Tag Archive for: red flags

Gravitational Insecurity and Recess

in , , ,

Gravitational insecurity is a term that means an excessive fear of ordinary movement. Blog-Gravitational Insecurity-Main-LandscapeIt can also be characterized by a child being uncomfortable in any position other than upright, or fear of having one’s feet off the ground. Gravitational insecurity is a form of over-responsiveness to vestibular input. This input is detected by the Otolith organs, located in the inner ear. These organs detect movement through space as well as the pull of gravity.

Recess is a common time you may notice children having difficulties with gravitational insecurities.

Here are some common red flags that may indicate your kiddo is having difficulty with gravitational insecurity:

  • Avoidance of playground equipment that kids of similar age enjoy
  • Avoidance of swings
  • Fear of heights or uneven surfaces
  • Overwhelmed by changes in head position
  • Fear of having their feet off the ground
  • Overly hesitant on slides
  • Has difficulty tilting their head back to look up at monkey bars

If you notice your child exhibiting some of the red flags listed above, they would likely benefit from an occupational therapy evaluation and treatment focusing on sensory integration. Throughout therapy your child will receive graded vestibular information through a multisensory approach. Slowly, they will learn to integrate and process sensory information more effectively.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

Meet-With-An-Occupational-Therapist

10 Red Flags for Poor Sensory Registration

in , , , ,

When most people hear Sensory Processing Disorder (SPD), they tend to think of the child who cannot tolerate tags on clothes, covers their ears and screams at parades, and who pulls away from hugs at family parties. While these are all behaviors associated with SPD, they only align with one type. Blog-Sensory Registration-Main-Landscape

Hypersensitivity, or sensory defensiveness, occurs when a child has difficulty filtering unnecessary sensory input and therefore gets bombarded with a waterfall of input, overflowing his or her regulatory system. However, there is another side to the story that often surprises parents that I work with. Just like a child may be over-sensitive, they may also be under. Poor sensory registration, or hypo-sensitivity, is another common classification of sensory processing disorder and applies to children who do not absorb, or register, all of the input entering their body. They are therefore “missing out” on crucial information from their own body and the environment, which is used to make adaptive responses and learn.

Imagine a giant waterfall, filling a pool at the bottom to the “just right” level. Now imagine that waterfall has a giant strainer at the bottom, causing a tiny fraction of the water to pass through and barely filling the pool. While typically processing children naturally and efficiently take in information from the environment through their many sensory receptors and use this information to make adaptive responses, this is much more difficult for children who miss some of the information coming in. Using the waterfall metaphor again, think how much more water you would need to send through the strainer to fill up the pool. This explains why poor sensory registration is often (but not always!) associated with “sensory seeking” behaviors, as children attempt to obtain additional input so that they may better absorb it. These seeking behaviors can often be misperceived as having difficulty following directions or misbehaving, while children may actually be trying to “fill their pool.” Another possible presentation is that children might appear to “be in la la land” and are likely not noticing or absorbing the cues they need to respond appropriately.

While it is very important to identify poor sensory registration, it can be difficult to identify at times.

Below you will find 10 red flags for poor sensory registration, organized by sensory system, to help you identify potential sensory processing deficits in your child:

Touch (Tactile) Processing:

  1. Your child does not notice when his or her face has food, toothpaste, or other materials on it. He or she may not be registering that input and will not notice unless pointed out by someone else or by looking in a mirror.

Auditory Processing:

  1. Your child does not respond quickly when you call his or her name or needs to hear directions several times to respond. If a child does not have actual hearing impairment, being less responsive to auditory input can be a sign of poor registration of sound input.

Visual Processing:

  1. Your child has a particular difficulty finding objects in a drawer, toy box, or other storage space, even when the object is very visible. They may have visual perceptual deficits related to poor registration of visual information.
  2. Your child may perform writing, coloring, or other visual motor tasks in a way that appears careless and not notice their errors unless specifically pointed out. They may be having difficulty noticing the difference between good work and poor work.

Body Awareness (Proprioceptive Processing):

  1. Your child may have difficulty navigating through hallways without leaning against or rubbing their hands against the walls. This may be their way of compensating for decreased body awareness to help them understand where their body is in space.
  2. Your child may have difficulty maintaining upright posture, whether slouching in a chair, w-sitting on the floor, or leaning against a wall when standing.
  3. Your child may use excessive force when giving hugs or using objects (e.g. breaks crayons, throws balls too hard).
  4. Your child may prefer sleeping with very heavy blankets or prefer to keep their coat on indoors. This input gives them the weight he or she needs to better perceive where his or her body is.

Movement/Gravitational (Vestibular) Processing:

  1. Your child loves intense movement (i.e. spinning, rolling, or going upside down) and can do so for a significant period of time without getting dizzy or nauseous.
  2. Your child may appear clumsy when moving about and lose his or her balance unexpectedly.

Of course, as with any set of red flags, one or two red flags does not qualify for a sensory processing disorder. However, if quite a few of the sensory registration items above resonate with you, and if any of these items significantly interfere with your child’s daily functioning, it would be helpful to set up an evaluation with an occupational therapist.

Occupational therapists are specially trained to identify sensory processing disorder through parent interviewing and clinical observation of your child. If a disorder is identified, an occupational therapist can work with you to create a sensory diet, or prescribed set of sensory activities, to help your child get the input he or she needs to feel organized and calm to better learn and grow. They may also teach you strategies to help your child better attend to the input that is entering their body.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Meet-With-An-Occupational-Therapist

Red Flags for a Speech or Language Delay

in

It may be difficult to know whether or not your child is showing signs of a speech or language delay. Below are some key red flags to watch for: blog-speech-red-flags-main-landscape

By Age 1, your child cannot:

• Respond to his/her name
• Begin verbalizing first words
• Initiate or maintain eye contact

By Age 2, your child cannot:

• Begin combining two-word phrases (24 months)
• Child does not consistently add new words to expressive vocabulary
• Child does not follow simple instructions
• Child presents with limited play skills

By Age 3-5, your child cannot:

• Verbalize utterances without repeating parts of words or prolonging sounds (e.g. “m-m-m-my mother,” “ssssssister”)
• Seem to find the right words, describe an item or event without difficulty
• Begin combining four to five-word sentences
• Be understood by both familiar and unfamiliar listeners
• Repeat themselves to clarify without frustration
• Correctly produce vowels & majority of speech sounds (closer to 5 years old). Speech should be 90% intelligible to unfamiliar listeners by 5 years of age.
• Ask or answer simple questions
• Use rote phrases and sentences
• Play with peers and prefers to play alone

How Can a Speech or Language Delay Affect My Child?

Speech and language disorders can have a significant impact on a child’s ability to independently function in his/her environment. Without intervention, poor speech and language skills can lead to inability to communicate wants and needs across environments, social isolation and an inability to sustain an independent lifestyle.

How Can I Help Treat My Child’s Speech or Language Delay?

General treatment includes speech and language therapy from a speech-language pathologist, in order to evaluate and treat the specific aspects of the speech or language delay. Individual and/or group therapy may be recommended in order to treat all areas of the delay.

Our Speech and Language Approach at North Shore Pediatric Therapy

Our speech-language pathologists are trained in all areas of speech and language development. With extensive knowledge in typical speech and language, our pathologists can effectively identify and remediate speech and language disorders, using multi-sensory modalities.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Meet-With-A-Speech-Pathologist

5 Possible Autism Red Flags for Preschoolers

in , , , , ,

Autism spectrum disorder is a diagnosis that affects each child differently. Symptoms can range from mild to severe, and common ones include:blog-autism-red-flags-main-landscape

· Problems with social interactions

· Difficulties with communication

· Repetitive/stereotypical behavior

Our Family Child Advocates developed a list of five possible autism red flags for preschoolers. While this is not an all-inclusive list, and symptoms vary between children, these can be early indicators.

1. Not Just Shy

Don’t mistake shyness for autism — or vice versa. The Centers for Disease Control and Prevention published a chart for parents that highlights the difference. For example, a child with a shy temperament might be “quiet and withdrawn in new settings.” However, a child on the autism spectrum suffers from a “lack of spontaneous seeking to share enjoyment, interests or achievements with others.”

During preschool years (ages 3 to 5), children are exploring their environment and interacting with their peers, family members and teachers. These interactions help children develop an understanding of the world and form important relationships with others.

Around this age, children should start showing an interest in what their peers are doing and begin to interact with them both during organized (e.g., planned activities) and unstructured activities (e.g., free play). If they only want to play alone (even if there are peers around them), this could be a red flag. In addition, if a child demonstrates limited eye contact with adults and peers — this could also be a sign of autism — especially if the child doesn’t make any eye contact when their name is called or during times of play/activities with others.

2. Something Doesn’t Sound “Right”

It’s true that speech and language milestones are reached at different times for each child. However, at the preschool age, most children should be able to:

· Speak four or more words in a sentence.

· Follow three-step directions like “find your chair,” “raise your hand” or “shut the door.”

· Answer “WH” questions: Who, what, where and why.

· Recognize some letters and numbers.

Children on the autism spectrum disorder may not be able to speak about or do these things. Also, when autism spectrum children do speak, people may struggle to understand what they are saying.

A child on the autism spectrum might repeat the same words (e.g., “clap, clap, clap!”) or phrases, (e.g., “How are you? How are you?”) over and over again. The repeated words or phrases might be said right away or at a later time. While most children go through a repetitive speech stage, this type of speaking pattern typically ends around age three.

3. Demonstrating Major Fury with Minor Changes

It’s common for children to struggle with changes to their everyday routine. However, children with autism can become extremely upset when changes occur, especially unexpectedly. This may be seen during transition times between activities, clean up time or when they are asked to do something. Some behaviors that may occur include: exhibiting withdrawal, repetitive behaviors, tantrums or aggression.

4. Stimming and/or Obsessive Interests

Stimming is self-stimulatory behavior which appears as repetitive body movements and/or repetitive movement of objects. Stimming can involve one or all senses, and some examples are: hand flapping, body rocking, spinning in circles or spinning objects.

It’s natural for children to be curious of the world around them. But obsessive interests are routines or hobbies that the child develops that may seem unusual or unnecessary. Some example of common obsessive interests might include only wanting to talk about and play with computers, trains, historical dates/events, science or a particular TV show.

5. Showcasing Signs of Sensory Sensitivity

Children with autism may have a dysfunctional sensory system. This means that one or more of their senses are either over or under reactive to sensory stimulation. This sensitivity could be the cause of stimming behaviors. Some preschoolers might react unusually to the way things sound, smell, taste, look or feel. For example, during sensory play (e.g., playing with sand, Play-Doh or shaving cream) a child who does not like to get their hands dirty and prefers to continually wipe/wash their hands — or avoid sensory projects all together — could be demonstrating signs of sensory sensitivity.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help. Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates.

 

Red Flags for Dyslexia

in

Dyslexia is the most common learning disability in the United States, impacting 20 percent of the country’s population. If a child is not diagnosed by the second grade, there is a significant chanceblog-dyslexia-main-landscape he or she will remain undiagnosed until they reach adulthood. By educating yourself on the red flags of this learning disability, you can avoid misconceptions as well as delayed identification of this disability. Early identification of any disorder correlates with improved outcome and prognosis.

Preschool-Aged Red Flags for Dyslexia:

Difficulties with phonemic awareness or the ability to identify and manipulate individual sounds in words are beginning signs that your child may have dyslexia. Examples of phonemic awareness skills are:

  • Segmenting syllables (e.g., “how many syllables do you hear in butterfly?”)
  • Rhyming (e.g., “which word rhymes with mat; star or hat”?)
  • Phoneme isolation (e.g., “in the word sun, is the /s/ at the beginning, middle or end of the word?”)
  • Sound deletion (e.g., “say cup without the /k/.”)

Other signs include:

  • Trouble reading single words
  • Trouble generating rhyming words or identifying which words don’t belong
  • Reversing letters and words (e.g., tab/bat)
  • Difficulty identifying sounds at the beginning or end of a word (e.g., “what word begins with /t/; toad or boat?”)

Elementary-Aged Red Flags for Dyslexia:

Once children enter elementary school, the expectations for reading and writing abilities increase significantly. Children not previously identified as being at-risk may begin to exhibit signs as school work becomes more challenging. These children often have average or above average IQ, but demonstrate below grade-level reading and writing abilities.

Red flags include:

  • Trouble sequencing (e.g., steps, alphabet, naming months)
  • Continued trouble with rhyming
  • Difficulty with word finding (e.g., relying on “stuff,” “things” or other generic words)
  • Difficulty with organization and studying
  • Trouble with story telling
  • Avoidance or dislike of reading

Should an individual demonstrate some of these signs, it is not necessarily indicative of dyslexia. Other reading or language disorders may play a factor. However, if these difficulties persist through childhood, it may negatively impact that child’s academic success.

Through early identification, children with dyslexia can begin treatment in phonics-based programs, such as Orton-Gillingham or Wilson. These programs are unique in that the relationships between sounds and letters are explicitly and systematically taught. With consistent treatment, children with dyslexia can learn to compensate for their disorder, as well as begin to enjoy reading and writing.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Find-Out-More-Learning-Disabilities

Social-Emotional and Behavioral Red Flags for Toddlers and Preschoolers

in , , , , , , ,

It might be hard to imagine what mental health concerns may look like for your toddler or preschooler. Red FlagsHowever, it is important to realize that children experience the same emotions as adults do. They experience happiness, sadness, anger, fear, loneliness and embarrassment, however, they do not always know how to express these feelings in appropriate ways, so it’s important to look for red flags. When their feelings get too big, children do not always have the words to use to express themselves, resulting in using challenging or unsafe behaviors to express these big feelings. These behaviors make learning, play and relationships at home, and in the classroom difficult and can be very distressing and frustrating for everyone involved.

Here is a list of common red flags that can help you to determine if your child needs support:

  • Separation Anxiety:
    • Extreme distress (crying, tantruming and clinging to you) when separating from you or knowing that they will be away from you.
    • The symptoms last for several months versus several days
    • The symptoms are excessive enough that it is impacting normal activities (school, friendships, and family relationships).
    • The continuation or re-occurrence of intense anxiety upon separation after the age of 4 and through the elementary school years.
  • Social Concerns:
    • Little interest in playing with other children.
    • Poor body awareness that impacts relationships with peers
    • Failure to initiate or to participate in activities
    • Difficulty making eye contact with others
  • Behavioral Problems:
    • Defiance: Failure to follow rules or listen to directions and is often argumentative with adults.
    • Overly Aggressive Behavior:
      • Temper tantrums that last more than 5 to 10 minutes.
      • Excessive anger through threats, hitting, biting, and scratching others, pulling hair, slamming/throwing objects, damaging property, and hurting others.
  • Difficulty with Transitions:
    • Difficulty focusing and listening during transitions
    • Extremely upset when having to transition from one activity to another. Before or during each transition, your child may cry excessively or have temper tantrums that last more than 5 to 10 minutes.
  • Excessive Clinginess or Attention Seeking with Adults
    • Excessive anxiety related to being around new and/or familiar people/situations.
    • Child freezes or moves towards you by approaching you backwards, sideways or hiding behind you. Your child behaves this way in most situations and no matter how you support them, they continue to avoid interacting with others.
  • Attention concerns:
    • Difficulty completing tasks and following directives on a daily basis.
    • Easily distracted and has difficulty concentrating or focusing on activities.
  • Daily Functioning Concerns:
    • Toileting: Difficulty potty training and refuses to use the toilet.
    • Eating issues: Refusing to eat, avoids different textures, or has power struggles over food
    • Sleeping problems: Difficulty falling asleep, refuses to go to sleep, has nightmares or wakes several times a night.

Children can exhibit concerns in the above areas off and on throughout their childhood. It is when these behaviors begin to impact peer and family relationships, cause isolation, interfere with learning and cause disruptions at home and in school that it is time to reach out for support.

Who can help?

  • Licensed Clinical Social workers (LCSW),
  • Licensed Clinical Professional Counselors (LCPC),
  • Marriage and Family Therapists (MFT)
  • Psychologists

Therapists will work with your child to help them to learn how to handle their big feelings and behavioral challenges. Therapists will use a variety of modalities during sessions including play, art, calming and self-regulation strategies, behavioral therapy, parent-child therapy, and parent education and support. They can also provide parent support and coaching to assist in diminishing the challenging behaviors at home. Often these professionals will collaborate with your child’s school and can provide additional support for your child within the school setting.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

New Call-to-Action

Encouraging Muscle Development in the Infant Stage

in , ,

Importance of Tummy Time for Muscle Development

Tummy time is a great way for infants to strengthen their muscles and develop age appropriate motor Muscle Developmentskills. When a baby is born they are in a position referred to as physiological flexion which simply means they are in a “curled up” position. All their back muscles are stretched and their core muscles are tight. By incorporating as much tummy time as possible, babies are allowed to strengthen their back by extending and stretch their tummy and core muscles at the same time. Encouraging floor time is key to developing motor skills such as rolling, sitting, crawling, and eventually walking.

Jumpers, Swings, and Exersaucers

Devices that aid in childcare can be lifesavers, such as when you are taking a shower or cooking, however, they should never replace the benefit that a child receives from floor time. When a baby plays on the floor they are using their entire body to explore their space. On the contrary, when they are in a swing or jumper, something is not being utilized. Excessive use of swings can result in flattening of the skull or a preference to tilt their head to one direction which can then lead to muscle shortening that requires intervention. Jumpers, exersaucers, and bumbo seats can also result in muscle disuse since the hips are frequently placed in unnatural positions and the core is not allowed to rotate as much as when a child is working to navigate the floor. When using devices such as the ones mentioned above, be mindful to limit their use in order to maximize muscle development.

Developmental Red Flags to Be Aware of

Sometimes babies will discover a pattern that is different than what we typically expect. Below are some movement patterns to be aware of and mention to your pediatrician should you notice them.

  • Scooting on their bottom to get around rather than crawling. This does not allow for the proper leg strengthening and cross lateral movement that crawling incorporates.
  • Pulling up to stable surfaces using only hands and not adjusting legs in order to push themselves up.
  • Stiffness in the legs or trunk that is constant and impacting movement; may first become evident with a lack of voluntary rolling.
  • Head position that is not in line with the body or a preference to only look in one direction, roll in one direction, or reach with only one hand.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood,Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Meet-With-A-Physical-Therapist

‘Act First, Think Never’ – Warning Signs That A Child May Have ADHD

in , , , ,

In the United States, attention-deficit/hyperactivity disorder (ADHD) has become a very common Blog-ADHD-Red-Flags-Main-Landscapechildhood diagnosis (NIMH, 2015). Parents and teachers may often wonder if their child or student fits the criteria for this diagnosis. There are several common indicative signs and symptoms of ADHD; however, the best way to be sure is to get a proper assessment by a psychologist/neuropsychologist. There are various factors that may influence a child’s behavior, causing them to appear as though they have ADHD. Additionally, anxiety and depression are common mood disorders that resemble ADHD symptoms. Because, ADHD is more complex than inattention and restlessness, it is imperative that an assessment is conducted.

Some red flags that may warrant concern and need for an ADHD assessment are:

  1. Behaviors are frequent and negatively impact quality of life
  2. Behaviors impact school performance and everyday life
  3. Inability to regulate emotions- seeming impulsive and “over reacts”
  4. Short attention span
  5. Talkative
  6. Always moving, running, jumping, and fidgeting
  7. Forgetful- “where?” “What?” Uh?”
  8. Disorganized
  9. Curious- interested in a lot of things but has poor follow through
  10. Cannot wait turn- very impatient
  11. Often loud and struggle to play quietly
  12. Avoids tasks that require mental effort
  13. Makes careless mistakes, and does not seem to work to potential
  14. Difficulty following multiple step directions
  15. Often unaware of time and gets lost easily

It is important to distinguish what is normal childhood behavior from behaviors that are impairing developmental growth and academic performance. There are also gender differences in symptoms. Boys and girls often do not display symptoms in the same manner; boys tend to be more impulsive than girls and equally inattentive.

A standard rule of thumb is that children with ADHD display symptoms three times as much as their peers (NIMH, 2015). If you suspect that a child may have ADHD, it is best to refer for assessment from a qualified professional. Remember to be aware that the child’s behavior can be caused by a host of influential factors, i.e. neurological, psychological, and environmental. Nonetheless, if the behaviors persist and are worsening, thus essentially negatively impacting their quality of life, socially, academically, emotionally, and physically, then it is time to seek help.

References

Hasson, R. & Goldenring Fine, J. (2012). Gender differences among children with ADHD on Continuous Performance Tests A Meta-Analytic Review. Journal of Attention Disorders, 16(3), 190-198.

The National Institute of Mental Health (NIMH). (2015). Attention Deficit Hyperactivity Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Find-Out-More-About-ADHD

Oral-Motor and Feeding Difficulties in Young Children

in , , , , ,

All children are born hard-wired to eat. However, some children with poor oral motor skills may present with many challenges while feeding. Some children may appear to be “messy eaters”, but in reality, they may not have the strength to successfully close their lips around a spoon. Other kids may tend to rush through meals, however their oral awareness may actually be reduced and they may not even be aware of how much food is actually in their mouths. Therefore mealtimes may Young Girls Is A Messy Eaterprove to be difficult and frustrating for children, and equally as stressful for mom and dad.

Oral Motor And Feeding Red Flags

  • Lack of oral-exploration with non-food items as an infant
  • Difficulties transitioning between different textures of foods
  • Weaknesses sucking, chewing, and swallowing
  • Frequent coughing and/or gagging when eating
  • Vomiting during or after meals
  • Refusal to eat certain textures of foods
  • Rigidity with diet
  • Avoidance of touch on face and around mouth
  • Loss of food and liquids when eating
  • Obvious preference for certain textures or flavors of foods
  • Increased congestion during and after meals
  • Grimacing/odd facial expressions when eating
  • Consistent wiping of hands and face during meals
  • Pocketing of food in cheeks, or residue observed after swallow
  • Irritability and anxiety during mealtime
  • Excessive drooling and lack of saliva management
  • Sudden refusal to eat previously tolerated foods
  • Excessive weight gain or loss

Oral-Motor Skill Improvement

Fortunately, there are also many activities you can easily incorporate at home to facilitate improvements with oral-motor skills.

  • Blowing activities (blow-pens, instruments, whistles, etc.) help to improve posture, breath control, lip rounding, and motor-planning skills.
  • Infant massage may also help to increase oral-awareness and facial tone.
  • Straws, sour candies, and bubbles may help with drooling.
  • Constantly exposing your child to a variety of new foods will help to avoid food jags, and increase their tolerance to different textures and tastes.

If you notice that your child presents with some of the above-mentioned characteristics and does not seem to be improving, it would be advantageous to speak with a Speech-Language Pathologist about your concerns.