​When should I get a speech-language consultation?



​Development is fascinating and amazing, and there is a certain amount of variability in the acquisition of milestones. No two children develop in the same exact way and on the same timeline. However, if you notice that some skills expected for a given age are not yet acquired, it is always worth it to meet with appropriate professionals. It is ALWAYS better to identify and address areas of need sooner than later.

We hear a very common story from our clients. Parents, intuitive as they are about their children, will often notice some differences in their child early on, within the first to second year of life. They ask their pediatricians whether the child is meeting milestones. Frequently, pediatricians suggest the parents "wait and see", or something of the sort. In reality, if there is a developmental delay or a diagnosis, it is ALWAYS best to identify areas of need sooner than later.

So if you or someone you know is unsure about their child's development, call us and schedule a free consultation. Also, call the Central Valley Regional Center (number included below) and request an evaluation.  Below is a brief list of red-flags that may warrant a screening or assessment.

4-6 months

No cooing and does not react to you

6 months

No big smiles or other warm joyful expressions

9 months

No back and forth sharing of sounds, smiles, or other facial expression

12 months

No babbling, no pointing, no gestures such as reaching or waving. No response to own name being called, does not point to familiar objects or people on request,​ does not follow simple commands

1.5 years

No single words, uses less than 10 words consistently, does not use words to communicate wants such as "more" and "down", does not make animal sounds, not yet starting to combining words (ex: "more cookie")

2 years

No spontaneous 2-word phrases, speech is not understandable, does not follow simple directions (e.g., "roll the ball"), does not point to named body parts or pictures ​​

36 months

Says only 1-2 word spontaneous phrases, cannot answer "what" and "who" questions, does not initiate conversation, only speaks when spoken to or repeats what others say word for word

4 years

Talks only about the "here and now", not events in the past or future, puts words together in the wrong, order and/or leaves out words such as in, on, of, the, a, etc. Drops word-endings (ex: -ing, plural -s, etc.), cannot listen to 2-3 lines of a story and answer simple questions about it.

5 years

Does not engage in reciprocal conversation or make comments relevant to the topic or situation cannot answer "how" and "why" questions

Regression of skills at any age

Loss of babbling, language, or social interaction

When private therapy is not an option... 

Ages 0-3 Central Valley Regional Center (CVRC) funds speech-language evaluations and therapy up to age 3 when private insurance is not an option. In addition, they connect families to other incredible resources. ​Contact CVRC at (559) 276-4480

Ages 3+ Contact your local school district, and request an evaluation. School districts provide free speech-language evaluations and therapy to all qualifying children.​​​



​Speech-language pathologists (SLPs) cannot give an Autism diagnosis. However, since social communication and language are within SLPs' scope of practice, and these are the core affected areas in Autism, SLPs can serve as informants of observed characteristics that may warrant further testing for autism. If you notice any of the following characteristics and are concerned about your child's language development, you're welcome to take advantage of our free screenings.

Delayed expression or reception

Delayed expressive and/or receptive language skills (see "Children" section above) or REGRESSION of skills at any age (loss of babbling, language, or social interaction)

Response to name

Does not consistently respond to his/her name, doesn't consistently respond when you talk to him/her

Communication Initiation

Does not frequently initiate communication (e.g., come up to you, smile, point at something, make a sound or say "look!"); Does not share or show things to you (e.g., picks up a toy, looks at you, and says "ahh?" or "cat?").

Repeating Statements

Does not speak or only repeats what is said to him/her (i.e., echolalia)

Instructive difficulty

Does not consistently follow directions

Difficulty requesting

Has difficulty requesting desired items or activities using speech (e.g., instead of asking for "juice", takes you by the hand to the refrigerator and uses your hand to open the door).

Only parent's understand

Oftentimes you understand what your child is communicating but others do not

Inappropriate eye gaze

Using peripheral vision more than usual to look at objects; looking through the corner of the eye

Difficulty imitating

Little to no imitative skills (e.g., does not play peek a boo or imitate funny faces)

Decreased variety in play

Only enjoys playing with puzzles or trains, or cars, or spinning objects, lining object up, etc

Difficulty pretending

Lack of pretend play (e.g., does not pretend to talk on the phone or put a baby to sleep)

Repetitive physical movement

Continually opens and closes doors, watches the wheels move on a car more than the usual amount, lines up toys, sorts toys by color

Unusual sensory explanation

Walks on tippy toes, holds/shakes objects at the side of face, holds ear close to toys producing sound, puts unusual items in mouth

Excessive interest

Excessive interest in particular toys, letters, numbers

Memorizing media

Memorizing and scripting of familiar movies, books, etc

Inordinate behavioral difficulties

 Excessive behavioral outbursts



​Many adults benefit from speech therapy for different reasons. Below are a few reasons you may consider speech therapy for yourself or for a loved one.

Traumatic brain injury

Difficulty speaking or understanding speech, AND/OR cognitive deficits resulting in difficulty performing every-day tasks or performing at work.

Language difficulties

Difficulty understanding or using language

Attention difficulties

Difficulty cognitively attending in the same way as they used to, difficulty performing every day tasks, focusing/remembering, performing duties at work

Challenges with particular sounds

Difficulty pronouncing certain sounds (e.g., s, r, etc) or have difficulty with clear speech production/articulation within connected speech.

Disruptive stuttering

Stuttering and feel as though their stuttering is impeding on their overall ability to communicate and express themselves

Neurodegenerative disease

Diagnosed with a neurodegenerative disease such as Multiple Sclerosis, Parkinson's Disease, Huntington's Chorea, Dementia, etc.


​When should I get a Occupational Therapy consultation?

Below is a brief list of red-flags that may warrant a screening or assessment

Delayed Fine Motor Skills

Difficulty with grasping small objects, coloring/writing, self-feeding with a utensil, cutting/pasting, fastening buttons and zippers  

Delayed Gross Motor Skills

Missed developmental milestones, such as rolling, sitting, crawling, jumping, or climbing; difficulty with strength, muscle tone, endurance, balance, catching/throwing

Body Awareness Challenges

Frequently bumping into or breaking things; difficulty with alternating movements; difficulty using both sides of the body together as in jumping-jacks or playing catch  

Feeding or Eating Challenges

Difficulty with chewing/swallowing; stuffs or pockets food in cheeks; frequently spills or leaks liquids when drinking; significantly “picky” eating

Visual Scanning Difficulties

Difficulty tracking moving objects with the eyes; jumping around the page when reading, difficulty copying from the board at school 

Visual-Perception Difficulties

Difficulty locating missing items; difficulty with drawing, copying, and writing; dislikes or avoids puzzles, hidden pictures, or word-search games

Sensory Concerns

Easily upset by non-preferred touch, sounds, sights, or movement; seems highly sensitive to environmental changes; intently seeks out or avoids certain types of sensory input; demonstrates significant sensitivities with certain clothing or foods 

Self-Regulation and Social Challenges

Difficulty making or keeping friends; low frustration tolerance; difficulty calming down when upset; low sense of self-esteem or self-efficacy; difficulty reading social cues or others’ body language

Delayed Self-care Skills

Difficulty with age-appropriate activities of daily living such as dressing, feeding, personal hygiene, or toileting   

In addition to the developmental red-flags listed above, these example statements may be helpful in determining if occupational therapy may be a good fit to help support you and your child.

  • I have concerns about my child’s motor milestones
  • My child has trouble keeping up with peers
  • Transitions are very difficult for us
  • My child is easily upset by certain sights, sounds, or touch
  • My child is a “picky eater”
  • We experience frequent meltdowns every day
  • It seems like my child crashes, bumps into, and touches other people or things on purpose
  • My baby has trouble holding up his/her head
  • My child has trouble sitting upright
  • Tummy time was really hard when my child was a baby
  • My child skipped crawling and went straight to walkin
  • It is very difficult to capture my child’s attention
  • My child’s muscles seem “loose” or weak
  • My child is constantly moving even when exhausted
  • Drawing, writing, cutting, and pasting are my child’s least favorite activities
  • My child avoids climbing, swinging, and sliding at the park
  • It seems like my child frequently loses balance, trips, or falls
  • My child needs more help with self-care than peers

Empower Speech Therapy
& Life Skills Center - Fresno

745 E Locust #110,
Fresno, CA 93720

Call (559) 801-2626
Text (559)235-1571