During a child's development, between the ages of 2 and 6, they learn to communicate their thoughts and needs. This is the period when linguistic skills are expected to develop, along with the capacity for verbal communication. A child's language development, in both comprehension and expression, is anticipated within specific age ranges, which are crucial for their overall progress.
Every child develops at their own pace. Some children speak very early, while others may take longer to speak or walk. A delay or deviation in one developmental stage does not necessarily indicate the need for therapeutic intervention. However, when there are clear developmental disorders and delays in milestones that should have been reached based on the child's age, an evaluation by a specialist is necessary. The speech-language pathologist is the professional who will assess the child's development.
The results of the speech-language pathologist's evaluation do not always lead to a recommendation for speech therapy. After the evaluation, the specialist will determine whether the child requires speech therapy, whether parental guidance alone is sufficient, or if referrals to other professionals are necessary for further investigation.
The importance of early intervention is scientifically proven, with numerous studies highlighting the benefits of speech therapy programs for children in this age group. These programs optimize the child’s existing skills while addressing any difficulties.
When to Consult a Speech-Language Pathologist:
Absence of speech by age 2.
Use of vowels to replace syllables (e.g., "aaato" instead of "ice cream").
Use of single-word answers or phrases after the age of 2.
Limited vocabulary compared to peers.
Inability to follow simple or complex instructions appropriate for their age (e.g., "bring the ball" or "put the ball in the basket").
Repeats questions instead of answering them (e.g., Question: "Did you go to school?" Answer: "Did you go to school?").
Difficulty understanding prepositions like "on," "under," "behind," or "in front."
Confusion regarding gender pronouns (e.g., saying "he left" when referring to his sister) after age 3.
Speech blockages (e.g., "mmmmm-mom").
Repetition of syllables (e.g., "pa-pa-pa-ice cream").
Frequent repetition of the same words and phrases.
Speaking too quickly.
Speech is unclear to unfamiliar listeners after age 3.
Inability to produce certain sounds (e.g., /s/, /r/, etc.) after age 3.5.
Substitution of sounds (e.g., says "d" instead of "b," "f" instead of "th") after age 3.
Frequent grammatical and syntactic errors after age 3.
Referring to themselves in the third person.
Difficulty narrating simple recent events between ages 2.5 and 3.
Difficulty communicating their desires.
Lack of response when spoken to.
No response to their name.
Ignoring others and what is happening around them.
Lack of reaction to sounds or excessive sensitivity to noises.
Lack of comprehension.
Failure to use articles, adjectives, or plural forms after age 3.5.
Poor eye contact.
Repetitive play and obsession with specific toys, using them in a monotonous manner.
Preference for solitary play.
Inability to mimic facial expressions and movements.
Food or drink escaping from the lips.
Coughing during or immediately after swallowing food or drinks.
Strenuous effort or longer time taken to chew or swallow.
Avoidance of hard foods.
Common Speech and Language Disorders:
Autism Spectrum Disorder (ASD)
Developmental Language Delay
Specific Language Impairment (SLI)
Articulation Disorder
Developmental Phonological Disorder
Childhood Apraxia of Speech
Stuttering
Specific Learning Disabilities
Hearing Impairment/Deafness
Intellectual Disability and Syndromes
Aphasia after a Stroke
Evaluation and Speech Therapy Program
In the initial evaluation, the speech-language pathologist will need detailed information about the child's developmental history, language development, medical background, family history, educational history, and any other relevant factors. The specialist then performs an assessment using various methods and tools, and recommends whether to begin speech therapy, explaining the reasons behind the recommendation. If speech therapy is advised, short- and long-term therapeutic goals will be outlined.
The frequency of therapy sessions depends on factors such as the severity of the disorder, the child's cognitive level, and their ability to cooperate. Typically, therapy sessions occur one to three times a week, though this may change depending on the child’s progress and other factors.
Parents play a pivotal role from the first interaction with the speech-language pathologist. After identifying communication challenges in their child, parents decide to seek professional help. During the evaluation, parents provide a history and description of the child's language difficulties. The collaboration between parents and the therapist is often critical to the success of the therapy.
Parents may feel anxious or uncertain about their involvement, but they know their child better than anyone else. With guidance from an experienced therapist, parents become valuable allies in achieving positive outcomes.
Parental involvement during therapy has two forms. First, parents provide feedback on the child’s progress in their social environment. Second, they participate in the intervention by doing specific exercises at home during daily activities (e.g., during a bath or walk), without requiring extra time. This makes therapy a natural part of the child’s life and not limited to session time, often resulting in a more positive attitude toward the therapy program. As parents gain understanding, they can offer more meaningful support.
Working together to address the child’s difficulties creates a more effective therapeutic framework. At the same time, through counseling, parents often reduce their own anxiety and come to better understand and accept the challenges, adopting a more productive and positive approach.
The relationship between the therapist, the child, and the parents, along with the parents’ commitment and trust in the therapy program, greatly contributes to the success and duration of speech therapy.
Language disorders involve difficulties in speech, language, and communication that affect social interactions and daily life. Examples include Specific Language Impairment (SLI), developmental phonological disorder, and language delay.
Language disorders can affect a child's academic performance. Phonological awareness has been shown to be linked with the learning process. Disorders involving phonological awareness, morphology, syntax, semantics, and pragmatics directly impact the child’s ability to read, write, and learn. Additionally, these challenges can negatively affect the child’s psychological well-being, hindering socialization and personal relationships.
A child with a language disorder may simultaneously experience:
Difficulties understanding and remembering language or comprehending written texts.
Difficulties using language (limited vocabulary, unclear speech, grammatical and syntactic errors).
Learning difficulties.
Difficulties with written language.
These language disorders can lead to low academic performance, which in turn can result in learning difficulties
Speak slowly and clearly. Use simple but grammatically correct speech that your child can easily imitate. Talk about what you're doing and point out shapes, colors, types of clothing, and body parts.
Play games with your child, especially those that involve describing objects or asking questions, as these are great ways to develop language skills.
Read to your child. Reading to your child is an excellent way to develop speech and language skills. If they are old enough, let them read to you. If they are too young to read, have them explain what they see in the pictures. Ask them to point to the pictures you name or name the pictures you point to.
Limit screen time. Research shows that too much screen time can delay language development.
Be patient and attentive. If your child has a speech disorder, it is important to be patient. Do not rush them to speak; this can cause additional stress, worsening the issue. Give them your full attention while they are communicating with you.
Occupational Therapy is both an art and a science that assists individuals in carrying out daily activities that are important to them, regardless of the condition, disability, or limitation they may face (AOTA, 1994).
Areas of Intervention in Occupational Therapy:
Population for Occupational Therapy:
Occupational therapy may benefit children, adults, and elderly individuals facing:
Depending on the target population or specific challenges, occupational therapy is categorized into several specializations, including Psychiatric Occupational Therapy, Geriatric Occupational Therapy, Neurological Occupational Therapy, Orthopedic Occupational Therapy, and Pediatric Occupational Therapy.
Occupational Therapy Intervention
The occupational therapists at our center conduct a thorough analysis of physical, environmental, psychosocial, cognitive, and cultural factors to identify barriers to participation through assessment.
Subsequently, they establish goals and design interventions in collaboration with the family, school, and other extracurricular activities, utilizing assessment results to create the most suitable treatment plan. The intervention program employs a combination of contemporary methods and approaches to achieve optimal results.
At our center, the occupational therapy team consists of licensed therapists who are passionate and dedicated to their work.
What is Pediatric Occupational Therapy and What Are Its Goals?
Pediatric occupational therapy adopts a holistic perspective towards individuals and intervenes across a broad range of areas and specific skills. In the field of pediatric rehabilitation, occupational therapists focus on the functionality and independence of the child, as well as their ability to interact in various environments such as family, school, and community.
Pediatric occupational therapy is aimed at children aged 0-18 years, with the goal of developing, recovering, or maintaining skills considered essential for participation in all aspects of their lives.
Areas of Focus in Pediatric Occupational Therapy
Fine Motor Skills : This area is responsible for the grasp, control, and manipulation of objects such as pencils and other small items, the ability to use scissors, and skills related to hand-eye coordination and bilateral coordination.
Gross Motor Skills : This encompasses coordination of the upper and lower limbs, balance, strengthening, relaxation, visual-motor organization, and static control.
Cognitive-Perceptual Skills : This area includes attention span, organization, spatial-temporal orientation, understanding, memory, imitation, expressive and executive skills, and the development of concepts and skills, as well as visual and auditory perception.
Social Skills : This includes eye contact, adaptability, communication, social responsiveness, emotional connection, interaction skills, social play, willingness to share, self-image development, and self-esteem.
Activities of Daily Living (ADLs) : These encompass dressing and undressing, feeding, bathing, and personal hygiene practices such as using the toilet and grooming.
Sensory Skills : These are necessary for sensory integration, a normal neurological process through which the brain organizes sensory information from the environment through the coordination of sensory systems (vestibular, proprioceptive, tactile, auditory, and visual).
Assistive Technology: Occupational therapists are trained to select and educate patients on assistive technology, school equipment, and adaptations in the classroom and home, as well as fabricating splints. They also counsel parents and caregivers of patients.
How Do We Recognize When a Child Needs Occupational Therapy Intervention?
Some indicators include:
Clumsiness, frequent stumbling, poor balance, and poor posture.
Low endurance and poor muscle tone.
Inability to control or adjust strength (frequently breaking toys or unable to apply adequate pressure when writing).
Difficulty manipulating small objects, holding a pencil, using scissors, forming letters, drawing within boundaries, and copying shapes or lines.
Avoidance of daily self-care activities, such as brushing hair or teeth.
Sensitivity to certain fabrics, or being overly sensitive or under-sensitive to touch, tastes, or noises.
Challenges with dressing, buttoning, tying shoelaces, eating independently, or using the toilet alone.
Sleep difficulties.
Aversion to certain foods, reluctance to try new flavors.
Inability to imitate others' movements or participate in symbolic play.
Difficulty understanding the structure and meaning of games, reduced attention span, and challenges following complex instructions.
Poor visual, auditory, and verbal memory, along with difficulty learning new skills and concepts.
Struggles to grasp quantitative, temporal, and pre-mathematical concepts.
Difficulty calculating their body's position in space, resulting in clumsiness.
Engaging in stereotypical or rigid movements.
Hyperactivity.
Avoiding interaction with peers, preferring solitary play, and exhibiting low self-esteem.
Difficulty making age-appropriate friends.
Discomfort with hugs and kisses.
Reduced self-confidence.
How Does the Occupational Therapist Intervene and What Happens During Therapy Sessions?
The first step is assessment. During the assessment, the occupational therapist gets to know the child, uses various evaluation tools, and observes the child during play to determine areas needing improvement. Following this, the therapist informs the parents of their observations, proposes a treatment plan, and together they establish long-term goals and the frequency of sessions.
The occupational therapist then communicates with others in the child’s immediate environment, including teachers, other therapists, and doctors. After reviewing discussions with those involved in the child's life, the therapist determines short-term goals aimed at achieving the long-term goals within the specified timeframe. These short-term goals
Sensory integration is a physiological neurological process through which the brain appropriately organizes sensory information from the environment by coordinating and integrating sensory systems.
The theory of sensory integration was developed by occupational therapist Jean Ayres, who is renowned for both her significant clinical work and her research contributions.
In sensory integration, we particularly refer to the last three senses: touch, proprioception, and vestibular sensation.
The interconnection of these senses begins to form before birth and continues to develop as the individual matures and interacts with their environment. Although these three senses are less recognized than vision and hearing, they play a crucial role in our lives. They fundamentally enable us to perceive, process, and respond to various stimuli in our environment.
Sensory Integration Therapy
Sensory integration therapy is conducted in a specially designed room that provides stimuli to the sensory systems.
The equipment used is aimed at stimulating the vestibular system and includes items such as suspended equipment, commonly known as swings. There are also ramps with scooters, trampolines, rollers, mats, and climbing structures for proprioceptive stimulation.
For tactile stimulation, a variety of materials are used, including fabrics, foam, pasta, finger paints, modeling clay, and more.
