Make a Silly Face! Oral Motor Imitation: What Is It and Why Should You Target It?

Do you remember the first time your child made that cute little “raspberry” sound? What about the first time he or she blew a kiss of stuck out his or her tongue?  Did you know that these seemingly small (yet adorable) moments are actually important building blocks towards your child’s speech, language, and feeding development?

What are oral motor movements?

Just as we develop gross motor movements (e.g., walking) and fine motor movements (e.g., grasping), we also develop oral motor movements that impact our ability to speak and eat. While any movement made by your lips, tongue, or oral structures are considered an oral motor movement, the following are some specific movements that are beneficial for development as well as highly visual, thus increasing your child’s ability to imitate.

  • Opening mouth: The basis of speech, opening the jaw is imperative for both articulation (speech sounds) and feeding.
  • Lip pucker: “Kissy face.” Lip pucker strengthens lips, which helps with producing bilabial sounds (i.e., /p, b/) as well as controlling food and saliva.
  • Tongue protrusion: Sticking the tongue out helps with a variety of speech sounds (specifically lingual sounds).
  • Tongue lateralization: Moving the tongue from side-to-side helps with a variety of speech sounds, as well as chewing and swallowing food.

How does imitation of these movements impact development?

Imitation of movements, including oral motor movements, is a skill that toddlers master before words emerge. Some children are able to produce specific oral motor movements independently, but have difficulty imitating them on command. While oral motor imitation varies among children, once a child is able to consistently produce the movement independently, we would expect them to imitate it fairly consistently. Continuing to provide repetitive models of the movement you’re eliciting will go a long way in encouraging your child to imitate. If your child consistently has difficulty imitating movements that he or she can produce spontaneously and demonstrates difficulty with speech and language skills, an evaluation could be warranted to determine if he or she is demonstrating some difficulties with motor planning.

How can I target oral motor imitation?

It can actually be quite simple to practice oral motor imitation! The only two things you really need are you and your child; however, there are some tips and tricks to eliciting imitation. If your child is very young, simply engaging with your child by making silly faces is perfect! You can also add oral motor movements to books (e.g., pucker face when reading about a duck, etc.). If your child is an older baby, toddler, or school-aged, the mirror can be a wonderful teaching tool. While I typically prefer low-tech modes of practice, taking silly “selfies” or using apps with photo filters can also be a motivating tool!

Questions or concerns?

If you have questions or concerns about your child’s ability to imitate oral motor movements, reduced oral motor movement, or concerns regarding speech, language, or feeding development, please contact us at info@playworkschicago.com or 773-332-9439.

Sarah Lydon, MA, CCC-SLP
Speech-Language Pathologist

Photo Credit: Chayene Rafaela on Unsplash

Chill-dren: Calming Strategies For Your Child At Home

Picture this: You’ve had a long day at work, reprimanded by your boss and had a disagreement with that one co-worker who always gets under your skin. All you can think of is how much you want to get home! You already have in mind exactly what will help you let the stress of the day go.

Children and Stress

Although our children do not have bosses or coworkers, they do experience daily stress and share your feelings of wanting time to relax. The only thing is, they often do not know exactly what will help them de-stress and calm down in the moment. You can help your child by having a conversation about quiet activities they enjoy and items or experiences that make them feel better when they are upset. Discussing and practicing their calming strategies while they are feeling happy and relaxed will be important so your child knows how to use them during frustrating moments. Below are ideas to get you and your child started with their own relaxation routine.

Calming Ideas for Children

  1. Calm Down Corner
  • Different from a time-out spot, the calm down corner is a place your child can go when they are feeling overwhelmed or stressed. It can be any spot around the house that they always have access to and can leave set up. Encourage your child to put blankets, pillows, and anything comfortable to cuddle with. Let them know that this is their special spot they can come to whenever they need a break.
  1. Deep Breaths
  • Deep breaths are a great tool for calming because once your child masters them at home, they can use them anywhere! Together with your child, practice taking three to five slow, controlled breaths. You can prompt your child to pretend their body is balloon and to watch their midsection fill up while they inhale, and see it deflate while they exhale. Modeling with your own body is a great way to show them exactly how their air should move and sound when they breathe.
  1. Yoga
  1. Calm down kit
  • The calm down kit is a bucket or bin full of items and pictures that is easily accessible to your child when they are feeling upset. It might include crayons and paper, something to squeeze, play-doh, snacks, bubbles, stickers, a book, and/or a feelings chart. You can also fill it with pictures of any of the ideas above!

What else can I do?

If your child is demonstrating continued difficulty calming themselves at home, consider contacting our office, as our social workers can provide your family with helpful tools and supports to help your child move from angry, sad, and/or scared back to the loving, happy child you know them to be.

Questions or concerns?

If you have questions or concerns about your child please contact us at info@playworkschicago.com or 773-332-9439.

Amanda Deligiannis, MSW, LSW
Licensed Social Worker
Photo Credit: Photo by Anissa Thompson from FreeImages

Employee Spotlight: Kristen McManus

What do you love most about being an Occupational Therapist?

I love that occupational therapy is all about cultivating success in everyday activities. Occupations for us mean anything a person needs or wants to do in his or her daily life. For kids, their most important occupation is play! There is no better job than playing with children to help them learn and have fun!

What is your favorite children’s book?

My favorite would have to be The Giving Tree. I think it has such a beautiful lesson, and Shel Silverstein’s illustrations are so unique.

What do you enjoy most about living in Chicago?

As a Texan born and raised, Chicago was quite the change for me! I love the views of Chicago most, especially those of the skyline or river. It is such a beautiful city, whether covered in sunshine or snow.

What is your favorite childhood memory?

I fondly remember playing board games with my grandmother. She played harder games with me, such as Scattergories or Scrabble, and she always had so much patience. I certainly think this is why I love incorporating games into my sessions, and why I use that same patience with the kids I work with in therapy.

Would you rather a mountain or beach vacation?

I would pick a beach vacation without a doubt. I am a fan of warm weather, and I think the sights and sounds of the ocean are wonderful.

Share a proud “therapy moment” with one of your clients.

I am a strong proponent of learning the child’s own goals. One little girl with cerebral palsy wanted to learn how to brush her own hair. One little boy on the autism spectrum wanted to learn how to make himself a snack. Some of my clients on the autism spectrum want to have a best friend. Nothing makes me more proud than to help these children achieve what is important to them.

What is your hometown?

I was born and raised in Beaumont, Texas.

What do you like to do in your free time?

In my free time, I like exploring the city. My fiancé and I will often go to a new neighborhood and walk around for hours, trying new restaurants and shops. I also enjoy reading novels, taking boxing classes, scrapbooking and crafting, and playing board games.

What is your favorite therapy toy?

I love using pretend play food or picnic sets. They encourage great imaginative play skills, along with social skills and fine motor skills.

Share a fun fact about yourself.

I can play the alto saxophone.

Kristen McManus, MOT, OTR/L
Occupational Therapist

Language Milestones: School-Age Children

As your child grows, their understanding of language, use of language, and ability to use language to interact socially with family and friends will continue to expand and become more complex. It can often be difficult to know what language skills you should be looking and when you should expect them to be developed. The chart below outlines general milestones for language development in regards to receptive-language, expressive-language, and pragmatic-language.  If you have any concerns regarding your child’s language skills, please contact your speech-language pathologist.

Questions or concerns?

If you have questions or concerns about your child’s language development, please contact us at info@playworkschicago.com or 773-332-9439.

Claire Hacker MS, CCC-SLP
Speech Language Pathologist

Photo Credit: from Pixabay

What’s So Fine About Fine Motor Coordination?

Do you remember back when you first learned to zip up your own jacket? How about tie your shoes? Write your name for the first time? Color carefully to stay inside the lines? You may not have known it then, but as a child you built many of the fine motor coordination skills you still use every day. When you think of “coordination” you might think of playing sports or swimming, and you would be right! However, when we talk about fine motor skills, we also use the word “coordination” to describe how many different muscles in your hands are working together to accomplish the smallest of movements.

Fine motor coordination involves learning many different skills simultaneously in order to have more control and precision over tools or objects in order to be accurate. These skills include having strength in the small muscles within your hand and fingers, developing a good grasp on tools, moving items around your hand without dropping them, and developing precise targeting. As your child practices these skills, he/she will refine these skills to help learn the foundational skills in many different areas of development. In general, large motor skills (stability of the head, core, controlled limb movements), become more consistently accurate before fine motor skills.

What skills should my child have now?

  • Around 12 months: Pulling off socks, starts to finger feed self with small table foods, can use a spoon to dip, grasps objects of different sizes, uses their whole hand to grasp around writing utensils, places and releases small objects down on a flat surface
  • Around 24 months: Pulling off untied shoes, can use a fork to pierce food, and a spoon efficiently to transfer food, shows an interest in scissors but may not be able to open and close them with one hand, may use a pronated (thumb side of hand down) grasp on writing utensils, they are starting to pick up small items and tuck them into their palm, they are starting to place items from the inside of their palm down by passing them to the finger tips, they consistently rotate items 90 degrees using just their finger pads (such as when taking the top off a small twist top jar)
  • Around 36 months: Unbuttoning large buttons on a jacket, pulling on socks with some help, can open and close scissors, and snip through paper, may continue to use a pronated (thumb side of hand down) grasp on writing utensils
  • Around 3rd birthday: Putting shoes with Velcro fasteners, putting on socks, zipping and unzipping a jacket (help putting both sides together at bottom), buttons large buttons on a jacket, starts to use scissors to cut through paper, over the next year practices pushing scissors forward to cut on a line, starts using a three-finger grasp that is looser and their arms and shoulder move lots when coloring
  • Around 4th birthday: Able to put together jackets that have a snap or hook fastener, some snaps on pants, zipping jacket independently, puts on shoes (needs help with tying laces), can put a belt through loops, pushes scissors to cut out simple shapes, over the next year starts cutting curved lines and circles, your child continues to get more efficient and accurate with drawing with their three-finger grasp, they are able to separate two pieces of paper by rubbing their fingers together
  • Around 5th birthday: Can tie knots, improved accuracy with scissors, the child uses a dynamic grasp (three fingers on utensil near the tip, their shoulder/arm are stable, their fingers and wrist are controlling movements, they are more accurate and efficient with this grasp, they can adjust their grasp on a pencil by moving it between their fingers
  • Around 6th birthday: Can tie a bow, independently manage shoes, other clothing fasteners, can cut more complex figures, they can flip a pencil around to reach the eraser without picking up and moving the pencil, they can pick up small items sequentially while holding other small items in their hands

My child isn’t ready to tie their shoes or write yet; why do these skills matter now?

Fine motor coordination skills are built over a long period of time, and gradually get more complex as a child gets older. Foundational skills in this area, such as grasping tools and moving small items from the palm to tips of the fingers, are key for later important skills such as writing, typing, cutting, money management, using utensils to eat, tying shoes, and managing fasteners on clothing. A child may become successful and efficient with navigating these skills as they continue to develop other skills through play and participation in daily routines.

Why do occupational therapists work on these skills?

Occupational therapists focus on these skills because they are a part of our daily living skills, from putting toothpaste on our toothbrush, to getting dressed, to participating in school, and feeding ourselves! Children use their fine motor coordination skills during daily living activities, in education, and in play, all areas which are covered by the domain of occupational therapy! During an occupational therapy evaluation, a therapist would look more in depth at your child’s fine motor coordination skills for their age.

What can I do?

  • Play games while picking up small items with kitchen tongs, chopsticks attached at the top with a rubber band and paper, or a straw bent in half to form tongs
  • Snap/button art boards
  • Puzzles with different snaps, buckles, locks to open
  • Read books with flaps to lift up to reveal pictures below
  • Practice tearing paper with your child, crumpling it up between your fingers, and using it in an art project, such as gluing it onto a snowman outline to make it 3-D.
  • Make a paper cup lantern by pushing a paper clip through the side of the cup and place an LED tea light inside
  • String beads or pasta on spaghetti noodles, string, or pipe cleaners
  • Make PlayDoh with salt, flour, and cream of tartar. Roll it into snakes, small balls, build tiny snowmen
  • Let your child practice opening items in the house for food consumption, such as bags of chips, twist off applesauce pouches/water bottles,
  • Tape small animals to a baking sheet and practice pulling the small pieces of tape off
  • Cut a slot in the top of an oats container. Have your child practice placing popsicle sticks in the slot; recreate this activity with Q-tips and a plastic lid with a straw hole, sort coins into different piggy banks
  • Stretch rubber bands around the outside of a small jar
  • Pull pom poms or other small items out of a kitchen whisk
  • Decorate cookies and allow your child to pick up the small sprinkles and push them into the dough
  • Let your child have as much practice as possible with fasteners (snaps, buttons, zippers, and shoe tying)
  • Cut through different layers/thicknesses of paper (tissue paper, paper, paper plates, cardboard)
  • Increase your child’s opportunities to practice writing outside of school by having the child write the score of a game, write letters to family members, write the list of items needed at the store
  • Use a stylus if your child plays games on a device. There are apps to practice coordination while using a stylus such as: iTrace, LetterSchool, Dexteria Jr, Writing Wizard, Trace it/Try it
  • Paint using the ends of Q-tips to make small dots on paper to draw fireworks
  • When recycling boxes, have your child cut the box instead of breaking it down for extra scissor practice
  • Allow your child to practice peeling fruit, picking the stems off the ends of beans, etc.
  • Hide toys in small jars and bottles, and have the child practice getting them out by twisting open the top

Questions or concerns?

If you have questions or concerns about your child’s fine motor coordination, please contact us at info@playworkschicago.com of 773-332-9439

Caroline Stevens, MS, OTR/L
Occupational Therapist

References: Fleming-Castaldy, Rita. (2019). National occupational therapy certification exam review and study guide. 8thedition. Therapyed.

Photo Credit: Markus Spiske via unsplash.com

Blankets, Vests, and Lap Pads…Oh My! A Guide to Weighted Objects

What are weighted objects, and how do they work?

In the context of pediatric therapy, a “weighted object” refers to any object or item that is worn, placed on, or carried by the body to elicit a desired sensory response. These objects work by providing deep pressure, or distributed weight over parts of the body through cuddling, hugging, squeezing, and holding, to regulate the nervous system and calm the body. Additional input is processed by the proprioceptive system, which provides information about the position and movements of our muscles and joints, to increase understanding and awareness of where our body is in space.

What are some potential benefits of using weighted objects?
Potential benefits of using weighted objects include:

1. Better attention and focus: weighted objects are often calming for children that seek opportunities for movement and deep pressure and for those that have a difficult time sitting still and attending to structured activities. As weighted objects provide the input these children are seeking, their bodies become more calm and organized, and they are better able to focus and stay on-task, especially in the classroom environment.

2. Less anxiety and improved sleep: the calming effects of weighted objects on the nervous system help to reduce sympathetic arousal, or the fight-or-flight response, and promote feelings of comfort and relaxation. For these reasons, use of weighted blankets at night has also been found to help individuals fall asleep more easily as well as improve overall quality of sleep throughout the night.

3. Smoother transitions between daily routines and activities: when children experience increased regulation and sensory organization due to the effects of weighted objects, they often feel more “in control” of their bodies and are better equipped to handle transitions and changes in their routines, leading to fewer or less intense tantrums and emotional outbursts.

What are examples of weighted objects and where can I find them?

Common examples of weighted objects include:
• Vests
• Blankets
• Lap pads
• Backpacks
• Stuffed animals

Depending on your child’s needs, weighted objects come in a variety of shapes and sizes and can be worn or held during specific activities (vest; lap pad; stuffed animal) to improve attention, carried between environments (backpack, stuffed animal) to improve smooth transitions, and placed on the body (blanket) during quiet activities, such as reading books, riding in the car, and when going to sleep, to provide comfort, reduce anxiety, and promote a calm, organized state of arousal.

Many weighted objects are available for purchase from online and in-store retailers. Weighted objects may also be created by adding weight to items already found in your home. For example, filling a long tube sock with dry rice or beans and tying off the end securely or adding these materials to one of your child’s favorite stuffed toys may work well for use as a lap pad or weighted stuffed animal. Similarly, adding books or bottles of water to your child’s backpack makes for an easy weighted adjustment during transitions to and from school. Research suggests that each object should be about 10% of the user’s body weight plus one pound to promote optimal effects, so be sure to consult with a trained therapist or doctor before trialing weighted objects with your child at home.

Do weighted objects work for every child?
While research suggests that weighted objects have several positive benefits, they may not be appropriate or suitable for every child. Objects are often most effective when implemented with other sensory strategies and should be used only as directed by your child’s occupational therapist or doctor to best target their individualized needs and ensure safe and appropriate application.

Questions or concerns?
If you have questions or concerns about whether your child may benefit from using a weighted object, please contact us at info@playworkschicago.com or 773-332-9439.

Caitlin Chociej, MS, OTR/L
Occupational Therapist

References:

Chen, H., Yang, H., Chi, H., Chen, H. (2013). Physiological Effects of Deep Touch Pressure on Anxiety Alleviation: The Weighted Blanket Approach. Journal of Medical and Biological Engineering, 33(5), 463-470. doi:10.5405/jmbe.1043

Vandenberg, N. L. (2001). The Use of a Weighted Vest to Increase On-Task Behavior in Children with Attention Difficulties. American Journal of Occupational Therapy, 55(6), 621–628. doi: 10.5014/ajot.55.6.621

Photo Credit: Naomi Shi via Pexels

Employee Spotlight: Stephanie Wroblewski, MSW, LCSW

What do you love most about working for PlayWorks Therapy?

My favorite thing about working at PlayWorks is the welcoming environment. I love that the clinic was created in a way to promote collaboration and connection between families, staff, and therapists. Every time I walk into the clinic, I feel like I am entering the center of a special community, where everyone is focused and committed towards enhancing the lives of all children.

What is your favorite children’s book?

Instead of choosing just one book I will have to choose a series, and that is Junie B. Jones! I still remember reading my first Junie B. Jones book (when I was in early elementary school), and instantly falling in love with her character. As a child I was eager to purchase the latest book in the series, and I was constantly reading (and re-reading) each and every one.

What do you enjoy most about living in Chicago?

It is hard for me to choose just one thing I enjoy most about living in Chicago, but when I think of how much I love this city, the first thing that comes to mind is the lake. Through all seasons, I really enjoy walking/biking down the lakeshore path, waking up early to enjoy a sunrise over the water, or just taking in the beautiful waters and seemingly endless horizon.

What is your favorite childhood memory?

Again I will choose a “series” of memories instead of just choosing one: my family’s yearly vacation to Wisconsin Dells. Each summer my entire family (grandparents, aunts, uncles, cousins, etc.) drives to Wisconsin Dells to spend a week together enjoying picnics, bonfires, and all sorts of summertime activities. The tradition began a few years before I was born and continues to this day, even as our family has nearly tripled in size!

Would you rather a mountain or beach vacation?

Mountains. I will definitely choose mountains over the beach every time! I love the feel of the crisp mountain air and the panoramic views from the top of a high peak.

Share a proud “therapy moment” with one of your clients.

There are so many successes I am lucky enough to experience with my clients, both big and small, and I think it is very important to acknowledge and celebrate each and every one. A few weeks ago one of the young boys I work with was having a difficult time leaving the sensory gym in order to return to our therapy room and resume work for the day. Before I was even able to suggest some strategies he can use to calm down he stopped shouting, took a big deep breath, and told me exactly how he was feeling. This was the first time this particular child independently used a calming strategy in my presence, and I was so proud of him for doing so!

What is your hometown?

I grew up in Western Springs, Illinois.

What do you like to do in your free time?

My absolute favorite thing to do in my free time is travel! I also love to read, spend time with my family, and do just about anything outside.

What is your favorite therapy toy?

Currently my favorite therapy toy is Mr. Potato Head. I love how this toy allows for endless possibilities when it comes to creativity and expression.

Share a fun fact about yourself.

I have a goofy and energetic English bulldog named Filomena.

Stephanie Wroblewski, LCSW
Licensed Clinical Social Worker

Bilingualism: Can a child with language delays learn two languages?

As a speech-language pathologist and Early Intervention provider, I frequently work with families who speak more than one language. While there is plenty of research on the benefits of bilingualism on children’s language development and cognitive skills, there is often confusion regarding the impact of two languages on delayed language learners. This blog aims to address frequently asked questions by bilingual families to guide language use inside and out of the home.

Question: My child has been exposed to two languages since birth. Has this caused his/her language delay?
Answer: Bilingualism itself will NOT cause a language delay. In fact, research shows that bilingualism may lead to long-term advantages, such as increasing vocabulary and problem solving skills. Birth-to-three years of age is the critical period for language acquisition, meaning that this is the easiest time in childhood for children to learn a second language.

Question: My child has a language delay. I’m afraid that a second language will confuse him/her. Should I stop speaking a second language to my child?
Answer: Definitely not! It is encouraged that bilingual families continue to speak both languages to their child and that this is carried over across settings (e.g., school, playgroups, etc.). Children with language delays can learn to speak two languages if given the appropriate supports and opportunities.

Question: My child is two years old and not yet speaking. He’s exposed to both English and our native language at home, so this is okay, right?
Answer: While children simultaneously exposed to two languages may say their first words a bit later than monolingual children, they are still expected to learn language at roughly the same rate. If your child is two years old and not yet producing words, he or she should be referred for a full speech and language evaluation.

Question: How can I support bilingual language acquisition in my child?
Answer: Some families choose to have one parent solely speak one language and have the other parent solely speak the other language. Some families decide to have parents speak both languages and use them interchangeably. Either way is fine, but it is important to consider what feels the most natural for you and your family!

What’s the takeaway?
There is NO scientific evidence that living in a bilingual household will negatively impact the language development of children. Furthermore, children with language delays CAN learn two languages with consistent, rich exposure to both languages.

Questions or concerns?
If you have questions or concerns about the impact of two languages on your child, please contact us at info@playworkschicago.com or 773-332-9439.

Jill Teitelbaum, MS, CF-SLP
Speech-Language Pathologist

References:

Lowry, L., & Speech, H. C. (2012). Can children with language impairments learn two languages?. The Hanen Centre.

Photo Credit: 4dgraphic via unsplash.com

Language Milestones for Children with Down Syndrome (Birth to Five)

Birth to five years of age is a critical period for language development for all children. Each child progresses at his or her own rate, and each presents with his or her own strengths or weaknesses. The same applies to children with Down syndrome. However, children with Down syndrome tend to develop language skills at a slower rate than their typically developing peers. This blog will aim to answer questions regarding language development in children with Down syndrome by comparing language milestones to those of their typically developing peers.

While the milestones above are based on general trends, it is important to note that language development will vary for both typically developing children and children with Down syndrome. Speech therapy is recommended for children with Down syndrome, starting younger than one year of age to target feeding and oral-motor skills and after 15- to 18-months of age to target speech and language skills. Common early speech and language targets for children with Down syndrome include verbal turn taking, vocabulary acquisition, use of simple signs and gestures, following simple routines-based directions, use of age-appropriate speech sounds, and more.

Questions or concerns?

If you have questions about language development in children with Down syndrome, please contact us at info@playworkschicago.com or 773-332-9439.

Jill Teitelbaum, MS, CF-SLP
Speech-Language Pathologist

Reference: Layton, T. (2004). Developmental Scale for Children with Down Syndrome.

Photo Credit: yulia84 via pixabay.com

Employee Spotlight- Becky Clark

  • What do you love most about being a Developmental Therapist?

I love how Developmental Therapy allows me to look at the big picture to see how all the various areas of development and environment affect the others. I also enjoy the focus on a child’s social and emotional development in that bigger picture.

  • What is your favorite children’s book?

When I was a young child, it was The Berenstains’ B Bookby Stan and Jan Berenstain, much to my parents’ chagrin. Now in my sessions, I love using Brown Bear, Brown Bear, What Do You See?by Bill Martin Jr. I guess there is a bear-theme in my reading choices!

  • What do you enjoy most about living in Chicago?

I enjoy Chicago’s diversity the most. It’s one of its richest assest. I also love how Chicago incorporates nature and green spaces into the cityscape.

  • What is your favorite childhood memory?

I went to a summer camp for many years in North Carolina, and each summer was a blast, but I especially remember the summers I went backpacking on the Appalachian Trail. I picked wild blueberries, pet wild ponies, and enjoyed gorgeous views.

  • Mountain or beach vacation?

Mountains, hands down!

  • Share a proud “therapy moment” with one of your clients.

I had a client diagnosed with Autism Spectrum Disorder and he had been working for months on regulating his body enough to engage with others in the room. I walked in one session and knelt down to say hello and he calmly walked to me, let me take his hands, then he kissed my forehead. It was the sweetest “hello!”

  • What is your hometown?

Archdale, North Carolina

  • What do you like to do in your free time?

I work once or twice a month at the Chicago Children’s Museum and enjoy working with different populations and ages. When I’m not working, I’m going for walks to my neighborhood beach or hanging out with family and friends.

  • Fun fact about yourself?

I have been to three continents other than North America: Europe, Africa, and Oceania. I would love to see a couple more!

  • Favorite therapy toy?

Songs and books!

Becky Clark, MS, DT
Developmental Therapist