|
Welcome, and thank you for visiting our website. In this area you will find basic information regarding the services we provide. These include descriptions of what Speech, Occupational and Physical Therapies are, and how they can help a child who may need one or more of these therapies. In addition, in this section you will find child development milestones. These child development milestones, might help you gauge whether you child is meeting his or her developmental milestones accordingly. Also, for your convenience we have included some links to community resources you may find helpful under our social worker section. Please note, this page is meant to be for informational purposes only, you should always consult with your child's pediatrician if you think your child is not meeting his developmental milestones.
Screenings Available… If you have concerns about your child’s development and would like to speak to one of our licensed therapists, please call any of our locations to schedule an informal screening.
What Are Speech and Language?
How Do Speech and Language Normally Develop?
What Are Speech and Language Developmental Milestones?
How Do I Know If My Child Is Reaching the Milestones?
What Should I Do If My Child's Speech or Language Appears to Be Delayed?
What is Occupational Therapy?
What are the areas that Occupational Therapy targets?
How do perceptual and fine motor skills develop?
What Are perceptual/fine motor skills developmental milestones?
How Do I Know If My Child Is Reaching the Milestones?
What Should I Do If My Child's perceptual/fine motor skills Appear to Be Delayed?
What is Physical Therapy?
How Do I Know If My Child Is Reaching the Milestones?
What Should I Do If My Child's Gross/Fine Motor Skills Appear to Be Delayed?
Our social workers provide assistance with socio-economic and psychosocial issues that may impact treatment plans. They also assist in coordinating community resources assistance for clients and family member in need. For a list of Community Resources in your area, please click on the links below.
Note: Adobe Acrobat Reader is required to open the above files. Click here to download.
What Are Speech and Language?
Speech and language are tools that humans use to communicate or share thoughts, ideas, and emotions. Language is the set of rules, shared by the individuals who are communicating, that allows them to exchange those thoughts, ideas, or emotions. Speech is talking, one way that a language can be expressed. Language may also be expressed through writing, signing, or even gestures in the case of people who have neurological disorders and may depend upon eye blinks or mouth movements to communicate.
While there are many languages in the world, each includes its own set of rules for phonology (phonemes or speech sounds or, in the case of signed language, hand shapes), morphology (word formation), syntax (sentence formation), semantics (word and sentence meaning), prosody (intonation and rhythm of speech), and pragmatics (effective use of language).
How Do Speech and Language Normally Develop?
The most intensive period of speech and language development for humans is during the first three years of life, a period when the brain is developing and maturing. These skills appear to develop best in a world that is rich with sounds, sights, and consistent exposure to the speech and language of others.
There is increasing evidence suggesting that there are "critical periods" for speech and language development in infants and young children. This means that the developing brain is best able to absorb a language, any language, during this period. The ability to learn a language will be more difficult, and perhaps less efficient or effective, if these critical periods are allowed to pass without early exposure to a language. The beginning signs of communication occur during the first few days of life when an infant learns that a cry will bring food, comfort, and companionship. The newborn also begins to recognize important sounds in his or her environment. The sound of a parent or voice can be one important sound. As they grow, infants begin to sort out the speech sounds (phonemes) or building blocks that compose the words of their language. Research has shown that by six months of age, most children recognize the basic sounds of their native language.
As the speech mechanism (jaw, lips, and tongue) and voice mature, an infant is able to make controlled sound. This begins in the first few months of life with "cooing," a quiet, pleasant, repetitive vocalization. By six months of age, an infant usually babbles or produces repetitive syllables such as "ba, ba, ba" or "da, da, da." Babbling soon turns into a type of nonsense speech (jargon) that often has the tone and cadence of human speech but does not contain real words. By the end of their first year, most children have mastered the ability to say a few simple words. Children are most likely unaware of the meaning of their first words, but soon learn the power of those words as others respond to them.
By eighteen months of age, most children can say eight to ten words. By age two, most are putting words together in crude sentences such as "more milk." During this period, children rapidly learn that words symbolize or represent objects, actions, and thoughts. At this age they also engage in representational or pretend play. At ages three, four, and five, a child's vocabulary rapidly increases, and he or she begins to master the rules of language.
What Are Speech and Language Developmental Milestones?
Children vary in their development of speech and language. There is, however, a natural progression or "timetable" for mastery of these skills for each language. The milestones are identifiable skills that can serve as a guide to normal development. Typically, simple skills need to be reached before the more complex skills can be learned. There is a general age and time when most children pass through these periods. These milestones help doctors and other health professionals determine when a child may need extra help to learn to speak or to use language.
How Do I Know If My Child Is Reaching the Milestones?
Here is a checklist that you can follow to determine if your child's speech and language skills are developing on schedule. You should talk to your child's doctor about anything that is checked "no."
Birth to 5 months |
Yes |
No |
Reacts to loud sounds. |
___ |
___ |
Turns head toward a sound source. |
___ |
___ |
Watches your face when you speak. |
___ |
___ |
Vocalizes pleasure and displeasure sounds (laughs, giggles, cries, or fusses). |
___ |
___ |
Makes noise when talked to. |
___ |
___ |
|
|
|
6 - 11 months |
Yes |
No |
Understands "no-no." |
___ |
___ |
Babbles (says "ba-ba-ba" or "ma-ma-ma"). |
___ |
___ |
Tries to communicate by actions or gestures. |
___ |
___ |
Tries to repeat your sounds. |
___ |
___ |
|
|
|
12 - 17 months |
Yes |
No |
Attends to a book or toy for about two minutes. |
___ |
___ |
Follows simple directions accompanied by gestures. |
___ |
___ |
Answers simple questions nonverbally. |
___ |
___ |
Points to objects, pictures, and family members. |
___ |
___ |
Says two to three words to label a person or object (pronunciation may not be clear). |
___ |
___ |
Tries to imitate simple words. |
___ |
___ |
|
|
|
18 - 23 months |
Yes |
No |
Enjoys being read to. |
___ |
___ |
Follows simple commands without gestures. |
___ |
___ |
Points to simple body parts such as "nose." |
___ |
___ |
Understands simple verbs such as "eat," "sleep." |
___ |
___ |
Correctly pronounces most vowels and n, m, p, h, especially in the beginning of syllables and short words. Also begins to use other speech sounds. |
___ |
___ |
Says 8 to 10 words (pronunciation may still be unclear). |
___ |
___ |
Asks for common foods by name. |
___ |
___ |
Makes animal sounds such as "moo." |
___ |
___ |
Starting to combine words such as "more milk." |
___ |
___ |
Begins to use pronouns such as "mine." |
___ |
___ |
|
|
|
2 - 3 years |
Yes |
No |
Knows about 50 words at 24 months. |
___ |
___ |
Knows some spatial concepts such as "in," "on." |
___ |
___ |
Knows pronouns such as "you," "me," "her." |
___ |
___ |
Knows descriptive words such as "big," "happy." |
___ |
___ |
Says around 40 words at 24 months. |
___ |
___ |
Speech is becoming more accurate but may still leave off ending sounds. Strangers may not be able to understand much of what is said. |
___ |
___ |
Answers simple questions. |
___ |
___ |
Begins to use more pronouns such as "you," "I." |
___ |
___ |
Speaks in two to three word phrases. |
___ |
___ |
Uses question inflection to ask for something (e.g., "My ball?"). |
___ |
___ |
Begins to use plurals such as "shoes" or "socks" and regular past tense verbs such as "jumped." |
___ |
___ |
|
|
|
3 - 4 years |
Yes |
No |
Groups objects such as foods, clothes, etc. |
___ |
___ |
Identifies colors. |
___ |
___ |
Uses most speech sounds but may distort some of the more difficult sounds such as l, r, s, sh, ch, y, v, z, th. These sounds may not be fully mastered until age 7 or 8. |
___ |
___ |
Uses consonants in the beginning, middle, and ends of words. Some of the more difficult consonants may be distorted, but attempts to say them. |
___ |
___ |
Strangers are able to understand much of what is said. |
___ |
___ |
Able to describe the use of objects such as "fork," "car," etc. |
___ |
___ |
Has fun with language. Enjoys poems and recognizes language absurdities such as, "Is that an elephant on your head?" |
___ |
___ |
Expresses ideas and feelings rather than just talking about the world around him or her. |
___ |
___ |
Uses verbs that end in "ing," such as "walking," "talking." |
___ |
___ |
Answers simple questions such as "What do you do when you are hungry?" |
___ |
___ |
Repeats sentences. |
___ |
___ |
|
|
|
4 - 5 years |
Yes |
No |
Understands spatial concepts such as "behind," "next to." |
___ |
___ |
Understands complex questions. |
___ |
___ |
Speech is understandable but makes mistakes pronouncing long, difficult, or complex words such as "hippopotamus." |
___ |
___ |
Says about 200 - 300 different words. |
___ |
___ |
Uses some irregular past tense verbs such as "ran," "fell." |
___ |
___ |
Describes how to do things such as painting a picture. |
___ |
___ |
Defines words. |
___ |
___ |
Lists items that belong in a category such as animals, vehicles, etc. |
___ |
___ |
Answers "why" questions. |
___ |
___ |
|
|
|
5 years |
Yes |
No |
Understands more than 2,000 words. |
___ |
___ |
Understands time sequences (what happened first, second, third, etc.). |
___ |
___ |
Carries out a series of three directions. |
___ |
___ |
Understands rhyming. |
___ |
___ |
Engages in conversation. |
___ |
___ |
Sentences can be 8 or more words in length. |
___ |
___ |
Uses compound and complex sentences. |
___ |
___ |
Describes objects. |
___ |
___ |
Uses imagination to create stories. |
|
|
What Should I Do If My Child's Speech or Language Appears to Be Delayed?
You should talk to your family doctor if you have any concerns about your child's speech or language development. The above checklist should help you talk about your concerns. Your doctor may decide to refer you to a speech-language pathologist, a health professional trained to evaluate and treat people who have speech, language, voice or swallowing disorders (including hearing impairment) that affect their ability to communicate. The speech-language pathologist will talk to you about your child's communication and general development. He or she will also evaluate your child with special speech and language tests. A hearing test is often included in the evaluation because a hearing problem can affect speech and language development.
Depending upon the test results, the speech-language pathologist may suggest activities for home to stimulate speech and language development. These activities may include reading to your child regularly; speaking in short sentences using simple words so that your child can successfully imitate you; or repeating what your child says, using correct grammar or pronunciation. For example, if your child says, "Ball baybo" you can respond with, "Yes, the ball is under the table." This allows you to demonstrate more accurate speech and language without actually "correcting" your child which can eventually make speaking unpleasant for him or her.
The speech-language pathologist may also recommend group or individual therapy or suggest further evaluation by other health professionals such as an audiologist, a health care professional who is trained to identify and measure hearing loss, or a developmental psychologist.
Excerpted from April 2000 NIH Publication No. 00-4781
National Institute on Deafness and Other Communication Disorders
National Institutes of Health
31 Center Drive, MSC 2320
Bethesda, MD USA 20892-2320
What is Occupational Therapy?
Occupational Therapy is the treatment of physical and developmental disorders through purposeful activities that improve & develop skills, needed for everyday independence. Both children with or without disability may receive therapy.
Occupational therapy is beneficial when there are concerns regarding fine motor, sensory, visual motor, and/or motor planning. These children have a limited sensory experience and lack normal motor control.
Occupational therapist use play to enhance the child's fine motor skills and muscular strength. They also address feeding and oral motor skills, self-care skills, positioning, adaptive equipment, splint fabrication and use, sensory integration techniques, and assist individuals in acquiring the knowledge, needed to perform.
Occupational therapist have used brushing and joint compression as an intervention technique. This method of therapy is to provide deep tactile input to help organize the sensory system, increase focus and level of alertness. It is best to
provide this technique daily every two hours and prior to activities that may bring fear, anxiety, or resistance.
Therapists also help those with permanent disabilities, such as spinal cord injuries, cerebral palsy, and aid in eating and dressing. Assessing and recording a client’s activities and progress is an important part of an occupational therapist’s job. Accurate records are essential for evaluating clients, and for reporting to physicians and other healthcare providers.
Therapists will use any combination of activities to strengthen muscles, increase movement, restore co-ordination and balance. In schools, they evaluate children’s abilities, recommend and provide therapy, modify classroom equipment, and help children participate as fully as possible in school programs and activities.
What are the areas that Occupational Therapy Targets?
Fine motor skills generally refers to actions of the hands, wrists, and arms, including dexterity, coordination, and strength. Handwriting is a complex process of managing written language by coordinating the eyes, arms, hands, pencil grip, letter formation, and body posture. The development of a child’s handwriting can provide clues to developmental problems that may hinder the child’s learning. Sensory integration (SI) is the process of receiving, organizing, and interpreting input, becoming the basis for motor planning, learning and behavior. When this process is disorganized, it is called Sensory Integration Dysfunction.
Tactile Processing
The tactile system interprets touch and the perception. It protects us from stimuli that may be perceived as harmful. With an over or under sensitive tactile system, the body interprets touch differently. When this occurs, due to certain types of clothing, food textures or unexpected touch, the body releases an excessive emotional reaction such as hitting, crying or other behaviors.
Motor coordination
Poor range of motion, deficits in eye and hand coordination, problems with fine motor ability, and decreased visual perception often result in poor performance in sports, poor handwriting, and will likely lead to problems with academic performance. In addition, the child's functional abilities, such as self-care, may be impacted, as the child may not be able to function at a developmentally appropriate level.
How do Perceptual and Fine motor skills develop?
As a toddler is growing his motor skills develop from the center of his body to the outer extremities. This is why babies sit-up, then crawl, then walk...each part of the body learns its role. The trunk for sitting up, the legs, arms, and trunk for crawling, and then the feet are added for walking. Once they have mastered these skills, a "toddler" can start working on his fine motor skills, which is his hands.
Even watching the development of a baby's hands you can see how the development moves from the inside out. An infant grasps with his fist, then his thumb and hand, and then his fingers. Some toddlers have more difficulty developing fine motor skills that can be improve with specific activities using small objects and therapy. Most fine motor skills also require some extent of hand eye coordination, so it takes time. A toddler that continues to have problems "may" have
What Are Perceptual/Fine Motor Skills Developmental Milestones?
A developmental milestone is a skill that a child acquires within a specific time frame. For instance, one developmental milestone is learning to walk. Most children learn this skill or developmental milestone between the ages of 9 and 15 months.
Milestones develop in a sequential fashion. This means that a child will need to develop some skills before he or she can develop new skills. For example, children must first learn to crawl and to pull up to a standing position before they are able to walk. Each milestone that a child acquires builds on the last milestone developed.
How Do I Know If My Child Is Reaching the Milestones?
Here is a table that you can follow to determine if your child's Perceptual/Fine Motor skills are developing on schedule. This information is for educational purposes only and should not be considered to be a medical advice. You should talk to your child's doctor about any concerns you may have.
OT/PT Checklist |
1 Month
 Responds to different light
Focuses on face momentarily
Follows a moving object from side to side
Quiets when picked up
Responds to sound
Lifts head when at shoulder level |
2 Months
Mouthing of hands
Responds to voice
Stares and gazes
Makes eye contact
When on stomach, lifts head
Rolls from side to back |
3 Months
Reaches for dangling objects when on back
Searches with eyes for sound
Follows with eyes upwards and downwards
Grasps toys actively
Keeps hands open 50% of the time
On back, brings hands together for play
Begins to show head control in supported sitting |
4 Months
Enjoys repeating newly learned activities
In supported sitting, follows a moving object with eyes.
Responds with a smile when socially approached
Rolls from back to side
Reaches towards a toy without grasping
Begins to play with rattles |
5 Months
Plays with own hands, feet, fingers, toes
Localizes sound with eyes
Reaches for a toy with both hands
Reaches and grasps objects
Places both hands on the bottle
Plays on his or hers side
Sits with slight support
Rolls from stomach to back
Bears some weight through feet when supported in standing |
6 Months
Brings feet to mouth
Drops and picks up objects
Holds small objects in each hand
On stomach, pushes up onto hands
Sits momentarily while leaning on hands
Bears all weight through feet when supported in standing |
7 Months
Responds to facial expressions
Reaches for an object with one hand
Moves toy or object from one hand to another
Bangs object on table
Sits without support
Rolls back to stomach
Bounces in standing |
8 Months
Shows interest in sounds of objects
Looks for family members or pets when named
Bites and chews toys
Feeds self a cracker
Crawls backwards |
9 Months
Plays 2-3 minutes with a single toy
Lifts arms to parent
Responds playfully to mirror
Crawls forward
Sits without support for about 10 minutes |
10 Months
Plays “Peek-a-boo”
Tips a bottle to drink
Moves into a sitting position without help
Pulls to standing at furniture
Makes stepping movements
Moves from sitting to lying on stomach
Lowers to sitting from standing at furniture
Climbs
Cruises along the length of the sofa |
11-12 Months
Imitates a new gesture
Throws objects
Knows what “no no “means and reacts
Takes objects out of a container
Puts objects into a container
Tries to imitate scribbling
Removes an unbuttoned coat
Picks up finger foods and eats
Holds/drinks from a bottle or spout cup
Walks with one hand held
Stands alone for a few seconds |
13-15 Months
Responds to simple verbal request
Enjoys looking at pictures in books
Understands pointing
Hands toy back to adult
Helps turn pages
Marks a paper with a crayon
Brings spoon to mouth-turns spoon over
Holds cup handle
Takes independent steps or walks independently
Squats |
16-18 Months
Brings objects from another room upon request
Identifies one body part
Scribbles spontaneously
Holds and drinks from a cup with some spilling
Shows a pattern of control with bowel and bladder
Indicates when pants are soiled
Removes socks
Lifts foot for shoes on
Holds hands out to be washed
“Hurried” walks
Throws a small ball
Walks up steps holding rail |
19-24 Months
Turns pages one at a time
Matches sounds of animals with a picture
Identifies 6 body parts
Imitates a circle scribble
Scoops food and feeds self with the spoon with some spilling
Gives up bottle
Removes shoes when laces are undone
Assists with pulling pants up
Runs
Jumps in place
Squats to play
Kicks a ball forward |
25-30 Months
Listens to stories
Folds paper in half
Holds a small cup in hand
Puts shoes on with assistance
Washes hands
Uses spoon well with minimal spilling
Spears with a fork
Stands on tiptoes
Rides a tricycle
Runs
Walks up and down steps without support while putting one foot on each step |
31-36 Months
Knows own sex or sex of others
Identifies the function of body parts
Matches shapes: circles, triangle, square
Matches colors: black and white
Matches shapes: circles, triangle, square
Uses toilet with some assistance and has daytime control
Undresses with assistance
Dresses self with assistance
Wipes nose with assistance
Can button large buttons
Dries hands
Unties and removes shoes
Tries to tie shoes
Turns facet on
Brushes teeth with assistance
Jumps forward and down
Catches a large ball |
What Should I Do If My Child's Perceptual/Fine Motor Skills Appear to Be Delayed?
You should talk to your family doctor if you have any concerns about your child's fine motor skills development. The above table should help you talk about your concerns. Your doctor may decide to refer you to an Occupational Therapist, a health professional trained to evaluate.
An occupational therapy evaluation assesses a child’s gross motor skills, fine motor skills, visual motor skills,
handwriting skills, daily living skills, oral motor skills, and sensory processing skills. The use of standardized
assessment tools, non-standardized assessment tools, parent interview, and clinical observations will be used to assess the child’s performance.
Occupational therapy treatment is necessary when several areas of performance are affected.
Fine Motor Skills: movement and dexterity of the small muscles in the hands and fingers.
Gross Motor Skills: movement of the large muscles in the arms, and legs. Visual Motor Skills: a child’s movement based on the perception of visual information.
Oral Motor Skills: movement of muscles in the mouth, lips, tongue, and jaw, including sucking, biting, chewing, and licking.
Self-Care Skills: daily dressing, feeding and toilet tasks. Sensory Integration: ability to take in, sort out, and respond to the input received from the world.
Motor Planning Skills: ability to plan, implement, and sequence motor tasks.
What is Physical Therapy?
Physical Therapy services are designed to promote strong gross motor and balance skills. Therapists, specialized in pediatric therapy, work with families to assist their children in sitting, crawling, walking, running and jumping, as needed.
A Physical Therapist (PT) are healthcare professionals who diagnose and treat individuals of all ages, from newborn to the very oldest, who have medical problems or other health-related conditions, illnesses, or injuries that limit their abilities to move and perform functional activities as well as they would like in their daily lives. Physical therapy helps children with physical, developmental or neurological disabilities, musculoskeletal problems or cardiopulmonary diagnoses. Their main emphasis is on impairments of movement that leads to functional limitations.
Physical therapists who treat infants and toddlers are specialists trained to treat movement and functional dysfunctions. A primary role by the physical therapist includes enhancing the stimuli and cognitive skills normally provided to the child by play and exploration. This includes assisting the child into several positions and several movements. With the goal of enhancing the child's developmental skills, processing and overall learning. Physical therapy may play a critical part in the child's achievement of functional independence and integration into the school system.
How Do I Know If My Child Is Reaching the Milestones?
Here is a check list that you can follow to determine if your child's Perceptual/Fine Motor skills are developing on schedule. This information is for educational purposes only and should not be considered to be a medical advice. You should talk to your child's doctor about any concerns you may have.
You should talk to your family doctor if you have any concerns about your child's fine or gross motor skills development. The above checklist should help you talk about your concerns. Your doctor may decide to refer you to a Physical Therapist, a health professional trained to evaluate.
A physical therapist will perform the gross and fine motor examination to assist in determining the developmental age and abilities of the child. From this information the therapist will determine functional goals such as rolling or sitting independently, developmental skills, improved motor control and planning, and improving quality of life. Also, they participate in deciding on assisting devices for the child, educating families on handling and positioning of the child, and teaching the child functional movement, stability, and skills as well as providing important sensory input to the child's compromised nervous system.
Physical therapy will help your child to enhance their independence, physical and emotional well-being. These qualities are the precursors for many school and home skills.
Important disclaimer: The information on mercykidsrehab.com is for educational purposes only and should not be considered to be medical advice. It is not meant to replace the advice of the physician who cares for your child. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.
|
