There are a few signs that may indicate that your child needs speech therapy. Here are some things to look out for:
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Speech Therapy
- Difficulty with pronunciation: If your child struggles to produce certain sounds or consistently mispronounces words, it could be a sign that they need speech therapy.
- Limited vocabulary: If your child has a smaller vocabulary than other children their age or has difficulty finding the right words to express themselves, they may benefit from speech therapy.
- Trouble understanding others: If your child has difficulty understanding what others are saying or following directions, it could be a sign of a language disorder that could be addressed with speech therapy.
- Stuttering or other fluency issues: If your child stutters or has other fluency issues such as repeating sounds or words, it could be a sign that they need speech therapy.
- Difficulty with social communication: If your child has trouble with social communication, such as taking turns in conversation or understanding nonverbal cues, it may be helpful to seek speech therapy.
If you are concerned about your child’s speech or language development, it’s a good idea to consult with a speech-language pathologist (SLP) who can evaluate your child and provide guidance on whether speech therapy is necessary.
If your child is having difficulty producing speech sounds, it’s important to have them evaluated by a speech-language pathologist (SLP) to determine if speech therapy is necessary. Some children may have difficulty producing certain speech sounds until they are older, but if your child is significantly behind their peers in this area, it’s important to seek professional help.
There are a few reasons why a child may have difficulty producing speech sounds. One possible cause is a speech sound disorder, which is a type of communication disorder that affects a child’s ability to articulate sounds. Another possible cause is hearing loss, which can make it difficult for a child to hear speech sounds accurately and reproduce them correctly.
The SLP will evaluate your child’s speech and language skills, determine if there is a problem, and develop a treatment plan if necessary. Speech therapy can help your child learn to produce speech sounds correctly and improve their overall communication skills.
In summary, it’s important to have your child evaluated by a speech-language pathologist if they are having difficulty producing speech sounds, as early intervention can improve outcomes and help your child communicate more effectively.
If your child stutters, there are several things you can do to help them:
- Listen actively: When your child is speaking, make sure to give them your full attention and listen actively. Try not to interrupt them or finish their sentences for them.
- Speak slowly: When you’re talking to your child, try to speak slowly and clearly. This can help your child understand and follow your speech, and may also help them regulate their own speech.
- Avoid correcting your child: Try not to correct your child’s speech or point out when they’re stuttering. Instead, model clear and slow speech yourself.
- Create a relaxed environment: Stuttering can be exacerbated by stress and anxiety, so try to create a relaxed environment for your child. Avoid putting pressure on them to speak perfectly or perform in front of others.
- Seek help from a speech-language pathologist: A speech-language pathologist (SLP) can evaluate your child’s stuttering and develop a treatment plan that is tailored to their individual needs. This may include strategies to improve fluency, such as breathing exercises or speech therapy techniques.
It’s important to remember that stuttering is a common speech disorder, and most children who stutter will eventually outgrow it. However, early intervention can improve outcomes and help your child communicate more effectively, so don’t hesitate to seek help from a speech-language pathologist if you have concerns about your child’s stuttering.
It’s not uncommon for young children to have difficulty producing certain speech sounds, such as substituting a “t” sound for a “k” sound. This type of substitution is known as a phonological process, which is a pattern of speech errors that children use to simplify their speech as they learn to talk.
The “t” sound is produced in a different part of the mouth than the “k” sound, and it may be easier for some children to produce. However, if your child is consistently substituting a “t” sound for a “k” sound past a certain age, it could be a sign of a speech sound disorder.
There are several reasons why a child may have difficulty producing speech sounds correctly, including:
- Hearing loss: If a child has difficulty hearing certain sounds, they may have trouble producing them correctly.
- Oral motor difficulties: Some children may have difficulty coordinating the muscles needed for speech production, which can make it difficult to produce certain sounds.
- Speech sound disorder: A speech sound disorder is a type of communication disorder that affects a child’s ability to articulate sounds.
If you’re concerned about your child’s speech development, it’s a good idea to have them evaluated by a speech-language pathologist (SLP). The SLP can determine if there is a problem and develop a treatment plan if necessary. Speech therapy can help your child learn to produce speech sounds correctly and improve their overall communication skills.
There are several reasons why a child may have difficulty producing speech sounds correctly, including:
- Encourage communication: Encourage your child to communicate their wants and needs to you by giving them opportunities to express themselves. Use simple language and ask open-ended questions to encourage conversation.
- Use visual aids: Visual aids such as pictures, drawings, or gestures can help your child understand and communicate their wants and needs more effectively.
- Be patient: It’s important to be patient and give your child time to express themselves. Avoid interrupting or finishing their sentences for them.
- Simplify the environment: Try to simplify the environment to reduce distractions and make it easier for your child to communicate. Turn off the TV, reduce background noise, and avoid multitasking while your child is speaking.
- Consider seeking professional help: If your child is consistently having difficulty communicating their wants and needs, it may be helpful to seek the guidance of a speech-language pathologist (SLP). An SLP can evaluate your child’s communication skills and provide strategies to help them communicate more effectively.
It’s important to remember that every child develops at their own pace, and some children may need more time and support to develop their communication skills. With patience and support, you can help your child learn to express themselves more effectively and reduce their frustration.
It’s not uncommon for young children to resist attempts to teach them new words or to imitate speech sounds. Here are some strategies you can try to encourage your child to imitate you:
- Make it fun: Young children learn best through play and fun activities. Try making speech practice into a game, using toys or puppets, or singing songs together to make the activity more engaging and enjoyable.
- Use repetition: Repetition is an important part of learning speech sounds. Repeat the same sounds or words several times, and gradually increase the complexity of the sounds or words you’re teaching.
- Use positive reinforcement: Praise your child for their efforts and successes, even if they are small. Use positive reinforcement, such as hugs, high-fives, or stickers, to encourage your child to keep trying.
- Keep it short and simple: Keep speech practice sessions short and simple, and focus on a few key sounds or words at a time. This will help prevent your child from becoming overwhelmed or frustrated.
- Model correct speech: Model correct speech sounds and words for your child to imitate. Speak clearly and slowly, and exaggerate the sounds to make them more obvious.
If your child continues to resist attempts to imitate speech sounds or words, it may be helpful to seek the guidance of a speech-language pathologist (SLP). An SLP can evaluate your child’s speech and language skills and provide strategies to help them develop their communication skills.
Pointing is a natural part of a child’s communication development, and it can be an effective way for them to express their wants and needs. However, it’s important to encourage your child to use other forms of communication as well, such as words or gestures. Here are some strategies you can try:
- Encourage vocalizations: Encourage your child to vocalize or make sounds when they point at objects. For example, you can say, “Yes, that’s the ball. Can you say ‘ball’?” This can help your child associate the object with the word and encourage them to use vocalizations to communicate.
- Use visual aids: Use pictures or drawings to help your child associate words with objects. Show your child a picture of the object and say the word, then encourage your child to say the word or point to the picture.
- Model language: Model language for your child by speaking clearly and using simple, age-appropriate language. Use short sentences and emphasize key words to help your child understand the meaning of the words.
- Provide choices: Provide your child with choices to help them learn to communicate their wants and needs. For example, you can hold up two objects and ask, “Do you want the ball or the book?” This can encourage your child to use words or gestures to indicate their choice.
- Seek professional help: If your child continues to rely solely on pointing to communicate their wants and needs, it may be helpful to seek the guidance of a speech-language pathologist (SLP). An SLP can evaluate your child’s communication skills and provide strategies to help them develop their language and communication skills.
Remember that every child develops at their own pace, and it’s important to be patient and supportive as your child learns to communicate. With time and practice, your child can learn to communicate their wants and needs more effectively.
There can be many reasons why a child may have difficulty following directions. Here are some possible reasons:
- Developmental delays: Some children may have delays in their development that affect their ability to follow directions. This could be due to a variety of factors, such as a hearing or vision impairment, a speech or language delay, or a cognitive or learning disability.
- Attention difficulties: Children who have difficulties with attention and focus may have difficulty following directions. They may become distracted or have trouble staying on task, which can make it difficult for them to follow through with instructions.
- Behavioral challenges: Some children may have behavioral challenges that make it difficult for them to follow directions. This could include oppositional behavior, defiance, or a lack of motivation.
- Communication difficulties: Children who have difficulties with communication may have difficulty understanding or processing instructions. This could be due to a speech or language delay, hearing loss, or other communication challenges.
- Environmental factors: Environmental factors, such as noise, distractions, or changes in routine, can also make it difficult for children to follow directions.
If your child is consistently having difficulty following directions, it may be helpful to seek the guidance of a professional, such as a speech-language pathologist (SLP) or an occupational therapist (OT). They can help identify any underlying issues and provide strategies to help your child improve their ability to follow directions. In addition, you can work with your child to simplify instructions, break them down into smaller steps, and provide clear and consistent feedback and reinforcement for following through with instructions.
Speech therapy can be beneficial for children of all ages, from infants to teenagers. The specific age at which a child may start speech therapy will depend on their individual needs and developmental level. Here are some general guidelines:
- Infants and toddlers: Speech therapy can be helpful for infants and toddlers who have difficulty with feeding or early communication skills, such as babbling or making sounds. Some children may start speech therapy as early as 6 months of age.
- Preschoolers: Speech therapy is often recommended for preschool-aged children who have speech and language delays or disorders. This may include children who have difficulty with articulation, vocabulary, grammar, or social communication skills.
- School-aged children: Speech therapy may be recommended for school-aged children who have difficulty with reading and writing, as well as those who have more complex speech and language disorders.
- Teenagers: Speech therapy may be helpful for teenagers who have difficulty with public speaking, social communication, or academic communication skills.
If you are concerned about your child’s speech and language development, it’s important to consult with a speech-language pathologist (SLP). An SLP can evaluate your child’s speech and language skills and provide recommendations for therapy if necessary. Remember, early intervention is often key to improving outcomes for children with speech and language delays or disorders.
Feeding therapy is a type of therapy that focuses on improving a child’s ability to eat and swallow safely and effectively. It is typically provided by a speech-language pathologist (SLP) who has specialized training in feeding and swallowing disorders. Feeding therapy can be helpful for children who have difficulty with any aspect of eating, including:
- Accepting different textures and types of food
- Chewing and swallowing food safely
- Sucking and swallowing during breastfeeding or bottle-feeding
- Transitioning from a feeding tube to oral feeding
- Managing reflux or other medical conditions that affect feeding
The goal of feeding therapy is to help the child develop the skills and behaviors necessary to eat and swallow safely and effectively. The SLP will evaluate the child’s feeding and swallowing abilities, as well as any underlying medical or developmental issues that may be contributing to the feeding difficulties. Based on the evaluation, the SLP will develop a treatment plan that may include a variety of strategies and techniques, such as sensory integration techniques, behavioral interventions, and oral-motor exercises.
In addition to working with the child, feeding therapy often involves working with the child’s caregivers to help them understand and support the child’s feeding needs. This may include providing guidance on mealtime routines and strategies to encourage the child’s acceptance of different foods and textures.
It’s important to seek the guidance of a professional, such as an SLP or pediatrician, if you have concerns about your child’s feeding or swallowing abilities. Feeding difficulties can impact a child’s growth and development, and early intervention can be key to improving outcomes.
In some cases, surgery may be necessary to correct a tongue tie. In these cases, speech therapy may be recommended as part of the child’s post-operative care to help improve their speech and language skills. It’s important to work closely with a team of healthcare professionals, including an oral surgeon and a speech therapist, to determine the best course of treatment for your child.
- Oral motor exercises: Speech therapists can provide oral motor exercises to help improve tongue mobility and coordination. These exercises may involve using different textures and objects to stimulate the tongue and encourage movement.
- Articulation therapy: Children with tongue ties may have difficulty with certain speech sounds, such as “t,” “d,” “n,” and “l.” Speech therapists can provide articulation therapy to help the child learn how to produce these sounds correctly.
- Feeding therapy: Children with tongue ties may have difficulty with breastfeeding, bottle-feeding, or eating certain types of food. Speech therapists can provide feeding therapy to help the child develop safe and effective feeding skills.
- Education and support: Speech therapists can provide education and support to parents and caregivers on how to best support the child’s speech and language development. This may include recommendations for positioning during feeding, strategies for encouraging speech and language development, and information on follow-up care.
In some cases, surgery may be necessary to correct a tongue tie. In these cases, speech therapy may be recommended as part of the child’s post-operative care to help improve their speech and language skills. It’s important to work closely with a team of healthcare professionals, including an oral surgeon and a speech therapist, to determine the best course of treatment for your child.
Occupational Therapy
Occupational therapy for kids is a type of therapy that focuses on helping children develop the skills and abilities they need to participate in daily activities and routines. The goal of occupational therapy is to help children achieve greater independence and success in all areas of life, including self-care, play, socialization, and academic performance.
Occupational therapy for kids may involve a variety of interventions and strategies, depending on the child’s needs and goals. Some common areas of focus in pediatric occupational therapy include:
- Sensory integration: Many children with sensory processing difficulties can benefit from sensory integration therapy, which uses play-based activities to help children regulate their responses to sensory input.
- Fine motor skills: Occupational therapists can work with children to develop fine motor skills, such as grasping objects, manipulating small items, and using utensils for eating and writing.
- Gross motor skills: Occupational therapists can help children develop gross motor skills, such as walking, jumping, and running, as well as coordination and balance.
- Self-care skills: Occupational therapists can help children develop the self-care skills they need to perform daily tasks, such as dressing, grooming, and feeding themselves.
- Executive functioning: Occupational therapists can work with children to develop executive functioning skills, such as planning, organizing, and problem-solving.
- Socialization and play skills: Occupational therapists can help children develop socialization and play skills, including turn-taking, sharing, and imaginative play.
Occupational therapy for kids is typically provided by a licensed occupational therapist (OT) who has specialized training in working with children. The therapist will work closely with the child and their caregivers to develop a customized treatment plan that addresses the child’s unique needs and goals. Therapy sessions may take place in a clinic or school setting, and may involve individual or group therapy.
There are several strategies that can help improve a child’s handwriting:
- Practice: Like any skill, handwriting requires practice. Encourage your child to practice writing regularly, and provide them with a variety of writing tools and surfaces to work with (such as pencils, pens, markers, and different types of paper).
- Proper grip and posture: Make sure your child is holding their writing utensil correctly and sitting in a comfortable and supportive position. An occupational therapist can provide guidance on proper grip and posture if needed.
- Hand strength and coordination: Improving hand strength and coordination can help improve handwriting. Activities such as squeezing a stress ball or playing with putty can help build hand strength.
- Visual-motor integration: Handwriting also requires good visual-motor integration skills, which involve the ability to coordinate eye movements with hand movements. Activities such as tracing, copying, and drawing can help develop these skills.
- Use of guides and tools: Using guides and tools such as writing templates, raised line paper, or pencil grips can help improve letter formation and spacing.
- Breaks and pacing: Encourage your child to take breaks and pace themselves while writing to prevent fatigue and frustration.
If your child’s handwriting difficulties persist despite these strategies, it may be helpful to consult with an occupational therapist (OT) to determine if there are underlying sensory or motor issues that need to be addressed.
An occupational therapist (OT) can be instrumental in helping a child with sensory processing disorder (SPD) develop the skills and strategies needed to manage their sensory input and navigate their environment more effectively. Some ways that an OT might work with a child with SPD include:
- Sensory integration therapy: Sensory integration therapy uses play-based activities to help a child become more comfortable and regulated in their response to sensory input. This might involve activities such as swinging, jumping, or playing with textured materials to help the child learn to process and integrate sensory information.
- Environmental modifications: An OT can help identify and modify environmental factors that may be contributing to a child’s sensory difficulties, such as lighting, noise levels, or textures.
- Adaptive equipment: An OT can recommend and provide adaptive equipment, such as noise-canceling headphones or weighted vests, to help a child manage their sensory input and stay focused.
- Self-regulation strategies: An OT can teach a child self-regulation strategies, such as deep breathing or mindfulness techniques, to help them manage their sensory input and emotional responses.
- Skill-building activities: An OT can provide activities that help a child develop skills in areas such as balance, coordination, and body awareness, which can improve their ability to process sensory information.
- Family education and support: An OT can provide education and support to the child’s family, including strategies for managing sensory input at home and in the community.
Overall, an OT can work with a child with SPD to develop a comprehensive treatment plan that addresses their unique needs and goals, with the ultimate goal of improving their ability to participate in daily activities and routines with greater comfort and confidence.
An occupational therapist (OT) can be very helpful in working with children to improve their ability to perform activities of daily living (ADLs), which are the tasks that children do every day to take care of themselves and their homes. These tasks may include things like getting dressed, brushing teeth, eating, bathing, grooming, and household chores. Here are some of the ways an OT might work with a child to improve their ADL skills:
- Assessment: An OT will first assess the child’s current abilities and needs in relation to ADLs, including any physical, cognitive, or sensory challenges that may be affecting their performance.
- Goal setting: Together with the child and their family, the OT will set goals for improving the child’s ADL skills based on their unique needs and priorities.
- Skill-building: The OT will work with the child to develop the skills needed to perform ADLs more effectively, using a variety of techniques and tools as needed. This may include exercises to improve strength and coordination, strategies for developing fine motor skills, or modifications to the environment or tasks to make them more accessible.
- Adaptive equipment: The OT may recommend and provide adaptive equipment, such as a special spoon or adapted clothing, to help the child perform ADLs with greater ease and independence.
- Training and education: The OT will provide training and education to the child and their caregivers, including strategies for maintaining independence, using adaptive equipment, and preventing injuries.
- Follow-up and support: The OT will continue to work with the child over time to monitor their progress, adjust their goals and strategies as needed, and provide ongoing support and encouragement.
Overall, an OT can be very effective in helping children improve their ADL skills and maintain their independence, even in the face of physical, cognitive, or sensory challenges.
An occupational therapist (OT) can be very helpful in working with children to improve their emotional regulation, which is the ability to manage and express emotions in a healthy and appropriate way. Here are some of the ways an OT might work with a child to improve their emotional regulation:
- Assessment: An OT will first assess the child’s current emotional regulation abilities, including identifying triggers for emotional dysregulation and the child’s current coping strategies.
- Goal setting: Together with the child and their family, the OT will set goals for improving the child’s emotional regulation skills based on their unique needs and priorities.
- Skill-building: The OT will work with the child to develop skills needed to regulate emotions more effectively, such as deep breathing exercises, mindfulness techniques, sensory-based strategies, and cognitive-behavioral techniques.
- Environmental modifications: The OT may make modifications to the child’s environment to support emotional regulation, such as creating a calm sensory space, providing visual supports, and creating predictable routines.
- Self-regulation strategies: The OT will teach the child self-regulation strategies that they can use in different settings and situations, such as using a visual schedule to anticipate transitions or using sensory tools to regulate emotions.
- Collaborative work with caregivers: The OT will collaborate with caregivers to support the child’s emotional regulation skills, including providing training and education, modeling strategies, and developing home-based activities and routines that support emotional regulation.
Overall, an OT can be very effective in helping children improve their emotional regulation skills, reduce emotional dysregulation, and improve their overall quality of life.
It is common for children to have difficulty transitioning between activities or leaving a preferred place, and sometimes this can result in a meltdown or tantrum. Here are some strategies you can try to help your child with these transitions:
- Prepare for the transition: Give your child plenty of notice before the transition is going to happen, and use visual aids if possible to help them understand what is coming next.
- Provide choices: Give your child choices about what they can do next or where they can go, within reason. This can help give them a sense of control and reduce resistance.
- Use a transition object: Some children benefit from having a special object, such as a favorite toy or blanket, to help them transition between activities or leave a preferred place.
- Use a transition song or activity: Some children respond well to a specific song or activity that signals the transition, such as singing a song while cleaning up toys or doing a special handshake before leaving a place.
- Validate their feelings: Acknowledge and validate your child’s feelings, letting them know that it’s okay to feel upset or sad about leaving a place or changing an activity.
- Provide sensory input: Some children benefit from sensory input, such as deep pressure or heavy work activities, to help them regulate their emotions and prepare for the transition.
- Establish routines: Having predictable routines can help reduce anxiety around transitions and make them feel more comfortable and in control.
Remember that each child is unique and may respond differently to these strategies. Be patient, consistent, and try different approaches to see what works best for your child. If you continue to have difficulty, it may be helpful to consult with a professional, such as an occupational therapist, who can provide more specific guidance and support.
For some children, completing homework and remembering to bring it home can be a real challenge. Here are some strategies you can try to help your child:
- Create a homework routine: Establish a consistent time and place for doing homework, and stick to this routine as much as possible. This will help your child develop good study habits and make homework a regular part of their daily routine.
- Break it down: Help your child break down their homework into manageable chunks, and set specific goals for each session. This can help make the task feel less overwhelming and more achievable.
- Use visual aids: Use visual aids, such as checklists or a whiteboard, to help your child remember what they need to do and what materials they need to bring home.
- Provide incentives: Consider offering rewards or incentives for completing homework or remembering to bring it home. This could be something as simple as extra screen time or a special treat.
- Communicate with teachers: Reach out to your child’s teacher to discuss the homework situation and work together to find solutions that work for your child.
- Consider accommodations: If your child is struggling with homework due to a learning disability or other issue, talk to their teacher or a specialist about possible accommodations that could help.
- Be patient and supportive: Remember that completing homework and remembering to bring it home can be a real challenge for some children. Be patient and supportive, and focus on the progress they are making rather than perfection.
Overall, it’s important to remember that each child is unique and may respond differently to these strategies. Try different approaches and see what works best for your child. If you continue to have difficulty, it may be helpful to consult with an occupational therapist for further guidance and support.
Messy coloring is a common issue for young children, especially those who are just learning to use crayons and other coloring tools. Here are some strategies you can try to help your child:
- Practice: Encourage your child to practice coloring inside the lines and using different techniques such as shading and blending.
- Use thicker crayons: Thicker crayons are easier for young children to grip and control, which can help them stay within the lines and prevent messy coloring.
- Provide visual aids: Use coloring books with bold outlines or provide your child with stencils or tracing sheets to help them learn to color within the lines.
- Demonstrate proper technique: Show your child how to hold the crayon correctly and how to move it in different directions to create different effects.
- Praise effort: Encourage your child and praise their efforts, rather than focusing solely on the end result. Let them know that it’s okay to make mistakes and that practice is important.
- Use a designated work area: Designate a specific area for coloring and other art activities, and make sure it’s easy to clean up. This can help contain messes and make cleanup easier.
- Use washable art supplies: Consider using washable art supplies, such as washable markers or paints, which are easier to clean up in case of accidental spills or messes.
Remember that each child develops at their own pace and may need different types of support. Be patient and supportive, and encourage your child to continue practicing and trying new techniques. With time and practice, your child will become more confident and skilled at coloring. If your child continues to have difficulty, it may be helpful to consult with an occupational therapist for further guidance and support.
Learning to use scissors is an important fine motor skill for young children, and it can be challenging at first. Here are some strategies you can try to help your child:
- Provide child-friendly scissors: Look for scissors that are designed specifically for young children and are easy to grip and control.
- Demonstrate proper technique: Show your child how to hold the scissors correctly and how to open and close them while cutting.
- Practice with playdough: Encourage your child to practice cutting playdough into small pieces using scissors.
- Use cutting worksheets: There are many cutting worksheets available online that provide practice cutting along lines and curves.
- Cut paper strips: Start by having your child cut paper strips, which are easier to cut than shapes or curves.
- Use visual cues: Draw lines on the paper to provide guidance for where to cut.
- Praise effort: Encourage your child and praise their efforts, rather than focusing solely on the end result. Let them know that it’s okay to make mistakes and that practice is important.
Remember that each child develops at their own pace and may need different types of support. Be patient and supportive, and encourage your child to continue practicing and trying new techniques. With time and practice, your child will become more confident and skilled at using scissors. If your child continues to struggle with scissor use, you may want to consult an occupational therapist for further guidance and support.
There can be many reasons why a child may appear to be clumsy. Some possible causes include:
- Delayed motor development: Some children may experience delays in their motor development, which can affect their coordination and balance.
- Sensory processing issues: Children with sensory processing issues may struggle with processing information from their senses, which can affect their motor skills.
- Poor vision: Children with poor vision may struggle with depth perception, which can affect their coordination and balance.
- Medical conditions: Some medical conditions, such as cerebral palsy, muscular dystrophy, or seizure disorders, can affect a child’s motor function and coordination.
- Environmental factors: A child’s environment can also play a role in their coordination and balance. For example, a cluttered or unsafe living space can increase the risk of falls and injuries.
If you are concerned about your child’s clumsiness, it may be helpful to consult with an occupational therapist. They can evaluate your child’s motor skills, identify any underlying issues, and provide recommendations for interventions or therapies to help improve your child’s coordination and balance.
Working with Tammy Myers and her staff has been such a blessing. They have a plethora of ideas of how to adapt skills and lessons to meet individual student’s needs. They take time to brainstorm ideas with me because they truly care for each child. I’ve worked with Tammy for numerous years and am thankful that she is an advocate for my students’ care and growth. Tammy and her staff are wonderful!