Monthly Archives: June 2015

Is My Child’s Speech Normal?

My child’s speech & language skills… are they delayed?
by Michelle Turkoglu, Speech Therapist at ABS

A colleague of mine mentioned that when he meets his friends’ children or sees children out and about, their speech and language skills seem to differ greatly. The children are all around the same age and don’t appear to have any developmental delays such as Autism, syndromes or other disorders, so why is their language so different?

The easy answer is that there is a wide range of what is considered “normal” for speech, language, and communication development. And while that’s true, it doesn’t help parents, caregivers, teachers or anyone who works with children a good idea if the child needs therapy support or not.

Pediatricians, teachers, speech-therapists and the internet can all provide you with charts, graphs and lists of what is considered typical. While some of this information is accurate, you’ll find that the information can vary from one source to another. It also seems like people are hearing blanketed or general statements that don’t really give enough information. For example, some lists would state that the following milestones should occur between 1-2 years of age:

  • Understands “no”
  • Uses 10 to 20 words, including names
  • Combines two words
  • Waves good-bye
  • Makes the “sounds” of familiar animals
  • Gives a toy when asked
  • Brings object from another room when asked
  • Uses words to make wants known
  • Points to body parts such as eyes, nose, mouth

There is nothing wrong with this information. All these milestones should in fact occur around age 1 and before or right around 2 years. But if an 11-month-old child can do all these things proficiently and a 23-month-old child is just learning these skills, should both be considered “typical”? If we simply based our evaluation off of the “list” we could come to a few conclusions:

  • the 11-month old is advanced
  • the 23-month old is delayed
  • both children are “fine” because there is a wide range of typical

As a speech-language pathologist, I think that these lists can be helpful guidelines but really should be interpreted by a professional with advanced training in child development (SLPs, developmental pediatricians, pediatric neuropsychologist, etc.). The professional that you seek help from should spend some time with the child and engage with him or her in a variety of activities in order to get a good sense of how they communicate and interact. Videos of children at home or in various settings can provide really great insight into how a child is communicating in various environments.


In the case of the 10-month old vs. the 23-month-old, there could be so many other conclusions drawn once he or she is evaluated by a professional. For instance, the 11-month-old uses well over 10-20 words but all those words are related to a single topic. He or she waves goodbye but only when told to do so and does not look at the person when waving. He or she engages in sing-along but only 1-2 songs from their favorite TV show. They can identify and get items for you but maybe they need the direction repeated several times along with gestures and pointing to understand. So while they can perform the skills that are listed, the manner in which they are performed may be considered “atypical”.

The 23-month-old child may in fact be “delayed” if the listed skills are just beginning to emerge. The extent of the delay would need to be examined. The delay may need therapy to help him or her “catch up”. The delay may be pervasive (continue on) and would definitely need intervention to help him or her develop language skills. On the other hand, maybe the 23-month-old was adopted and is just starting to hear and learn English. Maybe the child’s overall communication, social interaction and other developmental skills are on-track. If we just looked at the “list”, we would consider the child to be delayed or disordered, when in fact, they could just be acquiring a new language (which is not a disorder of speech-language skills).

So if you are thinking that your child may have speech-language-communication delays, getting a professional opinion is the best option. A pediatric speech-language pathologist should be able to determine if your child would benefit from starting therapy right away or explain why he/she thinks that your child does not need therapy.

One final note…As a parent or caregiver, you know your child best. Ask lots of questions. Let the professional know that you’ve done your research and explain why you are concerned. An open dialogue will answer the most questions and help understanding for both the professional and parent.

How Occupational Therapy Can Help Your Child at Alternative Behavior Strategies

What does occupational therapy do?
by Victoria Kochanek, Occupational Therapist at ABS

Occupational therapy is client-centered, occupation-based and evidence-based. An occupational therapist creates an individual therapy plan based on the routines and environment of your family at home. Within the therapy gym and a structured home program the outcome is that your child will be able to do tasks they need and want to do, with as much independence as possible, satisfaction and success.

Occupational therapy uses a holistic approach to work with parents and their children in developing performance skills and coping mechanisms to do necessary and desired occupations and routines. When we use the word occupations we refer to a variety of things you do in your daily life. Using the word occupation for self care: an occupational therapist addresses children’s ability to get dressed, toilet/bathe themselves, perform daily hygiene such as brushing teeth/combing hair, etc. OT also addresses the skill sets and situations in which children perform entire routines; from getting ready for bed/ready in the morning to tolerating different transitions between play and work. An OT also helps a child with their occupations and skills to eventually start helping to take care of them selves such as making a simple snack/meal to doing chores/homework successfully and efficiently.

OT is also provided to help children who have delayed/poor motor coordination skills required to enjoy various play-based occupations such as kicking/throwing a ball, playing on a playground or riding a bike. Occupational therapists work with a variety of children who have special needs that impact their occupations; whether developmentally they are having some difficulty achieving these different occupations or if they have a specific diagnosis. OTs work with children who have Autism, Aspergers, William’s Syndrome, Down syndrome, Cerebral Palsy, Acquired Brain injury or other social/emotional/behavioral/neurological conditions.

An occupational therapist can address these different needs by looking at the child, their different environments and the tasks they need to do in a holistic way. Assessing the child’s fine motor/gross motor strength/coordination, visual perceptual and hand eye coordination skills, emotional self regulation, learning style and different executive function processes such as attention, memory, sequencing, organization and planning. The therapist also analyzes the different environments the child is in during these tasks as well as the tasks themselves to determine what other difficulties may occur that challenge the child’s abilities. Using all of this different information, the occupational therapist then creates a child-centered plan of treatment. The OT strives to create a functional balance and fit between a child’s abilities, the tasks they need to do and the environment they do them in.

Occupational therapy is unique in the use of evidence-based theory of sensory integration/processing for children who demonstrate unsuccessful coping strategies to the 6 senses:
• Sight, hearing, taste, touch, smell and movement.

The 6 senses of input are integrated and modulated in occupational therapy with the use of sensory integration/processing of tasks they do, their environment and even their own bodies. This is often paired with one of our other foundations of practice in neurodevelopment/motor control, cognitive processing, and occupation/skills acquisition.

ABPathfinder: Frequently Asked Questions


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At Alternative Behavior Strategies, we are committed to providing better care of our clients, investigation into their problems and further education of those who serve. As a parent of a child diagnosed with autism, we understand some of the challenges you face as you and your family find the best therapy solution for your child.

Therefore, we are pleased to implement ABPathfinder across our therapy centers. Below are some frequently asked questions about the tool.

For Parents:

  • My child was recently diagnosed with autism. What does ABA therapy entail?

Applied Behavior Analysis (ABA) is a science in which procedures are systematically applied to improve socially significant behavior to a meaningful degree. An ABA program is a systematic teaching approach that involves breaking skills into small, easy-to-learn steps. Praise or other rewards are used to motivate the child, and progress is continuously measured for opportunities to optimize as needed.

ABA is widely recognized as the single most effective treatment for children with autism spectrum disorder and the only treatment shown to lead to substantial, lasting improvements in the lives of individuals with autism.

  • I’ve heard about ABPathfinder. What is it?

ABPathfinder is a leader in autism therapy management solutions that tracks skills and behaviors in one central software application, with complete data storage and security.

ABPathfinder helps the therapy team capture your child’s progress throughout his/her therapy sessions, allowing our therapists to build customized day-to-day plans for clients based on their current progress and future goals.

Alternative Behavior Strategies is proud to partner with ABPathfinder to offer a new tool to help our talented therapists as they work with your child during autism management therapy sessions.

>> FACT: A recent study resulted in a decrease of administrative time, but also an increase in therapy quality and consistency that resulted up to a 20% increase in the speed with which children mastered skills. Continue reading