EVALUATIONS AND CONSULTATIONS
Our goal during an evaluation is to obtain relevant and meaningful information, to begin to understand each child’s unique developmental profile.

►Speech and Language Consultation
This is a 1 hour consultation for children who have had a recent speech and language evaluation, are being assessed for placement in on of our group programs, or are over the age of 4 and are being evaluated only for articulation/speech production with no language concerns. A written report is included except for children who are being evaluated for a group program, unless required for insurance billing.

►Standard Speech and Language Evaluation
This is a 2 hour assessment for children who have more extensive communication needs or have not had a speech and language assessment within the past year. The assessment procedure includes a combination of parent interview, observation of the child playing with his/her parents, play-based assessment, and standardized assessment procedures. The last ½ hour of the evaluation is dedicated to discussing assessment findings with the child’s parents and developing an intervention plan as a team. This evaluation includes a written report.

►Extensive Speech and Language Evaluation
This assessment occurs in 2-3 hour blocks over 2-3 days and includes parent interview, educational staff interviews if warranted, and extensive standardized testing. This evaluation is appropriate for children who are elementary age and older in which a thorough assessment of the child’s individual learning profile is necessary to help determine appropriate academic placement, classroom supports/modifications, teaching strategies, and services and programs to maximize learning potential. This includes a reading assessment if necessary. This evaluation includes an extensive written report.

►Occupational Consultation
A 1-hour consultation may be appropriate for families who are interested in grouping/pairing their child with another child during therapy.   An occupational consultation may also be benefiical to assist speech therapists at Milestones with insight into a child's sensory, motor, and regulatory needs.  
 
►Occupational Evaluation
This typically is a 2 hour assessment for families who have questions about their child's fine motor development and self-help skill development.  The assessment process includes a combination of a parent interview, observation of the child's motor skills and problem solving while playing on various sensory equipment pieces, observation of the child during parent-child/parent-therapist/parent-sibling interactions, and standardized testing using fine and gross motor standardized tests and/or administration of the Sensory Profile Questionnaire to appropriately identify sensory difficulties which may be adversely affecting a child's day to day function.  1 to 2 followup visits are often necessary to fully complete standardized motor testing, complete and discuss test scores and the child's performance, and to assist in identifying appropriate goal areas.   This evaluation includes a written report that serves as a guideline for goals for therapy.  Parent contribution to goal formation is expressly welcomed, as the parents truly know the child best. 

►Social Emotional Evaluation
This is a 2 hour assessment with a speech language pathologist and an occupational therapist utilizing social emotional assessment tools such as The Functional Emotional Assessment Scale (FEAS). This assessment is specifically designed for children with autism spectrum disorders and other disorders affecting regulation and engagement. Because these children demonstrate stronger skills when interacting with people with whom they have a strong relationship, parents will be the primary individuals interacting with the child and the clinicians will play more of a coaching role throughout this assessment process. Parents will be videotaped interacting with their children in both sensorimotor and representational play activities. A feedback session will be scheduled on a different date to review video clips, discuss the child’s developmental profile, and develop a treatment plan. This evaluation includes a written report.

►Reading Evaluation
This is a 1 hour screening that utilizes the Adapted Rosner Test. This assessment screens for auditory processing, blending, segmenting and code knowledge (sound to symbol knowledge).  A brief written summary will be provided upon request.

TREATMENT
Our goal is to provide a highly individualized treatment plan based on each child’s unique developmental profile and learning needs. Parents and caregivers are considered key members of the treatment team and are encouraged to actively participate in treatment sessions.

►Individual Speech and Language Therapy

Individual therapy is the primary modality in which we provide therapeutic intervention to facilitate improved oral motor, feeding, articulation, language comprehension, and social communication skills.  When working with young children, we incorporate a play-based, developmental treatment model.

Treatment goals are implemented during naturally motivating activities with an emphasis on building success and confidence.  When working with older children, we often use more structured activities that are motivating to the child. 

►Group Speech and Language Therapy
Group therapy is used to help children improve upon their social emotional skills when relating and communicating with peers. Group therapy is also used when children are working on similar articulation error and have similar interests.
 
►Buddy Builders
Groups of 3-12 children over the age of 5 who are participating in regular education classrooms but have difficulties navigating the social world and building friendships.   The purpose of this group is to facilitate independent creative social interactions, forming friendships based upon mutual respect, common interests, and shared interests, expanding symbolic play skills and reasoning, strengthening non-verbal and verbal communication skills during spontaneous and highly motivating social interactions, and building negotiation, cooperation, and shared enjoyment.  The Think Social! curriculum by Michelle Garcia Winner is utilized along with DIR/Floortime strategies.  At this time, our Buddy Builders group is held at EWU/WSU Speech and Hearing Clinic with graduate student clinician's providing direct therapy while Chanda Davis Neu is providing student supervision.
 
►Individual Occupational Therapy
Individual therapy is the primary modality in which we provide therapeutic intervention to facilitate engagement in meaningful activities of daily life (self-care, education, and social interaction), fine motor skills, feeding, and sensory integration.  Occupational therapy goals are embedded into naturally motivating activities whenever possible utilizing a child-directed, developmental model.  When working with older and more regulated children, we often use more structured activities that are motivating to the child.   
 
►Group Occupational Therapy
Group therapy is used to help children improve upon their sensory motor and emotional regulation skills when relating and problem-solving with peers during meaningful activities of daily life. Group therapy is also used when children are working on similar fine motor goals and have similar interests.
 
►Co-Treatment with Speech and Occupational Therapy
At times children are seen by both speech and occupational therapists simultaneously.  This is more common when children have sensory integration and emotional regulation difficulties.  The role of the occupational therapist is to address the underlying difficulties with regulation, while the speech therapists targets the underlying difficulties with communication. 

►Reading/Cognitive Therapy

COGNITION involves the ability to process and visualize information, use memory more efficiently, improve auditory processing connections and gain confidence in overall thinking function.  READING involves sound to symbol connections. Cognition and reading go hand and hand at Milestones.  Reading training includes the following skills: segmentation, blending, auditory processing, code knowledge, multi-syllable management, fluency, and comprehension. Most students who need intensive reading training respond exceptionally well to the  Phono-Graphix Program, which is simply the most well-respected reading method, developed in 1996. It is a hands-on learning process to get kids reading on level efficiently. Most students need between 24-36 hours of training. Students who are dyslexic, have speech challenges, autism spectrum disorders, or other severe disabilities, generally begin with intensive auditory processing training and move towards unlocking their potential to reading, fluency, and comprehension. The process may take longer, but success is inevitable.   Our sessions are short (typically 1/2 hour) and intensive, but our results are  long-term and extensive. The procedures we use are challenging, fun, and leveled so that success can be consistently measured.  
 
►Interactive Metronome

This is a computer based treatment modality that trains optimal neuronal firing to improve neurological processes of attention, motor planning, and sequencing with functional improvements in language, communication, reading, and math.  It is an approved treatment for ADHD.  Children respond best to intensive Interactive Metronome programs which consist of 3-5 half hour sessions per week for a minimum of 4-6 weeks.  Slow but steady changes have been observed with as little has 1/2 hour per week; however, these changes are over the course of 6-12 months.  There is also an Interactive Metronome Home version which can be purchased and monitored through this clinic. 

►Therapeutic Listening

This is a listening program that utilizes filtered frequency principles of auditory integration to facilitate integration of the auditory and vestibular systems and auditory desensitization to promote improved sensory integration, attention, articulation, communicaton, and motor planning.  This is a home program in which children listen to a modulated CD for 1/2 hour, twice a day.  CDs are changed every 2 weeks.  This is a relatively low cost intervention program.  The specialized headphones cost $145 through Vital Sounds and the CD rental fee is $25/month.  Due to the fact that program planning is highly individualized based on sensory and behavioral responses, only children who are currently receiving speech or occupational therapy at Milestones are eligible to participate in therapeutic listening.  This allows for effective clinical monitoring of the child's response to the program.