3-4 years old

By 3-4 years old, the child should begin to show a hand preference and be able to use both hands to complete a task. It is an exciting time to see the child form lines and shapes and begin to cut on lines and curves. Here are some fine motor and visual motor milestones for this age:

• Cuts paper into 2 pieces within ½” of a straight line
• Completes 3 holes of a lacing card and strings beads
• Picks up tiny objects and puts in a small container
• Winds up a wind-up toy
• Holds pencil with thumb, index, and middle fingers
• Draws a circle and cross shape
• Traces horizontal line
• Puts together a 6-8 piece puzzle
• Builds a 9-10 cube tower & imitates building a 3 cube bridge

To improve your child’s fine motor skills, you can increase hand and finger strength with the following activities:

• Work with therapy putty or clay
• Use hold punches or craft punches
• Use spray bottles to water plants or wash toy cars
• Pick up small objects with tongs or tweezers
• Play with clothes pins
• Play tug-o-war
• Tear paper and fabrics and scrunch in one hand
• Place pegs in a pegboard or Lite Bright
• Pop plastic bubbles on packing sheets
• Use a medicine dropper to make pictures with water mixed with food coloring on paper towels
• Practice cutting on a variety of materials including play dough, straws, sandpaper, or index cards

To help develop pre-handwriting skills and visual perceptual skills:

• Write on a vertical surface (i.e. easel) or slant board (3 ring binder to promote wrist extension and develop grasp
• Use small pieces of broken chalk or crayons to develop a 3 finger grasp
• Improve motor coordination with simple beginner mazes, dot-to-dots and tracing around stencils
• Practice drawing shapes in finger paint, shaving cream, sand, etc.
• Hidden picture books (I Spy, Where’s Waldo)

1/2 cup honey
1/4 tsp. gfcf vanilla extract (this means alcohol free)
2/3 cup raisins
1/3 cup dried shredded coconut
1/3 cup gfcf chocolate chips (optional, Tropical Source is a good brand)
1/4 tsp. Coconut oil
3 cups gfcf crispy rice cereal (Erewhon is a good brand)

Mix almond butter, honey and vanilla until smooth. Add all other ingredients except the rice. Mix until well coated. Add the crispy rice gradually while stirring. When well mixed, firmly press the mixture into a greased square baking pan. Cover and refrigerate 1 day prior to serving so the bars can set up. Cut into bars and serve.

On September 9^th, 2009, a three and a half year old boy named Nathan and his family walked into OT Connection for their first Speech and Language evaluation due to a referral from a pediatric neurologist.  It was determined during this evaluation that Nathan used 50 signs/words/gestures, used two-word phrases and was approximately 50% intelligible; these skills are equivalent to that of a two-year old, indicating a 17 month delay.  Nathan was aggressive and defiant due to a significant language delay and diagnoses of Epilepsy and Autism.  It was at this time that speech therapy was recommended twice a week as Nathan was not yet enrolled in a school or daycare program and his delays were severe.  Before Nathan started therapy, the family stated they were glad someone was going to begin working with them as they had been told for months that he would grow out of his current behaviors and that he would develop appropriately.  “When he started therapy he didn’t talk to us a whole lot, and only I could really understand him”, says Aimee, Nathan’s mother.

Nathan was born on May 3^rd, 2006, 11 weeks before his due date.  He weighed three pounds three ounces and stayed in the NICU for a few weeks before going home.  Despite no prenatal care, complications with pregnancy or delivery were not present and developmental milestones were met within normal limits with the exception of speech and language.  Before walking into OT Connection in September, Nathan had only been followed by a pediatric neurologist due to febrile seizures, night terrors and aggressive behaviors.  His family was confused and concerned about his delays, behavior and attention. How this family was about to change over the next 9 months, they never expected.

During Nathan’s first sessions, he was angry and spoke mostly in one-word phrases.  He attempted to play with new toys/activities but became easily agitated and therefore required calming by his mother and therapist.  His parents assisted in therapy sessions when necessary, however they also understood that Nathan needed time to grow and learn from others.  Over the course of a few months, Nathan’s expressive and receptive language skills were improving. He was conversing with others, could tolerate re-direction when he was upset and greeted others spontaneously.  He was also enrolled in an early education class within the local school district which came with mixed emotions due to his history of inappropriate behaviors.  Nathan received individual speech therapy twice a week where he grew accustomed to his therapist and her training methods.  His parents were given specific recommendations to continue his treatment at home as well.

After receiving private speech therapy for seven months, Nathan received a Speech and Language Reassessment.   No one could have predicted what the results would indicate.  Given the same test from the prior year, Nathan had improved by 29 months in receptive language and 18 months in expressive language.  His age-equivalents in 2009, when he was chronologically three years of age, were that of a two year old and at the chronologic age of four, his equivalents were that of a three year and 11 month old child.

After such progress was made in speech and language and his disruptive behaviors had decreased significantly, his therapy was decreased to once a week.  It was in June of 2010 that he returned to regular classroom school sessions, enjoying his teacher, classroom and peers.  Nathan has made such progress that he is even riding the bus to and from school and is potty-trained.

Nathan has shown significant improvements over the course of therapy and his family and therapists are very proud of him.  If Nathan were to walk in our doors today, we would be happy to say that he would not qualify for services, and he should continue with regular school education and social/community based activities.  At this time, Nathan’s mother says “now he talks and talks and talks and he can tell us what he wants and needs, I honestly feel like we have a closer bond.  He has been able to grow into an amazing little boy cause of you because of the work of his speech therapist”.

Life with Nathan may still not be without challenges however he has made miraculous strides and his family unit is much less strained and happier.

Vocabulary can be thought of as the set of words that your child both understands and uses when he or she speaks. Vocabulary development begins during the first few months of life and lasts a life time. Vocabulary plays an important role in learning language. Prior to learning to speak, your child will build vocabulary of words that he or she understands.  As a child grows older their ability to produce vocabulary verbally begins to catch up with their ability to understand vocabulary. At 18 months, a child usually produces between 10-20 words, at 2 years of age a child typically has a vocabulary of around 200 words and at 3 that vocabulary typically grows to 900- 1,000 words.  By the time a child is 5 years old they have a vocabulary between 2,000-2,200 words. Parents can play an important role in growing their child’s vocabulary just by taking time to talk about experiences and activities of life that happen on a daily basis.

Fun Ideas for Increasing Your Child’s Vocabulary

• Read to your child every day. Use an enthusiastic tone of voice when reading and point out and specifically name familiar and unfamiliar pictures throughout the book.
• Providing new experiences to expose children to new vocabulary such as baking something and talking about the different ingredients, going to the zoo and talking about what the animals look like/where they live, visiting a children’s museum, or simply taking a walk in your neighborhood and talking about what you see.
• Listen and sing along to children’s songs.
• Give your child an object and help them describe it using all of their senses. How does the item look, feel, sound, smell or taste?
• Categorize items. Take turns seeing how many different types of foods, toys, clothing, animals, sports, or you and your child can name.
• Pick to objects and talk about their similarities and differences. For example, “How are a pencil and a marker the same?” “How are they different?”
• Teach opposite words. For example “That elephant was so big, but that mouse was so little!”
• Repetition, Repetition, Repetition! Repeat words and have your child imitate words you say.

So your child is a picky eater?  Keep trying, there is definitely hope.  Firstly congratulate yourself, because you child is probably still growing and learning so are doing something right.  It is so difficult when you child will not eat well.  This is one of the most basic things we provide for our children and when it is challenging it can be so stressful, to everyone.

Secondly, and possibly most importantly try to de-stress mealtimes.  If we stress about their eating they will pick up on that and often will resist our attempts to get them to eat even more.  Be calm, don’t over emphasize when they do well or poorly at a given meal.  When they do well, say “Good Job!” and no more.  Do no over-praise for success.  We want to communicate that we are glad but that we expect them to eat well.  When they refuse a bite or a new food, have a calm, neutral response, or say nothing.  Just try it again in a little bit.  If they have negative behavior, like throwing food, correct them one time, “Don’t throw food.”  Then ignore the behavior, and remove the item they are throwing.  Then offer it again later.

Here are a few tips to “warm-up” your child for meal times.

1) Do firm, slow, stroking of their cheeks:  start at the jaw and move toward the lips.  Do it high, in the middle and low on the cheeks.   2) Try to get them to bite/munch/chew on both side of the mouth on an appropriate oral toy (your finger if they don’t have any teeth or a chew toy if they do have teeth).   3) Try to touch their tongue firmly and slowly, with the chew toy on the front ½ of the tongue.  Be careful not to cause a gag.  Try and sing a song while you do the stimulation.  It should take 1-2 minutes at the most.

4)  Offer small portions of foods you want them to eat.  If they refuse, keep offering again a little later.  Gentle persistence is our friend!!  5) Never force your child to eat anything, no one wins in that situation.

If you have any concerns of course talk to you health care provider and of course, you can always ask your therapist with your concerns.

Cindy Martin, OTR

Difficulty: Easy
Age: 6 and up, though younger children can assist with adding water and glitter.
Parental supervision is recommended


Let it snow, let it snow, let it snow! This darling little craft is made from recycled baby food jars, or any other type of jar you have sitting around collecting dust. We suggest making more than one, or you won’t want to give up this little keepsake to your child—they’re great to keep around your own home, perfect for your computer desk. Give your globe a theme and make it a gift for Christmas, Halloween, birthdays or any occasion. Or, you can make a snow globe featuring your favorite characters or animals such as Dinosaurs, Spiderman or Barbie. Enjoy!

What you’ll need:
•    Baby food jars (medium or large) or any other type of jar with a lid
•    Florist clay (can be found at any craft supply store)
•    Small figurine (see “Choosing your figurine” under “Helpful Hints”)
•    White and/or silver glitter or fake snow
•    Hot glue gun or aquarium sealing glue (hot glue is less expensive)
•    Ribbon or felt (optional)
•    Garland plastic greenery (see “Getting your greenery” under “Helpful hints”)

How to make it:
1.    Wash and dry your jar completely, including the lid.
2.    Attach figurine to inside of jar lid using florist clay. If you are using a small object, it’s a good idea to build up the clay so the object will appear taller. To preview, simply place empty jar over the top of your figurine to see if you have the height where you want it. Attach any optional items with the clay (greenery, berries, etc.). Important: Use your imagination, but make sure whatever you use is waterproof and won’t dissolve.
3.    Fill jar with water to within 1/2 inch (1 cm) of top. Use cold water, warm water tends to cloud. Sprinkle ½ teaspoon of glitter, or “ snow” into water. This measurement is based on a medium to large baby food jar. Adjust glitter amount according to your size jar.
4.    Using hot glue gun, line inside of lid with glue. Insert figurine in water and screw on lid.
5.    Dab lid dry if any water dripped or spilled. Apply a layer of hot glue around the rim of the lid to seal shut.
6.    Let stand and dry overnight — lid side up.
7.    Decorating the lid rim is optional, and there are several ways to do it. Attach decorative ribbon with glue, use plastic holly berries for a holiday feel, or use colored felt as we have. This can be as simple or as elaborate as you like. Use white or craft glue to run a squiggly line around the felt then sprinkle with glitter and let dry. Glue on buttons, use stickers, or personalize your globe by writing your name in glue and sprinkling with glitter. You may also paint the lid rather than use ribbon or other embellishments. The possibilities are endless so have fun!
Tips:
Keep your globe secure. Make sure the objects are secure in the clay, you could even glue them for added security.
Choose your figurine wisely. Choose a figurine made of a material that will not dissolve or deteriorate in water over time. Cake toppers, small ornaments with the hanger removed, miniature toys and dolls are all possibilities.

Easy-to-find greenery. You will only need small pieces so look for stems in the floral department that are on sale or inexpensive. You can also trim pieces from silk and plastic greenery, or you can even fashion your own small trees out of chenille stems. Another option is to use tiny plastic pine trees found in toy train and car sets.
Glitter tips. Before gluing or sealing the lid, make sure you have sufficient amount of glitter. Depending on the size of the jar, you may need more or less. Be careful! Too much glitter will completely obscure your figurine.
Add color and pizzazz. To make a more elaborate snow globe, add tiny objects to “ float” in the water, use a drop of colored oil to create a swirling effect or use food coloring in the water. Or, instead of using just white or just silver glitter, mix the two colored glitters. Silver tends to fall faster, the white floats more. Putting them together creates a fun effect. These are just some ideas to help you create your one-of-a-kind snow globe. Use your imagination and have fun.

Choose a theme . Make your snow globe for any occasion or theme such as Halloween, birthday, sports, holiday, Victorian and beach (seashells). You can also make two and give one away as a gift.Save your felt scraps. This craft is a perfect example of utilizing small felt pieces that were left over from other projects so remember to save those scraps.