fun for your child – let’s be detectives to find the evidence, let’s be lawyers and argue our case, etc.:

  • “No one will play with me.”       “Even though meeting new people is hard, I can do  my best to say ‘hi’ and make new friends.  If I feel left out, I can ask a counselor for help joining in. I have been worried about making friends before but it took a few days and then I felt comfortable.  I just need to give myself some time to adjust.”
  • “There will be too many bugs.  I will get stung.”      “I might not like bugs but they are part of summer.  I can wear bug spray, wave them away or ask to take a break inside if I feel overwhelmed.  Even though I don’t like bugs, they are not putting me in danger. It is unlikely that I get stung because I have been outside thousands of times and I have not been stung most of those times [calculate the percentage if that’s helpful for your child].  If I get stung, there is a camp nurse that will help it feel better. Every time I have been hurt in the past, the pain does go away.”
  • “What if my parents don’t pick me up?”      “It’s unlikely that my parents won’t pick me up because they do for everything else.  If for some reason they were running late, the camp staff could call them to make sure they were on the way.  I won’t be left alone until they get there to pick me up. My parents are always thinking about me and would not leave me behind.”


Before you know it, it will be time to head back to school.  For school transition anxiety, or starting a new school in the fall, give your child chances to visit the new school over the summer, play on the playground and set up playdates with classmates.  If it helps for your child to have a walkthrough, call the administrators and set this up privately.  Even though heading back to school is hard, remind your child what they can to reward themselves for being brave –special dinner or activity and getting to share about their first day with you.

Being anxious isn’t fun for anyone – children or parents, or siblings.  If your child is not able to work through their challenges and find enjoyment in everyday life, it may be time to get some additional help.  Especially if you work on this with your child and it affects your relationship negatively, it may be time to outsource this work.  Anxiety is difficult and it is something that can be managed but does take work.


Rebecca Goldberg, LCSW, RPT is a Licensed Clinical Social Worker and Registered Play Therapist in private practice in McLean, VA.  She specializes in working with children and adolescents who experience mental health issues and a large majority of her clients present with anxiety related issues.  The above information is adapted from her years of clinical work, experience in the field of anxiety and from the many other qualified professionals, she has trained with.  Feel free to contact Rebecca directly or see more about her work on her website: www.rebeccagoldberglcsw.com.


-Elizabeth Clark McKenzie, MS, CCC-SLP

What’s Happening?

We’ve been busy busy busy at Skill Builders! There are lots of exciting things happening around here. Here are some highlights!

Skill Builders Del Ray           

 Little Yellow House

In case you missed the big announcement- Skill Builders now has a Del Ray location. You can find us at the “Little Yellow House” right on Mount Vernon Avenue. We are currently only seeing speech therapy clients there, but keep your eyes peeled for updates as we get to know our new neighborhood. We hope to be bringing our full array of services to Del Ray soon!


This month, we say goodbye to two phenomenal therapists. Lauren Mazel is relocating to Massachusetts (But first, she taking time to travel around Southeast Asia!) and Julie Aills is returning back to her home state of Ohio. These two will be sorely missed around here, but we are eager to hear of their successes!

New Faces

We are thrilled to welcome THREE new therapists to the Skill Builders team!


Amanda Biesecker received her BS in Rehab and Disability Studies from Auburn University in 2008, and her Master’s in OT from the University of Alabama Birmingham in 2010. She just moved to Alexandria from Boston with her husband and 3 year old son.


Caitlin Jones (you may remember her as a speech-language pathology intern here last Fall!) received her Bachelor’s Degree in Special Education from Elon University, and taught for one year in North Carolina, before moving to Washington DC to attend the George Washington University.  She received her Master’s Degree from GWU in 2018. She is originally from Pennsylvania.


Aimee Jennings received her Bachelor’s degree from Longwood University in 2014. She also received her Master’s degree from Longwood University in 2016! She is originally from Northern VA.

Internship Program


Did you know that Skill Builders has a new internship program? This is a fabulous opportunity for teens and young adults to work on important vocational skills under the supervision of a skilled therapist, all in the welcoming and inclusive setting of our office! You might see our interns taking care of things in the waiting room or greeting clients at the front desk. If you catch any of them doing a great job…be sure to let them know! 🙂

Fun Summer Offerings


Emily Smolak, MS, OTR/L is offering Aquatic OT sessions! These fun, individualized one-on-one sessions will be held at Audrey Moore RECenter, off of Braddock Road in Annandale. You can contact Emily directly for more info! (Emily@skillbuildersllc.com)

dance class

My popular dance and movement class is back for the summer, and I am offering classes “a la carte” for the first time! If you have ever wanted to try out my dance class, this is a perfect time. You can contact me directly for dates and sign up details. (ElizabethM@skillbuildersllc.com)

Camp SuperNOVA

Camp SuperNOVA Rocket

Our smash-hit summer camp is back and we are excited to say that we are officially full! Each week, 15 lucky campers will join us for exciting activities and fun new experiences. Keep your eyes on our social media pages for photos and updates. Missed out on camp for this year? Sign up for our emails to get priority notification about camp registration for 2019!

PLAY Project


Skill Builders is co-hosting the PLAY Project with our friends at Washington Speech.       This is a fabulous opportunity for parents and professionals who work with children on the Autism Spectrum. Several of our therapists will be attending and we hope to see you there! Click here for registration info.


Do you have any ideas or things you want to see at Skill Builders? We always want to hear from our clients about ways we can better serve the families we work with. Drop us a line and give us your thoughts! (info@skillbuildersllc.com)


We hope your summer is off to a great start! Check back soon for more fun updates about practice.


-Elizabeth Clark McKenzie, MS, CCC-SLP

Summer Therapy



Schools are out and hot weather is here to stay…it is SUMMER TIME! 🙂

Here at Skill Builders, we are gearing up to start our summer schedule next week. The summer can be a really busy time for families between camps and vacations, and it is easy for the weeks to fly by quickly! Now is a great time to shake things up in therapy. Here are 5 tips to help you get the most out of your summer therapy sessions:

1. Schedule a team meeting

– The summer can be a really nice time to schedule a meeting with both parents, the therapist(s) and even nannies or other caregivers.   At our practice, we have both SLPs and OTs on staff, so we try to include both treating therapists when at all possible.  This meeting can be used to talk about progress, share important updates from school and talk about any changes in the routines at home. I also use these meetings as an opportunity to modify or update goal areas.

2. Choose a focus

-Since you often only have about 8 sessions over the summer, it is a great time to select one or two goal areas to intensively focus on. This allows us to really make some progress in one area, and have the satisfaction of checking a goal off our list by the end of the summer. I like to get input from my kids. I will ask them “What is something you really want to work on this summer?“. One year, I worked with a kid on intelligibly saying his sister’s name. It was great to target something so functional and my client was extra motivated to work on this goal. How satisfying!

3. Pick a project

-For many kids, it can be fun to pick a project that will be worked on every week. I like to pick a project that is tailored to the child’s personal interests. Doing this can make the summer feel more like a special camp that is separate from the rest of the school year. At the end of the summer, the child has a finished project to show off all of his hard work! One of my kiddos wrote his own comic book over the course of 8 weeks, and we surprised his parents with it at the last session.

4. Change it up

-I have been seeing some of my kids for years! Even the hardest little workers can get demotivated by the same old routine over and over again. Try changing rooms, starting a new type of schedule, or playing music during the session. The summer is also a great time to try having the child work with another therapist once or twice. A new set of eyes can be really helpful in setting new goals, and it allows the child to practice generalizing skills with a whole new person. Shaking things up in the summer can help you start the new school year off with a fresh attitude.

5. Do the homework

-I get it…the word homework does not scream “summer fun!” but the summer is a really great time to prioritize home practice because you don’t have other school assignments to do.  I love it when parents ask me for ideas for home because it increases the carry-over from session to session! There are lots of ways to make homework a bit more fun, like earning stickers towards a fun reward or creating assignments that can be done outside or better yet, in the swimming pool!

Looking forward to a fun and productive summer here at Skill Builders! Check out our Instagram feed for fun pictures of all the fun things happening in therapy this summer!


-Elizabeth Clark McKenzie, MS, CCC-SLP



The Theory of Loose Parts

‘In any environment, both the degree of inventiveness and creativity and the possibility of discovery are directly proportional to the number and kind of variables in it.’

~ Simon Nicholson, Architect




In 1971, architect Simon Nicholson wrote a groundbreaking paper in an architecture journal titled “How Not To Cheat Children- The Theory of Loose Parts“.  Nicholson proposed that it is loose parts in our environment that empower creativity.

Loose parts refer to objects that have no predetermined purpose or set of directions and can be used alone or with other objects. Loose parts can be moved, carried, combined, redesigned, lined up, assembled, taken apart and put back together. The best example of loose parts is a set of wooden blocks. Think of all the possibilities beyond just building a tower- making a train, tossing blocks into a bucket, filling a toy truck, pretending to cook/eat the blocks, etc etc etc. There is no wrong answer!

Nicholson’s theory is based on the idea that all children are creative beings- not just a gifted few- and by giving children “open-ended” play materials, we are giving them endless opportunities to create. Over the years, this concept has completely changed the play landscape of preschools, childcare centers, and toy design. Experts love loose parts because they can be used in any way the child chooses, encourage mastery and generalization of multiple skills, and promote individuality. Parents love loose parts because you don’t have to invest in expensive, fancy toys!

I have been thinking a lot about this recently with many of my little friends who struggle with creativity in play. I have been trying to be more mindful of what materials I am offering, as well as what recommendations I am making for home. Children don’t always use materials the way us adults expect them to. Just the other day, I pulled out a bin of plastic balls, in all different sizes and colors. I was planning to show the 20-month old that I was working with how to roll these balls down a ramp. Before I knew it, the little guy had hidden 3 of the balls in his shoe and was covering his eyes saying “Ball….where are you?“. Why didn’t I think of that?!


For more ideas of materials to keep on hand, check out our previous post on non-toys.

-Elizabeth Clark McKenzie, MS, CCC-SLP


Useful Apps

In this day and age of technology, there are many useful apps out there that can make the jobs of parents, caregivers and therapists just a little bit easier! Here are 7 fantastic apps to check out:

Tantrum Tracker   Tantrum Tracker App 1Tantrum Tacker App 2This app is great! It allows you to track locations, triggers, take photos and videos, and write up to 25,000 characters of notes related to the event. It also consolidates the data and looks for any patterns or commonalities for you. You can easily share the information with teachers, therapists, and other caregivers.

Time Timer time timer 2Time Timer 3The Time Timer app is SO useful for therapists and parents alike! You can adjust the timer to any increment that you like, and you can have multiple timers going at once. Children can easily see how much time is left. You can also save your timers to reuse for future!

Learny Food Food App1Food App 2I like this app to use for my picky eaters. It provides visual prompts and rewards for trying new foods, allows children to earn tokens and prizes, and keeps track of progress. My favorite feature is that you can offer the child visual choices, and he can rate the food right within the app!

iPrompts First Then AppFirstThen 2I just recently discovered this app and it has been a game changer for one of my clients! The app allows you to create and save visual schedules that are completely customized to the child, complete with real photos!

First Then Visual Schedule iPrompts AppiPromptsApp2Similar to the iPrompts app, this app creates visual schedules but in a much more simplistic way. I love this app for earlier language learners. It also comes with a timer that can be paired with each task. I also love the “make a choice” feature, which provides visual choices to the user.

DreamyKidDreamyKid1DreamyKid2 Mindfulness is all the rage these days, and for good reason! I have been trying to work some calming strategies into all of my sessions, and this app is super helpful! It has fun graphics that guide children through meditations, as well as ideas for activities, inspirational quotes, and yoga poses. You can also access calming background music or nature sounds to use while completing other tasks.

ArtKiveArtKive1ArtKive2This is a little bit of a bonus, but I love this app! It is designed to store and organize photos of children’s artwork, but could also be used by therapists to keep track of drawing, handwriting, and other visual-motor tasks. The files are easily accessible and you can create profiles for multiple children.

I am always looking for ones to recommend to parents. What are some of your favorite apps?

Elizabeth Clark McKenzie, MS, CCC-SLP

Time to Play


Play. This word might seem inconsequential to some, but for the developing child, play is absolutely essential.

For many adults, we equate play with relaxing. As in, “First we do our work, and then we get to play.“, or “I don’t understand how he can be so tired- we did nothing but play all day!“.  What many don’t realize is that play IS the work.  Play is how children experience the world around them, master new concepts, utilize their sensory systems, and socialize with others. Research shows that children learn best through discovery and exploration using all of their senses. When young children are playing, they are actually learning to learn. So what you see your 18 month old doing with a bin of blocks is way more than just having fun. She is building the foundation to be a life-long learner!

Just like gross motor skills or language skills, play skills develop in phases. According to Cari Ebert, MS, CCC-SLP, we see play skills develop in this order:

1.Random and Exploratory Play 

In this phase, kids are picking up objects, banging them, mouthing them, holding them, and throwing them. This phase is all about taking in how things feel, and how objects relate to your body in space.

2. Cause and Effect Play

Now, children start to figure out that their actions can lead to an outcome. If I press the button, a light turns on. If I say “ba”, my mommy blows bubbles. If I push the block tower, all the blocks fall down. Cause and effect is the foundation of all other play, because it is the beginning of playing with a plan.

3. Functional Play

In this stage, children begin to play with the functions of objects. They are able to think about the concept of an object, and this directs their play. Children will start to push cars along a road or stir with a spoon which shows that they are applying previously learned knowledge into their play. How cool is that?!

4. Symbolic Play

Once functional play is mastered, a child is now able to think about objects that are not in the room. A plain wooden block can turn into a helicopter and a throw pillow can be a dog to take on a walk. This phase is so fun because the sky is the limit! Your child can now pull any fun idea into his play schema.

5. Constructive Play

At this point, kids will start to use their imagination and previous experiences to create. You might catch your kiddo building houses, skyscrapers, castles or even whole cities! Constructive play also involves building a play space, so you might see your child designate different materials to represent parts of an idea. For example, this pile of leaves is my bed and this pine cone is my alarm clock, and that tree over there is my mom’s bedroom. Kids in this phase may spend just as much time setting up their play as they actually do playing!

6. Dramatic Play

This is where the fun really begins! This is the phase in which they put it all together. Kids use their experiences, imaginations, fears, daydreams and emotions to orchestrate elaborate play schemas that may involve many different toys and materials, or no materials at all. This is the phase where collaborative play with friends really takes off too. Kids in this phase create their own storyline, and use their play as an avenue to explore all kinds of concepts and ideas. As their language skills expand, their dramatic play will too.



It is really important to consider the play phase that a child is in, rather than his chronological age. I advise parents to ignore that recommended ages on toys, and to focus more what what skills their child currently has. There is no need to rush the developmental process because we want a solid, strong foundation to build upon later.

Don’t succumb to the notion that young children need heavy academics and a rigorous schedule of extra-curricular activities to thrive! I’d actually argue just the opposite- kids need ample time carved out in each day that is dedicated completely to “just playing”. The most powerful learning experiences can come wrapped up in the simplest of packages.

Stay tuned to our blog for more tips on how to play with your child! To check out previous posts on play, click here, here or here.


Elizabeth Clark McKenzie, MS, CCC-SLP

Bubbles Bubbles Bubbles


If I could have one item in my therapy room, I would hands down choose bubbles.  You might be thinking “What is so great about bubbles?!“. Let me tell ya…I can target dozens of goals with one little container. Here is a list of my 10 favorite ways to use bubbles in therapy:

  1. Anticipation – For those early language learners, I hold the bubble wand up to my mouth, draw in my breath and round my lips. Then, I wait for the child to make eye contact, gesture or vocalize before I blow a bubble.
  2. Bilabial Sounds – Think of all the bilabial targets that you can hit! BUBBLE, MORE, POP, etc.
  3. Oral- Nasal Contrasts – For children who have difficulty keeping sounds out of their nose, I like to use bubble blowing as a way to demonstrate control of air flow.
  4. Lip Rounding –  Especially with little ones, learning to blow bubbles can be a fun way to model lip rounding! Sometimes, I even add a vocalization of a round vowel before blowing the bubble. (ex: “OO”)
  5. Breath Support– It takes a lot of control to blow a really big bubble! Practicing blowing one big bubble vs. many small bubbles is a great way to develop breath support.
  6. Requesting – Think of all the core words that you can utilize to request bubbles: MORE, AGAIN, GO, UP, DOWN, IN, OUT, PULL, WANT, HELP,etc.
  7. Turn Taking– If your child can blow bubbles himself, practice taking turns. Layer expressive language goals on there by adding “my turn”/”your turn“, or asking a question: “Do you want to try?
  8. Following Directions – My kids love playing the “Bubble Pop” game! We take turns giving each other directions on which parts of our body to use to pop the bubbles- thumbs, pinky fingers, elbows, knees, and even tummies! Social skills groups particularly get a kick out of this one.
  9. Impulse Control – I ask my child to strike a pose and hold it like a statue. I blow a bunch of bubbles around her, and she has to hold the pose without giving into the temptation to pop the bubbles!
  10. Regulation- In my therapeutic dance class, we like to end our class with a little something called “Bubble Yoga”. The children find a comfortable position on their backs or seated, and I blow bubbles all around them. The goal is for the children to watch the bubbles float and pop as their body relaxes into a calmer state. It works like a charm!


So the next time you need some inspiration, or you are running short on time to plan an elaborate therapy lesson, look no further than your trusty tumbler of bubbles! (I like this non-toxic and spill proof variety) Kids can’t get enough of them, and the possibilities are endless.

Have fun!


-Elizabeth Clark McKenzie, MS, CCC-SLP