Frequently Asked Questions

Many parents have questions or concerns regarding child development, and early intervention and preschool services that are available to children. Following, please find some questions and answers that may assist you in these areas. If you have a question that is not answered here, please feel free to contact LIIDP at (516) 546-2333, (631) 300-2333, or by email at info@liidp.org and one of our professionals will be happy to respond to your question.

Please remember that these questions and answers are for general informational purposes only; they are not an attempt to diagnose or treat any condition or situation. All children develop at different rates and there is a broad range of “typical” development. If you have any specific medical concerns, always contact your physician before using any suggestion or treatment.

SLEEP

How can I start my infant off with good sleep habits?

Infants—to about 4 months—cry because of physical need. They can’t be “spoiled” at this age, so when your infant cries, pick him up and give comfort by rocking and cuddling. When your infant wakes up at night, take care of him quickly and matter-of-factly, without much social contact or play. Then put him in the crib, on his back, and leave the room, to discourage waking up for the rewards of play and attention.

How can I put my older baby to sleep?

The older baby (4 months and older) must learn to relax and fall asleep without help. After the rituals of bathing, quiet play, and feeding, put your older baby into the crib while he is still awake. Your baby will become better at relaxing and drifting off to sleep without help, which will also help when he wakes up in the middle of the night.

What should I do if my baby wakes in the middle of the night?

Many older babies wake up at night for the privilege of sleeping in the parents’ bed. This desire often continues throughout childhood. Unless you believe in the family bed, avoid this attractive response to nighttime waking at all costs!

What tips can you offer for helping my baby sleep?

Establish daytime routines, including consistent waking times. Regular meal and activity times promote regular sleeping times. Develop bedtime rituals (a story or song, bath); routines make it easier for a child to “wind down.” Provide an environment that promotes sleep. A cool, dark, quiet room is best. Discourage excessive evening fluids. Be consistent!

If I wait a while, will bedtime be easier?

Don’t postpone bedtime in the hope that a tired child will be easier to put to bed. When an over-tired child loses self-control, it can be almost impossible to meet the child’s needs and the child can’t fall asleep comfortably.

What if my preschooler won’t go to sleep?

If your older preschooler resists going to sleep, try allowing the child to stay awake—but only in his bedroom—as long as the child wants, but without the stimulation of television. Your child feels somewhat in control, while you maintain a defined bedroom time. There’s little reason to stay awake once the child realizes that further contact with the family is unlikely, and the child is likely to drift off to sleep—perhaps while playing on the floor. Eventually, the child will find that a soft bed is a better place to spend the night.

My child is on medication. Does that affect sleep?

Medications can affect a child’s sleep. Many medications—over the counter and prescription—can cause or add to a sleep problem. Always check with your child’s pediatrician before administering medications of any kind.

PLAY

Why is play important?

Babies play at every stage of development. Infants learn about how the world works by looking at their own hands, grabbing rattles or hitting objects. Toddlers use play more creatively. As they approach age 2, playing alone—solitary play—isn’t as much fun as parallel play with other children. Encouraging more complex play helps children with important thinking skills and with the social understanding of what they can do and how competent they are.

How do babies play differently than toddlers?

As soon as babies can grasp with their hands, they explore toys by putting them into their mouths. By 9 months, mouthing toys is not as much fun as banging, shaking, and dumping things. By age 1, babies are putting objects into containers, and they understand that pushing a button or pulling a string can make things happen. It’s exciting to watch how an 18-month old uses objects to act out familiar activities like eating, drinking and telephoning. By age 2, children are able to use pretend objects in place of real ones. Learning how to pretend is the beginning of dramatic play and is an important first step in learning how to play pretend games with other children.

What are the usual stages of children’s play from birth to age 3?

Solitary play—this is the first kind of play where children play alone with their own toys or activities and do not try to make contact with nearby children. Examples include banging, shaking, filling, dumping.
Onlooker behavior—the child is interested in the play of other children but doesn’t join in. Examples including functional use of common objects; understands “pretend”, uses objects appropriately, such as feeding a doll.
Parallel play—children play independently but near each other. Examples of types of play include representational play with objects—manipulates doll to do common things; combined representational play— child does series of pretend activities, such as pouring and drinking pretend milk.
Associative play—children share, borrow, and lend play materials among themselves. Examples include sequential play—acting out simple daily routines such as undressing a doll, washing and diapering it, drying it, and putting clothes back on.

What can I do to encourage play?

Babies need you to talk and sing to them and provide many kinds of toys and materials for them to explore. When the baby is tired and no longer wants to play, it is time to stop. Toddlers need you to play with them in games they choose themselves. You can help by giving suggestions; withdraw from the play when your child can handle the activities alone. A 2-year old likes to “play house” and eat the pretend food you offer. The way you play helps your child learn about appropriate behavior.

What toys and playthings are recommended?

For babies, it’s good to have toys that you and the baby can look at together. Talking about and playing with toes, fingers and body parts is just as wonderful as having rattles or soft animals to touch, chew on or shake. After the first few months of life, give toys that your child can use to make something happen, rather that just watch or listen to. A toy that pops back up when it is pushed over is better than a stuffed animal. For a toddler, rings to stack are better than a toy that talks when a string is pulled.

What is sensory exploratory play?

We all learn from our senses. We learn from seeing, hearing, tasting, smelling and touching. We also learn from the sensation of movement. Your play—and your child’s—should include all of these sensations.

How can I help my child use the senses to explore and learn?

Birth to age 1—Hang mobiles across the crib to provide new sights. Play new sounds on a tape recorder. Babies enjoy sound games as they approach their first birthdays. Hide musical toys so your child can locate them.
The 1-year old explores by touching. In a special drawer, keep objects that are safe to touch and play with, such as a wooden spoon, funnel, old pan. A flashlight is another toy for this age. Sand and water play is fun, too.
The 2-year old touches and tastes everything, so keep electrical outlets protected and cords out of reach. He is able to match textures and likes to play “name that smell” game with soap, coffee and other familiar smells.
The 3-year old is learning more about the world. Imitation is how 3-year olds act out this understanding: they “bake” mud pies, “drive” a car, and “sweep” the floor. He enjoys blowing bubbles, splashing in water, and playing in sand.
The 4-year old loves to run and chase, and to kick a ball. He loves to pretend to be someone else and enjoys dressing up. He can roll sections of play dough and form people. (see dough recipe below)
The 5-year old can climb up steps to a slide, ride a bicycle and use a monkey bar. He can learn to swim, skate, ski, dance and use a trampoline. He adds details to drawings, and may print his name.

Homemade play-doh recipe: 1 cup flour, 1 cup salt, 1 tablespoon salad oil, water and food coloring (optional). Mix the flour and salt together in a mixing bowl. Add the oil and slowly add in water until mixture feels spongy and claylike.

TOILET TRAINING

When do most children learn to use the toilet?

It is important to remember that each child is an individual and develops at his own rate. Generally speaking, you can expect your child to achieve daytime control sometime between ages 2 and 3, and nighttime control between ages 3 and 4-1/2.

What are the signs of readiness for toilet training?

Some—but not necessarily all—of the following are signs that a child is becoming ready for toilet training: pausing and making sounds and grimaces while having a bowel movement; being regular in bowel movements; staying dry for an hour or two in the daytime; waking up dry from a nap; complaining when wet or soiled; being aware that urine and feces come from his body; telling the parent when he has had or is having a bowel movement; wanting to imitate adults and be grown up.

How can I prepare my child for toilet training?

During your everyday activities, point out when he is having a bowel movement or is urinating; teach him that urine and feces come from the body; teach him the words you want to use for bathroom functions; allow him to observe others using the toilet; read books about toilet training.

What should I do about accidents?

Accidents will happen—and are to be expected. Be relaxed about them. Express no anger or disapproval; don’t scold, shame or punish him. Clean up calmly and reassure him that “next time you’ll remember to use the potty.”

If my child has been clean and dry for a while and suddenly begins having many accidents, what should I do?

Regressions to wetting and/or soiling are not uncommon in toddlers and are usually a reaction to stress. Look for sources of pressure in the child’s life—separation from a parent, a new baby, starting nursery school, moving, etc.—and try to ease tension by providing reassurance. If this persists, speak to your pediatrician.

What are the best words to use for toilet training?

Think carefully about the words you teach your child for body parts, urine and bowel movements. Not only will you hear these words daily throughout the preschool years, but he is sure to repeat them often to relatives, neighbors, teachers and friends. To encourage a child’s healthy body image, use anatomically correct names for all body parts. When an elbow is an elbow, but a penis is a “weenie,” children wonder why one part of their body is so special that it can’t be called by its real name. On the other hand, most people don’t use terms like “urine” or “feces” to explain their bathroom needs. “Pee pee,” “wee wee,” “wet,” and “tinkle” are more commonly understood childhood descriptions of urination, while “poo poo,” “doo doo,” “BM,” “poop” and “doody” are the usual choices for a bowel movement. In addition, simply saying “going potty” can be confusing to a child because it doesn’t differentiate urination from defecation.

What books can you recommend for toilet learners?

No More Diapers! by Jo Graham Brooks, MD
Once Upon a Potty by Alona Frankel
Going to the Potty by Fred Rogers
Potty Time! by Betty Reichmeier
Everyone Poops by Taro Gomi
Uh Oh! Gotta Go! by Bob McGrath
I Have to Go: Featuring Jim Henson’s Sesame Street Muppets by Anna Ross

SPEECH AND LANGUAGE

What types of activities can I do to stimulate my child’s language development?

Talk to your child about everything! Talk about things you are doing: washing dishes (plates, bowls, silverware); setting the table (forks on napkin, spoon next to knife); bath time (reinforce body parts); dressing the child (body part and spatial relationships, i.e. leg in pants); laundry (name socks, shirts, pants).

Where can I take my child to encourage his language development?

Provide new experiences for your child by taking him to new places: supermarket (name fruits and vegetables); playgrounds (talk as you push your child on a swing); television (talk about shows with your child-Sesame Street, Wiggles); airport (see planes arrive and depart); zoo (animals, what they eat).

What should I do if I do not understand my child’s speech?

Talks in ways your child can do; give him models that are likely to give him successes. Show him a next step, but not too much. Regularly, ask yourself: am I talking in ways my child can do? Your child needs practice hearing speech in pieces he can do, otherwise he may fail and withdraw.

Should I demand that my child speak “adult perfect” speech?

Do not demand “adult perfect.” Your child learns to speak clearly in small steps. Encourage him to change, come a little closer to you. Be very careful not to make him feel failure if he does not say the word just like you do. Come to appreciate small changes in your child’s speech; when you show you do, he will reward you with even more changes.

Which is more important about speech—quantity or quality?

Both are important! Learning to speak clearly involves coordinating the brain and muscles in very complex ways. It requires a great deal of practice. The more you and your child communicate in ways that let him take the lead and talk frequently, the more likely he is to speak more like you.

NUTRITION

Why should I teach my child to feed himself?

The main way to prevent feeding struggles is to teach you child how to feed himself at as early an age as possible. You can wait for your infant to show you when he is ready to eat (by leaning forward, for example) and allow him to pace the feeding himself (by such indications as turning his head). Do not insist that he empty the bottle, finish a jar of baby food, or clean the plate. By the time your child is 6 to 8 months of age, start giving finger foods. Such foods allow him to feed himself at least some of the time. By 12 months your child will begin to use a spoon, and by 15 months he should be able to feed himself completely.

What happens if my child won’t eat a lot?

Put your child in charge of how much he eats. Trust your child’s appetite center. The most common reason that so many children never seem hungry is that they have so many snacks and meals that they never become truly hungry.

How big should a portion size be?

Children need smaller portions than adults. Approximately 1 tablespoon of each type of food for every year of the child’s age is an ample portion size in most cases. For example, a three year old’s plate might contain 3 tablespoons of chicken, 3 tablespoons of rice, and 3 tablespoons of vegetables.

Should my child eat snacks during the day?

Children also need to snack throughout the day—in addition to being offered regularly scheduled meals. However, try to discourage large snacks or beverages other than water around mealtimes. This way, your child will be hungry enough to eat with the rest of the family. Some snacking suggestions are: yogurt (low-fat or nonfat), dry cereal (low sugar), crackers (whole grain, low fat), plain mini bagels or whole grain breads with jelly or peanut butter, fruit, graham crackers, vanilla wafers, pretzels and carrot or celery sticks with low fat yogurt dip.

How much milk should my child have during the day?

Limit milk to less than 16 ounces each day. Milk contains as many calories as most solid foods. Drinking too much milk can fill up children and dull their appetites.

How can I get my child to give up the bottle?

Try to offer liquids in a cup at about six months old. Offer about ¼ of an ounce of liquid in a small, open plastic cup. Hold the cup while your baby learns how to adjust his lips to the edge of the cup. When your baby is completely weaned from the bottle, give the baby all liquids in a cup.

BEHAVIOR AND DISCIPLINE

What can I do to encourage good behavior?

The most effective way to build good behavior is to shape it with praise. Shaping with praise is a teaching tool that must be used repeatedly to show your approval of your child’s newly established behaviors. We refer to this as praising behavior, not personality. For example, if you say “That’s a good boy!,” that sends a message that being good all the time is the goal, which is an impossible expectation. Instead, you might say, “I like the way you spoke to grandma just now.” No amount of “good boy” will build a positive self-concept unless the child receives specific feedback on his actual good behaviors, because his self-image is composed of his accomplishments.

What is meant by specific praise?

The more specific your praise is, the better the child will understand what he’s doing right and the more likely he will be to repeat it. To increase desirable behaviors, you must emphasize the specific behaviors that please you. One morning, for example, you notice your child has made his bed. At that moment, he’s brushing his hair. If you simply say “Looks nice,” he won’t know whether you are referring to his bed or his hair. Instead, you can say, “I really like the way you made your bed so neatly this morning. Thanks.”

How can I praise progress if I hardly notice any?

Start praising every little step toward the target behavior, making a point of catching the child at being good. Suppose you have told your child he must clean up his toys when he’s through playing with them, though he’s never done this before. Praise every bit of progress, however minor. At first, praise him for picking up one toy even though he’s left three others on the floor. You might say, “It was great the way you picked up your truck and put it in the toy box. Let me help you pick up the others.” The next time, praise him for picking up two items, and so on.

What else can you suggest regarding discipline?

The Seven Principles of Discipline listed below may prove helpful to remember:
1. Tell children what they can do instead of what they can’t do, or focus on the dos instead of the don’ts.
2. Protect and preserve children’s feelings that they are lovable and capable.
3. Offer children choices only when you are willing to abide by their decisions. (Children usually take us seriously when we offer them a choice: for example-do you want to play with your toys in your room or go to the playground?)
4. Change the environment instead of the child’s behavior. (Clear our a low kitchen cupboard and stock it with pots and pans that are safe for your baby to play with while you cook.)
5. Work with children instead of against them. (Be firm, but pleasant and calm.)
6. Give children safe limits they can understand. (State why a particular rule exists.)
7. Set a good example. (Speak and act as you want your child to speak and act.)

QUESTIONS REGARDING EARLY INTERVENTION SERVICES

How is an early intervention referral for evaluation made?

Please call LIIDP and an experienced early intervention professional will take you through the process to arrange for an evaluation. The early intervention program will be explained to you in great detail. If you are interested in pursuing an evaluation, basic information (name, address, phone, pediatrician, and concerns) will be requested with your permission. This information will then be transmitted to the Department of Health. You will receive a phone call to arrange for a visit by an Initial Service Coordinator and information via mail. After LIIDP is requested by you to provide your evaluation, our trained staff will provide the appropriate evaluations.

Who is eligible for an early intervention evaluation?

To be eligible, a child must be under the age of 3 with a diagnosed condition, or where a parent has a suspicion of a delay.

Who are the evaluators?

Evaluators are trained and experienced licensed NYS professionals. These include psychologists, special educators, speech-language pathologists, physical therapists, occupational therapists, or other licensed professionals.

Where does an early intervention evaluation take place?

LIIDP can conduct evaluations either in your home or in our Merrick location. Most evaluations are conducted in the home as this conforms to the early intervention law. A parent must be present at the evaluation.

How much will services cost?

There is no out of pocket cost for either the evaluations or for services. At no point in time, should a service provider ever require a fee or payment from you.

Why do I have to deal with the Department of Health?

Early intervention is the result of a federal law from the IDEA. Various agencies in different states have been chosen to coordinate these services. In New York State, the Department of Health has been selected to do that.

What is an IFSP?

An IFSP (Individualized Family Service Plan) is a written plan for the child’s and family’s services in the early intervention program that the family develops with a team of qualified personnel and the Early Intervention Official. This includes goals and strategies to address priorities and concerns.

How often does a child get services?

Service frequency and duration are determined at the EI/IFSP meeting or CPSE/IEP meeting. Since all services are individual, the amount and types of services will be written as per your child’s needs.

What are the qualifications of the service providers?

All service providers are licensed or certified New York State professionals. All early intervention providers must have a NYS early intervention approval letter in order to provide these services.

Will my child be labeled?

Children in early intervention are not labeled, but they will be deemed eligible to receive services.

How long does it take for the early intervention process to be completed?

The process should take no longer than 45 calendar days from the time of the initial referral until the determination of services.

If I want to change my service coordinator, may I do so?

You can tell your service coordinator directly that you would like to change or you can contact your service coordinator’s supervisor with a change request.

What happens if I am not satisfied with my service provider?

If for any reason you are not happy with your service provider, speak with that person directly. If necessary, you may contact your service coordinator to further discuss this concern.

How often do early intervention services get reviewed?

Services are reviewed every three months. After your child begins services, you will receive progress reports at three-month intervals. During the 3, 9, 15 etc. month review, you will receive general progress reports. At a 6, 12, 18, etc. month review, you will receive progress reports that include formal testing in order to determine your child’s progress. A review meeting is typically conducted by your service coordinator at that time.

What happens if my child needs more early intervention services?

IFSPs can be amended at any time, as long as there is a documented and substantiated need. This can be done by parents and/or providers.

When my child leaves Early Intervention, what happens to his records?

Strict confidentiality regulations (FERPA- Federal Educational Rights and Privacy Act, HIPPA- Health Insurance Portability and Accountability Act of 1996) are adhered to in the early intervention program. No information is distributed without your consent.

When do I need to think about CPSE?

A parent will be informed about the transition process (“leaving early intervention to preschool”) at the initial IFSP by your service coordinator. This information will be discussed at every 6 month review. If your child is not in early intervention, the CPSE evaluation process can be explored when your child is 2.6 years old.

QUESTIONS REGARDING PRESCHOOL SERVICES

How does the preschool process work?

Please call LIIDP and an experienced preschool professional will explain the process in detail. You will be asked in which school district you reside. Information about who to contact in your local school district will be given to you. You will be advised how to request LIIDP for your evaluation by our trained professional staff.

How long does it take for the preschool process to be completed?

The process should take no longer than 30 school days from the time of the initial referral until the determination of services.

Where does a preschool evaluation take place?

Evaluations can also be either in your home, your child’s nursery school, child care location or in our center.

Will my child be labeled?

Children receiving CPSE services are not labeled, but they will be classified according to New York State Education guidelines as a “preschooler with a disability” if they are eligible for services.

How often do early preschool services get reviewed?

Services are reviewed four times (three progress reports and one annual review) during the 10 month school calendar and one time during the summer. The annual review contains formalized testing to determine your child’s progress that will be reviewed at your school district’s annual review meeting.

For how long can my child receive preschool services?

Your child will continue to receive services as long as he continues to have a documented need.

What happens if my child needs more preschool services?

IEPs can be amended at any time, as long as there is a documented and substantiated need. This can be done by parents and/or providers.

SUPPORT SERVICES

What are family support services?

These are services that are available to assist family members who are struggling with infants and toddlers who have developmental concerns.

How can a family get them?

Similar to all services in early intervention/preschool, they are part of an IFSP/IEP.

What format is available?

Family support group, individual and family counseling are available.

Who provides them?

Licensed social workers and psychologists, as well as special educators who can provide “family training.”

How often?

Frequency is indicated in the IFSP/IEP—usually one time per week or once every two weeks, for 60 minute sessions.

How can I find out more about family support services?

More information can be found in the early intervention handbook supplied by the county.

DEVELOPMENTAL & SUPPORT GROUPS

What is “group intervention”?

A group is 3 or more children at a time, as opposed to individual.

How long does it take for services to begin?

It usually takes 30 days for services to begin.

Who is entitled to these services?

A child with a documented delay or diagnosed condition. (see section on evaluations)

What is the purpose of a developmental group?

This group addresses pro-social skills like turn-taking, social language, and following directions.

What is the purpose of a parent support group?

This group provides information and emotional support to parents by bringing together families who have common issues and concerns.

How can I find out more about available support family services as well as developmental groups?

Call Tara Miguel of LIIDP at (516) 546-2333 or contact your ongoing service coordinator.