Resources

• Articulation (speech sound development)

• Receptive Language (understanding language)

• Expressive Language (using words and sentences to communicate)

• Social Skills (pragmatic language and interaction)

• Fluency (stuttering and speech flow)

• Feeding (oral motor skills and safe eating)

• Swallowing (dysphagia management)

• Voice (vocal quality, pitch, and volume)

• Cognitive Skills (memory, attention, problem-solving)

We serve clients of all ages but specialize in working with children. If you’re wondering whether your child may benefit from speech or language therapy, please don’t hesitate to reach out. One of the most common questions we receive from families is whether their child qualifies for services. 

As your child grows, you’ll witness many exciting milestones as their skills develop.

Developmental milestones are abilities that most children achieve by a certain age. While every child develops at their own pace, these milestones typically occur within predictable age ranges and are built on a foundation of earlier skills. This checklist is designed to help you evaluate your child’s communication development and identify whether speech and language services may be beneficial.

12 to 18 Months

• Speech is about 25% intelligible

• Says and uses 10 to 50 words

• Follows 1-step directions without visual cues (e.g., “Sit down”)

• Identifies 3 or more body parts by pointing or labeling

2 Years Old

• 50–75% intelligible to familiar people; about 50% intelligible to unfamiliar people

• Says and uses 200–300 words

• Mastered the sound /p/ in all word positions

• Uses 2-word phrases (e.g., “more milk,” “play ball”)

• Uses pronouns like I, it, me, mine, you, my

• Follows 2-step related directions (e.g., “Take your shoes off and put them in the closet”)

3 Years Old

• 75–100% intelligible to familiar people; about 75% intelligible to unfamiliar people

• Says and uses 1,000+ words

• Mastered sounds: /p, b, t, d, k, g, m, n, ng, f, h, y, w/

• Answers yes/no, what, and where questions

• Uses 3–4-word sentences (e.g., “I want more”)

• Uses possessives and pronouns like your, she, he, yours, we, they

4 Years Old

• 100% intelligible to everyone

• Says and uses 1,500+ words

• Mastered sounds: /v, s, z, sh, ch, j, l/

• Answers when, why, and how questions accurately

• Uses all possessives and pronouns like her, his, its, their, our, them, him, us

5 Years Old

• 100% intelligible to everyone

• Says and uses 2,000–2,500 words

• Mastered sounds: /zh/ (as in “beige”), voiced /th/ (as in “them”), /r/

• Uses regular and irregular past tense (e.g., “played,” “went”)

6 Years Old

• 100% intelligible to everyone

• Says and uses 2,500+ words

• Mastered sound: voiceless /th/ (as in “bath”)

• Uses prepositions and articles correctly (e.g., “above,” “below,” “a,” “the”)

If your child has not yet reached these milestones, we encourage you to sign up for a speech and language screener or contact us at contact@shisacare.com to learn more about how our team of experienced speech-language pathologists can support your child’s communication development.

References

• American Speech-Language-Hearing Association (ASHA). How Does Your Child Hear and Talk?

• American Academy of Pediatrics. (2009). Shelov, S. & Altmann, T. Caring for Your Baby and Young Child: Birth to Age 5 (5th ed.).

• McLeod, S., & Crowe, K. (2018). Children’s Consonant Acquisition in 27 Languages: A Cross-Linguistic Review. American Journal of Speech-Language Pathology.

• HearingFirst.org (formerly FirstYears.org). Developmental Milestones, Birth to 8 Years.

• Activities of Daily Living (ADLs)
  Dressing, grooming, feeding, toileting, and other self-care tasks

• Fine Motor Skills
  Writing, cutting, buttoning, using fasteners, and tying shoes

• Motor Planning
  Coordinating and sequencing movements for tasks like playing games or navigating playground equipment

• Visual Motor & Perceptual Skills
  Recognizing shapes and letters, completing puzzles, copying designs, and writing with correct orientation

• Executive Functioning
  Skills such as initiating tasks, planning, organizing, problem-solving, and managing time and attention

• Sensory & Emotional Regulation
  Managing sensory input and emotional responses to participate effectively in daily life

• Feeding Support
  Developing tolerance for various textures and participating in mealtime routines

• Play Skills
  Engaging with toys and peers in age-appropriate, purposeful ways

We work with children of all ages and developmental levels. If you’re unsure whether your child could benefit from occupational therapy, our team is here to help you understand the process and support your family’s needs.

Adult Conditions

• Acute and chronic joint pain (neck, back, shoulder, elbow, wrist, hand, hips, knee, ankle, foot)

• Sprains and strains

• Arthritic pain (Osteoarthritis and Rheumatoid arthritis)

• Adhesive capsulitis

• Amputee rehabilitation 

• Impingement syndromes

• Bursitis

• Degenerative disc and joint disease

• Disc herniation

• Epicondylitis

• Gait and balance disorders

• Pelvic and abdominal pain and pressure

• Pregnancy-related conditions (pre-natal and post-natal)

• SI Joint pain

• Bladder and bowel incontinence

• Pain during intercourse

• Myofascial pain

• Nerve entrapment

• Plantar fasciitis

• Rotator cuff tears/repairs

• Patellofemoral pain

• Tendonitis

• Post-operative rehabilitation (hip, knee, shoulder replacements)

• Work-related injuries/overuse injuries

• Fall prevention

• Vertigo (BPPV)
  
  

Pediatric Conditions

• Cerebral palsy

• Chondromalacia

• Developmental delay

• Down syndrome

• Gait abnormalities/walking difficulty

• Gross motor coordination issues

• Lower and upper extremity fractures, sprains, and strains

• Muscle tightness/weakness

• Postural dysfunction/scoliosis

• Sports-related injuries

• Torticollis/plagiocephaly

• Nocturnal enuresis

• Constipation

At ShisaCare, we provide ABA therapy to clients diagnosed with Autism Spectrum Disorder (ASD), per insurance guidelines. ABA may also be available to clients without a formal diagnosis through private pay options.

What Can ABA Help With?

ABA therapy can support individuals in:

• Developing language and communication skills

• Improving attention, focus, memory, and academics

• Enhancing social, imitation, receptive, and expressive skills

• Building play skills

• Reducing challenging behaviors

ABA methods have been researched and refined for decades. Since the 1960s, ABA has been used to help individuals with autism and other developmental disorders acquire meaningful life skills.

How ABA Therapy Works

ABA uses a variety of techniques to assess, teach, and reinforce behavior. It is a highly individualized and flexible treatment approach that can be:

• Adapted to meet each person’s unique needs

• Delivered in different settings: at home, clinic, or in the community

• Focused on teaching everyday, functional skills

• Provided through one-on-one sessions

A Core Strategy: Positive Reinforcement

Positive reinforcement is a foundational technique in ABA therapy.
When a desired behavior is followed by a meaningful reward, that behavior is more likely to be repeated. Over time, this shapes positive behavioral change.

Here’s how it works:

1. A therapist identifies a specific goal behavior.

2. Each time the behavior is demonstrated correctly, a reward is given.

3. The reward is personalized — it might be praise, a favorite toy, a book, access to a playground, or time with a preferred activity.

4. The consistent use of positive reinforcement encourages lasting behavior change.

• Eye Movement Desensitization and Reprocessing (EMDR)

• Dialectical Behavior Therapy (DBT)

• Cognitive Behavioral Therapy (CBT)

And more individualized treatment methods tailored to your needs.

• Autism Spectrum Disorder (ASD)

• Attention-Deficit/Hyperactivity Disorder (ADHD)

• Dyslexia (Specific Learning Disorder with impairment in reading)

• Learning Disabilities (LD)