Educational Archives

How Occupational Therapy Supports Children with Autism: Building Skills for Everyday Life

Educational, Featured, Occupational Therapy | Mar 24, 2026 5 min read

As we recognize Autism Acceptance Month and Occupational Therapy Month in April, it’s a meaningful time to celebrate each child’s unique strengths and the ways thoughtful support can help them grow. In fact, it’s the perfect opportunity to highlight how occupational therapy can play a meaningful role in helping children with autism thrive in their everyday lives.

Every child experiences the world differently. For children with autism, those differences can show up in how they communicate, play, process sensory input, and navigate daily routines. Occupational therapy helps bridge those gaps by building skills in a way that feels natural, supportive, and individualized to each child.

What Is Occupational Therapy?

Occupational therapy focuses on helping children develop the skills they need for everyday life. For kids, that includes things like playing and interacting with others, managing daily routines like dressing and feeding, regulating emotions and attention, and participating in school and community activities

At its core, OT meets children where they are and helps them build the skills needed to participate more fully in their world.

How Can Occupational Therapy Support Children with Autism Spectrum Disorder?

Children on the autism spectrum often benefit from occupational therapy in several key areas:

1. Sensory Processing and Regulation

Many children with autism experience the world in a more intense or different way. Sounds may feel louder, textures may feel uncomfortable, or movement may be either overwhelming or highly sought after.

OT helps children:

Better tolerate different sensory experiences
Develop coping strategies for overwhelming environments
Build regulation skills for calmer, more focused participation

This might look like creating a sensory-friendly routine, introducing calming strategies, or helping a child feel more comfortable with everyday experiences like haircuts or mealtimes.

2. Emotional Regulation and Transitions

Big emotions can be difficult for any child, but for children with autism, transitions and unexpected changes can feel especially challenging.

OT supports:

Flexible thinking
Transitioning between activities
Managing frustration and anxiety
Developing calming strategies that work for the child

Over time, these skills help children feel more confident and secure in their day-to-day routines.

3. Play and Social Participation

Play is how children learn. It’s also how they build communication, problem-solving, and social skills.

Occupational therapy helps children:

Engage in back-and-forth play
Explore imaginative and pretend play
Build joint attention and shared experiences
Increase comfort interacting with peers

These foundational skills often overlap with speech and language development, making collaboration between OT and speech therapy especially valuable.

4. Daily Living Skills

Independence looks different for every child, and OT supports progress in meaningful, functional ways.

This may include:

Dressing and grooming
Feeding and utensil use
Following routines
Participating in school tasks

The goal isn’t perfection. It’s helping children feel capable and confident in their everyday lives.

A Strengths-Based, Family-Centered Approach

At SmallTalk, we believe that therapy should support the whole child and their family. That means building on each child’s unique strengths while respecting their individual differences, and supporting parents with practical, real-life strategies that carry over beyond the therapy room.

Our goal is to create a positive, engaging experience where children feel comfortable, capable, and understood. Occupational therapy isn’t about changing who a child is. It’s about giving them the tools to navigate their world in a way that feels successful and empowering.

When to Consider Occupational Therapy

You might consider an OT evaluation if your child:

Has strong reactions to sounds, textures, or movement
Struggles with transitions or daily routines
Has difficulty with play or interacting with peers
Experiences frequent meltdowns or regulation challenges
Shows delays in self-help skills like feeding or dressing

Early support can make a meaningful difference in helping children build skills and confidence over time. At SmallTalk Pediatric Therapy, our occupational therapists work closely with families to create individualized, supportive plans that fit into real life, not just the therapy room.

If you’re wondering whether occupational therapy could support your child, we’re always here to talk it through. Give us a call at 619-647-6157 or email us at hello@smalltalkspeech.com.

Community and Support

If you’re looking for ways to get involved or connect with other families in the San Diego community, local events like the Race for Autism hosted by the National Foundation for Autism Research (NFAR) are a wonderful place to start. Each year, this event brings together families and organizations in a supportive, family-friendly environment focused on connection and awareness.

SmallTalk Pediatric Therapy participates each year and hosts a booth, and we always love the opportunity to meet families, answer questions, and connect outside of the clinic. Whether you’re new to the journey or have been part of the community for years, it’s a meaningful way to feel supported and connected.

Autism Acceptance Month is a time to build understanding and celebrate differences. Occupational Therapy Month is a time to recognize the impact of meaningful, skill-building support. Together, they highlight something important: With the right support, every child can grow, connect, and thrive.

Is Screen Time Affecting Your Child’s Speech Development? What Parents Should Know

Educational, Featured, News, Speech Therapy | Feb 27, 2026 4 min read

Screens are part of modern parenting. Whether it’s a favorite show while you make dinner or an educational app during travel, most families use technology in some way. There’s no judgement here.

But many parents are starting to wonder:
Is screen time affecting my child’s speech, attention, or behavior?

If you’ve noticed shorter attention spans, fewer conversations, or meltdowns after turning off a device, you’re not imagining things. In the blog post below, we break down the research and give some tips on how to create a healthy balance that supports your child’s development.

What Do Experts Say About Screen Time?

The American Academy of Pediatrics (AAP) recommends:

Avoiding screen media (except video chatting) for children under 18–24 months
Limiting screen use to 1 hour per day of high-quality programming with parental engagement for children ages 2–5
Age 5 years and older: No more than two hours a day, while engaging in conversation with a parent or family member about what is being viewed

These guidelines are based on growing research showing that early brain development depends heavily on interactive, real-world experiences.

How Screen Time Impacts Speech and Language Development

Young children learn language through real-life interaction, not just exposure to words.

Speech and language development relies on something called “serve and return” communication. This is the back-and-forth exchange that happens when:

Your child babbles and you respond
They point at something and you tell them what it is called
They ask a question and you answer and expand on it

These everyday moments build vocabulary, social skills, and comprehension.

Passive screen time (like watching videos alone) does not provide that same interactive feedback. Even high-quality educational content cannot replace real-time conversation.

Research shows that excessive passive screen use in toddlers may be associated with:

Delayed expressive language
Reduced vocabulary growth
Shorter attention spans
Fewer opportunities for imaginative play

That doesn’t mean all screens are harmful 100% of the time, but balance matters, especially in the early years when brain development is rapid.

Signs Screen Time May Be Affecting Your Child

Every child is different. Research shows that you may want to make some changes if you notice:

Limited back-and-forth conversation
Fewer spoken words than peers
Difficulty playing independently without a device
Meltdowns when turning screens off
Trouble transitioning between activities
Short frustration tolerance
Increased sensory seeking or dysregulation after screen use

Often, it’s not only about the screen itself, it’s about what screen time is replacing: movement, sensory input, social interaction, and creative play.

When to Consider a Speech or Occupational Therapy Evaluation

If you’re concerned that screen time may be masking or contributing to delays, trust your instincts.

You may benefit from a professional evaluation if your child:

Has fewer words than expected for their age
Struggles to combine words into phrases
Avoids conversation
Has difficulty regulating emotions
Shows attention or sensory challenges
Struggles with transitions off devices

Sometimes reducing screen time helps significantly. Other times, screen reliance highlights underlying speech, sensory, or regulation needs that would benefit from support.

Early intervention can make a meaningful difference.

You’re Not Alone, And You’re Not Doing It Wrong

Parenting in the digital age is complicated. Screens can be helpful tools, but they aren’t substitutes for interaction, movement, and play.

If you’re wondering whether your child’s communication, attention, or regulation skills are on track, getting clarity can bring peace of mind.

At SmallTalk Pediatric Therapy, our speech-language pathologists and occupational therapists take a family-centered approach. We help parents understand what’s typical, what may need support, and how to build strong developmental foundations in everyday routines.

Sometimes small changes lead to big growth.

If you have questions or would like to talk through your concerns, we’re here to help. Give us a call at 619-647-6157 or fill out the form below and we will get back to you within 24 hours.

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When Is Picky Eating a Problem? Signs Your Child May Need Feeding Therapy

Educational, Featured, General | Jan 26, 2026 3 min read

Many children go through phases of picky eating, especially during toddler and preschool years. But sometimes feeding challenges go beyond typical preferences and can signal a need for professional support. Knowing when to seek a feeding evaluation can help reduce stress at mealtimes and ensure your child is getting the support they need to thrive.

When to Consider a Feeding Evaluation

It may be time to seek a feeding evaluation if your child:

Eats a very limited number of foods, especially fewer than 10 to 15 consistently
Refuses entire food groups or specific textures
Gags, vomits, or becomes distressed when presented with new foods
Shows strong sensory reactions to smells, textures, or the look of food
Experiences frequent mealtime anxiety or meltdowns
Struggles with chewing, swallowing, or moving food in their mouth
Has feeding challenges that impact nutrition, growth, or family routines

These signs may indicate more than typical picky eating and can be related to sensory processing differences, oral motor challenges, or both.

What Happens in Feeding Therapy

Feeding therapy is designed to support children in a safe, gradual, and encouraging way. During therapy, a speech-language pathologist and or occupational therapist will first assess your child’s feeding skills, sensory responses, and mealtime behaviors.

Therapy may focus on:

Increasing tolerance for new textures, smells, and foods
Supporting oral motor skills like chewing and tongue movement
Reducing sensory overwhelm around eating
Building positive, low-pressure experiences with food
Helping families create supportive and realistic mealtime routines

Therapy follows your child’s pace, often starting with non-eating interactions such as touching or smelling foods and gradually progressing toward tasting and eating as comfort increases.

How Feeding Therapy Can Help

With consistent support, feeding therapy can help children:

Expand the variety of foods they accept
Feel more comfortable and confident at mealtimes
Improve nutrition and overall health
Reduce stress for both children and caregivers

Most importantly, feeding therapy helps families turn mealtimes into more positive, connected experiences rather than daily struggles

Trust Your Instincts

A feeding evaluation doesn’t mean something is “wrong.” It simply gives you clarity, guidance, and a plan that meets your child where they are. With the right support, children can build confidence around food, expand their preferences, and make steady progress in a way that feels safe and encouraging.

If mealtimes feel stressful, overwhelming, or stuck in the same patterns, you’re not alone, and you’re not doing anything wrong. Many families wonder if their child will “grow out of it,” but when feeding challenges start to impact nutrition, development, or family routines, getting extra support can make a meaningful difference.

At SmallTalk Pediatric Therapy, our therapists bring both clinical expertise and a family-centered approach to feeding therapy. We work closely with caregivers to support real-life mealtimes, reduce stress, and help children develop skills that last well beyond the therapy room.

If you have questions or are wondering whether a feeding evaluation might be helpful for your child, we’re always happy to talk it through. Give us a call or send us an email today, because sometimes a small step can lead to big changes at the table!

New Year, New Goals: Supporting Your Child’s Growth in the Year Ahead

Educational, Featured, General | Jan 15, 2026 3 min read

The start of a new year brings a natural pause. It’s a time for reflection, fresh starts, and setting intentions for the months ahead. For parents, it’s also a moment to think about how your child is growing, what milestones they’re working toward, and how you can support their development in a way that feels realistic and encouraging.

At SmallTalk Pediatric Therapy, we believe the new year isn’t about pressure or perfection. It’s about progress, connection, and building skills through everyday moments.

Why the New Year Is a Great Time to Check In on Development

Children grow and change quickly, and small developmental shifts can add up over time. The new year offers a natural opportunity to check in on your child’s speech, language, motor skills, and overall communication.

You might be noticing things like:

Your child understands more but isn’t using many words yet
Speech sounds are still hard to understand
Transitions or routines feel especially challenging
Fine motor tasks like holding crayons or utensils are tricky

These observations don’t mean something is “wrong.” They’re simply signals that your child may benefit from extra support, guidance, or targeted strategies.

Setting Realistic Developmental Goals for Your Child

When it comes to child development goals, small and specific works best. Instead of broad resolutions, focus on simple, meaningful steps that fit into your life. Daily routines like meals, bath time, playtime, and errands are rich opportunities for learning and connection.

Examples of development-friendly goals include:

Reading together for 10 minutes each day
Encouraging your child to make choices using words or gestures
Practicing turn-taking during play
Building fine motor strength through crafts, play-dough, or even helping with household chores like preparing a meal or washing dishes
Creating consistent routines for mornings and bedtime
Narrating what you’re doing to model language
Giving your child extra time to respond
Offering choices to encourage communication
Celebrating effort, not just outcomes

Progress often comes in inches, not leaps, and that’s okay! These small habits support speech, language, sensory regulation, and independence over time.

How Speech and Occupational Therapy Support New Year Growth

Speech therapy helps children develop communication skills such as expressive language, articulation, social communication, and understanding directions. Occupational therapy focuses on fine motor skills, sensory processing, self-help skills, and emotional regulation.

Together, these therapies support the skills children need to succeed at home, in school, and in their community.

The new year is also a great time to:

Start therapy if you’ve been on the fence
Reassess goals if your child is already receiving services
Adjust schedules or routines to better support consistency
Review insurance benefits and coverage for therapy services

A Gentle Reminder for the Year Ahead

If the past year felt overwhelming, you’re not alone. Parenting is demanding, especially when you’re supporting a child with additional needs. The new year doesn’t require you to have all the answers. It simply offers another chance to move forward with support, information, and the right team beside you.

At SmallTalk Pediatric Therapy, we’re proud to support families throughout San Diego, with clinics in La Mesa, Mission Valley, and Scripps Ranch, as well as virtual services. Whether your child is just beginning their therapy journey or continuing to build on existing skills, we’re here to help make this year one of growth, confidence, and connection.

Here’s to a new year filled with progress, patience, and celebrating every step forward!

Holiday Travel Tips for Children with Sensory Needs

Educational, Featured | Nov 12, 2025 4 min read

Holiday travel can bring excitement and a bit of chaos. For children with sensory needs, unfamiliar environments, loud sounds, and changes in routine can make the experience overwhelming. At SmallTalk Pediatric Therapy, we’ve helped many families prepare for smooth and successful trips by planning ahead, creating structure, and bringing familiar tools from home. Whether you’re heading across town or across the country, these travel tips can help make your journey calmer, happier, and more connected.

1. Prepare Your Child with Visuals and Stories

Children who thrive on routine often benefit from knowing what to expect before a trip. Creating a simple visual schedule or social story can help your child understand each step from packing, driving, flying, arriving, and unpacking. Research shows that using visuals can help reduce anxiety and improve understanding of transitions in children with developmental differences.

Walk your child through what the day might look like, using photos or drawings. You might even watch a short video about airports or road trips together to make the process more predictable and less intimidating.

2. Build a Sensory Travel Kit

Long trips can expose your child to new smells, sounds, textures, and sights, all of which may be overstimulating. A sensory travel kit gives your child tools to regulate and find comfort along the way.

Try including:

Noise-canceling headphones
A small weighted lap pad or favorite blanket
Sunglasses or a hat to reduce bright lighting
Fidget toys or chewy jewelry
Familiar snacks and a water bottle

Every child’s sensory system is unique, so let them help choose what to pack. Having control over their environment even a little can make travel feel more manageable.

3. Choose Travel Times and Routes Thoughtfully

Timing can make a big difference. Traveling during quieter hours, such as early mornings or mid-week days, often means fewer crowds and shorter lines. When driving, plan frequent rest stops where your child can stretch, jump, or move before getting back in the car.

It can also help to avoid rushing. Extra time at each step, boarding, restroom breaks, or security, gives everyone breathing room and helps prevent meltdowns from stress or fatigue.

4. Maintain Familiar Routines

Even away from home, maintaining small pieces of your regular routine can help your child feel grounded. Try to keep consistent meal and sleep times, and bring familiar bedtime items like a favorite stuffed animal or book.

Keeping a short bedtime ritual, such as reading a story together, is not just comforting, it also helps your child transition more easily to sleep in new environments. Predictability builds confidence and regulation.

5. Plan for Quiet Spaces and Calm Breaks

During busy holiday events, identify quiet spots in advance where your child can take breaks. Many airports, museums, and large public spaces now offer sensory-friendly rooms or low-stimulation areas.

If you’re visiting relatives, ask ahead if there’s a calm room or corner your child can use when they need downtime. You can also establish a “quiet signal” with your child, a hand gesture or phrase that means, “I need a break.” Giving them a way to communicate their needs can prevent sensory overload before it escalates.

6. Use Travel as a Language and Learning Opportunity

Every part of your journey can help build speech, language, and social skills. Narrate what’s happening: “We’re putting our bags in the car,” or “The airplane is taking off!” Describe what you see, hear, and feel to model rich vocabulary.

Ask open-ended questions:

“What do you think we’ll see when we land?”
“Can you tell me what’s outside your window?”

These small interactions encourage language use in real-world situations. For children receiving speech or occupational therapy, this kind of meaningful play and communication helps generalize skills beyond the clinic.

7. Be Flexible and Celebrate Small Wins

Even the best-planned trips come with surprises, delays, detours, or changes. Flexibility is key. Offer praise for small victories: getting through a noisy terminal, waiting patiently in line, or using coping tools independently. A calm, encouraging tone helps your child feel secure, even when things don’t go perfectly. Remember that your goal isn’t a flawless trip, it’s connection, confidence, and fun along the way.

Holiday travel with children who have sensory needs doesn’t have to be stressful. With thoughtful preparation, familiar routines, and a bit of flexibility, you can create positive, memorable experiences for your family. At SmallTalk, we support San Diego families, whether at our clinics in La Mesa, Mission Valley, and Scripps Ranch, or through virtual sessions, so your child can keep growing and thriving wherever the season takes you.

Safe travels and happy holidays!

Would you like to start therapy or schedule a virtual appointment during this holiday season?

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Preparing for Insurance Changes in the New Year: A Guide for Parents

Educational, Featured, General | Oct 23, 2025 4 min read

Parenthood is a rewarding journey filled with joy, milestones, and countless decisions. One of the most important (and often overlooked) responsibilities is understanding your insurance coverage, especially when it comes to services like speech and occupational therapy. With a new year just around the corner, now is the perfect time to review your benefits, make any updates, and ensure your child continues receiving the support they need.

Why It Matters

Insurance coverage can change from year to year, especially if you switch plans during open enrollment. Benefits for services like therapy may vary, and delays in updating or confirming your benefits can interrupt care. That’s why we’re encouraging all families to check their insurance details and notify us of any changes as soon as possible.

Insurance Terms Made Simple

Insurance language can be confusing, so here’s a quick glossary to help:

Insurance Policy: A contract outlining coverage, terms, and limits.
Coverage: The medical services your plan will pay for.
Premium: Monthly amount paid to have insurance.
Deductible: What you must pay before insurance starts covering costs. This amount will typically reset in the new year.
Coinsurance: The percentage of costs you pay after your deductible is met (e.g. 30%).
Copay: A set fee paid at each visit (e.g. $25 per session).
Out-of-Pocket Maximum/Catastrophic Cap: The most you’ll pay in a year for covered services (excluding premiums) — after which insurance pays 100%.

Steps to Prepare for the New Year

1. Review Your New Plan

Start by checking if your plan is changing in the new year. If anything about your plan has changed, or you are unsure, please send us a copy of your new insurance card to frontoffice@smalltalkspeech.com.

2. Understand Your Costs

Check what your benefits and patient responsibility are for speech therapy and occupational therapy. This information is typically listed in the “Benefits” section of your plan summary. Ask your insurance provider about:

Copayments
Deductibles
Coinsurance
Out-of-pocket maximums

3. Check for In-Network Providers

Is SmallTalk in-network? In-network therapists generally result in lower out-of-pocket costs.

4. Get a Referral if Needed

Some plans require a doctor’s referral before therapy services can begin. Check with your pediatrician and your insurer.

5. Ask About Pre-Authorization

Certain services require pre-approval before coverage begins. Skipping this step could result in denied claims.

6. Know Session Limits & Rules

Plans may place limits on how many sessions your child can attend or may limit coverage based on diagnosis.

7. What to Do if a Claim is Denied

Denied claims can often be appealed. Don’t give up! Ask your insurer for steps to initiate an appeal if needed.

8. Explore School-Based Services

Your child’s school may also offer therapy services, which can be used in conjunction with or as an alternative to private therapy.

9. Keep Communication Open

Share any insurance changes with us right away so we can help avoid coverage gaps and ensure continuity of care. You can contact us at frontoffice@smalltalkspeech.com or 619-647-6157 ext. 7 if you have any insurance updates or have any questions.

How to Check Your Benefits

When you call your insurance company, here are some helpful questions to ask:

Is SmallTalk Pediatric Therapy in-network with my plan?
- You may need our NPI: 1619298791
What are my benefits for these CPT codes?
- Speech Therapy: 92523, 92507
- Occupational Therapy: 97166, 97168, 97530
Is there a deductible that applies, and how much of it has been met?
What is my copayment per therapy session?
Are there session limits for speech or occupational therapy?
Do I need pre-authorization?
Are there any diagnosis exclusions?

Always call the Member Services number on the back of your insurance card. If you are having trouble finding it, you can also try the numbers below:

Insurance Provider	Member Services Number
Anthem Blue Cross (CA)	1‑800‑967‑3015
Blue Shield of CA	1‑800‑443‑5005
Blue Shield Federal (FEP)	1‑800‑411‑2583
Kaiser Permanente	1‑800‑464‑4000
Sharp Health Plan	1‑858‑499‑8300
TRICARE West (TriWest)	1‑888‑874‑9378
UnitedHealthcare	1‑800‑577‑8539

Final Thoughts

Understanding and preparing for insurance changes doesn’t have to be stressful. Taking the time now to review your benefits, ask the right questions, and share updates with us ensures that your child’s therapy can continue uninterrupted. Please contact us at frontoffice@smalltalkspeech.com or 619-647-6157 ext. 7 if you have any insurance updates or have any questions. We’re here to support you and your family every step of the way.

Let’s work together to make the new year a successful one for your child and their care.

Why Clinic-Based Pediatric Therapy Often Outperforms In-Home Sessions

Educational, Therapy | Aug 27, 2025 4 min read

When your child needs speech-language therapy or occupational therapy, choosing the right setting can make a significant difference in their progress. While in-home therapy can feel convenient, many families are surprised to learn that clinic-based therapy often offers more advantages, both for the child’s development and for the family’s overall experience.

If you’re considering where your child should receive services, here’s why a clinic-based model may be the stronger option for long-term success.

1. Fewer Distractions, More Focus

Home environments are full of everyday distractions such as pets, siblings, television, and toys that aren’t part of therapy. These can make it harder for a child to fully focus on their goals. In a clinic setting, the space is purposefully designed for learning and engagement. Everything from the layout to the materials is tailored to help children stay on task and maximize each therapy minute. At SmallTalk, our toys and activities are chosen with your child’s development in mind. Every single activity has a bigger purpose.

2. Access to Specialized Equipment and Materials

Clinics are equipped with therapeutic tools and activities that most homes simply can’t replicate, think sensory gyms, fine-motor skill stations, and advanced speech-language resources. These specialized materials give therapists more ways to engage your child, challenge their skills, and accelerate progress. Where else can your child build their own obstacle course with multiple swings, ropes, a climbing wall, and more?

3. Opportunities for Peer Interaction

In a clinic, your child can see other children working hard toward their own goals. Even without direct group sessions, watching peers model language, social skills, and cooperation can inspire confidence and motivation.
Peer interaction is especially important for building real-world communication and social skills, something that’s harder to simulate in a one-on-one home setting.

4. Clear Separation Between “Home” and “Work”

When therapy happens at home, it can be hard for children to mentally shift between playtime and “therapy time.” In a clinic setting, walking through the door signals that it’s time to learn, work, and grow. Clinic-based sessions typically operate on a regular schedule, with fewer interruptions from outside factors. This consistency is vital for building momentum in therapy and helping children reach their goals faster.
This separation also helps parents establish a healthy boundary, home remains a safe, relaxed space, while the clinic is where focused skill-building happens.

5. Access to a Collaborative Team

In a clinic, your child’s therapist can collaborate in real time with other speech-language pathologists, occupational therapists, and support staff. This teamwork means your child benefits from multiple professional perspectives, shared resources, and coordinated care, something that’s much harder to achieve in a home-based model.

6. Increased Parent Support and Education

Clinic visits create natural opportunities for parents to observe their child, connect with therapists, ask questions, and receive hands-on coaching. You will gain access to other in-clinic resources that simply aren’t part of most in-home programs.

Why This Matters for Your Child’s Development

Early intervention matters, but so does the quality and structure of the therapy your child receives. A clinic-based setting creates an environment that’s more engaging, better equipped, and more socially enriching, setting your child up for long-term success.

At SmallTalk Pediatric Therapy, we’ve seen firsthand the difference that the right setting can make. Our clinics are designed to be fun, welcoming, and filled with the tools your child needs to thrive. We work closely with families to ensure that every session moves your child closer to their goals, whether that’s clearer speech, improved fine motor skills, or greater confidence in daily activities.

If you’re considering a change in your child’s therapy setting, we’d be happy to answer your questions and show you what’s possible in a clinic-based model.

Give us a call at 619-647-6157 or send us an email at hello@smalltalkspeech.com if you’d like to get started.

Identifying Speech and Language Delays: A Guide for Referring Providers

Educational, General, Speech Therapy | Aug 13, 2025 4 min read

As a pediatrician or primary care provider, you are often the first professional a family consults when they have concerns about their child’s development. One of the most common questions parents ask is:

“Is my child’s speech development on track, or should I be concerned?”

Speech and language delays are among the most prevalent developmental concerns in early childhood, yet many children with delays are not identified or referred for support until after critical early windows have passed. Early intervention and timely referrals can significantly improve long-term outcomes in communication, academic readiness, and social-emotional health.

This guide outlines key speech and language early indicators, supported by current research, to help guide your decisions around when to refer for a speech-language evaluation.

The Prevalence of Speech and Language Delays

According to the National Institute on Deafness and Other Communication Disorders, approximately 8-9% of young children have a speech sound disorder, and 7-8% of preschool children have language delays that may affect learning, behavior, and social interaction.

While every child develops at their own pace, persistent delays or lack of progress in key communication areas can indicate the need for further evaluation. Below are typical early indicators that suggest a child may benefit from a referral to a speech-language pathologist.

Early Indicators of Speech and Language Delays

By 12 Months

Does not babble with a variety of sounds (e.g., “ba,” “da,” “ga”)
Does not respond to name or familiar voices
Limited use of gestures (e.g., pointing, waving)

By 18 Months

Says fewer than 10 meaningful words
Does not attempt to imitate words or sounds
Cannot follow simple one-step commands without gestures

By 24 Months

Says fewer than 50 words
Not combining two words (e.g., “more juice,” “mama help”)
Speech is largely unintelligible to caregivers

By 36 Months

Struggles to form simple sentences
Speech is unclear to unfamiliar listeners more than 50% of the time
Limited vocabulary for age
Difficulty answering basic “wh” questions (e.g., what, where)

At Any Age

Regression in language skills
Persistent drooling or oral motor difficulties
Frustration or behavior issues related to difficulty communicating

Why An Early Referral Matters

Research supports early intervention as a key predictor of long-term success in children with language delays.

Children who receive therapy before age 3 make significantly greater gains in expressive language skills than those who begin later.
Without support, early speech and language delays can evolve into academic struggles, including reading and writing difficulties.

The earlier children receive therapy, the more effective and efficient their progress tends to be, both developmentally and from a resource perspective.

Our Approach at SmallTalk Pediatric Therapy

At SmallTalk, we specialize in evaluating and treating children with speech and language delays from infancy through school age. We understand that your time with families is limited, and our role is to support both you and your patients by providing:

Prompt evaluations and clear feedback
Family education and involvement in treatment planning
Collaborative care with pediatricians, early childhood educators, and specialists
Evidence-based, play-centered therapy that fosters engagement and growth

Whether a child is showing subtle signs of delay or more significant concerns, our team is here to help determine whether intervention is needed, and to guide families with care, compassion, and clinical expertise.

How to Refer

Referrals can be sent directly via fax or by calling our administrative team. We welcome direct conversations with providers who may want to discuss a particular case or family dynamic prior to referral.

If you’re unsure whether a child qualifies, we’re happy to offer an evaluation and determine if therapy is appropriate.

You as the primary care provider are the starting point for families. By identifying and referring children early, you play a critical role in shaping their communication journey—and in many cases, changing their trajectory for life.

How Virtual Speech and Language Therapy Can Support Your Family

Educational, Featured, General, Speech Therapy, Therapy | Apr 22, 2025 2 min read

As the world continues to expand its abilities to connect with other people, so has our ability as therapists to connect with you in ways that are flexible, effective, and fun! Virtual visits are a great method of speech-language services that ensure your child’s ability to make progress on their communication goals, while simultaneously supporting your family navigating busy schedules and lives.

What can be accomplished virtually?

There are a variety of benefits that a virtual visit can provide, much like in-person visits:

Assessments: Standardized assessments to determine the diagnosis of potential speech-language delays, as well as implementation of a comprehensive treatment plan are entirely achievable by meeting virtually. Virtual assessment sessions usually include a combination of standardized testing, particularly if your child is of age to participate. Another effective measure is parent interview, hearing from you exactly what your concerns and observations are of your child in their home environment.
Treatment: Virtual speech therapy sessions can be designed to meet the communication-specific needs of your child. Whether it is articulation, expressive/receptive language, social/pragmatic skills, or related areas, tasks developed through various online games, interactive stories, and songs/videos help support the progress of your child. Not to mention, they are designed to be fun and engaging so that your child will want to continue to attend these virtual visits!
Parent Education and Collaboration: Parents are just as important to the process of speech-language development as the therapists that work with your child. Virtual visits allow for private, constructive conversations to give parents suggestions, resources, and in-the-moment opportunities to demonstrate language facilitation strategies with their children right in the comfort of their own home!

So what now?

If your child might need a little guidance in speech and language, receiving services virtually is an effective way to support the communication journey of your child. SmallTalk offers virtual sessions all-week long, including several therapists, like me, who have dedicated an entire day to virtual sessions to connect with more families around the San Diego community. Please consider giving it a try – I hope to see you online!

By Alex Maloney, SLP

Catching Some Z’s

Educational, Occupational Therapy, Therapy | Mar 27, 2025 2 min read

Sleep is extremely important for one’s mood, growth, and overall wellbeing, but sometimes counting sheep just isn’t enough to fall asleep. Falling asleep can be particularly challenging for children with sensory processing differences, developmental delays, or Autism. Working with your family, occupational therapists can develop an individualized plan to help your little one fall asleep and catch some Z’s.

Why Isn’t My Kid Falling Asleep?

Sleep can be challenging for multiple reasons including:

Sensory Sensitivities and Overstimulation: Your child may have heightened or under-responsive sensory processing, which means they can be overly sensitive to certain sights, sounds, textures, or even smells. These sensory sensitivities can make it difficult for them to relax and fall asleep.
Difficulty Regulating Emotions: The transition from daytime and play to nighttime and bed can be challenging for those learning calming strategies for when transitioning can be challenging. Changes to routines from earlier in the day or known changes in future routines can also impact a child’s stress and ability to navigate through challenging emotions before they can calm to fall asleep
Medical Issues: Gastrointestinal problems or other sleep-related disorders such as sleep apnea could also be negatively impacting your child’s ability to fall asleep and stay asleep (Consult with your child’s pediatrician to rule out any medical issues that may be affecting sleep.)

How Occupational Therapy Can Help

Developing a Bedtime Routine: Having a routine helps kids wind down for the night. They know what to expect and don’t have to use additional brainpower to go from one step to the next.
Creating a Sensory-Friendly Sleep Environment: Occupational therapists can coach you to make your child’s sleep environment the best for them. That may mean using a sound machine, looking at the fabrics of both the child’s clothes and the sheets, and incorporating calming sensory supports prior to bedtime.

Final Thoughts

If your child is experiencing difficulty falling asleep, reaching out to an occupational therapist may be a valuable step towards finding a solution that works best for your family. With the right support, restful nights and more manageable days can be within reach.

By Lauren Fong, OTR/L