Frequently Asked Questions
**The following FAQ’s were compiled from The Center for Pediatric Therapy Inc., the SPD Foundation, Incredible Horizons, and LD Online.
What is occupational therapy?
Occupational Therapists who specialize in pediatrics are trained to create opportunities for children to master developmental tasks and achieve independence in their home, school, and community. Occupational therapists use a variety of intensive treatment interventions tailored to meet each individual child’s development needs. A child may be referred for evaluation and treatment if he or she exhibits one or more of the following behaviors:
- Avoids climbing or playing balls and seems clumsy; falls frequently
- Struggles or is unable to hold a pencil and/or scissors; difficulty with motor skills
- Avoids or struggles to draw and handwrite
- Sitting still is a challenge, unless focused on computer or TV
- Seems sensitive to the world
- Difficulty playing or socializing effectively
Your child’s teacher may recommend your child for occupational therapy if your child’s difficulties directly interfere with education.
How can occupational therapy (OT) help children at school, at home, and on the playground?
Occupational therapists may provide services to a child who is having difficulty with coordination, handwriting, motor skills, or sensory processing so that he/she may better access the educational and home environment. The therapist utilizes a variety of treatment strategies to support and facilitate motor, sensory, and perceptual development. At the Child Success Center®, OT services are provided on a one-to-one basis for the majority of the session, ending occasionally in a small group setting in the children’s gym to promote social skills and peer interaction.
How can occupational therapy support teachers in the classroom?
If needed, the occupational therapist will collaborate with teachers and the educational team to foster increased independence and self confidence with skills such as climbing, coloring, cutting, promoting a functional pencil grasp, participation in circle time, and social interaction.
What is sensory integration? What does the term mean?
The term “Sensory Integration” is used to describe an intervention strategy based on a theory developed by occupational therapist and child development expert A. Jean Ayres.
Sensory Integration is used to describe certain processes that go on in our brain, allowing us to make sense of the information we get from our environment and act on it. The term refers to the process by which the brain interprets and organizes various sensory experiences including sight, sound, smell, touch, movement, body awareness, and the pull of gravity.
Sensory integration is a normal phenomenon of central nervous system functioning and provides a foundation for more complex learning and behavior. For some individuals sensory integration does not develop as efficiently as it should. Sensory integration dysfunction can result in motor development difficulties, learning difficulties, or behavioral concerns.
How do I know if my child has a sensory integration disorder?
Efficient organization of sensory information provides the foundation for the development of basic functional skills. If there is a problem with the processing of sensory information, there can be many potential outcomes that might cause a parent concern.
A disruption in sensory processing can result in sensory defensiveness (sensory seeking or sensory avoiding behaviors), problems in self-regulation (activity levels too high or too low, not matched for the task at hand), and difficulties with praxis (the ability to conceive, organize and execute skills of all kinds). Disruptions in processing sensory information can interfere with self-care skills, language skills, motor skills, academic skills, and social/emotional skills.
Some specific concerns might be:
- Takes a long time to learn a new task/skill
- Seems clumsy, has too many accidents
- Not keeping up with peers
- Presents as a behavior problem at school
- Has trouble with handwriting
- Demonstrates unpredictable behavior in social situations, especially new or highly stimulating ones
- Acts restless/fussy when held
- Displays short attention span
- Seems overly dependent on routine or schedules and/or easily upset with minor changes
- Acts impulsively or explosively
- Angers easily or frequently accused of fighting, acting out or “bullying” others
- Appears overly colicky or fussy
- Exhibits “picky” eating behavior
What should I do if I suspect that my child has this difficulty?
If you suspect your child might have a sensory integrative disorder, the next step is evaluation. An evaluation usually consists of standardized testing (when possible), a structured observation of play and responses to sensory input, and an interview with the parent or adult. If intervention is recommended, it can be intensive (twice a week), weekly, or consultative.
Does my child really need sensory integrative therapy? Can’t they just practice?
We are sure that the family and teaching staff have tried to “teach” the child skills that appear difficult. Unfortunately, unless the child has the underlying ability to “be taught” the skill, it will not be mastered. It is important to remember that not all types of learning, particularly motor learning, can be mastered by practicing. No matter how many times children practice a wrong pattern, it won’t make it right. Until they have the internal ability to do it correctly, they will be unable to correct the problem.
What would happen during therapy?
An important component of sensory integrative therapy is the inner drive, and motivation of the child. This plays a crucial role in the selection of the therapeutic activities. The therapist, based on the evaluation results, utilize their specialized knowledge to analyze the tasks your child needs to master for successful involvement in life’s roles. The therapist will customize the activities during the session based on your child’s needs.
The Child Success Center® has several rooms, each with different activities and a children’s gym. The therapist will utilize the different treatment rooms and the gym matching a variety of activities with the child’s needs in order to have more efficient processing of sensory input. This allows the child to guide the session, within the activities that the therapist has set-up, and therefore, capitalize on the inner drive. This active involvement and exploration enables the individual’s nervous system to become a more efficient organizer of sensory information.
What is sensory processing, and how is it different from SI?
Sensory processing is the initial step of sensory integration. Inputs must be taken in, filtered, and organized before integration can occur. Integration is the final step of an organized response to inputs received. It includes a motor response typically called an adaptive response.
What is body awareness?
There is an internal body “map” each of us has that allows us to know where we are, what position we are in, and how we are moving at any given moment. The body map allows us to move without relying on our visual system to guide each movement. The body map is created over time as we develop from infancy throughout childhood, via repeated accurate sensory inputs produced from our motion through space. Inaccurate sensory perceptions do not allow for the creation of accurate body maps. Children with inaccurate body maps typically rely heavily on their visual systems and have significant difficulty with many aspects of motor skill.
What is the vestibular system?
This sense allows us to maintain our balance and upright posture. It is also closely involved with the visual system, allowing us to judge our motion in relation to the objects around us. This can sometimes play tricks on us (sitting in one of those movies where you feel like you are moving when you aren’t). This sense allows us to feel secure with gravity and is a way of knowing where we are in relation to gravity (i.e.. if we are upside-down or sideways).
What is proprioception?
This is the sense that allows us to know what position our body parts are in. For example, without looking at them, you can tell if your elbows or knees are bent or straight. This sense also tells us about the force of our movements. So if we see a cup and want to reach for it, we can judge how much force and speed we are reaching with so we can accurately get our hand to the cup without knocking it over or missing it. We can also tell how hard we need to hold on to lift the cup without squashing it or dropping it. It is primarily proprioception you are using when you walk a familiar flight of stairs in the dark and know exactly where to place your feet and how high the steps are by the feel of the movement of your legs. This sense is extremely important for body awareness and coordinated movements.
What is sensory defensiveness?
Sensory defensiveness is a term coined by some OT’s to describe a group of oversensitivities to touch, vision, auditory, movement and smell sensations. Sensory defensiveness is just oversensitivity to certain input. With the term defensiveness, a range of behaviors is implied. These behaviors are the things we can observe that indicate that a sensory input is aversive.
Who will pay for therapy?
Most insurance companies will pay for “medically necessary” therapy. Otherwise the family will assume financial responsibility. Our experience with this process is that the insurance company will cover the cost of the evaluation, and then determine funding the services from the results of the evaluation. The Child Success Center® does not accept insurance, but is more than happy to provide you with all the necessary forms to submit to your insurance for reimbursement.
** Educational Therapy FAQ’s compiled by CSC Educational Therapists.
How do I know if my child needs educational therapy?
Your child may need our help if you recognize some of the following behaviors:
- Avoids or struggles to read
- Gets into trouble and dislikes school
- Avoids, cried, and/or battles over homework
- Is easily frustrated and emotionally fragile
- Struggles to pay attention and follow directions
- Has poor writing skills
- Finds math very difficult
- Struggle to remember things
- Has been diagnosed with an attention or learning issues
What is the difference between Educational Therapy and tutoring?
Educational therapists have a knowledge of how brain processes work. Educational therapy:
- Addresses underlying processing issues/skills
- Focuses on learning styles
- Focuses on executive functioning, organizational skills, study skills, attention
- Communication, language skills, and/or comprehension
- Homework help
- Test preparation
- Academic skills development
- Academic confidence
- Reading comprehension, math thinking & reasoning
Speech and Language
**The following FAQ’s were compiled from the Bright Minds Institute, ASHA, The University of Michigan Health Systems, and CSC Speech and Language Therapists.
What is the difference between a speech disorder and a language disorder?
When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder.
When a person is unable to produce speech sounds correctly or fluently, or has problems with his or her voice, then he or she has a speech disorder.
What are some warning signs of a possible problem?
If you’re concerned about your child’s speech and language development, there are some things to watch for.
An infant who isn’t responding to sound or who isn’t vocalizing is of particular concern. Between 12 and 24 months, reasons for concern include a child who:
- Isn’t using gestures, such as pointing or waving bye-bye by 12 months
- Prefers gestures over vocalizations to communicate by 18 months
- Has trouble imitating sounds by 18 months
- Struggles to pay attention and follow directions
- Is difficult to understand when speaking
- Lacks order and clarity when sharing thoughts and ideas
If you or your doctor suspect that your child has a problem, early evaluation by a speech-language pathologist is crucial. Of course, if there turns out to be no problem after all, an evaluation can ease your fears.
What should I do if I think that my child may have a speech or language problem?
If you think your child may have a speech or language problem, contact the Child Success Center® to speak to a speech-language pathologist. The Child Success Center® peech-language pathologists (SLPs) help children develop their communication abilities as well as treat speech, language, swallowing, and voice disorders. Their services include prevention, identification, evaluation, treatment, and rehabilitation.
Why is speech-language treatment needed?
- My baby isn’t talking yet!
- My child will outgrow it. Every kid uses “baby-talk.”
- Everyone in our family was a late talker. My child will talk when the time is right.
- Why worry now? Speech and language services will be available when school starts.
- Treatment? Looks like they are just playing games to me.
You may have had similar thoughts or comments. Usually, there is concern about a child’s speech and language skills if there is no speech by the age of 1 year, if speech is not clear, or if speech or language is different from that of other children of the same age.
Why does my child need help at such a young age? Couldn’t s/he grow out of it?
The earlier a child’s speech and language problems are identified and treated, the less likely it is that problems will persist or get worse. Early speech and language intervention can help children be more successful with reading, writing, schoolwork, and building interpersonal relationships.
Dr. Stanley I. Greenspan, Chairman of the Interdisciplinary Council on Developmental and Learning Disorders, and the world’s foremost authority on clinical work with infants and young children with developmental and emotional problems, believes early intervention is the key to preventing more serious secondary problems.
Most mommies and daddies tell me “I thought there was a problem at 14 or 15 months…and they told me let’s wait and see because sometimes some kids grow out of it. Well, that’s not a good answer. We’ve got to make the distinction between less important problems, where we can wait and see from core problems, which involve a lack of reciprocity and a lack of getting to know your world. For these core problems, we have to act on it yesterday. We can’t wait nine months, we can’t wait two months.” (Stanley I. Greenspan, M.D., Child Psychiatrist)
What is early identification?
It is estimated that 2% of all children born each year will have a disabling condition. Many of these children will have speech and or language delays and disorders that may have a significant effect on personal, social, academic, or vocational life. Although some children will develop normal speech and language skills without treatment by the time they enter school, it is important to identify those who will not.
Many people falsely believe that speech-language treatment cannot and should not begin until a child begins to talk. Yet research has shown that children know a great deal about their language even before the first word is said. For example, children can distinguish between their native language and a foreign language, use different nonverbal utterances to express different needs, and imitate different patterns of speech through babbling.
Early identification includes the evaluation and treatment provided to families and their children under 3 years old who have, or are at risk for having, a disability or delay in speech, language or hearing. A child can quickly fall behind if speech and language learning is delayed. Early identification increases the chances for improving communication skills.
What are the causes of delayed speech or language?
Many things can cause delays in speech and language development. Speech delays in an otherwise normally developing child are rarely caused by oral impairments, such as problems with the tongue or palate (the roof of the mouth). Being “tongue-tied” (when the frenulum — the fold beneath the tongue — is too tight) is almost never a cause of delayed speech.
Many kids with speech delays have oral-motor problems, meaning there’s inefficient communication in the areas of the brain responsible for speech production. The child encounters difficulty using the lips, tongue, and jaw to produce speech sounds. Speech may be the only problem or may be accompanied by other oral-motor problems such as feeding difficulties. A speech delay may also indicate a more “global” (or general) developmental delay.
Hearing problems are also commonly related to delayed speech, which is why a child’s hearing should be tested by an audiologist whenever there’s a speech concern. A child who has trouble hearing may have trouble understanding, imitating, and using language.
Ear infections, especially chronic infections, can affect hearing ability. Simple ear infections that have been adequately treated, though, should have no effect on speech.
What do speech-language pathologists do?
In conducting an evaluation, a speech-language pathologist will look at a child’s speech and language skills within the context of total development. Besides observing your child, the speech-language pathologist will conduct standardized tests and scales, and look for milestones in speech and language development.
The speech-language pathologist will also assess:
- What your child understands (called receptive language)
- What your child can say (called expressive language)
- If your child is attempting to communicate in other ways, such as pointing, head shaking, gesturing, etc.
- Your child’s oral-motor status (how a child’s mouth, tongue, palate, etc., work together for speech)
What can I do to help at home?
Here are a few general tips you can employ at home:
- Spend a lot of time communicating with your child, even during infancy — talk, sing, and encourage imitation of sounds and gestures.
- Read to your child, starting as early as 6 months. You don’t have to finish a whole book, but look for age-appropriate soft or board books or picture books that encourage kids to look while you name the pictures. Try starting with a classic book, where a child can imitate the motions, or books with textures that kids can touch. Later, let your child point to recognizable pictures and try to name them. Then move on to nursery rhymes, which have rhythmic appeal. Progress to predictable books, in which your child can anticipate what happens. Your little one may even start to memorize favorite stories.
- Use everyday situations to reinforce your child’s speech and language. In other words, talk your way through the day. For example, name foods at the grocery store, explain what you’re doing as you cook a meal or clean a room, point out objects around the house, and as you drive, point out sounds you hear. Ask questions and acknowledge your child’s responses (even when they’re hard to understand). Keep things simple, but never use “baby talk.”
Whatever your child’s age, recognizing and treating problems early on is the best approach to help with speech and language delays. With proper therapy and time, your child will likely be better able to communicate with you and the rest of the world.