Blogs

To be independent is to have confidence in one’s ability to face daily challenges head-on, and is the feeling of freedom while living a life without limits. 

In essence, occupational therapists take on the task of helping patients reach this level of confidence. It is not solely our extensive training, years of hands-on experience, or the letters that follow the names that make us qualified. It is our passion that qualifies us to be the second set of hands and eyes that parents need to make sure their child lives a full life. 

As a pediatric occupational therapist, we address anything from developmental delays, sensory integration issues, handwriting concerns, ADL’s (activities of daily living) such as chores, personal hygiene, feeding, and getting dressed. 

We also closely monitor gross motor coordination to enable children to play safely and be successful in team sports. After all, the safety of our patients is our number one concern. When it comes to team activities, we also know that communication plays a major role in a child’s ability to play safely with others. This is why we do not stop at observing fine and gross motor skills, but we work with our patients and their families to make key observances of their social interaction skills, as well. We want our patients to live a life of confidence, and that includes them having the ability to interact with peers, adults, their families, and friends. 

With our guidance, our patients and their families are able to feel at ease knowing that they are equipped with the appropriate tools and skills to take home and apply to their everyday lives. We also go the extra mile to make necessary referrals and follow-up with Physical Therapists, Speech Therapists, Pediatricians, Optometrists, and so forth depending on the specific need of each of our patients. 

A limitless lifestyle begins and ends with confidence, and confidence is truly who we are. We are the small hands that help smaller hands do BIG things.

Written by: Nykia Petty- OTR/L

Most toddlers substitute sounds and simplify words as they learn to talk. Many children will continue to substitute later developing consonant sounds (r, l, th) until they’re 6 or 7. Even when a child’s speech contains some sound errors, a parent should understand at least half of what a 2-year-old says and nearly all of what a 3-year-old says. We do not expect unfamiliar adults to understand 100% of what a child says until he’s 5. Even then there may be some sound substitutions. Children with muscle tone differences that have impacted their feeding skills will also have difficulty being understood when they are learning to talk.

**PLEASE NOTE** When a child talks in what a parent might call “his own language” or uses long strings of unintelligible speech, this is jargon. Jargon is a part of  NORMAL expressive development, but when jargon persists past age 2 and the child is not using very many single words you do understand, this is usually a problem related to language development rather than how a child pronounces words.

Even though we do not expect that everyone would understand 100% of what a child says until he’s older, there are characteristics, even before age three, that may suggest the presence of significant speech delay or disorder.

Limited consonant sounds in a child’s speech

Red Flags For Speech Development

• Vowel sounds are substituted or left off in words
• Beginning consonant sounds are left off in words
• No two-syllable words are used

Ways you can help your child at home

1. Avoid overcorrecting a new talker’s word attempts. Focus on the intent of the child’s message.
2. Don’t repeat a child’s errors back to them. If a child says, “uh” for “cup,” say, “Cup! Here’s your cup!” Many toddlers need practice hearing words produced correctly before they recognize an error in their own speech.
3. Practice a new sound alone only a few times, then quickly move the new sound to a word. Some toddlers will respond and correct their mistakes when you ask them to repeat words as you slowly model the correct way to pronounce words. Toddlers with developmental delays may not be able to do this until after age 3.
4. Negative attention and overemphasizing speech sounds may stall progress in toddlers who are new communicators.

Focus on talking and communicating rather than perfect speech with late talkers 

Source: https://teachmetotalk.com

Written by: Madison Dolecki, MS, CCC-SLP

Food! Mealtime! Are you having difficulty with your child eating a variety of foods? It’s understanding how hard it is to ensure your child is consuming a variety of foods to be healthy and grow. If you recognize two or more symptoms below in your child’s feeding, please speak to your pediatrician to determine if a feeding evaluation is warranted.

Does your child present with one or more symptoms during mealtimes?

• Avoids all foods in specific texture or food group
• Choking, gagging, or coughing during meals
• Mealtimes are a battle for your child to eat non-preferred foods
• History of a traumatic choking event
• Medical condition: acid reflux, respiratory issues, etc.
• During 2 or more well check visits child was reported as being a “picky eater”
• Poor weight gain or weight loss
• Eats/consumes less than 20 foods by 24 months of age
• Difficulty transitioning to baby food purees by 10 months of age
• Difficulty consuming any table food solids by 12 months of age
• Difficulty weaning off of baby foods by 16 months of age

Do any of these statements remind you or your child?

“Morgan won’t eat anything green because of the color”

“Strawberries used to be Morgan’s favorite food; now she refuses them.”

“Morgan will only eat chicken nuggets!”

“He gags at the sight of oatmeal.”

If your child only eats certain types of food or refuses foods based on colors, textures, or brands, he/she may be a picky eater, and mealtime may be a sore topic in your household. While some parents worry about what their children eat or how much they consume, no need to worry too much because you are not alone. To help increase the variety and nutrition, you can make sure your child is exposed to different foods and textures from each food group. It’s okay if they don’t like chewy foods but consumes all other textures during their picky stage; eventually, they should add that texture to their diet at some point. Picky eating is a common behavior for many children from the age of 2 to 5 years. However, if these behaviors persist beyond this age or the picky eating results in nutritional compromise and weight loss, your child could be at risk for a true feeding disorder.

If you find that your child does not consume a variety of foods and textures please speak with your child’s pediatrician first to discuss your concerns about picky eating. If you believe your child’s picky eating is more severe than what is considered typical for his/her age, please talk to your child’s pediatrician for a possible feeding referral with a Speech-Language Pathologist or Occupational Therapist.

How to cope with picky eating: It’s okay your child is a picky eater, as long as it’s temporary.

Try some of the following tips to help your child’s picky eating behaviors in a positive way:

1. Let your kids pick fruits and vegetables at the grocery store.
2. Let your kids help you prepare the meals. Let them add ingredients or stir the food.
3. Offer choices, such as, “do you want green beans or broccoli for dinner?”
4. During mealtime, have fun family conversations without the TV on for distractions.
5. Offer the same foods for the whole family. Stick to mealtime routines.
6. Cut food into fun shapes but keep it simple.
7. Plate small portions on a child’s plate. Given them a small taste at first. You can always give them more if they like it!
8. Offer only one new food at a time up to 10 times. Always serve something they like with new food. Children may need to try a new food 10 or more times before they accept it.
9. Offer the new foods first! Your child is most hungry at the start of a meal.
10. Be a Good Role Model at dinner time.

Bilingualism is the ability to communicate in more than one language and can be thought of as a continuum of language skills in which proficiency in any of the languages used may fluctuate over time and across social settings, conversational partners, and topics, among other variables.

Many children are exposed to one language in their home and as they get older, they become exposed to one or more new languages via television, the community, school, and other places. Over time, children become more aware of situations/places where it is appropriate to use each language.

It is important to note that a child exposed to two languages is NOT at an increased risk for speech and language difficulties. Many times, for example, a parent will notice their child begin labeling colors in English when only Spanish is spoken in the home and will assume they should start speaking to their child in English. It is most beneficial for a child who will be a dual language learner to be continuously exposed to both languages, as early on as possible. Speaking in one language or another will not increase your child’s likelihood of having speech or language difficulties. In fact, research has shown that children exposed to two languages can have increased cognitive skills, problem-solving abilities, better native language structure and vocabulary, and higher standardized test scores when they are older.

Types of Bilingualism:

• Simultaneous vs sequential
  • Simultaneous: learning two (or more) languages at the same time, typically introduced to both languages prior to the age of three.
  • Sequential: a second language introduced after age 3, at which time some level of proficiency has been established in the primary language
• Dominant vs balanced
  • Dominant: one language is used more often/more comfortable with
  • Balanced: all languages are used the same amount

Red Flags for potential speech and language difficulties:

• History of delayed developmental prior to second language exposure
• Medical/developmental history or problems
• Academic difficulties prior to second language exposure
• Processing difficulties
• The slower rate of second language acquisition when compared to peers
• Persistent social problems, even after years of exposure
• Speech production difficulties in both languages

Tips for parents:

• Choose a place in your home where you will practice a language together
• Maintain exposure to both languages
• Sing and read to your child on a daily basis
• When your child uses incorrect words or grammar, simply model the correct vocabulary and/or sentence structure in response to the child’s utterance.
• Even if your child is tending to speak more in the second language, continue speaking to him/her in the first language.

If you suspect your child is having speech and/or language difficulties in one or more languages, talk to your child’s doctor. It is the role of a speech-language pathologist to complete an assessment in your child’s most natural language to determine if there are any concerns that should be addressed with therapy.

Written by Madison Dolecki, MS, CCC-SLP

Most toddlers substitute sounds and simplify words as they learn to talk. Many children will continue to substitute later developing consonant sounds (r, l, th) until they’re 6 or 7. Even when a child’s speech contains some sound errors, a parent should understand at least half of what a 2-year-old says and nearly all of what a 3-year-old says. We do not expect unfamiliar adults to understand 100% of what a child says until he’s 5. Even then there may be some sound substitutions. Children with muscle tone differences that have impacted their feeding skills will also have difficulty being understood when they are learning to talk.

**PLEASE NOTE** When a child talks in what a parent might call “his own language” or uses long strings of unintelligible speech, this is jargon. Jargon is a part of  NORMAL expressive development, but when jargon persists past age 2 and the child is not using very many single words you do understand, this is usually a problem related to language development rather than how a child pronounces words.

Even though we do not expect that everyone would understand 100% of what a child says until he’s older, there are characteristics, even before age three, that may suggest the presence of significant speech delay or disorder.

Red Flags For Speech Development

• Limited consonant sounds in a child’s speech
• Vowel sounds are substituted or left off in words
• Beginning consonant sounds are left off in words
• No two-syllable words are used

Ways you can help your child at home

1. Avoid overcorrecting a new talker’s word attempts. Focus on the intent of the child’s message.
2. Don’t repeat a child’s errors back to them. If a child says, “uh” for “cup,” say, “Cup! Here’s your cup!” Many toddlers need practice hearing words produced correctly before they recognize an error in their own speech.
3. Practice a new sound alone only a few times, then quickly move the new sound to a word. Some toddlers will respond and correct their mistakes when you ask them to repeat words as you slowly model the correct way to pronounce words. Toddlers with developmental delays may not be able to do this until after age 3.
4. Negative attention and overemphasizing speech sounds may stall progress in toddlers who are new communicators.

Focus on talking and communicating rather than perfect speech with late talkers 

Source: https://teachmetotalk.com

Written by Wanda Wims, MS, CCC-SLP

Some children are shy and do not like to talk to people they don’t know. They usually start talking when they feel more comfortable. However, some children will not talk at certain times, no matter what. This is selective mutism. It is often frustrating for the child and others. This might start when your child goes to school. Sometimes, it starts when a child is younger.

Signs of Selective Mutism

If your child has selective mutism, you may notice that:

• She will not speak at times when she should, like in school. This will happen all of the time in that situation. Your child will talk at other times and in other places.
• Not speaking gets in the way of school, work, or friendships.
• This behavior lasts for at least 1 month. This does not include the first month of school because children may be shy and not talk right away.
• Your child can speak the language needed at that time. A child who does not know the language being used may not talk. This is not selective mutism.
• Your child does not have a speech or language problem that might cause her to stop talking.

Causes of Selective Mutism

No single cause of selective mutism has been identified, an

d according to various research, it could be caused for multiple reasons. A child with selective mutism may:

• Have an anxiety disorder.
• Be very shy.
• Be afraid to embarrass themselves in public.
• Want to be alone and not talk with friends or others.

Testing for Selective Mutism

Talk to your doctor if you have concerns about how and when your child talks. Collaboration between the speech-language pathologist (SLP) and behavioral health professionals (such as a school or clinical psychologist, psychiatrist, or school social worker), as well as the classroom teacher and the child’s family, is particularly important for appropriate assessment and treatment planning as well as implementation because selective mutism is categorized as an anxiety-based disorder. SLPs are in an excellent position to coordinate intervention for children who have selective mutism because of their knowledge and skills in effective communication treatments (Schum, 2002).

Treatment for Selective Mutism

Each person with selective mutism may need different medical attention, or to have different skills addressed. SLPs will work to get your child comfortable talking in all situations. Your child may need to work to change how she behaves at those times when she won’t talk. Or, she may need to work on her speech and language. The SLP will also work with your child on any speech or language problems that he may have. This may include helping him say sounds clearly or helping him say words loudly. The SLP may also help him use words to ask questions or talk about his thoughts. Your child may be more willing to talk to others once he feels better about how he sounds.

The SLP may also work with others in the places where your child has trouble. This may include your child’s teachers, counselors, coaches, or family members. The goal is for your child to be comfortable talking in any situation.

Sources: www.asha.org; https://selectivemutismcenter.org/

Written by Wanda Wims, MS, CCC-SLP

What does it mean to self-regulate?

Self-regulation is a child’s ability to adjust their emotions, behaviors, and level of energy to be appropriate (socially acceptable) when transitioning to a new environment or when apart from a caregiver.

How does self-regulation impact children?

By the age of 2, a child should be able to self-regulate most of the time without a parent present. If a child is unable to self-regulate, this can make social interactions, following directions, and paying attention very challenging. Some signs that might indicate poor self-regulation include: throws tantrums for longer than other children, has difficulty falling asleep, is easily distracted, has difficulty playing with peers, is either under or over-reactive to sensations, and is difficult to discipline.

How can occupational therapy help?

Occupational therapy can facilitate self-regulation by supporting children during transitions and providing them with tools and coping strategies to maintain a calm and alert state. Therapists address all areas of self-regulation including sensory, emotional, and cognitive. Occupational therapy will enable your child to reach their full potential.

Pointers for parents:

• Timers can help a child transition to and from an environment since there is a clear limit placed.
• Visual schedules can help a child to be able to see and understand what is happening next.
• Provide your child with activities or games that have a defined start and finish such as a puzzle, maze, or dot-to-dot.

Written by Moriah Nesbitt, COTA