Read Across America Day: 2021

The Ultimate List of Children’s Books featuring Children with Disabilities!

This year, to celebrate Read Across America Day, we’ve compiled a list of children’s books featuring children with disabilities.  The website, Teaching Exceptional Thinkers, writes about children needing book characters that they CAN relate to, seeing themselves in the stories, but that they also need characters that they CANNOT relate to and thus, learn from their differences.  This year, we celebrate the ways in which we are unique, while promoting diversity and inclusion

Happy 10niversary Little Hands Pediatric Therapy!

Established in 2010, Little Hands Pediatric Therapy is celebrating 10 years of helping families in Northern Virginia! Thank you for entrusting us with your children and helping us grow. We had a huge celebration planned, but we have had to use our flexible thinking to shift gears and celebrate virtually with you all. We celebrated with 10 Days of Giveaways from June 11- June 20th, 2020 on our Facebook and Instagram pages. We had a blast giving out fun prizes to all our families and friends!

Part of the LHPT team was able to meet recently to cut the cake and celebrate!


We are so proud that LHPT has made a difference in the lives of so many children and look forward to the next 10 years!

Bilingualism Myths - Busted- Little Hands Pediatric Therapy

Bilingualism Myths – Busted!

Why learning two (or three, or four) languages is great for everyone and any ability!

Myth #1:

Learning more than one language will cause a language delay.


Learning two or more languages at a young age will NOT cause a language delay/disorder.  This was a popular opinion in the 1970s that still persists today, especially in regard to children who are deaf or hard of hearing.

If a true delay exists, it will be present in both languages.  If Ethan’s mother speaks Spanish with him and considers that his first or native language (L1), and his father speaks English, and Ethan has a true language delay, we will see delays in both Spanish (L1) and English (L2).

Myth #2:

Our child has a language delay so we should speak to him only in one language.  He can learn the native language of our family when he is older.


Children with language disorders can become bilingual.  This includes children with Autism, Down Syndrome, Deaf/ Hard of Hearing, Everyone!  Dual language exposure will not cause or make the delay more severe.  Ensure that the child is receiving sufficient exposure in both languages and speak to your child in the language that you are most comfortable.

Babies and children have the ability to learn multiple languages at a very young age, in fact, much more easily than us adults!  The ability to acquire a language in a native manner is particularly available to us before the age of 7.  And while it’s not completely a myth that your child can learn later in life, it will probably impact their fluency and will definitely limit their communication with family members in the here and now.

Strategies to use to help children learn their second language (L2) 

  • Ensure sufficient exposure to the L2
  • Use shorter and grammatically simple sentences
  • Make important words stand out
  • Slow down when speaking
  • Use simple, everyday vocabulary
  • Use gestures
  • Talk about the here and now
  • Repeat, repeat, repeat

When to contact a speech-language pathologist:

If you have concerns for your bilingual child’s language development, we recommend you consult with a speech-language pathologist who is trained in assessment and intervention in bilingual language learners.  Of concern is a simultaneous learner (a child learning two languages at the same time before age 1 (up to age 3)) showing delays in both languages and a sequential learner (a child learning a 2nd language after age 3)  who has an observed or reported delay in their first language.

Increase Early Language Through Play with These Signs & Activities - Little Hands Pediatric Therapy

Increase Early Language Through Play with These Signs & Activities

Try these fun activities with your baby or toddler to use signs all throughout your day!

What’s in the box?

Ages: 8 months-3 years
Materials:  Box, Desired toys
Vocabulary: OPEN, BALL/Object

Begin by placing a highly desirable object or food in a sealed container or bag.  Let’s pretend that we have a ball hidden in a box.  Entice the child, “look what I have! It’s a ball. Do you want the BALL?”  Then model the sign, OPEN for opening a box to get the ball out. “We can OPEN the box!” Encourage your child to use the sign OPEN to request this action. If they don’t sign it, give them hand-over-hand assistance to be successful. Once they sign or say it (either the actual sign or word or an approximation of either) praise them and let them open the box immediately to make the connection. Allow the child to play with the object for about 20 seconds, then playfully return it to the box to hide. This should be fun and rewarding for the child and not frustrating.


Ball: fingers form the shape of the ball and bounce

Open/Close: mimic opening or closing



Ages: walkers -3 years
Materials: slide
Vocabulary: GO, MY-TURN

When your child climbs up the stairs, model “up, up, up the stairs!” Playfully obstruct the slide to and cue your child by asking asking her, “Whose turn is it?” and model MY-TURN. Give hand over hand assistance to the child to approximate the sign MY-TURN. If MY TURN is too difficult, try using predictive language, “ready, set, _____” (GO) with the sign for GO!




Join us each month on Facebook Live for free basic sign language class for infants through preschoolers and their caregivers. No experience is required. We will learn basic signs, discuss speech and language development and learn how to support your child’s language development from birth to age five.

Frequently asked questions about baby sign language and teaching sign language to hearing babies and toddlers can be found here.

Interested in learning ASL?  Start here!

Little Hands’ Quick-Start Guide to Signing with your Child - Little Hands Pediatric Therapy

Little Hands’ Quick-Start Guide to Signing with your Child!

You’ve learned a few signs and you’re ready to start using them with your hearing baby or toddler.  But, where to start?  Here are some tips to get you started signing.

  1. Select your CORE Vocab! For Babies: Pick 5 high-frequency words in your house.  For Toddlers: Pick up to 10.  Common words include: More, Eat, Milk, Dog/Cat, Sleep, etc.  This is your CORE Vocabulary.
  2. Tell Everyone your Core Vocab. Does Grandma spend a lot of time with you?  How about daycare?  Everyone around you should have a list of your 5-10 Core signs so that they can use them too.
  3. Use Your CORE Vocab! Anytime you say one of your core vocab words, make the sign with it.  Sign all of the words you can remember, but try to provide numerous repetition of the core vocab words throughout the day.  Just as we talk to babies from birth, your child will need to see the sign frequently in order to learn it and sign it back to you.
  4.  Words & Signs Go Together. We are trying to facilitate spoken language development by using signs so be sure to keep your voice on and use the word with the sign, in any language you chose!
  5. Sign In the Bath, and Other Places. Sure, food signs are great, but signs aren’t just for the dinner table!  You can sign while getting dressed, while on a walk, at the park, and in the bath!
  6. Hand over Hand. Place your hands over your baby’s hands and guide them to form signs like “more” and “dog”.
  7.  Eyes on Eyes. Get your child’s visual attention before signing to them.  Bring the object up to your face, get your child’s visual attention, then show them the sign.
  8.  Reward their attempts. As soon as your child gives you a sign/ word approximation/ gesture, reward it immediately so you do not lose the connection.  Remember, communication is a 2-way street.

Join us each month at Brambleton Library for free basic sign language class for infants through preschoolers and their caregivers.  No experience is required.  We will learn basic signs, discuss speech and language development and learn how to support your child’s language development from birth to age five.

Frequently asked questions about baby sign language and teaching sign language to hearing babies and toddlers can be found here.

Interested in learning ASL?  Start here!

Six Signs to Get Started With Today- Little Hands Pediatric Therapy

Six Signs to Get Started With Today!

Ready for more communication with your baby or toddler?  Try incorporating these six signs into your daily routines!

HELP: right hand with thumb up rests on left palm, gently bounce.


EAT: R hand, fingers closed, comes to mouth as if eating food.


DRINK: R hand pretends to hold a cup and drink.


MILK: R first opens and closes as if milking a cow.


BOOK: Hands closed move open, as in opening a book.


MUSIC: R hand moves from side to side, over L arm, as if conducting an orchestra.  Also: Song.


Join us each month at Brambleton Library for free basic sign language class for infants through preschoolers and their caregivers.  No experience is required.  We will learn basic signs, discuss speech and language development and learn how to support your child’s language development from birth to age five.

Frequently asked questions about baby sign language and teaching sign language to hearing babies and toddlers can be found HERE.

Interested in learning ASL?  Please click here.

National Unplugging Day - Little Hands Pediatric Therapy

National Unplugging Day

Every March we celebrate National Day of Unplugging and pledge to put our phones down and live in the moment with our children and families.  Here are 5 cheap and free ideas of unplugged activities!

  1. Scavenger Hunt
    We LOVE scavenger hunts for all ages.  Working backwards, write clues to find something special at the end!  Practice prepositions, basic concepts, problem solving, and working together as a team.
  2. Board Games
    It’s no secret we love our board games.  Pull out your old games and play together as a family.  Some of our favorites are the classics: Sorry, Candyland, Chutes and Ladders, Memory, checkers, UNO, Guess Who, Connect Four, Twister.
  3. Get Outside
    Kids need fresh air daily, even when it’s cold outside.  Grab some sidewalk chalk and beanbags (easy to make) and you can make everything from a bike/ scooter course to a baseball field!
  4. Painter’s tape
    Weather not cooperating?  Use painters tape to make a road for toy cars and trucks to drive on, an obstacle course for the kids to jump, hop and skip on, a tic-tac-toe board, hopscotch or make a maze and collect letters to spell words.
  5. Rube Goldberg Machine 
    This might be our favorite rainy day activity.  A Rube Goldberg Machine is an elaborate way to solve a simple problem, such as turning on a light, or pouring a cup of water, using simple, everyday materials.  Find inspiration here.

Check out for more information!

Increase Early Language Through Play with These Signs & Activities - Little Hands Pediatric Therapy

Learning American Sign Language (ASL) – Start Here!

By Kelli Atangan, Speech Language Pathologist

What is ASL?

American Sign Language (ASL) is the primary manual language used by Deaf and Hard of Hearing people in the US and Canada.  ASL is a complete and complex language, meaning it has it’s own set of rules for phonology, morphology, syntax, semantics, and pragmatics. ASL is a fascinating language to study and it is recognized as a foreign language in Virginia high schools.

Who should learn ASL?

I highly encourage parents with deaf and hard of hearing children to learn ASL to provide their children with a solid language base.  Whether you are deaf, hard of hearing, or hearing, learning ASL does not interfere with spoken language development.  Children have an innate capability to learn multiple languages that they are exposed to!

What is the difference between ASL and Baby Sign Language?

ASL is a complete language whereas baby sign language uses ASL signs (or Signed Exact English or sign approximations) along side the spoken word.  Learning signs for common words is wonderful to help babies communicate their wants and needs when they are pre-verbal and can help them acquire spoken language more quickly.  If you are interested in learning some basic signs to help your baby or toddler communicate, read more about our Baby Sign Language classes here.

Ready to Learn ASL?  Start with these resources:

Dictionaries/Apps:  Dictionaries are great for when you need to look up vocabulary, but just as a Spanish dictionary wouldn’t teach you grammar, an ASL dictionary likely won’t either.  Use dictionaries as a reference, but rely on the videos and courses below to learn the language.

Videos: Videos by native Deaf ASL-users are a wonderful way to build your receptive ASL skills.  While there are many videos online, many are made by ASL students as projects and are not always accurate.  Check out these reputable videos below!

Online Courses:  These free and paid courses are a great way to get started learning ASL.

In Person Courses in NOVA/DC: The best way to learn ASL is from a native user of the language, such as a Deaf ASL instructor.  Here are the classes that we know of in the DC and NOVA area.


  • ASL 1: LCPS Adult Ed
  • ASL 2: Contact Us for information on our current private class, taught by a local Deaf instructor.
  • Loudoun’s Bilingual ASL Families: this group is for families of children who are Deaf/HH and interested in learning ASL.  We meet for weekly park playdates at Rust in Leesburg, Monthly Saturday Playgroup in Ashburn, and monthly silent dinners.
  • Dulles South ASL Study Group: This free ASL study group currently meets Tuesday evenings at Gum Springs library, 8-9pm.



Resources for Parents of Children Diagnosed with Hearing Loss: 

Deaf Community – 
The best way to gain fluency in a language and understanding of the culture is to go straight to the source.  Finding Deaf community to interact with will help take your ASL skills to the next level.  Locally, check out McLean Bible Church, take a tour of Gallaudet’s campus, and look for Deaf happy hours, socials and silent dinners.

We hope you find these resources helpful!  If you are local to Northern VA and have a child age 0-5 with a hearing loss, please contact Kelli to learn more about our free monthly ASL family playdates in Eastern Loudoun.

We hope you find these resources helpful!  Want to add a resource to this list?  Contact us!

How Long Should I “Wait & See”?

It is still common practice for pediatricians to tell parents to wait and see before seeking a speech and language, occupational, or physical therapy evaluation.  After all, there is a wide-range of normal, and many children just need a little more time.  Pediatricians don’t want to alarm parents by unnecessary referrals to therapists, ENTs, and audiologists.  However, there are many children that slip through the cracks with a wait and see approach and many lose valuable time, further widening the gap.  Specific groups of children that often miss out on early referrals for evaluation include children with persistent, non-infected, middle ear fluid, girls on the autism spectrum, and children with sensory processing disorder, but there are many more.  The later children receive services, the further the gap may become.


The Center on the Developing Child at Harvard University has found, through decades of research, that 1, 2, 3:

  • The neural circuits in a child’s brain are most flexible or “plastic” during the first three years of life.  After this period these circuits become more difficult to change.
  • Early intervention services, those received between the ages of 0-3 years, that are high-quality and evidence-based can alter a child’s developmental trajectory and improve outcomes for children, families, and communities.
  • Intervention is likely to be more effective and less costly when it is provided earlier in life rather than later.


If you are concerned about your child’s development of speech, language, feeding, sensory, fine motor or gross motors skills, please see the following checklists.  We recommend printing and completing these checklists and bringing them to your pediatrician to discuss your child’s development.  You and your pediatrician can work together to find services or to set a timeline to “wait and see” that you both feel comfortable with.


CDC Milestones from 2mo to 5 years

Infant Toddler Connection of Virginia’s Developmental Checklist

MCHAT- If your child is between 16-30 months and you are concerned that your child may have Autism, take the MCHAT screener online or print and bring to your pediatrician. It is available in many languages.

More resources can be found on our website.


  1. Goode, Diefendorf, & Colga. The National Early Childhood Technical Assistance Center.
  2. Center on the Developing Child at Harvard University (2008). In BriefThe science of early childhood development.
  3. Center on the Developing Child at Harvard University. (2010). The foundations of lifelong health are built in early childhood.

Engaging Children’s Books for Ages 0-5

Welcome to our list of favorite engaging, language-rich children’s books! Before we begin, here are some tips on how to read these books (or any book) with your child:

  • Read with emotion and inflection! Get excited, quiet, and loud!
  • Read face to face so your child can see your mouth, eyes, and facial expressions.
  • If your child has difficulty sitting for books, read when your child is in the high chair, car seat, or stroller.
  • Add your own words. Sometimes the text is too wordy and loses your child’s interest. Sometimes the text is too brief and can be expanded upon. Improvise!
  • Don’t drill vocabulary. Being able to name or point to pictures like “house, car, dog, and ball” is only one small piece of language. Reading engaging stories that have emotion, repetition, adjectives, problem solving, and rhyming will have a larger impact on your child’s language development than vocabulary alone.

1. Peek-a Who? By Nina Laden

Peek-a Who? Is a sweet beginner book that has a surprise behind each page, all while working on simple sounds like whoo, moo, & choo choo!

2. All Better By Henning Lohlein and Bernd Penners

This interactive book comes with durable reusable stickers that look like Band-Aids. When the animals get a boo-boo, your child comes to the rescue to clean it, kiss it, and put a Band-Aid on it. Through playful repetition, this book can be used to work on problem solving, sequencing, and prepositions.

3. Little Bear Needs Glasses By Bernd Penners

This book is just like All Better, except the animals have glasses instead of Band-Aids. Can you help Little Bear find a pair that fit him? This book can be used to work on problem solving, colors, and size.

4. That’s Not My Snowman… By Fiona Watt

These touchy-feely books are great first books that keep your infant or toddler’s attention and grow with them, introducing adjectives like sticky, bumpy, shiny, and more!

5. Brown Bear, Brown Bear By Eric Carle

This classic book should be on every shelf in every house! Practice colors, animals, and filling in the words to this repetitive sing-song book. We also love Carle’s Polar Bear, Polar Bear and Panda Bear, Panda Bear, and The Very Hungry Caterpillar.

6. Boynton’s Greatest Hits By Sandra Boynton

You’re sure to find a Boynton book you’ll love to read over and over again. Filled with animal sounds, repetition and a often a song, Boyton keep even the busiest toddler’s attention.

7. Dear Zoo​ By Rod Campbell

This classic lift-the-flap book uses repetition and surprise to keep children engaged.

8. Where is the Green Sheep By Mem Fox

This is a great book to work on opposites like near, far, thin, wide, and actions all while searching for the elusive green sheep!

9. The Cow Loves Cookies By Karma Wilson

The author of the Bear Wants More series bring you an endearing story full of rhyming and repetition.

10. If you give a Pig a Pancake By Laura Numeroff

One of many books in this series, this book is wonderful for making inferences (what will happen next?), talking about emotions, and action words.

Want more ideas? Ask your child’s therapist for suggestions to help target their specific speech or language goals.