Reading is Fundamental

Reading is paramount in your child’s development.  It serves to enhance your child’s language development, creativity and ability to think. It also builds strong social emotional ties and encourages cognitive development.   Additionally, it is a perfect venue to spend quality time with your child.  Even if your baby does not yet understand words, by reading to them, they will begin to recognize and enjoy the sound of your voice.  Reading to your child will assist in creating parent/child bonds that will build your child’s sense of self and safety.  These connections are necessary precursors to spoken language.  Children who form secure relationships early in life with their parents and caretakers are likely to be able to develop healthy social emotional connections with peers and others later in their lives.  Furthermore, as you read to your toddler and begin to identify objects in books and ask wh questions, you are building their vocabulary, their ability to form sentences and narratives as well as enabling them to respond, question and reason.  Children who grow up reading are more likely to pick up words quickly, choose books rather than television, and develop a healthy respect for books.  All of which will lead to a strong foundation for a successful life.

Holiday Gifts for your Little Ones

FUN FUN FUN -- From music and books to toys and crafts, language development and FUN go hand in hand.  As the holidays are fast approaching, many of the parents I work with ask for recommendations for holiday gifts for their kids. The following are links for items that will engage your children for hours, while providing them with learning experiences through color, sensations, creative and  imaginative play.

Music:

     

Books:
   

Toys:

    
                 

A Model for Early Education!

http://www.nytimes.com/2013/11/10/opinion/sunday/kristof-oklahoma-where-the-kids-learn-early.html?smid=fb-share&_r=0

Speech and Hearing Loss

Spoken language and healthy hearing go hand in hand.  Even a mild hearing loss may impact your child's ability to develop speech and language.  With the slightest inability to hear the different frequencies of our phonetic sound system, a child may not be able to receive the correct signal, interfering and corrupting the incoming message.  Additionally, if a child does not perceive the correct sound they will be challenged to replicate it correctly.  


There are two types of hearing loss; Conductive and Sensorineural Loss:

According to the American Speech, Language and Hearing Association (ASHA), conductive hearing loss occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones (ossicles) of the middle ear. Conductive hearing loss usually involves a reduction in sound level or the ability to hear faint sounds. This type of hearing loss can often be corrected medically or surgically.  

The Inner, Middle and Outer Ear

ASHA defines sensorineural hearing loss (SNHL) as damage to the inner ear (cochlea), or to the nerve pathways from the inner ear to the brain. Most of the time, SNHL cannot be medically or surgically corrected. This is the most common type of permanent hearing loss. SNHL reduces the ability to hear faint sounds. Even when speech is loud enough to hear, it may still be unclear or sound muffled.If you suspect that your child is experiencing hearing loss, whether it is conductive or sensorineural, your pediatrician should be consulted and s/he will refer you to an Audiologist for an evaluation.  Additionally, you may be referred to an Otolaryngologist; (ENT) Ear Nose Throat medical specialist.  

An ENT is a medical doctor who specializes in the diagnosis and treatment of disorders of the head and neck.  They are medically and surgically trained to treat ailments of the inner, middle and outer ear. For instance they treat; perforated ear drum, conductive hearing loss, sensorineural hearing loss, weak tympanic membrane, otitis media and many more medical conditions.  

An Audiologist not only services hearing aids but they provide a complete diagnostic evaluation.  Audiologists are professionals who have received graduate and post graduate academic and clinical training.  They work in private practice, clinics, hospitals, Ear, Nose, Throat physician offices, industrial testing, and schools.

The scope of practice of an Audiologist include diagnostic evaluations, newborn and pediatric testing, sales and service of assisted hearing devices, tinnitus, vertigo (dizziness), balance, rehabilitation, industrial audiology, cochlear implants, recommendation and servicing of school FM systems, and counseling about hearing loss. 

I recommend a full hearing evaluation to all my families who are concerned about their child's speech and language development.  If you are concerned about any aspect of your child's development, contact your pediatrician.  S/he will be able to make the appropriate referrals and guide you through intervention and remediation. 

Reading is Paramount for your Child's Successful Future

DianaBananaKids.com

Reading is paramount in your child’s development.  It serves to enhance your child’s language development, creativity and ability to think. It also builds strong social emotional ties and encourages cognitive development.   Additionally, it is a perfect venue to spend quality time with your child.  Even if your baby does not yet understand words, by reading to them, they will begin to recognize and enjoy the sound of your voice.  Reading to your child will assist in creating parent/child bonds that will build your child’s sense of self and safety.  These connections are necessary precursors to spoken language.  Children who form secure relationships early in life with their parents and caretakers are likely to be able to develop healthy social emotional connections with peers and others later in their lives.  Furthermore, as you read to your toddler and begin to identify objects in books and ask wh questions, you are building their vocabulary, their ability to form sentences and narratives as well as enabling them to respond, question and reason.  Children who grow up reading are more likely to pick up words quickly, choose books rather than television, and develop a healthy respect for books.  All of which will lead to a strong foundation for a successful life.



          

Communication Begins Day One of Your Child's Life

Language acquisition begins before your baby speaks his/her first words, before jargon, babbling and vocalizations. Communication begins day one of your child's life. First glances, touch, smells, sounds are all paramount in many facets of his/her development. There are several precursors to language that are essential for healthy development. 

Perhaps the most important is the relationship between you and your child. Most importantly, your child is dependent on you to make certain all his/her basic needs are met; nourishment  safety, health, comfort.  It is your responsibility to create a safe, loving, nurturing environment for your child.  In such an environment a child will feel comfortable to explore their surroundings. In the process of exploration, your child will begin to realize his or her impact on their world.  This valuable understanding is paramount in the development of language.  Once your child realizes that he or she could make things happen they will look to your response for validation.  This non- verbal connection to their caretaker, the ability to feel engaged and connected through facial expressions, eye contact, body language, touch, is your child's first experience with expression and communication.

Oral Motor Deficits

How does a parent know if their child has low muscle tone of the oral mechanism?

The muscles of the oral mechanism include the muscles of the lip, tongue, and jaw.  Very often when these muscles are weak your child will present with an open mouth position with the tongue placed anteriorly. They might experience severe drooling and have difficulty eating, drinking and maintain a closed seal around the straw,  Weakness of the lips, tongue and jaw will most certainly impact your child’s ability to produce the precise articulation (movements of the tongue, lips and jaw) and will likely result in your child’s ability to produce understandable speech.   Additionally, low tone may result in difficulty chewing, swallowing and  can result in an inability to stick the tongue out, or move it from side to side.  Drooling can also be caused by weakness in the muscles of the mouth.  Strengthening these muscles can be very important in improving both feeding deficits and speech intelligibility.

During mealtime, weakness of the muscles of the lip, tongue, or jaw can have a negative impact on the ability to maneuver the food laterally and posteriorly in the mouth as well as efficiently removing the food from the spoon or fork, and swallowing.   A heightened gag reflex and frequent choking may be caused by weak oral motor muscles, which make feeding your child quite challenging.    

Are there any quick fixes?

When a child presents with oral motor weakness, I recommend a structured oral motor program designed to strengthen the lips, jaw, and tongue.  Parents are asked to participate in these routines several times a day before feeding and to increase the difficulty as the child’s strength, awareness and range of motion increases.  The following are some activities and tools that I recommend to increase your child’s strength and abilities to feed and produce intelligible speech.

Chew Tube:  (textured and not textured)

• ·         Place laterally along teeth.  Allow your child to bite on each side. 
• ·         Place centrally on your child’s lips/mouth and allow him/her to round his/her lips while creating as tight of seal as possible for as long as s/he can maintain it.
• ·         Place laterally in-between cheek and teeth so child can feel the ridges/bumps on chew toy.
• ·         Swipe his tongue so he can feel the texture and receive sensation orally.
•  

Jiggler:

• ·         Start on child’s hands and move to his shoulders so as to prepare him/her for the activity. 
• ·         Using slight pressure, move the jiggler from ear to corners of the mouth several times or as long as s/he will tolerate it.
• ·         Allow your child to bite on the jiggler so s/he can receive sensory input orally.

Probe and /or Z-vibe:

• ·         Place laterally and posteriorly towards molars. 
• ·         Apply slight pressure and encourage your child to bite down on each side. 
• ·         Place laterally in-between cheek and teeth so your child can feel the ridges/bumps and vibrations on probe.
• ·         Swipe his tongue so he can feel the texture and receive sensation orally.
• ·         Put slight pressure against your child’s tongue and encourage him/her to push back with their tongue.

Straws and Sippy Cups: (using a straw will help stabilize your child’s jaw and keep it from shifting; build his/her strength and musculature)

• ·         Encourage your child to suck through the straw while holding his/her chin stable with your thumb and forefinger.
• ·         Discourage him/her from biting on the straw while drinking.  Very often a child will attempt to bite on the drinking straw to stabilize their jaw and keep their head from moving.
• Horns and Whistles:
• ·         Allow your child to explore the tools/toys orally. 
• ·         Place in between lips.
• ·         Discourage your child from biting on the tools/toys.
• ·         Encourage lip rounding around the horn for as for as s/he can maintain the position while blowing.
• ·         Model blowing for your child.

Oral Motor Games and Activities:

• ·         Fish faces – Use tactile prompts to bring your child’s cheeks together
• ·         Massage – With firm touch using one or two fingers, massage from their ears to the     corner of his mouth in a circular motion (along his teeth)
• ·         Lip smacking
• ·         Blowing kisses and raspberries
• ·         Bubble blowing  and popping on your child’s cheeks
• ·         Tongue clicking
• ·         Place something sweet around your child’s lips so he can attempt to use his tongue to lick it off.

As with any concern you may have about your child’s development, please contact you pediatrician and or a qualified speech language pathologist.

Please see Oral Motor and Sensory Tools for information on recommended products available at Amazon.com's Diane's Picks.  

Oral Motor and Sensory Tools

Children who have low tone around their mouths may benefit from oral motor activities.  Low tone and weak musculature can impact your little one's ability to speak clearly and eat efficiently.  Oral motor activities are paramount to successful development in the realm of speech, language and feeding.  A regular routine incorporating oral motor massage, and other oral motor activities will support your child's awareness, build the strength and range of motion of their oral motor mechanism for both speech and feeding purposes  The following items used regularly will promote intelligible speech and well as strong chewing, swallowing and overall good feeding protocols.

   

I recommend that a consistent program implementing these activities take place 3 times daily before each meal to bolster your child's healthy development. 

As with any issue regarding your child's speech, language and or feeding, you should consult your pediatrician and or a qualified speech language pathologist.

Auditory Processing Disorder and Your Child's Success

Auditory Processing Disorder, APD can be defined as the inability to recognize and identify sounds; primarily sounds that comprise speech.  It is the inability of the brain to accurately process the speech signal.  For instance, a person with APD may not be able to differentiate the sound /f/ from /th/ from /v/.   As you can imagine, when a student cannot easily distinguish between the word /feign/, and /vain/, or /fin/ and /thin/, the communication process becomes quite challenging and the classroom can become a difficult environment for a child to navigate.  Not only does APD impact the comprehension of the spoken word, but a fragile phonological/phonemic foundation can also impact negatively on academic success, reading comprehension and the child’s understanding of nuanced language.

While working with a qualified Speech Language Pathologist is paramount to develop and implement compensatory strategies, it is also imperative that child’s educators understand the unique needs of a child with APD. It will benefit the child if the classroom teacher implements the following strategies in the classroom.

1.       “Front and center” in the classroom.  Seating in the front of the room allows the child with APD to pick up on the non-verbal and visual cues such as facial expressions and articulation so as to comprehend the subtleties of the signal/message.

2.       A quiet classroom is paramount for success.  Research has been conducted that indicates that a classroom is many times noisier than healthy and acceptable levels.  NYC classrooms are probably worse and more worrisome.  A student with APD can become easily distracted by sound, and very often cannot prioritize the speech signal from other ambient and environmental sounds.  I suggest that the child with APD utilize an FM system.  However, many children are not eager to take this step.  Something as simple as closing the windows and curtains serve to significantly reduce the environmental sounds and will help tremendously.

3.       Allowing significant time for the child with APD to process a question or statement; whether written or verbal is imperative for their success.  For instance, when you interact with this child you may need to rephrase your question or statement in order for them to fully comprehend it.  Working with children with APD, I have found that, at times, they do not understand some of the nuances of complex language.  For instance, some older children with APD do not easily understand analogies without an explanation and have difficulties with metaphors.  You may find that this type of language may present a challenge and may need to be rephrased. Questions that include analogies and metaphors can be very tricky and may not be the best indication of their understanding of a topic.  A child with APD may understand more direct language and will be more successful at answering direct questions.

4.       During classroom lectures and tests, providing handouts, and using visual tools and illustrations very often support students with APD.

5.       Also, allowing extra time for testing will significantly help a child with APD.

As with any concerns you may have regarding your child’s speech and language, consult with your child’s doctor or a qualified SLP.  Referrals can be made for an assessment to determine whether your child has APD.  Please be aware that APD is not diagnosed in young children.  However, if it is suspected, a qualified SLP will be versed in treatment.

The Importance of Parental Involvement

This is a great Op Ed piece  by Thomas Friedman.   Thanks for sharing it, Cassandra.

Autumn Fun for the Family!

Now that summer has unofficially ended and autumn is upon us, parents are looking for activities that will engage their children, build their self-esteem, encourage healthy and successful development and not cost an arm and a leg. With a focus on broadening your child’s experiences while encouraging successful motor coordination, language, social emotional, and cognitive development, the following are some suggestions that will take you and your little ones away from the television and the video games and into the truly interactive world.


A child’s play is not only amazing and amusing, but it is also paramount in healthy childhood development. The playground is your child’s early life university. Whether it is the 2 year old dipping one toe and then the other in the sprinklers until she builds her confidence and courage to get her entire body wet -- or the 6 year old challenging the 5 year old to climb higher on the jungle gym -- the playground is an ideal environment for your child to learn how to navigate the world, build relationships and learn about life. The Bleecker Street playground at Bank Street is always filled with children of all ages, as well as activities and equipment that will promote your child’s language, social, and motoric development. The Imagination Playground at Burling Slip is a safe, creatively designed space which encourages child directed, unstructured play.

The New York City Public Library is a great place for your child to build their imagination along with their love for books. Offering activities from arts and crafts to music and film for children, the library is an ideal nurturing environment where your child can flourish. All branches offer story time for children of different ages. Story time is where children and their care takers can enjoy new and classic children’s stories, learn action songs, make friends, and meet other children from their neighborhood.

The zoo! There is nothing more educational and exciting to a child than seeing lioness care for her cub, or watching a polar bear jump in and out of the water. One of the world’s most spectacular zoos is just a short subway ride to The Bronx. The Bronx Zoo has events and exhibits throughout the fall including a scary Halloween celebration for all family members. “ Boo at the Bronx Zoo” runs throughout October and includes a haunted safari, hayrides and parades. Your child will love it.

Rainy day activities can run the gamut from pretend play tea parties to baking chocolate chip cookies, to charades and Pictionary. A rainy day is a great opportunity to engage playfully with your child. The positive interaction between a parent and child is paramount in developing language, self-esteem, and social skills. For great rainy day ideas there are many sites to visit, my favorite site is Amazing Moms. You will find loads of creative ideas to keep your children occupied while sparking the creative fires. One simple project I enjoy and so will your kid constructing a time capsule. A decorated shoe box, and a few keepsakes can create hours of fun and it will certainly make for an interesting conversations between your child and yourself.

Curiosity, exposure, and interaction are key in your child’s development. Participation in simple activities this autumn can encourage healthy development on all levels. Don’t skip the hayrides or the pumpkin patches this fall. Create memories and enjoyment that your child will cherish for years to come!

Story Hour, June 18, 2011

Here are some photos from this past weekend's story hour hosted by Little Marc Jacobs, books read by Diane Freedman.  A good time had by all ... especially me!!!!  Please join me next weekend.  Saturday, June 25 at 10:30 AM -- Bleecker Street Playground!

Preschool is a Time for Exploration

I am grateful that one of my clients shared this article with me.  Alison Gopnik, the author, expresses an interesting perspective on preschool.  She emphasizes the value of exploration vs. instruction for a child of preschool age.  A good and important read!

Why Preschool Shouldn't Be Like School
New research shows that teaching kids more and more, at ever-younger ages, may backfire.
By Alison Gopnik

Reading is Fundamental

Reading is paramount in your child’s development.  It serves to enhance your child’s language development, creativity and ability to think. It also builds strong social emotional ties and encourages cognitive development.   Additionally, it is a perfect venue to spend quality time with your child.  Even if your baby does not yet understand words, by reading to them, they will begin to recognize and enjoy the sound of your voice.  Reading to your child will assist in creating parent/child bonds that will build your child’s sense of self and safety.  These connections are necessary precursors to spoken language.  Children who form secure relationships early in life with their parents and caretakers are likely to be able to develop healthy social emotional connections with peers and others later in their lives.  Furthermore, as you read to your toddler and begin to identify objects in books and ask wh questions, you are building their vocabulary, their ability to form sentences and narratives as well as enabling them to respond, question and reason.  Children who grow up reading are more likely to pick up words quickly, choose books rather than television, and develop a healthy respect for books.  All of which will lead to a strong foundation for a successful life and academics.

Here are some recommendations for just a few books that you and your children will love...
On Top Of Spaghetti
There was an Old Lady who Swallowed a Fly
Caps For Sale
A Very Special House
Madeline (series)
One Fish - Two Fish - Red Fish - Blue Fish

Pervasive Developmental Disorder (PDD)

According to the NIH, Pervasive Developmental Disorders (PDD) refers to a group of disorders including Autism, Asperger’s Syndrome, Childhood Disintegrative Disorder, and Rett's Syndrome. PDD is characterized by delays in many areas of development. While symptoms of PDD may appear as early as infancy, the typical age of onset and diagnosis is around 3 years of age. A child with PDD may demonstrate delays and problems across all realms of development including receptive and expressive language, social and emotional interactions, sensory motor, and play. A child with PDD may also exhibit difficulty transitioning from one activity to the next, s/he may also appear to be unable to attend to a communication partner, activity or task, demonstrate repetitive body movements, and may be unable to sit in one position for any length of time.


Children with PDD will vary greatly in their abilities. While some children may not speak at all, others may have limited language, and still others may appear to have typical age appropriate language. Many children with PDD will exhibit limited play skills and will not interact socially nor will they play collaboratively with other children. Rather they will exhibit peripheral parallel play. Some children with PDD may exhibit sensory defensiveness and react unusually to light, touch, and sounds, while others may seek out and desire these sensory stimuli.

Early intervention services are paramount in the treatment of PDD. If you suspect that your child has PDD it is important that you express your concerns to a qualified pediatrician. S/he can refer you for a proper evaluation which can determine the need for early intervention services. Very often, speech-language therapy when paired with occupational and physical therapy, and special instruction can serve your child’s needs and support him/her in his/her journey upon a successful life.

Shared Experiences

Just a few sites I wanted to share with you guys … they are informative, entertaining, and insightful.

Yike Dat

A site for both parents and educators, YikeDat is a brand new resource for parents and teachers focusing on early childhood.  They update regularly. Expect new information for early childhood teachers almost daily.  There is a section for parents of preschoolers as well.  

Hidden Truths

A really funny blog about one parents experience raising his children

2E Child
A description of a successful ABA therapy graduate. Initially diagnosed as Autistic, he is a 2E child (twice exceptional - In the Autistic Spectrum and Profoundly Gifted). A brief description of his path to enrichment and excellence as laid out by the therapists and by, mostly, his Mother - his chief Instructor.


Autism Mom Rising
A mother of a son with Autism and Landau Kleffner Variant. They have a blast baking around their many food sensitivities and blogging about  their creations. Their show Autism Family Cooking will debut here in 2011. This site also explores the general nuances of life with Autism.

These are mostly inspirational blogs written by parents of children who are both typically developing and who have autism.

Conference on Autism

Understanding Autism Spectrum Disorder; From Basic Science to Intervention

An Autism Symposium for the Community

Hunter Weill Cornell

Saturday

April 16, 2011

8:00 AM – 5:00 PM

Sensory Integration and Your Child

Sensory Integration/Sensory Processing Disorder (SPD) and Speech-Language Development

One of the most valuable lesson I learned in graduate school and through my practice working with children as a Speech Language Pathologist is: “In order for a child to learn, s/he must be in a neutral state.”

Think about it, have you ever had one loose strand of hair on your arm which was so annoying that it was the only thing you could think about. Or has the seam of your sock pressed ever so lightly against your pinky toe that you had to take your shoe off immediately to fix it? Better yet, has your focus been disrupted for a few seconds by a siren outside your window? Have you experienced the sensation of pins and needles when your foot falls asleep? Think about the numbness of frozen fingers after shoveling snow. Have you ever taken a ride on a snowy day and the light was so bright that even your newest pair of Ray-Bans didn’t seem to help? Been seasick? Been dizzy? Sat next to someone with really strong perfume?

These are not uncommon experiences for anyone. Our senses are bombarded every moment of every day, even when we are sleeping. It is how we process our environment. These sensory messages are sent to our brain and we are able to prioritize them and continue on with the task at hand. We draw conclusions from the stimuli and form decision on how to proceed. Sometimes, unless we have a really bad headache, we don’t even consciously hear the siren outside our window when we are involved in an engaging activity. This is the process of typical sensory integration and processing.

There are some children who are hypersensitive and those who are hyposensitive to sensory input. A child with hypersensitive atypical sensory processing does not have the ability to prioritize these stimuli and he or she becomes overwhelmed by the different sensory input. Think about your sensory experience and then multiply it by one hundred. If you can, picture the child sitting in the classroom that hears the siren outside the window and is so overwhelmed by it that s/he cannot pay attention the teacher reading a book. Simultaneously, the slight flicker of the florescent light and the hum of the loudspeaker system have increased his/her level of anxiety. Now couple that with the fact that his/her body is feeling a little numb except for his wool socks that itch the hell out of his/her feet. And to add insult to injury, there is a tree outside the window with its branches gently swaying back and forth. A child with SPD will either become extremely agitated and distracted with heightened irritability or s/he may have the opposite reaction and shut down all together… or possibly both.

A profile of hyposensitive SPD is the child who appears to be immune to these sensations, not able to process them at all. S/he typically may not be able to feel temperatures the way that you do. S/he may be oblivious to loud sounds or changes in lighting. S/he might be the kid who is ripping off their down jacket in sub-freezing weather conditions – or s/he may be the child who is thought of as the “clumsy” kid because they are always walking very heavy on their feet, falling, and banging into people and things. This may be caused by the inability to determine their current physical state and their positioning in space. They are unable to process the environmental feedback which tells them about their surroundings and state of being.

In order to develop language, a child needs to maintain a calm, regulated and neutral state of being. S/he needs to be able to maintain eye contact, read the facial expressions and other non-verbal communicative overtures. He or she must feel safe and protected. Furthermore, they must be able to listen, focus, and not be distracted by their internal state or external environment. They must be able to prioritize the environmental and internal stimuli and mute the nonessential input. For the child who is challenged by SPD, these can often become insurmountable goals, causing a delay in their motor, social emotional, and speech and language development.

As with any other concerns you may have about your child’s development, contact you pediatrician. Your pediatrician can provide a referral for an evaluation. A trained Occupational Therapist can evaluate your child for SPD and help you implement sensory strategies to support their ability to maintain attention. A qualified Speech Language Pathologist can also work with your child in ways that will provide your child with the support needed to become successful communicators.

Interesting reading material: 
The Out of Sync Child
http://www.amazon.com/Out-Sync-Child-Recognizing-Integration/dp/0399523863

The Sensational Child
http://sensationalchild.org/child/

Anna Jean Ayres
http://www.google.com/search?sourceid=navclient&aq=3&oq=anna+jean&ie=UTF-8&rlz=1T4SKPT_enUS406US407&q=anna+jean+ayres

Play Groups

Diane Freedman is offering moderated play groups for preschoolers with an emphasis on speech and language, and social emotional interactions.  Groups will be held on Saturdays throughout the fall and winter.   For more information please contact Diane at dfreedman.slp@gmail.com.

You and your Baby!

Language acquisition begins before your baby speaks his/her first words, before jargon, babbling and vocalizations. Communication begins day one of your child's life. First glances, touch, smells, sounds are all paramount in many facets of his/her development. There are several precursors to language that are essential for healthy development. 

Perhaps the most important is the relationship between you and your child. Most importantly, your child is dependent on you to make certain all his/her basic needs are met; nurishment, safety, health, comfort.  It is your responsibility to create a safe, loving, nurturing environment for your child.  In such an environment a child will feel comfortable to explore their surroundings. In the process of exploration, your child will begin to realize his or her impact on their world.  This valuable understanding is paramount in the development of language.  Once your child realizes that he or she could make things happen they will look to your response for validation.  This non- verbal connection to their caretaker, the ability to feel engaged and connected through facial expressions, eye contact, body language, touch, is your child's first experience with expression and communication.