How to Encourage Your Child to Practice Their Speech and Language Skills at Home

Are you having trouble motivating your child to practice their speech and language skills at home? Your child’s speech therapist is likely assigning tasks to practice at home throughout the week to reinforce the skills they’re learning in therapy. Home practice can make a huge difference in their progress and usually means faster improvement. Speech therapy isn’t an easy fix and it requires a lot of hard work and consistent practice over many months or even years. Home practice does not have to be boring! Below is a list of applications, websites, and games that you can utilize to make home practice fun:

  • Applications

o   My PlayHome

  • Compatibility: iPhone, iPad, and iPod touch
  • Price: $3.99
  • Description: My PlayHome is an interactive doll house game that contains a variety of male and female characters that can eat, drink, cook, shower, sleep, and so much more. Your child can explore every room in the house while enjoying the colorful and detailed illustrations.
  • How to use it:
  • Expressive language skills: Labeling actions and common objects, producing regular and irregular past tense verbs, answering wh- questions, describing picture scenes, telling how common objects are used, naming categories, producing he/she pronouns and regular plural -s.
  • Receptive language skills: Identifying common items, understanding verbs in context, understanding use of common objects, following directions, and understanding pronouns.
  • Why it works: My patients absolutely love this game. It is so fun and motivating- they don’t even realize they are working on a variety of language skills!


o   Articulation Station

  • Compatibility: iPhone, iPad, and iPod touch
  • Price: Lite version is free, individual sounds range from $3.99 to $7.99, and full version is $59.99
  • Description: The application includes 22 different sounds and 6 engaging articulation activities to help your child speak and pronounce their sounds more clearly.
  • How to use it: Select the individual sound(s) your child is working on in speech therapy and practice at the word, phrase, sentence, or story level.
  • Why it works: The application is fun, colorful, and engaging. You can practice your child’s sounds through flashcards, matching games, rotating sentences, unique sentences, and stories. The activities are so fun that my patients often forget they are “working” on their articulation skills.

  • Websites

o   Home Speech Home

  • Link:
  • Description: Home Speech Home is a website created by two certified speech-language pathologists. This website offers a variety of activities and word lists to practice articulation, apraxia, language, and stuttering principles. In addition, speech and language developmental norms and an overview of various speech and language disorders are also included.
  • How to use it: I frequently utilize the word lists feature with my older patients. I select the specific sound(s) that my patient is working on and incorporate the words while playing their favorite board game or within conversation. You can practice their articulation skills at home with premade words, phrases, sentences, and stories.


o   Mommy Speech Therapy

  • Link:
  • Description: Mommy Speech Therapy is a website created by a certified speech-language pathologist. This website offers a variety of free articulation worksheets that include colorful pictures of your child’s specific target words, as well as helpful tips and tricks on how to increase your child’s speech and language skills at home.
  • How to use it: You can select your child’s specific sound(s) and print out the associated free articulation pictures, cut them into individual pictures, and play a variety of games at home. You can hide the pictures around the house and have a “scavenger hunt” and ask your child to name the pictures when they find them. You can print out an extra page and play Go Fish or a matching game with the pictures while reinforcing their articulation skills. The options are limitless!


  • Games

o   Guess Who

  • How to play: You can target a variety of language and articulation skills with this classic board game. Guess Who is great for working on he/she pronouns, asking questions, answering yes/no questions, producing grammatical forms (e.g. do/does, has/have), and articulation skills at the conversational level.

o   Hedbanz

  • How to play: Hedbanz is a fun way to work on naming categories, answering yes/no questions, turn taking, and articulation skills while your child guesses the identity of the card they’ve been dealt.

o   Simon Says

  • How to play: Simon Says is a quick and easy game to work on identifying common objects (e.g. body parts), following one-step directions, as well as directions of increasing length and complexity.

If you have questions about your child’s speech and language skills please contact ABC Pediatric Therapy Network at

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ABC Pediatric Therapy Jenn working with young adult

How to Teach Your Child Through Play by Jenn Jordan, Q102 Radio Host

Jakob was 11 years old and he only ate four foods.  Kay’s Naturals Apple Cinnamon Protein Cereal, Applegate Farms Antibiotic-Free Beef Hot Dogs, Bolthouse Farms Green Goodness bottled smoothies and bananas, and it had to be those brands. No deviations. If we tried to sneak in a different cereal or hot dog, he would know. He could tell by sight and by smell. There was no getting anything by him. He would eat a whole box of cereal each day and as many as 16 hot dogs. Can you imagine? 16 hot dogs a day?

It’s impossible to know why he was that picky of an eater. My best guess was he had stomach issues and he felt safe with those particular foods, knowing exactly how they would affect his system. I also believe he had sensitivities to smells and textures. Whatever it was, he had his reasons. My biggest concern was that he ate something. I knew far too many kids who were thin and malnourished. At least Jakob was eating and I gave him vitamins and supplements to make up for all the things that his diet didn’t provide. But I certainly hoped he wouldn’t eat 16 hot dogs per day for the rest of his life and I wanted him to expand his diet. So what to do?

I tried all kinds of different interventions. Withholding foods, eating specialists, sneaking other cereals into his bag of protein cereal. We got nowhere. The more I tried, the more he dug in his heels. So I stepped back, thought about it and came up with an idea.

At the time, one of Jakob’s favorite things to do was look at and write on calendars. He loved knowing what days holidays fell on, we would add our social events, and birthdays on all 27 calendars we had in the house. We shopped for calendars and we spent hours every day just looking at them and talking about them. If something was written on a calendar, then it was written in stone.

Light bulb moment.

I came up with a list of foods that I wanted him to try. I kept it all pretty simple with similar textures to what he was already eating and things that would be easy on his tummy. Toast with almond butter, pretzels, scrambled eggs, waffles.

Then I got out his favorite calendar. I enthusiastically gave him the choice between two of the foods and then let him decide what date and time to put the food on the calendar. There was no hesitation on his part. He chose the food and happily picked when he wanted to try it and we wrote it down. We did it for everything on my list. Then over the course of the next few days, every time we took out the calendar, we talked about that something new he was going to try. He actually seemed excited about it. Then when the day came, he took his time smelling the new food, feeling it with his fingers and then would take the tiniest of bites. But he ate it, every single time. And we had a ball throughout the entire process. It was so easy. So very easy.

I’ve used this approach so many times to teach him so many things. I would pick a goal and then use something he loves to help him learn about and accept it. Right now, I’m using his love for letter writing to work on conversation loops and sentence structure.

What I love the most is that it never feels like I’m sitting him down and trying to force him to learn things that he couldn’t give a rip about. It’s always me spending precious time with my son who I love more than life just playing and having fun. And somewhere in that party, we both learn something new.

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How to Have a Sensory Friendly Halloween

Kids LOVE Halloween…between dressing up, the decorations, parties, and of course the candy…what’s not to love? But let’s be honest, Halloween is definitely not the most sensory friendly holiday.  For kids with sensory processing disorder, it can be a literal nightmare.  From the itchy costumes, flashing lights, loud noises, and unexpected scares, the night of Trick-or-Treat can be really overwhelming for you and your child.  Below are 6 ways to have a sensory friendly Halloween this year!

  1. The costume…perhaps the most important step that you can control! Some costumes are scratchy, come with face paint that can be sticky or slimy, masks that smell funny, or other head pieces, that can just be painful for kids with sensory issues.  Take your child with you to the store to feel the costume and gage their reaction when they touch the costume.  That will give you a good idea if they’d be able to tolerate it for a whole evening or not.  You could also have them wear some of their most comfortable clothes under their costumes.  Or focus on using some of their own clothing to make a unique costume, keep it simple like a cowboy or a cat!  When in doubt, do a trial run a few days before to ensure their comfort…you’ll appreciate it later when you have avoided a meltdown.
  2. Practice, practice, practice! Set-up time for you and your family to practice Halloween etiquette. First start with your own home, where things are most familiar.  Work on ringing the door bell, what to say/how to respond, and how to take the candy…that way they know what to expect and can learn the routine. Next practice at a family or friends house, where things are familiar.  It’s much easier to practice on a familiar face than a stranger.
  3. Plan your Trick-or- Treat route ahead of time. Try to Trick-or-Treat at neighbors who know you and your kids if possible. It is always easier to go to familiar places with familiar people.  And you will also feel comfortable asking them questions like: what kind of decorations they have in their yard. Or they will not get offended if your kiddo is getting overstimulated and does not say “thank you” or respond appropriately to a question.
  4. Plan your time accordingly. Going Trick-or-Treating earlier in the night can be helpful, as it is often less crowded initially. Your child may benefit from a picture schedule, timer, or checklist so they know what to expect!  Incorporating “break” times in which they can go back to the house or into your car, can help sensory overload.  Be aware of your child’s warning signs that they might be getting overstimulated.
  5. Go to smaller events…Trunk-or-Treats, mall, and/or church events are becoming increasingly popular, especially for parents who work, thus limiting the time families can go Trick-or-Treating. These events tend to be for kids of all ages, so it could limit the number of scary masks or decorations you encounter. This will greatly reduce the amount of transitions for you to navigate as well!  These events can get crowded, so be sure to call ahead, to see what times tend to be less busy or how many people they are expecting.
  6. Make your own Halloween Traditions. When all is said and done, there is no rule saying you have to participate in any of these activities.  If they are too much, it’s simply too much! Take it in stride and create your own Halloween traditions, by making it a pizza or game night, do your child’s favorite activity, or have a special Mommy or Daddy only date every year to make the holiday special in another way.

I hope these recommendations help you and your child have a happy and safe Halloween!  Be sure to visit our website for other fun tips and information

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How Do You Measure Progress?

What is Progress?

The Merriam-Webster dictionary defines progress as forward movement.   I love this!

I want to challenge you to always be sure your child is moving forward!  To do this you have to define for yourself (and your child) “what is progress?”.

In the therapy world, there are many methods of receiving help for your child…..Early Intervention, Help Me Grow, Early Steps, school therapy, private therapy, ABA, music therapy, vision therapy, hippotherapy, massage therapy and there are others.  Some are free, some are covered by your insurance and some you pay for yourself.  One type of therapy is not best for every child.  So how do you decide what is best for YOUR child?

I have the answer.

You know your child best.  So first, define for yourself your wants and needs for your child and your family in regards to the problems you are looking to solve.  What causes the most disruption to the happy family unit?  What limits your child’s success the most?  Actually write down as many challenges as you can that you would like to solve for your family and/or your child.

Now, how to solve these limitations that are barriers to your happy family and your confident child.  You cannot just look for what is most convenient although that might be a good place to start.  You cannot just look for what is cheapest but you can start there as well.  The solution lies in what gives your child the most progress! 

As a parent of 3, I sympathize with you on finding services that are convenient and affordable.  But the only true solution to the challenges that face your family and your child is the one that leads to progress!  You will waste your time and your money if you do not seek out that which brings about the most progress.   Your child deserves to make consistent progress as that is what will lead you to a confident, successful, happy and social child.  That, for all of us, is priceless!

So back to my challenge to every parent of every child.  What keeps your child moving forward?  Not goals met in a year but goals met in a month or a week!  Educate yourself!  Be sure you are aware of what goals your child is pushing to accomplish and check in every 4 weeks or so to ensure to ensure you are seeing progress.  Is your child seen in a group?  How is that working?  Seeing progress?  Keep asking yourself…”seeing progress?”

If progress is happening at the rate you are happy with – bravo!  You made the right decisions to support your child.  Pat yourself on the back parent!

If you would like to see more progress, don’t wait!  Make change now!  Children grow up fast!  Do not waste your child’s time when he/she could be making progress.  You are seeking a confident, successful, happy and social child.

His/her self esteem could be effected as he/she confronts social situations where he should fit in and even excel.  Our job as parents is to give them the tools prior to when they will need them so they do amazing things.

Do you have concerns that your child needs help with his physical, social or emotional development?  Do you want help in ensuring your child is achieving as his/her maximum potential?

Reach out to your pediatrician for guidance and ask him to allow you to seek out alternatives to challenge your child in a way that will ACTUALLY result in progress. loves to accept and meet the challenge of forward progress!  Accept nothing less than the best for your child.  Your child deserves it!

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Therapy- Medical Model vs. Educational Model – Which Is Best For My Child?


Medical Model

In the medical model, an occupational, physical, or speech therapist performs evaluations and treatments in a clinical setting after being referred by a doctor. These evaluations and treatments often mimic a child’s natural play environment.  Therapists look at the whole child, and their ability to function in all aspects of daily life. Goals are focused toward the child’s home and community function, as opposed to their function at school.  However, the interventions at school and in the clinic may go hand in hand. For instance, if a child needs to improve balance and strength in order to get to downstairs at their school, they will also need to improve balance and strength to climb up the stairs at home to get to their bedroom. 


ABC Pediatric Therapy Network ( has six locations throughout the Cincinnati and Dayton areas that present children with the challenges of their home and community environment.  All locations have a full-size jungle gym, trampoline, and foam pit in the large gym setting. For example, the foam pit can be used in therapeutic ways to help a child to gain motor planning through building block towers, and to gain coordination, trunk strength and upper extremity strength through swinging. As treatment is completed on the equipment, children are able to gain confidence in themselves, which will carry over to the playground and school. This will allow the children to better interact with peers in the classroom and playground.


In the clinical setting, therapists interact not only with the child, but also with the child’s primary caregiver, and siblings.  Family dynamics are taken into consideration when forming a treatment plan that is realistic to the child and family as a whole.  Families are an active participant in therapy sessions, and help form goals that would be beneficial to the child’s function throughout the day. ABC Pediatric Therapy Network also understands the importance of peer interaction and encourages patients to interact with each other during treatment.  This allows children to build social skills such as initiating conversations, turn taking, and sharing. Children will often play games together to work on social skills including conversational skills, and appropriate responses to winning and losing.

Occupational, physical, and speech therapists working in a clinical setting offer direct, individualized treatment to their patients.  At ABC Pediatric Therapy Network, therapists are part of a unique multidisciplinary team. This is a major benefit to the patients because skills that are being targeted during one therapy can be enforced during the other therapies.  For instance, if the speech therapist is working toward a goal of a child using three-word requests, the physical therapist can augment his or her treatment by having the child use a three-word request prior to carrying out the activity (i.e. “kick the ball”).



School-based therapy uses an educational model that focuses on academic performance, and is governed by IDEA (Individuals with Disabilities Education Act). In the educational model, children with disabilities benefit from evaluations and treatments in a setting that is in their natural environment with their peer group. This model of pediatric therapy also focuses on a multidisciplinary approach to the therapy assessment, planning, and intervention.  A multidisciplinary team includes the parents, teacher, special education teacher, and therapists. The team must be in agreement in order to implement an Individualized Education Plan.  In order to receive therapy services at school, a child’s functional performance must be impaired to the extent that it interferes with the child’s functioning at school. Each district has strict standards for qualifying children for an Individualized Education Plan. The emphasis of treatment is on function at school and goals are related to the educational program.  The therapy intervention may be direct, indirect, or on a consultation basis.  Therapy is often in a group setting rather than an individual one-on-one session.

Therapists also make significant contributions to school programs by identifying environmental barriers and planning for accessibility modifications.  They adapt classrooms to provide the optimal learning environment for children with special needs, help promote acceptance of students with disabilities, adapt recreational activities, and contribute to the development of safety procedures for emergency evacuation of students with disabilities.  Occupational therapists may help include modifications and accommodations in the classroom including sensory seating, break areas, or specialized fine motor tools. Speech therapists may help in making visuals including communication picture books, break cards, or visual schedules to help ease transitions and communication in the school environment.

In the end, it all about progress.  Is your child making the progress you want to see?  If so, fantastic!  Do not change a thing!  If not, look for additional help to ensure your child reaches his/her maximum potential.  Delays in development can effect self esteem, the ability to make friend and academic performance.  Let’s work together to help every child to succeed!


If you have questions about next steps for your child, please go to or give us a call at 513-755-6600.

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Stuttering – How Can I Help My Child?

When is it “appropriate”

Many young children go through periods of times where their speech is “disfluent”, or bumpy-sounding.   These bumpy periods often occur during “language explosions” when children are rapidly learning new words and grammatical structures.  Your child’s disfluencies may be developmentally appropriate if he or she:

·        occasionally repeats the first sounds or word in a phrase (usually 1-2x)

·        is between the ages of 1.5-5 years old

·        has disfluencies that are not consistent; your child may go through phases of disfluency that go away on their own after a short period of time

 When to seek help from a therapist

There are several red flags that indicate a child’s disfluencies may be indicative of a “true stutter” vs. developmental disfluencies.  You should consider having your child evaluated by an ASHA certified speech-language pathologist if one or more of the following red flags are present:

·        your child’s disfluencies have lasted for longer than 6 months

·        your child is 5 years old or older

·        you have a history of stuttering in your family

·        your child is a boy (boys have been shown to stutter 4x more than girls)

·        your child’s disfluencies occur more frequently/appear more severe

·        your child gets “stuck” on sounds or words, typically at the beginning of sentences and phrases, and can’t “get their words out”

·        your child may prolong sounds, such as “mmmmmmmmore please”

·        your child’s dysfluencies appear effortful and strained

·        your child demonstrates “secondary characteristics”, or behaviors that occur during disfluencies, i.e. forcefully blinking eyes, slapping leg, turning away

·        your child is aware of their disfluencies and becomes upset, embarrassed, or frustrated when disfluencies occur

Can you prevent stuttering?

Unfortunately, there are no known ways to “prevent” your child from developing a stutter.  Stuttering is a neurological communication disorder that can be “caused” by a combination of complex factors, including genetics, child development, neurophysiology, and family dynamics. (see FAQ from The Stuttering Foundation website).  There is currently no known “cure” for stuttering; however, there are many treatment approaches that can be performed by a speech-language pathologist that have been proven affective in helping to reduce or eliminate stuttering.  There are also many ways that you can change the way you and your child communicate to promote smooth, more fluent speech in the home- see the parent section below for tips and tricks for increasing your child’s fluency. 

How to treat stuttering

There are a variety of treatment methods to help reduce the frequency of stuttering and promote smooth speech.  A speech-language pathologist can help determine the severity and types of dysfluencies that your child is experiencing and will assist in developing a plan of treatment that is best suited for your child.  This plan of treatment may include modification of speaking rate, modification of muscle tension/relaxation during speech, modification of respiration, etc.  A speech-language pathologist will also work with your child to help them learn more about stuttering and its causes, as well as helping your child identify any negative emotions associated with stuttering and working through these emotions to achieve fluent speech.  For more detailed information regarding treatments for stuttering, please visit the American Speech-Language-Hearing Association website.

How a parent can help at home

You can help your child reduce his or her dysfluencies at home in the following ways:

·        Slow it down!  Model slow and relaxed speech around your home.  This helps reduce the “pressure” your child may feel to “keep up” by using fast paced speech, which often leads to increased disfluencies

·        Make time for your child to communicate with you.  Set aside a time of the day where you can listen to your child without multi-tasking or interjecting with questions or comments- allow your child to tell you whatever they’d like without feeling any pressure.

·        Before responding to your child or other family members, try to pause rather than immediately responding.  This encourages a more relaxed pace for communication for the whole family

·        Don’t interrupt or try to “finish” a sentence for your child when they are stuttering- this can be discouraging for your child and make them feel that they have failed in their attempt to communicate.  Allow them to finish their thought regardless of the length of stutter.  Try to avoid speaking about or reacting in a negative way when stuttering occurs; reacting in a kind and accepting way can help encourage your child.  

What can happen if stuttering goes untreated

If stuttering remains untreated, it can have serious emotional consequences for your child as they grow older.  Children who stutter often experience negative emotions associated with their stuttering, including feelings of frustration, anger, confusion, embarrassment, and sadness.  Children who stutter may start to withdraw socially.  They may experience anxiety in social situations and “pressured” communication settings, such as restaurants, stores, etc.  You child may have difficulty participating in school activities or being in front of others during presentations or speeches.  Treatment of stuttering by a certified speech-language pathologist can not only help your child become more fluent, but can also help your child understand and confront the negative emotions associated with stuttering.  As stated by the Stuttering Foundation, “Overcoming stuttering is often more a matter of losing fear of stuttering than a matter of trying harder”; a speech language pathologist can help assist you and your child on your journey to reduce stuttering.


If you have questions or concerns regarding your child’s fluency, please see the ABC Pediatric Therapy Website,, for more detailed information or call any of our locations to speak with a speech-language pathologist. 

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Insurance Made Easy

Breaking Through The Financial Barriers

ABC is passionate about making sure that finances are not a barrier for your child to receive the services that they need and deserve.

What does ABC do to make understanding insurance benefits easy?

An ABC staff member will call your insurance company to determine your benefits.

We also ask that you also call your insurance company to hear your benefits as well.

We will share with you what we learn about your benefits.  Helping you understand your financial responsibility is important to us.

What insurance companies is ABC in network with?

ABC is in network with nearly every insurance company.

Once I understand my benefits, what do I do if I can’t afford therapy or find that therapy is not covered?

ABC has helped hundreds of families find alternative funding to help pay for therapy.  Please call or email us and we are happy to help you too.

What if I run out of visits?

If your policy allows more visits to be authorized, ABC will handle requesting additional visits for you or give you the information that is needed to request additional visits if that is what is required by your insurance company.

What if my policy does not allow more visits to be approved?

ABC will work with you to explore alternative funding sources to help pay for more visits.

We also offer private pay and sale appointments to ensure you can continue to watch your child be the best them they can be.

At ABC, HELP does not just occur in our treatment sessions.  We HELP to make scheduling and billing easier as well.

Please visit to answer more questions you might have.  We want to help you!

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ABC Pediatric Therapy Teacher and Student on Swing

Building Friendships When You Have Autism by Jenn Jordan, Q102 Radio Host

When Jakob was first diagnosed, one of my biggest worries was that he would never enjoy being with other people. I feared that he would never care whether or not I was in the same room with him and that he would never want or have any friends.

He was perfectly fine all by himself in a room with a huge pad of drawing paper. He would fill every page with letters and numbers. Then he would watch Baby Einstein videos over and over and jump on his trampoline. He would take his stuffed bear that played a recording of ‘Twas the Night Before Christmas and play it again and again. All the while not needing anything from me other than a fresh pad of paper or new batteries. I went years feeling sad about that, feeling sorry for him and thinking that he was missing out on some of the most important things in life.

What a load that was. I was causing myself so much unnecessary suffering from all those beliefs that I was projecting onto him. I was the one missing out, not him. He had everything all figured out. He found the things that made him happy and he did them. Once I came to that realization, I stopped trying to drag him into the world he didn’t have any interest in (mine) and I joined him in his. I wrote the alphabet, I rolled markers across tables, I jumped on trampolines right alongside him. And that’s when a bond was created. That’s when he learned that it can be a whole lot of fun to do things with other people.

For years, that’s what we did. He chose the games and how he wanted to play and I followed his lead. I would look for openings and signs that he might be willing to try something new and different or let me take the lead. And it happened more and more with time. He came out of his world and joined me in mine. It was, and continues to be, a beautiful journey.

Eventually, he started to take an interest in other kids. It was difficult for him because of his limited ability to communicate clearly. The other kids couldn’t understand what he was saying. It’s still an issue, but he’s learning and he’s motivated. He truly wants to interact. It’s such a cool thing to watch and be a part of.

It was almost exactly one year ago today when we planned his first big party at the house. We were on the way home from school and his friend and classmate, Sarah was in the car with us. “Cars 3” was coming out on DVD soon and I just put it out there that we should have some friends over for a movie night. His eyes lit up and he said “Cars 3 party” and that was that. He’s been having regular gatherings at the house with 3-5 of his friends from school. He writes out save the date cards, invitations, RSVP cards with self-addressed stamped envelopes and then a few days before the party, he delivers a schedule of events. He has so much fun with the party prep and gets so excited as he waits for the doorbell to start ringing.

So much worry. So much pain. So much time wasted. I am so glad I learned how to love, accept, join and let him show me the way. Now it’s just a party.

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Trouble With Changes In Routine?

Many people have difficulty and can feel anxious with changes in routine but especially children.   Children thrive on routine and knowing what expectations are so when the routine is off, it can throw our children for a loop.  Some common triggers include: going to the dentist, leaving the house, having guests over, holiday get-togethers, changes in plans and unexpected cancelled activities.

There are several strategies that can help children tolerate these changes in routine.  Discuss changes in advance if possible to allow your child time to adjust and anticipate the change.  Social Stories can give children an idea of how the event may go.  For example, if you’re having people over for the holidays or if taking him/her to the dentist you can make a quick story with pictures of who they will see, what they might do and so on.  Ending the story in a positive way so he/she will know what to expect and reassure them that nothing bad will happen. 

Visit new places ahead of time.  If he/she is going to a birthday party or going to the dentist, make arrangements to visits ahead of time when there won’t be any pressure and when it will just be a quick visit to see what the setting is like.  The more comfortable he/she is ahead of time, the better experience it will be!

Using schedules can help as well!  It can be a simple 2 step schedule or a schedule with the day’s activities.  A simple 2 step schedule may be, “first grocery store, then home”; “first lunch, then park”.  Making a written or picture schedule for the day can also help children tolerate changes in routine.  For example, a picture of the car, the store, grandparents house, a restaurant and home will give the child a visual to refer to so they know what to expect.  If as a parent, we don’t know if something might come up or we might change plans, you can also add a picture of a question mark into the schedule.  First let the question mark be something fun and exciting so children see that some unexpected plans are fun.  Then you can let the question mark represent the possibility of Plan B (stopping at a new grocery store) and not Plan A (stopping at a familiar grocery store).

For non-preferred activities, it can help children to use a visual timer or a behavior chart!  A visual timer will give children a great visual in regards to how long the non-preferred task will take.   A behavior chart can be used during the non-preferred task to keep children motivated and to give them positive reinforcement for tolerating the activity.  There are phone and tablet applications that have schedules and visual timers.  To find some motivating charts you can go to  For more information on transitioning please go to

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ABC Pediatric Therapy boy in weighted vest walking

Toe Walking – Why Does My Child Do That?

Learning to walk is a fun and exciting time for new parents and young children. Children typically begin to walk independently around 12 months of age and require a lot of practice, trial and error, falling and getting back up. Kids do not have a normal, adult-like walking pattern until closer to the age of seven. Therefore, those who are just learning to walk or have been walking for a very short period of time will have a wider base of support with their legs further apart, absent heel strike, and absent arm-swing. It isn’t until 18-24 months of age when little ones consistently begin to land on their heels and swing their arms reciprocally.  Due to this lack of heel strike, it may appear that your child is walking on their toes.  Toe walking can be considered a normal variant of early walking. However, it becomes more of a concern if and when they consistently walk up on the tips of their toes.

Why is my child walking on the tips of their toes?

Many kids toe-walk and the reason is often unknown and can be considered idiopathic. Idiopathic toe-walking means there is no known reason; the child does not have any other medical diagnosis that would cause the child to walk this way. Sometimes, toe-walking can become purely habitual.

A few potential factors that may contribute to the toe-walking include: difficulty with processing sensory information through their feet and/or legs, muscular tightness and/or weakness, poor bony alignment, or nervous system involvement. Toe walking can also be associated with several diagnoses, including cerebral palsy, muscular dystrophies, autism spectrum disorder, and global developmental delay. However, this is only an association and does not mean the child has one of these conditions nor does it mean that they will necessarily toe-walk if they are diagnosed with one of these conditions.

When does toe-walking become a concern?

Toe-walking puts abnormal stresses on the body that can lead other problems. It causes extreme tightness of the calf muscles, limiting the motion of the ankle. With prolonged toe-walking, the calf muscles become tight and can limit the range of motion at the ankle. This loss of motion will not only affect the way they walk, it will make riding a bike, walking up/down stairs, and playing more difficulty. Finally, toe-walking causes more stress at the knees, hips, and back putting the child at risk for pain and/or injury in the near future.

What can be done if the child does not outgrow the toe-walking?

It is possible that the child will “outgrow” this, with the emergence of a normal heel-to-toe pattern around the age of 18-24 months. But what do you do if they don’t? Physical therapy is a great first choice of treatment to help your child beat the habit of toe walking in a conservative manner. In other words, using treatments such as stretching, strengthening, orthotics or shoe inserts, and play under the supervision of a physical therapist can help reverse the effects that toe-walking has on the body, and get your little one walking with an age-appropriate pattern. If these forms of treatments are not working as planned or the child’s toe-walking has led to severe loss of motion within their feet and ankles, another option a physical therapist can provide is called serial casting. Serial casting is considered a conservative intervention.  A series of casts are used (similar to a cast you may have after breaking a bone), which is typically on for one week, and then replaced weekly for a set period of time. With each cast, the child’s foot is brought forward towards their body (dorsiflexion) in order to stretch the calf and restore motion. At the end of the casting, the goal is for the full range of motion to be restored in order to allow for a proper heel-to-toe walking pattern and eliminate the habitual toe-walking.  If left unaddressed, toe walking can lead to contractures (shortening of a muscle leading to decreased movement) and the inability to stand with feet flat on the ground.  As the child grows, surgery may be recommended when left unaddressed or if the severity of the toe walking is such that conservative measures are unsuccessful.


Toe-walking can be decreased and a typical walking pattern can be established.  If you notice that your child consistently walks on their toes, consider making an appointment with a physical therapist in order to prevent future pain and injury, and help set up your child for future success. If you have any questions, contact ABC Pediatric Therapy, specifically a physical therapist, for more information, and visit our website at to find the location nearest you.

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