Eating Therapy
 

Birth - 4 Months

Eating frequently 1.5-3 hours apart, breast or bottle fed

What issues may occur?

  • Difficulty latching-poor closure/cheek pads underdeveloped, difficulty with suck or swallow, tongue tie
  • Reflux
  • Gagging
  • Difficulty going to bottle from breast

4 Months - 6 Months

Introduce cereals and purees
  • Rice, oatmeal, barley
  • Stage 1 veggies, then fruits
  • Play with spoon, mixing purees, play in food/getting messy
  • Introduce sippy cup

What issues may occur?

  • Tongue thrusting, Tongue tie, gagging/choking, poor control moving food/liquid back to swallow, & teething

6 Months - 9 Months

Beginning to accept table foods-up and down chew
  • Finger foods to start with
  • Transition to table foods
  • Introduce breast milk/formula in sippy cup periodically

What issues may occur?

  • Pocketing, gagging/choking, tongue tie, tongue thrusting, raking-pincer grasp under developed, difficulty with no hand to mouth connection

9 Months - 12 Months

Expanding variety of tastes, textures of table foods
  • Taking bites of soft foods
  • Begin rotary chew
  • Begin weaning from baby foods slowly
  • Introduce straw cup and open cup

What issues may occur?

  • Tongue thrusting, Pocketing, gagging/choking, chewing difficulty or not transitioning to rotary chew, little to no biting off pieces of foods

12 Months - 24 Months

Becoming independent feeders
  • Using utensils
  • By age 2, can safely eat most foods
  • Weaned from bottle, using straw cup/360 cup/open cup

What issues may occur?

  • Tongue thrusting, Pocketing, gagging/choking, decreased chewing of foods or no rotary chew developed, not biting off pieces of foods(variety of textures), not using utensils to feed, continued difficulty managing liquids in an open cup.

 
Speech Therapy
 

Birth - 6 Months

  • RECEPTIVE
    • Smiles at sound of voice
    • Attends to sound and startles at loud noises
    • Responds to sound by moving eyes
    • Pays attention to music or toys that make sound
  • EXPRESSIVE
    • Cooing sounds
    • Differentiated cries
    • Smiles when seeing familiar person
    • Responds to sound by making sounds
    • Use voice to express joy or displeasure
  • SPEECH
    • Vocal play
    • Syllable repetition
    • Babbling different sounds(p, b, m)

6 Months - 12 Months

  • RECEPTIVE
    • Turns in direction of sounds
    • Listens when spoken to
    • Enjoys games like peek-a-boo and pat-a-cake
    • Begins to respond to requests
    • Recognizes words for common objects(cup, shoe, book)
    • Responds to “no”
  • EXPRESSIVE
    • Babbling long and short groups of sounds
    • Babbles “mama”, dada” sometimes in reference to mom and dad
    • Uses inflection when babbling
    • Uses exclamations like “uh-oh”
    • Uses gestures to communicate and speech sounds to get attention
    • Has one or two words(dada, mama, dog)
  • SPEECH
    • Imitates different speech sounds

12 Months - 18 Months

  • RECEPTIVE
    • Understand simple instructions(Kiss Mommy, Give me)
    • Point to things when asked(familiar people or objects)
    • Recognizes increasing amount of words
    • Points to several body parts
  • EXPRESSIVE
    • Uses up to 20 simple words
    • Gesture with words to show what they want
    • Imitate words heard in conversations by adults accompanied by gestures they have seen from familiar adults
  • SPEECH
    • Uses many different consonant sounds at beginning of words

18 Months - 24 Months

  • RECEPTIVE
    • Understand up to 200+ words
    • Sit and listen to simple stories
    • Points to pictures that are named
    • Understands simple questions(Where is your shoe?)
  • EXPRESSIVE
    • Uses up to 50 single words more recognizable to others
    • Starts to put 2 words together
    • Imitates words at increasing amount
  • SPEECH
    • Not a great variety of sounds used
    • Typically sounds used include: p, b, m, t, d, w
    • Leave ending sounds off words

24 Months - 30 Months

  • RECEPTIVE
    • Understands most sentences
    • Recognizes and identifies almost all common objects and pictures
    • Listens to and enjoys hearing stories for longer periods of time
    • Beginning to follow 2-step simple directions
    • Beginning to understand simple prepositions(in/out)
    • Beginning to answer some simple questions
  • EXPRESSIVE
    • Has word for almost everything
    • Uses 2-3 word phrases to express self and ask questions
    • Has expressive vocabulary of approximately 200 words
    • Uses simple pronouns(me, you)
    • Uses simple possessive forms(mine)
    • Beginning to say name and age
  • SPEECH
    • Using more consonant sounds(p, b, m, t, d, n, h, w, k, g)
    • More consonants appear in final position
    • 75% intelligible to family and friends

30 Months - 36 Months

  • RECEPTIVE
    • Understands more complex directions
    • Identifies objects by function
    • Beginning to understand quantity(one, one more)
    • Understands prepositions on/under
  • EXPRESSIVE
    • Now using approximately 450 words
    • Using 3 + word sentences to include nouns, verbs, adjectives
    • Using simple prepositions(in/out, on/under)
    • Can say name, age, gender
    • Asks “why”
    • Uses pronouns(me/you, she/he)
  • SPEECH
    • Can be understood by strangers 75% of the time
    • Understood by familiar people
    • Gained consonants(f, y, ng)

36 Months - 48 Months

  • RECEPTIVE
    • Understands words for descriptive concepts, such as colors
    • Understands words for family members(brother, grandmother)
    • Understands questions(who, where, what)
    • Understands concepts like “same” and “different”
  • EXPRESSIVE
    • Talks about events happening in their daily activities
    • Can answer “wh” questions using phrases/sentences
    • Asks “how” and “when” questions
    • Uses 4+ word sentences
    • Uses pronouns(I, me, you, we)
    • Uses plurals
  • SPEECH
    • Most people understand speech, including unfamiliar people
    • Most sounds developed
    • Clusters developing
    • May still delete weak syllables
    • Talks easily without repeating words or syllables

48 Months - 60 Months

  • RECEPTIVE
    • Understands words for order(first, next, last)
    • Understands for time(yesterday, tomorrow)
    • Follows more complex directions(2-3 step)
    • Follows classroom directions
  • EXPRESSIVE
    • Speaks in sentences more than 5 words
    • Recalls parts of a story
    • Tells more stories
    • Says name and address
    • Keeps a conversation going
    • Names letters and numbers
    • Sentences may contain more than 1 action word
  • SPEECH
    • Uses most sounds
    • May continue to make mistakes on sounds that are more difficult(r, s, ch, etc.)
    • Understood by others all the time

 
 
Playing Therapy
 

Birth - 6 Months

Baby will learn to explore parent/caregivers face, begin to gaze between speaker’s face and toys, reaching and grasping small toys, rattles, board or fabric books, mouth objects, tummy time/back play exploring toys and motor skills, looking in a small mirror

6 Months - 12 Months

Begin back and forth play with soft blocks or soft rolling toys, stacking toys, in/out play, push/pull toys, exploring board books(especially those with textures), exploring busy boxes, mirror play, play peek-a-boo, engage with songs or finger plays

12 Months - 18 Months

Begin to match simple shape sorters or knob puzzles, more meaningful play with busy boxes, identifying and naming more objects/pictures, attend to and engage with short books/stories, begin pretend play(feeding a baby/stuffed animal), learning how to use musical instruments, participating in simple “art” activities(painting, coloring, etc), more advanced back and forth play while making sounds/using words with toys(ball, vehicles, play food, etc), motor based activities

18 Months - 24 Months

Begin to complete puzzles more independently, attending to and engaging in stories with others for longer periods of time, “planning” play activities starts, pretend play with more of a variety of toys, combining toys during play more frequently, back and forth play with adults mastered, “sharing” during routines with adults(sharing food or drinks), beginning to show more interest in peers, imitating others behaviors/play

24 Months - 30 Months

Begin to sort objects(colors, sizes, use), imaginative play with toys and people, “memorizing” and spontaneously engaging with familiar songs/books, increasing attention to stories while answering questions about them, playing with peers for longer periods of time using same materials, beginning to share/take turns with adult assistance, exploring more “hands on” activities(play dough, coloring, etc)

30 Months - 36 Months

Begin to follow more adult directed activities, continuing to advance peer play, completing more problem solving activities(puzzles), more advanced imaginative play, engaging others more often in play for turn taking activities

36 Months - 48 Months

Continues to advance imaginative/pretend play both independently and with others, continues to engage with peers with less assistance for sharing/turn taking, attending to and participating in adult directed tasks, completing more complicated puzzles and memory games, participating in simple games with others, mastering toys with moving parts(levers, buttons, etc), mastering beginning concepts(opposites, letters, numbers, colors, shapes)

48 Months - 60 Months

Play is more cooperative with peers, advanced imaginative/pretend play, memorizing and reciting songs/books/favorite cartoons, participating in many adult directed activities with little resistance, continues to complete more complicated puzzles or problem solving activities, participates in board games, play independently for long periods of time

 
 
 

Additional Resources

Here are some additional resources for you to reference:

 
 
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