+ Why Expressions?

We believe in taking a common sense approach to therapy. That starts with treating the root cause of a speech, feeding, or language issue rather than only addressing the symptoms. We work closely with families and provide weekly homework to help the child make consistent progress.

Also, our approach encourages therapists to specialize in areas that are most interesting or important to them instead of trying to be a jack of all trades. The fields of pediatric therapy (i.e. ST, OT, PT) are vast and varied. Having our therapists specialize allows them to get a lot of experience with certain areas (i.e. speech sound disorders, language disorders, feeding disorders) and develop expertise in those areas.

Here’s an exaggerated example: you wouldn’t see an ENT for foot pain, and you wouldn’t see a podiatrist for ear infections. An ENT and a podiatrist are both doctors, but they have different areas of specialty. Therapy is similar! You want to find someone who specializes in the areas related to your child’s needs if at all possible. At Expressions, we have therapists who specialize in language disorders, speech sound disorders, motor speech disorders (i.e. apraxia, dysarthria), orofacial myofunctional disorders, and feeding disorders.

+ What should my child be doing?

There’s an age range that typically developing children learn speech, language, and feeding skills. Once kids surpass that age range and haven’t learned certain skills, there may be room for concern. There could be several reasons for delays in development, so it’s always a good idea to talk with an SLP to determine the cause of delays and what treatments will be the most effective.

+ Will my child grow out of it?

You may be wondering if therapy is really necessary, or if your child will grow out of the issues that concern you. Unfortunately, the answer is "we don't know." While some children with delays develop appropriate speech, feeding, or language skills with little to no intervention, others fall further and further behind if they don’t receive therapy. Some medical professionals may tell you that the child will outgrow their symptoms. The truth is, there’s really no way to know. If you have concerns, the best option is to consult with a licensed speech-language pathologist who has training and experience with the suspected issues. The SLP can complete an evaluation to determine if therapy is necessary.

+ What does speech therapy look like?

Speech therapy is the overarching term used when a child needs help learning and using their words, producing speech sounds correctly, or learning to eat and swallow food. Depending on the child's needs, therapy will look different from one child to the next. A child with a language disorder may have difficulty knowing what words to use to request desired items or answer questions. Therapy for that child may look a lot like play. For a child with a speech sound disorder, therapy may include oral motor activities and “drilling” of sounds to develop a new motor plan for that sound. For picky eaters, therapy may involve oral motor activities and interacting with new foods in a non-threatening environment.

+ How long will therapy last?

Length of treatment varies based on the child's needs, family involvement, and consistency in doing homework. Children with a few sound errors who do their homework each day may finish therapy in a few months, where a child with significant language needs may be in therapy for years. Speech, language, and feeding issues take time to treat. Expect at least a few months of therapy, but know this will vary greatly depending on the above mentioned factors.

+ What is my role in therapy as my child’s parent/caregiver?

As a parent or caregiver, you play an integral role in your child’s therapy! We only see our clients once or twice a week, so continuing therapy activities at home plays a huge role in your child’s progress. We train the parent/caregiver in how to do exercises or recommended activities and send homework after each therapy session.

+ Can I sit in on the therapy session?

In most cases, yes! Having parents in the room can be very beneficial for carryover at home and we love having parents in the session so you fully understand what we’re working on. Depending on the child and the type of therapy, having a parent in the room can be distracting and may hinder participation and progress. In those cases, we may ask parents to stay in the waiting room to ensure the child’s time in therapy is used wisely. We often ask parents to come back in the room before the end of the session for training purposes and to answer any questions.

If a parent wants to attend therapy with the child, we always try to make that happen. If it becomes an issue, you and your therapist will discuss other options to make sure therapy time is the most beneficial for your child. No matter what, we want you to feel comfortable with your therapist and trust her to treat your child with respect and care.

+ How long is a therapy session?

This depends on the child! We typically do 30 or 40 minute sessions for speech, language, feeding, or myofunctional therapy sessions, with the last 5 minutes consisting of explaining homework and answering any questions.

+ How often will my child be seen for therapy?

Every child is different, so there’s no cut and dry answer to this question. In most cases, a child is seen once or twice a week depending on his or her needs.

+ Will my child work with the same therapist each week?

In most cases, yes! Your child is intentionally paired with the therapist we think fits best based on your concerns. If we ever do recommend you see a different therapist, there's usually a practical or therapeutic reason. For example, your child has met all their language goals and now you want to work on feeding. Or your work schedule changes and your current therapist doesn't have openings available when you need.

However, we don't regularly move kids around between therapists like some clinics do. While there are some benefits to that model (and it sure makes scheduling easier), we believe that when therapists, kids, and families are able to establish a relationship and get to know each other, kids make the best progress and therapists can do the best work.

+ What is orofacial myology?

ASHA defines Orofacial myofunctional disorders (OMDs) as "patterns involving oral and orofacial musculature that interfere with normal growth, development, or function of orofacial structures, or call attention to themselves (Mason, n.d.A). OMDs can be found in children, adolescents, and adults." There are many habits or abnormal movements that can lead to OMDs including low tongue resting posture, mouth breathing, teeth grinding, forward tongue movement when swallowing, or sucking/digit habits (i.e. nail biting, extended pacifier use). Children with speech or feeding disorders often exhibit symptoms of an OMD, meaning the articulation disorder is not developmental in nature, but a result of poor tongue/lip/jaw placement and/or muscle development.

While many children benefit from traditional speech therapy, they often develop compensatory strategies that affect them later in life. For example, they learn to produce an S sound that sounds correct, but tongue placement is wrong. Since the body is all connected, incorrect tongue placement for S could potentially lead to headaches, neck pain, back, pain, TMJ issues, etc. It sounds a little crazy that such a small issue could lead to bigger issues, but there is plenty of research and clinical experience to prove that the body is connected and one part can affect other parts in unexpected ways.

"Picky eaters" may also have an OMD as the root issue. If children can't manage food safely or efficiently, they may reject certain textures or demonstrate mealtime behaviors such as eating slowly or extreme distress when required to eat non-preferred foods. Treating the OMD first can make traditional speech and feeding strategies more successful. OMD treatment is a team approach that may involve SLPs, dentist and orthodontists, ENTs, body workers (i.e. OT, chiropractor, massage therapist), and pediatricians.

+ Do you accept insurance?

Yes! We accept Blue Cross Blue Shield, ALL Kids, and Medicaid. If we don’t accept your child’s insurance, we’re happy to get you the paperwork needed to file claims for possible reimbursement. Please note: we can’t guarantee reimbursement and can’t help you negotiate with an insurance carrier for which we are out of network. It’s best to check with your insurance provider before beginning treatment to see what they will cover for out of network services.

+ Therapy can be expensive. Are there any financial resources available?

There are some organizations that offer grants or some kind of financial support if you meet certain qualifications. Each of these organizations have their own requirements and we recommend you direct your questions to them. One organization is called The UnitedHealthcare Children’s Foundation, which may be able to provide a grant to assist in the cost of therapy services. You can find out more information at https://www.uhccf.org/.

+ Do I need a referral before we can start therapy?

While Expressions does not require a referral for services, it his highly preferred! We want to work with your pediatrician to help your child, and the best way to do that is to start with a referral. That being said, some insurance plans do require a referral before services will be covered:

Medicaid: A specific referral from your pediatrician is required before services can begin. This is called an EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) referral. Pediatricians usually complete an EPSDT screening of Medicaid patients once per year (often at the child’s yearly check up). That screening must be completed before they can refer a child for therapy services. If you’ve never mentioned your concerns regarding speech, language, or feeding skills to your pediatrician, you may need to set up a visit before he or she will be comfortable referring your child for services. The pediatrician’s office can fax that referral form to us at (205) 719-4022.

BCBS: Many plans don’t require a referral for services, but some do. You’ll need to check with your particular plan to see what they require. We may be able to help you find out if you have trouble getting a clear answer, so give us a call if you’re not sure.

+ How do we get started with speech therapy?

Give us a call at (205) 739-2066, email frontdesk@expressionspediatrictherapy.com, or click "Get Started" at the top of the page to set up an evaluation. Once the evaluation is completed, your therapist will create a treatment plan to address your child’s areas of need. That treatment plan will be discussed at the next session.

Please note: When you call to set up an evaluation, you will be asked to complete intake paperwork before we can schedule an appointment. The sooner this paperwork is completed, the sooner you will get scheduled for an evaluation. Thank you for your cooperation!