Why is it important to check my toddler’s hearing?

In most cases, a child with an articulation disorder or language disorder has normal hearing. However, the quality of our hearing is directly impacts language development, so we always want to rule out any hearing impairment. Whether it is temporary due to otitis media or fluid in the ears or whether it is permanent, hearing impairment will cause articulation difficulties as well as receptive and expressive language challenges. We have to be sure that we identify any possible hearing loss so that we design effective treatment plans and also insure that a child gets the intervention they need from an audiologist.

When will I know the results of the testing?

The therapist will give you an overview of the results immediately following the assessment. Once the report has been written, you will have an appointment with the therapist to discuss the results of the evaluation in detail. This typically takes about one week, sometimes sooner.

What type of testing do you do?

The therapist will get some preliminary information from you ahead of time. Based on this information, the testing will either be standardized assessment or play-based assessment, depending on the age and level of the child.

How long does an evaluation take?

An evaluation usually takes an hour.

Occupational Therapy

How can an occupational therapist help children with handwriting difficulties?

Occupational therapists are trained in the detailed mechanics of hand function as well as all other aspects that relate to the task of handwriting. The skill of handwriting requires several underlying skills before a child can effectively write. The skills that are needed for handwriting are: Body & Spatial Awareness, Laterality, Directionality, Visual Perception, Visual Motor, Integration, Postural Stability, In Hand Manipulation, Hand Separation, Hand Strength, Movement & Position Awareness, Motor Planning, Ocular Motor Control, Bilateral Integration, Eye Hand Coordination, Sensory Integration, Tactile Discrimination, Memory, Attention, Orientation to Letters, and Sequencing. It is hard to know exactly what is at the root of a handwriting problem without a thorough assessment from an occupational therapist.

How do I know if my child has sensory processing issues?

Some signs of sensory processing difficulties are:
• Overly sensitive or under reactive to sight, sounds, movement, or touch.
• Can’t get “enough” sensory input: moving, bouncing, squeezing, or mouthing.
• Difficulty with behavioral and/or emotional regulation. Easily overwhelmed (may result in overexcitement, meltdowns or shutting down.)
• Has poor muscle tone, fatigues easily, leans on people, or slumps in a chair. Uses an inappropriate amount of force when handling objects, coloring, writing, or interacting with siblings or pets
• Is clumsy, falls frequently, bumps into furniture or people, and has trouble judging position of body in relation to surrounding space.
• Has difficulty learning new motor tasks; experiences frustration when attempting to follow instructions or sequence steps for an activity.
• Avoids playground activities, physical education class, and/or sports
• Difficulty learning how to play or get along with other children
• Difficulty with everyday activities like eating, sleeping, brushing teeth or getting dressed
• Problems learning to color, cut, draw or write
• Difficulty transitioning from one activity or place to another
• Challenges in school, including attention, organizational perception and listening skills.

What is Pediatric Occupational Therapy?

For children and youth, occupations are activities that enable them to learn and develop life skills (school activities), be creative and/or derive enjoyment (play), and thrive (self-care and care for others). Play is the media most often used in the Occupational therapist’s treatment of children. The act of playing is an important tool that influences a child’s life. The primary goals of childhood are to grow, learn, and play. It is often through play that children learn to make sense of the world around them. It is a child’s “job” or “occupation” to play to develop physical coordination, emotional maturity, social skills to interact with other children, and self-confidence to try new experiences and explore new environments. Recommended interventions are based on a thorough understanding of typical development and the impact of disability, illness, and impairment on the individual child’s development, play, learning, and overall occupational performance.

What is proprioception and body awareness?

Proprioception is the sense that allows us to know what position our body parts are in without looking at them. 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. Proprioception is extremely important for body awareness and coordinated movements.

Body awareness is the 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. Via repeated accurate sensory inputs produced from our motion through space, the body map is created over time as we develop from infancy throughout childhood. 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 sense allows us to feel secure with gravity and is a way of knowing where we are in relation to gravity e.g. if we are upside-down or sideways.

Speech Therapy

Do ear infections cause language or articulation problems?

Not always, but often they do. If your child has had frequent ear infections, the result can be a delay in language acquisition. Even if he only had fluid behind the eardrum, hearing can be compromised – think hearing when you are underwater. Not only might this inhibit vocabulary acquisition, but it may also affect a child’s ability to form sounds appropriately. Once medical issues are resolved, a speech-language pathologist can work with young children to help improve communication skills.

Do you have some suggestions for helping my toddler increase his language?

Yes, there are many things you can try before contacting a speech pathologist.
1. label or name everything you see using one word – this is a great way to increase receptive vocabulary
2. keep instructions simple using short phrases (i.e. “put in,” “go bye-bye,” “all done play-doh”)
3. facilitate anticipatory communication by setting up fun, repetitive routines (such as pushing cars off a table, swinging him in the air, etc.) Once he knows and understands the routine, cue him to verbalize or gesture for continuation of the activity (i.e. “car fall,” “up,” or “more”)
4. establish visual attention when talking to him
5. do not anticipate his needs but rather reward his communication attempts by giving him the desired objects or actions once he uses a vocalization or a word.

If communication doesn’t improve, it may be time to have a speech-language pathologist evaluate your child. This is generally accomplished in a play-like environment, so it is not a traumatic event! A therapist will assess his ability to name items while playing, but also his comprehension skills or receptive language (i.e. follow directions, play with items in a typical manner, answer yes/no questions, demonstrate knowledge of familiar items, etc.) The therapist will then compare his communication skills with that of a typically developing child of his age and determine if therapy is warranted.

My child’s friend talks much more than he does. Is this normal?

From birth to the age of five, language develops at a very rapid pace, but the age and the pace at which a child reaches each milestone of language development can vary greatly. If you are concerned about your child’s expressive or receptive language, you can contact our office and we will be happy to discuss your concerns.


Do certain insurance plans cover therapy better than others?

Yes, each policy is different and is designed with imput from your employer, if you are insured through your job. So some plans have more extensive coverage for speech and occupational therapy. It is important to communicate with your Human Resource Department about benefits that are important for your family. If we are a network provider for your insurance provider, we will be happy to check benefits for you, though this is not a guarantee of coverage.


Do you accept cash?

Yes, we do, for the exact amount. We also accept credit cards and checks.

Do you accept checks?

Yes, we accept checks at the time services are rendered.

Do you take major credit cards as payment?

We accept Visa and Mastercard at both offices. We accept Discover in the Frisco office and American Express in the Plano office.


Can I choose my own therapist?

We make every effort to assign a requested therapist to a child. There are times when that is not possible due to scheduling constraints or specific needs of the child. We assure you that your child will be seen by a highly qualified therapist.

Do you have OTs who specialize in Sensory Processing issues?

Yes. We have a few occupational therapists who are SIPT certified, or therapists who have passed the Sensory Integration and Praxis Test. All of our occupational therapists are highly trained and educated in sensory integration disorders, regardless of whether or not they are SIPT certified.

Do you have therapists who specialize in feeding therapy?

Yes. We have several therapists who specialize in feeding therapy. Several of our occupational therapists and speech-language pathologists have gotten extra training for feeding therapy.

Do you have therapists who specialize in stuttering?

Yes. We have several therapists who have received additional education and who are very experienced in fluency issues for both preschoolers and school-aged children

How do I know my child will get a qualified therapist?

All of our therapists are highly qualified in their particular field. Many of our therapists have received additional education and training in certain areas. We get information about your child from you, and based on that information, we assign a therapist who will best suit the needs of your child. We will never assign a therapist who is not comfortable or experienced in a particular area to a child who needs treatment in that area.

How long are the therapy sessions?

The length of therapy/treatment sessions are based on individual needs. A session can be anywhere between 30 minutes and an hour. The typical speech therapy session is 30 minutes, whereas, the typical occupational therapy session is one hour.

How long does treatment typically last?

The length of a session and the duration of treatment (how many months) is determined by a child’s evaluation and subsequent treatment plan. A mild articulation disorder would typically call for 2 half hour sessions weekly for 3-6 months. A more significant articulation disorder may be of longer duration because there are more sounds or phonological processes targeted in the treatment plan. A child with an autism spectrum disorder may typically be seen for half hour to 45 minutes per session depending on the level of severity of the associated language disorder. Duration of treatment may be 6 months or several years, depending on the number of goals that must be addressed as the child masters each level of objectives. So it is an individual recommendation, based on the evaluation.

How many times a week will my child need to be seen?

The amount of time and the times per week that a child needs to be seen for therapy is dependent on their individual needs and treatment plan. Recommended times per week range from once a week to four times a week. Most clients are seen twice a week, however.