Here you will find answers to some of the most common questions that parents have.
How do I know if my child needs therapy?
Your child may benefit from an evaluation by a pediatric therapist if you have concerns about your child’s overall development in thinking and learning, communicating, playing, and moving. You, your therapist, and pediatrician will discuss the concerns and create a plan for addressing your child’s needs.
What is the process for obtaining authorization for therapy services from Medicaid/Soonercare?
Soonercare requires a prescription from your pediatrician for evaluation. When received, a state-licensed therapist performs an assessment and testing to develop a Plan of Care with your pediatrician.
Will my insurance pay for therapy?
Many insurance plans cover occupational, physical, and speech therapy services but there may be certain conditions or limitations to your own plan’s coverage. Therefore, it is very important that you know what your plan will cover before your child begins therapy. You should call your insurance company to find out what your plan will cover. Here are some questions to ask:
Does my plan provide coverage for my child’s occupational, physical, and/or speech therapy?
How many visits are allowed under my insurance plan?
If my child needs several therapies, will the same number of visits be allowed for each?
Are there any exclusions or limitations to therapy coverage? For example, some insurance plans will not cover services for children diagnosed with developmental delay.
Why early intervention?
Early intervention is essential to reaching optimal progress in the shortest period of time. Therefore, if your child has been evaluated and your therapist recommends services, starting therapy right away is best.
What is Autism?
Autism is a neurological condition caused by a combination of genetic and environmental factors and is characterized by deficits in social skills, communication skills, and restricted and repetitive behaviors. These deficits all begin before a child is 3 years old. Autism can manifest itself in a wide spectrum from “high functioning” where the deficits are slight and do not obviously impact an individual’s daily living, to more severe forms in which an individual is unable to communicate or take care of himself/herself. Clinicians often group individuals with a variety of the above symptoms into a single category called “Autism Spectrum Disorders” (ASD) which includes Autism, Asperger’s syndrome, Sensory Processing Disorder (SPD), Pervasive Developmental Disorders, and others.
Autism differentiates itself from Asperger’s syndrome in that individuals with Asperger’s do not demonstrate a language delay, and often actually demonstrate above average verbal skills. Though hyper-verbal, individuals with Asperger’s syndrome still lack the ability to understand the full context and pragmatics of language, and will be very concrete in their language patterns.
In addition, individuals with Autism Spectrum Disorders often have difficulty with executive functioning. Executive functioning involves having the attention, organization, sequencing, and problem solving skills required to solve life’s everyday problems. Individuals with poor executive functioning skills are often referred to by teachers as “being very bright, but having no common sense”. Even though he may be highly intelligent, the individual may have great difficulty navigating through everyday problems such as paying bills, traffic, meal planning, social situations, making a doctor’s appointment, finding employment, etc.
What is sensory processing disorder?
Sensory Processing Disorder (SPD) is a neurological condition causing difficulties with processing and responding to sensory information from the environment and from within one’s own body. This information is in the form of auditory, visual, tactile (touch), olfaction (smell), gustatory (taste), vestibular (relation of body to earth’s gravity), and proprioceptive (relation of body parts to self) input. Individuals with SPD can demonstrate a series of seeking behaviors, avoiding behaviors, or both seeking and avoiding behaviors that are outside the normal range.
How do I know if certain negative behavior is sensory processing disorder, or simply poor behavior? It is difficult to determine if individual negative behaviors are due to a sensory processing response, or a poor behavior response. Most negative behaviors are a combination of sensory and behavioral deficits, but determining which plays a stronger role can be tricky, even for a trained professional. However, a general rule of thumb is that if an individual can turn on/off negative behaviors like a switch, then the negative behavior is behavioral based. If the individual has a more difficult time calming down, even after the problem has been resolved, then the negative behavior is more likely to be sensory based.
For example, a child might be crying and throwing a tantrum when getting a haircut. If the child stops crying immediately after the haircut is over and he calmly steps down from the barber chair, then the tantrum was more likely behavior based. However, if the child continues to be tearful and hesitant even after stepping out of the barber chair, then the tantrum was more likely sensory based.
What is the difference between occupational therapy (OT) and Physical Therapy (PT)?
Occupational therapists help individuals participate in the things they want and need to do through the therapeutic use of everyday activities or “occupations”. OT’s have a holistic perspective in which the focus is on adapting the environment to fit the person, and the person is an integral part of the therapy team. (www.aota.org)
Physical therapists restore and improve movement, activity, and health to enable individuals to have optimal functioning and quality of life. (www.moveforwardpt.com)
If one were to observe a pediatric occupational or physical therapy session, many similarities could be found in the actual activities. However, each therapist might be working on very different goals. For example, both OT’s and PT’s often utilize obstacle courses as a treatment technique. The physical therapist might use the obstacle course to focus on the gross motor skills of balance, jumping, endurance, strengthening, motor planning, etc. as needed for an individual to more fully participate in school PE or in playing with peers. An occupational therapist might use the exact same obstacle course, but would focus on the skills of attending to task, auditory processing skills, motor planning/body awareness, sequencing skills, and short term memory skills as needed to maximize functional abilities in a classroom setting. In addition, the OT might also be addressing the proprioceptive, tactile, and vestibular sensory input that is provided in the obstacle course.
My child was just diagnosed with Autism. What do I do now?
If your child has just been diagnosed with Autism, it can be a very overwhelming time. We are here to help. Many children with an Autism diagnosis will require occupational therapy and speech-language therapy services as part of their early intervention plan. Our therapists are trained to work with children on the spectrum. We are here to answer any of your questions. Please call if you would like to speak with a therapist or schedule an evaluation.
What age should my child begin therapy?
The sooner the better! The younger the child is, the more moldable their neurological system. Numerous studies show that the sooner a child begins therapy, the more likely they are to make the most significant gains, and to be discharged from therapy more quickly. We at Jarvis Pediatric Therapy really focus on starting therapy early (birth to 3 years old) with the objective that, with intensive therapy, the child will no longer require services once they reach kindergarten. This said, many of our clients do not begin therapy until they are well into elementary school. These older children benefit from intensive therapy as well and can also make significant gains through this therapeutic approach. The sooner the better! The younger the child is, the more moldable their neurological system. Numerous studies show that the sooner a child begins therapy, the more likely they are to make the most significant gains, and to be discharged from therapy more quickly. Sunshine Center Pediatric Therapy Center applies focus on starting therapy early (birth to 3 years old) with the objective that, with intensive therapy, the child will no longer require services once they reach kindergarten. Many of our clients do not begin therapy until they are well into elementary school. These older children benefit from intensive therapy as well and can also make significant gains through this therapeutic approach. Where can I get more information about sensory processing disorder? You can contact one of our therapists for a free consultation and/or you can visit the SPD Foundation website. We also recommend the following books: The Out-of-Sync Child and Sensational Kids. What kinds of speech and language disorders affect children? Speech and language disorders can affect the way children talk, understand, analyze or process information. Speech disorders include the clarity, voice quality, and fluency of a child’s spoken words. Language disorders include a child’s ability to hold meaningful conversations, understand others, problem solve, read and comprehend, and ability to express thoughts through spoken or written words.
What is a language disorder?
An expressive language disorder is generally a childhood disorder. Expressive language disorder is characterized by a child having difficulty expressing him- or herself using speech. The signs and symptoms vary drastically from child to child. The child does not have problems with the pronunciation of words, as occurs in a phonological disorder. Children with expressive language disorder have the same ability to understand speech as their peers, and have the same level of intelligence. Therefore, a child with this disorder may understand words that he or she cannot use in sentences. The child may understand complex spoken sentences and be able to carry out intricate instructions, although he or she cannot form complex sentences. Some examples of expressive language disorder are listed below.
Trouble organizing sentences
Difficulty with proper grammar, such as verb tenses or pronouns
Not able to communicate thoughts, needs, or wants at the same level as peers
Problems recalling appropriate words to use
A receptive language disorder is characterized as difficulties in the ability to attend to, process, comprehend, and/or retain spoken language. Children with receptive language disorders often have difficulty understanding what other people are saying to them. This lack of comprehension may result in inappropriate responses or failure to follow directions. Some people think these children are being deliberately stubborn or obnoxious, but this is not the case. Some examples of receptive language disorder are listed below.
Difficulty following directions
Difficulty with answering questions appropriately
Use of jargon while talking
Difficulty attending to spoken language
Inappropriate and/or off topic responses to questions
Does my child have a feeding disorder?
Many parents often worry that their child is not eating enough volume or enough variety. A feeding disorder occurs when the child’s feeding skills are disrupting the child’s ability to maintain adequate health, growth, and nutrition. A feeding disorder can have a severe impact on the family’s overall mealtime routine and can lead to stress for all family members.
How long will each treatment last?
Treatment sessions typically last 30 to 60 minutes per visit, with the initial evaluation visits lasting 60 minute s. This does not include the time it takes to fill out the initial paperwork if it has not been completed prior to the 1st visit. Paperwork usually takes about 15 minutes to complete, and subsequent visits usually take 45 minutes for treatment but can take longer or shorter depending on the child's diagnosis, mood, and if they are seeing another healthcare professional occupational therapist or speech therapist) the same day. It is recommended that parents stay for the initial visit to answer any questions the therapist may have regarding the child. On subsequent visits, parents may choose to leave and come back to pick up their child or you can come back with your child to the gym or treatment room to watch them in their therapy session, as long as it does not interfere with the child's work ethic. If you choose to leave, please be on time to pick up your child.
Does my child need speech therapy?
We are mothers and we know about a mother’s instinct! If you have concerns regarding your child’s communication please call us. We are happy to listen to your concerns and advise you on whether what you are seeing is developmental or a cause for concern. Please look at the ASHA website for a list of developmental norms based on a child’s age. This will give you some idea of what is age appropriate. http://www.asha.org/public/speech/development/chart.htm
What if my child stutters?
Most children go through periods of increased stuttering. It typically lasts a few weeks and then subsides. If you observe your child exhibiting struggling or facial tension during stuttering or the stuttering doesn’t go away, an evaluation may be necessary.
What is a receptive language disorder?
Receptive language refers to the skills involved in understanding language. Difficulties in receptive language may be present in the ability to attend process, comprehend, retain or integrate spoken language.
What is an expressive language disorder?
Expressive language refers to the skill of being precise, complete and clear when expressing thoughts and feelings, answering questions, relating events, and carrying on a conversation.
Is my child showing signs of expressive language disorder?
Early signs may include:
word retrieval difficulties
misnaming items (dysnomia)
difficulty acquiring the rules of grammar
difficulty in verb tense change
difficulty in word meaning
What is Pediatric Occupational Therapy?
Our Pediatric Occupational Therapists work with families to assist children to learn functional skills. These include the ability to pay attention; remain calm; teach themselves self-care, such as learning to feed themselves, brushing hair, brushing teeth, dressing, and eventually bathing; encourage development of eye-hand skills, oral skills for eating; coordination of the whole body; feeling comfortable with the positioning and movement of their body during daily activities such as play. We work with families to help children learn cooperative behavior, and work with learning problems. Pediatric Occupational Therapists:
Assess and treat sensory processing disorders.
Improve upper extremity muscle strength, endurance, range of motion, coordination, fine motor abilities and function.
Address self care skills.
Recommend strategies for managing decreased or emerging function and movement which may include assistive equipment.
Work on social and peer interaction skills.
Provide education to caregivers.
Consult with other professionals regarding the role of occupational therapy and how it can improve the child's daily life.
Collaborate with caregivers and child to create effective carry-over from the occupational therapy clinic to home.
What is Sensory Integration Therapy?
Sensory Integration is the ability to take in information through the senses of touch, movement, smell, taste, vision, hearing, and to combine the resulting perceptions with prior information, memories, and knowledge already stored in the brain.
Sensory Integration Therapy is usually performed by Occupational Therapists. They assess developmental levels and determine whether sensory-motor processing is impaired. Sensory Integration Therapy looks like play, because play is the child's way of learning and developing. Activities are carefully chosen to stimulate development in deficient areas. Children with lower sensitivity (hyposensitivity) may be exposed to strong sensations such as stroking with a brush, vibrations or rubbing. Play may involve a range of materials to stimulate the senses such as play dough or finger painting. Children with heightened sensitivity (hypersensitivity) may be exposed to peaceful activities including quiet music and gentle rocking in a softly lit room. Treats and rewards may be used to encourage children to tolerate activities they would normally avoid.
What is Pediatric Speech Therapy?
Our Speech Language Pathologists provide support to children in the areas of language acquisition, articulation, oral motor stimulation, feeding issues and communication skills. These areas may include improving and working with production of sounds, communication skill development (including sign language and PECS), increase the range of sounds, quality of language use, increase in feeding skills, improve oral motor functioning and development of oral motor muscles to improve language use.
We look at the quality of a child's speech/language such as their pronunciation and articulation, their ability to communicate their needs, their ability to chew and swallow food properly and their families concerns. Speech Therapists are concerned with helping children reach their full developmental potential and realizing their full range of sounds and communication abilities to improve their quality of life.
As Speech Therapists specializing in Pediatrics, we assess and treat all areas of speech and language development. Some of these areas include:
Apraxia of Speech
Articulation and Phonology
How do I know if my child needs Pediatric Speech Therapy?
Parents should consider seeking an evaluation with a Speech/Language Pathologist if their child demonstrates any of the following: Birth to 2 months:
Does not cry when hungry or uncomfortable
Does not make comfort sounds or sucking sounds
Cry does not vary in pitch, length and volume to indicate different needs
Difficulty establishing/maintaining a rhythmical suck/swallow pattern
Significant loss of breast milk/formula out of side of mouth during feeding
3 to 5 months:
Vocalizes separately from body movements (sound is not a response to body movement)
Inability to establish or maintain face-to-face communication during feeding
Does not vocalize in response to sound stimulation
Has not begun to laugh by 5 months in response to play
Difficulty with feedings such as above
5 to 7 months:
Does not babble during play or in response to stimulation (may suggest a hearing problem)
Does not use voice to vocalize attitudes other than crying
Does not respond to sound stimulation (indicative of hearing problems)
Difficulty with swallowing early solids or other feeding issues
7 to 9 months:
Does not look towards sounds or own name
Is not babbling double consonants (bababa....)
Difficulty with textures in foods (gagging, choking, etc.)
Is unable to participate in conversations with adults using babbling noises
Does not say "mama" or "dada" non-specifically
Does not use different inflections to produce exclamations
9 to 12 months:
Is unable to successfully eat early finger foods or munch/bite on foods
Cannot babble single consonants such as "ba" or "da"
Does not respond to words/language appropriately
Does not experiment with language when playing independently
Does not participate in conversations by responding with vocalizations
12 to 15 months:
Does not use inflection during vocalization
Is not experimenting with language during play
Is not using 1 to 3 words spontaneously while repeating additional words
Does not vocalize or gesture to communicate needs
Is not using "no" emphatically and meaningfully
Is not using exclamatory expression such as "oh-oh", "No-no", Ta-da", etc.
15 to 18 months:
Is not attempting to sing songs
Cannot use 10-15 words spontaneously
Is not using vocalization in conjunction with gestures
Does not use language to communicate needs
Is not repeating sounds or words or imitating environmental sounds
Is not jabbering tunefully during play
Continues to demonstrate eating problems (swallowing issues, choking, etc.)
18 to 24 months:
Is not using jargon with good inflection
Cannot label 2-4 pictures while looking at a book
Is not putting 2-4 words together to form short sentences or communicate needs
Does not understand nouns, verbs and modifiers an their uses
Is not using intelligible words to communicate needs
Cannot imitate 2-4 word phrases
Does not relay experiences using jargon, words and/or gestures
Does not have at least 50 - 100 words
24 to 33 months:
Cannot sing phrases of songs
Is not using three word sentences
Is not using a wide range of consonant and vowel sounds
Does not use past tense words "He runned"
Is not expressing frustration at not being understood
Does not use up to or more than 50 expressive words
Is not imitating phrases or experimenting with new words
Words are not clearly articulated
33 to 36 months:
Is not responding to questions when asked things
Is not producing correct beginning sounds of words
Is having a hard time understanding prepositions’
Is not speaking in complete sentences
Does not use plurals to refer to more than one (even if not correct)
Is not participating in storytelling
Does not have expressive vocabulary of 200 - 1000 words
Is not using expressive vocabulary to communicate all needs
Is not using sentences to communicate
What is Pediatric Physical Therapy?
Our Pediatric Physical Therapists work with families to provide support in the areas of gross motor development, motor planning and visual motor skills. These may include improving and working with muscle tone, strength and development, range of movement, quality of movement, eye-hand coordination, attention to task and sensory integration. We see children from birth through adolescence with health problems related to injury, disease, or congenital conditions. We look at the quality of a child's movements such as their pace and gait when they learn to walk, their balance and coordination skills, regaining range of motion after an injury or from trouble during birth, or the pressure they are able to use during play. Physical Therapists are concerned with helping children reach their full developmental potential and realizing their full range of motion to improve their quality of life.
Pediatric Physical therapy at Sunshine Center provides evaluation, intervention and consultation in the following areas:
Gross motor development
Muscle tone and strength
Pre-gait and gait training
Environmental adaptations/seating and positioning
Wheelchair positioning and mobility
Physical therapists may incorporate many intervention approaches, including stretching, massage, mobilization, strengthening and endurance training to enhance the child's capabilities and prevent deformities and contractures. We also assess and modify environmental obstacles that might impede optimal performance.
With physical therapy, kids build strength and improve motor function, balance and coordination in fun, creative ways. In fact, most of the work we do is based in play... it’s the most positive way to get children motivated and involved. That’s why you’ll see swings, ball pits, climbing walls and all kinds of toys in our clinics. They’re important for your child’s therapy and they also help us create the child-centered environments that help our clients thrive.
How do I know if my child needs Pediatric Physical Therapy?
Parents should consider seeking an evaluation with a Physical Therapist if their child demonstrates any of the following:
Birth to 2 months:
Doesn't lift head in prone position (while lying on their stomach)
Does not turn head to one side in prone position
Does not turn head to both sides in supine position (lying on back)
Does not hold head up 90degrees in prone position (lying on stomach)
Does not extend both legs or kick reciprocally
Does not roll to back when placed on their side
Does not place weight on forearms in prone position (lying on stomach)
Does not rotate or extend head
Is unable to grasp a rattle
Cannot bring both hands together
Does not roll over one way
Does not hold head up when pulled to sitting
Is unable to hold head steady in supported sitting position
Does not bear weight on legs
Is unable to keep head level with body when pulled to a sitting position
Does not demonstrate balance reactions
Cannot bear weight on hands in prone position (lying on stomach)
Does not move head actively in supported sitting position
Does not roll over either way
Does not bear weight on legs
Cannot lift head or assist when pulled to sitting position
Demonstrates little balance reactions or protective extension of arms
Does not roll over both ways
Cannot sit with little or no support
Does not hold weight on one hand while in the prone position (lying on stomach)
Cannot bear weight on legs and bounce
Cannot get to sitting position without assistance
Does not assume crawling position (hand-knee position)
Does not show interest/motivation to crawl
Cannot sit on own without hand support
Does not pull to stand using furniture
Cannot switch positions from sitting to prone
Does not creep on hand and knees
Cannot pivot while in sit position to retrieve toy
Cannot pass an object from one to the other
Cannot stand holding on to someone or something
Cannot pick up small objects
Does not walk with one hand held
Cannot stand alone well
Does not demonstrate balance reaction while in kneeling position
Does not walk alone one to two steps
Does not demonstrate motor planning by climbing on furniture
Has a hard time picking up small objects
Does not attempt to creep upstairs
Does not walk without support
Cannot throw ball
Does not bend down to retrieve objects
Does not demonstrate balance reaction in standing
Does not run
Cannot walk upstairs with one hand held
Cannot carry large toy while walking
Does not squat in play
Cannot retrieve toy off of floor from standing position