It is the neurological process of organizing information we get from our body and from our environment. This process occurs in our central nervous system (brain and spinal cord). We take information in from our environment via our sensory systems (auditory, visual, smell, taste, touch, vestibular-balance/movement, proprioceptive-body awareness through muscles/joints), process that information, and make an appropriate behavioral or motor response, thus interacting purposefully with the environment. In sensory processing (also known as sensory integration dysfunction), the sensory input is not integrated or organized appropriately in the nervous system and may produce varying degrees of problems for children in motor/muscle, academic, and/or social development. Sometimes one or more senses in children with sensory integration problems are either over- or under-reactive to stimulation. As a result some of these children often experience challenges in many areas of development including unusual behaviors. Some signs of sensory integration problems include:
- Strong adverse reaction to sound and/or expresses moderate to severe discomfort in being in a multi-sensory environment i.e. birthday parties, large crowds, sporting events, movie theaters, concerts, parades, etc.
- Intolerance to certain touch/textures/clothing
- Unusually high or low activity levels and/or difficulty paying attention, easily distracted/impulsive
- Poor body awareness; clumsy/accident prone
- Problems with muscle tone, motor planning, coordination, and balance
- Decreased endurance/strength relative to peers/siblings
- Resistance to change in routine
- Dislikes school and/or uncomfortable or awkward in social situations
- Difficulty with keeping up with peers and/or mastering age-appropriate play skills
Knowing for sure if your child has a communication delay is often difficult. If you are unsure, mention your concerns to your pediatrician. Remember a good pediatrician is not just concerned about your child’s health, but also about how your child is developing across all domains. This would include assessing his or her cognitive growth, communicative and social functioning and motor abilities.
In addition to the pediatrician, you can self-evaluate, too. Look around when you are in situations with other children of the same age group. How is your child interacting? Is he or she engaged? Is he or she speaking to his or her peers? Does he or she seem able to communicate his needs and wants? Is he or she frustrated? Does he or she use gestures more than words, or resort to hitting and pulling when he or she wants something? Is it extremely difficult to understand what your child is saying? If you want to know for sure, the absolute best way is to reach out to a state licensed speech-language pathologist to complete a thorough evaluation of your child.
This is one of the most commonly asked questions of parents with children who have communication and/or feeding issues. Research shows that children who have disabilities have a greater chance of developing feeding issues, so paying close attention to eating habits is very important. There are many clinical indicators that a trained professional would look for before making a definite diagnosis. Your practitioner will likely ask you many probing questions upon your initial consultation to determine even the need for an assessment. This is to identify the presence of any “red flags”. Has your child been dropping foods from his or her diet without replacing them with new ones? Does your child eat less than 10 foods in total or refuse food when it is changed even ever so slightly? If the issue at hand is becoming so disruptive to your child or family’s life, then seeking out the advice of a professional is probably best.
Occupational therapy benefits children who have delays in fine and gross motor skills, sensory processing, and self care skills. If your child has difficulty with any of the following, occupational therapy can help.
- Unable to hop, skip, catch a ball, etc. like other children his/her age.
- Difficulty with coloring, cutting with scissors or other pre-school/kindergarten fine motor tasks.
- Difficulty with academic tasks such as handwriting. Unable to hold a pencil correctly or complains of hand pain and fatigue.
- Unable to use utensils to eat, has trouble dressing self like others his/her age.
- Reacts negatively to stimuli in the environment such as sounds, bright lights. Doesn’t like messy play and may react negatively to touch. May only eat certain textures of foods.
- Seeks out excessive sensory stimuli like swinging, spinning, roughhouse play
Speech therapy benefits children who are not talking, not talking in complete sentences or are hard to understand as well as children who appear to stutter or have rough/hoarse voices. If your child experiences any of the following then a speech evaluation may be needed:
- Unclear articulation
- Does not speak in complete sentences by an age you believe he/she should be speaking in full sentences
- Uses “baby talk”
- Does not follow directions
- Does not know colors, numbers, etc. in comparison with his/her peers
- Experiences difficulty getting along with other children in social/group situations
- Has a rough/hoarse voice quality
- Seems to be stuttering or experiencing difficulty getting words out
- Has a hearing impairment
Every insurance contract is unique, so there is no way of knowing for sure until you call the plan. Keep in mind that many companies, especially if they are a smaller company, will place exclusions of therapy benefits to keep costs down. Key phrases to look out for are: “medical necessity”, “habilitative benefit”. Best practice is to call your plan and explain the issue in detail to determine if the plan will cover. However, no plan will ever guarantee payment until the actual claim is received and reviewed. This is why it is so very important to understand your insurance contract before making a commitment to move forward with treatment. If the language of your contract is vague, unclear or contradictory (which sometimes happens), we will help guide you in the process and specific questions to ask. The last thing we want is anyone to be surprised by an unexpected bill. If you decide to call your plan (which is always recommended) insurance companies are required to document what was discussed. Ask for a tracking number just so you have something to reference, most especially if an unexpected denial comes through. Always get the name and ID number of the representative with whom you spoke to. Also do not forget to write down the date.
Parent collaboration is an integral component of our therapeutic process. As therapists, we spend a limited amount of time with your child each week, so we find a significant value in the learning that occurs at home when parents make home practice a priority. After each session, your child’s therapist will take time to explain the activities they used during the session and discuss your child’s progress so you can practice these skills at home between the sessions. Our goal is to work with parents as a team to ensure gains and consistent progress, not just during individual sessions.
The answer to this question will also vary based on several factors. This would include the nature and severity of the problem, how consistent attendance is in therapy, whether or not home carryover activities are completed, and how well your child responds to treatment in general. Keep in mind though that this is just an estimate, and there is no possible way to know exactly how many sessions will be needed to resolve the issue.
School-based therapy is provided by a school district or county when it is determined that your child’s delay or impairment is having an adverse effect on his or her ability to succeed academically. In most cases, therapy in school employs an educational model of delivery, as opposed to a clinical one. This is why in many cases; the school district will not address certain areas of intervention. Keep in mind that what is educationally relevant for one child may not be for another, depending upon the child’s educational setting, abilities and nature/severity of his or her impairment. Since therapy in a school setting most often has a “qualification criteria”, in some cases a child may not qualify for the service even if he or she presents with impairment. This does not mean that therapy is not warranted. It just means that the degree of impairment or implication on education is not severe enough to warrant the service under an IEP. If your child gets approved for services, you will also come to realize that therapy in school is often within a group setting or that the sessions may only be provided one time per week. Conversely when you seek out private therapy, the intensity and consistency of therapy is greater simply because your child is being seen individually and the frequency of the sessions are usually more. When therapy is consistent, outcomes are greater and achieved faster. Lastly, the greatest difference between private treatment and school treatment is the level of involvement that you will have with your child’s therapy experience. There is no substitute for having weekly face to face contact with your child’s private provider to discuss your child’s session performance and review home carryover suggestions, which unfortunately is typically not possible when you have school-based services.
Occupational therapy provided through the public school system is categorized as related services. This means that in order for a child to receive occupational therapy as a free service through the public school, the child must qualify for special education services. A child cannot receive occupational therapy unless they meet the criterion set up by the state to be eligible for special education. Many students who do not meet this criterion need occupational therapy services.
Additionally, students who do qualify for occupational therapy at school might need additional therapy. While school occupational therapists are highly qualified and perform an excellent service, the realities of school based practice often mean the therapist carries a large caseload and the amount of service provided could be minimal.