Supporting your baby's early learning development at home (0 - 2 years)

No two babies are affected in the same way by spina bifida and hydrocephalus, and each one is unique and individual. With this in mind, new parents need to give their baby all the experiences that will help them to become the best that they can be. 

There are no limits to what your baby can learn to do. Given the right opportunities, your baby will amaze you. Your baby can achieve many things and reach many milestones given encouragement, adaptation, organisation and challenges. 

Learning Through Play

When you are a new parent, your baby is getting to know you and you are learning about them. 

As you get to know your baby you will find out about their individual qualities, what they enjoy, what soothes them and what helps them to develop and to learn. 

Remember to use lots of talking and singing when caring for and playing with your baby. At first, it will seem like a one-way conversation but soon your baby will make noises in response. Playing noisy and facial expression copying games with your baby develops their communication skills. Then the interaction really gets going. 

Words for Life is a good website to get communication ideas, along with songs, rhymes and books to read with your baby. Follow the links below for a wide range of lively ideas.  They also have information about talking to babies born prematurely.

Like all children, babies with spina bifida or hydrocephalus need to develop, learn and practice skills through play. Babies and children learn through experience and the stimulation of their senses: sight, touch, hearing, taste, smell and movement. 

It is through play that babies and small children ‘learn how to learn’ so they can build up the skills needed for independent life. The important abilities learnt as a baby or small child are transferable skills for use throughout the rest of a person’s life. Once these abilities are learned, they are in a child’s skills bank for later on in life. 

Children with spina bifida or hydrocephalus may take longer to learn how to play, due to issues around initiating and deciding. If you notice that your child may not 'just play' they may need more encouragement to engage in play. 

Parents and carers are advised to play alongside their child and to model the type of play that they would expect when playing with toys. If a child has a shape sorter toy then they may need to be shown repeatedly how to play with the components, receiving praise whenever they are successful.  

Talking through the activity will give your child a language model as well as a physical model of how to play. 

If your child has lots of appointments, finding time to play can be difficult, but trying to find the time is important as play can be just as important as therapies and procedures for your child’s cognitive development. 

Play nourishes every aspect of your child’s development and forms the foundation for cognitive, physical, sensory, social and emotional skills that are vital for success in school and in life. 

About Kids Health provide play ideas for the first six months - Play is more important than you might think - play activities that challenge help to counteract the possible effects on learning. 

Play paves the way for learning by building social and emotional skills too, such as: 

  • Communication skills 
  • Understanding of social rules and friendship 
  • Developing a sense of ‘give and take’, partnership and teamwork 
  • Gaining patience and perseverance
  • Empathy and understanding of others
  • Initiating and taking a lead rather than being passive, as some children with spina bifida can be. 

Play can take many forms:

  • Physical play- exploring, climbing, rolling, ball games 
  • Sensory play - experimenting with water, sand and clay 
  • Social play – games and turn-taking, like Peek-a-boo and ‘What time is it, Mr Wolf?’ 
  • Communication play- singing, looking at books, rhymes and stories 
  • Creative play – painting, colouring and sticking 
  • Imaginative play – dressing up and ‘being’ a character, making up stories with toys 
  • Construction play – building and making models with construction toys 

Make sure your child has all these play experiences during the week.

A weekly play timetable with a range of play activities helps you to get into a routine and find out what type of play your child enjoys and what they don’t like.  

Encourage your child to try play activities they find less interesting in order to build their skills in play activities that they find less attractive.

Movement

Knowing where your body is or having body awareness is proprioception, which is so important for learning gross motor and fine motor skills as well as establishing depth perception( the ability to see things in three dimensions and judge the distance of objects), sometimes a difficulty for children with hydrocephalus. 

Play helps to develop your baby’s vestibular system, which tells a child about their head position in relation to gravity so they know which way is up. It has a vital role in allowing children to move safely, pay attention, sit still and maintain an appropriate level of alertness for daily play activities. 

Playing ‘Head, Shoulders, Knees and Toes’ every day during nappy changing and bath times helps a baby to recognise their body. This is especially important if your baby has little or limited sensation in part of their body due to their neurological condition. This understanding of their own body is really important for independent self-care as a child grows up. 

Tummy time

It is important for all babies to experience different positions for play, such as on the floor, on your knee or on their tummy. Babies, especially if they have additional needs, should experience the world from more than just a sitting position. 

Bouncing cradles, car seats and high chairs put babies in the same seated position for most of the day so it is vital that babies move around freely as much as possible. 

If your baby has difficulty holding up their head, you can place a wedge or rolled up towel under them for tummy time. 

Encourage rolling by putting their favourite toy just out of reach at the side so your baby turns their head and brings their arm across. Ensure you encourage rolling towards both sides in a safe area. 

If you would like any support with tummy time, please speak to your baby’s health visitor or our physiotherapist at Shine.

Why is this important?

Independent mobility is an important factor in a child’s physical, cognitive, sensory, emotional and social development. Babies should be actively exploring their environment by 12 months. Mobility is not just walking. Rolling, crawling, using a mobility aid or self-propelled wheelchair are all ways of offering independence and your child may need help with this. If your baby has additional needs then being able to move and interact with their world can reduce the effects of their condition. Your therapist will be able to provide advice. 

For more information about proprioception and the vestibular system, follow the links to these websites and to the book ‘A Moving Child is a Learning Child 

The Motor Story - Sensory Processing

Stellar Caterpillar - A game for baby

Toys

It is not necessary for children to be surrounded by expensive toys in order to play. 

  • A large cardboard box can become an excellent playhouse, a pretend boat or a dolls house. 
  • A bowl of water, plastic cups and a large clean paintbrush can encourage a child to pour water and to ‘paint’ outside on walls and paths. 
  • Cooking and baking is a fantastic activity for practising counting, weighing and learning the concepts of ‘more’ and ‘less’. 

Play routine

Avoid putting out all the toys a child has to play with. Instead, have a routine of different types of play, using a range of toys. 

You may wish to have a timetable, calendar or diary to maintain your child’s play routine. Then you can see if your child is experiencing all types of play activities to minimise any risk of having gaps in their play development. 

play calendar is available to download here 

Choosing toys and games for a child with hydrocephalus or spina bifida

Pop-up toys, which demand 'cause and effect' play, are suitable for children who may have difficulties with prospective memory, which is often described as ‘remembering to remember’. 

Predicting or anticipating games like Peek-a-boo and Round and Round the Garden rhymes are all helpful for children with spina bifida or hydrocephalus, who often have difficulty with prospective memory. 

Some children can be very passive in their play where they don't initiate, partly because they don't anticipate anything will happen. Opportunities to experience toys and games that enhance their prospective memory can be very useful. 

Toys that develop and improve spatial skills are important for children with spina bifida or hydrocephalus. Some children with these conditions have difficulties with spatial skills so they need experience of handling, investigating and building with a range of objects. 

SeeTen tips for improving spatial skills in children and young people  

Be gender-free in your choice of toys and activities

Traditional ‘girls’ and ‘boys’ toys can lead to children missing out on types of play which can enable them to overcome some difficulties associated with hydrocephalus. 

Girls are often missing out on construction-type play, which can hinder their development of spatial, 3D planning and early maths skills. 

Boys can miss out on imaginative play through having little experience of playing games with teddies or dolls. Boys benefit from play involving daily routine, which helps with sequencing skills and understanding the feelings of others. 

Care.com has a list of recommended gender free toys

Further Reading

  • Your child and Hydrocephalus 
  • Cerebra’s postal toy lending library offers a range of sensory toys and is free to parents who sign up 
  • Local Toy libraries – check on your Local Offer for your area 
  • Free play resources and therapy pods for babies and children with disabilities can be borrowed from Newlife who also offer funding and loans towards equipment for children with complex needs
  • Disability Grants offers advice on toys for babies and children with additional needs  
  • Pre- school play ideas 
  • Sense charity has a series of booklets to download providing play advice for children with sensory impairments.
  • Making Play Inclusive  a toolkit for parents 
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