General Archives | SmallTalk

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

Handwriting Readiness

Activities, Educational, General, Occupational Therapy | Aug 29, 2024 2 min read

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!

Educational, General, Speech Therapy | Jul 26, 2024 2 min read

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

Summer Themed Activities for Speech and OT

Activities, General, Occupational Therapy, Speech Therapy | Jun 28, 2024 3 min read

Summer is finally here! We are excited to share some summer-themed activities you can enjoy with your child. These activities offer therapeutic benefits, helping your child work toward their goals while still enjoying the summer season.

Ice Cube Animal Rescue

To do this activity, put little plastic animals in an ice cube tray, fill it with water, and freeze it. Gather some tools found in your home to break the ice and rescue the animals. For example, use a small hammer to break open the ice, tongs/tweezers to pull the animals out, or an eye dropper with warm water to melt the ice. Use the tools to break and melt the ice more quickly. Once all of the ice melts, you have rescued the animals!

To target language goals, talk about the animals using descriptive language. Describe the animal’s appearance, where they live, and the sounds they make. Use language like, “Oh no, we need to rescue the animals,” “The animals are stuck,” “It feels very cold,” “This animal is really fast,” “That animal has cool stripes,” etc.

To target occupational therapy goals, use a variety of tools, as mentioned above, to work on hand strengthening, force modulation, and grasping patterns, which will contribute to your child’s overall fine motor development.

Use your imagination with this activity! If you do not have little animals, you can freeze other mini objects or toys, little craft pom-poms, etc.

Fun with Chalk

Use sidewalk chalk to draw pictures to target both speech and language goals! Draw pictures and practice speech sounds your child works on in speech therapy. For example, if your child is working on “s,” draw a sun, a bus, an octopus, ice cream, etc. Play pictionary! Take turns drawing pictures and guessing the drawing. Use language to describe colors, patterns, etc. Drawing with chalk is great for developing fine motor and visual motor skills as well!

Make a sensory path! Use sidewalk chalk to create a series of guided movements to challenge your child’s gross motor skills while providing regulating sensory input. These movements could include anything that involves running, jumping, skipping, spinning, or balancing.

For example, start with a two-foot bunny hop, then walk along a curved line, trying to maintain balance. From there, do an animal walk, such as a bear walk or frog jumps, followed by a hopscotch sequence. Then, balance on one foot for 10 seconds and end with a race to the finish line! Get more inspiration on Pinterest or Instagram!

For an added challenge, have your child create their own sensory path to work on executive functioning skills such as planning and organization. See how creative they can get!

Scavenger hunt

Get outside and look for items in nature that are a specific color, texture and/or size! For example, look for something pink, yellow, bumpy, smooth, crunchy, etc. This simple activity can target skills such as describing, following directions, and increasing vocabulary. It is also great for tactile sensory processing, for example, exploring and discriminating between textures. Scavenger hunts can also help your child develop visual perceptual skills, such as finding differences between items and scanning through a busy background to locate an item.

By Nathalie-Rose Malecot, MS CCC-SLP and Jamie Carlson, OTR/L

Poop is a funny word: Resources for Toileting

Educational, General, Occupational Therapy | May 30, 2024 4 min read

Toileting, or as more commonly known as potty training, can be a challenging endeavor for children. Toileting is a complex task which requires many skills such as executive functioning skills including sequencing, sensory processing skills such as interoception, motor skills such as reaching and grasping, balance, dressing skills and so much more. However, occupational therapists are here to help with this challenge. Throughout this post, there will be a multitude of different books to read with your child to help improve their ability to toilet!

The first few books cover the science behind using the bathroom, exciting stuff, right? Well, using books to break down a basic task can help a child understand the process a little bit more and why it is important for our bodies.

“From Chewing to Pooing: Food’s Journey Through Your Body to the Potty” by Lauren Gehringer & Dr. Natalie Gehringer

The first book is called, “From Chewing to Pooing: Food’s Journey Through Your Body to the Potty” by Lauren Gehringer & Dr. Natalie Gehringer. This book talks about digestion in a fun way for children to understand. A child may feel fear surrounding using the bathroom, so learning more about the task can ease toileting anxiety.

“See Inside Your Body” by Colin Daynes and Katie King

The second book titled, “See Inside Your Body” by Colin Daynes and Katie King is a book to help children understand the organs involved with digestion. The more children can understand the process of digestion, the less pressure there may be surrounding using the bathroom. It also contains a lot of fun flaps to lift up and down to learn a little bit more about the body. Through learning more about the body, children can better understand interoception. Interoception is the sensory information people receive from their organs that lets them know if they are hungry, thirsty, sick, or need to use the bathroom.

“My Body Sends A Signal: Helping Kids Recognize Emotions and Express Feelings” by Natalia Maguire

The next book helps children learn more about interoception. The book titled, “My Body Sends A Signal: Helping Kids Recognize Emotions and Express Feelings” by Natalia Maguire teaches about the body sending us different messages and what these messages might mean. While this book focuses a lot on bodily cues related to emotions, it is still a valuable book for children to explore to learn more about how their body can send different signals such as their belly hurting or feeling like there are ‘ants in their pants’.

“It Hurts When I Poop: A Story for Children who are Afraid to Use the Potty” by Howard J. Bennett, M.D.

The last two resources or children’s book shared in this blog post focus more on constipation, which is the build up of hard stool inside the colon that is difficult to pass. Constipation is a common problem that affects a lot of children. Some children may find using the toilet aversive because of constipation. So here are a few books below to help a child defeat the potty time blues.

The first book is titled, “It Hurts When I Poop: A Story for Children who are Afraid to Use the Potty” by Howard J. Bennett, M.D. In this book it follows a main character who experiences constipation in an easy to understand format for kids. It also includes a “poop program” for parents to help their child through this process.

“I Don’t Want to Go To the Toilet” by B. Annyne Rothenberg, Ph.D.

The last book included in this post is titled “I Don’t Want to Go To the Toilet” by B. Annyne Rothenberg, Ph.D. which is a great guide for parents to use throughout the process of potty training, especially if there is a youngster who is having a hard time with this skill.

For more specific information regarding your child’s toileting success, reach out to your child’s occupational therapist. We are here to help, even if it stinks!

By Kat Danella, OTD, OTR/L

Childhood Occupations and How OT Supports Them

Educational, General, Occupational Therapy | Apr 01, 2024 3 min read

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

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

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.

References:

American Occupational Therapy Association. (2002a). Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 56, 609–639. https://doi.org/10.5014/ajot.56.6.609

By Erin Christensen, OTD, OTR/L

Valentine’s Day Activities for Speech and OT

Activities, Educational, General, Speech Therapy, Therapy | Feb 01, 2024 2 min read

As Valentine’s Day approaches, we’re excited to share some heartwarming and therapeutic activities that not only celebrate the season of love but also contribute to the growth and development of our clients. Join us on this journey of combining affection with effective therapy!

Speech and Language Therapy

Valentine’s Day provides a unique opportunity to explore the language of love. Speech and language therapy can be both educational and enjoyable as we engage our clients in activities that focus on expressing emotions, social interactions, and building meaningful connections through communication.

Activity Ideas:

Love Letter Writing: Encourage clients to express their feelings by writing or dictating love letters. This activity enhances language skills and emotional expression.
Conversation Hearts Challenge: Use conversation hearts candy with words or phrases related to communication goals. Clients can create sentences or engage in conversations using these sweet treats.

OT- Sensory

Occupational therapy often involves sensory activities that stimulate and enhance sensory processing. This Valentine’s Day, let’s explore sensory-rich experiences that promote engagement and development.

Activity Ideas:

Scented Sensory Bins: Create sensory bins with Valentine-themed scents like roses, chocolate, or strawberries. Clients can explore different textures and engage their senses.
Heart-shaped Stress Balls: Make heart-shaped stress balls filled with different textures to provide tactile stimulation. This activity is great for hand strength and stress relief.

OT- Fine Motor Fun

Fine motor skills are crucial for daily activities, and what better way to practice than with Valentine-themed fine motor activities?

Activity Ideas:

Valentine’s Day Crafts: Engage clients in crafting activities like making heart-shaped cards, cutting out paper hearts, or creating tactile crafts. This enhances fine motor coordination.
Cupid’s Arrow Game: Use a bow and arrow game to target various objects. This activity improves hand-eye coordination and fine motor precision.

Valentine’s Day is not just about chocolates and flowers; it’s about fostering growth, connection, and joy through therapeutic activities. We invite you to join us in celebrating the language of love and the development of essential skills that make every day special for our clients. Happy Valentine’s Day!

By Amy Rawlings, MA, CCC-SLP

San Diego’s NEW All-Inclusive Playground

Activities, General, News | Jan 01, 2024 2 min read

I recently checked out a brand new playground in Mission Bay that is a game-changer for families with children of all abilities – the all-inclusive playground. I did a bit of research and want to share the inspiring story of the origin of this park and why parents of kids with special needs should make it a must-visit destination.

How did the playground come to be?

The story begins with a shared vision among Mission Bay’s residents – a space where every child, regardless of their abilities, could play together. Turning this vision into reality required financial backing, and Mission Bay’s residents, local businesses, and organizations joined forces in a series of fundraising initiatives. From charity events to donation drives and sponsorships, the community garnered enough financial support to begin the process of getting bids, imagining, and drawing up plans. To ensure the playground met the highest standards of inclusivity, design and accessibility experts were brought in. Their expertise played a crucial role in crafting a space that accommodates children with a wide range of physical and cognitive abilities.

How is this play area different?

This isn’t your average playground – there are areas where every child, regardless of their abilities, can play and explore. From inclusive play structures to sensory-rich zones, this playground is designed to be a haven for kids of all kinds.

Pathways are wide and ramps make it stroller-friendly. Kids with different mobility needs can move around freely with wheelchair-accessible swings to inclusive slides and climbing structures. This playground has some cool sensory play zones with textures, colors and engaging sounds that rival our OT gyms at SmallTalk!

Not only is this playground a place for play, but it also offers a bit of casual learning. Info panels and interactive features are scattered around, providing a chance for kids and adults to explore and talk about different abilities in a natural, easygoing way.

If you haven’t checked out Mission Bay’s new all-inclusive playground yet, what are you waiting for? Grab the family, pack a sweatshirt and enjoy one of the best months outdoors in San Diego with very few tourists. :) See you at the playground!

By Jen Traina, CEO

Holiday Gift Guide & Events

Educational, General | Dec 01, 2023 3 min read

Tis the season for decking the halls and all the fa-la-las! With the holidays right around the corner, parents may be seeking gift suggestions to work on progressing therapy goals and bringing the fun of occupational and speech-language therapy to your home. While this gift guide may help to give your children presents that can help them practice their speech and occupational skills in a fun and unique way – the best gift for your children is quality time together. Ditch the toys with batteries, flashing lights, and loud noises and opt for something that encourages creativity and play!

Sensory Toys

Squish, build, mold, and play! Sensory toys are particularly enjoyable for children with autism due to their sensory processing needs. Sensorimotor toys can help alleviate these needs by stimulating or calming the senses and can facilitate communication and occupational success. In occupational therapy, you can expect to find toys and games that support development such as motor planning, coordination, balance, fine and gross-motor skills, and problem solving. Some of our occupational therapists’ favorite OT toys include:

Movement-Based Activities

Toys and activities that get us up and moving are great for facilitating language development and are especially wonderful for our friends with sensory needs! These toys can also be very useful for improving fine and gross-motor skills. We recommend small trampolines, swings, building blocks, and train sets to get our kiddos moving during at-home play.

Pretend Play

Open-ended toys (more than one way to play with the toy) allow your child to build their imagination and creativity while targeting therapy goals. When you follow your child’s lead they will be more motivated to interact because it feeds into their unique interests and abilities.

Animal Toys

Some of the most engaging toys are centered around our furry friends. Animal toys and games are a fun and versatile way to target nearly therapy goals and help foster language development. Engage your child by making early developing sounds (moo, baa, woof, ink, grr), practice new words through play (dinosaur…hungry dinosaur…dinosaur eats), work on following directions (bunny is jumping, kitty is running), and modeling new phrases (cow says moo). This low pressure activity is functional and gives them endless possibilities for fun.

Sensory-Friendly SmallTalk Holiday Events

What: Sensory Santa East County

Where: SmallTalk Speech & Occupational Therapy, 260 E Chase Ave Ste 204 El Cajon, CA

When: Sat Dec 02 2023 at 9:00am to 1:00pm

What: Sensory Santa North County

Where: SmallTalk Speech & Occupational Therapy, 12030 Scripps Summit Dr, Suite A

San Diego, CA 92131

When: Sat Dec 09 2023 at 9:00am to 1:00pm

By Madison Trussell, M.S., CCC-SLP

How Should My Child Swing? Intensity of Vestibular Input

Activities, Educational, General | Nov 01, 2023 3 min read

Swinging, or any kind of movement, provides input to the vestibular system. There are a variety of types of vestibular input, as well as the impact that it has on a person. This can vary depending on how their sensory systems process the information. Our vestibular system gives us information about movement and where our head is in relation to gravity. The vestibular system provides us with information about the speed and direction of our movement. This system provides the foundation for our balance reactions and has a strong connection to our postural control. There is also a connection between the vestibular system and a child’s ability to self-regulate. Depending on the type of vestibular input received, the effect on a child’s brain can be calming, organizing, or altering. The more intense the type of vestibular input, the more alerting the input will be for the child.

Depending on the child’s threshold for vestibular input, they may require a more intense type of vestibular input in order to register the input. For a child that is under-responsive to vestibular input, that child may need more intense vestibular input such as spinning or swinging in an orbital motion. Some children may also benefit from having their head inverted or being upside down for an increased registration of the vestibular input. For children who are over-responsive to vestibular input, starting with lower levels of input such as up and down (vertical) or front to back (linear) can help increase their tolerance of vestibular input.

Levels of Vestibular Input in Order of Increasing Intensity

1. Up and Down Movement

2. Front to Back Movement

3. Side to Side Movement

4. Diagonal Movement

5. Arc Movement

6. Spinning

7. Inversion (upside down)

High Level of Arousal Protocol:

For children with high levels of arousal the goal of swinging is to provide the sensory system with calming input.
Children with high levels of arousal often respond best to slow, predictable, and rhythmic movement.
Giving your child the ability to self direct their vestibular input may be beneficial in bringing them to the optimal level of arousal.
Rhythmic front to back or side-to-side movement can provide calming input to the child.

Low Level of Arousal Protocol:

For children with low levels of arousal the goal of swinging vestibular input is to alert the sensory system.
Children with low levels of arousal often respond to vestibular input that is unpredictable, fast, and angular.
Some children may respond best to input that is received in side lying, rather than in upright.
Spinning can provide alerting input to the child to bring them to optimal level of arousal.

By Erin Christensen, OTD, OTR/L