HELPFUL INFORMATION
Speech and language developmental milestones:
These are some of the many developmental milestones for children from birth through 5 years old. Please keep in mind that all children develop at their own pace and that most children will not follow the chart exactly. However, these milestones are helpful in determining if your child would benefit from a speech and language evaluation. Remember that the best expert on your child's behavior is you, so if you have any concerns, please contact the office with any questions.
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• Makes sounds back and forth with you
• Makes happy versus upset sounds
• Coos with simple vowels and early syllable combinations (ooooh, mooo, etc.)
• Turns to people talking to them
• Giggles
• Blows raspberries
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• Looks at person calling their name
• Babbles short syllables (“mamamama”, “babababa”, etc.)
• Points, waves, shows objects by gesturing to them
• May say 1-2 simple words (“mama”, “dada”, etc.)
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• Uses at least 50 single words for basic nouns and simple verbs (“dog”, “bird”, “go”, etc.)
• Uses early pronouns (“me”, “Mine”, “you”)
• Beginning to string 2 words together (“mommy go”, “more cheese”, etc.)
• Follows simple one and two step related commands (“get your shoes and put them on”, etc.)
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• Uses 2+ word sentences• Says own name when asked
• Beginning more complex grammar forms and vocabulary (daddy’s shoe, he running vs. he run)
• Answers simple questions
• Produces speech sounds /p, b, m, d, t, n, k, g, w, ng, f, y/ correctly
• Overall speech is at least 68% understandable at all times
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• Increasingly complex sentence structure and vocabulary
• Longer sentences with 4+ words
• Identifies colors and categories
• Produces speech sounds /l, j, ch, j, sh, s, v, z, and clusters/ correctly
• Overall speech is at least 86% understandable at all times -
• Uses location words (inside, under, etc.) and some timing words (beginning, end, etc.)
• Starting to understand and tell/retell short simple stories with main characters and sequence
• Produces speech sounds /r, zh (as in “treasure”), th (as in “feather”)
• Overall speech is at least 94% understandable at all times
Feeding milestones:
Your child may benefit from a feeding assessment if you have any concerns with their feeding development. Children between the ages of 18 months and 4 years old are often picky eaters. However, they should be eating a variety of tastes and textures willingly without signs of aversion or extreme pickiness. Some characteristics to watch for that may indicate delayed or disordered feeding skills are excessive drooling after 18 months of age, poor attention to food (requires excessive distraction to eat), difficulty chewing or swallowing foods, extreme food preferences, not requesting foods or drinks, gagging or vomiting, pain or discomfort during or after eating, and signs of food allergies.
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Liquid only. Babies develop at various rates and differences are common. However, a feeding should be efficient and effective from birth. Ideal feeding time takes 15-30 minutes and babies should be on a schedule with periods of obvious hunger vs. satiation. Latch should be with complete lip closure around the nipple from birth as well.
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Pureed textures are introduced. While babies may gag initially or have preferences, they should adapt within 2-4 weeks. When children begin to crawl, they are developmentally able to learn to chew table foods.
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Eats variety of tastes and textures easily. Children at this age can take bites from a cracker or sandwich without having it cut into smaller pieces and drink from a cup and straw well.
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Eats same food as rest of the family.
Occupational Therapy Terms:
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Research shows that DCD is currently present in a t least 6-8% of children. DD affects the way children are able to adapt, plan, and control their movements. Children with DCD have a harder time learning new skills to problem solve and engage in tasks such as writing, dressing, and playing. Social skills and learning ability may also be negatively affected. Children with DCD’s confidence and participation often deteriorate over time, contributing to academic and developmental difficulties. If you feel your child may be having difficulty with coordination, occupational therapy can often help.
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Sensory processing is the way that the brain interprets and integrates sensations throughout the body. These senses are regulated and transmitted in behavioral and motor responses subconsciously every minute of every day. Sensory processing deficits have been linked to decreased mood, and ability to cope with certain activities. The body requires proper processing of sensory input to produce functional motor output. Therefore, sensory processing difficulty may cause difficulty in motor skills in certain children. Treatment for sensory processing is called sensory integration, and involves a specialized plan to aid the brain in processing and integrating sensory input. Many people only know about the five senses, and do not realize that there are actually seven! The seven senses are taste, smell, touch, hearing, sight, vestibular, and proprioceptive. Some researchers also express that there may be eight senses. The 8 th sense is called interception, which is the body’s internal feeling (hunger, thirst, drives, pain, etc.).
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Vestibular processing is essential for children, as it supports and is linked to other sensory systems. The vestibular system is responsible for balance, and helps your brain determine where your body is in space. It is also closely related to the auditory and visual sensory systems as the vestibular headquarters is located in the inner ear. Balancing the regulation of the vestibular system has been associated with improved attention and calming in many children. A child may be under-regulated or over-regulated in regard to vestibular functioning. Common signs of vestibular dysregulation are fatigue, constant rocking or spinning, head banging or overheard shaking, and side-looking. It is important that every child receive the “just right” amount of vestibular input as they develop. An occupational therapist is trained to help your child target the vestibular processing that is needed to regulate their sensory system.
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Proprioception is the way that your sensory system processes information from the joints and muscles about the body’s position, stretch, weight, movement, and change in position. Our proprioceptive system aids us in grading movements to accomplish everyday tasks. The following are a few of the signs that children are not processing proprioceptive input functionally: clumsiness, difficulty walking down steps, liking to crash into things, missing the chair to sit, hand flapping, hitting, etc.
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VMI is the way that your eyes coordinate with your hands to complete tasks. The eyes are guiding the activity while the hands are controlling the activity. Therefore, even small tasks require a joint effort from multiple systems at once. VMI is essential for drawing, copying, and writing. VMI is required to copy basic shapes which is a prerequisite to writing letters. If a child’s handwriting is disjointed or does not flow they may be struggling with VMI.
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Handwriting is a complex skill that sometimes requires special attention from an occupational therapist. It has been proven that certain children benefit from cursive writing rather than print, even at a young age. There may be other compensatory methods or adjustments to the environment that may help with writing as well. If your child is struggling with illegible writing, an occupational therapist can determine if there are underlying skills that may need to be addressed such as visual motor integration. Progress requires taking things one step at a time.
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All children need to be provided daily opportunities and coaching to develop these intricate and detailed skills of the hand which we refer to as fine motor skills. FM skills consist of strength and coordination of the small muscles of the hand. They also include reaching, grasping, and manipulation of objects. Engaging a child in motivating activities that build fine motor skills can prepare children for many important “daily occupations” such as the ability to hold a pencil, or placing body parts into a Mr. Potato Head, etc.
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Poor core strength can cause postural instability and gross motor delays. Core strength also indirectly affects the development of fine motor ability as well, as core strength is the foundation to all other muscle coordination and strength. A child’s core begins to strengthen as a baby during “tummy time”, when a baby learns to lift their head and torso, pushing off the floor with the upper body. Children further develop core strength by everyday activities like playing outdoors, running, jumping, climbing, crawling, and playing. Poor core strength presents as slouching shoulders, poor endurance, poor balance, W-sitting, etc. Research has shown that children with better core strength also have better fine motor skills and writing ability. Overall, children that develop good core strength have increased self-assurance, and endure tasks longer.
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Self-regulation is the ability to maintain a level of alertness appropriate to a given activity. Self- regulation is a process that develops naturally as a child matures. Yet, some children need help developing self-regulation. Self-regulation is heavily dependent on attention, sleep cycles, emotional control, and transition between routines. Much of the body’s ability to self-regulate is driven by a child’s arousal level. Arousal has to do with the level of alertness, how the child is feeling inside, and how a child’s sensory system is processing information presented.
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Proper vision is more than passing a basic vision screening. A child with 20/20 vision may still have difficulty with visual processing. Visual processing is how the brain receives and interprets the information that is seen. A child with VP difficulties may have trouble with age appropriate mazes, hidden pictures or puzzles, sight words, writing, finding information, noticing small differences, etc. Deficits in VP may underlie motor and academic issues, and occupational therapy is often imperative to a child’s success.