Taxonomy

The following taxonomy follows the structure of Discipline -> Major focus area -> Minor focus area. The focus areas are based on the study of the field work of speech, occupational, physical, and feeding therapists.

• Speech Therapy (ST)

  • Articulation

    Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables in words and sentences for a child, often during play activities. Most professionals characterize a child with an articulation disorder as someone who has difficulty producing a few phonemes and the child’s errors may be linked to oral motor weakness and/or normal development.
    • Accent Modification

      An accent is the unique way that groups of people who speak the same language sound. A person’s accent depends on many things. Changing your accent is also known as accent modification.
    • Additions

      One or more extra sounds are added or inserted into a word (e.g., 'buhlack' for 'black').
    • Distortions

      Distortions are when a child uses a non-typical sound for a typically developing sound. Generally the parts are mostly there, but they are a little wrong. A child says a word that sounds like something what it should, but is not quite right. For example, 'shlip' instead of 'ship'.
    • Omissions

      Omissions of phonemes is when a child doesn't produce a sound in a word. An example of an omission would be a child who says 'ool' for 'pool'.
    • Substitutions

      A very common speech sound error is the substitution, sound changes in which one sound class replaces another sound class. An example is 'thun' for 'sun'.
  • Augmentative and Alternative Communication

    Augmentative and alternative communication encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production or comprehension of spoken or written language.
    • Aided Communication

      Aided modes of communication include those approaches that require some form of external support, such as a communication boards with symbols (e.g., objects, pictures, photographs, line drawings, visual-graphic symbols, printed words, traditional orthography) or computers, handheld devices, or tablet devices with symbols that generate speech through synthetically produced or recorded natural (digitized) means.
    • Unaided Communication

      Unaided modes of communication include nonspoken means of natural communication (including gestures and facial expressions) as well as manual signs and American Sign Language (ASL). These modes of communication often require adequate motor control and communication partners who can interpret the intended message.
  • Execution and Speech Motor Planning

    The ability to plan out in the brain the sounds needed to produce words, figure out what muscles need to move and in what order and then say them correctly; children with apraxia have difficulty putting sounds together to form words (e.g., they can say “uh” and “p” separately, but have difficulty planning the order and movement of muscles to say the word “up”).
    • Complexity

      Children with speech impairments, especially apraxia, have difficulty as the words get longer and more complex with the sound combinations; adding syllables and difficulty to the words as they achieve high accuracy helps them learn how to better sequence sounds together (e.g., soup → super →superman).
    • Initiation

      Beginning the movement of speech; children with apraxia often show groping (i.e., mouth movements) as they search to figure out how to produce the sound. This can often lead to initial consonant deletion or just the production of a vowel.
    • Mean Length of Utterance (MLU)

      The average number of words produced in a phrase or a sentence; children with apraxia are often delayed in expressive language as well and so a goal could be to work on putting words/approximations together for a variety of pragmatic functions.
    • Response Time

      The amount of time it takes to respond to stimuli such as, repeating a word modeled or answering a question.
  • Executive Function

    Referring to the group of mental skills used daily including planning, thinking, self-regulation/self-control, working memory, self-monitoring, time management, and organization.
    • Attention

      The ability to focus on one of more specific items/tasks. Varying types of attention include Sustained Attention, Selective Attention, Divided Attention, Alternating Attention, Visual Attention, and Auditory Attention.
    • Mental Flexibility

      The ability to adapt thoughts and behaviors to accommodate situations in response to environmental changes.
    • Self-control

      The ability to regulate emotions and actions as well as resist impulsive behaviors to fit into social norms of a situation.
    • Working Memory

      Cognitive system that deals with short term memory storage and manipulating information for retrieval. For example, listening to a story, remembering events, and attempting to understand the meaning of the story concurrently.
  • Expressive Language

    Expressive language is the ability to use words, sentences, gestures, and writing to communicate with others.
    • Abstract / Figurative Language / Idioms

      Understanding non-literal language forms. Examples include: "It’s raining cats and dogs", "Fit as a fiddle"', or "Break a leg".
    • Adjectives

      A word naming an attribute of a noun, such as sweet, red, or technical.
    • Analogies

      Analogies are word relationships that compare two things that have a feature(s) in common but are otherwise unlike.
    • Answering Questions

      Responding to questions asked by another.
    • Asking Questions

      Requesting additional information regarding a topic.
    • Attributes

      Qualities of an object or item; adjectives to describe appearance, make-up, or uses/functions.
    • Basic Concepts

      Words that a child needs to understand in order to perform everyday tasks like following directions, participating in classroom routines, and engaging in conversation.
    • Categories

      Categories are a group or class of items with shared characteristics. Categories are a foundation for how we learn, relate, store, and recall words. Arranging thoughts, concepts, and words into categories facilitate meaning, memory, and retrieval. Categories give a connection between words based upon similarities and differences.
    • Cause and Effect

      The ability to explain the reasoning for an event that occurred or the connection between antecedent and event.
    • Commenting

      Adding additional information to a conversation by adding personal anecdote or description.
    • Communicative Intent

      Actions or utterances performed that represent a pragmatic function.
    • Comparisons

      Defining similarities or differences of two or more entities.
    • Describing

      To tell someone the appearance, sound, smell, events, etc., of (something or someone) or to say what something or someone is like.
    • Differences

      Reasons two or more items are not alike.
    • Function

      The specific use of an item or object (ex: scissors = cut paper).
    • Gestures, Signs, and Facial Cues

      Using hand motions, signs, or changing facial expression to express and communicate messages
    • Grammar

      Grammar is a set of rules and examples that encompass syntax and word structures (morphology).
    • Labeling

      Using nouns to identify a person or object.
    • Making Choices

      Selecting an option when provided two or more options are provided.
    • Morphology

      Manipulating language by adding prefixes, suffixes, conjugations, and other endings on words (examples: -s, -ing, -ed, 's, past/present/future tense).
    • Multiple Meanings

      Many words in the English language have multiple meanings (estimated at 50% of words). Teaching children about multiple meaning words encourages them to cross check meaning with the context of the sentence, which is a vocabulary learning strategy. Teaching multiple representations of one word may help increase the likelihood that a student will remember the word.
    • Narrative Development

      The ability to create or tell a story with correct sequence and on-topic elements. Begins with unrelated utterances, then sequences of related topics, adding of elements such as setting, characters, and central theme; inclusion of a logical sequence with contexts missing; and finally developed narratives with correct elements, sequence, and all information needed to understand the story.
    • Negation

      To negate statements or questions, we typically insert the words no or not into the phrase or sentence. Comprehending and using negation is a common grammar challenge in language acquisition.
    • Nouns

      A word (other than a pronoun) used to identify any of a class of people, places, or things.
    • Play Skills

      Stages of Play as Development Progresses include Solitary Play (exploring how body/objects move), Solitary Play (uninterested in play with others), Spectator/Onlooker (allows others to play near, but doesn't initiate play with others), Parellel Play (plays alongside others, not with them), Associative Play, Cooperative Play.
    • Prepositions

      Words deriving relation or location of an object or person to another. Examples include over, under, up, down, around, next to, between, before, after.
    • Pronouns

      Children with language delays often have difficulty with pronouns. 12-26 months: I, it 27-30 months: my, me, mine, you 31-34 months: your, she, he, yours, we 35-40 months: they, us, hers, his, them, her 41-46 months: its, our, him, myself, yourself, ours, their, theirs 47+ months: herself, himself, itself, ourselves, yourselves, themselves.
    • Reading

      The ability to make meaning of combined letters by decoding words and speak them aloud in sentences.
    • Requesting

      The ability to use language to ask for an item/action
    • Semantics

      The study of meaning of language and how words work together. This includes things such as multiple words that have the same meaning, but are used in different pragmatic situations.
    • Sequencing

      The ability to place events in order of how they happened or how they should happen in a routine.
    • Similarities

      Reasons that two or more entities are alike.
    • Syntax

      The ability to arrange words and phrases into sentences using correct word order using set rules of linguistics
    • Utterance Expansion

      Increasing the amount of words spoken at a time.
    • Verbs

      Verbs are action words such as go, walk, jump, eat, and come. Understanding and using verbs allow the child to communicate in sentences rather than 1-word phrases.
    • Vocabulary

      Vocabulary is the building block of language. A child's vocabulary knowledge relates to their reading comprehension.
    • Vocalizations

      Utterances that consist of 1 or more sounds that perform a communicative function. Vocalizations are bridges between non-verbal communication and real word oral communication.
  • Fluency

    Fluency refers to the smooth, forward flow of speech. An individual with a fluency disorder/difference such as stuttering or cluttering experiences disruptions in the forward flow of their speech. Examples of disruptions include repeating sounds or words, prolonging sounds, or blocking (getting stuck) on sounds or words. These disruptions can be accompanied by tension, observable behaviors or avoidance, negative thoughts, and negative feelings that impact the individual’s overall communication.
    • Affective Restructuring

      Affective restructuring refers to changing the underlying feelings about a person’s stuttering or cluttering. This can be achieved through approaches such as increasing an individual’s knowledge and education about stuttering or cluttering, building acceptance, and/or developing self-advocacy skills.
    • Awareness / Identification

      Awareness and identification refer to noticing when stuttering/cluttering occurs. It can also refer to noticing secondary behaviors around moments of stuttering/cluttering, or labeling thoughts and feelings about stuttering/cluttering.
    • Cognitive Restructuring

      Cognitive restructuring refers to changing underlying thoughts about an individual’s communication. Strategies to target cognitive restructuring can include reframing thoughts (looking at a thought or a situation in a different way), contingency planning (If a certain event or thought happens, I will do this action), or challenging thoughts (e.g., That thought isn’t true because...).
    • Dealing with Feelings / Self-disclosure / Support

      Dealing with feelings refers to skills individuals can practice to address or cope with their feelings surrounding stuttering/cluttering. Self-disclosure refers to the act of an individual communicating or identifying that they are a person who stutters or clutters. Support refers to identifying and building supportive systems for the individual who stutters or clutters (e.g., at home, school, in the community) and connecting them to resources for people who stutter or clutter.
    • Desensitization

      Desensitization refers to the process of reducing emotional responses to a stimulus, event, or situation through repeated exposure. This process can be achieved through exposing an individual to the event or situation in a controlled environment. The exposure can then gradually expand over time to include a broader set of individuals, different settings, and more challenging situations. For example, if the situation that provokes an emotional response is stuttering openly in front of someone, a first step to desensitization could be stuttering in front of a trusted friend or SLP. The next step could be stuttering in front of a small group of friends, then a group of acquaintances, then eventually a large group, etc.
    • Fluency Shaping Techniques

      Fluency shaping techniques refer to speech techniques that attempt to increase a client’s smooth, forward flow of speech and reduce disruptions in their fluency.
    • Secondary Behaviors

      Secondary behaviors refer to additional behaviors an individual does around moments of stuttering or cluttering. Examples of secondary behaviors can include blinking, breaking eye contact, making noises, facial grimacing, movements in the head, arms, and legs, using filler words like uh or um, and repeating phrases leading up to the moment of stuttering or cluttering.
    • Stuttering Modifications Techniques

      Stuttering modification techniques refer to speech techniques that attempt to modify stuttering or cluttering in a way that makes it easier, less tense, and more forward moving.
  • Hearing

    The type of therapy for individuals with hearing loss will differ greatly depending on the type and severity of hearing loss, the age of onset, and the age at which compensatory modes of communication were introduced. Although the therapy is conducted by a Speech Therapist, the patient and therapist may not always be using speech to communicate. Areas of focus in aural hab/rehab may include training in auditory perception and visual cues, improving speech, developing language, managing communication, and the management of devices that aid in hearing.
    • Auditory Rehabilitation

      Retraining the auditory system to minimize the loss-induced deficits of function, activity, participation, and quality of life following hearing loss, such as learning to adapt to hearing aids, cochlear implants or other hearing assistance. Techniques may include sensory management, perceptual training, or counseling.
    • Auditory Skills

      Hearing abilities such as auditory discrimination (syllabification, noticing differences in words), auditory figure-ground discrimination (attending to speaker, blocking out background noises/music), auditory memory (recalling information previously presented via audio), and auditory sequencing (understanding and recalling direction sequence, number sequence, etc). attention to a speaker, blocking out background noise,
    • Gestures, Signs, and Facial Cues

      Identification and interpretation of non-verbal cues that can assist in hearing a speaker's message.
    • Hearing Aid Management

      Steps and maintenance of hearing aids including identifying when hearing aids are not functioning properly, developing routines for cleaning and removal at night, cleaning regiments daily, watching battery use, and getting them serviced by audiologists if needed.
    • Hearing Amplifier Management

      The care and maintenance of hearing amplifier including cleaning, programming, or wearing schedules.
    • Self-advocacy

      Ability to act to gets needs met - including, but not limited to - asking communication partner to speak up, moving self to adjust volume/noise, student asking teacher to use an assistance device, or to ask for batteries changed in a hearing device.
  • Intelligibility

    Speech intelligibility refers to how well someone can be understood when they're speaking. Speech-Language Pathologists often qualify this by examining the percentage of speech understood in conversation; children age 2 should be understood 50% of the time, age 3 should be understood 75% of the time and age 4 should be understood 100% in conversation with context unknown to a familiar listener.
    • Gestures, Signs, and Facial Cues

      Gestures, Signs, and Facial Cues are any movement used in place of a word to communicate a message when unable to expressively say words/sounds (e.g., gesture=pointing, bringing hands together to sign “more” and showing happy versus sad using facial expressions).
    • Pace and Breathing

      The rate of speech (fast vs. slow) and pausing between words in a phrase/sentence that is needed to increase intelligibility.
    • Prosody Errors

      Prosody errors are errors in the rhythm, stress and intonation of speech. For example, errors may be the raising of a voice at the end of a sentence when not asking a question or using equal stress on all syllables of words (i.e., monotone). Children with apraxia often have difficulties saying the same word with different inflection to show their emotions or whether they are asking a question or saying a statement.
    • Volume and Resonance

      Volume and Resonance are the perceived loudness of the speaker and the airflow of speech through the vocal tract. For example, errors of resonance could be hypernasal (too much air coming out the nose) orhyponasal (not enough air coming out the nose for nasal sounds).
  • Oral Motor Skills

    Coordination of oral structures and how they work together to produce speech sounds
    • Endurance

      The ability to sustain oral movements for lengths of time needed for speaking and communicating without fatiguing.
    • Range of Motion

      The amount of space that an articulator can move. Decreased range of motion of articulators can negatively impact intelligibility due to negative impact to coordination or inability to reach position needed for correct articulation.
    • Strength

      The ability of the oral motor structures to perform actions for speaking or feeding with appropriate force (i.e. mastication). Hypotonicity and hypertonicity each have negative impacts on speech and feeding tasks.
  • Phonology

    Phonology can be described as an aspect of language that deals with rules for the structure and sequencing of speech sounds. A phonological disorder may be characterized as a child who has numerous phoneme errors that can usually be grouped into categories (phonological processes), and they are usually not linked to oral motor difficulties and/or normal development.
    • Affrication

      When a nonaffricate is replaced with an affricate (ch or j) (e.g. 'joor' for 'door').
    • Alveolarization

      When a nonalveolar sound is substituted with an alveolar sound (e.g. 'tu' for 'shoe').
    • Assimilation

      When a consonant sound starts to sound like another sound in the word (e.g. 'bub' for 'bus').
    • Backing

      When alvoelar sounds, like /t/ and /d/, are substituted with velar sounds like /k/ and /g/ (e.g. 'gog' for 'dog').
    • Cluster Reduction

      This process occurs on words which feature consonant sounds that are grouped together. For instance, the words snake and snail both feature the consonant cluster sn. In a cluster reduction snake and snail are commonly misarticulated as nake and nail. The /s/ at the beginning of the word is deleted.
    • Coalescence

      When two phonemes are substituted with a different phoneme that still has similar features (e.g. 'foon' for 'spoon').
    • Deaffrication

      When an affricate, like ch or j ,is replaced with a fricative or stop like sh or /d/ (e.g. 'ships' for 'chips').
    • Denasalization

      When a nasal consonant like /m/ or /n/ changes to a nonnasal consonant like /b/ or /d/ (e.g. 'doze' for 'nose')
    • Depalatalization

      When a palatal sound is substituted with a nonpalatal sound (e.g. 'fit' for 'fish').
    • Epenthesis

      When a sound is added between two consonants, typically the uh sound (e.g. 'bu-lue' for 'blue')
    • Final Consonant Deletion

      The final consonant sound in a word is deleted. For instance the words sheep, duck and carrot may be produced as shee..., du... and carro... When a child has final consonant deletion he or she tends to delete just about all final consonants.
    • Final Consonant Devoicing

      When a voiced consonant at the end of a word like /b/ or /d/ is substituted with a voiceless consonant like /p/ or /t/ (e.g. 'pick' for 'pig').
    • Fronting

      Very common processes and speech sound errors seen in young boys and girls. Velar fronting occurs on production of the /k/ and /g/ phonemes. The /k/ and /g/ phonemes are made at the back of the mouth, when the tongue contacts the velum, which results in a blockage of the air stream. Children with velar fronting difficulty don't do this. Their tongue tip touches the front of the mouth to produce a /t/ or /d/. For instance, cart becomes tart, and goat becomes doat.
    • Gliding

      A very common process where the liquid sounds /l/ and /r/ are replaced by /w/ or /y/. For instance, leaf becomes weaf or yeaf, and red becomes wed or yed. Liquid glides are later developing sounds and so are not really considered speech sound errors in younger children, but more as a natural process.
    • Initial Consonant Deletion

      When the initial consonant in a word is left of (e.g. 'unny' for 'bunny').
    • Labialization

      When a nonlabial sound is replaced with a labial sound (e.g. 'pie' for 'tie').
    • Phonological Awareness

      Phonological awareness is the foundation for learning to read. It is the ability to recognize and work with sounds in spoken language; an individual's awareness of the phonological structure, or sound structure, of words. Phonological awareness is an important and reliable predictor of later reading ability.
    • Prevocalic Voicing

      When a voiceless consonant in the beginning of a word like /k/ or /f/ is substituted with a voiced consonant like /g/ or /v/ (e.g. 'gomb' for 'comb').
    • Reduplication

      When a complete or incomplete syllable is repeated (e.g. 'baba for 'bottle').
    • Stopping

      Fricative sounds (stream of air) are replaced by sounds that don't have a stream of air. That is, long windy sounds such as /sh/ or long hissing sounds such as /s/ are replaced by short sounds such as /t/ or /p/. So for instance, the word ship may be pronounced as pip, or tip, or even dip.
    • Syllable Shapes / Consonant-Vowel Combinations

      Children with apraxia have difficulty putting sounds together rather than producing specific sounds in isolation. Goals should be focused on shapes of words such as, CV (e.g., “me”), VC (e.g., “up), CVC (e.g., “hat”), VCV (e.g., “okay”), CVCV (e.g., “bunny”), CVCVCV (e.g., “potato”) rather than specific sounds to teach the movements needed to put sounds together without segmenting the word or omitting/substituting sounds.
    • Vowelization

      When the /l/ or er sounds are replaced with a vowel (e.g. 'appo' for 'apple' or 'papuh' for 'paper').
    • Weak Syllable Deletion

      When the weak syllable in a word is deleted (e.g. 'nana' for 'banana').
  • Pragmatics / Social Skills / Life Skills

    The rules associated with the use of language in conversation and broader social situations.
    • Being Prepared

      Gathering materials necessary for an event or task. Skills include time management, organization of packing, and identifying possible problems.
    • Conversation

      The ability to hold a successful conversation which requires skills including topic maintenance, turn-taking, and appropriate commenting.
    • Dealing with Conflict

      Being able to identify a problem, use self-control to identify solutions, and appropriately follow through with a solution.
    • Dealing with Feelings

      The ability to cope with both positive and negative emotions in an appropriate manner. May involve strategies to deescalate from overly positive or negative including breathing, taking a break from the environment, or spending time alone.
    • Following Directions

      Following instructions is a part of everyday life. It is the child’s ability to act on requests by others. Following instructions requires the child to attend to detail in spoken language, to sequence the information in the appropriate steps and to seek clarification if they have trouble remembering or recalling the information.
    • Friendship-Making

      Being able to use appropriate pragmatic skills to communicate and interact with others. Friendship making includes sharing interests, listening to the ideas of others, participating in joint activities, and communicating socially.
    • Gestures, Signs, and Facial Cues

      Being able to use, interpret, or react to the actions of others to communicate feelings and messages. These messages can be positive (high five, thumbs up) or negative (scowl, eye roll).
    • Getting the Teacher's Attention

      Following classroom rules when needing assistance such as hand raising, approaching desk, or waiting for teacher to finish speaking with others. Avoiding things such as calling out, adverse behaviors, or using physical means to gain attention.
    • Greetings and Personal Information

      The ability to assess environment and communication partner to appropriately greet (hi, hello, howdy), possibly paired with gesture (wave, handshake, slang, hug), and provide appropriate amount of personal information (name, profession, relationship to other communication partners) without breaking social etiquette of the situation.
    • Group Work

      The ability to work joint with peers to complete a task. Skills needed include the ability to not overshadow others, listen and respond to others' ideas, separate workload evenly, and contribute evenly.
    • On-Task Behavior

      Being able to identify the expected task and then sustain attention in order to complete steps to finish the task. Off-task behavior occurs when attention is directed away from the task or when avoidance of task behaviors emerge.
    • Problem Solving

      The ability to identify the problem, regulate emotions, identify possible solutions, organize necessary steps to follow a solution track, and assess if solution track solved the problem initially identified.
    • Prosody Errors

      Errors of speech including intonation (inflection errors in statements/questions), stress pattern (uneven stress), loudness variations (too loud or quiet), pausing (inappropriate pauses or no pausing at all), and rhythm (uneven cadence).
  • Receptive Language

    Receptive language is the ability to understand and comprehend spoken language that you hear or read.
    • Abstract / Figurative Language / Idioms

      Understanding non-literal language forms. Examples include: "It’s raining cats and dogs", "Fit as a fiddle"', or "Break a leg". Receptive tasks include being given an idiom and identifying a picture representation of the figurative language.
    • Adjectives

      A word naming an attribute of a noun, such as sweet, red, or technical. Receptive task example includes picture/object ID from a field of 2+ (find BLUE, which is SMALL)
    • Analogies

      Analogies are word relationships that compare two things that have a feature(s) in common but are otherwise unlike.
    • Answering Questions

      Responding to questions asked by another or identifying the picture/item/response that would answer the question.
    • Associations

      Being able to identify how items or objects can go together or identifying similarities.
    • Attributes

      Qualities of an object or item; adjectives to describe appearance, make-up, or uses/functions.
    • Auditory Processing

      How the brain receives information related to sound. Can be broken down into 3 categories: Auditory Awareness (sound detection, localization, attention/figure-ground), Auditory Discrimination (environmental sounds, suprasegmentals, segmentals), and Auditory Identification (association, feedback/self-monitoring, phonological awareness).
    • Auditory Response

      Auditory response or the auditory brainstem response (ABR) measures brain wave activity in response to sounds.
    • Basic Concepts

      Words that a child needs to understand in order to perform everyday tasks like following directions, participating in classroom routines, and engaging in conversation (i.e. up/down, in/out, big/small, around/between/next to). Receptive tasks related to basic concepts include placing items in given direction locations, identifying pictures of paired concepts, or performing other actions (i.e. turn lights OFF).
    • Categories

      Categories are a group or class of items with shared characteristics. Categories are a foundation for how we learn, relate, store, and recall words. Arranging thoughts, concepts, and words into categories facilitate meaning, memory, and retrieval. Categories give a connection between words based upon similarities and differences.
    • Cause and Effect

      The ability to identify the reasoning for an event that occurred or the connection between antecedent and event.
    • Differences

      Being able to identify which items in a set do not belong
    • Following Directions

      Following instructions is a part of everyday life. It is the child’s ability to act on requests by others. Following instructions requires the child to attend to detail in spoken language, to sequence the information in the appropriate steps and to seek clarification if they have trouble remembering or recalling the information.
    • Grammar

      Grammar is a set of rules and examples that encompass syntax and word structures (morphology).
    • Inferences

      Inferences are the conclusions and presumptions we draw from what we have read or heard using, the information given, our prior knowledge, our experiences, our imagination and intuition.
    • Labeling

      Identifying items, objects, or people by name. Receptive tasks include pointing to pictures from a field of 2 or more pictures when given an item/object/person name.
    • Localization

      The ability to identify the origin of verbal input or sound
    • Morphology

      Manipulating language by adding prefixes, suffixes, conjugations, and other endings on words (examples: -s, -ing, -ed, 's, past/present/future tense). Receptive tasks for this subject could include identifying the plural, identifying verb tenses, or the action -ing.
    • Multiple Meanings

      Many words in the English language have multiple meanings (estimated at 50% of words). Teaching children about multiple meaning words encourages them to cross check meaning with the context of the sentence, which is a vocabulary learning strategy. Teaching multiple representations of one word may help increase the likelihood that a student will remember the word.
    • Negation

      To negate statements or questions, we typically insert the words no or not into the phrase or sentence. Comprehending and using negation is a common grammar challenge in language acquisition.
    • Nouns

      A word (other than a pronoun) used to identify any of a class of people, places, or things.
    • Play Skills

      Stages of Play as Development Progresses include Solitary Play (exploring how body/objects move), Solitary Play (uninterested in play with others), Spectator/Onlooker (allows others to play near, but doesn't initiate play with others), Parellel Play (plays alongside others, not with them), Associative Play, Cooperative Play.
    • Prepositions

      Words deriving relation or location of an object or person to another. Examples include over, under, up, down, around, next to, between, before, after.
    • Pronouns

      Children with language delays often have difficulty with pronouns. 12-26 months: I, it 27-30 months: my, me, mine, you 31-34 months: your, she, he, yours, we 35-40 months: they, us, hers, his, them, her 41-46 months: its, our, him, myself, yourself, ours, their, theirs 47+ months: herself, himself, itself, ourselves, yourselves, themselves.
    • Reading

      The ability to put letters together to decode and derive meaning in words and sentences.
    • Semantics

      The study of meaning of language and how words work together. This includes things such as multiple words that have the same meaning, but are used in different pragmatic situations.
    • Sequencing

      The ability to order pictures or sentences into a logical pattern to tell events of a story.
    • Similarities

      Being able to identify two or more items that share characteristics such as color, shape, size, trait, etc.
    • Verbs

      Verbs are action words such as go, walk, jump, eat, and come. Understanding and using verbs allow the child to communicate in sentences rather than 1-word phrases.
    • Vocabulary

      Vocabulary is the building block of language. A child's vocabulary knowledge relates to their reading comprehension.
  • Self-regulation

    Self-regulation refers to the ability to monitor and/or control one's own emotions, responses and behavior in response to events, sensory stimuli, and interactions experienced. Self-regulation is a cognitive, developmental and sensory based process. Self-regulation is required to engage appropriately in important daily routines and activities, maintain attention, respond to overwhelming, unexpected, aversive sensory stimuli (i.e., by removing stimuli, self, or using strategies), and interact with others. It is important for an individual to sense and understand how he or she is feeling, understand triggers which impact regulation, and utilize strategies and tools to maintain regulation.
    • Cognitive Regulation

      Allows children to use cognitive (mental) processes necessary for problem solving and related abilities in order to demonstrate attention and persistence to tasks.
    • Emotional Regulation

      Allows children to respond to social rules with a range of emotions through initiating, inhibiting, or modulating their behavior in a given situation to ensure social acceptance.
    • Sensory Regulation

      Allows children to maintain an appropriate level of alertness in order to respond appropriately across environments to the sensory stimuli present.
  • Voice

    Voice therapy is an approach used by speech-language pathologists to help patients find relief from symptoms and achieve the best possible voice.
    • Prosody Errors

      Errors occur in stress, intensity, rhythm, and intonation.
    • Transgender Voice and Communication

      In addition to providing services to help with an individual's laugh, cough, and all aspects of voice (intonation, pitch, quality, and resonance), an SLP will also provide guidance on pragmatics while demonstrating cultural sensitivity in communication with the clients and their families. An SLP is well-versed in inclusive, respectful, and non-pathologizing terminology.
    • Vocal Function

      The use of one's voice. Exercises can be used to improve function including warm-up, power, stretching, and contracting.
    • Vocal Hygiene

      Behaviors that keep the voice functioning appropriately. Examples of proper vocal hygiene elements include drinking enough water, not screaming to children or pets across the house/yard, avoiding throat clearing, or warming up voice before singing or performing.
    • Vocal Quality

      Description of the sound of a voice including descriptors such as raspy, harsh, breathy, strained, or low.
    • Vocal Stamina

      Ability to sustain vocal demands over time. Low vocal stamina results in inability to sustain conversation.
• Occupational Therapy (OT)

  • Activities of Daily Living / Self-care

    Occupational therapists help individuals become as independent as possible in daily tasks required to take care of one’s own body. An occupational therapist may provide adaptive equipment/seating, modified steps of the task, therapeutic activities/exercises to address the skills needed for a specific task or training to caregivers to increase the individual's independence, participation, and safety.
    • Bathing and Showering

      Bathing and showering includes gathering supplies, transferring into and out of the tub/shower, and completing the steps of washing, rinsing, and drying.
    • Dressing

      Dressing includes choosing appropriate clothing for the occasion/weather, gathering the clothing, sequencing the steps appropriately, putting on and taking off clothing, and manipulating fasteners (zippers, buttons, buckle, etc.).
    • Feeding / Utensil Management

      The setting up, arranging and bringing food to the mouth.
    • Personal Hygiene

      Personal hygiene and grooming includes tasks required to care for our hair, skin, eyes, nose, teeth, etc. Some common tasks include putting on makeup/deodorant, brushing teeth/hair, flossing teeth, trimming nails, etc.
    • Sleep

      Sleep includes getting ready for sleep, falling asleep and staying asleep. An occupational therapist may provide strategies/routines to improve relaxation, preparing the body and mind for sleep, and/or set up an environment appropriate for rest and sleep.
    • Toileting

      This task includes transferring on/off toilet, managing supplies/clothing, emptying the bowel or bladder, and cleaning one’s self.
  • Attention

    Attention is a cognitive process in which an individual focuses on one or more aspects of his or her environment. There are different types of attention including divided, selective, and sustained. Occupational therapists address attention in order to improve an individual’s ability to participate and complete daily occupations with independence. Attention may be impacted by sensory processing challenges, personal needs not being met (tired, hungry, feeling unsafe, etc.), overwhelming or underwhelming environment impacting level of alertness, lack of motivation or interest in the task, etc.
    • Alternating Attention

      The ability to switch or immediately transfer focus from one activity to another.
    • Divided Attention

      One's ability to focus on two or more things at the same time.
    • Selective Attention

      Paying attention to specific input by the brain's ability to select the input we pay attention to. Consiously, and unconsiously, we are able to select the input which is most important.
    • Sustained Attention

      Holding and mainting attention over a period of time, necessary for the focus and concentration needed in learning, listening, and paying attention during conversations or instructions.
  • Augmentative and Alternative Communication

    AAC is an alternative way for an individual to communicate when there are difficulties with speech or writing. Occupational therapists (OTs) focus on assisting an individual communicate his or her wants and needs. OTs often collaborate with a speech and language pathologist to find effective AAC methods. An OT may assist in assessing an individual’s visual, perceptual, motor and cognitive skills in order to increase participation and independence with the AAC method.
    • Accessibility

      Occupational therapists assess and address the accessibility of an individual’s form of communication in order to increase independence in communicating wants and needs. Examples of accessibility include; increasing font size for the individual to read independently, changing color/brightness of pictures/words to adhere to the individual’s visual and processing needs, adapting the location of where an AAC device is placed in relation to the individual depending on vision/motor abilities for reaching, etc.
    • Aided Language Modeling

      A communication strategy that requires a communication partner to teach symbol meaning and model symbolic communication by pairing speech with graphic symbols or other forms of aided augmentative and alternative communication (AAC).
    • Motor Planning

      Motor planning requires an individual to plan and carry out a movement. Motor planning is important in using augmentative and alternative communication as it often requires motor skills from the eyes, hands, arms, etc. to push a button, sign, point, look at a specific object/visual, and many other actions.
    • Self-advocacy

      Self-advocacy relates to one's ability to understand and express wants, needs, rights, goals, interests, etc. Occupational therapists promote self-advocacy and assist individual's ability to advocate whether that be through spoken word, writing or augmentative and alternative communication, often in collaboration with a speech language pathologist.
  • Balance

    Occupational therapists address balance as it relates to an individual’s daily occupations. Balance is required for several important daily tasks, for example, stepping into and out of the shower, reaching for a toy or dish, kicking a ball while playing a game, maintaining a safe seated position at a desk or table, climbing up the steps of the playground at recess, and many more.
    • Sitting

      Sitting balance is important for safety (to avoid falling and to protect body structures) and can impact an individual’s attention to a task. Occupational therapists address sitting balance at all stages of life to improve an individual’s independence completing activities like sitting while tying a shoe, learning in class, sitting at the dinner table, etc.
    • Therapeutic Exercise

      In the simplest terms, therapeutic exercise involves movement prescribed to correct impairments, restore muscular and skeletal function and/or maintain a state of well-being.
  • Bilateral Coordination

    Bilateral coordination is described as using both sides of the body (arms and/or legs) to complete an activity or task. Occupational therapists address bilateral coordination as it relates to an individual's daily activities. Some examples of tasks requiring bilateral coordination include: holding food while cutting with a knife, crawling on the floor while playing with toys, holding a backpack while pulling the zipper, stabilizing a cup while pouring a beverage.
    • Alternating Movements

      Using the two extremities in alternating motions. You will see alternating bilateral coordination with swimming or climbing a ladder. Activities to work on this skill include: Riding a bike; Marching.
    • Dominant Hand / Non-dominant Hand

      Using one hand to perform a task while the other assists is needed for many fine motor skills. This type of bilateral coordination is needed for writing, and cutting with scissors. Activities to work on this skill include: Threading; Lacing cards; Coloring; Writing; Tying shoes.
    • Symmetrical Movements

      Both hands do the same thing at the same time. An example of this would be pulling up pants or socks. Other activities that can work on this skill include: Holding a squeeze bottle with both hands at the midline to paint; Jumping rope; Jumping Jacks; Catching a ball with two hands.
  • Executive Function

    Executive function is a broad term used to describe complex cognitive processes which are used to think, make decisions, plan, and control behavior. Occupational therapists address executive functioning skills in order to help individuals participate in daily activities with as much independence and success as attainable.
    • Attention

      Attention is a cognitive process in which an individual focuses on one or more aspects of his or her environment. There are different types of attention including divided, selective, and sustained.
    • Cognitive Flexibility

      Cognitive flexibility refers to the ability to adjust one’s attention, plans, perspective, etc. This skill is important for participating in groups, with family, throughout unexpected changes and situations, etc. while maintaining appropriate regulation and continued participation.
    • Emotional Regulation

      Emotional regulation refers to the ability to control one’s own emotions in response to events, stimulation, and interactions experienced. In order to regulate emotions, an individual needs to understand his or her emotions and utilize strategies to cope with various emotions so that daily occupations may not be impacted.
    • Foresight

      Helping patient improve their ability to predict what will happen or be needed in the future.
    • Hindsight

      Helping patients better understand a situation or event after it has happened or developed.
    • Impulse Control

      Impulse control is a skill used to resist or control urges, desires, etc. Impulse control is an important skill beginning in early childhood. For example, a child is taught to resist the urge to take a toy from a peer, hit when upset, or run across the street when the ball rolled away. Adults use impulse control to maintain a healthy diet, stay calm when upset or frustrated at work, buy an expensive item at the store, etc. Impulse control is addressed by occupational therapists to maintain safety, positive social relationships, and succeed in daily occupations.
    • Organization

      Organization can refer to maintaining physical organization of materials or organization of thoughts. Organization is important in daily activities in order to stay attentive, aware of one’s schedule and plans, find important or required materials for tasks, and to complete tasks efficiently. Occupational therapists can help individuals determine and utilize strategies for organization in a variety of settings (school, home, work, etc.).
    • Persistence

      Persistence involves sequencing, willfulness, and the ability to learn from experience, and is particularly important when task demands are long-term. It is very important in maintaining effort with tasks that are boring or uninteresting. Goal-directed persistence is one of the last executive functions to mature.
    • Planning

      Planning is a cognitive skill which involves thoughts and ideas which will help reach a goal. Figuring out the steps required to reach the goal are also part of the planning processes. Planning is important in completing everyday tasks such as grocery shopping, completing homework or a project, getting to work on time, etc. Occupational therapists can work on the skill of planning as it relates to any daily routine or activity which is important to an individual.
    • Prioritizing

      OTs help patients learn how to prioritize. Prioritization is the activity that arranges items or activities in order of importance relative to each other.
    • Problem Solving

      Problem solving is an important skill defined as identifying a problem, thinking of strategies to solve the problem and carrying out the strategies. Problem solving is used in daily life and can be addressed by an occupational therapist if there is a deficit or challenge in using this skill, impacting function. Examples of daily activities requiring problem solving include: a student breaking his or her pencil while writing, missing the bus to go to work, missing ingredients for a recipe, etc. Occupational therapists often address the emotional regulation required for dealing with a problem in order to come up with an appropriate solution.
    • Processing Speed

      Helping patients process information more quickly. Processing speed is how long it takes someone to get something done.
    • Self-Monitoring

      The ability to to self-monitor oneself and monitor actions, behaviors, and thoughts as they happen. This also affects one's ability to problem solve.
    • Self-Talk

      OTs teach kids how to use positive self talk as a tool to build confidence, ease anxiety, and help with attention and focus.
    • Shift

      Task switching, or set-shifting, is an executive function that involves the ability to unconsciously shift attention between one task and another. In contrast, cognitive shifting is a very similar executive function, but it involves conscious (not unconscious) change in attention.
    • Task Completion

      Task completion refers to understanding when a task is complete and terminating action toward the task or goal due to completion. Occupational therapists can address this skill in order to help individuals understand the sequence of a task, how to recognize when the task is completing and teach specific tasks or activities to improve independence.
    • Task Initiation

      Task initiation refers to an individual's ability to begin an activity or task. In order to begin a task, the individual must understand what is required, what materials will need to be used, and the first step of the task. This often requires a motor skill as well, for example, reaching for a bowl to initiate preparing breakfast. Occupational therapists can assist individuals who struggle with task initiation through modifying and adapting tasks, providing direct teaching of specific skills required to initiate important tasks and/or providing opportunities to practice the skill with motivating and preferred activities.
    • Working Memory

      Working memory is a skill used to retain information as we work through a task. Working memory is used in the following examples: completing a math problem, playing a game, having a conversation, cooking, and taking notes in class. Working memory is used throughout many daily activities and occupational therapists can address this skill in order to promote independence in individuals of all ages.
  • Fine Motor Skills

    Fine motor skills require the control or coordination of small muscles, involving the hands, often times hands and eyes are coordinated together to complete tasks using small muscles. Occupational therapists address fine motor skills through therapeutic activities for practice and teaching, strengthening, adaption of tasks and/or materials (i.e. pencil grip), and education of specific techniques.
    • Drawing

      Drawing is often used as a prerequisite for handwriting (prewriting). Drawing requires an individual to grasp a writing tool, stabilize the paper, and control the writing tool to produce desired strokes on the paper.
    • Dressing Fasteners

      Fasteners include buttons, snaps, zippers, buckles, velcro, and laces. Fine motor skills are required to manipulate the fasteners. Occupational therapists teach individuals to manipulate fasteners, educate on strategies or modifications when there are fine motor delays or difficulties, and adapt the fasteners as needed for an individual to be independent.
    • Manipulation Skills

      In hand manipulation is used when using one hand to pick up and utilize an object or multiple objects. Examples of in hand manipulate skills include: turning the pencil from writing side to eraser using only the dominant hand, holding coins in hand and placing one coin at a time into a piggy bank, and passing out papers in the classroom.
    • Pincer Grasp

      Pincer grasp is defined as using the tips of the thumb and index finger to pick up and hold small objects. Individuals across all ages use a pincer grasp to complete tasks including the following examples: picking up small food items or toys and manipulating fasteners.
    • Pre-writing / Copying / Drawing

      Pre-Writing skills involve a child tracing and forming proper strokes (horizontal, vertical, and diagonal lines). Success with tracing and pre-writing skills can have a positive effect on handwriting abilities, as tracing lines are the prerequisite to letter formation. Pre-writing skills are the fundamental skills children need to develop before they are able to write. These skills contribute to the child’s ability to hold and use a pencil, and the ability to draw, write, copy, and colour. A major component of pre-writing skills are the pre-writing shapes. These are the pencil strokes that most letters, numbers and early drawings are comprised of. They are typically mastered in sequential order, and to an age specific level. These strokes include the following strokes: |, —, O, +, /, square, X, and Δ.
    • Scissor Skills

      Scissors skills require vision and fine motor skills to be used in coordination. Occupational therapists address an individual's ability to place the scissors into the hand accurately, manipulate the scissors (open and close), line up the scissors with the paper/line/etc., and hold/manipulate the paper or object with the opposing hand while cutting.
    • Self-care

      Self-care is any necessary human regulatory function which is under individual control, deliberate and self-initiated.
    • Stacking Blocks

      Stacking blocks is a play task and often used as a therapeutic activity to address and develop fine and visual motor skills. An individual must pick up, manipulate, and place the block using small muscles in the hand and vision for accuracy.
    • Stringing Beads

      Stringing beads is a play task and often used as a therapeutic activity to address and develop fine and visual motor skills. Stringing beads requires a pincer grasp to pick up and place the bead on the string, a pincer grasp to hold the string and visual skills to align the bead with the string to place with accuracy.
    • Typing

      Typing has become an important skill for students and adults. Typing requires fine motor skills to press the keys and visual skills to find the accurate keys and place the hands correctly. Typing is often addressed in occupational therapy when an individual has difficulty with legible handwriting and is used as an adaptation to written expression. Typing may be addressed when an individual has difficulty accessing or utilizing a keyboard as occupational therapists can adapt and modify the task to increase independence.
    • Writing

      Writing is a complex visual motor task used throughout the lifespan. Writing requires fine motor skills to grasp and manipulate writing tools and paper. Vision is incorporated when writing to print within lines, copy and/or form letters with accuracy, use accurate spacing between letters/words, and accurately align writing on paper (horizontally, write left to right, etc.). Occupational therapists address handwriting using direct teaching of the skill, adapting or modifying tools and tasks, or finding alternative forms for written expression (i.e., voice to text into a computer).
  • Gross Motor Skills

    Gross motor skills require the control and coordination of large muscles in the body often including the arms and/or legs. Occupational therapists address gross motor skills as they relate to important daily routines and activities for example: a child participating in recess or physical education, an adult transferring into and out of the shower, a child sitting on the floor for learning. Occupational therapists may collaborate with physical therapists when implementing interventions and strategies to improve gross motor skills.
    • Crossing Midline

      Crossing midline refers to moving an arm or leg across the middle of the body. Crossing midline is used in the following examples: reaching with the dominant hand to the opposite side to pick up and object, writing from left to right across a piece of paper without switching hands, and kicking a ball in the opposite direction of the dominant foot. Crossing midline is an important skill to develop to allow both sides of the brain to work together.
    • Motor Planning

      Motor planning or “praxis” is planning and carrying out a motor movement or sequence. Motor planning is required in any action we make that is not reflexive or automatic. Motor planning is required for fine and gross motor activities.
    • Movement Changes

      The ability to change from one type of movement (involving large muscles in the body) to another.
    • Sequencing

      Sequencing is used when completing multi-step gross motor actions. Sequencing also requires motor planning. Occupational therapists often address gross motor sequencing skills through games and obstacle courses.
  • Handwriting

    Handwriting is a complex task used throughout the lifespan. Writing requires fine motor skills, visual motor skills, attention, sensory processing, efficient posture and set up of materials, visual memory, bilateral coordination, and visual processing skills. Occupational therapists address handwriting using direct teaching of the skill, intervention to address underlying deficits, adaptations or modifications of tools and activity demands, or alternative forms for written expression (i.e., voice to text into a computer).
    • Letter Formation

      Letter formation refers to the way in which a letter is printed or written. Letters are meant to be formed from top to bottom and left to right. Letters are formed using prewriting strokes such as horizontal and vertical lines, diagonal lines, and curved lines. An individual should be able to form prewriting stokes prior to being taught how to write letters.
    • Line Awareness

      When writing on lined paper, it is important to be aware of the lines provided to ensure accurate letter size, placement and spacing. Delays or difficulties with vision may impact line awareness and require intervention or adaptation.
    • Pencil Grasp

      Grasp is a developmental skill and begins at a young age. Children may begin to grasp writing tools with their whole fist (1-2 yrs) and move through the developmental stages of grasp including: Digital pronate grasp (2-3 yrs), 4 finger grasp (3-4 yrs), static tripod grasp (4-6 yrs) and eventually use a dynamic tripod grasp (6-7+ yrs). As the grasp develops, more fine motor control is available to write precisely.
    • Scribbling

      Scribbling is a prewriting skill typically developed around 1-2 years. Scribbling is beneficial in helping children become interested in drawing and using writing tools.
    • Spatial Awareness

      Spatial awareness is used when writing to determine the size of letters, when to move to the next line, how close the letters should be printed, etc. Occupational therapists often provide visual cues or adaptive paper to help individuals increase spatial awareness when handwriting.
  • Instrumental Activities of Daily Living

    Activities in which a person engages with his or her environment in order to maintain independent living. Instrumental activities of daily living are often not engaged in until later in childhood, the teenage years or early adulthood. IADLs include care of others, child rearing, care of pets, communication device use, community mobility, financial management, health management and maintenance, home establishment and management, meal preparation and clean up, religious observance, shopping, and safety procedures and emergency maintenance. Occupational therapists can address any and all IADLs including underlying skills required in order to promote independent living.
    • Health Management and Maintenance

      Health management includes engaging in routines for wellness like getting exercise, eating required nutrients, taking medications as prescribed, and maintaining health by setting up and attending required medical visits and following required health routines.
    • Home Management Activities

      Home establishment and maintenance includes taking care of one’s living space, possessions (clothing, vehicle, appliances), yard, land, etc.
    • Safety Procedure and Emergency Responses

      Safety procedure and emergency maintenance refer to promoting a safe environment, attending to and responding to an emergency, and taking action following an emergency.
  • Neuromuscular Retraining

    Neuromuscular retraining focuses on improving the strength, timing, coordination and force production of muscles affected by injury.
    • Postural Stability

      Postural stability is the ability to control the body position in space for the purpose of movement and balance and to maintain an upright position.
  • Play

    Play is an important occupation for children to provide learning, development, and joy. Play is activity engaged in by people across the lifespan providing fun, entertainment and enjoyment. Play can be completed individually or with others. Pediatric occupational therapists often focus on play as an intervention and a goal to promote learning, skill development, social participation, and regulation.
    • Imaginative

      Imaginative play, or "make-believe", occurs when a child role-plays experiences of interest, such as playing 'house' with their toys. There are various benefits that imaginative play contributes to a child's development. Children engage in imaginative play alone or with others.
    • Independent

      Solitary play, sometimes called independent play, describes when children are playing by themselves independently of other children and are solely focused on themselves instead of others. Independent play is also a stage that older preschoolers and children choose to engage in after they know how to play with others, proving just how valuable this skill is. Independent play is one of Mildred Parten's six stages of play.
    • Parallel

      Parallel play is a form of play in which children play adjacent to each other, but do not try to influence one another's behavior. Children usually play alone during parallel play but are interested in what other children are doing.
    • Peer

      Peer play provides a context in which children can learn skills from more advanced playmates, and is associated with cognitive growth. Interactions with peers provides opportunities for development of a variety of skills that support children's academic and social competence.
  • Praxis

    Motor planning or “praxis” is planning and carrying out a motor movement or sequence. Motor planning is required in all skilled, intentional actions. Motor planning is required for most daily activities. Occupational therapists address praxis or motor planning as it impacts the participation and/or independence in an individual’s meaningful occupations.
    • Execution

      Execution of a task includes physically performing the sequence of movements planned. An individual may plan to brush his or her hair and execution of the task would include picking up the brush, bringing the brush to hair and brushing all sides of his or her head.
    • Ideation

      Motor ideation refers to planning a motor sequence or movement. An individual must first plan the movement or sequence prior to execution of the plan.
    • Motor Planning

      Motor planning or “praxis” is planning and carrying out a motor movement or sequence. Motor planning is required in all skilled, intentional actions. Motor planning is required for most daily activities. Occupational therapists address praxis or motor planning as it impacts the participation and/or independence in an individual’s meaningful occupations.
  • Self-regulation

    Self-regulation refers to the ability to monitor and/or control one’s own emotions, responses and behavior in response to events, sensory stimuli, and interactions experienced. Self-regulation is a cognitive, developmental and sensory based process. Self-regulation is required to engage appropriately in important daily routines and activities, maintain attention, respond to overwhelming, unexpected, aversive sensory stimuli (i.e., by removing stimuli, self, or using strategies), and interact with others. It is important for an individual to sense and understand how he or she is feeling, understand triggers which impact regulation, and utilize strategies and tools to maintain regulation.
    • Coping Skills

      Coping skills refer to the strategies or tools one can use when he or she is dysregulated or not-regulated or in order to prevent dysregulation. Occupational therapists work with individuals across the lifespan to identify and utilize appropriate coping skills based on personal preferences and needs. Examples of coping skills used include the following: deep breathing, mindfulness or meditation, exercise, eating a snack or drinking water/coffee, etc., listening to music, coloring, and so many more.
    • Deep Breathing

      A technique to lower stress and to calm the mind, done by expanding the lungs and forces better distribution of the air into all sections of the lung.
    • Mindfulness

      Mindfulness is a human ability to be fully present, aware of where we are and what we're doing, without interpretation or judgment. Practicing mindfulness involves breathing methods, guided imagery, and other practices to relax the body and mind and help reduce stress.
  • Sensory

    Sensory processing refers to the way we take in, interpret and respond to the information in our environment. We obtain sensory input in many ways through different sensory systems including vision, hearing, touch, taste, and smell. Three additional sensory systems are not as obvious/well known and include proprioceptive, vestibular and interoceptive. Occupational therapists work on sensory processing skills when an individual’s participation in important daily activities is impacted by challenges processing information in one or several of these areas.
    • Auditory

      Auditory processing is the way in which we take in and interpret what we hear. Examples of auditory processing challenges include the following examples: Difficulty noticing when one’s own name is being called, difficulty attending to verbal instructions, inability to block out background noise impacting attention, and constantly making sounds or noises to a point of disrupting participation in the task at hand.
    • Interoception

      Interoception refers to the body’s ability to recognize and interpret sensations inside the body. Interoception is used to determine when one needs to use the bathroom, eat a snack or meal, drink water, rest or nap, etc. Examples of signs of challenges in interoceptive processing include the following: difficulty learning to potty train, difficulty determining when one is full, difficulty differentiating between hunger and thirst, and difficulty determining when the body needs a break or rest from physical activity.
    • Olfactory

      Olfactory processing is the way in which we take in and interpret what we smell. Examples of olfactory processing challenges include the following examples: inability to smell or notice hazardous smells (i.e, gas, fire), and heightened sensitivity to smells causing nausea/inability to be in a required space or try new foods.
    • Proprioception

      Proprioception, also referred to as kinaesthesia, is the sense of self-movement and body position. It is sometimes described as the 'sixth sense'.
    • Reflex Integration

      Reflex integration is about using tools to develop and mature the body's reflexes for optimal functioning.
    • Tactile

      Tactile processing is the way in which we take in and interpret what we touch and physically feel. Examples of tactile processing challenges include the following examples: inability to notice extremely hot or extremely cold temperatures, difficulty tolerating the feel of pants or long shirts in the winter, becoming dysregulated when hands or face are messy during mealtime, and limited tolerance of various food textures impacting participation in meals.
    • Vestibular Sensory Input

      The vestibular system operates through receptors in the inner ear and in conjunction with position in space, input from the eyes, and feedback from muscle and joint receptors, is able to contribute to posture and appropriate response of the visual system to maintain a field of vision.
    • Visual

      Visual sensory processing is the way in which we take in and interpret what we see. Examples of visual processing challenges include the following examples: difficulty focusing on important information in a busy environment, difficulty understanding/following written or visual instructions, failing to notice important information when driving (I.e., red vs green light), and becoming overwhelmed or dysregulated with bright lighting.
  • Visual Motor Skills

    The ability to observe, recognize, and use visual information about forms, shapes, figures, and objects makes up our visual motor abilities. Visual motor skills include a coordination of visual information that is perceived and processed with motor skills, including fine motor, gross motor, and sensory motor. Occupational therapists address visual motor skills through therapeutic activities for practice and teaching, strengthening, adaption of tasks and/or materials (i.e. pencil grip), and education of specific techniques.
    • Design Replication / Puzzles

      Design replication and puzzles are ways to help patients build their visual motor skills.
    • Eye-Hand Coordination

      Using the visual input effectively and efficiently with the hands allows us to manipulate and manage objects and items. This coordinated motor skill requires fine motor skill development. These motor skills allow us to collect visual information and use it in a motor action. Eye-hand coordination requires fine motor dexterity, strength, shoulder stability, core stability, etc. Examples of eye-hand coordination include catching a ball, manipulating pegs into a pegboard, lacing a lacing card, etc. Visual motor skills both require and utilize eye-hand coordination, however the overarching visual motor skills utilize additional components and are a higher level skill.
    • Visual Perceptual Skills

      Visual perception is our ability to make sense of what we see. Visual perceptual skills are essential for everything from navigating our world to reading, writing, and manipulating items. Visual perception is made up of a complex combination of various skills. Visual perceptual skills include visual memory, visual closure, form constancy, visual spatial relations, visual discrimination, visual attention, visual sequential memory, and visual figure ground.
    • Visual Processing Skills

      These skills include how the eyes move and collect information. These are visual skills that take in and use the information in order to process that input. Visual skills include visual tracking, convergence, saccades, visual fixation, and visual attention. A component of visual processing includes visual efficiency. This refers to the effective use of that visual information.
• Physical Therapy (PT)

  • Assisted Device

    Any device that a patient uses to assist them developmentally or physically.
    • Augmentative and Alternative Communication

      Physical therapists can encourage the patient to use their AAC devices by using them during the PT sessions to ask for specific tasks, exercises, and/or rewards.
    • Compliance

      It is important to keep track of the patient’s use of their assisted device. Are they wearing their foot orthotic or helmet the appropriate amount of hours a day? Are they doing their home exercise program and following through at home?
    • Crutch Training

      There are multiple types of crutches and different ways to use them. PT’s make sure you have the right style of crutch that is fitted properly for you and ensure that you are using it the right way. Sometimes you can use both feet, sometimes only one!
    • Device Management

      PT’s can help make sure all you devices are working and fitting you properly including, but not limited to, wheelchairs, standers, gait trainers, orthotics, etc.
    • Orthotic

      Orthotics can be made to give you support at your foot, ankle, knee, hip, back, neck, and/or head. PT will assess the patient’s need for extra stability. These can be: an SMO or AFO- both types of foot orthotics; HKFO- large device that covers the ankle to hip typically after surgery or a stroke; TLSO- back brace after surgery or for scoliosis. Another type of need is a cranial orthotic- for babies that have flat spots on their heads (most commonly plagiocephaly or other forms of -cephaly).
    • Positioning

      Positioning is important for all of our patients for various reasons. Different seating options at school for good posture, various seat and back cushions for wheelchairs to prevent pressure points, and giving new parents different positions to play with their newborn to encourage safe development and/or prevent head preferences and flat spots.
  • Balance

    The ability to stay upright when sitting or standing without falling over. Balance is looked at statically (sitting or standing still) and dynamically (sitting or standing while moving or being moved) and eyes open vs eyes closed. There are three main things our body uses to maintain balance: proprioception (knowing where your feet are), vision (seeing where you are), and vestibular (the rocks and fluid in your ear).
    • Kneeling

      Kneeling in various positions challenges our balance and engages our core and leg muscles. Different types of kneeling follow from easiest to hardest: short kneel (sitting on heels), tall kneel (toes and knees on floor with bottom not resting on heels), half kneel (start in tall kneel and bring one foot up and place it in front of you).
    • Protective Response Safety

      As newborns become infants, they have reflexes to help them keep balance. These safety responses can be seen when a baby is sitting in the floor. If they fall sideways, they’ll place their arm down to their side. If they fall backwards, hands go back; if they fall forward, hands go forward to catch them. These responses are learned as babies and follow us through adulthood.
    • Reaction Strategy

      There are three main reaction strategies we use to catch ourselves if we fall. Ankle strategy - using our ankle and lower leg muscles to respond to a small loss of balance (like when you're trying to stand on a trampoline and not move). Hip strategy - using our bigger leg muscles to react to a bigger push or to stop ourselves from moving (like when you bend your hips and knees to get lower to the ground to steady yourself like on a skateboard). Stepping strategy - when you step to the front, side, or back to catch your balance (like if brother gets mad and shoves you real big).
    • Single Limb Stance

      Single Limb Stance ("SLS") is when one stand on one leg. This is practiced a lot in PT because you stand on one leg a lot during normal activities - like walking, going up stairs, and climbing bleachers at school.
    • Sitting

      Sitting balance is important for staying upright in a chair or when sitting on the floor. It takes a lot of coordination of our ab and back muscles to stay upright for any period of time statically and dynamically.
    • Standing

      Standing balance is important for staying upright when we're standing. This can be when we're first learning how to stand while holding onto parent's fingers, and it can be when you’re a big kid trying to stand and move in line for lunch. It uses a lot of muscles in our whole body to stand statically and dynamically.
    • Vestibular Rehabilitation

      Our balance can feel off or it feels like the room is spinning and you feel dizzy. Sometimes this can last for a few seconds (like getting off a spinning swing), but sometimes it can last for days at a time. When this happens, PT can help re-train your vestibular system, which is inside your ears! We help build all 3 areas in our body that help with our balance.
  • Bilateral Coordination

    The ability to use both sides of your body at the same time and making them do the same or opposite thing.
    • Alternating Movements

      PT helps make sure your body will perform alternating movements - like when you take a step with your right foot and your left arm swings forward or marching in place. This is controlled by your brain and its ability to do two things at once.
    • Dominant Hand / Non-dominant Hand

      Most everyone has a dominant hand we write with or throw a ball with, but we want to make sure we can use both hands when we need to. Some things we do with both hands is catch a big ball or hold our lunch tray as we carry it to the table. PT can help us strengthen our non dominant hand/arm to make sure we can do these things with both hands.
    • Symmetrical Movements

      This is our brains ability to use both hands or both feet (or our right arm and leg or our left arm and leg) to do something - think of jumping jacks, dribbling a ball with two hands, or jumping down from a step with both feet. PT helps make sure we can use both sides or both arms or both feet at the same time. If you can't do it at the same time, it might because the sides of our brain aren't talking to each other like they should or it could be that one side is stronger than the other.
  • Gait

    Gait analysis is the medical term to watching someone walk. PT does gait analysis on most every patient because we can gather so much information from this analysis.
    • Mechanics

      Gait mechanics describes what our joints are doing when the muscles move them. This can be looking at the arches of the foot, how your knees line up over your ankle, and how much movement occurs at the hips and trunk. If there is an issue with any of the gait mechanics, there are various ways to address it - with orthotics, exercises, and assisted devices. Within gait analysis, we are also looking at gait speed (how fast or slow you walk), step length, stride length, step time, step width, and how the muscles contract and relax during each part of gait.
    • Patterns

      There are lots of gait patterns that we see with our patients. Some are normal gait patterns, but some are atypical. Some atypical gait patterns we address follow: toe walking, in-toeing, out-toeing, Trendelenburg, ataxic gait, stuttering gait, waddling gait, and limping (antalgic gait). PT s can teach a patient a new, energy efficient gait pattern when using crutches or when going up and down stairs.
    • Phases

      Gait occurs in two phases, the part where you're standing on one leg (stance phase) and the part where you're swinging one leg to step forward (swing phase). In each phase, we look at each part to make sure it's symmetrical on each leg and there's no altered gait mechanics. During stance phase (which is standing on one leg and makes up 60% of the gait cycle), there's initial contact, loading response, midstance, terminal stance. During swing phase (which is when your leg is moving forward to take a step), there's pre-swing (toe off), initial swing, mid-swing, terminal swing.
    • Retraining Exercises

      With all these phases and patterns and mechanics of gait, there's a lot that can go wrong. PT 's are known for improving gait patterns (with or without an assisting device or orthotic). We do this through various exercises, activities, and stretches to retrain gait patterns.
  • Gross Motor Skills

    These are skills that typically developing kids should reach along a certain timeline as part of a child's motor learning. By the time they reach two years of age, almost all children are able to stand up, walk and run, walk up stairs, etc.
    • Ambulation

      Walking is usually seen by 18 months of age, but that's not where ambulation stops! PT also looks at walking up and down stairs, walking backwards, walking up and down ramps, walking over pliable surfaces (like grass, mulch, or trampolines), walking with adult patterns of gait, and running. If there's any difficulty in reaching these other walking milestones, that is when PT steps in to help correct and advance.
    • Ball Skills

      Ball skills start in infants throwing a ball and advance through catching a ball one handed. For PT, we look at our patients ability to and mechanics of throwing, catching, dribbling, and shooting a ball as they grow.
    • Milestones

      Infants, babies, and toddlers have a long list of developmental milestones that they reach during those first few years of life. If there is any delay of a child reaching a developmental milestone, PT is involved to catch them up! This could be a baby who doesn’t want to roll over or crawl, or it could be a toddler who isn’t able to step up a staircase or jump off a small step. Each milestone is important and PT wants to ensure your child checks them all off.
    • Transitions

      Transitions in PT are considered ways a child moves from one position to another. Example of transitions are: moving from sitting on a chair to standing, moving from sitting on the floor to laying on your belly, moving from a crawling position to standing up at a piece of furniture, and so on.
  • Neuromuscular Retraining

    Neuromuscular Retraining is focused on teaching the brain. Our brain is in two halves and we need both halves to talk to each other. When these two halves talk to each other, we are able to move smoothly and know where our body parts are in space without having to look at them.
    • Body Awareness

      Some kids have poor body awareness. These kids may appear clumsy, they trip frequently, have difficulty with hand eye coordination, and tend to run into other people in the hallways at school. PT can help connect our brains and our body parts to help these kids improve their ability to know what their body is doing, which decreases those clumsy tendencies.
    • Coordination

      With each part of our brain talking to each other and relaying information through our nervous systems to our muscles, it can take a lot of brain power to coordinate movements. Some of these coordinated movements come easy, like walking, but some of them are hard, like patting your head and rubbing your tummy. PT wants to make sure that all of these things are coordinating with each other.
    • Crossing Midline

      Midline is an imaginary line that runs from the top of your head to the bottom of your feet - imagine a line running from your nose to your belly button and all the way down between your feet. When we cross midline, that means that our right hand crosses over that imaginary line to the other side. This task helps both sides of our brain talk to each other which increases balance, body awareness, and coordination.
    • Proprioception

      Proprioception is the ability to close your eyes and know where a body part is without opening your eyes, even if someone moves that body part. It's knowing where your body is in space. This is important so we can move easily around lots of obstacles without tripping.
    • Weight Bearing

      Weight bearing refers to how much weight a person puts through an injured body part.
  • Nutrition

    Nutritional therapy, under the supervision of a physical therapist, addresses the appropriate nutritional intake and eating patterns of patients. It is important to address nutritional concerns in physical therapy when there is a recovery period after an injury or if an individual is gaining new functional expertise.
    • Amount / Intake

      PTs should be concerned with and address nutritional intake and eating patterns of their patients and clients.
    • Eating Patterns

      One's eating pattern is the quantity, variety, or combination of different foods and beverage in a diet and the frequency with which they are habitually consumed. PT's can help a patient improve their eating patterns.
    • Weight Management

      Weight management describes both the techniques and underlying physiological processes that contribute to a person's ability to attain and maintain a certain weight. Most weight management techniques encompass long-term lifestyle strategies that promote healthy eating.
  • Pain

    For acute (recent injury) or chronic (present longer than 3 months) pain treatment, physical therapy can use different things to decrease pain while doing every day tasks.
    • Cold Laser Therapy

      Cold laser therapy is low-intensity laser therapy that stimulates healing while using low levels of light. The technique is called “cold” laser therapy because the low levels of light aren't enough to heat the body's tissue.
    • Manipulation of Joints and Bones

      Joint and bone manipulation is a type of passive movement of a skeletal joint. It is usually aimed at one or more 'target' synovial joints with the aim of achieving a therapeutic effect.
    • Manual therapy

      Using hands or tools on soft tissue
    • Massage

      Massage therapy is a therapeutic hands-on treatment used to manipulate soft tissue in the body, including muscles, ligaments, joints, tendons, and connective tissue in order to alleviate chronic pain.
    • Microcurrent Stimulation

      A microcurrent electrical neuromuscular stimulator or MENS is a device used to send weak electrical signals into the body. It is used primarily for the management of acute, chronic, and post-operative pain.
    • Movement Therapy and Exercise

      Patients learn to move from a stable, central core. The physical benefits of movement therapy include greater ease and range of movement, increased balance, strength and flexibility, improved muscle tone and coordination, joint resiliency, cardiovascular conditioning, enhanced athletic performance, stimulation of circulation, prevention of injuries, greater longevity, pain relief, and relief of rheumatic, neurological, spinal, stress, and respiratory disorders.
  • Praxis

    Praxis is planning and sequencing a movement; it’s the ability to think about what you want to do (ideation), how you will do it (motor planning), and then using muscles to do it (execution). To plan and sequence a movement, we need our brain to take in information from all our senses and organize it. After it's organized, we are able to perform a task. A new task is hard until we practice it over and over again. Eventually, a task will be loaded into our brain and we will barely think about doing it. For example: Brushing your teeth or walking up steps. At first, these tasks are hard and look clumsy, but eventually we just do it without thinking.
    • Coordination

      Being able to integrate multiple movements into one efficient movement. When you stand from a chair, you have to put your feet on the floor, lean forward, push with your legs, then straighten your back. Multiple movements happen quickly to become one big movement. Some kids have difficulty coordinating all the smaller movements into one big one. PT can help break down bigger tasks into smaller tasks to improve coordination.
    • Execution

      Execution is when your brain communicates with your muscles via nerves, and when your muscles move to actually do the task. PT can help your child to perform tasks by given tactile/physical cues to move a certain body part at a certain time.
    • Ideation

      This requires a child to think about, visualize, or watch the task they want to do. Once they know what they want to do, they can move to the next step. If your child has difficulty visualizing a task, the task can appear clumsy or uncoordinated or your child may be labeled as lazy or lack safety awareness. PT can help by showing the child picture cards, demonstrating a task, and helping talk them through the task.
    • Motor Planning

      Motor planning is figuring out how your body will move to perform a task by taking each step, sequencing it appropriately and timing it to perform body movements smoothly. This is similar to coordination but looks at the brains ability to remember each step in a task and make it a set plan to happen every time. Physical therapy can help a child improve their ability to motor plan by breaking down big steps into tiny steps, giving your child different or similar tasks to complete, and providing sensory input.
  • Range of Motion

    Physical therapists work with patients to assess and improve the range of motion of muscles by keeping them strong and flexible. Range of motion exercises are typically divided into active range of motion (AROM) or active-assisted range of motion (AAROM) if assistance is required.
    • Active

      These exercises involve very little assistance from the physical therapist. The patient is entirely capable of performing these exercises, and most often, the therapist’s involvement is limited to verbal cues and directions on how to improve the posture and movement involved in the exercises.
    • Active Assist

      These exercises involve partial assistance from the therapist. The patient does most of the movement, but they get a little help to complete the movements correctly. In most cases, this restricted motion is a result of weakness or pain caused due to falls, bruises, or accidents, up to serious injuries.
    • Passive

      In passive range of motion exercises, the patient does not perform any movement themselves; instead, the therapist moves the limb or body part around the stiff joint, gently stretching muscles and reminding them how to move correctly.
  • Strength

    Physical therapists use strength training exercises to improve mobility, manage pain and chronic conditions, recovery from injury, and/or prevent future injury or chronic disease. A PT will work with the patient to develop a personalized plan to strengthen muscles, improve the cardiovascular system, control body weight, benefit mental health, encourage socialization, and reduce the risk of chronic disease.
    • Core

      Our abdominal muscles and back muscles have to work together so our bodies can sit, stand, or move. When our core strength is weak, babies tend to fling themselves backward in sitting or school kids have a difficult time sitting in their desk all day without squirming around. PT focuses on improving core strength in all ages.
    • Endurance

      Our muscles may be strong for a few seconds to jump really high, but that doesn’t mean they have the endurance to jump over and over again. PT works on strengthening our muscles so that they can last a long time- like running on the playground or climbing a big set of stairs.
    • Lower Extremity

      Lower extremity strength, or leg strength, is important for moving and walking safely. PT works on strengthening patient’s legs so they can jump with both feet at the same time, walk over various surfaces without falling, step over obstacles without hitting your toe, and walk with good bony alignment and support. PT helps build leg strength with exercises and activities that target muscles in the hips, glutes, thighs, calves, and feet.
    • Mobility

      The ability to move around without compensation or pain. Mobility is important for all ages. For babies, mobility includes rolling, moving in a circle on their belly, crawling, taking sideways steps when holding onto furniture, and eventually walking. For kids, mobility is how well they can move from sitting or standing, climbing over obstacles, moving between desks at school, etc. There are lots of reasons a baby or child can have issues with mobility, and PT can help build the strength and endurance to improve mobility.
    • Sitting

      When a baby struggles to sit alone, PT can work on strength and balance exercises. When a child struggles with sitting in the floor or in a chair, PT can help work on core strength and leg stretches to make sure the child can sit for long periods of time with good trunk control.
    • Stability / Balance

      Balance is important when sitting, standing, and moving. We want our patients to feel stable in all of those positions. PT helps strengthen postural muscles to improve stability in any position.
    • Symmetry

      When we look at a patient, we want the right side of their body just as strong as the left side. We also want their front muscles as strong as their back muscles. When all these things are equal, we are symmetrical. In babies, PT works on bringing both hands to the middle, making sure they use both hands to catch themselves, and making sure they are putting weight through both feet when in standing. For kids, we look at their ability to throw and catch a ball, jumping off a step with feet together, and how they walk up the stairs.
    • Total Body / Gross / Overall

      Overall body strength is important so we can use body parts or our body as a whole to perform a task. Overall body strength is worked on in physical therapy by doing tasks that require large muscle groups, such as jumping on the trampoline, squats, going up and down the stairs, and climbing over obstacle courses.
    • Upper Extremity

      Our upper extremities is our arms. PT works both arms to make sure patients are strong enough to use both arms for any task, like climbing a ladder or crawling. PT works on upper extremity strength by doing exercises with the shoulders, upper arm, forearm, and hands.
• Feeding Therapy (FT)

  • Augmentative and Alternative Communication

    Items such as visual schedules, manipulatives, sign, or pictures to assist in the set-up, process, or clean-up of a mealtime.
    • Aided Communication

      Aided modes of communication include those approaches that require some form of external support, such as a communication boards with symbols (e.g., objects, pictures, photographs, line drawings, visual-graphic symbols, printed words, traditional orthography) or computers, handheld devices, or tablet devices with symbols that generate speech through synthetically produced or recorded natural (digitized) means.
    • Unaided Communication

      Unaided modes of communication include nonspoken means of natural communication (including gestures and facial expressions) as well as manual signs and American Sign Language (ASL). These modes of communication often require adequate motor control and communication partners who can interpret the intended message.
  • Behavior

    Common behavioral concerns faced by parents include: solid or liquid refusal, physical and verbal protest, refusal to self-feed, throwing food, expelling food, gagging or coughing, selectivity by texture, type or color, as well as vomiting. Research on this subject has determined that there are three common consequences that maintain the problematic behaviors surrounding feeding disorders. They include providing escape (e.g. ending the meal, or removing the non-preferred food), attention (can be in the form of coaxing, comforting, or reprimands) or access to preferred items or food, with escape being the most common consequence following problematic mealtime behavior.
    • Appropriate Seating

      Related to the type of seating used when child is at mealtime. Appropriate seating considers factors such as foot support, trays, trunk support and positioning, location to family at mealtime, and location relative to feeder if applicable.
    • Cleanup

      Skills such as putting plates and utensils in a bin or in sink, washing hands, wiping table/tray, and cleaning face after a mealtime has ended.
    • Coughing

      Food or liquid penetrating or aspirating, leading to coughing to clear the airway.
    • Expelling Food

      Food exiting anterior barrier of lips; mostly “spitting out” of unwanted food items.
    • Gagging

      Sensory reflex when unwanted food is presented or when sensory system is hyperactive with substances entering the oral cavity.
    • Meal-time Behavior / Family and Social Interaction

      Behaviors such as socializing about day, passing plates to family members, remaining at table, keeping calm voice, no refusals/bargaining.
    • Physical or Verbal Protest

      The act of pushing food off table or plate, physically pushing away utensils presented, or verbally yelling, squirming, or saying “no” to food presentation.
    • Refusal to Self-feed

      Relying on caregiver or others to present utensils and not willing to use utensils or bring food to mouth on their own.
    • Selectivity by Texture

      Client’s preference to eat specific texture group such as crunchy, crumbly, puree, or soft while avoiding another group of textures.
    • Solid or Liquid Refusal

      Refusing to accept presentations of certain solids or liquids.
    • Throwing Food

      Flinging or throwing food items off of plate, off of tray, or across the room to avoid eating and demonstrate refusal.
    • Tolerance

      Ability to have new foods introduced or unwanted foods in the eating space without demonstrating negative behaviors.
    • Vomiting

      Regurgitation of previously swallowed foods or liquids. May be a sign of gastrointestinal upset.
  • Fine Motor Skills

    Smaller muscle coordination needed to perform appropriate motor movements for swallowing.
    • Bottle Feeding

      Tongue, jaw, lip, and cheek movements for appropriate suckle to get milk from breast or bottle nipple.
    • Utensil Use

      Ability to grasp utensils, get food on utensil, bring to mouth, place in mouth, and remove foods from utensil.
  • Nutrition

    Nutrition therapy addresses barriers to achieving appropriate nutrition for growth. An occupational or speech therapist will work with the the patient and caregivers to address the barriers to proper nutrition whether they are based on sensory or swallowing issues.
    • Amount / Intake

      The volume and variety of food required to meet nutritional needs
    • Expanding Variety

      Taking a restricted diet and adding different textures, temperatures, food groups, or brands to better meet nutritional needs.
    • Malnutrition

      The lack of proper nutrition due to restricted diet, intake, or variety. Malnutrition can lead to many negative health effects and impact overall development.
  • Oral Motor Skills

    Oral motor skills include awareness, strength, co-ordination, movement and endurance of the mouth; jaw, tongue, cheeks and lips. The ability to move oral structures appropriately for various feeding steps.
    • Bottle Feeding

      Coordination of oral structures (including, but not limited to cheeks, fat pads, tongue, lips, and jaw) to be able to close around bottle nipple, draw milk, suckle, coordinate suck-swallow-breathing, and release to feed.
    • Breast Feeding

      Coordination of oral structures (including, but not limited to cheeks, fat pads, tongue, lips, and jaw) to be able to latch, draw milk, suckle, coordinate suck-swallow-breathing, and release to feed.
    • Cheeks

      Necessary movements include motion to assist in navigating food in the oral cavity such as placing food between the teeth for chewing, and to assist other structures in performing duties for swallowing and bolus management. Fat pads in cheeks of infants assist in ability to latch to breast/bottle.
    • Chewing

      Mastication including developing from munching to a rotary chew as a child develops.
    • Jaw

      Necessary movements include rotary, up/down, and lateral for mastication. Chewing patterns strongly relate to movement of the jaw. Jaw must be dissociated with the tongue movements for appropriate bolus control and swallowing.
    • Lips

      Necessary movements include lip closure to utensil, ability to hold bolus without anterior spillage, and assist in sucking.
    • Open Cup Drinking

      Ability to coordinate oral structures to close over cup edge, tip cup, control bolus, coordinate swallow, and release from cup without anterior spillage.
    • Range of Motion

      Oral structures and their coordinating ability to open wide enough and close small enough to perform feeding and drinking actions.
    • Straw Drinking

      Ability to close lips around straw, use oral structures to coordinate sucking motion, and release without anterior spillage or posterior spillage in uncontrolled swallow of liquid bolus.
    • Tongue

      Motion to lateralize food to molars when chewing solids and to press on bottle or brease nipple to draw out milk.
  • Sensory

    Sensory therapy addresses the processing, visual, and motor challenges apparent in individuals requiring feeding therapy. Therapy strategies address tolerating, interacting, touching, smelling, tasting, chewing, and swallowing non-preferred foods.
    • Gustatory

      Sense of taste.
    • Olfactory

      Sense of smell.
    • Tactile

      Sense of touch/pressure.
    • Visual

      Sense of sight.
  • Swallowing

    Therapists utilize a combination of Compensatory Techniques and Direct Treatment strategies to improve the safety of oral intake by reducing the risk for aspiration while maintaining quality of life. Compensatory Techniques are used to increase control of the swallow to protect the airway and reduce aspiration risk. These include positioning strategies to redirect the movement of food or liquid in the mouth and throat safely to the esophagus, swallowing maneuvers which change the timing or strength of the movements of swallowing to safely move food or liquid in the mouth and throat safely to the esophagus, and modification of food and liquid consistencies to improve control of allow for safe oral intake. Direct Treatment involves the completion of exercise to improve range of motion, coordination, and the strengthening of muscles of the jaw, lips, cheek, tongue, soft palate, and vocal cords to improve swallow function.
    • Behavioral Approaches

      Using a series of positive/negative rewards/punishments to change the behavior of a client in regards to mealtime behaviors. The biggest note for behavioral approaches is to ignore or to NOT reward negative/unexpected behaviors.
    • Motoric and Coordination

      Referring to the physical movement and how oral components move together and in conjunction to complete feeding and swallowing tasks.
    • Postural Changes

      Changes needed in how a child is seated or placed at the table/eating area.
    • Swallowing Maneuvers

      Various swallowing exercises that may aid a patient in their ability to safely swallow a bolus. Examples include (but are not limited to) Mendelsohn, chin tuck, head tilt, or hard swallow.
    • Therapeutic Strategies

      Strategies used in feeding therapy to get a client eating a proper variety, amount, and method of food intake.
• Audiology (AUD)