Archives: Services

The Medical Services Department at the Integrated Center for Child Development offers a comprehensive medical approach to special needs. Dr. Susan Manea, our Medical Director, is a Board certified pediatrician and pediatric neurogeneticist specializing in the diagnosis and treatment of children with Autism Spectrum Disorders, as well as genetic, neurologic, and developmental disabilities.

Our medical department provides a variety of services including diagnostics and treatment for a variety of genetic and developmental disabilities as well as comprehensive evaluations for Autism Spectrum Disorders. A full neurodevelopmental evaluation will define possible underlying medical etiologies and determine appropriate laboratory studies and evaluations. Comprehensive medical care includes extensive recommendations for treatment and educational programming that can be utilized to advocate for therapeutic needs. Follow-up care will address specific patient needs in the realm of behavior, sleep, nutrition, and general health with monitoring of developmental progress and continued recommendations for educational programming and home-based interventions.

Psychopharmacologic modalities can be utilized as needed in patients whose family function is significantly altered and in children whose developmental progress or well being is impacted heavily by behaviors. A number of strategies are utilized to address these behaviors including ruling out underlying medical etiologies such as seizures or gastrointestinal symptoms, outlining behavioral strategies, maximizing educational programming, and helping families establish home-based strategies. Once these strategies are in place, pharmacologic agents then can be considered if the patient’s overall function does not improve. The number of medications and options that are available to families can be overwhelming; Dr. Manea feels it is important to take time to talk with families, observe children, and target specific aspects of behavior that may benefit from psychopharmacologic intervention. More importantly when prescribing medications open lines of communication and accessibility must be established to prevent untoward effects and determine efficacy.

Medicine today has evolved into multiple doctors managing specific aspects of a patient’s care. In children with special needs and disabilities, it only makes sense to look at the child and family as a whole as each system impacts all others. In understanding the whole child and their family, one can provide more comprehensive care that better suits the needs of the child and the family.

Medical Services Intake Form

What is a neuropsychological evaluation?

A neuropsychological evaluation uses the assessment techniques of clinical psychology and neuropsychology to assess learning and developmental challenges; to identify their underpinnings; to offer a diagnosis; and to make recommendations for treatment and for management.

What is the focus of this evaluation?

A neuropsychological evaluation will take a holistic focus and will assess multiple aspects of a child’s or an adult’s functioning. It will include intellectual assessment, academic testing, emotional assessment, and assessment of a broad range of neurological domains (such as memory, language, visual-spatial skills, and executive functioning).

What can you expect at the conclusion of the evaluation?

At the conclusion of the neuropsychological evaluation, parents need to be given more than a label. Parents should gain a better understanding of their child’s developmental profile: their strengths and challenges, and how their child experiences the world. Parents should also expect to be supported in translating this understanding into a plan for helping their child with whatever challenges have prompted the evaluation. The same results can be expected of our adult clients.

What happens next?

In addition to direct assessment, neuropsychologists at ICCD are available to collaborate with families in the long term. A family may choose to bring the clinician into the special education process by inviting them to observe the child in school or to participate in a team meeting. They may also wish for the clinician to consult with other professionals involved in the care of the child: teachers, therapists, and health care professionals. Again, our adult clients can expect the same level of long term collaboration.

Neuropsychological Assessment Intake Form

What is Pediatric Occupational Therapy or OT?

Occupational therapists build skills at each stage of development to promote participation in play, learning, and activities of daily living. Occupational Therapist’s engage in play-based therapy, providing “just right challenges” to encourage development towards goals established by the family and occupational therapist.

Who do we serve?

ICCD offers occupational therapist assessment and therapy for children from birth through adolescence. Although not all children have a formal medical diagnosis, ICCD occupational therapists have expertise in evaluating and treating:

• Autism Spectrum Disorder
• Developmental Delays
• Sensory Processing Disorder
• Learning Disabilities
• ADD/ADHD
• Fine and Gross Motor Coordination Disorder
• Genetic Disorders
• Other Psychological and Neurological conditions

How do we serve?

Every child receives a screening evaluation and then an individualized treatment plan is created in conjunction with the therapist and family. Examples of skills that occupational therapists can address include:

• Fine and Gross Motor Skills
• Sensory Processing/Integration
• Self-Care Skills
• Handwriting
• Feeding Therapy
• Visual-Motor/Visual Perception
• Self-regulation/coping skills
• Play Skills
• Executive Functioning

Unsure if occupational therapy is right for your child? View a list of red flags that might indicate your child would benefit from occupational therapy. If you have any questions about occupational therapy or our services, please contact Leanne Holland, Director, at lholland@iccdpartners.org

Red Flags

If you indicate yes to any of these areas, your child may benefit from an occupational therapy evaluation and intervention.

• Delayed fine motor skills (skills using small muscles of the hand): For example, has difficulty playing with age-appropriate toys with small pieces, poor handwriting, difficulty with self-feeding, and poor hand-eye coordination.
• Delayed Gross Motor Skills (skills using large muscles): delayed or skipped developmental milestones such as rolling, sitting, crawling, walking, jumping or climbing stairs, decreased balance, difficulty catching or kicking a ball, and difficulty with riding a bike.
• Lack of Attention/organization: has difficulty maintaining attention in class or a conversation, difficulty remembering things, poor organization skills
• Hyperactivity: impulsive, difficulty keeping hands off people and things
• Visual Scanning Problems: difficulty reading without skipping to another line, difficulty copying information from a board at school, slow to find hidden objects in a picture or word search
• Visual-Perception Problems: difficulty with puzzles or copying shape designs
• Sensory Concerns: responds too much or too little to sounds, movement, heights, touching and being touched, and types of clothing. Becomes distressed with self-care tasks like hair washing, teeth brushing, or nail cutting.
• Poor Body Awareness: may be seen as “clumsy”, fall frequently, bumps into furniture and people, may have trouble judging the position of body in relation to others and space, uses an inappropriate amount of force with siblings or pets.
• Feeding Problems: picky eater, difficulty chewing or swallowing, sloppy or clumsy eater
• Delayed Self-Care Skills: difficulty with age-appropriate dressing, feeding, personal hygiene, or toileting.
• Transitions: difficulty with transitions or change of plans. Prefers routines and can be rigid or controlling.
• Motor Planning: has difficulty learning new motor tasks; needs more practice time to master new tasks, difficulty imitating actions or movements.

Occupational Therapy Intake Forms

ICCD offers expert speech-language assessment and therapy for children from pre-school through adolescence in a variety of disorder areas. A speech and language evaluation entails formal and informal assessment of skills and areas of particular concern. Following an evaluation, the speech-language pathologist will determine areas of weakness as well as a plan for intervention. Speech-language therapy is offered to children with fundamental communication difficulties as well as children with more subtle language challenges that may undermine verbal expression or the development of written language. Speech and language therapy occurs weekly and is tailored to the individual, focusing on targeting specific goals and improving below-average skills.

Speech Disorders

A speech disorder is when a person is unable to produce sounds correctly or fluently or has trouble with his or her voice. Examples include stuttering or difficulties producing certain sounds (articulation disorders).

Language Disorders

A language disorder is when a person has trouble understanding others (receptive language) or has difficulties sharing wants/needs, thoughts, ideas, and feelings (expressive language). This also can include weaknesses with social communication (pragmatic language).

Augmentative & Alternative Communication Support

Augmentative and alternative communication (AAC) can be described as a multi-modal communication system that promotes understanding and use of language by means of personalized tools. An AAC device is recommended and customized to fully support the communicator’s needs. AAC includes both low tech (e.g. picture symbol communication, communication books) and high tech (e.g. tablets or devices that are dynamic and generate speech) to promote functional communication in everyday life.

Feeding Therapy

Feeding therapy performed by a speech-language pathologist addresses a variety of issues, including increasing oral feeding to wean from reliance on gastrostomy and nasogastric tubes, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake, and reducing avoidance behaviors during mealtimes. Feeding therapy begins with an evaluation of feeding skills, in which the therapist gathers background information, history of feeding difficulties, and medical history. The diagnostic evaluation is used to assess whether your child presents with a feeding disorder (dysphagia) by looking at your child’s feeding skills and profile, including progression from purees to solids, chewing skills, food preferences, avoidance and refusal behaviors, sensory profile, drinking skills, and variety and volume of food intake.

Speech-language therapy can also improve the skills of those diagnosed with:

• Autism Spectrum Disorders
• Language-based Learning Disabilities
• Non-verbal Learning Disorder
• Attention Deficit/Hyperactivity Disorders
• Developmental Delays
• Executive Functioning weaknesses, particularly as related to poor written expression
• Auditory Processing Disorders
• Dyslexia, phonological processing impairments, and poor reading comprehension

An abbreviated speech-language evaluation is used to assess a specific area of communication, typically to establish a starting point to set goals and measure progress for weekly therapy. A score report is provided with an outline of scores and highlighted areas of strength and weakness. If applicable, broad recommendations for speech-language therapy are given.

A pragmatic (social) language evaluation focuses specifically on social communication skills including perspective-taking, identifying and interpreting nonverbal cues, initiating and maintaining conversations, figurative language, and problem-solving. The assessment utilizes the Social Thinking Dynamic Assessment Protocol developed by Michelle Garcia Winner, as well as standardized measures. Many children who achieve average scores on language tests still present with social language deficits, and would benefit from a more targeted evaluation.

A comprehensive speech-language evaluation assesses many aspects of communication to determine if a speech-language disorder is impacting functioning in the home, school, or community. It provides detailed information on students who are having difficulty with language-based tasks. Testing is highly individualized based on parent and professional reports of current concerns, as well as a review of completed testing to date. Areas of focus may include:

• Receptive language (phonological awareness, listening skills, reading comprehension)
• Expressive language (grammar and syntax, formulation and organization, narrative language, and writing)
• Speech production (articulation and oral motor skills)
• Fluency (stuttering)
• Social communication (perspective-taking, conversation skills, problem-solving, flexible understanding/use of language)

The report accompanying a comprehensive evaluation will include a thorough review of previous testing, an overview of current test results, a summary and analysis of findings, functional goals and speech-language treatment plan, recommendations for related services, and suggested educational accommodations (all as appropriate). Reports can be shared at team meetings and used for implementing appropriate goals and related services in the school setting or privately.

Contact Christina Fulone, M.S., CCC-SLP at cfulone@iccdpartners.org with interest or questions regarding comprehensive evaluations.

Are you unsure if speech-language therapy is right for your child? An evaluation with a qualified speech-language pathologist is always the best place to start. See the linked list of developmental milestones and our list of red flag questions to determine if your child might benefit.

Speech & Language Intake Form

A multidisciplinary team at ICCD offers consultative services in support of children, families, and systems using a tailored and individualized approach. ICCD’s consultants have extensive experience and are skilled at identifying accommodations, modifications, interventions, and instructional strategies necessary for learners to meet with successful outcomes.

Individual School Program Review

This service is often requested when a family or school Team is concerned about whether the child is accessing instruction and if the educational services, accommodations, and curriculum align their individual needs. In addition to conducting an observation in the school setting, the consultant will review relevant background information, as well as interview caregivers and educators in order to offer comprehensive recommendations about what is necessary for the child to make effective progress.

On-going School Based Consultation

ICCD consultants work closely with school teams to evaluate the needs of the child or program and provide continued guidance to support the development of programming and intervention strategies.

System-Wide Program Review

A team from ICCD can provide a comprehensive review of the services offered by a school or school district. Through a review of relevant documents, classroom observation, interview, and questionnaire, the consultants will objectively analyze the instructional model, curriculum, and service delivery and provide recommendations formulated to address identified areas of concern.

Training & Professional Development

ICCD consultants, who come with a broad range of expertise, offer trainings designed for professionals and families. Current trainings focus on behavior management, emotional and behavioral interventions for the inclusion setting, and reading support for dyslexia, adaptive literacy, and reading comprehension.

In-Home Consultation

This service is often requested when a family is seeking support in the home setting to address behavioral concerns and related challenges the child is having engaging in everyday activities. The consultant will work closely with caregivers to evaluate the needs of the child and provide guidance as recommended interventions are implemented.

Appointment Intake Form