Pronoun Practice


written by Nancianne Chin, Speech Therapist

Learning when to use gender specific pronouns she and he can be challenging for some children. In these cases, adults can help their child learn by simply placing stress on the pronouns they use when talking to their children.

Example: “Jimmy is in the playground. HE is swinging. What do you think HE will do next?”

Parents can stress pronouns during play and also when talking about what is happening in the world around them. Take a look at the toys in your house and consider which ones which have a gender. There may be some girl dollies, a stuffy who is considered to be a boy or male toy soldiers. Parents can stress the pronouns they use during play with these toys. Here are some ideas.

Tea Party: Talk about what the dolls are doing and wearing.

Example: She can wear this dress. Do you think SHE would like the blue or the white shoes? SHE likes chocolate cake. Would SHE like some more? Mmmm… SHE likes tea too!

Mr. Potato Head: Provide your child with Mr. Potato’s main body piece of the game while you keep the remaining Potato Head pieces for yourself. Provide your child with piece options while she or he puts Mr. Potato Head together.

Adult: “Does HE want blue shoes or green shoes?” Hold up the two options for your child to see.
Child: “Blue shoes.”
Adult:  “HE wants blue shoes!” Hand the preferred item to your child. “Good choice!”

Note: Try not to correct your child when your child makes errors, as this often results in a child feeling self-conscious about how she or he speaks. Repeating your child’s utterance is a less direct way to let your child know that the words she or he used were correct.

Books: For some other ideas on opportunities to practice, these books can also be helpful.

  • He Bear She Bear, by Stan and Jan Berenstain
  • Silly Sally, by Audrey Wood. Retell the story to talk about what SHE (Silly Sally) did!
  • Franklin, by Paulette Bourgeious and Brenda Clark. Talk about what HE (Franklin) did during or following the reading.

What is Speech-Language Pathology?


With May being Speech and Hearing Month, its a great time to celebrate and bring awareness to speech, language and hearing delays and disorders.

Let’s look at the facts: 1 in 10 Canadians has a speech, language or hearing problems. An estimated 4% of the preschool population has a significant speech or language disorder and communication disorders in school-aged children are often misdiagnosed as learning disabilities or behavioural problems

When a lot of people find out I’m a Speech-Language Pathologist (or SLP for short), I always get the question- “What is that?” “Do you like help people talk better?” [BIG SIGH]. Well, not exactly. We do a lot more than that. And really, our name’s kind of a misrepresentation of our field. My response to those questions, normally starts off with- “You know those kids who can’t say their /r/ or have a lisp? I treat those children and help them say their sounds properly.” But in reality, we do so much more than that… We can work with clients who are newborn infants all the way to adults in Nursing homes. We work with infants who have feeding problems, young children who are delayed in their language development or their speech sounds, children who stutter, and even children who have voice problems (e.g. they talk too loudly or they yell and scream so much their voice is hoarse 24/7). So, there you have it… We shouldn’t be called Speech-Language Pathologists; we should really be called a Speech-Language-Swallowing-Voice Pathologist.

So enough about WHAT we do… What about HOW we do it? If you walk into one of my therapy sessions right now, here’s a view of what it would look like. There are always toys set up all over the room and lots of games to play. We are always playing games and working on language goals at the same time. The games we play will target specific words/vocabulary or language that I want to practice with your child (e.g. We work on concepts ‘up’ and ‘down’ while playing with a car ramp, where the cars have to go UP and DOWN. Or work on asking questions by playing ‘Guess Who’ and ‘Go Fish’). The entire session is fun, up-beat and loaded with games, so your child is engaged and learning tons of language, while still playing and having a good time. I know it’s been a good session when the kids don’t want to leave and would rather stay and play more games with me.

Come visit us at Canoe Therapy!  You can see the clinic, meet some of the therapists and get to know the team, before even starting an assessment.

Physiotherapy and its role for active kids!


Finding the right type of physical activity for your child is tough with busy schedules, video games and computer technology. It is more important than ever to create healthy habits at a young age to combat the growing popularity of sedentary lifestyles. Physical activity has proven beneficial in preventing diseases, increasing quality of life, improving self-esteem, and promoting healthy growth and development. But is your child getting enough? The Canadian Physical activity guidelines recommends children and youth accumulate a minimum of 60 minutes of moderate to vigorous- intensity physical activity daily.

It’s important to remember that every child has different needs and interests. Keep this in mind when seeking out a physical activity for your child to best help them succeed. If you have questions or concerns about how best to increase your child’s physical activity or how to get them involved, a pediatric physiotherapist is a great resource. A pediatric physiotherapist can provide you with community opportunities for physical activity and can develop child specific exercise programs to assist your child to reach their full potential.

Physical activity is so important for our bodies, self- esteem and has a positive impact on children’s growth and development. If you need assistance picking out appropriate physical activities, require community resources or have concerns with how to get your child more physically active, a physiotherapist can provide you with additional information.

New Canadian Physical Activity Guidelines. Tremblay et al. (2011).

Haircuts without Tears


Written by: Sandra Ellis, Student Occupational Therapist, McMaster University

Like nail clipping, haircuts can also be a challenging task for a child with special needs, especially if they have sensory challenges. For many kids, haircuts cause pain or discomfort, anxiety or sensory overload. If a trip to the hairdresser has ever turned into a meltdown or you find yourself avoiding it all together, here are some suggestions that might help make the process a little easier for you and your loved one.

Sensory challenges:

  1. Try to plan the haircut for a time when the shop is less busy i.e. early in the morning or at the very end of the day to avoid sensory overload from a busy salon. Some hairdressers may be able to make exceptions (i.e. cutting your child’s hair after hours) if they know about your child’s challenges and if they are provided adequate notice.
  2. Wash your child’s hair at home – This can help avoid too much stimulation around the head, especially the vestibular impact of having to tilt their head backward for a wash at the salon. You can also control what shampoos are used (i.e. unscented, non-foaming).
  3. Try a different cutting tool – For boys, vibrating/buzzing electric razors may be preferable to the sensory impact of scissors (due less sudden movements, less noise), or vice versa. It may take a few trials, but you can try out different tools at home and see what works best for your child. If vibrating tools are preferable, you can prepare your child at home by giving them vibrating or buzzing toys to play with to help them get used to the sensation.
  4. Try giving your child headphones to listen to music or earplugs – the sound of the hair clippers or scissors may distress a child with auditory sensitivity. Listening to their favourite song can block out distressing sounds and help them stay calm.
  5. Cover their neck and skin with towel or cloth to avoid loose hair falling onto their body – this can be extremely uncomfortable for a child with tactile sensitivity. Using talcum powder on the neck before a haircut may help as it allows you to blow the loose hair off more easily (with a cool blow dryer) and it doesn’t itch!
  6. Bring a fresh shirt for after the haircut – this way, your child doesn’t have to deal with little loose hairs that hide themselves inside clothing.


  1. Increase exposure – Have your child visit the hairdresser and sit on your lap while you get your haircut, watch their siblings get their hair cut, or give a haircut to their bear or doll even when they are not getting their own hair cut. This way, they can generalize the experience and understand that it is a routine activity that everyone does.
  2. Talk through the process with your child (visual aids can be helpful as well) – explain what is happening and what the child can expect i.e. type of noises they might hear or sensations they might feel throughout the haircut experience. This may eliminate the extra stress of not knowing what to expect.
  3. Use friendly language – instead of “haircut,” talk about getting a “trim,” “tidying up” their hair, or getting their hair “styled.”

Finally, it is important to try and make haircuts a fun experience – offer your child something special after a haircut like a special toy or doing an activity they really love. This way, even if the haircut experience isn’t enjoyable, they can associate it with something they really like and will be more likely to do it again in the future.

All kids are different and it may take a few tries to figure out what tricks work best with your child. An Occupational Therapist can help to identify specific challenges your child is facing in their daily life and can help provide you and your child with strategies to reduce the impact of sensory issues or anxiety on this and other areas of your child’s life.


Promoting Speech and Language Through Books


By Victoria Vanderstoep (Student Communicative Disorders Assistant, Durham College)

As I was browsing through a local book store the other morning, the sheer number of children’s books amazed me. Some of them are stories I remember from my childhood, like the Dr. Seuss books, and the rest are newer books. The bookshelves are lined with brightly coloured, illustrated book covers, some of them with textured covers; I wanted to read them all!

Children’s books are an excellent and fun resource to use for promoting speech and language in young children! Story time allows parents and their children to sit quietly together while sharing a story or two. Books come in all sorts of shapes and sizes, some might rhyme, some might have flaps that children get to open, some could have textured pieces, like a dog’s fur, and some may even be noisy! But books aren’t only fun to read, books also promote joint attention, literal and inferential language comprehension, narrative comprehension and expressive and receptive vocabulary in children.

Exposure is a key ingredient to learning language. Children acquire the words they are hearing in their environment. Books expose children to a plethora of language, both familiar and unfamiliar words. Books encourage repetition, not only through reading the books multiple times, but also throughout the pages of a book. Words are repeated throughout the story, and used in different sentences, allowing the children to begin understanding the meaning of the word.

Reading books allows parents to join focus and follow their child’s lead, many times, children pick the books they are interested in reading, this allows for the parents to respond to the child’s interests and expand on their ideas.

Children learn language when their interest is sparked. The brightly coloured illustrations captivate their attention, drawing them into the book. These images encourage conversation between parents and children. Parents can ask questions about the pictures, or point out different parts of a picture that the child might not have realized. Parents can also expand on the written story by using the illustrations on each page. It’s important to remember that books don’t have to be read exactly as it is written. Parents have the ability to change the story. Stories can be changed to focus on a specific interest of the child, or to target a specific language area. For example, if a child loves dogs and the book has the dog as a character in the book, why not change the story so the dog is the main character, and the story is being told by the dog.

If you think your child may be struggling with literacy, speak with their teacher or Speech-Language Pathologist for more information.

Nail Care Tips for Sensory-Sensitive Children


Written by Sandra Ellis, Student OT, McMaster University

Recently, I was talking to a parent who was having trouble getting her sensory-sensitive child to let her cut his nails. This prompted me to wonder what kinds of parent-friendly strategies I could offer parents facing the same challenge. Many kids with sensory challenges can be adverse to personal hygiene activities like nail care because their super-sensitive finger tips may perceive the sensations involved in the activity as uncomfortable or painful. This reaction can result in a really stressful experience, both for the child and the parent. So, what’s a parent to do? Here are a few suggestions that may help you to conquer the nail cutting beast:

  • Try using alternative tools like nail scissors or baby nail clippers – these tools can be easier on the finger nails, creating a less of a sensory impact. They are also smaller, so less of the nail is being cut at one time, which may also be less stimulating for the child. Additionally, these tools can have a less intimidating appearance which might help avoid triggering any anxiety in your child.
  • Try cutting your child’s nails after a shower or bath, or soak the nails with some soothing aromatherapy oils – your child’s nails will be wet and soft, rather than dry and hard which will make the cutting process quicker and easier and may be less of a shock to your child.
  • Give your child’s hands, fingers, feet and toes and gentle massage or gently press on the centre of the nail before cutting – deep pressure can help to reduce overall sensitivity.
  • Cut only 1 or 2 nails per day – This way, nail cutting can be a short experience at first and becomes an everyday activity. The child will get more practice having his or her nails cut and can become desensitized over time. Once your child gets used to this, you can gradually build up to more and more nails at a time!
  • Model the activity for your child – let your child watch you clip your own nails, this way the child knows it is a normal and safe activity.
  • Stay calm and comfortable – It is important for you to stay happy and calm during the process too! If you are frustrated or upset, your child may pick up on this and it could trigger a negative response from them. More importantly, they may come to associate the activity with these negative feelings which could make nail care even more challenging in the long run. So, remember to keep a calm voice, calm and steady breathing, and calm controlled movements. You can even try to make the activity fun by singing a soothing song or counting softly during the process!
  • If your child is old enough, try teaching them to cut their own nails – this may reduce the surprise or anxiety of not knowing what to expect.

Grooming is important and can be a major challenge for kids with sensory issues, but with some patience and a few strategies, the process can be made a little easier. Nail care is just one of many personal hygiene activities that can be difficult for our sensory kids. An Occupational Therapist can help determine the best way to approach sensory issues with your kiddo and can provide strategies and work with kids directly to overcome these underlying sensory challenges.

G-Tube Transitioning


By Kayla Brown, Student Occupational Therapist, McMaster University.

A gastric feeding tube (g-tube), provides a long-term solution for children who are unable to get enough nutrition through traditional feeding methods. This ensures that a child can get the nutrition they need to grow and develop. However, as time goes on, many children are able to transition off of the g-tube and receive the majority of their nutrients through oral feeding. This transition can be a challenging process for many kids, but there are multiple ways that an occupational therapist can help your child have a successful transition.

Depending on their feeding history, a child may have unpleasant memories or pain that they associate eating. These can be conscious or unconscious memories. This can cause the child to fear eating even if the issue that caused pain or discomfort in the past has resolved.  Occupational therapists take a gradual approach to introducing your child to food, which helps to provide a safe and comfortable feeding experience. This slow and steady approach helps a child learn to view eating as a safe and enjoyable activity.

Although we don’t often think about it, chewing and swallowing requires a fair amount of strength and endurance from the muscles of the lip, jaw and tongue. Just like your leg muscles need regular exercise to stay strong, the muscles we use to eat can become weak if they are not used for an extended period of time. An occupational therapist can develop an exercise program to strengthen the muscles involved in feeding, and to help the child learn or relearn how to safely chew and swallow food.

If a child has been getting nutrients through a g-tube for an extended period of time and has not been using their mouth to explore different foods, eating can be an overwhelming experience for the child’s senses.  The different textures, tastes, and smells involved in eating may feel like more than a child can handle.  An occupational therapist can develop a plan to gradually introduce the child to these different sensory experiences so that they become comfortable with more stimulation over time.  In addition issues with sensory stimulation from food, the child may also be unable to sense where the food is in their mouth, which leads to swallowing difficulties and food rejection.

In addition to helping your child develop feeding skills, an occupational therapist can help you as a parent to learn how to best support the child during this transition to oral feeding.  He or she can provide education on which foods are safe to try, strategies you can use to decrease your child’s stress during mealtime, and help you set realistic goals and expectations.  In order to help your child to have a safe and comfortable experience, the occupational therapist may start with non-food items to teach chewing and proper use of the jaw, and then move on to food as skill develops.

Learning language through daily routines


By Victoria Vanderstoep (Student Communicative Disorders Assistant, Durham College)

It’s never too early to begin encouraging communication in young children. But teaching language is not something parents need to set aside extra time for – it is something that happens by sharing time with parents and siblings, and exploring the world around them. When children are beginning to learn language, they need to have experiences to do so. Then they need to learn the words to talk about those experiences, and finally, they will need someone to talk with. Engaging your child in conversations as you are going about your day provides them with experiences and the words that go along with those moments.

Routines are an excellent opportunity for language learning – during these parents can talk about what is of interest to their child. Children begin to make sense of their world by participating in daily routines, such as getting dressed, brushing their teeth, eating meals and going for a ride in the car. Not only are they learning about the organization of their world through these routines, but they are also learning about social roles and the language that is used in these routines. During these routines parents give their children the important words for that routine. For example, providing the child with language during bath time, allows the child to have the language needed to express excitement over bubbles popping in the tub.

Each of these routines has a series of short steps that need to be done in a specific order. Parents can use this to their advantage. By labelling items, such as the clothes the child is putting on, or the ingredients being used to make cookies, parents are exposing their children to new words which will make their vocabulary grow.

Language learning doesn’t have to be an activity that time is set aside for each day. Use every opportunity of your day to engage your child in what you’re doing. It’s important to be flexible, and following the child’s lead. Share their interests, build language into what they want to explore, and their language will begin to blossom. It’s amazing how quickly children begin to pick up the language they are exposed to.

Functional Recreation for Children with Special Needs


By Sandra Ellis, Student Occupational Therapist, McMaster University

Many parents of kids with special needs have concerns about involving their kids in recreational activities. Often parents wonder: Do the benefits of recreational activities outweigh potential risks?

This question reminds me of a topical issue in Hamilton, where an existing tobogganing ban was recently reinforced, due to the health and safety risks for children involved. While this bylaw has not been heavily enforced through ticketing, it has the potential to reduce the already limited winter recreational activities available to children (especially those accessible available to kids with motor or coordination challenges). This situation is a prime example of what can happen to recreation when the fear of risk is determined to outweigh the benefits.

Recreation is a huge part of young people’s lives – like we have jobs as adults, a child’s main job is to play. This is how kids learn certain skills, like social skills, that will become even more important later in life. Recreational activities such as biking, swimming, skating, and team sports (to name a few) are a great way to work on physical, social and cognitive skills like coordination, turn-taking, communication, and planning. Plus, if a child is able to participate in more activities with their peers, they can build self-esteem and independence.

Reaction can offer children many positive, developmentally important experiences. Success and failure are two vital learning curves in reaction activities. It is important for a child, just like it is for adults, to feel successful at something important to them – this builds confidence and life satisfaction. Equally, it can be beneficial for a child to not always succeed at new challenges because failures help us develop problem solving skills and perseverance, and makes the eventual success so much more rewarding!

However, it can scary to let our kids stumble a bit, so to speak. Many parents worry that their child with special needs may not be able to succeed at a particular recreational activity or that they may get hurt trying. This is when an Occupational Therapist might be able to help.

Occupational Therapists have a knack for breaking down challenging complex tasks into smaller manageable steps – we call this “task analysis”. Using this skill, an Occupational Therapist can work with kids to figure out how to modify the activity or the expected outcomes (making several smaller goals instead of one big goal). In doing so, an Occupational Therapist can create a program that allows for success and a reasonable amount of challenge, while creating a safe environment. By getting to know a child, and with input from parents, an OT can tell if the an activity needs to be modified based on how the child is performing on any given day. Sometimes a child may need to learn an activity in a different way than other kids or may need special equipment to participate – these are also things that Occupational Therapist’s can help with.

Functional recreation can be a great way for kids to develop important skills while being fun and fulfilling. If you are not sure about how to begin a recreational activity with your kiddo, are worried about how to do it safely, or if you notice that your child is having trouble learning the activity in the traditional way, it may be helpful to talk to an Occupational Therapist.

3 Tips for Packing Lunch for Picky Eaters

PickyEaterBy Kayla Brown, Student Occupational Therapist, McMaster University

Brainstorming what to pack for your child’s lunch can be a tricky task, especially if he or she is a picky eater. Whether they are in daycare or 5th grade, kids do a lot of work and play during the school day, and a nutritious lunch can give them the fuel they need to help them succeed. But what do you do if your child regularly doesn’t eat the lunch you prepare for them? Below are a few tips and tricks to help you pack a lunch your fussy feeder will actually eat.

  1. Involve your child: If you left your child to their own devices, they might have chocolate pudding with a side of jellybeans for lunch every day!  However, if you work together, you can pack a lunch that makes both of you happy.  One option is to give your child a choice between two options you approve of; this way, they will feel like you have considered their ideas, and you can rest assured that they are getting the nutrition you want.
  2. Make food fun: Cookie cutters can be used to cut sandwiches into cool shapes.  Or, you can pack their veggies in a Tupperware container with their favorite television characters on it.  Appealing to their interests can help your youngster view lunchtime in a more positive light.
  3. One step at a time: If introducing a new food at lunch, or packing an item that isn’t a favorite, it is best to include it in small portions along with other foods you know they like. This way you know that even if they don’t eat the new food, they still have enough food to fuel their day.  Encourage them to try the new food, but let them know it’s ok if they don’t finish it. Change takes time and your child may require multiple exposures to a new food before they feel comfortable enough to give it a chance.

For tips and tricks that are individualized to your picky eater’s needs, consider contacting an occupational therapist. Canoe offers various feeding groups (Little Munchers currently offered and Monster Munchers in March) to help children make progress with foods.