Frequently Asked Questions

Won’t my child just outgrow these language delays and catch-up in time to start school?

Language delays and processing disorders usually have a physical causality with medical underpinnings. Speech pathologists are trained in identifying children who are “at risk” for having delayed speech and language problems or processing disorders continue to be problematic without direct therapy intervention. Some issues such as hearing loss from chronic ear fluid or sensory processing dysfunctions may need medical attention along with speech therapy to correct the underlying cause as well as remediate the outward symptoms.

My child has ADHD or ADD, but talks very well. Why do I need a speech pathologist?

I work with many children and adults who have ADHD or ADD. I find that the majority of them have abnormal auditory processing. About 75% of the ADHD individuals I have seen in my practice have ineffective listening systems that interfere with their ability to focus, concentrate or make sense of what they are hearing. Some are misdiagnosed and are inattentive to language with symptoms that mimic ADHD. Others are ADHD in addition to auditory processing issues. Providing a more accurate diagnosis of why the individual has attention deficit symptoms is a starting place. A speech pathologist can evaluate the individual’s language processing, listening and timing skills, and working memory abilities, in order to recommend strategies that address underlying issues, coping strategies, and retrain the auditory system to think in a more calm, focused, and organized manner. They use the individual’s strengths to improve their weaknesses.

Does it matter which treatment option I choose first?

The order you present each strategy is critical to the effectiveness of the outcome. I have know families who spent thousands of dollars on very good strategies that produced limited results because they were not in the order to address the most foundational issues first. Over thirty years of experience in this field working with numerous experts in processing disorders from various professional and educational fields has led Jane Shook to be uniquely qualified to make recommendations on the order of strategies used to achieve the most beneficial and cost-effective outcomes.

What will you look for when you evaluate my child?

What a speech language evaluation will contain will be based on the presenting problems related in the case history you submit.

A typical evaluation for a pronunciation problem would look at what sounds are misarticulated, how are they mispronounced, and how prevalent the errors are affecting intelligibility. It would also involve looking at the child’s ease in pronouncing the error sounds in imitation or making specific motor movements needed for sound production, and the child’s level of awareness of his mispronunciations.

A typical evaluation for oral language delays would be to look at receptive understanding of grammar and vocabulary, basic concepts, and attention and focus to social language cues. It would also look at the child’s ability to express those same language components with others and compare any differences. There are elements of language acquisition that depend on the emergence of basic cognitive skills, so those basic concepts are evaluated as well.

An assessment of linguistic/ auditory processing would look at an individual’s abilities to accurately understand words in various environments such as noisy vs. quiet or when two people are talking. It would also evaluate elements of working memory and comprehension of oral narratives like story telling, following discussions, understanding and answering questions, and comprehending stories at a concrete as well as an abstract reasoning level to make predictions and draw conclusions.

An assessment for swallowing and/or feeding issues would evaluate sensory defensiveness for texture, smell and taste, oral motor structure and functional skills, and behavioral factors influencing picky eating.

An assessment for voice or fluency problems would target the presenting problem to determine underlying causalities, possible physical, cognitive or sensory processing deficits or imbalances in order to determine an effective treatment plan.

I can find all the information I want on the internet. Why would I need a therapeutic strategist?

There are many professional paradigms with numerous diagnoses for the same or similar conditions. Each of these have various treatment modalities that are effective for some people. Sorting through this maze of options and ways of looking at conditions can be overwhelming to the family or individual who has just become aware that something is not quite right and problems need to be addressed. The order of addressing sensory processing issues is unique to each individual. The order you present each therapy strategy is critical to the effectiveness of the outcome.
Center for Therapeutic Strategies is a one-of-its kind consulting service that provides an overall treatment plan with referrals to other professionals and educational options in your local area. A Therapeutic Strategy with Jane Shook walks you through a process of gathering information to create an individualized approach to best serve each person according to the needs and resources of your family.
CTS devises a roadmap of the primary goals with the most effective treatment strategies to reach that goal at each stage of the treatment journey. CTS will follow your plan through the various stages to obtain the highest potential possible.

I don’t want my child to be labeled and have that follow him throughout life. Why do I have to have a diagnosis to receive treatment?

An evaluation is necessary to identify the root issues underlying the behavioral and functional challenges your child is facing so that accurate treatment strategies can be implemented. If your child had a broken leg you would want an x-ray to determine the place and extent of the break for the physician to provide adequate and effective care so the bone can heal. A diagnostic label may or may not be necessary for you to acquire the most cost-effective educational or therapeutic options available, so your practitioner can provide you with adequate and effective care. It is my experience that a label of delayed language or a processing disorder is not something that follows someone forever if the disorder is remediated. The label is removed and the child is expected to compete with typical peers?

How do we help smooth things between home and school?

We see angry outbursts, yelling, kicking at home but they don’t see those behaviors at school. A child that is keeping himself together at school but not regulating at home is probably using a lot of intentional energy to keep the lid on during the day, but runs out of steam and falls apart at home. Using a sensory diet prior to going to school to help ease the load during the day, then intensifying the sensory activities when arriving at the car to come home can be helpful. Where developmentally appropriate, discussing the child’s need for sensory input to help him stay calm, organized and focused at home engages the child in the process of self-care. This enlists his cooperation in finding the best combinations to help him feel better in his own skin.

In children with mild forms of sensory processing disorder, does it just “go away” without therapy as the child matures?

SPD is an inflammatory condition that has complex physiological roots. If it is a very mild condition that is left untreated medically or with physical therapy, some of the more overt symptoms may decrease over time, if the child’s overall immune system improves. Usually in cases where it “disappears” without SI therapy, it has involved the parents being very proactive in finding similar physical activities and nutritional modalities; however, it is more common to find the situation worsens with age.

If a child has minor symptoms of SPD (i.e. clothing texture discomfort, tags in clothes, food texture issues) but is highly functional and well adjusted, what do you recommend?

SPD is a condition on a wide spectrum of degrees of severity. It is likely that up to 25% of the American population is somewhat affected by it due to environmental toxins, fast food choices, and stressful lifestyles. Everyone has a sensory system that is adversely affected when the nervous system is compromised for any reason. We all make sensory choices based on individual needs and preferences. Knowing the principles of utilizing sensory input to calm and organize the system will help anyone create a calmer, more organized environment to function by being more intentional with a wider repertoire of appropriate sensory choices. I have seen children with very mild symptoms greatly benefit from a few months of sensory integration therapy that jump started their system. I have seen others that were typically development children, but were having mild focusing problems, utilize a home therapy listening program with noticeable positive results. Some typical children with mild symptoms have benefited from active involvement in physical recreational activities that provided proprioceptive input with organized movement. The choice is up to each family and the degree of difficulty the child is having being successful in typical activities.

My son is a year and a half and is already showing some sensory processing issues in the area of hyposensitivity (i.e. stuffing his mouth with food, not recognizing when bugs are crawling on him, craving intense tastes, craving intense vibration or sounds). What can I do as a mom to help him thrive?

Recognizing that this is usually the result of an inflammatory condition that can be treated medically and nutritionally is a start. Providing safe opportunities for movement and deep pressure like ample time to run, jump, climb, play outside and tumble with peers is also important in a child’s developing healthy sensory system. If these typical activities don’t seem adequate and hypo/ hyper sensitivities still seem to be hindering normal development of motor strength, coordination, eating habits, speech or language, or social skill, then an evaluation by pediatric SIPT certified occupational or physical therapist and/or a speech pathologist is probably the next step. If you are in doubt as to the steps you are to take, Jane Shook at CTS inventories your experiences with your child’s functional behaviors and if needed, evaluates speech and language developmental skills prior to making recommendations for a comprehensive therapy plan with prioritized goals and objectives for you to use as a guide.

What resources are available to public/ private school educators to educate them how to understand and deal with SPD children?

Numerous workshops are available throughout the year that gives helpful information on the needs of SPD children as well as practical suggestions for the classroom.

Are large motor activities (like in outside recess or physical education classes) good for all children or only helpful for SPD children?

We all have a sensory processing system that responds best when ample exercise and fresh air are provided on a regular basis. Research has shown that regular exercise makes all our brains function more optimally as well as keeps our circulation and lymph system working more optimally.

As a parent I feel bombarded with information and people who want to sell a service or product with good intentions that will help my SPD child. It can’t all be necessary and it isn’t all affordable? How do I choose what would be the most helpful for my child at this time?

It can be overwhelming as a parent of a child with special needs to determine which of the many resources available really provide the best choice for your child’s needs at this time. There are many therapy options that are excellent and effective when the child is ready physically, mentally, and cognitively. Those same options may be a waste of money and time if the child is not ready to acquire the task of the activity. It was this dilemma that inspired Jane Shook to create Center for Therapeutic Strategies. She inventories your child’s functional behaviors, evaluates speech and language developmental skills, determines a single goal based on your expressed desires for your child. She then makes recommendations for a comprehensive therapy plan with prioritized goals and objectives for you to use as a guide along with suggested practitioners that are in your area and their contact information. She provides this in a written report and explains all of it in a lengthy conference with you where you can ask questions regarding your child’s specific needs.

What kind of therapist is certified in sensory integration?

Only occupational therapists and physical therapists are able to be certified in sensory integration. The original SIPT (Sensory Integration and Praxis Test) certification based on Jean Ayres work was available through SI International, which is no longer in existence. The four course certification process is now available through Western Psychological Services that trains therapists in test administration and interpretation as well as intervention strategies and techniques.

How many hours of occupational therapy are appropriate for a child with SPD and a PDD diagnosis?

The amount of treatment time per week varies according to the severity of your child’s issues, your child’s age and endurance, your family’s time and monetary resources, as well as the policy of the treating practitioner. Some practitioners prefer to see the child initially very frequently (even daily) initially and at regular stages to create intensity with the hope of creating more possibility of change. Others prefer to see children of a younger age for shorter sessions two to three times a week. Other therapists prefer an hour to an hour and a half one time a week. Finding a therapist that your child connects with and what works best for your child’s developmental needs is up to you and your therapist.

What are some activities I can use to get my child energized, as she is very passive and sedentary?

Most children like to blow bubbles. Blowing activities of all kinds are normalizing for everyone. Keeping a box of blowing toys, of various degrees of difficulty, can be a regular afternoon activity. Eating a crunchy or chewy snack or sucking a thick smoothy through a straw also utilizes the powerful integrator we have in our mouth. Blowing and sucking activities help low energy children perk up and higher energy children calm down with greater organization and purpose. Then they may be more open to movement activities like jumping on a mini-trampoline (rebounder) or crawling through a cloth tunnel or simply taking a walk with mom and dad. Doing activities together that include your children in meaningful relational ways also are more likely to motivate a sedentary child to move.

Disclaimer: The information on this website is for educational purposes only and is not intended to take the place of individual therapy nor primary medical care. This information is to be used for reference only. This information is not intended to diagnose, treat, cure or prevent disease nor be a substitute for specific individual or group therapy. If you have medical concerns please contact your personal physician.

  Center for Therapeutic Strategies, Quantum Treatment Solutions, and Therapeutic Strategies, P.C. do not diagnose, treat, nor prescribe for a specific medical condition or illness and any recommendation made is not intended to replace the advice of a licensed medical practitioner.