The holidays are quickly approaching! Let’s talk toys! Playing is the work of childhood, and the types of toys we bring into our homes can have a huge impact on how our children improve their language, motor, and social skills.


There are two types of toys- close-ended toys and open-ended toys. Close- ended toys are toys that have a clear ending. For example, your child pushes a button and the toy lights up or sings. These types of toys do not allow for creativity, problem solving, or social interaction. While they do entertain your child for a short time, they do not teach him to entertain himself. We want our children to be the entertainers!


Let’s fill our homes with open-ended toys! Open-ended toys allow your child to use his or her imagination. They allow your child to include you in their play. Open-ended toys also provide dozens and dozens of opportunities for you to stimulate your child’s language development by labeling the items he is playing with and illustrating what he or she is doing. Below is a list of therapists’ favorite open-ended toys for babies, toddlers, and preschool aged children.


For Babies and one-year-olds    stacking toy

Simple wooden cars or trucks

Farm animals and farm

Stacking toys and rings

Ball pit

Bath toys

Big knob puzzles



For Toddlerslittle people

Duplo blocks

Play kitchen

Toy doctor kit

Mr. Potato Head

Pretend tea or coffee set

Vehicles with people

Doll house


For Preschoolers

Floor puzzleshippos

Superhero capes

Simple board games such as “Hisss” or “Hungry Hungry Hippos”

Lego bricks

Fort builder kit

Marble run

Magnetic tiles

kid watching tvWe live in a digital society so it is hard to avoid screen time. Screen time includes watching videos, TV, playing video games, and using a computer, phone, or tablet. Controlling your child’s screen time can be difficult. Here are helpful tips for controlling screen time with young children.

  1. The American Academy of Pediatrics discourages screen time for children younger than 18-24 months. If you want to introduce media to children 18-24 months, make sure it’s high quality and educational. Avoid solo media use.
  2. For children ages 2-5, limit screen time to one hour per day of high quality programming.
  3. Unstructured play time is more valuable than screen time in children younger than the age of 2. Children younger than the age of 2 are more likely to learn and remember information from a live presentation than from a video.
  4. By the age of 2, children can benefit from certain kinds of screen time, such as programming with music, movement, and stories. Co-view with your child to help him/her understand what he/she is viewing and how to apply it to real life and do not let screen time replace time spent reading, playing, or problem-solving.
  5. Make a schedule for screen time. Limiting younger children to 1-2 hours a day for screen time is recommended. Avoid letting your young child play on your phone or tablet throughout the day because this screen time can really add up.
  6. Monitor the content when your child has screen time. Content that your child can learn from will be more beneficial to your child.
  7. Make sure that you are making time throughout the day to interact with your child. Ask questions about your child’s day, go on a walk and discuss things you see in nature, do craft activities such as coloring, play with blocks, etc.
  8. Monitor your child’s reaction once screen time is over. Does your child have new ideas or ask inquisitive questions or is your child irritable, anxious, or withdrawn?
  9. Avoid giving your child your phone to play on while at a restaurant, in the car, or during errands. It’s important for children to learn how to manage their emotions and giving them a screen robs them of opportunities to learn how to cope with and move past boredom or emotional discomfort.
  10. Preview any new app that you get for your child. Look for apps that encourage your child to actively participate and that support learning and strategic thinking. Play alongside your child in order to open up conversation about what they are doing/learning.

Too much screen time can affect their social, emotional, and behavioral development. High media use has been associated with shorter attention spans, hyperactivity, ADHD, and aggressive behavior. Studies have shown that too much screen time can contribute to weight gain and childhood obesity. Screen time can also be a hard habit to break as kids get older, if they are exposed to excessive amounts at a younger age. Overall, monitor the amount of time spent in front of a screen, along with the quality of that time. Nothing can replace the need for real-time interactions, play time, and conversations. These are key to helping a child develop normal language and social skills.


Information taken from

slider-kids-elbows-1024x419What is a voice disorder?

Voice disorders occur when voice quality, pitch, and loudness differ or are inappropriate or for an individual’s age, gender, cultural background, or geographical location.( )

Does my child have a voice disorder?

If you think your child may have a voice disorder, ask yourself the following questions:

  1. Does he/she have a hoarse/unpleasant voice?
  2. Does he/she have an inefficient voice?

If you answered “yes” to either of the above questions, then your child should receive a medical evaluation by an ENT and a speech-language assessment by an SLP.

What causes a voice disorder?

There are three causes of voice disorders-vocal abuse, vocal misuse, and medical problems.

  1. Vocal abuse is caused by straining the vocal cords-screaming, forceful talking, frequent coughing/throat clearing, imitating environmental sounds (engines, sirens, animal sounds).
  2. Vocal misuse is caused by loud talking, using a pitch that is either too high or too low, and talking over background noise.
  3. Medical problems that cause voice disorders are numerous but include frequent colds/congestion, allergies, reflux, and neck injuries.

If your child is abusing or misusing their voice, the following tips can help to help reduce these harmful behaviors.

  1. Determine when your child is harming his/her voice (outside play, sports, etc.), then discuss with him/her when they are misusing their voice.
  2. Use reminders to decrease harmful use-
  3. Tell him/her to use a softer voice
  4. Use a signal to remind him/her to decrease effortful speech
  5. Post a picture in your home that reminds your child to use appropriate speech level
  6. Discuss substitutes for voice use-
  7. Texting rather than talking on your phone in a loud area
  8. Take pom-poms or signs to sporting events
  9. Use clapping instead of cheering
  10. Use waving rather than yelling to a person far away
  11. Reduce the use of environmental sounds and throat clearing.
  12. Reduce unnecessary background noise- turn down the TV/music and keep car windows closed.
  13. Talk less-choose quiet activities or establish daily quiet times in order to rest voice.
  14. Set up a reward system- verbal praise, prizes, and charts can be used to reward good vocal habits.
  15. Model good vocal habits for your child by using appropriate pitch/loudness and take turns talking.
  16. Monitor your child’s health and consult their pediatrician if he/she has frequent congestion, reflux, or other condition that can be harmful to the vocal cords.
  17. Monitor your child’s voice and consult with their pediatrician or SLP if his/her voice changes in any way.

Voice disorders can affect adults and children of all ages.  If you suspect a voice disorder in your child, your child should receive a medical evaluation by an ENT and a speech-language assessment by an SLP.   Our speech pathologists at JHA are knowledgeable in this area and able to help you determine if your child needs voice intervention. If you would like more information or to set up an evaluation please call our front desk, 901-328-2110. 

David Street story - Germantown News 5.9.2018


blog postEarly language and literacy skills develop within the first three years of life. Literacy includes reading and writing. This development is closely linked to the child’s earliest experiences with books and stories. Interactions with literacy materials such as, books, paper, and crayons, and with adults in their lives are the building blocks for language, reading, and writing development. Early experiences are critical in shaping brain development. The development of language and literacy skills begin at birth through every day loving interactions, reading and telling stories, singing songs, and talking to one another.

Tips for introducing books to your toddler:

  1. Have fun together: When children are engaged and enjoying themselves, they are learning. When children have positive interactions with books, they develop good feelings about reading and become more motivated to continue seeking out other books and literacy materials as they grow.
  2. A few minutes at a time is okay: Young children can only sit for a few minutes for a story, so don’t worry if you can’t finish the books. As children get older, they will be able to sit for longer periods of time. Let your child decide how much or how little time they spend reading. You don’t have to read every page. You may find that your child has a favorite page or picture and that he/she will want to focus in on it for a while and then move on to another book or activity. Babies may just want to mouth books, but this is ok because exploring books in ways that are interesting make the reading experience more meaningful.
  3. Talk or sing about the pictures: You don’t always have to read the words to tell a story. Look at the pictures and tell stories about each picture. When your child is old enough, have him tell the story back to you or make up his own stories using the pictures.
  4. Let children turn the pages: At 18 months, a baby can attempt to turn the pages of a book. A three-year-old should be able to turn pages independently. This is another way of exploring books and allows the child to become familiar with the structure of books. Exploring books by turning pages also allows the books to become more meaningful to the child.
  5. Show children the cover page: Explain what the story will be about. You can show the cover page to older children and ask them to tell you what the story might be about.
  6. Show children the words: Run your fingers along the words as you read them. This will show your child that we read from left to right and introduce your child to letters and how letters form words. Older children can look for sight words within books.
  7. Ask questions about the story: Use the story to have a conversation with your child. Ask questions about familiar activities or objects you see or read about in the story. Ask older children questions relating to details heard within the story. Children as young as three should be able to recall details to tell the story back to you.
  8. Create books together: Take family photos, cut out pictures from magazines, or have your child illustrate the pictures. Put the pictures together and use the pictures to tell a story or have your child make up his own story.
  9. Make books part of your daily routine: Make it a priority to read books daily. Before nap time or bed time is a great time to read books because sitting down and reading a book will help your child to wind down and calm down in order to fall asleep.  


Many parents ask, “What is the difference between Autism (ASD) and Sensory Processing Disorder (SPD)? Are they the same thing?”  They are two distinct diagnoses.  Some children just have SPD or ASD, while other children demonstrate both.

What is SPD?  Sensory Processing Disorder, originally called Sensory Integration Dysfunction, refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses (, 2017). SPD is exhibited when sensory signals are not organized into appropriate responses. You process sensation all day long.

Whether you are biting into a crunchy food, riding a scooter, or simply lying on a firm sofa, you are processing sensation in some way.   SPD can affect one or more of the senses and varies from person to person.  Someone with SPD may be over-responsive to environmental stimuli.  For example, the touch of firm paper, or a soft shirt may set off a tantrum or meltdown.  Others may be under-responsive to environmental stimuli.  They may not be able to determine excessively hot or cold temperatures.  Children with this disorder may be uncoordinated, moody, and bump into things.  They may be unable to know where their body is in space, have unusual eating habits, and have difficulty engaging in play.

What is Autism Spectrum Disorder? The National Institute of Mental Health defines ASD as the name for a group of developmental disorders, which include a wide “spectrum” of symptoms, skills, and levels of disability ( 2016).  ASD can be characterized by difficulty interacting with peers, language impairment, and repetitive behaviors.  Some children with autism may have difficulty expressing emotions. Autism is a developmental disorder that has symptoms related to delayed social skills, language, and obsessive interests, while SPD is a sensory disorder with symptoms caused by reactions to sensory stimuli.

It is important to know that a child with SPD can easily be misdiagnosed for a child with ASD, due to similar sensory symptoms. However, the SPD Foundation explains that most children with SPD do not have autism.IMG_3173If you have any questions regarding SPD or ASD, please contact us to speak to an occupational therapist trained in sensory integration.  The occupational therapist will be able address  any concerns you may have.

Janna Hacker and Associates   901-328-2110





When your little one begins preschool, a proper pencil grip and scissor cutting skills seem to take center stage. But if a child starts to lag behind, parents naturally wonder about getting extra help to catch up.

What is occupational therapy (OT)?
Commonly referred to as OT, occupational therapy focuses on helping children and adults acquire (or re-gain) the skills needed to perform the activities or “occupations” of daily life. It’s a broad field that includes:

– Fine motor skills (finger and hand movements, handwriting, typing);
– Visual motor skills (coordinating eye/hand movements, copying from the board, throwing/catching);

– Sensory integration skills (over/under active, picky eater, seeks/avoids sensory input); and
– Self-help skills (oral-motor, eating, getting dressed, washing).

Below is a list of 8 questions you should ask yourself to see if your child might need a professional occupational therapy evaluation:

  • Is your child reactive to sounds or touch (clothing) by seeking out or avoiding too much input?
  • Is your child a picky eater?
  • Does your child have difficulty manipulating puzzles or toys with small pieces?
  • Does your child have difficulty using a fork or spoon to feed independently?
  • Can your older child dress/undress herself/himself appropriately? Can he/she manipulate buttons and zippers and tie his/her shoes?
  • Does your child have difficulty grasping a pencil or difficulty with coloring/handwriting?
  • How does your child’s artwork and handwriting compare to his/her peers?
  • Can your child ride a bike independently by the age of 6?

A child’s earliest years are filled with new stimulations and experiences that drive his or her growth in many areas. If you’re concerned about your child and think he or she may need the help of an occupational therapist, please contact Janna Hacker & Associates for a consult at 901-328-2110.

IMG_0241 Summer has faded and a new school year is in bloom. Whether your child is in preschool or older, now is a great time to take a fresh look and see if there might be developmental delays you need to address.

Children all develop at different rates, so sometimes it’s natural for parents to overlook or ignore speech issues. But communication disorders are prevalent in the U.S., and the earlier you diagnose and treat a speech-language disorder, the less impact it may have on your child’s academic and social well-being.

We’ve identified 12 red flags, so you know when to seek an evaluation of your child’s language and speech development:

  • Does your child have 50 words by the age of two?
  • Is your child pairing two to three words together at the age of two?
  • Can you understand 80% of what your child says by the age of three?
  • Does your child follow directions easily and understand what you are saying to him/her?
  • Does your child struggle to make sounds to form words?
  • Can your child read consonant-vowel combinations by first grade?
  • Does your older child have difficulty with reading comprehension or writing assignments?
  • Does your child have difficulty with short term or long term memory tasks?
  • Does your child demonstrate difficulty maintaining attention to a task?
  • Does your child demonstrate play skills consistent with his/her peers?
  • Does your child play well with his/her peers?
  • Ask your child’s teacher how he/she compares to peers in the classroom. Is he/she in the upper or lower end of his/her peers?


If you think your child may need the help of a speech therapist, please contact Janna Hacker & Associates for a consult at 901-328-2110. Our team of speech-language pathologists (SLPs) help children of all ages who have speech and language disorders.


Whether your child is starting a new school or is a seasoned school veteran, jitters usually go along with the first day. So what can parents do to help minimize anxiety?  Below are five ways to help ensure your child has a great first day.


1. Set up a playdate with a classmate
Before school starts, have your child spend time with friends attending the same school and, preferably, the same class. While there’s bound to be some anxiety on the first day, kids will appreciate seeing a familiar face and having a buddy who cares.

2. Read a book about going to school

There are a host of great books about the first day of school, whether it’s starting kindergarten or 1st grade or going back in general. Visit your local library and dive in. Some of our tried and true favorites include The Night Before Kindergarten and The Berenstain Bears Go to School. 

3. Talk openly with your child
Be honest about your own experiences, and discuss a time when you felt excited or nervous going to school or trying something new. Talk freely and regularly, and encourage your child to talk about how he or she is feeling, too.  Normalize feelings of nervousness by telling your child it’s okay to have first day jitters.  

4. See the classroom beforehand
If possible, visit school ahead of time with your child and find his or her homeroom. Work with your child to write up an appropriate school-day routine and talk about how the day will go. You could even give it a dry run before school starts packed lunch and all!

5. Meet your teacher beforehand

Introducing your child to his or her teacher ahead of time is another great way to minimize those first day jitters and eliminate the unknown. Even showing a yearbook picture can put your child at ease and know who to expect.

It’s common for children to feel hesitant about going somewhere new and meeting new people, and so starting school can be uneasy time. If you feel like your child needs additional help preparing for school success (speech, language, motor, behavior, social skills) please contact Janna Hacker & Associates for a consult at 901-328-2110 or read more at 


  1. Make a 4th of July Wand

Work on discussing parts and whole, similarities and differences, and other places we may see wands/stars/red, white, blue/etc. These festive and fun wands are perfect for those kiddos who are still too small to use sparklers (P.S. – kids should ALWAYS be supervised around fireworks, no matter how big or small!).

You’ll need:

  • 3 inch foam star
  • Red and blue craft paint
  • Red, white, and blue ribbon
  • Wooden dowel
  • Scissors
  • Paint brush

What to do:

  • Paint the foam star red. Paint the wooden dowel blue and set aside to dry.
  • Stick the dowel into the bottom of the star till secure.
  • Tie on red, white, and blue ribbon.

Have fun waving your wand all night long!

  1. Patriotic Party Games

If the weather is nice, have some outdoor fun! Work on turn taking, problem solving, and following directions by having a relay race, holding a water balloon fight.

  1. Try one of these Patriotic treats exps15284_CT10183C42B

Prepare a fruit tray using red, white and blue fruit! You could use strips of watermelon or cut-up strawberries for the red stripes; sliced bananas for the white stripes; and lots of blueberries for the stars! Make sure to practice your good speech sounds while talking about how to assemble your flag fruit tray.


Sugar Cookie Bars – fun for kiddos to help you make! Work on comparing/contrasting amounts, textures, and flavors while you bake!

  • 1 c. unsalted butter; softened
  • 2 c. sugar
  • 4 eggs
  • 2 tsp vanilla
  • 5 cups flour
  • 1 tsp salt
  • 1/2 tsp baking soda
  • White vanilla or cream cheese frosting
  • Red, white, and blue sprinkles

Mix the dry ingredients in a medium sized bowl and set aside. Next, in a separate large bowl, cream the butter and sugar until light and fluffy. Then, add eggs, one at a time, mixing well after each addition. Add the vanilla and mix again. Now slowly add the dry ingredients and mix until combined. Spread batter into a greased 10×15 or 13×18 inch pan Bake at 375 for 12-15min. They are done when the top is just starting to turn a light golden color and you can stick a toothpick in and it comes out clean. Do not over bake or they will end up dry. Let them cool, then add your frosting and sprinkles!