Why would an infant need a speech-language pathologist

Why would an infant need a speech-language pathologist?

People are often surprised to hear that speech-language pathologists (SLPs) treat newborns and infants. They can’t speak, so why would they need an SLP, right? However sometimes babies need a little help learning how to eat and drink properly. Infant feeding and swallowing is a specialized field within speech-language pathology that can help.

Some babies, especially if they were born premature, can have difficulty with breast or bottle feeding and/or trouble transitioning to solid foods. These feeding and swallowing issues can lead to:

  • Poor weight gain
  • Difficulty with suck-swallow-breathe coordination
  • Mealtime struggles
  • Choking, gagging or vomiting while eating
  • Only eating a limited diet
  • Disorganized feeding patterns
  • Problems with speech and language in the future

As if having a baby wasn’t stressful enough! If you are seeing any of these signs in your baby, your pediatrician may recommend a feeding evaluation and possible therapy from a speech-language pathologist.

Specialized feeding and swallowing SLPs have advanced training and knowledge of the anatomy of the mouth, throat and larynx (the voicebox), the mechanisms of chewing, sucking and swallowing as well as an understanding of sensory issues and other related medical conditions. They work closely with physicians, lactation consultants, pediatric physical and occupational therapists, pediatric dentists and bodyworkers such as craniosacral therapists to improve outcomes.

SLPs also work with children with tethered oral tissues (commonly referred to as tongue and lip ties), craniofacial disorders including those with cleft lip and palate syndromes, infants coming home from the NICU with nasogastric tubes and those with G-tubes.

Our team of specialized SLPs at Little Hands Pediatric Therapy can provide your baby with a feeding evaluation in our Sterling clinic on Mondays or in your home at your convenience. These evaluations usually last about an hour and include a detailed birth and feeding history, thorough examination of your baby’s oral structure, observation of bottle and breastfeeding and a plan of care for therapeutic interventions.

Since this is a time-sensitive issue, please contact us immediately if your baby is struggling to feed and we will get you in as soon as possible – even if we have a wait list.

How Can I Help My Preschooler with Sensory Issues?

Sensory processing is a term we hear often but that isn’t often understood. People who have sensory processing disorder (SPD) essentially have difficulty processing information from the five senses. Usually they have one or more senses that under or overreact to a stimulus, therefore making it hard to respond appropriately.

Sensory processing issues can manifest in a variety of ways including children who:

  • Dislike being touched or getting messy
  • Crave pressure, movement and tactile stimulation
  • Prefer specific food tastes or textures such as bland, spicy, dry or crunchy
  • Are sensitive to smells or seek out strong smells
  • Refuse to wear clothing with a certain fabric or fit or that have seams, tags or hems
  • Are bothered by loud noises or busy places

As adults, we can choose to avoid places, tasks and situations that are uncomfortable to our sensory system. Children don’t always have this option. And since preschool-aged kids don’t yet have the tools to regulate or communicate about their emotions, it can become very challenging for them.

While you may notice signs of sensory processing differences as early as the baby and toddler years, preschool is the perfect time to seek guidance and possible therapy to help support your child. Using a variety of techniques and coping strategies, you can aid your child in regulating their sensory input with the goal of making them feel safer, more comfortable and less distracted in the world.

Top ways parents and caregivers can help kids with sensory processing issues:

  • Make your home “sensory smart” – Eliminate known triggers such as clutter and create a quiet, safe space for your child to retreat to whenever he or she needs to calm down.
  • Invest in tools and aids – There are countless products designed to help children with sensory issues such as weighted blankets, fidget toys and chewable necklaces. Have a few on hand in a portable sensory kit as well.
  • Get your child moving – We all know the benefits of exercise, but it has been proven to be especially helpful for kids with SPD.  Find a local sensory gym or just get your kid running around outside or having a dance party.
  • Have a code word or signal – Work with your child to create a secret word or discreet hand signal that lets you know when they’ve had too much. This could help to divert some public meltdowns.
  • Find support – Connecting with other parents and caregivers is a great way to share stories and tips on how to better accommodate your child. Sometimes simply knowing you aren’t alone can be a big help.
  • Let it go – It’s easier said than done, but know that it’s OK to let your child self-soothe themselves with things that may look strange or out of the ordinary to others.

Parents of children with sensory processing issues also find that bringing in the aid of an occupational therapist can be a lifesaver. A pediatric OT can help preschool children with SPD with a therapy called sensory integration.

How sensory integration therapy works at Little Hands Pediatric Therapy:

  1. Your therapist will first spend time evaluating and observing your child. We will also speak with you, his or her teachers and other caregivers to get a complete picture of the specific issues your child seems to be experiencing.
  2. Next, a collaborative, play-based treatment plan will be constructed that will include movement activities, resistive body work and more.
  3. Lastly, since you and other caregivers will spend the most amount of time with your child, your OT team will train you on implementing an at-home “sensory diet” and other coping strategies.

The experienced occupational therapists at Little Hands Pediatric Therapy work with many children with sensory processing disorders and can collaborate with you to create a plan for your child. We will work with your family in the comfort of your own home in Loudoun or Fairfax Counties or via teletherapy if you are outside of our service area.

For more information about sensory processing disorder and motor delays, please read this article by our OT Lindsay Borda.

Read Across America Day

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 https://www.nationaldayofunplugging.com 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!