At SmallTalk, we believe parents and family play an important role in the success of a child’s therapy. We train family members so that they can be empowered to affect positive change toward their child’s communicative and sensory progress. Below are our New Patient Forms, plus some helpful resources and information regarding speech and sensory development. If you have any questions about your child’s development, or about our services, contact Shauna.

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New Patient Forms

Before your first visit, please print and complete these forms. These will give us the background information we need to best evaluate and treat your child. Maintaining your privacy is very important to us, so please print, read and sign our Privacy Policy and bring it, along with the other forms, to your first session.

New Patient Forms:

These are important documents that should be completed and brought to your child’s first session.


New Patient Forms: Occupational

These are important documents that should be completed and brought to your child’s first session.


Does my child need Speech Therapy?

You know your child best—you know their strengths, their weaknesses, and you may have some concerns about their speech and language development. Check out our developmental checklist below to determine if your child’s speech and language skills should trigger a referral (either through your pediatrician or from yourself) for an evaluation.

If by 6-9 months your child does not:

  • Exhibit cooing and babbling;
  • Seem to be aware of sound (doesn’t turn to sound, stop crying when spoken to);
  • Use eye gaze to indicate interest;
  • Smile;
  • Demonstrate understanding of daily routines;
  • Babble with speech-like sounds;
  • Imitate actions and/or sounds in a turn-taking exchange with parents;
  • Make eye contact consistently.

We recommend:

Test your child’s hearing. Talk about your child’s daily routines frequently, and in simple language (2–3 words at a time). Use speech/routine games suck as “Peek-a-boo”, “Patty-cake”, “Itsy bitsy spider”.

If by 12 months your child does not:

  • Turn when parents say the child’s name;
  • Babble back and forth with the parent/caregiver;
  • Recognize his/her name;
  • Understand simple instructions;
  • Initiate familiar words, gestures, and sounds;
  • Understand common objects and actions (e.g., cookie, eat, juice).

We recommend:

Label items frequently, using 1–2 words. Take turns with your child and WAIT for your child to respond, and then imitate him/her.

If by 15-18 months your child does not:

  • Show language behaviors listed in previous ages
  • Turn to look when the parent points saying, "Look at…";
  • Point themselves to show parents an interesting object or event;
  • Have 5–10 words including names;
  • Say more words every month;
  • Follow simple directions;
  • Show recognition of pictures of familiar persons, objects;
  • Doesn’t point, gesture or imitate simple actions.

We recommend:

Speech/language evaluation and therapy. Also, a developmental evaluation if any previous behaviors listed are not resolved. Find out what he/she is interested in. Follow their lead and let them guide the play. Talk about what your child is doing in very few words.

If by 24 months (2 years), your child does not:

  • Understand simple questions and commands;
  • Respond to such commands as "show me your eyes (nose, mouth, hair)";
  • Label pictures;
  • Have a vocabulary of at least 25 words (norm is 50–100, with word combinations)

We recommend:

Speech/language evaluation and therapy. Developmental evaluation if any previous behaviors listed are not resolved.

If by 30 months (2 1/2 years), your child does not:

  • Speak in 2–3 word combinations;
  • Does not have a vocabulary of at least 75 words;
  • Does not follow two-step directions (given without a point).

We recommend:

Speech/language evaluation and therapy. Developmental evaluation if any previous behaviors listed are not resolved.

If by age 3 years, your child cannot:

  • Retell a basic story or idea;
  • Be understood by family and/or caregivers;
  • Repeat when not understood without becoming frustrated;
  • Understand most simple questions dealing with his environment and activities;
  • Give his/her gender, name, age.

We recommend:

Speech/language evaluation and therapy. Developmental evaluation if any previous behaviors listed are not resolved.

If by age 4 years, your child cannot:

  • Be understood by individuals with whom he/she does not associate regularly;
  • Communicate as well as their peers (as seen in daycare, preschool, playgroups);
  • Use extensive verbalization as he carries out activities;
  • Maintain appropriate tense, grammar, use appropriate word endings independently;
  • Talk easily and fluently– without repeating syllables or words
  • Play well with others her age and younger.

We recommend:

Speech/language evaluation and therapy.

If by age 5 years, your child cannot:

  • Be understood in all situations by most listeners;
  • Correctly produce most speech sounds;
  • Follow a three-step command;
  • Pay attention to a short story and answer simple questions about it;
  • Tell stories that stick to the topic;
  • Does not desire to play with children his same age or engage in role-play with friends;

We recommend:

Speech/language evaluation and therapy.

After age 5, if your child struggles with receptive language (understanding), expressive language (expressing him/herself with adequate phrase length, grammar, taking turns in conversation), or articulation (speech sounds), he/she should be referred for a speech/language evaluation.


Does my child need Occupational Therapy?

Pediatric occupational therapists assist children develop the skills necessary to become functional and independent adults. These skills include:

1. Regulation of arousal level in order to attend to the tasks of daily living.

Different activities in a child’s day-to-day routine will evoke varied responses. A fast-paced game of tag evokes a different level of arousal than waiting in line listening for instructions. Some children are unable to regulate their responses between activities and have difficulty transitioning from one task to the next. Learning to regulate their level of arousal from activity to activity helps children to become more attentive and better focused.

2. Sensory processing.

Children gather information through seven senses. The five commonly known senses are: visual (sight), auditory (sound), olfactory (smell), tactile (touch), and oral/gustatory (taste). The other two are vestibular (movement through an environment) and proprioceptive (position in an environment). How children process this information can effect concentration, organization, motor control, language, problem-solving, and other high-level learning skills. Occupational Therapists help children learn to process this information and react accordingly.

3. Development of gross motor skills.

Gross motor skills involve the large muscles of the body that enable such motions as running, walking, throwing a ball, or climbing stairs. They also include jumping and balancing.

4. Development of fine motor skills.

Fine motor skills involve the small muscle movements that occur in the fingers, usually in coordination with the eyes. It enables you to perform self-care (buttoning, zipping, tying), writing and drawing. We work with school age children who have difficulty with handwriting in unique, fun ways to help them feel more confident.

5. Development of communication skills and appropriate social interaction.

As part of our humanity, we attempt to avoid awkward social situations. For some children, this is not a natural process. These children must be taught the rules of social interaction to avoid being ostracized by their peers. Teaching these rules is best done by a combination of professionals such as mental health specialists, speech pathologists, teachers, parents and so on. Occupational Therapists are best suited to address social skills that involve self-regulation and problem-solving.

6. Age appropriate self care skills.

Self care skills can include but are not limited to; eating, sleeping, dressing, toileting and bodily cleanliness. An Occupational Therapist works with the child and the child’s caregivers to help the child meet their self care needs.

The educational background of Occupational therapists includes extensive course work in anatomy, neurology and psychology. Their education also includes course work in activity analysis. This enables the therapist to analyze the components of a play or work activity choosing tasks that will improve the child’s basic skills.

The expectations for the level of development of any of these skills will vary depending on the child’s age. It is critical to remember that all of these skills are developing simultaneously. Impairment of one area is likely to stunt development in other areas. If you have concerns about your child’s development of any of those skills, please make an appointment for an evaluation.

The American Occupational Therapy Association, Inc.


Frequently Asked Questions

Who do you see at SmallTalk?

At SmallTalk, we work with children of all ages, developmental levels and with a broad range of diagnoses. The following list covers just a few of the more common delays that we address:

  • Speech/language delays and disorders
  • Apraxia of Speech
  • Articulation Disorder
  • Autism Spectrum Disorders/Pervasive Developmental Disorder (ASD/PDD)
  • Auditory Processing Disorder
  • Sensory Integration/Dysfunction
  • Gross Motor Delays
  • Fine Motor Delays
  • Feeding/Swallowing Difficulties
  • Phonological Disorder
  • Expressive Language Disorder
  • Social/Pragmatic Delays
  • Literacy and Writing Delays
  • Stuttering
  • Voice Disorders
  • Laryngitis
  • Vocal Cord Lesions
  • Poor Speaking Technique
  • Vocal Cord Paralysis
  • Other Services

Where are you located?

We currently have two clinics in the San Diego area. We are located in the Sabre Springs area in North County, and El Cajon in East County. We will be opening our third clinic in Point Loma in Summer, 2013.

Do you take insurance?

Yes! We are a preferred provider for most local insurance companies, including Triwest, Blue Shield of California Federal, Blue Shield of California PPO, Anthem Blue Cross, CPMG, Scripps Health Plan, Tribal Health Partners, United Healthcare and others. We also work through the San Diego Regional Center and accept private payments.

What hours are you open?

We are open Monday through Friday, starting at 8:00AM, with our last appointments ending at 6:00PM.

Do you offer home visits?

Most of our therapy sessions take place in our clinics. Our therapy rooms are designed to be engaging and fun, while still enabling us to maintain control of the space—resulting in a higher level of engagement and attention than is possible in other settings. We have a mountain of tools, devices, toys, activities, games, and assessment materials within arm’s reach at our offices. However, we do offer home visits throughout the county, in certain circumstances. Contact us to learn more.

Can I pay directly for your services, rather than going through my insurance?

Yes! We offer a discounted fee for those paying out-of-pocket, when payment is made on the day of therapy.

Can I get Speech and occupational therapy back-to-back?

Our goal is to find a schedule that works the best for your child. We do everything we can to make your therapy sessions as convenient as possible. Yes, in most cases we are able to offer speech and occupational therapy back-to-back.