When it comes to childhood development, timing is everything. The early years of a child’s life are a period of rapid growth and change, especially in areas like language and communication. For families navigating speech and language delays, early intervention services can make a significant difference. Here’s why starting therapy early is one of the most impactful decisions you can make for your child.

The Benefits of Early Intervention Services

1. Tailored Support for Unique Needs: Early intervention services are highly individualized, focusing on the child’s specific strengths and challenges. A speech-language pathologist (SLP) works closely with families to develop strategies that align with the child’s developmental goals.
2. Empowering Families: Parents and caregivers play a vital role in a child’s progress. Early intervention includes parent coaching and guidance, equipping families with tools and techniques to support communication development during daily routines.
3. Building Confidence: Early intervention helps children develop foundational skills in a supportive, encouraging environment. Success in communication fosters confidence and a positive self-image, setting the stage for lifelong learning and social connection.

What Does Early Intervention Look Like?

Early intervention services for speech and language delays might include activities such as:

• Encouraging turn-taking during play to develop conversational skills.
• Using gestures, pictures, or signs to promote communication before verbal skills emerge.
• Practicing simple words or sounds in fun, engaging ways.
• Building vocabulary through shared storytime or interactive games.

Sessions are designed to feel like play, making learning enjoyable and stress-free for young children.

What are age appropriate skills for my child at this time?

RECEPTIVELY, children between the ages of 18-24 months of age should be able to:

• Understand simple action words
• Understand simple adjectives (e.g., big, small, hot, cold) 
• Understand simple objects and pictures
• Identify at least 3 body parts  
• Understand simple directions (e.g., Touch ball, Find dog) 
• Comprehend familiar routines (e.g., It’s bath time) 
• Respond to their name when called 

EXPRESSIVELY, children between the ages of 18-24 months of age should be able to:

• Refer to self by name 
• Use nouns, verbs, and pronouns
• Label objects and items
• Use increasing vocabulary (18 months: around 20–50 words; 24 months: around 200–300 words.)
• Say phrases such as “uh oh” 
• Express basic wants and needs (e.g., More juice, All done)
• Use an increased variety of speech sounds (Most children can produce vowels and many consonants like /b/, /m/, /d/, /p/, and /n/, though errors are still common.)
• Use gestures and words together (e.g., Wave and say “bye bye”) 
• Start to imitate words that adults model 
• Combine two words to form simple phrases (This is closer to 24 months, e.g., Want cookie, Go car)
• Name familiar objects, people, and actions (e.g., ball, doggy, eat) 

Examples of Activities used in Early Intervention:

1. Pretend Play (tea sets, dolls, animals)
   1. How is it used? → label objects, actions, and turn taking 
2. Books
   1. How is it used? → Read with your child daily and point to pictures, asking, “What’s this?” or saying, “I see a dog! The dog says woof!”
3. Songs and Rhymes
   1. How is it used? → Use songs with gestures (e.g., Wheels on the Bus, Itsy Bitsy Spider) to combine words and actions, which help link language to meaning.
4. Cause and Effect toys (ramps, pop up toys) 
   1. How are they used? → model phrases like, “Open,” “Push,” “Pop!”
5. Blocks, Puzzles, and Stacking Toys
   1. How are they used? → teach concepts such as size, color, and spatial words (e.g., “On top,” “Next to”).
6. Social Games
   1. How are they used? → use turn-taking games (like rolling a ball) to encourage social interaction and joint attention.

Invest in Your Child’s Future

Every child develops at his or her own pace, but seeking help early can make a world of difference. Early intervention services provide the tools, support, and opportunities your child needs to thrive. By addressing challenges early, you’re not only fostering communication skills but also giving your child the confidence to express and connect with the world around them.

If you have questions or want to learn more about our pediatric speech therapy services, call us today at 609-924-7080. 

The post The Power of Early Intervention: Why Starting Speech Therapy Early Matters appeared first on Princeton Speech, Language and Learning.

Dr. Russel Barkley, ADHD expert, author, and speaker, reminds parents in his famous long but well-worth it talk, “Essential Ideas for Parents”, that the executive functions are delayed by approximately 30% in children with ADHD. I often point this out to parents and teachers of my clients when they express frustration at what appears to them to be simple tasks that the “extremely intelligent” child should be able to perform.  

When your straight A student can’t wake up in the morning, make it to class on time, or remember to throw away his or her wrappers, it can be helpful to remind yourself and actually do the math. Your 18-year-old may have had the academic skills to get into a good university, but now he or she is expected to not only manage the rigors of college classes, but to wake up, get to class on time, do laundry, and get meals ready as well.

All of these skills rely on the executive functions. This could be challenging for a neurotypical 18-year-old, but applying the Barkley formula, we realize that we are basically sending our students with ADHD off to college when they have the executive function skills of a 13-year-old. This knowledge can not only help parents and teachers understand the challenges that come with ADHD but also understand how critical it is for students to learn strategies to compensate for them

-Carol Cooper-Braun, MA, Learning Specialist/Executive Function Teacher at PSLLC

The post Understanding Your Child’s ADHD appeared first on Princeton Speech, Language and Learning.

Goals

• School Speech Therapy: Goals typically focus on supporting the child’s educational needs, are aligned with the school curriculum, and address skills that directly impact classroom performance.
• Private Speech Therapy: Goals are created based on the child’s performance on dynamic assessments, may be modified at any time based on how the child is progressing through therapy, and are not necessarily tied to the school curriculum. 

Frequency & Duration

• School Speech Therapy: Scheduling is based on the student’s Individualized Education Plan (IEP); sessions may be shorter, and there may be fewer sessions per week. 
• Private Speech Therapy: There is the option for increased flexibility in scheduling based on the child’s needs rather than school resources and the IEP. 

Session Format

• School Speech Therapy: Oftentimes group sessions occur in the school setting. In groups, students may be targeting a variety of different goals. 
• Private Speech Therapy: Sessions can be individual or group. Individual sessions can target specific areas of difficulty unique to your child. Group sessions are carefully planned. Clinicians meet weekly to discuss current groups and match students appropriately based on similar goal areas. 

Treatment

• School Speech Therapy: Evidence-based treatment approaches are utilized. 
• Private Speech Therapy: Evidence-based treatment approaches are utilized but can use a broader range of approaches, including specialized treatments like PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) and NLA (Natural Language Acquisition).

Signs that additional private therapy might be needed:

• If your child is not making expected progress or you’ve noticed a plateau in performance as your child progresses through school therapy. 
• If your child is unintelligible to unfamiliar listeners after 3-4 years of age or if your child is still working on articulation goals after first grade.  
• If your child’s literacy skills are being impacted by his or her speech sound disorder (i.e., writing “w” for “r” or “l”).
• If your child has more severe or specific speech-language disorders, such as childhood apraxia of speech (CAS), autism spectrum disorder (ASD), or a severe phonological or articulation disorder.
• If you want more focused and frequent intervention to remediate delays or disorders faster, take a more robust approach to your child’s therapy, or want to supplement school-based therapy. 

School therapy ensures support in an academic setting, helping the child succeed in school while private therapy can address more complex or persistent speech-language issues. The combined effort of both school and private speech therapy can lead to better overall outcomes. Parents and caregivers, it is important to consider your child’s unique needs when deciding on speech therapy options. Reach out to us here at PSLLC if you are unsure about the best approach for your child.

The post The Difference Between School Speech Therapy and Private Speech Therapy appeared first on Princeton Speech, Language and Learning.

*Establish a Routine

 A consistent routine helps children feel secure and can reduce anxiety. It also supports their ability to manage time and transition smoothly between activities.

• Morning Routine: Create a visual schedule for morning routines, including getting dressed, eating breakfast, and packing their school bag. Visual aids can help children understand and follow the sequence of tasks.

* Organize School Supplies and Workspace

Having a designated and organized space for school supplies can reduce stress and help your child stay focused.

• Supply Checklist: Make a checklist of required school supplies and involve your child in shopping for and organizing these items. This can help your child feel more prepared and excited about the school year.
• Designated Workspace: Set up a specific area at home for homework and school projects. Ensure it is well-lit, quiet, and free from distractions.

* Practice Self-Care and Self-Regulation Skills

       Developing self-care and self-regulation skills helps children manage their emotions and behaviors, which can be especially important during transitions.

• Self-Care Routines: Practice self-care routines like handwashing, using a tissue, and managing personal items. These small but important skills contribute to independence and confidence.
• Emotional Regulation: Teach your child strategies for managing his or her emotions, such as deep breathing, counting to ten, or taking a break. Role-playing different scenarios can help with practicing these skills in a supportive environment.

* Encourage Social Skills and Peer Interactions

        Building strong social skills helps children navigate peer relationships and feel more comfortable in group settings.

• Play dates: Before schedules get too busy, set up a playdate with a friend from school.
• Social Stories: Use social stories or role-playing to discuss potential social situations your child might encounter at school. This can help him or her feel more prepared and confident.

*Focus on Nutrition and Physical Activity

 Proper nutrition and regular physical activity support overall well-being and cognitive function, which are crucial for a successful school year.

• Balanced Diet: Ensure your child has a balanced diet that includes a variety of fruits, vegetables, proteins, and whole grains. Encourage healthy snacks and hydration throughout the day.
• Physical Activity: Incorporate regular physical activity into your child’s routine. Whether it’s a sport, dance class, or outdoor play, physical activity can boost mood and energy levels.

* Create a Supportive Environment at Home

A supportive home environment reinforces positive behaviors and helps children feel secure and valued.

• Open Communication: Keep the lines of communication open. Encourage your child to share his or her thoughts and feelings about school and listen actively.
• Positive Reinforcement: Celebrate successes, no matter how small. Positive reinforcement can build confidence and motivation.

Preparing for a new school year involves more than just buying supplies and setting up routines. By focusing on emotional readiness, organizational skills, and healthy habits, you can help your child navigate this transition with confidence and ease. Feel free to reach out if you have specific concerns or need additional support. Our occupational therapists are here to help. Here’s to a great start to the school year!

The post Back-to-School Tips from a Pediatric Occupational Therapist appeared first on Princeton Speech, Language and Learning.

The Importance of Social Skills

For many neurodivergent individuals, social interactions can be challenging. Understanding social cues, maintaining conversations, and building relationships can often feel overwhelming. Our social groups focus on developing communication skills, building confidence, and fostering friendships. 

Our Approach

Our approach to running social groups is based on empathy, understanding, and evidence-based practices. Here’s how we do it:

1. Individualized Support

We understand that each participant is unique, and we tailor our activities to meet his or her specific needs. This may involve modifying activities, using visual supports, or providing one-on-one assistance.

2. Structured and Predictable Environment

A consistent routine helps reduce anxiety and provides a sense of security. We maintain a structured schedule for each session, clearly outlining the activities and goals.

3. Focus on Strengths

Rather than concentrating on what individuals find difficult, we emphasize their strengths. This positive reinforcement builds self-esteem and encourages participants to engage more fully in group activities.

4. Parent and Caregiver Involvement

We believe that involving parents and caregivers is crucial for the success of our social groups. Regular updates, feedback sessions, and resources are provided to help families support their loved ones at home.

Please call our office at 609-924-7080 to schedule a free consultation to discuss our social groups.

The post Embracing Neurodiversity in Social Groups at PSLLC appeared first on Princeton Speech, Language and Learning.

We are just starting to scratch the surface when it comes to learning how critical the executive functions are and how best to help those with EF challenges. Executive function skills are seldom taught in schools, but instead, specific tools are often utilized in grammar school. For example, having students purchase different color folders for specific classes is a great tool to keep materials organized. Students are often issued agendas or planners where daily homework assignments are recorded. The teacher initials the planner as a signal to the parent that his or her child recorded the information accurately. The parent then also initials the child’s planner as a response to the teacher that he or she saw the assignment and made sure the student completed it. There might also be a homework bin in the classroom where students place their homework assignments. Elementary school teachers also help students transition from one class to another by alerting students to start times and end times of classes. However, by the time a student enters middle school, these supports often fall off. Some children might be ready for this, but many, especially those with ADHD, are not. Not only that, but because much of our children’s class materials are now digital, many of the old tools that were formerly in place no longer are. 

Typically, parents reach out to an executive function teacher at transition times in their children’s academic careers. Most students with ADHD have high academic and intellectual abilities, so they can often compensate with their intelligence for what they lack in their executive function skills, at least for a while. Some hit a metaphorical wall in middle school. Some in high school. And some make it to college and end up having a very difficult time during their freshman year. Did you know that the number one predictor of college success is the ability of students to rouse themselves in the morning? More often than not, it is a student’s weak executive function skills that make college so challenging. 

So how do you know if an executive function teacher will help your child? Just as you might seek out the help of a reading specialist if your child struggled with reading, reaching out to an expert in executive function makes sense if your child has a diagnosis of ADHD or if you notice your child struggling with skills such as

• Time Management: Is your child often running late or slow to get ready? 
• Organization: Is your child often losing things? Is his or her room a mess?
• Planning/prioritization: Does your child know how to break down a task and plan when to do it?
• Goal-directed persistence: Can your child work toward a goal when progress is far into the future? 
• Sustained attention: Can your child sustain attention to tasks he or she doesn’t want to do?
• Emotional regulation: Does your child have reactions that do not match the problem?

• Cognitive flexibility: Can your child shift easily and handle transitions well?
• Response inhibition: Does your child think things through before acting and/or responding?
• Task Initiation: Is getting started a struggle? 
• Working memory: Does your child leave a trail wherever he or she goes? 
• Metacognition: Does your child self-monitor and self-assess? 
• Tolerating stress: In stressful times, is your child grace under pressure or barely treading water?

As you can imagine, challenges with these skills can result in challenges with many basic life functions, such as school, work, and even relationships. Some of these challenges may not be evident until a child goes through adolescence. It is truly tragic when college freshmen, some of whom were spectacular scholars in high school, fail their first semester because they can’t get to class on time, can’t get assignments turned in on time, don’t have study skills, and/or haven’t learned how to break down large assignments. Getting help for the executive functions can be a life-changing and lifelong support to help those with neurodiversities thrive. 

The post Executive Function Skills: Does My Child Need an Executive Function Teacher? appeared first on Princeton Speech, Language and Learning.

Private Practice Occupational Therapy:

1. Holistic Family-Centric Approach:

• Unlike the school-based setting, our OTs take a holistic approach, addressing challenges that extend beyond academic concerns. They zero in on difficulties encountered in daily routines, social interactions, and leisure activities.

2. Flexible Settings and Scheduling:

• Operating outside the constraints of the school system, private practice OT offers flexibility in settings and scheduling, fitting seamlessly into family routines.

3. Tailored Interventions for Everyday Life:

• Our OTs tailor interventions to suit individual family dynamics and routines. In addition to providing therapy to help with fine motor, gross motor, and visual motor skills, the personalized approach families receive in the private practice setting allow us to target the struggles encountered during family outings, vacations, mealtimes, dressing, hygiene, homework sessions, transitions, and social engagements.

4. Comprehensive Support Beyond School Hours:

• Recognizing that challenges persist outside of school hours, occupational therapy at PSLLC provides support after school hours and holidays, ensuring continuous assistance where needed most.

How Private Practice OT Helps Navigate Everyday Family Challenges:

1. Family Outings:
2. We equip families with strategies to navigate routine events providing strategies and tools to use when waiting at the doctor’s office or standing in line at the grocery store, addressing sensory sensitivities, behavioral concerns, and organizational difficulties that may arise in different environments.
3. Family Meals:
4. By focusing on sensory processing, self-regulation, and feeding skills, our OTs assists children in overcoming challenges during mealtimes, ensuring a more enjoyable and stress-free dining experience for the entire family.
5. Homework and Academic Tasks:
6. We support children in managing homework and academic tasks, addressing attention, executive functioning, and fine motor skills to enhance independence and academic success.
7. Transitions in Daily Routines:
8. Through targeted interventions, OT facilitates smoother transitions during daily routines, such as getting dressed, toothbrushing, toileting, preparing for bed, and transitioning between activities, reducing meltdowns and conflicts within the family.

In essence, while school-based OT plays a vital role in supporting academic success, private practice OT shines in addressing the multifaceted challenges encountered in everyday family life. The OT department at PSLLC is able to foster a supportive environment where children can thrive, enhancing overall family dynamics and quality of life.

The post Bridging Gaps: Why Private Practice OT Can Enhance Family Dynamics Beyond School Hours appeared first on Princeton Speech, Language and Learning.

You might want to consider an ASD evaluation if your child has any of the following symptoms, which are considered red flags or concerns in the course of a child’s development that may need further evaluation:

• Social red flags:
  • Does not respond to name
  • Avoids eye-contact 
  • Prefers to play alone
  • Does not share interests with others
  • Only interacts to achieve a desired goal
  • Has flat or inappropriate facial expressions
  • No social smiles or joyful expressions directed at people
  • Does not understand personal space boundaries
  • Avoids or resists physical contact
  • Is not comforted by others during distress
  • Has trouble understanding other people’s feelings or talking about own feelings

• Communication red flags:
  • Delayed speech and language skills
  • Repeats words or phrases over and over (echolalia)
  • Reverses pronouns (e.g., says “you” instead of “I”)
  • Gives unrelated answers to questions
  • Does not point or respond to pointing
  • Uses few or no gestures (e.g., does not wave goodbye)
  • Does not pretend in play (e.g., does not pretend to feed a doll)
  • Does not understand jokes, sarcasm, teasing, or others’ feelings
  • Any regression, loss of language, social skills, etc.

• Behavioral red flags:
  • Lines up toys or other objects
  • Plays with toys the same way every time
  • Likes parts of objects (e.g., wheels)
  • Gets upset by minor changes
  • Has obsessive/narrow interests
  • Has to follow certain routines
  • Flaps hands, rocks body, or spins self in circles
  • Has unusual interest/aversion and often intense reactions to sounds, smells, tastes, textures, lights, and/or colors

What to expect from an autism evaluation? 

• The clinician will usually start with a clinical interview to gather information from the parent regarding the symptoms that may be related to autism spectrum disorder. 
• The clinician will then evaluate the child in the office, using measures that help identify symptoms of ASD. 
• At PSLLC, we use gold-standard assessment measures, such as the Autism Diagnostic Observation Schedule (ADOS-2) and Autism Diagnostic Interview – Revised (ADI-R). The clinician may also ask those who interact with the child the most to complete questionnaires to assess the child’s social communication and behaviors.

If my child has autism, what can I do?

• There are many avenues for treatment when a child receives a diagnosis. At PSLLC, the psychologist will create an individualized treatment plan for your child based on his or her needs. Every child with ASD is different, therefore, treatment can range from multiple therapies to psychoeducation about his or her differences. Therapies may or may not include speech therapy, social communication therapy, applied behavioral analysis, behavior therapy, behavior parent training, social skills training, occupational therapy, and accommodations or special education in school. What we do know is that supporting the child in those early developmental years is pivotal in order to achieve the best outcomes. 

Are there screening tools I can complete to see if an evaluation is necessary?

• Yes. If your child is between the ages of 16 to 30 months, the MCHAT is a great and free tool you can use to determine the risk factor for your child https://www.autismspeaks.org/screen-your-child 

The post Does my child need an evaluation for autism spectrum disorder?  appeared first on Princeton Speech, Language and Learning.

Step 1: Review your insurance policy

It is essential to review your insurance policy.  Familiarize yourself with the terms and conditions of your coverage, specifically related to out-of-network benefits.  Pay attention to any limitations, deductibles, and reimbursement rates. Verification of benefits is not a guarantee of coverage or payment. 

When calling your insurance company to inquire about coverage, ask if medical necessity is required for therapy coverage.  If it is, we often recommend asking your pediatrician to write a prescription for the evaluation/therapy to be provided. 

Our front desk will be able to give you the procedure codes (CPT) used for the specific service you are receiving.

Step 2: Gather all relevant information

After receiving treatment, you will receive an itemized receipt in your email.  Notice on the receipt is our name and address (Princeton Speech-Language & Learning Center, 615 Executive Drive, Princeton, NJ  08540) our NPI# (1346411717), our tax ID # (22-3388799), phone and fax numbers, the diagnosis code (ICD-10 Code) and the procedure code (CPT).  In addition, the name and credentials of your clinician will be on your receipt. It is crucial to keep all documentation organized for the claim submission process.

Step 3: Complete the Claim Form

Obtain the necessary claim form from your insurance company.  Fill out the form accurately, providing all required information, including your policy number, personal details, and the details of PSLLC.  Attach the itemized bill and any supporting reports/evaluations to support the necessity of the therapy. (It is important to indicate on the claim that any reimbursement should be sent to the insured and not the therapy provider.)

Step 4: Submit the Claim

Submit the completed claim form along with the supporting documents to your insurance company.  Be sure to follow the preferred method of submission outlined by your carrier.  This may include mailing the documents or submitting them electronically through an online portal. Submit claims in a timely manner (within 7-14 days) from your date of service and follow up within 14 days of your claim submission.  Timeliness is essential when managing the claims process.

Step 5: Follow-up and Track

After submitting your claim, keep track of its progress.  Follow up with your insurance company to ensure it has received the claim and all necessary documents.  Take note of any reference numbers or confirmation emails for future reference.  Include reference numbers in all correspondence about the claim.

Step 6: Review the Explanation of Benefits (EOB)

Once your claim has been processed, your insurance company will send you an Explanation of Benefits (EOB).  This outlines the details of the claim, including the amount covered and any deductions or adjustments made. If the claim is denied, it will give an explanation and procedures for the appeal process. 

Processing a claim for out-of-network benefits can be a complex and frustrating process.  By following these steps and adding a little bit of patience, you can navigate the process with confidence.  By staying organized and proactive, you can maximize your chances of receiving reimbursement for out-of-network services.

Helpful Hint:  If you have a FSA or HSA that uses a MC/Visa, we can use that to pay for your therapy charges.

Flexible Spending Account (FSA) – This is a pre-tax benefit most employers offer in which you can utilize pre-tax dollars that you put into your FSA for medical costs inclusive of therapy, dentist, healthcare, etc.

Health Savings Account (HAS) – This is a savings account used in conjunction with a high-deductible health insurance policy that allows users to save money tax-free against medical expenses.

GAP Exception – A network gap exception is a tool health insurance providers use to compensate for gaps in their network of contracted healthcare providers.  This is a way that clients may be able to access “in-network benefit coverage” from an out-of-network service provider.  This is specifically useful when submitting claims for our social communication groups.  All of our speech therapists are specifically trained in the social thinking curriculum and therefore this specific training separates PSLLC therapists from the majority of in-network providers that do not have the training. 

The post A Step-by-Step Guide to Processing a Claim for Out-of-Network Benefits appeared first on Princeton Speech, Language and Learning.

1. Nature Walk and Talk

• Take a nature walk with your child to explore the sights, sounds, and sensations of spring.
• Encourage your child to describe what he or she sees, hears, smells, and feels.
• Discuss the colors of the flowers, the sounds of the birds, the textures of the leaves, and other springtime observations.

2. Spring Storytelling Sessions

• Read spring-themed books or stories with your child.
• Encourage your child to retell the story in his or her own words, add new details, or create an original springtime story.
• Discuss the characters, settings, and events of the story to help your child develop storytelling skills.

3. Springtime Show and Tell

• Invite your child to choose a spring-themed object or picture to share with the family.
• Encourage your child to describe the object or picture, tell a story about it, or explain why it represents spring.
• Ask open-ended questions to help expand your child’s vocabulary.

4. Spring Sensory Play and Language

• Set up a spring-themed sensory bin with items like flower petals, seeds, water, and gardening tools.
• Encourage your child to explore the sensory materials and describe his or her own experiences.
• Discuss the colors, textures, and sensations of the.

5. Spring Art 

• Engage in spring-themed art activities like painting, drawing, or crafting.
• Encourage your child to talk about his or her artwork, describe what was created, and explain the choices using creative words.
• Discuss the colors, shapes, and themes of the artwork.

Please reach out to PSLLC to schedule a free consultation and to hear about speech therapy services that we can offer. 

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