If you have been following Momfaming you know that my son Ryan has Down syndrome and because of that qualifies for Early On. This service is provided through our school district and includes an Occupational Therapist and a Physical Therapist coming to our house to work with him each week. These wonderful ladies give us so many great ideas and activities to help promote his physical and cognitive development.

Ryan is 16 months old (today, actually!) but is not necessarily working on milestones for a typical 16 month old. So to figure out if these activities are developmentally appropriate for your child, focus on the concepts they are working on as opposed to their specific age. So if you have a baby that is working on goals such as sitting up, mimicking, or using signals, check out my first post here. If you have an older baby (or toddler) working on things like standing, walking, or a pincer grasp you’re in the right place! Read on for the activities I have found the most helpful and Ryan has found the most fun! Let me know in the comments some activities you do to help your child meet these milestones, we’re always looking for new things to try!

~Erin

Large Motor Practice – Standing

Right now we are really working on standing with Ryan. These are the three activities that we’ve been doing to help strengthen his legs and teach him how to pull himself up to stand:

Standing with Assistance – he starts out sitting in a chair with his knees bent and feet flat on the floor, then he puts his hands onto a walker (or other toy that is the correct height) and he pulls himself up with assistance. I always make sure I’m correcting his feet once he’s up so that he has a sturdy base and each time he goes to stand I say the words “stand up” or just “up” so that he starts to learn the word that correlates to the action.
Keep Toys Out of Reach – once Ryan started pulling himself up to stand without much assistance we started putting his toys (and books) up on the couch or ottoman instead of on the ground. This way if he wants to play with his toys/read his books he not only has to pull himself up, but he also has to stand there while he plays.
Encourage “Cruising” – now that Ryan is continuing to pull himself up and standing to play for a few minutes we are starting to try to get him to “cruise” along the couch by moving the toys he wants to play with a little to his left or right. He needs a lot of support while he moves right now but hopefully soon he will start to do it more independently.

Large Motor Practice – Crawling

Ryan is now crawling around the house like a champ! Now that he is comfortable doing this we are working on crawling onto things. These activities are helping him practice this:

Start with the Couch – I know what you’re thinking, the couch cushion again!? But I’m telling you it works! We just pull a cushion off of the couch and put it on the ground right in front. We then put one of his favorite toys onto the couch where he can see it. When we first started we had to first put the toy on the cushion so he would crawl onto that; then move it onto the couch where the cushion used to be and so on so that he wouldn’t get discouraged. Now that he’s more comfortable doing it we can just put the toy high up on the couch and he crawls to get it immediately.
Crawling Onto Your Lap – once he got the hang of climbing onto the couch I started to encourage him to crawl all the way into my lap instead of just grabbing him and putting him in my lap when he crawls to me.
Finally…the Stairs – climbing up the stairs is eventually the goal of all of this so once you feel your child is ready, make them try it! When Ryan first started I had to really assist him (by kneeling right behind him so he could push off of my legs and encouraging him to put his hands onto the next stair). Then we moved on to helping him bend his knees and lift one leg up at a time (to do this, just gently squeeze the hip of the knee you want him to bend and his natural reflex will be to lift that knee up). He is still not doing the stairs independently but he crawls (with some assistance) up them every time we go upstairs and he is definitely getting better each time!

Fine Motor Practice

Fine motor skills are definitely harder for Ryan to master. Luckily, these activities are fun so he likes to practice often!

Put On/Take Off – we use a toy (like the ring towers below) and I say “take off” and have him take the rings off one at a time (sometimes he just knocks the whole thing over so that they all fall off but I encourage him to do it one at a time because that takes more fine motor control). Then I have him pick up one of the rings while I hold the base out and instruct him to “put on”. I make sure that he is successful by moving the base around until he is able to easily place the ring on it. Then we cheer like he just finished a marathon so that he knows that he did it right. This is also great because along with practicing fine motor skills it also helps him start to follow simple directions.
Put In/Take Out – we started to introduce this concept with a large bin that had several small toys in it. I would have Ryan put his hand in the bin and say “take out” each time he would reach in and bring out a toy. Then we would empty the bin and encourage him to put the toys back in by handing him a toy one at a time, holding the bin under his hand and saying “put in” (if a child is having trouble releasing the toy make sure to rest his/her arm on the bin and it will cause him to drop the toy because of a reflex). After repeating this many times with help he is beginning to independently put toys in when asked. Next step, helping mom clean up!
Practice with Food – picking up food and putting it into our mouths takes a lot of fine motor control. We started to practice this by holding a piece of food in our palm and having him scoop it up with all of his fingers. Now we hand him a piece of food using our pincer grasp (thumb and pointer finger) which encourages him to grab it the same way. Right now he is using his middle finger along with his thumb and pointer but that is okay at this point!

Language Development

Give Choices – to add some language to play time we have started to give Ryan choices on what he wants to use. For example, when we are reading him stories we hold up 2 books and ask him to choose which one he wants us to read. He will point to one, so we read it, and when we are done reading we give him 2 new choices. We do the same for his toys but he isn’t always as decisive with this. To help him understand the name for each toy I made him a book with pictures of his favorite toys in it and what we call them (make sure you are calling it the same thing each time so that he can start to associate the correct name with each toy). We show him the pictures and ask him to point to which one he wants to play with and hand him the toy he points to (see picture below).
Use Signs – since Ryan doesn’t have very many words yet we have started to introduce signs. We started with “more” and have moved on to “all done”, “open”, and “want/give”. Whenever we are playing we make sure to make the sign while saying the word several times and encourage him to try to do it himself. If he is having a hard time we will move his hands with ours but we try not to do this too much.
Simple Directions – now that Ryan is understanding a lot of what we’re saying we ask him to follow simple directions. This also reiterates labels for things he sees all the time (ball, mama, doggy, etc.). A game we play a lot is “give the ball to mama” or “give the block to dada” to see if he will bring the correct toy to the correct person.

Foster Independence

Crawling Everywhere – now that Ryan is crawling so easily we don’t pick him up and carry him around as much. When it’s time to eat, we walk into the dining room and tell him to come with us. It may take a little longer but eventually that smiling face peeks around the corner and joins us. We do this as often as we can and he has really started to get the hang of it and follows us pretty easily.
Playing Independently – although these are all activities that involve you playing with your child I also encourage you to allow them to play independently (it is actually a milestone they need to reach!) Ryan loves to sit on the ground and “read” his books or play with his toys even when we aren’t doing it with him. He’ll always make sure we are close and checks in with us but he’s really good at playing by himself.

When Ryan was 4 months old he qualified for Early On because of his Down syndrome diagnosis. Early On is a special education program for children aged 0-3 that is provided through our school district. As part of his services he has an Occupational Therapist (OT) and a Physical Therapist (PT) come to our house once a week for an hour each. These amazing ladies use the hour to “play” with him and basically teach me (and sometimes my husband) activities to do with him to promote his physical and cognitive development. I thought I would share some of their tips and tricks for others looking to do the same with their babies.

Tips & Tricks from an OT and a PT

Start with Signals

Babies can understand and use signals long before they can actually say them. So if you want your baby to be able to communicate with you before he has the
words to do so teach him some easy signals.

Trick #1:
To get a baby to raise his arm up —
Softly run your hand down the baby’s arm (from elbow to wrist) and it will automatically raise up due to his natural reflexes

The three we started with were “up”, “hi”, and “bye”. All of these include the baby raising his arms up so the trick to get him to do this is to softly run your hands down his arms (from elbow to wrist) and his arms will automatically raise up due to his natural reflexes. Once you get his arm(s) up, say the word you want him to learn (“up”, “hi”, or “bye”).

So for “up”, run your hands down both of the baby’s arms at once and repeat “up” several times. We did this before we picked Ryan up each time (and had other people do the same) and he now does it whenever we say “up”. He also reaches up when he wants to be picked up without us prompting him occasionally.

For “hi” and “bye”, run your hands down whichever arm you want your baby to use and then once the arm is up, put your hand on his and move it back and forth while repeating “hi” or “bye”. We are still working on this one with Ryan but he does do it occasionally on his own.

Take Turns Talking

Babbling and cooing are a baby’s first steps in language development. In order to help your baby progress from this to saying real words you need to join in the conversation. When he is “talking” act interested and look in his eyes.

Trick #2:
To promote language development —
Have a conversation with your baby and say things like, “really!?”, or “I can’t believe it!”

Then when he takes a break, start talking back (just like you would in a real conversation). Either repeat back to him what you think he is saying or say things like, “really?”, or “I can’t believe it!”. Then once he starts saying a group of sounds (ga-ga, da-da) repeat those sounds back to him a few times and then introduce a new set of sounds (pa-pa) and see if he will say that back. We have been doing this with Ryan ever since he was a newborn and the OT and PT are both shocked at how vocal he has been since they met him!

Use Furniture Instead of “Containers”

We got to a point where we wanted Ryan to sit up and play before he was able to do so independently so we used a Sit-Me-Up Chair to help him. He loved it because he could see so much more than when he was laying on his back, and I loved it because I could see his cute little face while I played with him.

Trick #3:
To help a baby sit up before they are able to do so independently —
Use couch cushions to prop your baby up so that you can play with them

While this chair is perfect for when I want to leave the room for a minute and for feeding him (when we don’t have access to a highchair) the OT and PT suggested not to use it for play time. They said that the chair was doing most of the work for him instead of his muscles learning to do it for themselves. So instead, they suggested I use the furniture to help him sit up. We either put him in the corner of the couch (if we were sitting right next to him) or we bring the couch cushions to the floor and put him in the middle of them. He loves sitting like this to play with his toys and even though the cushions are there if he starts to fall, he is now usually sitting up on his own and not even using them.

Have Fun with a Mirror

Mirrors are great to promote language and cognitive development. When Ryan looks in the mirror he immediately starts “talking” to the baby looking back at him. This is great practice for him (and hilarious to watch)! He is also able to see how his mouth moves when he is making his sounds (or how my mouth moves if I join him in the mirror and talk back to him). This helps him understand that his mouth needs to make different shapes in order to make different sounds.

Play Peek-a-Boo

It is so fun when your baby reaches the age where he can really start to play with you and Peek-a-Boo is one of the first games he will be able to play. In order to help Ryan learn this game the OT first put a burp cloth over his head to see what he would do. The first time he just wiggled around trying to figure out how to get it off. After she did it a few more times, though, he realized that he had to grab it off using his hand. Once he had it off we excitedly said, “peek a boo!” so he realized that it was a game. He now immediately takes the cloth off and smiles because he knows that he has won the game. He will also sometimes hold the cloth over his own face, pull it down, and smile when I say “peek a boo”.

Trick #4:
To help your baby understand object permanence –
Teach them to play Peek-a-Boo with themselves and with toys

The OT then moved on to putting the burp cloth over one of his toys. She started with his favorite toy so that he would be more interested in finding it. So she put the toy in front of him, let him see and touch it, and then placed the burp cloth over it. This version of the game took a little longer for him to figure out but he finally understood that if he took the cloth off his toy was still under it. This really helps to promote cognitive development because it means that the baby is beginning to understand the concept of object permanence and realizing that something doesn’t disappear just because it is out of sight.

Encourage Mimicking

They say that imitation is the sincerest form of flattery, right? This is even true with babies! When you can get them to mimic something you are doing it is really helping to promote their cognitive development. One of the first things I was able to get Ryan to mimic (besides sounds) was clapping. I started by clapping his hands together with him and cheering, “yay, Ryan!” I did this for several days until one day I said it and he clapped all on his own. We then moved on to “Patty Cake” and he’ll now start clapping if I just start singing that song. Other ways to encourage mimicking are playing with a toy first and then seeing if he will do what you did after, making sounds and trying to get him to repeat them, and joining him in the mirror and seeing if you can get him to make the same silly faces that you do!

All of these activities are very simple and use things that are easily found in your home. Some may be things that you are already doing, but hopefully this gave you a few tips and/or tricks to help you the next time you want to meaningfully play with your baby!

What are the best activities you have found to help promote your baby’s cognitive and physical development?

Tag: Cognitive Development

Activities To Promote Cognitive and Physical Development: Part 2

Activities to Promote Cognitive and Physical Development in Babies