How SLPs Make a Difference

Raising awareness, changing lives

May is national speech, language and hearing month – a time to celebrate and acknowledge the profound influence and dedication of speech-language pathologists (SLPs). We are so grateful to all of our SLPs for their unyielding commitment, and the remarkable impact they make on the lives of so many families. Here are some of the areas that SLPs in pediatrics focus on:  

  • Speech sounds—A child may substitute one sound for another, leave sounds out, add sounds, or change a sound. It may be hard for others to understand them.
  • Spoken and written language—A child may have trouble understanding what others are communicating to them and may have problems explaining what they are thinking or feeling. They may also have difficulty with reading and writing.
  • Stuttering (fluency)—A child may get stuck on certain sounds or words. They also may have tension or negative feelings about talking. This tension can get in the way of how they talk to others.
  • Cognition—A child may have problems with long- or short-term memory, attention, problem solving, or organization.
  • Social communication—A child may have difficulty understanding how others feel or following the rules of conversation, such as knowing how to take turns.
  • Voice—A child may lose their voice frequently or use a hoarse or breathy voice. They may also speak with strain or effort.
  • Augmentative and alternative communication—A child may need to find other ways to communicate besides talking, such as using a picture board or a speech-generating device.
  • Feeding and swallowing—Problems with feeding and swallowing can make it hard for a child to participate in their school day. Speech-language pathologists help students eat and drink safely during the school day so that they have the energy to learn.

At SmallTalk, we asked some of our SLPs why they love their field. They responded: 

“I love being a speech-language pathologist because….”

  • “I get to help kids become more confident with communicating.” – Miss Sara
  • “I get to play all of my favorite games. My childhood spirit will never die!” – Miss Amanda
  • “I get to work hands-on with families and see the difference we make first-hand” – Miss Hannah

By Julia Navarra M.A. CCC-SLP

Childhood Occupations and How OT Supports Them

April is Occupational Therapy Month!

April is occupational therapy month! It is a month to celebrate occupational therapists and their work to make a difference in the lives of their clients. In pediatrics, occupational therapists support kids in the various occupations that they engage in. 

In occupational therapy, occupations are anything clients value and spend their time doing to make their lives more meaningful. In pediatrics, these occupations generally fall under the following categories: 

Activities of Daily Living (ADLs)

ADLs are basic self-care activities that include feeding, bathing, getting dressed, toileting, and more. The expectations regarding these activities change as a child grows. Still, through play and fun activities during our sessions, pediatric OTs work on supporting a child’s independence in age-appropriate activities. 

Instrumental Activities of Daily Living (IADLs)

IADLs support independent living skills in the community. These activities include meal preparation, chores, and transportation, to name a few. Supporting the skills needed to complete these activities is essential for a pediatric OT. 

Rest and Sleep

Rest and sleep are essential occupations that support children and their development. If they aren’t getting appropriate sleep, they can struggle to maintain a proper level of arousal to support engagement with their other occupations. Occupational therapists can help families set up a sleep routine and meet sensory needs for appropriate sleep, among other things. 


Education consists of being able to engage in a variety of learning activities. OTs support skill-building and environmental adaptations to allow children to access their education to the fullest extent possible. 


Play is the primary occupation for young children. They learn through play and build a majority of their skills through play. Occupational therapists help children engage in meaningful play and support their self-regulation skills through play. As pediatric OTs, play is the primary way we treat and engage with children. 

Social Participation

Social participation is another primary way children interact with their environment. It is how they interact with their peers and those around them. OTs support a child’s regulation and skills to engage in appropriate social participation. 

Occupations are not just work; they play a significant role in everyday life for everyone, including children. During April, if you encounter an occupational therapist, thank them for helping their clients engage in meaningful occupations and activities. 


American Occupational Therapy Association. (2002a). Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 56, 609–639.

By Erin Christensen, OTD, OTR/L

My child was just diagnosed with autism spectrum disorder… Now what?

Step 1: Take a deep breath!

Learning that your child has been diagnosed with Autism Spectrum Disorder, or ASD,
can understandably flood parents and caregivers with a range of overwhelming emotions.
It’s easy to feel trapped or condemned by a label. When the “what ifs” start to invade,
remember that this new information does not change who your child is or who you
already know them to be. It is simply an identification of a root cause for various
symptoms and the first step to helping your child reach their full potential.

Step 2: Free your child (and yourself) from expectations

Following a diagnosis of ASD, it is common for parents and caregivers to experience a
period of mourning for “normality” and feelings of uneasiness when thinking about the
future. However, the new diagnosis is not a predictor of the future, let alone a sentence to
a life of failure or unhappiness. Taking one day at a time and celebrating any progress,
no matter how small, is key in cultivating both acceptance and a sense of hope.

Step 3: Advocate for your child

With a new diagnosis comes a plethora of recommendations from medical and school
professionals. Always remember, though these recommendations are backed by research
and have been proven to help, you have the final say in your child’s treatment. Though
30 hours of therapy per week might be recommended, you may feel that is too much. Go
with your instinct! Your child’s team of professionals will work with you to ensure the
best possible treatment to match your child’s individual needs.

Step 4: Find community

No one has to face the journey alone! Consider joining a virtual or in-person support
group for parents and caregivers of children with Autism, or an online forum. Sometimes
well-meaning family and friends can misunderstand and unintentionally cause more pain,
so it can be important to connect with people who do understand. Autism Society San Diego offers both support groups for parents/caregivers and fun events for the entire family. Military families can take advantage of the Exceptional Family Member Program
(EFMP) for a range of family support. When in doubt, is a great place to

Step 5: Take care of yourself!

Self-care is often placed on the backburner when caring for a child who has an ASD
diagnosis. However, burn-out is not only emotionally draining for you, but is also
unhelpful for your child. It’s important to seek Respite Care services if you don’t have a
friend or family member to babysit while you take time for yourself to recharge. In
addition, pick your battles with your child. Rome wasn’t built in a day, so anticipating
immediate results and/or perfection can contribute to high stress levels.

Checklist, in no particular order:

  • Developmental evaluation (medical) through your doctor or San Diego Regional Center. It is important to get a medical diagnosis, not just an educational label
    through the school district. This is not the same as a formal diagnosis.
  • Speech therapy (medical/outpatient)
  • Occupational therapy (medical/outpatient)
  • Behavioral therapy (e.g., ABA) (in home or in facility)
  • Apply for school services at age 2 and 10 months to begin at age 3. This will determine eligibility for services through the school district such as, speech
    therapy, occupational therapy, and behavioral therapy. Your child can receive these therapies in both the medical and school setting, as medical and educational
    services are autonomous from one another.

Written by: Kat Winger, MS CCC-SLP

What is Pediatric Occupational Therapy and how would I know if my child would benefit?

Occupation refers to functional tasks or activities that bring meaning to your life. And our children’s main activity is PLAY. Did you know that kids play to learn and that play requires motor, sensory processing, cognitive, and social skills? All these skills work together for learning. However, when the necessary skills for play are observably difficult, it can make grasping new competencies challenging for kids.

Occupational therapy addresses all the skills needed for play. It works on strength, coordination, and control to support their movement. OT also helps with sensory processing difficulties by identifying the way your toddler receives or responds to sensory input and teaching fun ways for you to support your child. And finally, Occupational Therapy promotes executive function skills building on motor, attention, and regulation foundations for learning.

Though play can look different and vary from child to child, there are general toddler development skill ranges necessary for learning to happen. When these are not progressing or missing, they can inhibit engaging in and learning through play.

The development of sensory processing and motor skills begins immediately at birth. The brain is where all the magic happens. Newborns take in sensations, but their body is unable to organize them—their reflexes are neurological responses to stimulation, including the senses of light, sound, touch, or pressure input such as stroking and vestibular sensory input with sudden movement.

The sensory processing and motor skill development looks random and clumsy at first with the baby’s initial kicking of their legs or trying to find their mouth with their hand. As they continue to be exposed to the sensation and repeat the movement, it becomes more purposeful.

Babies are holding, pulling, pushing, and dropping toys as they learn about cause and effect. More and more skills work together to explore and learn through play.

For your toddler, the years from 1 to 3 are very busy. They are essential years of curiosity, trial and error, and learning about what they can do. At age one, toddlers are very active. Give them a container, and everything comes out; maybe a few things go back inside. Set something on the table, and they pull up to see if they can get it. They make sounds and babble and may tug on your heart with Ma Ma or Da Da words!

Toddlers are in a transition of building more independence. During the terrible twos, a stage that everyone stresses about, they continue to learn about their environment, manipulate things, and communicate their experiences. Their development takes all the work that the baby’s brain and body did and uses it in play to build confidence, control movement, and explore new sensations. Toddlers experience big emotions. They must learn about these feelings and how their body responds to them. How we react and support them is important.

They also learn to transition from one activity to another, even when they don’t want to.
For example, two-year-olds usually can stack a few blocks, string a few large beads on a shoelace, feed themselves with a spoon, drink from an open cup or a straw, remove/pull on clothing, brush teeth, help wash their body at bath time, jump, run, and walk up and down a few steps. They can also throw a small ball toward a target, help clean up, and put toys away. Though the terrible twos try on parents and toddlers, they don’t last long. And both parents and kids learn a great deal!

As we strive to develop more patience during these times, our toddlers are growing far more in their quest for independence. Two-year-olds should be able to attend and learn a new play activity for 4-6 minutes. Some research even suggests that this age group should be able to focus on a task for 10 minutes.

Though many toddlers can sit and play for extended periods of time with preferred toys or activities they have initiated themselves, a better learning opportunity is to give them a new task to work on to develop manipulation skills like using a tool to scoop, fill a container, feed themselves with a spoon or fork, stack or build with blocks, lace beads on a string, or roll a ball back and forth.

Notice how your child works through activities. When development is not smooth, there will be clues in how your child moves, plays, speaks, or acts. See if you observe any of these challenges:

  • unable to manipulate toys in play, they continue to dump, empty containers, or throw them around the room
  • difficulty using tools to scoop, squeeze, hammer, draw
  • unable to demonstrate repetitive play activities. May run around, only roll the car back and forth
  • moves between many play activities quickly, not engaging in any of them
  • requiring or demanding your attention and unable to initiate or engage in play by themselves for short periods
  • difficulty imitating actions in movement, imitating mouth or tongue movements, silly faces, or being unable to throw a ball at a target. Difficulty moving from sitting to moving under structures, crawling through a tunnel
  • unable or very clumsy with jumping, climbing, moving between different level surfaces, climbing ladder to slide
  • unable to take turns in play activities such as rolling ball back to you, stacking blocks
  • seems fixated on the television, tablet, or phone and unable to engage with other toys in play
  • difficulty putting things together such as connecting blocks, lacing, and beads
  • unable to tolerate play on a swing, on a slide
  • unable to play near or with other children
  • unable to tolerate tactile messy play or engagement with media like play-doh, finger paint, or shaving cream
  • difficulty removing pull on clothing from dress-up activities

Play is one of the most significant areas that can provide clues about your toddler’s development. As we’ve outlined, there is so much growth happening during this time. If you see your child struggling in any of the areas we mentioned, occupational therapy can help develop and strengthen the skills needed for learning.

Occupational therapists are experienced experts and can help identify the areas inhibiting your child’s primary occupation and introduce fun activities for successful skill development.

Children are tiny individual humans with varied interests and gifts. We embrace and work together with parents to help children reach their greatest potential.

Come in and check us out in April for Occupational Therapy month!

Author: Pamela Vasiloff, OT

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