EVALUATIONS AND CONSULTATIONS
Our goal during an evaluation is to obtain relevant and meaningful information to begin to understand each child’s unique developmental profile.
This is a 30 minute consultation for children who have had a recent speech and language evaluation, are being assessed for placement in one of our group programs, or are over the age of 4 and are being evaluated only for articulation/speech production with no language concerns. A written report is included except for children who are being evaluated for a group program, unless required for insurance billing.
This is a 1-2 hour assessment for children who have more extensive communication needs or have not had a speech and language assessment within the past year. The assessment procedure includes a combination of parent interview, observation of the child playing with his/her parents, play-based assessment, and standardized assessment procedures. The last ½ hour of the evaluation is dedicated to discussing assessment findings with the child’s parents and developing an intervention plan as a team. This evaluation includes a written report.
This assessment occurs in 2-3 hour blocks over 2-3 days and includes parent interview, educational staff interviews if warranted, and extensive standardized testing. This evaluation is appropriate for children who are elementary age and older in which a thorough assessment of the child’s individual learning profile is necessary to help determine appropriate academic placement, classroom supports/modifications, teaching strategies, and programs to maximize learning potential. This includes a reading assessment if necessary. This evaluation includes an extensive written report.
A 30 minute to 1 hour consultation may be appropriate for families who are interested in grouping/pairing their child with another child during therapy. An occupational consultation may also be beneficial to assist speech therapists at Milestones with insight into a child’s sensory, motor, and regulatory needs.
This typically is a 1-2 hour assessment for families who have questions about their child’s fine motor development, sensory processing, and self-help skill development. The assessment process includes a combination of a parent interview, observation of the child’s motor skills and problem solving while playing on various sensory equipment pieces, observation of the child during parent-child/parent-therapist/parent-sibling interactions, and standardized testing using fine and gross motor standardized tests and/or administration of sensory processing questionnaires to appropriately identify sensory difficulties which may be adversely affecting a child’s day to day function. 1 to 2 followup visits are often necessary to fully complete standardized motor testing, discuss test scores and the child’s performance with caregivers, and identify appropriate goal areas. This evaluation includes a written report that serves as a guideline for goals for therapy. Parent contribution to goal formation is encouraged, as the parents truly know the child best.
This is a 1-2 hour assessment with a speech language pathologist and/or occupational therapist utilizing social emotional and pragmatic language assessment tools. This assessment is specifically designed for children with autism spectrum disorders and other disorders affecting regulation, engagement, and social interactions and is conducted through a DIR model approach. Because these children demonstrate stronger skills when interacting with people with whom they have a strong relationship, parents will be the primary individuals interacting with the child and the clinicians will play more of a coaching role throughout this assessment process. These assessments are often videotaped for analysis and treatment goal development. A feedback session will be scheduled on a different date to review video clips, discuss the child’s developmental profile, and develop a treatment plan. This evaluation includes a written report.
Our goal is to provide a highly individualized treatment plan based on each child’s unique developmental profile and learning needs. Parents and caregivers are considered key members of the treatment team and are encouraged to actively participate in treatment sessions.
Individual therapy is the primary modality in which we provide therapeutic intervention to facilitate improved oral motor, feeding, articulation, language comprehension, and social communication skills. When working with young children, we incorporate a play-based, developmental treatment model.
Treatment goals are implemented during naturally motivating activities with an emphasis on building success and confidence. When working with older children, we often use more structured activities that are motivating to the child.
Individual therapy is the primary modality in which we provide therapeutic intervention to facilitate engagement in meaningful activities of daily life (self-care, education, and social interaction), fine motor skills, feeding, and sensory integration. Occupational therapy goals are embedded into naturally motivating activities whenever possible utilizing a child-directed, developmental model. When working with older and more regulated children, we often use more structured activities that are motivating to the child.
COGNITION involves the ability to process and visualize information, use memory more efficiently, improve auditory processing connections and gain confidence in overall thinking function. READING involves sound to symbol connections. Cognition and reading go hand and hand at Milestones. Reading training includes the following skills: segmentation, blending, auditory processing, code knowledge, multi-syllable management, fluency, and comprehension. Most students who need intensive reading training respond exceptionally well to the Phono-Graphix Program, which is simply the most well-respected reading method, developed in 1996. It is a hands-on learning process to get kids reading on level efficiently. Most students need between 24-36 hours of training. Students who are dyslexic, have speech challenges, autism spectrum disorders, or other severe disabilities, generally begin with intensive auditory processing training and move towards unlocking their potential to reading, fluency, and comprehension. The process may take longer, but success is inevitable. Our sessions are short (typically 1/2 hour) and intensive, but our results are long-term and extensive. The procedures we use are challenging, fun, and leveled so that success can be consistently measured.
Group therapy is used to help children improve upon their social emotional skills when relating and communicating with peers. Group therapy is also used when children are working on similar articulation error and have similar interests.
Group Occupational Therapy
Group therapy is used to help children improve upon their sensory motor and emotional regulation skills when relating and problem-solving with peers during meaningful activities of daily life. Group therapy is also used when children are working on similar fine motor goals and have similar interests.
At times children are seen by both speech and occupational therapists simultaneously. This is more common when children have sensory integration and emotional regulation difficulties. The role of the occupational therapist is to address the underlying difficulties with regulation, while the speech therapists targets the underlying difficulties with communication.
This is a listening program that utilizes filtered frequency principles of auditory integration to facilitate integration of the auditory and vestibular systems and auditory desensitization to promote improved sensory integration, attention, articulation, communication, and motor planning. This is a home program in which children listen to a modulated CD for 1/2 hour, twice a day. CDs are changed every 2 weeks. This is a relatively low cost intervention program. The specialized headphones cost approximately $145 through Vital Sounds and the CD rental fee is $35/month. Due to the fact that program planning is highly individualized based on sensory and behavioral responses, only children who are currently receiving speech or occupational therapy at Milestones are eligible to participate in therapeutic listening. This allows for effective clinical monitoring of the child’s response to the program.
Sensory Integration and Praxis Tests (SIPT)
The Sensory Integration and Praxis Tests (SIPT) help us to understand why some children have difficulty learning or behaving as we expected. The SIPT do not measure intelligence in the usual sense of the word, but they do evaluate some important abilities needed to get along in the world. They do not measure language development, academic achievement, or social behavior, but they assess certain aspects of sensory processing or perception that are related to those functions. They also evaluate praxis or the child’s ability to cope with the tangible, physical, two- and three-dimensional world.
Sensory integration is that neurological process by which sensations (such as from the skin, eyes, joints, gravity, and movement sensory receptors) are organized for use. Praxis is that ability by which we figure out how to use our hands and body in skilled tasks like playing with toys, using a pencil or fork, building a structure, straightening up a room, or engaging in many occupations. Practic ability includes knowing what to do as well as how to do it. Practic skill is one of the essential aptitudes that enables us “to do” in the world. “Dys” means “difficult” or “disordered”. Sensory integrative dysfunction may result in difficulty with visual perception tasks or in inefficiency in the interpretation of sensations from the body. A dyspraxic child has difficulty using his or her body, including relating to some objects in the environment. A dyspraxic child often has trouble with simply organizing his or her own behavior.
Taken from the SIPT Manual published by Western Psychological Services.
Description of the Sensory Integration and Praxis Tests For Parents
A. Jean Ayres, Ph.D.