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

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

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!

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

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 ProviderMember Services Number
Anthem Blue Cross (CA)1‑800‑967‑3015
Blue Shield of CA1‑800‑443‑5005
Blue Shield Federal (FEP)1‑800‑411‑2583
Kaiser Permanente1‑800‑464‑4000
Sharp Health Plan1‑858‑499‑8300
TRICARE West (TriWest)1‑888‑874‑9378
UnitedHealthcare1‑800‑577‑8539

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.

Identifying Speech and Language Delays: A Guide for Referring Providers

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.

Should My Child Start Speech Therapy? What Parents Should Know

When you’re worried about your child’s speech development, it can feel overwhelming to know what to do next. Maybe you’ve heard well-meaning advice like, “They’ll grow out of it,” or “Just wait and see.” But how do you know if waiting is the right choice? What if early speech therapy could help your child thrive?

At SmallTalk Pediatric Therapy, we often meet parents who aren’t sure whether to seek support or give their child more time. Here’s what you should know to make an informed decision.

Understanding Speech and Language Milestones

All children develop at their own pace, but there are general milestones most kids reach around certain ages. For example:

  • By 12 months: Babbling, using gestures, responding to their name.
  • By 18 months: Saying about 10–20 words.
  • By 2 years: Using two-word phrases (“more juice,” “mama help”).
  • By 3 years: Speech is clear enough for familiar adults to understand most of what they say.

You can read more about specific milestones with our Developmental Checklist. If your child is significantly behind in these milestones, it may be time to consider an evaluation.

The “Wait and See” Approach

Many parents are told to wait and see if their child will “catch up.” While this can be appropriate in some cases, especially when there is steady progress, delaying help can also mean missing the window when therapy is most effective.

Should My Child Start Speech Therapy? What Parents Should Know

Research shows that early intervention leads to better outcomes in speech and language development. If a delay is identified early, therapy can help build skills before gaps widen.

A 2011 meta-analysis published in the American Journal of Speech-Language Pathology found that parent-led early speech interventions significantly improved expressive language in young children—especially those under age 3 (Roberts & Kaiser, 2011). These findings support the importance of not delaying care when communication concerns arise.

Benefits of Starting Speech Therapy Early

Here are a few reasons why acting early can be so powerful:

  • Brain Plasticity: Young children’s brains are more adaptable, making it easier to learn new communication skills.
  • Confidence: Kids often feel frustrated when they can’t express themselves. Therapy helps reduce this frustration and build self-esteem.
  • Social Connection: Communication delays can impact play and peer relationships. Early support helps kids engage more successfully with others.
  • Family Support: Therapy gives you tools and strategies to help your child at home.

When to Seek an Evaluation

You don’t need a referral to have your child evaluated by one of our speech-language pathologists. If you notice any of the following, it’s a good idea to schedule an eval:

  • Your child is not meeting speech milestones for their age.
  • They appear frustrated by not being understood.
  • They rarely imitate sounds or words.
  • You have a gut feeling that something isn’t quite right. Trust your instincts—you know your child best.
When to Seek an Evaluation

How SmallTalk Pediatric Therapy Can Help

At SmallTalk, we believe in early, compassionate, play-based therapy that meets kids where they are. Our licensed speech-language pathologists will:

  • Assess your child’s speech and language skills.
  • Create an individualized treatment plan.
  • Guide you on how to support your child at home.
  • Celebrate every success, big and small!

You Don’t Have to Wait and Wonder

If you have concerns about your child’s speech, you don’t have to navigate them alone. Early intervention doesn’t mean something is “wrong”, it means you’re giving your child every opportunity to communicate confidently.

Contact us today to schedule a speech evaluation. We’re here to help.

Summer Speech & OT Tips: Five Ways to Support Your Child’s Development at Home

Summer break is here—and while it’s a great time to relax and recharge, it can also be the perfect season to support your child’s developmental goals through fun, play-based activities. Whether your child is working on communication, motor skills, or sensory regulation, there are plenty of simple ways to keep therapy going at home.

At SmallTalk Pediatric Therapy, we believe that kids learn best through play—and summer is full of playful opportunities. Here are some therapist-approved tips to help you make the most of the season.

1. Build Speech Skills Through Everyday Moments

Language is everywhere! Use summer outings—like beach trips, park days, or even grocery runs—to model vocabulary, ask open-ended questions, and encourage your child to describe what they see or feel. For younger children, narrate your activities and encourage imitation. For older kids, play games like “I Spy” or storytelling prompts in the car.

Summer Speech & OT Tips: Five Ways to Support Your Child’s Development at Home

Try this: Pack a “summer bag” and talk through each item: “This is sunscreen. It keeps our skin safe!”

2. Make Sensory Play a Daily Routine

Sensory bins, sand play, water tables, and even messy play with shaving cream or finger paint can help children with sensory processing challenges stay regulated and engaged. Summer is a great time to get messy outdoors!

Try this: Fill a bin with water, sponges, and cups for a simple, calming sensory station.

3. Strengthen Fine Motor Skills with Summer Crafts

From sidewalk chalk to water balloons, summer is full of hands-on activities that boost coordination. Crafts like beading, finger painting, and cutting shapes are great for improving grip strength and control—key goals in occupational therapy.

Strengthen Fine Motor Skills with Summer Crafts

Try this: Make homemade lemonade and let your child squeeze the lemons, stir, and pour—great for hand strength and sequencing.

4. Keep a Routine—but Keep it Flexible

Kids thrive on predictability. Try keeping some structure to your summer days (e.g., morning chores, mid-morning activity, afternoon free play), but allow room for spontaneity. Consistent mealtimes, bedtime routines, and regular movement breaks support both sensory and communication development.

Tip: Use visual schedules to help your child understand what’s coming next.

5. Stay Connected with Your Therapy Team

If your child is enrolled in speech or OT over the summer, be sure to attend regularly—and talk with your therapist about summer goals and carryover activities. If you’re taking a break, ask for a few at-home strategies to keep skills fresh.

Not in therapy yet? Summer is a great time to schedule an evaluation or get started without the school-year rush!

SmallTalk is Here to Help All Summer Long

At SmallTalk Pediatric Therapy, we’re here to support your family year-round—with fun, effective, and compassionate care. Whether you’re continuing therapy this summer or want ideas to use at home, our team is always happy to share tools and encouragement.

If you have questions about your child’s speech, motor, or sensory development, schedule an evaluation today.

Here’s to a summer full of growth, play, and connection!

From My Heart to Yours: A Grandmother’s Perspective on Children’s Therapy

By Shauna Oakes

Sometimes, when I walk through the halls in one of our clinics, I hear laughter creeping out from therapy rooms. At times I hear the frustration of a child who is just learning constructive ways to express emotions. And other times I see creative art pieces lovingly assembled by small hands or groups of children learning to work together. But every day, I feel a deep sense of gratitude that this is the work I get to be part of. 

I’m a grandmother and that role defines my heart. But I’m also the administrative director here at SmallTalk Pediatric Therapy-a place that has become a second home not just for me, but for so many families navigating life with little ones who need a bit of extra support. 

From the desks I have occupied, I have seen it all: the worried looks of new parents walking in for their first visit, the nervous energy of kiddos not quite sure why they are there or what to expect. But then-over time-the incredible transformation that happens when trust, patience, and care take root. 

The Strength in Showing Up: A Message to Parents

What I want parents to know is this: you are doing enough. You are showing up for your child in a world that can sometimes feel overwhelming. You are not alone. 

As a grandmother, I often find myself watching these children as if they were my own grandbabies. I see their bravery, their moments of frustration and celebration. I watch them find their voices, their balance, their confidence and I feel so much pride, even if I’m just a tiny part of their journey. 

As a mother, I recognize the deep sacrifices you make-your time, your energy, and sometimes other interests you may have had to put on the back burner. I hear your concerns, and I love to see, hear and celebrate with you the victories, especially the ones that once felt out of reach. 

Therapy Is a Relationship, Not Just a Service

Therapy, to me, is not just a service. It’s a relationship. It’s a safe space where children are reminded that they are capable, that they matter, and that they are deeply loved for who they are not just for what they can do. 

And for the families who walk through our doors: I hope you feel that we care about not just your kiddo but we care about you. I hope you feel our belief in your child, in your family, and in the progress that sometimes comes in inches, not miles. I know the road can be long. I have witnessed it myself over and over again. But I also know how beautiful it can be when you have the right people walking it with you. 

Celebrate Every Milestone—Big and Small

So from one grandmother’s heart to another parent’s hands-thank you for trusting us. Thank you for letting us celebrate your child’s growth, step by step. You may not always see it in the moment, but there is magic in the work we can do together. And I promise, from where I sit, it is the most meaningful work I’ve ever known.

Shauna Oakes is the Administrative Director at SmallTalk.

How Virtual Speech and Language Therapy Can Support Your Family

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

Handwriting Readiness

Handwriting readiness is a crucial part of a child’s development, involving fine motor and visual motor skills, which are essential for writing and dressing skills, like buttoning and zipping, that support their overall participation in school and activities of daily living. 

Fine Motor Skills 

Fine motor skills involve the small muscle movements in the hands and fingers that allow children to hold and manipulate writing tools effectively.

Children’s grasp of writing tools will change as they grow. By 4-5 years old, most children should be using a more mature grip. Here’s a timeline:

  • 1-2 years: Fisted grip (holding with their whole hand).
  • 2-3 years: Digital pronate grasp (holding with fingers pointing down, thumb up).
  • 3-4 years: Static tripod grasp (holding with three fingers, but using the whole hand to move the pencil).
  • 4-5 years: Dynamic tripod grasp (using three fingers with wrist and fingers moving independently for control).

Visual Motor Skills

Visual motor skills are essential for using scissors and making pre-writing lines, as they involve coordinating what the eyes see, with how the hands move. 

Children typically begin using scissors around 2-3 years old, starting with simple snipping. Here’s a timeline:

  • 2-3 years: Snipping paper and cutting along straight lines.
  • 3-4 years: Cutting out simple shapes like circles and squares.
  • 4-5 years: Cutting more complex shapes

Practicing pre-writing lines is crucial before learning handwriting because it helps children develop the fine motor skills and visual motor coordination needed to form letters and write neatly. Here’s a timeline:

  • 2-3 years: Scribbling and imitating horizontal lines, vertical lines, and a circle
  • 3-4 years: Copying simple lines, a circle, and imitating a cross
  • 4-5 years: Copying a square, cross, triangle, diagonal lines, and an ‘X’

Fun At-Home Activities to Boost Your Child’s Visual and Fine Motor Skills

  • Practice drawing pre-writing lines, shapes, and letters in sensory bins filled with rice, shaving cream, or sand
  • Use playdough or wikki stix to create different shapes, lines, and letters
  • Use broken crayons when coloring/drawing to help initiate a proper grasp 
  • Use large or small beads to string on a shoelace, pipe cleaner, or string
  • Rip paper to make crafts at home and practice opening and closing markers and glue sticks

By Allie Calcagno, OTR/L

OMG, it’s an OMD!

What is an oral motor disorder?

Difficulty with the function of the muscles and structures involved in speech and feeding

May be the result of:

  • A physical, structural issue such as cleft palate or tongue-tie
  • Prolonged pacifier or sippy cup use, which interferes with natural oral development
  • Injury
  • Fetal Alcohol Syndrome
  • A neurological condition such as cerebral palsy and Down syndrome which includes issues with muscle tone, resulting in dysarthria

Signs of an oral motor disorder include:

  • Droopy or “long” face with mouth that frequently hangs open
  • Drooling past the age of 18 months
  • Speech which is difficult to understand
  • Lisped speech
  • Difficulty sticking out tongue or moving it from side to side
  • Difficulty producing certain consonants or deleting them past age 3
  • Refusal to eat certain foods, especially meat or other tough foods to chew
  • Frequent gagging when eating
  • Open-mouth breathing (may be only when sleeping) and/or snoring

Key components affected by oral motor disorders include:

  • Articulation:  Difficulty in coordinating and controlling the movements of the lips, tongue, and jaw which can lead to reduced intelligibility
  • Chewing:  Challenges chewing and manipulating food in the mouth
  • Swallowing: Difficulty with coordinated and sequential movements required for safe and effective swallowing
  • Facial Expression:  Limited control over facial muscles, impacting facial expressions and non-verbal communication

If you suspect that your child may have an oral motor disorder which is impacting articulation and/or feeding, it is important to seek treatment with a speech-language pathologist and/or occupational therapist.  We are here to help!

By Kathleen Winger, M.S., CCC-SLP

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