By: Britt Collins M.S., OTR/L and Jackie Linder Olson

Here are some excerpts from Britt and Jackie’s new book that was just released October 2010
Buy this book on Amazon.com
The Importance of Tummy Time
OCCUPATIONAL THERAPIST TIP: From a sensory and development perspective, begin with “tummy time” as soon as you get home from the hospital. A few minutes a day with supervision will really strengthen your baby’s head and neck muscles, and he will begin holding his head up after the first couple of weeks. This developmental position is crucial for your baby’s development of motor skills, as well as increasing the tactile awareness of your baby’s cheeks, which helps with oral-motor skills.
Tummy time is when your baby lays on his stomach, on a blanket or a baby-friendly mat placed on the floor or on a table with supervision. Always stay with your baby during tummy time and lower yourself to be at eye level with them. Talk to your baby, sing to him, or be silly to encourage your baby to lift his head. You can also have “tummy-totummy” time with your baby. Start by leaning back at a 45º angle, on either the couch or the floor, making sure your back is securely supported (with pillows or the like). Next, place your baby onto your chest, on his tummy. He will be on his stomach, but able to look up at you. You may also try this while you are lying flat. When you place a child on his stomach, he usually does not like having his face down in the carpet, or he is interested in the fun baby mat he’s lying on, so he will eventually learn to turn his head from side to side and to lift it up off the floor. Be patient. This make take some time and practice. If your baby gets a little fussy on his tummy, that’s okay. If he’s crying uncontrollably, he may have reflux or an upset tummy. Move him to a more comfortable position, and try “tummy time” later.
Developmental Milestones,
0 to 6 Months
Babies develop at different rates and accomplish various milestones at different times, so please don’t worry if your child is not exactly on track. We will tell you what signs you should be looking for—if there is a delay, you can talk to your pediatrician, but again—EVERY child is different. That is what makes us so wonderful as human beings!
1-2 MONTHS
Gross- and Fine-Motor Development

• Displays jerky hand and arm movements
• Brings one hand to his mouth, hands are fists
• Lifts his head while lying on his tummy
• Moves his head side to side while lying on his tummy
• Brings his hands to midline while lying on his back

Visual Development

• Can focus 8-12 inches from his face
• Sees better in black or white or in highly contrasting colors
• Prefers to look a at human face, especially his mother’s face
• Follows a moving person with his eyes while lying on his back
• Has fully developed hearing

Touch and Smell Development

• Recognizes the smell of mother’s breast milk
• Prefers sweeter smells
• Prefers gentle touch rather than course touch

Speech and Language Development

• Startles at loud sounds
• Quiets when spoken to
• Makes cooing sounds

Social/Cognitive Development

• Smiles as a reflex
• Establishes eye contact
• Begins to draw attention to himself when he is distressed
• May begin to suck on his fingers at 1-4 months

Things to look out for at 1 month

• Stiffness or not moving the arms and legs much
• Poor suck or swallow or not gaining weight—check with your pediatrician about how much your baby should be gaining
• Not blinking at a bright light
• Not responding to loud sounds

3-4 MONTHS
Gross- and Fine-Motor Development

• Should be able to pick her head up when lying on her stomach
• Should be able to stretch out her legs and kick when lying on her back
• Grasps and shakes hand toys
• Begins to roll from her back to her tummy
• Holds her head up in supported sitting
• Opens her hands up more and brings them to midline
• Clasps her hands and grasps her toys actively

Visual-Motor Development

• Picks up small objects or toys
• Hits dangling objects, like those on a mobile
• Manipulates objects in her hands

Speech and Language Development

• Seems to recognize her mother’s voice
• Cries differently for different needs
• Smiles when she sees you
• Watches your face when you speak
• Makes noises when talked to

Social/Cognitive Development

• Socializes with strangers
• Stops unexplained crying
• Can tell the difference between mommy and a stranger
• Enjoys social play, like “Peek-a-boo”
• Recognizes her bottle visually
• May begin to eat pureed foods and/or rice cereal—check with your pediatrician on when to start baby foods
• Begins putting her hands up to her bottle

5-6 MONTHS
Gross- and Fine-Motor Development

• Is able to move his head side to side while sitting
• Sits by leaning on hands
• Can almost bear his entire weight on his legs
• Pulls clothing over his face
• Opens hands more and the fingers straighten out
• Reaches for and grasps objects
• Can drop and pick up a toy
• Bangs objects on a table
• Transfers an object from one hand to the other
• Holds his own bottle
• May push up to all fours from his tummy
• May begin to rock back and forth on his hands and knees
• Lunges forward and reaches while in a sitting position without losing his balance
• changes in the tone of your voice
• Notices that toys make sounds
• Vocalizes excitement and displeasure
• Makes gurgling sounds

Social/Cognitive Development

• Lifts his arms to be picked up
• May start displaying some stranger anxiety (or may not until 7-8 months)
• Explores adults’ facial features and hand features
• Recognizes his own name
• Displays stranger anxiety
• Enjoys social play
• Explores his hands and mouth
• Is interested in mirror images
• Opens his mouth when presented with food on a spoon
• Eats fruits and vegetables and gums dissolvable foods

If your child is not on target with her developmental milestones and you are concerned, consult with your pediatrician. Many times, as an occupational therapist, I have parents bring their kids in for occupational therapy around 1 or 2 years of age, and I ask them why they waited so long to come see me. The parents will many times reply that their doctor told them to wait and see. Well, sometimes that is the best thing to do, but other times it is not.
Speech therapist Nicole Collings states, “It does not hurt to at least have an evaluation completed by a therapist if you are concerned about your child, but it CAN hurt to wait!”
Baby’s Sensory Systems
Baby’s Ears
We conducted a survey and asked 100 parents which, if any, of their baby’s sensory systems was an issue. The results showed that more than 35% of parents noticed a problem with their baby’s auditory system. First, let’s explore just how much your baby’s auditory system is
developing.
Auditory Development
Your baby is able to hear at birth—however, his hearing abilities will become more complex throughout childhood. Your baby’s sound localization improves, meaning his ability to locate where a sound is coming from and if the sound is close by or far away. He’s also more likely to be able to differentiate sounds in an active environment—inside a restaurant, for example, he will be able to “tune out” some noises while focusing on his parents’ voices. Your baby’s auditory threshold is still developing, and he will most likely respond best to your “Mommy voice” (a high-pitched voice used to give praise and affection to our babies and pets). The frequencies of higher-pitched voices make it easier for babies to distinguish individual parts of speech.
Ear Infections
Why is it that our ears are most susceptible to ear infections at the age when our auditory development is so crucially developing? Ear infections can start early—even in the womb, caused by infections in a pregnant woman. Genital herpes, toxoplasmosis, syphilis, and rubella may cause ear infections in an unborn baby. Mercury and lead, amongst many other chemicals, are known to specifically damage the developing auditory system.
Once a child is born, there are several more factors to consider. Bottle-fed babies, children exposed to second-hand smoke, and children in daycare or in multiple-child environments are more prone to ear infections, but genetics are also an underlying factor. If your baby has narrow Eustachian tubes, the chances of developing an ear infection are higher.
Since ear infections are caused by bacteria or a virus, either can result in fluid buildup in the middle inner ear and through the Eustachian tube. While breastfeeding and keeping your baby home might help, there are no guarantees that your child will not get ear infections.
Signs of Ear Infection or Eustachian Tube Blockage
While not all the signs occur with every baby, look for a fever, reduced appetite, fussiness, grabbing at the ears, and possible yellow drainage. More persistent blockage may result in partial deafness. Is your child responding to her name being called? Is she babbling? Does she startle when there is a loud noise or when a siren drives by? Ear infections are painful. If your baby has an ear infection, know that she is uncomfortable. Since ear infections are often accompanied by a sinus infection or a cold, your baby is going to need some extra
tender loving care while her body fights off the infection.
What to Do?
Call your doctor immediately. It is always better to be safe than sorry. Your doctor might recommend letting your baby’s body fight the infection naturally, prescribe an antibiotic, or, if the ear infections are persistent and chronic, suggest surgically inserting tubes to alleviate the frequency of the infections. Whatever the choice, it is between you and your doctor. The good news is that there are not any conclusive studies stating that children with chronic ear infections suffer from language delays or learning disabilities in their school years. My personal experience is not consistent with their conclusions. My son had a hearing blockage (we’re not sure for how long), and it has taken a very long time for him to catch up to his peers in speech, as well as in language comprehension.
This Months Featured Authors Britt Collins, M.S., OTR/L & Jackie Linder Olson
We thank our authors for providing us with this article for our Monthly newsletter.
Britt Collins, M.S., OTR/L and Jackie Olson – an occupational therapist and parent team – have organized and combined parenting information along with sensory integration methods, tips and solutions. We’ve done our work, now it’s your turn! We’ve made it easy and fun and will help you avoid a lot of unnecessary battles between you and your child. It’s amazing how quickly our children adapt and the little adjustments that can make our days smoother. Who knew that our sensory systems affect every aspect of our lives? We all do now.
About Britt
Britt grew up with a younger sister with special needs, and always knew she wanted to work with this special population. She completed her undergraduate degree in Human Development and Family Studies and then went on to earn her Masters degree in Occupational Therapy, both from Colorado State University. While completing her graduate courses, she worked as a behavior consultant with children who were on the autism spectrum and had various behavior disorders. She has worked in private therapy clinics for children, schools across the country, skilled nursing facilities, homes and hospitals. Britt is going to be speaking at several OT and Autism conferences across the country over the next few months. Britt can be reached at [email protected].
To buy this book, please visit Amazon.com