Some Question and Answers:

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
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different from playmates, is reluctant to talk, is very self-conscious when speaking and becomes defensive, nervous, or withdrawn when speaking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
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

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