Brandhorst Specialized Therapy

Missed or delayed developmental milestones are flags to ask for an evaluation. There is generally an underlying reason that can be identified and addressed. Ask for an evaluation if your child has not met these milestones:

By 6 Months
Your child should babble (ex: baaaaa, uuuuum)

By 9 Months
Your child should use variegated babble (ex: mamama, gagaga)

By 12 Months
Your child should say their first words, follow simple directions.

By 28 Months
Your child should put 2 words together (ex: shoe on, truck go)

By Age 3
Your child should speak 3 or 4-word sentences.

By Age 4
Your child should be 100% intelligible but some speech sounds may be wrong.

By Age 5
Your child should be 100% intelligible and all speech sounds correct.

When feeding goes well, we do not realize how complicated it is! Gagging, gassiness, reflux, colic, failure to gain weight, excessive drooling, choking, picky eating, and refusal to try new foods can be indicators a structural issue is interfering with sucking, chewing, or swallowing. Contact us for a feeding evaluation. We can help transform mealtime stress into an enjoyable experience!

Awareness of tethered oral tissue (TOT) is increasing, but healthcare professionals disagree about when they need attention. Infants who struggle to feed or are colicky, children who have difficulty producing speech sounds, and anyone who mouth-breathes or snores may be experiencing decreased oral function due to TOT and benefit from therapy or revision. We recommend any TOT that interferes with oral function be evaluated, so you can make the best decision about your specific situation.

Recognizing the frustration that comes from blocked communication is an important first step! Schedule a free phone screening with us to discuss age-appropriate expectations and next steps. There is hope and help!

Therapy offers many benefits for those facing these challenges. We can help patients of all ages with intelligibility, compensatory strategies, augmentative communication, swallowing, and cognition. Call or email us to take the next step of adding us to your care team.

You do not have to accept a weak or hoarse voice as your new normal! There can be a number of treatable causes for this change. Schedule an evaluation to determine the root cause and develop a treatment plan to strengthen your voice.

Executive functions are skills that help you carry out daily activities. They include attention, planning, memory, and problem-solving. Speech therapy helps people improve these skills and develop strategies to compensate for them. We offer evaluations to determine what is causing the difficulty and how to help you stabilize and thrive.

Missed or delayed developmental milestones are flags to ask for an evaluation. There is generally an underlying reason that can be identified and addressed. Ask for an evaluation if your child has not met these milestones:

By 6 Months
Your child should reflexively grasp (birth); voluntarily grasp (3 months); controlled reach (6 months).

By 12 Months
Your child should reach, grasp, and put objects in their mouth; transfer objects from one hand to the other; drop and pick up toys; pincer grasp (ex: grab cheerio between thumb and 1 finger).

By Age 2
Your child should build a tower of 3 small blocks; place 5 pegs into a pegboard; scribble with a crayon; feed self with minimal help; hold and drink from a cup independently; turn 2-3 book pages at a time.

By Age 3
Your child should string four large beads; use one hand consistently in most activities; eat without assistance; imitate circular, vertical, and horizontal writing strokes; hold a crayon with thumbs and fingers, not fist; turn a single page of a book.

By Age 4
Your child should build a tower of nine small blocks; copy a circle; imitate drawing a square; use their non-dominant hand to assist and stabilize the object; snip paper using scissors.

By Age 5
Your child should cut on a line continuously; copy a cross (+) and square; copy most letters; print letters of their first name; write numbers 1-5; have well-established handedness; dress/undress self independently.

By Age 6
Your child should cut out simple shapes with scissors; copy a triangle; color within lines; use a 3 fingered grasp of pencil and use fingers to generate movement; draw a basic person.

By Age 7
Your child should form most letters and numbers correctly; print letters consistently on the line; build with Legos, K’nex, and other blocks; tie shoelaces.

By Age 8
Your child should maintain legible handwriting for the entire length of a sentence/simple story.

Missed or delayed developmental milestones are flags to ask for an evaluation. There is generally an underlying reason that can be identified and addressed. Ask for an evaluation if your child has not met these sensory processing milestones:

By 6 Months
Your child should track objects with eyes; coordinate suck, swallow and breathe; communicate hunger, fear, or discomfort by crying.

By 12 Months
Your child should play 2-3 minutes with a single toy; imitate gestures; respond to facial expressions; identify self in a mirror; tolerate a range of different textured foods.

By Age 2
Your child should play next to children; engage in imaginative play; sit to look and listen to books being read; enjoy/tolerate messy play; tolerate a range of different textured foods; copy sounds that you make; solve problems by trial and error.

By Age 3
Your child should pay attention for 3 minutes; tolerate a range of different textured foods; point to 5-6 parts of a doll when asked; follow simple instructions (ex: give the ball to mommy).

By Age 4
Your child should have awareness of parent’s approval or disapproval of their actions; take turns; play with 2-3 children in a group; tolerate different clothing textures (seams, tags, etc.); express emotions; play themes expand beyond personal experiences (ex: fireman rescuing people).

By Age 5
Your child should develop friendships; settle themselves to sleep at night; follow rules; play with 4-5 children in a group; focus in busy/noisy environments.

By Age 6
Your child should know where their body is in time and space to coordinate body movements for ball skills; distinguish between right and left; sit at a desk, following teacher instructions, independently do simple in-class assignments; recall events, and describe them.

By Age 7
Your child should attend for longer periods of time; eat a wide range of foods and tolerate a variety of textures; take on more responsibility/chores; sit still in class, at mealtimes, etc.; toilet independently day and night; read a book on their own.

Tummy time is important for your baby’s sensory, gross motor, fine motor, and oral motor development, but it should absolutely be fun and enjoyable! Physical therapy can help get to the root of why it is difficult and make this a pleasurable experience.

It can be concerning when your baby does not have a round head. Physical therapy can help determine the cause for the flattened area and assist with strategies to help it improve.

Babies should freely move their heads from side to side. If they are not, it is easier to fix the earlier it is addressed. Full movement is important for your baby’s sensory, gross motor, and visual-motor development and for preventing flattened areas on the skull. Physical therapy gently improves this movement.

Children described as “floppy” often have low muscle tone that can interfere in developing normal motor milestones such as rolling, sitting, crawling, and walking. Our therapists can help; call us for a consultation.

It is normal for children to walk on their toes at times. It can turn into a problem if your child walks like this more than normal walking. Some children grow out of it, but many do not. Physical therapy can help tease out your child’s reasons for toe walking and give you strategies to improve it. The earlier it is addressed, the easier it is to improve.

These can be early warning signs of some significant disorders. Please contact us for an occupational therapy evaluation to discover the root of these behaviors and therapy options.

Many children have delayed fine motor skills that interfere with play and school activities. It is important to address these delays as easily as possible. Set up an evaluation to determine how we can help them progress.

Sensory-motor processing issues can cause many problems like these. Occupational therapists specialize in helping children with all types of sensory processing problems. We are happy to set up an evaluation and gain insight that will help your child stabilize, grow, and thrive.

Both situations describe possible sensory problems that can interfere with daily activities. Tactile, proprioceptive, auditory, visual, and vestibular systems must all work together for a child to thrive. Our occupational therapist can help you and your child learn more about sensory processing.