Frequently Asked Clinical Questions

General Questions

When and how much should I prompt my child?

Please refer to the information about prompting in Prompting Hierarchy: Part 1, Part 2, and Part 3. Ask your child’s therapist for guidance on what level of prompting is most appropriate for your child.

Will it hurt my child if he/she doesn’t see the same therapist every session?

All members of our staff are trained to use the same approaches with children to promote relationships and emotional development. Changes in staff can actually be beneficial for your child.  With different therapists we can address generalization of skills across partners and locations. Additionally, different therapists bring unique approaches and personalities to therapy which better addresses your child’s needs.

Why are seatbelts used?

Rifton chairs with straps help promote focus, security, and posture. Most children grow to enjoy the independence of buckling the seatbelt themselves.

Communication Questions

Why can’t I tell my child to say the word the therapist is waiting for?

When the therapist prompts the child and waits for him/her to respond, she is giving the child an opportunity to independently make a request or answer a question. If the parent whispers in the child’s ear what to say, then even though the child may imitate, he is not communicating independently. The idea is to make the child the communicator, with support from the therapist. It can be hard to wait that extra time to allow your child a chance to speak or sign, but when he does respond on his own, he will feel empowered and learn that the words or signs he uses make a difference.

Will using sign language replace speaking?

No.  Some children are not yet at a developmental stage to use words. Sign language just gives them a way to communicate with you now. Signs serve to decreases frustration for both the child and the parents. Eventually, signing leads to speaking.  It will not take the place of speaking.

Will using picture icons replace speaking?

No.  In the same way that signing works, picture icons serve as another visual cue to help your child communicate and decrease frustration. Eventually, use of picture icons leads to speaking.

Why doesn’t the therapist “make” my child speak?

No one can make another person speak. We target therapy to the level the child is currently at and provide maximal opportunities and support for their participation.

Group Therapy Questions

Why won’t my child speak in group therapy? I know he/she knows how to say that!

Sometimes children have performance anxiety to speak in front of other children or adults. If your child feels he/she is put on the spot to respond “in the moment,” a natural response may be shyness. This is why it is important that we as adults respond to children when they communicate spontaneously. By doing this, we show them that their words mean something and they can make choices by using words, even if it’s not “in the moment.”

Why does the therapist sing the same songs session after session?

Repetition is an important way that children learn. You may have noticed your child wanting to read the same book or play with the same toy over and over again. In the same way, his/her familiarity with songs and the class routine helps him/her to master the language and cognitive tasks involved. Each time a song is re-sung, your child has an opportunity to better learn the sounds, gestures, and vocabulary that are part of that song.

Why are some children encouraged to repeat two or three words together and other children are given the snack for just using sign language or making just one sound?

Each child’s goals and the ways we target them depend on the child’s skill level. If the child isn’t using any words, we may use picture icons as a means to communicate. If the child is already using single words, we will encourage two words together. If he/she uses two words, we’ll encourage three, etc.

Why does my child sometimes not receive a snack from the therapist?  I know he/she is hungry!

During snack time, we wait for the child to show a natural interest in the food. For example, if a child is looking at a snack or raising his hand, the therapist may respond by prompting him to communicate at his current level. The adult could shake a snack container or show it to the child to elicit a request. However, if the child still does not show interest, we follow his lead and do not force him to request something he doesn’t want.

Why are you working on gross motor and fine motor skills when my child doesn’t have problems in these areas?

In the Early Intervention group, we work on all of these areas of development. There is a strong correlation between movement and the use of language. Strengthening the body and improving balance and core stability will help your child build speech and language.

Why do some parents leave the room and others stay in the room with their children?

The idea of gradual separation relates to “independence training.” By having parents of some children leave the room for a period of time, we are preparing the children for separation during preschool. Some children are not yet at a developmental stage where they are ready to separate, and that is okay. We also encourage parent participation, either directly in the group or through observation.

Will it disturb the group if I let my child cry? Is it ok for me to leave my child when he/she is crying?

We determine our response to a crying child on a case by case basis. All children cry sometimes. It is healthy to allow your child to cry at times in order to build independence and teach your child to cope. However, children at this age also need emotional support and security. Receiving the comfort of a trusted adult is also beneficial for a child’s development.

What do you do when children are aggressive?  What is the discipline method used?

Children with decreased language can easily become frustrated and may resort to physical ways of communicating. The therapists and paraprofessionals work together to redirect these behaviors so they can be expressed in a functional way. Gentle interaction, hugs, and friendship between children are promoted.

The other kids in this group seem to have a lot more words than my child.  Is this the right group for him/her?

Yes.  Other children with higher language development will provide a strong language model for children who have more limited skills. The therapists and paraprofessionals work together to design approaches that are individualized for each child.

Transition Questions

What will happen when I have the transition meeting and my child exits the program?  Will he/she still receive services?

The purpose of the transition meeting is to prepare your child to exit from California’s Early Start program (birth to age three) and enter into the public schools system in your district. The transition meeting usually occurs three months before a child turns three-years old. It is run by the case manager/service coordinator. The therapist is not usually present unless the transition meeting happens to correspond with a six-month review or annual review of the IFSP goals. During the transition process, your child will be evaluated separately by the school district in which you reside. Many school psychologists and therapists consult with the CSLOT therapists about how a child is performing. While the school districts take into consideration the therapist’s recommendations, it is no guarantee that the child will receive therapy services once he reaches the public schools. Please speak with your case manager about the details of the transition process.

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The key to effective treatment is an early response.
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