TRS Learning Center

Some Question and Answers:

Therapy Group

How would I know if my child needs to attend a Therapy Group?
Your child should attend group therapy if you have any concerns with their ability to interact with peers. Here are a few indicators that your child may benefit from group therapy:

Your child’s teacher often reports difficulties interacting with peers at school
Your child seems to avoid interacting with other children
You notice frequent conflicts during play dates or interactions with other kids
Your child feels afraid or refuses to attend social gatherings (e.g. play-dates, birthday parties)
Your child has difficulty being flexible during play activities (e.g. sharing others’ ideas, winning or losing)
Your child has difficulty joining in play or initiating interactions with other kids
Your child uses physical actions instead of words to communicate with others (e.g. grabs a toy instead of asking, pushes others instead of verbalizing how they feel)
Your child has had less opportunities to interact with age-matched peers

Speech and Language Therapy

How do I know if my child needs Speech and Language Therapy?
The following early warning signs can be indicative of a Speech and Language Delay. The following simple chart will help you determine if your child’s skills are developmentally appropriate -

Age	Speech and Language Skills
1 year	Your infant doesn't cry, babble, or pay attention to other voices
2 years	Your child can't put some words together in a speech
3 years	Your child's speech is difficult for those outside the family to understand
4 years	Your child doesn't have a growing vocabulary, speak in sentences, and make most sounds - or a child points to things instead of talking
5 years	Your child can't carry on a simple conversation, stutters, sounds much different from playmates, is reluctant to talk, is very self-conscious when speaking and becomes defensive, nervous, or withdrawn when speaking

If you are concerned about your child's speech production, please keep in mind that the majority of sounds a three year old makes should be normal. Although she/he may use all sounds correctly, she/he should be intelligible to strangers. The following chart provides the acceptable ages of speech sound development for children

Age	Consonants
3 years	m, n, p, h, w, b, t, d
4 years	k, g, f, v, ng, y, l
5 years	s, z, j, sh
6 years	r, t, dj, ch
7 years	v, th

Feeding Therapy

How would I know if my child needs feeding therapy?
The following are signs and symptoms of feeding and swallowing problems in children:

Difficulty breast feeding (for very young children)
Arching or stiffening of the body during feeding
Irritability or lack of alertness during feeding
Refusing food or liquid
Failure to accept different textures of food (e.g., only pureed foods or crunchy cereals)
Long feeding times (e.g., more than 30 minutes)
Difficulty chewing
Coughing or gagging during meals
Excessive drooling or food/liquid coming out of the mouth or nose
Difficulty coordinating breathing with eating and drinking
Increased stuffiness during meals
Gurgly, hoarse, or breathy voice quality
Frequent spitting up or vomiting
Recurring pneumonia or respiratory infections
Less than normal weight gain or growth

Occupational and Physical Therapy

What are the signs that my child may need Occupational or Physical Therapy?
Signs that your child may need occupational or physical therapy services would include difficulties performing certain tasks by certain ages. Here is a simple chart to help determine if your child’s skills are developmentally appropriate

Age	Fine Motor Skill	Gross Motor Skill	Self-Help Skill
1 month	Hands are in fists most of the time	Head bobs when held upright, kicks feet when on back	Coordinated suck from breast or bottle nipple
2 months	Holds a rattle when placed in their hand	Lifts head briefly when placed on tummy	Opens mouth when seeing breast or bottle nipple
3 months	Reaches toward dangling objects and people’s faces	Lifts head 2 to 3 inches off surface and pushes up with forearms when placed on tummy	Anticipates feedings, shows interest or excitement when seeing breast or bottle nipple
4 months	Holds and shakes rattle, plays with and watches their own fingers	Straightens legs when feet touch a flat surface; when on tummy, lifts head and chest off surface while looking forward	Brings toy to mouth
5 months	Reaches for a toy with two hands; uses whole hand to grasp a toy	Rolls from tummy to back (always supervise to avoid falls) Pulls self forward to sitting position when you hold baby’s hands	Places both hands on breast or bottle when nursing
6 Months	Passes a toy from one hand to another: bangs toy on table	Sits briefly without support; rolls from back to tummy	Holds own bottle or cup during feedings
7-9 Months	Releases objects Points and is developing finger pinching skills	Changes positions between sitting and standing with support Crawls on hands and knees Pulls to stand and cruises along furniture	Holds own bottle Feeds self finger foods using thumb and finger tips
10-12 Months	Grasps small objects in fingertips (3 finger grasp) Bangs objects together to make noise, places toys in containers Uses the index finger to explore toys Puts on their socks	Able to change positions into sitting upright Crawls upstairs Walks with hands held	Begins to hold a spoon and attempts to feed self Drinks from a cup with a lid or small sips from open cup
12-18 Months	Holds onto crayons and makes marks; scribbles Attempts puzzles Stacks blocks and begins to construct simple puzzles	Plays while standing Walks well, squats and picks up toys from the floor Flings a balls	Begins to use spoon and fork drink from cup Takes off socks and shoes (when laces are undone) Puts arms through sleeve and legs through pants legs Tries to wash face and hands help put toys away
18-24 Months	Completes 4-5 piece puzzle Builds towers of 4 blocks Holds crayons in fingertips and draws straight or circular strokes Strings beads	Throws ball at a large target Jumps with both feet	Feeds self with a spoon and fork suck through a straw Eats a combination of textures and chopped table foods Pushes arm through armholes in T-shirt to help with dressing Undresses completely except for fasteners Understands and stays away from common dangers: sharp or hot objects
24-36 Months	Snips with scissors Imitates horizontal, vertical, and circular marks on paper Builds towers and lines up objects	Rides tricycle Catches a large ball against chest Begins to hop on one foot	Uses a fork and spoon with spilling Washes and dry hands with supervision Brushes teeth with assistance Uses toilet consistently (a few accidents at times) Dresses and undresses self with help puts own things away, helps with clean up and putting things away
3-4 Years	Uses three fingers to grasp pencil or crayon Colors within lines Copies simple shapes; begins to copy letters Uses scissors to cut simple shapes Draws a face	Begins to skip and hop Skilled in jumping, climbing and running	Feeds self using utensils without spilling Puts on and take off shoes without ties Dresses and undresses with some help Manipulates large buttons and snaps Washes hands with help
4-5 Years	Draws with dexterity, using a dynamic tripod grasp Completes puzzles of up to 10 pieces Uses scissors to cut out squares and other simple shapes Color within the lines Copies own name and some letters	Throws a ball Hops for long sequences Climbs on playground equipment	Pours liquid from a small container Unscrews the cap of a toothpaste tube Uses hair brush, toothbrush, and tissues with some help Climbs in and out of the car, bathtub, and bed on own
5-6 Years	Prints name, copies letters, copies a triangle, begins upper and lowercase letters Constructs a complex building Completes puzzles of up to 20 pieces	Hops well for long distances Skips with good balance Kicks with accuracy