A Therapists Guide to Fix the Developmental Delay of Baby Milestones

One of the most effective therapy puzzle as child development skill buildertools I used was puzzles.

 People usually think of jigsaw puzzles when they hear the word, but there are many other types of puzzles that exist. And all of them foster developmental skills. Depending on the type of puzzle being used, visual perceptual, fine motor, critical thinking, memory, reasoning, sequencing, planning and logic skills are tapped. Many of these components make up executive function. What’s more is that puzzles can keep minds sharp throughout a lifetime. Babies as young as 6 months start with inserting shapes into matching holes. Seniors can be found working on jigsaw puzzles with as many as 10,000 pieces. Can you imagine the amount of skills utilized to put together such a massive puzzle? Aside from interlocking puzzles, there are word search puzzles, soduko, crossword puzzles, wooden pieces-as-whole- puzzles and cryptoquotes. Everyone remembers hidden pictures form Highlights Magazine. Those are puzzles as well.

I have gotten amazing results using puzzles even with very cognitively challenged toddlers and children.

 There is something very satisfying about connecting interlocking shapes, or inserting forms into the correct place on a board. And I believe it is this feeling of satisfaction that spurs motivation to try and do more and complete the puzzle. The fascinating aspect of working therapeutically with puzzles is that once learned, the child is able to carry-over the skill to new and increasingly more complicated puzzles.

Helping your young child learn to make puzzles is fairly easy. Whenever I work with a baby or toddler, I always sit long legged on the floor with the child tucked into the space between my legs. This enables me to work hand-over-hand with them and demonstrate by using the same hand as they would. If you sit facing your child, she will see a mirror image which is more difficult to process. If your child is left-handed, and you have no desire to promote right-handedness, then use your left hand as a guide. It may take some getting used to, but it is very important that you guide by helping their dominant hand. If your baby is young and you are not sure which hand is dominant, guide with whichever hand you use.

For very young babies or toddlers, start with a simple wooden puzzle such as those with 3 different sized circles.

 These typically have a large peg grasp. Place your hand over your child’s and have her grasp the large peg. Then, rather than simply placing it in the correct hole, touch the flat of the circle onto the outer wood surface of the puzzle and slide it into the appropriate hole. Add a slight pressure as the shape slides over the edge and into the hole. This pressure gives sensory input and helps your child to understand what it feels like to get the shape into the hole. I have discussed this in my post about hand-over-hand help. Stick with circle shapes only for awhile. They are the easiest to learn. Once your child is successful at the three different circle shape puzzle, you can move on to simple puzzles with circles, squares and triangles.

The next stage of development in learning puzzles would be with 5 or more non-interlocking piece puzzles.

Many therapists and clinicians stick with individual shapes and puzzles which have matching pictures behind them (e.g. transportation puzzles with boats, cars, ambulance etc). I don’t think you need to wait to move on. I have seen amazing success with these “pieces-as-whole” puzzles which make up a picture when put together. The children seem to love making the picture come together. These puzzles require a slightly different technique. You will continue to work with them hand-over-hand. However, you are going to put all the pieces in the board except for the final piece. It is that piece which you will help them with in the same way you assisted with the circle shape. Use hand-over-hand guidance and slide the piece into position. Continue to repeat this until your child can put in that one piece independently. The next step will be to repeat the same technique but leave out the last two pieces. You will continue to work backward in this manner until you are able to take out all the pieces and your child remembers where they go unassisted. You may need to give verbal cues while they are learning. Try to minimize the physical assistance once you have helped a few times at the beginning of the session. Use verbal cues instead such as “rotate, turn it a little, where is the top, etc).

The process of starting at the end with just the last piece and working in reverse is called “backward chaining”. In my experience, it is phenomenally effective. Children with autism spectrum and those with cognitive delays do very well with this technique.

 I even use backward chaining when teaching movement skills to very involved children. The reason it works so well is that success is very easy when a child performs the final piece of a task. Success builds self-esteem and motivation. For example, a few years ago I worked with a baby with Costello Syndrome. This is an extremely rare syndrome with physical abnormalities, internal anomalies and cognitive delay. The little girl did not seem to understand the concept of moving. I taught her to transition from lying on her tummy to sitting up. I did this by starting with the very final movement transition when getting into sitting. I repeated it over and over until she could do it. And then I started working backward to the beginning. It took about 6 months to teach it – but she learned it! Not only did she learn how to do it when prompted, but she started to move around on her own. By age three, she was walking. Every step of her physical progress was based on backward chaining. Her doctors were stunned because they didn’t think she had the cognitive ability to learn.

Getting back to puzzles, you want to continue to use the same protocol for each time you advance the difficulty. Start with the circle shape and progressively work up to interlocking puzzles. The best interlocking puzzles for 2 and 3 year olds are the 24 piece floor puzzles. You can find these sold on many internet sites. They seem to be limited in stores. The reason I like the floor puzzles is that the large pieces are easy to work with, and the size of the puzzle requires the child to use more of her visual field. The large size also promotes movement. These floor puzzles are also helpful for children with visual neglect. Children with disorders like hemiplegia may not look to their affected side. Tasks that occupy a wide space require visual searching in all fields –up, down and side to side.

Once your child can put together a 24 piece floor puzzle independently, you can be sure they have the skills for more complicated puzzles. In learning how to do a puzzle, your child has improved many developmental skills which will help her master other tasks. A puzzle requires looking at an individual piece, comprehending where the piece fits into a picture, planning where to begin and how to progress, manipulating and positioning that piece and others, and understanding the relationship and context of one piece to another. These skills can be applied for most activities of daily living. Learning puzzles is great therapy!

I want to mention the benefits of a few of the other types of puzzles I mentioned at the start of this post. Although I favor wooden peg puzzles and interlocking puzzles for young children, older children can benefit from jigsaw and other types of puzzles. Hidden Pictures help develop visual skills such as figure ground awareness (ability to distinguish figures from background) and visual discrimination (recognizing shapes and items). Word search puzzles provide much the same benefit: visual discrimination and visual perception. Crossword puzzles require reasoning and deductive skills, as well as planning and visual motor skills. Soduko elicits the same skills.

Puzzles are interesting and help children with attention issues, such as those with ADHD, to stay engaged. They promote many executive function skills which are helpful to children on the autism spectrum. They can foster social interaction when used in a group including turn taking and decision making. They can also foster movement and motor planning skills. They help improve fine motor skills such as grasp and manipulation. Best of all, these acquired skills can be generalized so that they carry over and help develop skills in other areas.

One Response to “Puzzles are incredible child development skill builders”

  1. [...] This post was mentioned on Twitter by Lou Lou's PlaySchool, Wendy Rawley. Wendy Rawley said: Puzzles are incredible child development skill builders | Nancy …: Read why learning to do puzzles can help bu… http://bit.ly/glTB8J [...]

Leave a Reply