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Assessing and treating multilingual children presents unique challenges that require a sensitive and comprehensive approach. Your points on researching the client's culture and language are crucial in providing effective therapy. Here are some additional considerations and strategies for speech-language pathologists working with multilingual children: Assessment in Both Languages: It's essential to assess the child's language abilities in both their native language and the language of instruction (usually English). This ensures a comprehensive understanding of their linguistic skills and needs. Language Sampling: Use language sampling techniques to gather spontaneous speech samples in both languages. This provides a more accurate assessment of the child's language skills in various contexts. Cultural Sensitivity: Understanding the cultural context of the child and their family is essential for effective therapy. This includes respecting cultural beliefs, practices, and values that may influence communication patterns and attitudes towards therapy. Bilingual Intervention: Implement therapy techniques that support bilingual language development. This may include code-switching and using materials and activities that are culturally and linguistically relevant. The following website has a vast variety of assessments and information about many languages all over the world: https://www.csu.edu.au/research/multilingual-speech/home

What are feeding disorders? Feeding disorders can be due to various reasons including difficulties with oral motor function, sensory issues, or behavioral issues. When a child has a feeding disorder they may not eat or drink enough food or liquid, or tolerate a broad enough variety of food making it difficult to grow and meet their nutritional needs. Common feeding disorder Oral motor function refers to the movements, coordination, and strength of the mouth including the tongue, lips, cheeks, and jaw. All of this is required for a child to safely eat and perform the tasks of suckling, chewing, licking, and swallowing. Dysfunctions with oral motor function may present as difficulty using a straw, refusal to eat, preference for soft foods, food falling out of the mouth, and excessive drooling. Sensory issues impact how a child experiences different foods and mealtimes and can lead to picky eating or even feeding delays. It is important to remember that all the senses come into play such as texture, smell, appearance, and temperature of the food. A child could be hypersensitive, meaning they may avoid touching or tasting the food, gag, or have other strong reactions. A child can also be hyposensitive, meaning there is a lack of awareness orally so they may pocket their food in their cheeks or drool unknowingly. Behavioral issues can present as a child refusing to eat their food or they may have food selectivity. It is important to remember that a child’s behavior is a form of communication. Try to figure out why they are having this behavior. Is the child anxious for new food? Do they have sensory issues as mentioned above? If you feel your child’s feeding difficulty is due to behavior, try to make eating a positive experience! Allow them to play in the food so it becomes more engaging and fun. If you believe your child is experiencing any of these issues regarding feeding, reach out to an occupational therapist (OT) to assist you and your child in promoting safe eating. An OT can provide skilled services that may include oral exams, exercises, equipment, schedules, routines, education, and so much more. Resource: O’Brien, J. C., & Kuhaneck, H. (2020). Case-Smith’s occupational therapy for children and adolescents (8th ed.).

What are Instrumental Activities of Daily Living (IADL)? Instrumental Activities of Daily Living (IADL’s) are activities related to living independently in the community. These activities could include creating a schedule, using the phone, preparing meals, shopping, money management, and cleaning the house. IADLs require problem-solving, organizational, and executive functioning skills. These skills involve remembering key information to complete a task, adjusting to unexpected changes, and understanding how you are doing at the moment. Activities to Improve IADL’s: Complete simple meals Prepare 3-4 step meals such as mac ‘n' cheese or a sandwich Follow this link to access visual step-by-step recipes for common meals  https://accessiblechef.com/ Play money management games Practice identifying coin value and dollar amounts with a board game such as Monopoly Use an app to organize daily tasks Use Google Calendar or the iPhone calendar to set alarms and reminders for upcoming doctor appointments, medication times, chores, meetings, or events Grocery shopping Practice creating a grocery list and finding each of the items in the local grocery store Roleplay phone conversations Create a story with pictures to practice how to have conversations on the phone and who to call during emergencies Consider reading more about instrumental activities of daily living with these evidence-based resources. Resource: Auld, C., Foley, K. R., & Cashin, A. (2022). Daily living skills of autistic adolescents and young adults: A scoping review. Australian Occupational Therapy Journal, 69(4), 456-474. https://doi.org/10.1111/1440-1630.12806

OUR TEAM Dr. Holly Ford, PT, DPT Physical Therapist Holly was born in Austin, Texas but grew up in Bismarck, North Dakota. She graduated with her Doctorate in Physical Therapy from the University of Mary Hardin-Baylor in 2019. She is currently serving as a physical therapist in the Texas Army National Guard rehabilitating soldiers in the great state of Texas to return to duty and be ready to mobilize in response to national and global emergencies. She has clinical experience and skills working with adult and pediatric outpatient orthopedics and sports therapy, military/tactical athletes, and TBI/vestibular dysfunction. She is extremely passionate about evidenced based manual therapy and is skilled to provide cutting edge care to meet the needs of complex patients. In Holly’s free time she enjoys spending time with family and friends, exercising, reading, and playing music.

OUR OFFICE STAFF Joyce Marshall Evaluation Coordinator Joyce joins All Care after retiring from a long career in early childhood education as a classroom teacher and administrator. She holds a Bachelor of Science in Interdisciplinary Studies and an Associates in Business Administration. Outside of work, Joyce values time spent with family and friends, as well as travel, yoga, theatre and Texas Longhorn football.

OUR THERAPY STAFF Kimberly Ibarra, MS, CF-SLP Speech Language Pathologist Kimberly earned her Bachelor of Science in Applied Learning and Development from the University of Texas at Austin in 2015 and specialized in bilingual education. She worked as a bilingual elementary school teacher for five years before pursuing a master’s degree. In May 2023, Kimberly earned her Master of Science in Communication Disorders from Texas State University, with a concentration in bilingualism. She has experience working in clinical, school, and hospital settings and providing services to a wide range of patients with diverse cultural backgrounds and diagnoses. Kimberly is passionate and excited about working with her patients and helping them achieve their goals! In her spare time, Kimberly enjoys going on long walks, trying new recipes, and spending time with her loved ones.