1. What is attention?
    Attention is the ability to obtain and sustain appropriate attention to a task. This can be influenced by motivation, self-esteem, sensory integration and language difficulties. Effective attention is what allows us to screen out irrelevant stimulation in order to focus on the information that is important in the moment.

  2. What are the necessary elements to build attention and how does Occupational Therapy help?

    The main building blocks for attention include:

    • Sensory processing
    • Self regulation
    • Receptive (understanding) Language
    • Auditory processing difficulties
    • Hearing impairment
    • Learnt helplessness
    • Limited motivation
    • Environment

    OTs combine consider all elements such as environmental factors, sensory related needs, and play skills to target attention from the child, tailoring these factors according to each individual child.

  1. The teacher says my child is not holding the pencil the correct way. What can I do to correct it?
    Development in prewriting skills begins around 1 year of age when children are exploring with different writing tools – crayons, markers while scribbling and doodling. As children grow, their grasp on the writing tools become more refined and controlled. An occupational therapist is able to observe how the child holds a pencil and assess his or her control and how it impacts writing. Besides determining the type of grasp the child utilizes, considerations will be given to the child’s endurance, pressure on paper and upper stability. Occupational therapy intervention may include fine motor strengthening, development of age-appropriate grasp and endurance training, so as to facilitate the ease and legibility of writing.

  2. My child does not like to color. When he colors, he just colors all over the paper. Sometimes he colors very hard and other times it is very light. What can I do?
    Coloring is a simple and fun activity that most children enjoy. However, when it is broken down, there are several components involved. Visual attention is required to locate the lines and boundaries between the different areas. Fine motor control is needed to color in different areas and still stay in the line. The ability to integrate sensory feedback from the paper is required to know how much pressure to apply when coloring. If the picture is large, endurance is required to finish coloring the entire area. Darkening or bolding the outline of the picture or figures with a marker increases the contrast and allows your child to become more visually aware of the spaces within. Coloring by numbers is a good way to way to limit the number of colors used (too many color pencils/crayon options may be distracting) and the numbers provide a visual cue to the boundaries and what colors to use where. An occupational therapist would be able to identify which specific area your child is struggling with and provide strategies to try at home.

  3. I cannot tell if my child is left-handed or right-handed. Sometimes he uses his left hand, but then he would switch half way. Should I force him to use one hand over the over?
    It depends on how old your child is. During the early years, children use both hands to explore the environment and to manipulate things around them. Hand dominance begins to develop around 2 to 3 years and should be established around 5 to 6 years of age. It is recommended to allow children to use both hands (and to switch between both) in the early years to promote fine motor dexterity, bilateral coordination and integration. Switching hands during activities may be a sign of fatigue. A good indication of hand dominance is the quality of manipulation and dexterousness of each hand. An occupational therapist can assess your child’s fine motor skills and development, then suggest different activities to try at home.

What are gross motor skills?
Gross motor skills are larger movements your child makes with his arms, legs, feet, or his entire body. So crawling, running, and jumping are gross motor skills.

Why are gross motor skills important in a child’s development?
Gross motor skills are important to enable children to perform every day functions, such as walking, running, skipping, as well as playground skills (e.g. climbing) and sporting skills (e.g. catching, throwing and hitting a ball with a bat). Gross motor abilities also have an influence on other everyday functions. For example, a child’s ability to maintain table top posture (upper body support) will affect their ability to participate in fine motor skills (e.g. writing, drawing and cutting) and sitting upright to attend to class instruction, Gross motor skills impact on your endurance to cope with a full day of school.

  1. My 7 years old child handwriting quality is very poor. His teacher always complains for his poor handwriting quality. How can I help him to improve it?
    There may be many reasons for your child’s poor handwriting.  Firstly, children with sensory processing issues may have difficulties paying attention while participating in any table top task. They find handwriting tasks to be very challenging as they cannot stay focused on their task. Next issue could be related to your child’s visual motor integration (VMI) which includes both visual perception and motor coordination.   Handwriting will be affected if he has difficulties in any of these areas. Other reasons for difficulties with writing may be your child’s low body muscle tone, poor body posture, inappropriate pencil grip while writing and sometimes lack of motivation to write properly.

  2. My child is 9 years old and he complains of frequent hand pain while writing a larger volume of work. How can I help him with this problem?
    Children with improper pencil grips, especially applying too much pressure on the pencil to grip it while writing may trigger hand pain. Gripping the pencil with too much pressure results in muscle fatigue in hand muscles, thus causing hand pain. Another reason may be that your child’s proprioceptive senses (joint sense) is poor , and he may have difficulty in gauging how much pencil pressure is needed when gripping the pencil during handwriting.  As a result he or she uses too much pencil pressure and pain happens. Finally, your child’s hand muscle may be very weak, and as result s/he need to apply increased amounts of pressure on his hand muscle to hold the pencil properly.
  1. What are the basic skills a child needs for preschool?
    Your child should be able to respond to their name when called and be able to follow basic verbal instructions (such as sit down, give high-5). Your child should be able to indicate simple needs either by words, or taking an adult’s hand. In order to learn, he or she should also have joint attention with adults and other children. Your child should be able to sit for an age appropriate amount of time, such as the time needed to finish a short story book.  Your child should also have foundational social skills such as taking turns, waiting, and sharing.

  2. How can I help prepare my child for transition to primary school?
    Help your child prepare to follow instructions in a bigger group by enrolling him or her in group activities such as camps or drama classes. Encourage your child to be more organized by having him or her draw up simple visual schedules and follow through independently. Practice packing and unpacking a school bag, having your child self-check if all items have been packed into the bag. Your child should have simple money skills so that he or she can buy food during recess. Have your child practice buying and carrying a food tray at the food court. Handwriting demands are also increased, so make sure your child is able to write legibly with a good pencil grip.

What is Sensory Processing?
Sensory processing is the normal neurological process of organizing sensations for our use in everyday life. We use sensations to survive, to satisfy our desires, to learn, and to function smoothly. Our brains receive sensory information from our bodies and surroundings, interpret these messages, and organize our purposeful responses.

What are the red flags when a child is having sensory processing problem?

Infants and toddlers

  • Problems eating or sleeping
  • Refuses to go to anyone but their mom for comfort
  • Irritable when being dressed; uncomfortable in clothes
  • Rarely plays with toys
  • Resists cuddling, arches away when held
  • Cannot calm self
  • Floppy or stiff body, motor delays

  • Over-sensitive to touch, noises, smells, other people
  • Difficulty making friends
  • Difficulty dressing, eating, sleeping, and/or toilet training
  • Clumsy; poor motor skills; weak
  • In constant motion; in everyone else’s  “face and space”
  • Frequent or long temper tantrums

  • Over-sensitive to touch, noise, smells, other people
  • Easily distracted, fidgety, craves movement; aggressive
  • Easily overwhelmed
  • Difficulty with handwriting or motor activities
  • Difficulty making friends
  • Unaware of pain and/or other people
Adolescents and adults
  • Over-sensitive to touch, noise, smells, and other people
  • Poor self-esteem; afraid of failing at new tasks
  • Lethargic and slow
  • Always on the go; impulsive; distractible
  • Leaves tasks uncompleted
  • Clumsy, slow, poor motor skills or handwriting
  • Difficulty staying focused
  • Difficulty staying focused at work and in meetings
  • Unmotivated; never seems to get joy from life

Q1: What will my child learn in social skills training?
A: Depending on the recommendation from the initial assessment, your child might benefit from individual or group social skills training.  Your child will learn social skills that are required to interact with others through verbal or non-verbal (e.g. gestural, body language) communications with others.
To have effective social interactions with others, some of the skills include but not limited to:

  • Joint Attention
  • Eye contact
  • Following instructions
  • Turn taking
  • Sharing
  • Understanding of emotions (self and others)
  • Emotional Regulation
  • Conflict resolution
  • Negotiation
  • Problem solving skills

Q2 : How will social skills be taught?
A: The social skills training will be fun and educational.  Mainly, games are used to facilitate children to learn the various social skills.  Some of the strategies used include: 1) Modelling, 2) Role play and 3) Feedback.  Each session will focus on a different topic and your child will have opportunity to utilise skills learnt from previous sessions.  Parent(s) will be briefed after each session on child’s progress and any follow-up home programmes.

Occupational Therapy

Occupational Therapy is concerned with a persons ability to participate in daily life activities or occupations, including self care, work, and play.

Pediatric Occupational Therapy

A childs job of growing into adulthood involves continual adaptation to the demands of the environment and assimilation of its opportunities. The dynamic nature of this interaction is determined by the childs internal clock of maturation as the child adapts to a changing environment. Occupational therapy practice is based on an understanding of the interactions among children, their activities (or occupations), and their environment.

Who are the children who can benefit from an occupational therapy intervention?

Children having difficulties in:

  • Fine motor skills
  • Gross motor skills
  • Coordination
  • Sensory integration issues (Modulation and Discrimination of sensory input)
  • Motor planning (praxis)
  • Visual motor integration
  • Visual perception skills
  • Oral Motor (Oral Defensiveness, and Motor Planning)

These difficulties might result in the following issues:

  • Handwriting
  • Balancing responses
  • Clumsiness
  • Manipulation of objects and tools
  • Independence in self care tasks
  • Performance in physical education
  • Sitting still in class
  • Hyperactivity due to sensory seeking behaviors
  • Short attention span
  • Feeding Issues

Occupational Therapy Services include:

  • Assessment (screening and in depth):
  • Standardized assessments
  • Informal assessments that includes clinical observations
    • Assessment is important in order to:
    • Find out where is the core cause of the difficulty
    • Set intervention goals
    • Set a base line of where is the starting point of abilities before intervention had started
  • Intervention (individual sessions)
    • The use of childs strength to compensate his weaknesses
    • Direct targeting of root causes of the observed behaviors
    • Modification of environment to match childs abilities
    • Teaching strategies
    • Direct training in targeted tasks
    • Remedial approaches for sensory integration that may include a Sensory Diet
    • Oral Motor intervention to improve feeding and oral defensiveness
    • Advising parents and teachers how to manage the child at home and in school
    • Occupational therapy intervention is child-directed and it incorporates play for motivation and experience. It is important to design a suitable challenge fo the child to provide an opportunity to learn and improve while not discouraging the child by failure.
    • The occupational therapy session should be fun and motivating for the child in order for him to benefit and get the opportunity to learn and improve his skills.

The Role of Occupational Therapy

A childs occupational performance might be affected by developmental, physical, sensory, attentional and learning challenges. The goal of occupational therapy is to improve the students performance of tasks and activities important for successful school and life functioning.

The occupational therapist is concerned with ensuring an understanding of, and match between the students skills and abilities and the expectations placed on him.

What is Sensory Integration (SI)?

Sensory Integration Theory was formed by A. J. Ayers who was an Occupational Therapist with advanced training in Neuroscience and Educational Psychology. She defined Sensory Integration as the neurological process that organizes sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment.

All the information children receive from their environment arrives through the sensory systems. Most of us are familiar with the sense of Smell, Taste, Sight and Sound. There are 3 more senses that we are less aware of and these are: the sense of Touch (the Tactile Sense), the sense of Movement (the Proprioceptive Sense) and the sense of Balance (the Vestibular Sense).

The SI theory puts an emphasis on these 3 important senses:

Tactile system detects qualities and locations of external stimuli applied to the skin. Information from the skin, about location of touch, pain and temperature is transferred through this system to the brain.

Proprioceptive system refers to sensation of movement (i.e. speed, rate, sequencing, timing and force). It's important for the development of body scheme, praxis (motor planning), and adaptive action. The information on proprioception arrives from the muscle receptors and partially from skin receptors which provide to the brain information about muscle change during movement. This allows generation of proper amount of force needed to act on objects

Vestibular system - the vestibular input contributes to posture and the maintenance of a stable visual field. The receptors for vestibular input are located in the inner ear. There is a combined impact of vestibular and proprioception input on muscle tone, posture, equilibrium, and motor behavior

Dysfunction in Sensory Integration (DSI)

If one or more of the sensory systems are not fine tuned to work with harmony with the rest, or information from the senses is not well processed the level of functioning of the child might be compromised.

Symptoms that are commonly displayed in DSI include:

  • Being overly sensitive to touch, movement sights or sounds
  • Being under reactive to sensory stimuli
  • High or Low Activity Level
  • Coordination problems
  • Delays in speech or language skills
  • Poor organization of behavior
  • A poor self concept

Sensory Integration (SI) Therapy

It is important to do an assessment with the child and interview the parents in order to identify the areas of strengths and weaknesses in order to tailor an individual intervention plan and to create a base line for future intervention.

The SI therapy is being done mainly in a special gym that includes plethora of suspended equipment (swings, ladders, tunnels, therapy balls and many more). The equipment allows us to give a variety of stimulation to all the sensory systems.

A: There can be many reasons why a child would need a feeding assessment. If your child has any of the following issues, a feeding assessment might be needed.

  • frequent gagging, choking or vomiting during meals
  • refusal to try new foods
  • picky eater – only eating certain foods
  • food range of less than 20 foods
  • difficult to feed

The symptoms of stuttering typically appear between the ages of 2.5 to 4 years. It is also possible for stuttering to start during primary school. About 5% of children display stuttering behaviours and stuttering is more commonly observed in males than females. Preschoolers may have little or no awareness of their fluency difficulties, especially so when they first start to display stuttering behaviours. However, most people who stutter become increasingly aware of their fluency difficulties and the responses they receive when they do not speak fluently.

It is important to have regular checkups with developmental and hearing specialists to ensure your child’s development is progressing appropriately. Concerns may be raised by your family doctor, professionals who work with your child, e.g. teachers and support staff, or from your friends and family regarding your child’s ability to; understand/follow instructions, communicate their thoughts/feelings/wants/needs or their ability to interact with their peers (social communication).

As parents you may also seek speech and language therapy for your child if you have concerns that your child is not reaching their language and communication milestones in the way that their siblings, friends and peers do. If you have any concerns, our clinicians will be able to perform an initial assessment to determine whether speech and language therapy may be beneficial for your child.

Children who stutter exhibit poorer educational and social outcomes than their normally fluent peers; it is therefore of importance to commence with therapy to reduce stuttering behaviours. Clinical evidence shows that children who stutter can benefit from treatment provided by speech therapists. Intervention approaches that appear to have the greatest efficacy for reducing the frequency of stuttering behaviours in children include behavioural treatments (e.g. Lidcombe Program).

Amounts and frequency of therapy varies greatly between each child and can last from weeks to many years. It is rarely possible to give an exact time frame for intervention as this changes due to the cause of communication difficulties, the child’s ability to build new skills and the severity of the delay or disorder.

Following the initial assessment, the therapist will plan both long and short term goals for your child. They will also seek you input for these goals. The therapist will then work with the child on achieving these goals which will be reviewed when necessary. This way, both the therapist and family can monitor the child’s development in a meaningful way, ensuring all skills are achieved before moving to the next stage of communication.

Each children develops in his own pace. The following table describes the age by which most children will accomplish various speech-related skills (taken from ASHA website).
Hearing and Understanding Talking
Birth-1 Months
  • Startles to loud sounds.
  • Quiets or smiles when spoken to.
  • Seems to recognize your voice and quiets if crying.
  • Increases or decreases sucking behavior in response to sound.
Birth-1 Months
  • Makes pleasure sounds?(cooing, gooing).
  • Cries differently for different needs.
  • Smiles when sees you.
4-6 Months
  • Moves eyes in direction of sounds.
  • Responds to changes in tone of your voice.
  • Notices toys that make sounds.
  • Pays attention to music.
4-6 Months
  • Babbling sounds more speech-like with many different sounds, including p, b and m.
  • Vocalizes excitement and displeasure.
  • Makes gurgling sounds when left alone and when playing with you.
7 Months-1 Year
  • Enjoys games like peek-o-boo and pat-a-cake.
  • Turns and looks?in direction of sounds.
  • Listens when spoken to.
  • Recognizes words for common items like "cup", "shoe," "juice."
  • Begins to respond to requests ("Come here," "Want more?").
7 Months-1 Year
  • Babbling has both long and short groups of sounds such as "tata upup bibibibi."
  • Uses speech or non-crying sounds to get and keep attention.
  • Imitates different speech sounds.
  • Has 1 or 2 words (bye-bye, dada, mama) although they may not be clear.
1-2 Years
  • Points to a few body parts when asked.
  • Follows simple commands and understands simple questions ("Roll the ball," "Kiss the baby," "Where's your shoe?").
  • Listens to simple stories, songs, and rhymes.
  • Points to pictures in a book when named.
1-2 Years
  • Says more words every month.
  • Uses some 1-2 word questions ("Where kitty?" "Go bye-bye?" "What's that?").
  • Puts 2 words together ("more cookie," "no juice," "mommy book").
  • Uses many different consonant sounds of the beginning of words.
2-3 Years
  • Understands differences in meaning ("go-stop," "in-on", "big-little," "up-down").
  • Follows two requests ("Get the book and put it on the table.").
2-3 Years
  • Has a word for almost everything.
  • Uses 2-3-word "sentences" to talk about and ask for things.
  • Speech is understood by familiar listeners most of the time.
  • Often asks for or?directs attention to objects by naming them.
3-4 Years
  • Hears you when call from another room.
  • Hears television or radio at the same loudness level as other family members.
  • Understands simple, "who?," "what?," "where?," "why?" questions.
3-4 Years
  • Talks about activities at school or at friends' homes.
  • People outside family usually understand child's speech.
  • Uses a lot of sentences that have 4 or more words.
  • Usually talks easily without repeating syllables or words.
4-5 Years
  • Pays attention to a short story and answers simple questions about it.
  • Hears and understands most of what is said at home and in school.
4-5 Years
  • Voice sounds clear like other children's.
  • Uses sentences that give lots of details (e.g. "I like to read my books").
  • Tells stories that stick to topic.
  • Communicates easily with other children and adults.
  • Says most sounds correctly except a few like l, s, r, v, z, ch, sh, th.
  • Uses?the same grammar as the rest of the family.

If you observe your child’s tongue going past his/her teeth as he says words such as “sea” or “zebra”, he/she might have an interdental lisp. Those two sounds, ‘s’ and ‘z’ respectively, are quite tricky to produce and tend to develop quite late. Therefore, it is ok for children to produce them with the tongue popping out at a young age. However, if this persists past the age of 4½, seeking a speech therapist’s assistance will be necessary to teach a correct production. Be mindful of those ‘s’ sounds produced in a “noisy” way, when you feel that you are hearing saliva bubbles forming, or just too much air coming out, specially from the sides of the mouth. This might be a “lateral lisp”, which is not a typical error in the sound development continuum. A speech therapist’s assessment and assistance will be required, the earlier the better.

At that age, you would expect your child to start playing with other children. If he/she interacts better with you, it might be because you provide a better structure, understand his/her non-verbal communication and easily know what he/she means, while the other children he/she plays with will not. He/she should be able to request from peers “gimme ball” and comment on situations eg “bear fell down”. A speech therapist will assist with the development of language and social skills.

“Augmentative and Alternative Communication” (AAC) encompasses all forms of communication (other than speech) that are used to express an individual’s wants, needs, opinions and ideas. AAC can be divided into 2 main categories – unaided communication systems and aided communication systems. Unaided communication systems include: body language, gestures, sign language (and Key Word Signing). Aided communication systems include: using pictures, writing, communication books or boards, switches, and also speech generating devices (both specialised devices and apps). Use of AAC can help reduce communication breakdown and frustrations. Research currently demonstrates that use of AAC will not keep a child from learning to talk. Children will choose the most effective method to communicate, whether that be speech or AAC or a combination.

Speech and language therapy may begin at any age. In babies, it may be needed to address feeding or swallowing difficulties which can cause difficulties in early development and well being. Communication (understanding and using language) therapy for children whose language is delayed from an early age will typically begin from 18-24 months, though children are often seen at a later stage as difficulties become more apparent. Children with speech difficulties are usually seen from the age of 3 years, though this depends on the nature of the difficulty.

If you have concerns with your child’s speech, language and communication at any point in their development we recommend you have an appointment with one of our clinicians to learn more.

Pragmatics or the rules for social language is another area in which speech and language therapists may work with children. Pragmatics involves using language for specific purposes, such as greeting, informing, demanding, promising, or requesting; changing language according to the needs of the listener or situation, such as talking differently to a peer than to an adult or giving context to an unfamiliar listener; following rules for conversations and storytelling, such as taking turns in conversation, introducing topics, or rephrasing when misunderstood, using appropriate verbal and non verbal gestures , facial expressions and eye-contact.

A child with pragmatic difficulties/disorders may use complex language but still have a communication difficulties such as saying inappropriate or unrelated things during conversations, telling stories in a disorganized way or have little variety in their language use and topics.

Both Hanen programs are delivered by a Hanen Certified Speech-Language Therapist. They can be delivered in individual therapy sessions or in group sessions. Both programs focus on communication in the everyday environment and using daily routines and activities to support communication.

The “It Takes Two to Talk” Program is designed specifically for parents/caregivers of young children (birth to 5 years of age) who have been identified as having a language delay. Parents/caregivers are supported to interact in ways that support the development of their child’s language and interaction.

The “More Than Words” Program is designed specifically for parents of children ages 5 years and under on the autism spectrum. The program provides parents/caregivers with tools, strategies and support to help their children reach their full communication potential. The program does this by teaching strategies to help improved social communication and back-and-forth interactions, improved play skills and improved imitation skills.

The exact cause of stuttering is currently unknown. Recent studies have suggested that genetics plays a role in the development of the disorder and that abnormalities in speech motor control, such as timing and sensory and motor coordination, are implicated.

A: You will be asked to bring certain foods from home to trial in the session with the therapist. After a thorough interview with the therapist, she will observe your child’s feeding and drinking abilities. During the assessment, she might trial some strategies that might improve your child’s feeding skills. Depending on the outcome of the assessment, feeding therapy might be recommended.

PROMPT Therapy

– Prompts for Restructuring Oral Muscular Phonetic Targets
Developed by: Deborah Hayden CCC/SLP

What Is PROMPT therapy?

PROMPT is a language–based treatment approach.

It provides tactile information to the oral musculature (jaw, lips, tongue) in an attempt to guide a child’s movements for speech production.

Sensory feedback from the movements is then stored and progresses as the child is provided multiple opportunities for practice. Muscle memory builds (this takes at least 6-8 weeks), and movement patterns for speech become more and more automatic.

There is a PROMPT for every sound in the language, vowel or consonant.

Why does it work?

Practice and feedback are integrated.

In PROMPT therapy, a child receives tactile cues as well as auditory feedback (two extremely important sensory systems required in learning to talk).

- Motivation is the key! It is very important to encourage a child so that they can maintain attention and effort required to make changes in speech production.
- Target sounds, words and phrases are practiced in a variety of interactions, both in therapy sessions and in the child’s natural environment.

How does it work?

First a motor assessment is carried out by our PROMPT trained therapist (Clare Hegarty at Dynamics Speech).

Target sounds are then selected to be developed and a lexicon (group of words containing these sounds) is then devised and used as the base line for therapy.

Practice Makes Perfect!

There are two types of practice:

Drill Practice - Sounds, syllables and words are practiced with high levels of repetition at the beginning of therapy sessions to stimulate a motor warm up
Distributed Practice – Retrieval of the sounds, syllables and words in a functional context (home and school etc)

Stuttering is a fluency disorder. It is also known as ‘stammering’ in some parts of the world. Stuttering is characterized by disruptions in the production of speech sound, which may be in the form of repetitions, prolongations or blocks. One or any combination of these behaviours may be observed consistently or variably. The frequency, duration, type, and severity of disfluencies vary greatly from child to child and from situation to situation.

There is no single right way to raise a bilingual child. Sometimes parents are advised to separate the two languages when talking to their children. For example, when parents talk with their children, one parent speaks one language and the other speaks in another. Although children can learn more than one language in this way, this is not the only option. It is also recommended that when speaking to a child that the parent/carer does not “code switch”. This means that you complete your conversation/sentence in one language and do not change mid conversation. This allows the child to build up a mental dictionary of words specific to the language but also to learn the grammar and sentence structures for this language. What really helps is to surround your child with a rich and valuable language.

In general, children who grow up in the U.S. learn English quickly because they have been exposed. However, learning the language of the home can be more difficult. It is important to offer children frequent opportunities to use their native language in meaningful and enjoyable ways.

Quite often parents and teachers will report concerns about a “speech delay”. However, during assessment it may become clear that the child has a language delay. Are they not the same thing? No. Speech and language are very different.

Language is made up of socially shared rules that include the following:

  • What words mean (e.g., “star” can refer to a bright object in the night sky or a celebrity)
  • How to make new words (e.g., friend, friendly, unfriendly)
  • How to put words together (e.g., “Peg walked to the new store” rather than “Peg walk store new”)
  • What word combinations are best in what situations (“Would you mind moving your foot?” could quickly change to “Get off my foot, please!” if the first request did not produce results)

Speech consists of the following:

– Articulation
How speech sounds are made (e.g., children must learn how to produce the “r” sound in order to say “rabbit” instead of “wabbit”).

– Voice
Use of the vocal folds and breathing to produce sound (e.g., the voice can be abused from overuse or misuse and can lead to hoarseness or loss of voice).

– Fluency
The rhythm of speech (e.g., hesitations or stuttering can affect fluency).

Before you attend your first appointment/assessment, have a think about your child’s developmental history and complete the Child History Questionnaire (CHQ). Some of the questions you will be asked in the assessment would be:

  • When did your child first babble/use first words/string 2 words together?
  • Has your child received any diagnosis?
  • Is there a history of speech and language difficulties in the family?
  • Have they attended speech and language therapy before?

If your child has attended an assessment or therapy elsewhere (another speech and language therapist, occupational therapist, psychologist, etc), it would be useful for you to bring reports or share the information from such sessions with your speech and language therapist also.

Speech is the ability to use your lips, tongue and other parts of your mouth to produce sounds. To produce clear speech children need to be able to produce the different sounds of speech, as well as understand the rules for putting those sounds together in their language.

Most children have mastered the following sounds by the following ages:

  • around 3 years: b, p, m, n, h, d, k, g, ng (sing), t, w, f, y
  • around 4-5 years: f, sh, zh, ch, j, s
  • around 6 years: l, r, v
  • around 7-8 years: th, z

Most children make mistakes in their speech during the first few years of speech development. But by about three years, most children can be understood by their main caregivers.

If you’re worried that your child might have a speech disorder, think about how often people who don’t know your child have trouble understanding your child.

  • around 2 years about 50% of your child’s speech should be understood by a stranger
  • around 3 years about 75% of your child’s speech should be understood by a stranger
  • around 4 years about 100% of your child’s speech should be understood by a stranger

It’s best to consider seeking help if your child:

  • is six months or more behind the approximate age ranges for using speech sounds
  • uses speech patterns that are delayed for his/her age, or speech sounds that are immature compared with peers
  • gets frustrated about speaking – for example, he/she gets upset when he/she isn’t understood and has to repeat himself/ herself frequently.

No. There are some common myths about multilingual development. It is been said to many parents that multilingualism will cause children to develop language at a slower pace. But there is no scientific evidence to support that belief. Many children around the world learn more than one language at the same time and don’t show language delays.

A social conversation requires many areas, all of which we are supporting your child in developing. These areas are not limiting but include, vocabulary, concepts, memory, organizing, sequencing skills, to support your child in being able to have a conversation.

Yes, all the information pertaining to the case is deemed highly confidential to respect individual privacy and for strictly upholding the ethical standards on which our psychologists function. Only after written consent from the parent/client can a professional share the information with another specialist if needed. More information can be found regarding this on our consent forms for psychological therapy and assessment.

With children, you should ensure familiarity to the process and environment. You can help your child understand what to expect during therapy/assessment with social stories. You may also introduce your child to his/her psychologist, here. During the consult session, you may ask your child’s psychologist for more assistance on how to help your child feel less anxious.

With teenagers, you should introduce the topic of seeing a psychologist in a gentle manner, when both you and your child are calm. Express your concerns clearly in an open and loving way, and let your child know you want him to be happier, healthier, more productive, and less sad or anxious. Avoid approaching your child with accusations, lectures and angry or disappointed reactions. This leaves them feeling ashamed and would be more reluctant to see a therapist. Also avoid broaching the topic right after an argument. Seeing a psychologist should not be seen as a punishment or threat to ensure compliance.

Many teens resist therapy because they may feel there is a taboo to it, or that their friends will find out and believe there is something ‘wrong’ with them. During the consult session, you may speak to the psychologist to find out more about the client-therapist confidentiality and limits; and how to communicate these to your teenager. You may also ask the psychologist for more assistance on how to help your child feel less anxious.

Adequately preparing your child for an assessment can reduce anxiety and encourage cooperation through the upcoming battery of tests.

Prior to the assessment:

  • Be open and honest. Clearly explain to your child the purpose of the testing. Reassure your child that the reason for testing is to better understand their struggles and figure out ways in which adults can help them feel and learn better.
  • Explain to your child that parents are not typically allowed to be present during testing. However, reassure your child that you will be close by while he/she works with the psychologist.
  • Schedule the test sessions during the time of the day when your child usually functions the best. Try to refrain from taking your child out of activities or classes he/she enjoys so that testing will not be a negative experience.

For young children:

  • Provide the name of the psychologist your child will be seeing
  • Explain that the visit does not involve any physical examinations or painful shots or procedures
  • Let your child know that the psychologist will have toys and games that he or she will get to play with

For school-aged children:

  • Described testing as being like in school. Tell your child that they will be doing many activities. These activities may involve listening and talking, while other activities involve looking at pictures, building things, and drawing.

The night before the assessment:

  • Ensure your child gets plenty of sleep the night before

On the day of the assessment:

  • Make the assessment day a special and stress-free day for your child by leaving brothers and/or sisters at home.
  • Ensure your child has eaten so that he/she will not be hungry during testing.
  • You child may like to bring a snack and/or drink to the session to have during our short breaks
  • Allow your child to bring an object that may help increase their sense of safety and security. Try to choose an object that will not be too distracting for the child (e.g., a small stuffed animal as opposed to a toy with many small parts)
  • As temperatures in our office fluctuates throughout the day, your child may want to bring a jacket to keep warm

Decades of research indicate that the provision of therapy is an interpersonal process in which a main curative component is the nature of the therapeutic relationship. Comparative studies of psychotherapy consistently report that measures of therapeutic relationship correlate more highly with client outcome than specialised therapy techniques. Some therapists are better than others at contributing to positive client outcome. Such therapists are more understanding and accepting, empathic, warm, and supportive. They engage in fewer negative behaviours such as blaming, ignoring, or rejecting.

As a therapist’s ability to form relationships and customize treatments play key roles, some key points to think about when choosing your therapist include:

  • Does the therapist has a sophisticated set of interpersonal skills?
  • Is he/she able to builds trust, understanding and belief?
  • How well is the therapist’s ability to an alliance with me?
  • How well can my therapist provide an acceptable and adaptive explanation of my condition.
  • Does my therapist has a treatment plan and allows it to be flexible.
  • Is the therapist influential, persuasive and convincing?
  • Does he/she monitors my progress effectively?
  • Does he offers hope and optimism (realistic optimism, not Pollyanna-ish).
  • Is he/she aware of my characteristics in context?
  • Is he/she reflective?
  • Does he/she relies on best research evidence?
  • Does he/she continually improves through professional development?

You can also enquire about the psychologist’s theories of practice, specialties, length of experience, academic degrees, and the extent of psychologist’s personal psychotherapy.

Finding a good therapist match is important for successful outcome. Always remember that you do not have to stick to one therapist if you find him/her not suitable. A good time to ask and find out more about your therapist is during the first/ consultation session. The therapist will also be asking you questions to assess suitability, and may suggest referral to a more suitable therapist should he/she find that more appropriate.

Difficulties are an inevitable part of our lives and during no stage of growth can we confidently say we are perfectly happy. However, when a concern for you or your dear ones reach a level of severity that are clearly effecting the different areas of functioning such as family/personal, academics/occupational or social life and no help or advice from friends and relatives seem to be solving the issue, you should seek help from a specialist, in this case a psychologist. The psychologist uses their objective observations to make experienced clinical judgments that are non-biased and are aimed to design the most suitable plan of treatment for the client. Usually, this consists of a detailed psychological assessment of the client followed by a structured goal oriented psychotherapy.

Here are just some of our areas of expertise:

  • Intellectual functioning
  • Sadness/Depression
  • Anxiety/Phobias
  • Social skills
  • Anger management
  • Family/Relationship challenges
  • Grief (Death, Loss and/or divorce)
  • Work/Productivity problems
  • Gifted & talented assessments
  • Sleep management
  • Learning difficulties
  • Autistic spectrum disorders
  • And more

Here are just some of our areas of expertise:

  • Intellectual functioning
  • Learning difficulties
  • Autistic spectrum disorders
  • Fears/Anxiety
  • Behavioural difficulties
  • Social skills
  • Anger management
  • Sadness/Depression
  • Peculiar/concerning behaviours
  • Grief (Death, Loss and/or divorce)
  • Gifted & talented assessments
  • Developmental assessments
  • Sleep management
  • Picky Eating
  • Toilet Training
  • Bedwetting
  • Family/Relationship challenges
  • And more

A Consult is an initial interaction between the primary caregiver (parents) and the psychologist where parents state and elaborate the concerns their child might be having. Here, focus is placed on collecting all the relevant information from the primary caregiver regarding the child to aid in case formulation and draw a preliminary picture of the possible intervention plan that will successfully reduce the difficulties. Although we assume that the child is the one who is struggling, the primary caregiver (parent) is most informed about the origin and course of the concerns in addition to the developmental history of the child. An accurate account of this information ultimately leads to rightly dealing with the concerns.

Psychologists are trained professionals who help to ensure the mental health and emotional well-being of all people: individuals, families, and groups. They perform testing, evaluate and treat a full range of emotional and psychological challenges. Our Psychological Team (hyperlink ‘Psychologists’ section) is made up of trained international and local psychologists who will discuss your concerns and tailor our services to your needs. We speak a variety of different languages.

For the wide range of services our Psychologists offer please click here.

A psychological assessment is conducted by a psychologist to ascertain an individual’s current level of functioning. The focus of the assessment and choice of assessment tools varies depending on the referral concerns and will be discussed and agreed upon during the initial consult. As the underlying cause of an individual’s problems are not always clear (For example, if a child is having trouble at school, does he have a learning difficult or is it ADHD or is deficits in memory), the results of the assessment allow a psychologist to gather a comprehensive understanding of the child. Results from the assessment is never focused on a single test score, instead, an individual’s competencies and limitations are evaluated and reported on in an objective but helpful manner. Understanding of a child’s strengths and weaknesses and the nature of the problem will help a psychologist to figure out the best way to address the challenges faced.

Psychotherapy and Counselling are professional interventions that utilise an interpersonal relationship to enable people to develop self-understanding and to make changes in their lives. Therapists rarely offer advice, instead they guide clients to discover their own answers and support them through the actions they choose to take.

While counselling and psychotherapy overlap considerably and are terms often used interchangeably, there exist a slight distinction between them. The focus of counselling is more likely to deal with present issues that can be easily resolved on the conscious level (e.g., specific problems, changes in life and fostering wellbeing) while psychotherapy is more concerned with the restructuring of self and beliefs, and the development of insight.

Counselling may deal with emotions (i.e., grief, anger, anxiety), identifying and managing stressors, clarifying values, managing conflicts, developing better interpersonal and communication skills or changing unproductive thoughts and behaviours. On the other hand, psychotherapy looks at long standing attitudes, thoughts and behaviours that have influenced the current quality of an individual’s life and relationships. It explores the root causes of problems with the goal of resolving underlying issues which fuel ongoing concerns. This may lead to changes in perspective of oneself and life in general, empowering an individual by increasing self-awareness of unconscious triggers.

We have a wide range of assessment tools to assess your childs academic potential or Intelligence Testing.

For pre-schoolers:

  • K-ABC

For school aged children (6 and above):

  • Woodcock Johnson III (WJ III)
  • K-ABC

For 17 years old and above:

  • Woodcock Johnson III (WJ III)

Meta-Analysis of psychotherapy research has found successes in general, and the average treated client is better off than 80% of untreated subjects.

While there are many factors that influences therapy success, Lambert & Barley (2001) research has pointed to four main areas: extra therapeutic factors (40 percent of effectiveness), expectancy effects (15 percent of effectiveness), specific therapy techniques (15 percent of effectiveness), and common factors (30 percent of effectiveness).

Of the four factors, extra therapeutic factors contributed as the highest factor for successful outcome (40 percent). These include the client’s personal strengths, weaknesses and other characteristics including beliefs and attitudes; and also factors in the client’s environment that help or hinder. Remaining hopeful contributes to another 15 percent of effectiveness. Together, your personal factors, environment factors, and a hopeful outlook contributes to more than half (65 percent) of therapeutic success.

This means that you make therapy successful; success in therapy is within your control.

Practically, some useful advice will be:

  • Take therapy (and homework) seriously. Treat it as a course that you want to excel by doing the assignments the therapist assigns you. Spend time to reflect and think about what you and your therapist have talked about.
  • Build social support by getting family and/or friends involved in your therapy experience, by talking about your sessions and telling them how they can help you.
  • Keep a journal, writing down times when you feel like things are not working out, and times when you feel that you are making good progress. Keep track of what works and what does not, and talk about them with your therapists.
  • Be patient – when we are working through our problems, we are bound to experience some distress and discomfort. Sometimes the most productive therapy session is when you feel frustrated or even depressed.
  • Do one nice thing for yourself every day. Being appreciative of yourself improves therapy outcome.
  • Remember that therapy is hard work, an investment in your mental health, but just as in exercise, the rewards can be invaluable.

On the therapists’ end, common factors such as empathy, warmth, and the therapeutic relationship (30 percent) have been shown to correlate more highly with client outcome than specialized treatment interventions (15 percent). The common factors most frequently studied have been the person-centered facilitative conditions (empathy, warmth, congruence) and the therapeutic alliance.

Reference: Lambert, M. J., & Barley, D.E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome.
Psychotherapy: Theory, Research, Practice, Training. Vol 38(4). 357-361.


The first therapy session is called a consult session. This is the time when the therapist gathers information about you and your needs. You may be asked to fill out forms about your current and past physical and emotional health. It might take a few sessions for your therapist to fully understand your situation and concerns and to determine the best approach or course of action. This is also an opportunity for you to interview your therapist and assess if he/she is a suitable match. In this session, your therapist will also explain to you what psychotherapy is, what to expect in sessions, fees, and other administrative details.


Psychotherapy is offered in different formats, including individual, couple, family or group therapy sessions, and it can be effective for all age groups. There are also various framework and techniques in psychotherapy. Your therapist may be specialised in a particular framework or adopts an eclectic approach. Depending on your specific issues, format, personal characteristics, and the therapist’s training, different framework and techniques may be used.

Some examples of psychotherapy techniques proven to be effective include:

  • Cognitive behavioural therapy (CBT), which helps you identify unhealthy, negative beliefs and behaviours and replace them with healthy, positive ones
  • Dialectical behaviour therapy, a type of CBT that teaches behavioural skills to help you handle stress, manage your emotions and improve your relationships with others
  • Acceptance and commitment therapy, which helps you become aware of and accept your thoughts and feelings and commit to making changes, increasing your ability to cope with and adjust to situations
  • Psychodynamic and psychoanalysis therapies, which focus on increasing your awareness of unconscious thoughts and behaviours, developing new insights into your motivations, and resolving conflicts
  • Interpersonal psychotherapy, which focuses on addressing problems with your current relationships with other people to improve your interpersonal skills — how you relate to others, such as family, friends and colleagues
  • Supportive psychotherapy, which reinforces your ability to cope with stress and difficult situations

While framework is a consideration, your personal factors such as being open and honest about your thoughts and feelings are also important to bring about effectiveness. For most types of psychotherapy, your therapist encourages you to talk about what’s troubling you. As you work through the difficult issues, you may experience intense emotions, and may find yourself crying, upset, or even having an angry outburst. Do not give up in such situations, as they can be your best therapeutic experiences. You therapist is there to help you cope with such emotions. You may also be asked to do “homework” – activities or practices that build on what you learn and feel about yourself, and improve your ability to cope with problems. Your diligence in completing this homework seriously plays a big role in successful outcome.

Duration and Length of psychotherapy

Each therapy session is 50 minutes in duration. The number of sessions you require depends on many factors including but not limited to:

  • Your specific issue
  • Severity of your symptoms; how much and how deeply these issues interfere with your day-to-day life
  • Hong long you’ve had symptoms or have been dealing with your situation
  • How quickly you make progress
  • How much support you receive from family members and others

There is no one fix answer to how many sessions you will need exactly. Short term therapy dealing with mild issues and generally using problem solving methods may take around 4 to 6 sessions. A medium length therapy framework that involve looking into a change in cognition style might takes around 8 to 12 sessions. For deeply rooted behaviours that might require a psychodynamic framework exploring unresolved conflicts may require a long term approach that can take more than 20 sessions.

ADHD is a neuro-developmental disorder and its characteristics are:

  • Inattention
  • Impulsivity
  • Hyperactivity (not present in ADD)
  • Boys are more commonly affected by it. The estimate of prevalence in the United States is 5-10% of school aged children. The causes of ADHD are yet to be discovered but there are several theories that talk about biomedical, sensory-motor, genetic predisposition and chemical imbalance in the brain.

We can help in four different ways:

  • Diagnosis and Behavior Therapy
  • Remedial Teaching
  • Social Skills Training
  • Sensory Integrative Therapy

Diagnosis & Behavior Therapy

Our Educational Psychologists can assess your child to diagnose his condition. Furthermore, they can equip you with practical strategies to manage your child at home and at school.

Remedial Teaching

Remedial teaching is defined as Specialized instruction for students deviating from the expected norm.

At Dynamics Therapy Centre for Kids, we provide remedial teaching services by a special-ed teacher. It may help you child if he appears to be falling behind in his school performance.

Social Skills Training

We conduct social skills training, both one-on-one and in a group setting. Our social skill classes are conducted by a special education teacher and allow children to develop age-appropriate skills of interacting with their peers.

Sensory Integration Therapy

Inattention is caused by the childrens inability to block stimulation that is not relevant to the task at hand. They attend to everything; all stimuli impinge on their senses with equal potency. This causes them to be distracted by the stimulation arriving from their environment (sounds, sights, thoughts etc), and prevent them from paying attention to the task at hand. This is similar to what occupational therapist will call a Sensory Modulation Dysfunction (SMD), where the child has difficulties to organize the degree, intensity, and nature of response to sensory input in a graded and adaptive manner. Sensory Modulation Dysfunction can cause emotional problems as well as attentional problems such as distractibility, impulsivity, disorganization and hyperactivity. mechanism.

Sensory Integrative Therapy provides a potential intervention for ADD/ADHD children without medication.

To modulate is to regulate or adjust to a certain level: To tone down, to adapt to the circumstances On the behavioral level, modulation refers to responses that match the demands and expectations of the environment. Inadequate modulation may result in problems in the following:

  • Modulation of sensory input
  • Filtering of sensation
  • Attending only to relevant stimuli
  • Maintaining optimal level of arousal
  • Maintaining attention to task

Sensory modulation may be manifested in:

  • Distractibility
  • Impulsiveness
  • Increased activity level
  • Disorganization
  • Anxiety
  • Poor regulation
  • Some children will develop inattention which is secondary to a learning disability. These children may become frustrated from academic tasks and they become inattentive as task avoidance

Dyslexia is a type of specific learning difficulty. A child with dyslexia may find reading, spelling and writing difficult, even though he may appear to be very able in other areas. These difficulties are caused by brain differences. This means that your childs difficulties have nothing to do with the way the child is taught, or parenting style, as this is biological.

The difference in the brain makes it more difficult for the child to process information for sounds in language. Therefore, it may take your child a longer time to recognize sounds, and to understand instructions said to him.

Dyslexics have poor phonological awareness, meaning they may find rhymes difficult. They also find it difficult to learn the sounds of the alphabet, and to use this knowledge to help them read or write. Many dyslexics have poor working memory, and so they find that verbal information such as spoken words are quickly forgotten.

Sometimes, dyslexia is accompanied with poor attention and speech and language development. Saying that, no two dyslexic children are the same. Some may find reading very difficult, some may find it easier, but they read slower. Some have problems with just writing.

Some languages are more difficult for dyslexics than others, and English words are considered to be more challenging for dyslexics, because the spelling is more irregular than for example, Spanish.

While dyslexia will make school more difficult for the child, there is a lot that we can do to help. At the end of the day, we must always remember that every child can learn. Research shows that most dyslexics will learn to read and write.

Some dyslexics can become highly successful. The way the dyslexic brain thinks may be different, and in some cases, this is an advantage. By providing your child with the education they need, the child is more likely to reach their potential.

With appropriate help from specialist teachers and using strategies, the effects of dyslexia can be largely overcome. Research also shows that the differences in the brain can also be overcome with teaching.

At Dynamics Therapy Centre for Kids, we provide dyslexia remediation services as well as speech therapy suitable for children with dyslexia.

Educational Therapy is defined as Specialized instruction for students deviating from the expected norm. At Dynamics Therapy Centre for Kids, we provide remedial teaching services by a special-ed teacher. Such services supplement our speech and occupational therapy services and are equally helpful for special needs children as well as any child which appears to be falling behind in his school performance.


I suspect my child is Autistic, how can you help me?

We are able to help in several ways. If needed, we can provide a formal assessment (based on IQ testing, ADOS, and other diagnostic tools) to verify whether your child is indeed an ASD child.

We can also design an early intervention plan to address some particular symptoms your child exhibits. Such an early intervention plan will address sensory and daily skills (by an Occupational Therapist), Speech Language and Communication (by a Speech Therapist) and academic skills and social skills (by our special education teacher).

We are also providing autism-specific interventions, namely Relationship Development Intervention (RDI), and Structured Teaching.

Early intervention is important, as various studies has shown that early intervention is much more effective for ASD children.

Therapy for the ASD Child

Autism Spectrum Disorder (ASD)

ASD is a developmental disorder, characterized by difficulties in communication and language skills, imaginative play and social interaction, and odd behaviors. Children with ASD often show early signs of deficits in sensory processing and social responsiveness.

At Dynamics Therapy Centre for Kids we provide autism assessment services (using ADOS), Occupational Therapy, Sensory Integration Therapy, Social Skills Training, Remedial Teaching, and RDI®.

How can I find out whether my child has ASD?

Early assessment of a child who is suspected to be on the spectrum is crucial so that intervention can start as early as possible.

The synthesis of all this information provides sufficient data to make a diagnosis.

The information taken from the collected data should be considered in respect to the DSM IV (Diagnostic and Statistical Manual, 4th Edition, 1994, American Psychiatric Association) criteria for autism. (The criteria can be viewed here http://ani.autistics.org/dsm4-autism.html).

What help you provide for ASD children?

We provide a comprehensive array of therapy services: Speech Therapy, Social Skills Training, Remedial Teaching, Occupational Therapy with emphasis on sensory integration, and RDI.

What is Social Skills Training?

Individuals with ASD or Asperger Syndrom have severe difficulties with social skills. Social skills training helps such individuals to improve the way they interact with others. We provide social skills training in a one-to-one setting, as well as in a group setting. Social skills training makes extensive use of role playing, soft play, and games in order to allow the child to have fun while learning to improve his social skills. Our social skill training is conducted by a special education teacher with extensive experience. The sessions are tailored to the needs of individual children, and children in a group setting are chosen to ensure that the group session is effective.

What is Remedial Teaching?

Remedial teaching is defined as Specialized instruction for students deviating from the expected norm. At Dynamics Therapy Centre for Kids, we provide remedial teaching services by a special-ed teacher. For children with ASD, our remedial teaching sessions focus on structured teaching and the use of PECS (Picture Exchange Communication System) to achieve acadmeic intervention.

What is Sensory Integration?

Sensory Integration refers to our ability to put together the inputs from our senses. The senses are meant to work together. Each sense provides certain input, and sensory integration is a critical function of the brain, that allows it to generate a composite picture. With this composite picture we are able to know where we are, what is going around us, and we are able to interact effectively with the surrounding.

While you are reading this page, your brain is automatically and unconsciously conducting sensory integration. You are coordinating your sight, sense of touch of the keyboard and mouse with certain movement to scroll the page. In more complex situations sensory integration synthesizes sight, sound, touch, movement, and body awareness.

For most children, sensory integration develops naturally, as they learn motor planning skills and to adapt to sensation. For some children, sensory integration does not develop as efficiently as it should, and this gives rise to problems in learning, development, or behavior.

What is Sensory Integration Dysfunction?

When the sensory integration capabilities are not fully developed, the child will be unable to modulate, discriminate, coordinate or organize sensation adaptively. In particular this will cause diminished ability to interact effectively or efficiently with the demands of ones culture, environment, relationship or tasks.

ASD children often have difficulties in registration of meaningful sensory information which at times may lead to sensory overload or shutdown. The child often may have a heightened sensitivity to the sensory quality of the experience and this sensitivity can change with place and time

Modulation of sensory experiences is a process in which we gather information about the intensity, frequency, duration, complexity and novelty of the sensory stimuli as we prepare to create an adaptive response, may present as a difficulty for the ASD child.

Sensory integration therapy is aimed at improving the childs sensory integration capabilities, and in particular helping him/her to cope with processing sensory information and modulating it.

The Sensory Systems:

The Vestibular System (our sense of balance)

  • Some ASD children experience severe reaction to a change in their head position and this might cause anxiety and fear
  • These children may result in either seeking or avoiding movement that might be presented as:
    • Rocking or rhythmic movements that can be referred to as calming or organizing motions
    • Twirling and swinging motions that are considered alerting or activating

The Tactile System (our sense of touch)

  • The system detects qualities and locations of external stimuli applied to the skin (light touch and deep pressure, vibration, temperature, texture and pain)
  • The ASD child might demonstrate problems in processing tactile information
  • Some will under react to touch and will need longer and stronger stimulation
  • Others will over react to touch and texture and become defensive which can lead to discomfort in:
    • Self care tasks, standing in a queue, engaging in creative activities and can impact social behavior by avoiding crowds and being touched by others
    • Affecting food preference as some textures will be avoided, hence they can be very choosy about what they eat

Visual Processing (what we see and how we interpret it)

  • Gives us the information about color, contrast, shape, form and movement. Helps us determine what to pay attention to and what to ignore and helps us direct our movement in the world
  • Many ASD children are considered visual learners, their visual memory is strong and visual manipulation of objects is common
  • They can be sensitive to lights, bright colors and have difficulty to sustain visual attention

Auditory Processing (what we hear and how we interpret it)

  • The auditory system gives us information about the volume, tone, rhythm, and sequence of sounds
  • Some ASD children experience sounds as painful and they are unable to filter out irrelevant noises
    • At times the ASD child can give the impression that he has hearing problems (e.g. he might not respond to our verbal communication)
    • Can seem inattentive to conversation, instructions and social communication
    • Participation in social or community activities can be irritating to the child due to many unexpected noises
    • Some can be observed covering their ears with their hands to block out sounds

Praxis (motor planning)

Difficulties in motor planning especially with ideation (an idea of how to approach a new task) can affect the quality of creative and imaginative play, engaging in new activities (hence the tendency to favor sameness and routine) and learning new skills

Sensory Integration Therapy

  • Principles of SI theory are appropriate for intervention with the ASD child:
    • Giving controlled and meaningful sensory experience to elicit adaptive responses is important to the therapeutic work
    • Meaningful sensory experience is the most direct way to establish rapport
  • An occupational therapy intervention usually starts as individual sessions in a therapeutic environment offering a variety of equipment and activities that will provide safe, purposeful and satisfying sensory experience
  • Purpose of intervention is to provide the types of sensory experiences that will have most organizing effect, and analyzing them in order to offer appropriate activities to be applied at home or in school
  • As caregivers there is a need to keep in mind that though therapy is helpful and can reduce many of the non adaptive behaviors, some of the ASD children (depending on the severity) might have sensory needs that will require attention throughout their lifespan
  • It is recommended to design organizing and calming activities to be carried out at home to provide the child with sensory experiences daily as a Sensory Diet
  • It is important that the caregiver will be involved in the therapeutic process

What is RDI?

RDI stands for Relationship Development Intervention, and it is an exciting intervention method for Autism, developed by Dr. Steven Gutstein. This relatively new intervention program tackles the core deficits of autism. These deficits revolve mainly around the inability to develop relationships, and the inability to accept novelty.

The approach taken by RDI stands in stark contrast to other intervention approaches which focus more on the symptoms of autism than on the core deficits of individuals with autism. Another difference between RDI and other methods is that RDI is family-centric, and requires immense involvement of the family. In other words, when you engage an RDI professional you are not paying her to "solve the child's problems". Instead, you are engaging her to empower you to help your child.

While RDI is relatively new, there are numerous success stories, and it is gaining popularity in the US. For more information about RDI, see www.RDIconnect.com which is the website for Connections Center which is the organization developing and promoting this method. Yael Sasson of Dynamics Therapy Centre for Kids is currently an RDI consultant-in-training, and we are launching our RDI service in July 2006. Contact us at RDI@dynamics.com.sg for more details.

How can I find out more?

If you are interested in exploring therapy for your child, contact us at autism@dynamics.com.sg

Making an appointment is simple. Call us at 61009235 or drop us an email at inquiry@dynamics.com.sg. We are open Monday to Friday 9am to 7pm, and Saturday 9am to 6pm. We accept referrals from schools, doctors and other health professionals, psychologists, as well as self-referral by parents.
In most cases, we provide therapy sessions once a week. However, we tailor the intervention plan to the needs of the child and the preferences of parents. The frequency of therapy session is therefore quite wide. In some cases, we may see a child once a month as 'maintenance' to ensure his progress is not reversed.
How long does therapy take?

All therapy is unique and individualized as each person and every kid learns at his or her own pace, therapy duration varies.

Some kids find their needs change as they get older or as they progress through the school system. They may return to the therapist to figure out new ways of coping with problems or to master a new skill.

Kids can help speed up treatment by following the instructions of their therapist, and in particular practicing on their own. In some cases, where the child may benefit from intensive therapy, we recommend attending our DynamicKids intensive program to accelerate progress.