Frequently Asked Questions

Parents, physicians, and educators frequently seek answers as to whether their observations and concerns should be addressed by a developmental specialist; new clients to Cawn/Krantz often have questions on what to expect when they begin therapy at the clinic. Here, then, are a few questions our therapists are often asked—and the answers we provide.

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How can I tell if my two year-old child’s communication is delayed or if he/she is just a “late bloomer?”

Why do I see such inconsistencies with my child? He has no issues at school but completely melts down when he gets home.

I sometimes notice that my infant doesn’t always respond to me, or that I have difficulty encouraging playfulness. Is this something to be concerned about?

My child has apraxia of speech: how does your treatment differ from articulation therapy?

My child eats only a few types of food. How do I know if he or she is just a picky eater or problem feeder?

Q: Do speech-language disorders affect learning?

Children with communication disorders may struggle with reading, including issues with early phonetic decoding and reading comprehension. They may have difficulty understanding and expressing language and misunderstand social cues; they may also have difficulties with attention. Written language problems may result because of difficulties using spoken language.

For children who have exhibited early speech-language difficulties, speech and language therapies can address these issues. Phonemic awareness (rhyming, sound play) and early literacy (telling and re-telling organized stories) may be part of the speech and language therapy process for preschool- and kindergarten-aged children; reading comprehension and written language organization and formulation may be an important component of speech and language intervention for the elementary-aged child.

For more information on speech-language disorders and treatments, vist our Speech and Language Therapy page.


Q: How can I tell if my two year old child’s communication is delayed or if he/she is just a “late bloomer”?

According to The First Word Project®, a child’s level of communication may be the best indicator of a developmental delay. A language delay may be the primary problem or reflect delays in other domains (i.e. social-emotional, cognitive, motor or sensory).
Researchers have identified several predictors of later language development:

  • Use of eye gaze and emotion
  • Use of communication
  • Use of gestures
  • Use of sounds
  • Use of words
  • Understanding of words
  • Use of objects
    (Wetherby & Prizant, 1993)
Studies have demonstrated that children delayed only in the use of words are likely to catch up on their own; children delayed beyond the aforementioned predictors are likely to have persisting problems.

For more information on language use, vist our Speech and Language Therapy page.

Q: Why do I see such inconsistencies in my child’s behavior? He/she has no issues at school but completely melts down when he gets home.

It is not uncommon for children to exhibit inconsistencies when they have some underlying sensory processing challenges. While children often “hold it together” in their crowded, activity-filled classroom during the day, such persistence can be extremely taxing on their nervous system. These children have expended a great deal of energy to simply get through their day; once home they are much more prone to irritability and seemingly unexpected emotional outbursts. Talk with your child’s occupational therapist about how to ease the transition from school to home.

For more information on treatment methods for behavioral concerns, vist our Occupational Therapy and Sensory Integration pages.

Q: I sometimes notice that my baby doesn’t always respond to me, or that I have difficulty encouraging playfulness. Is this something to be concerned about?

Interactions guide a child’s development. Even before your child speaks, you can help him or her to attend to you, to engage with you, to learn about causality, and to act to solve problems. Consider the infant who drops a spoon from her high chair and watches it fall: she is working on causality. But she will learn far more—and far earlier—by smiling and getting a smile back. Emotions make all learning possible (Greenspan & Wieder, 1992). It is this wordless communication that lays the foundation for all communication and learning. Together you will “open and close” circles of communication—what starts with the smile will lead to pointing and, eventually, to the use of words and ideas.

For more information, vist our DIR/Floortime® page.

Q: My child has apraxia of speech: how does your treatment differ from articulation therapy?

Research shows that children with Childhood Apraxia of Speech (CAS) make greater gains when they receive frequent (3-5 times per week) and intensive individual treatment. The focus of intervention for the child diagnosed with CAS is on improving the planning, sequencing, and coordination of muscle movements for speech. Isolated exercises designed to "strengthen" the oral muscles will not help without a combined focus on speech production. CAS is a disorder of speech coordination, not strength.

For more information on CAS, vist our Apraxia page.

Q: My child eats only a few types of food. How do I know if he or she is just a picky eater or problem feeder?

Both picky eaters and problem feeders consume a limited variety of foods. However, children who have problems with feeding usually have less than 20 different foods in their repertoire. Foods that a child discontinues eating are usually regained by the picky eater, but not so with the problem feeder. The child with feeding problems typically cries and “falls apart” when presented with new foods; the picky eater can tolerate new foods on their plate and will taste or touch a new food. The child with feeding problems refuses entire categoires of food textures.

Children with feeding problems may have associated difficulties or early medical and/or biological history that has contributed to problems with food. Early reflux, oral-motor difficulties (e.g., sucking, chewing, tongue and jaw mobility), and sensory processing challenges are but a few of the associated or contributing factors that play an important influence on a child’s ability to handle, tolerate, and enjoy food. Forcing a child who may have feeding challenges to eat likely increases his or her resistance to explore, eat, and enjoy new foods.

For more information on feeding issues, visit our Feeding Therapy page.

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650 Academy Drive, Northbrook, Illinois