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What is Early Intervention?

Soon after birth, an infant will show off their personality and develop nonverbal communication in an effort for their basic needs to be met. These early forms of communication exhibit as brief eye gazing at objects, crying or cooing communicating needs for physical bonding; being held and possibly soothed or fussing/crying to be fed. Development continues from infancy to childhood and may not always follow the same pace for every child, however, children do grow and develop acquiring skills at typical age-appropriate milestones such as crawling, walking, saying their first words at around the same age. When children are not reaching expected milestones and are showing significantly delayed development, parents may become concerned about skill development impacting school readiness and function.

Early Intervention services are available to help an infant- child who may have trouble reaching certain developmental milestones. Early intervention means using “therapy services to enhance a child’s ability to interact with others and the environment as these everyday experiences and interactions are essential for optimal child development.”

Early Intervention includes infants and toddlers, age birth to 36 months, who have or are at-risk for developmental disabilities or delays. Early intervention supports families and caregivers to increase their child’s participation in daily activities and routines that are important to the family.

Early intervention begins with a multidisciplinary team evaluation to identify a child’s needs. Research reveals that early intervention services can considerably lessen the effects of developmental delays.

Positive early learning experiences are crucial for later success in school, the workplace, and the community. Research shows that children’s earliest experiences play a critical role in brain development.

Early Intervention may include speech-language therapy, occupational therapy, physical therapy, and education specialist services based on the needs of the child and family.

We believe Early Intervention, both therapeutically and academically, is a key part of the Educational Journey and leads to success. Monitoring a child’s development for school readiness begins at birth and is a constant process. With that in mind, we have now released a comprehensive online developmental assessment service – K-Shield Screening – created for screening children from 0- 5 ½ years of age designed for collaboration, continuity, and academic success.

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Before you make a movement

Motor planning or “praxis” is our ability to unconsciously (or consciously) plan and then carry out purposeful movements with our bodies. It relies on a number of foundational sensory and sensory motor skills, such as knowing how your body is positioned, and having good feedback from your muscles and joints about how you are moving.

Think about the last time you learned a new movement with your body. Or when you learned a new sport as a child. A lot of effort when into thinking about how you needed to move in order to be accurate in your movement. This is motor planning.

For children with coordination difficulties, poor awareness of their own body, or difficulties with planning, being able to plan out and then complete movements is an energy intensive activity. For many children, they have difficulties with even coming up with an idea of what they would like to do with their body. For example, they may want a toy form a high shelf, but have no idea of how to get it. Or their idea may be completely unworkable.

For children with movement and planning difficulties, they often require many repetitions before they master a movement. Essentially, they need to plan it out consciously every time they complete it until the movement pattern is firmly established. If we think about getting dressed for example, this requires a significant amount of sequencing, body awareness and planning of movements. Imagine now that every morning you are doing this for the very first time. The level of concentration, planning and energy used, not to mention the time required, is very significant for a child.

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Hands and fine motor skills

Fine motor skills are abilities to control and coordinate the small muscles in the hand for precise movements. The development of children’s fine motor skills are important because they are the foundation for the development of many other important skills in the future, including reading, writing, and drawing, as well as the ability to undertake everyday tasks such as tying shoelaces or holding a knife and fork. There are many components of fine motor skills including the following:


Children require adequate muscle strength in their hands and arms, in order to effectively use them for fine motor tasks. – Just as a body builder needs to train in order to lift that dumbbell, children need to train their hand and arm muscles in order to build the quality of their movement, as well as their endurance levels.


The ability to freely open and close the hand in order to grip and let go of objects when needed. – It requires coordinated finger movements and shaping of the hand to use different grasps to pick up and hold objects of different sizes and shapes. – An efficient pencil grasp requires the ability to move fingers in isolation of each other, adequate hand strength and good wrist stability.


The ability to use both hands together in a coordinated way, such as when manipulating an object. – It develops early in a child’s life when they are observed to hold objects with two hands. – Each side of the body must be aware of what the other side is doing in order to cooperate and complete a task. It is a ‘doing/helping relationship’ –one hand does most of the task and the other helps out. – It is important for activities such as throwing and catching a ball and cutting skills.


The ability to use the eyes and the hands together to complete a task. – The child guides hand movements with their eyes to accurately manipulate objects and place them in specific positions (i.e. Putting block on top of tower without knocking all the other blocks off) Crossing the midline – The ability to use arms, legs and eyes across the midline of the body. (MIDLINE = imaginary line drawn vertically dividing the body into two equal parts). – It is essential for activities such as handwriting and using scissors.


In hand manipulation is the process of moving objects that are already in the hand. It determines how effective and efficiently a child can coordinate the hand and fingers to complete fine motor tasks. – It is important for tasks such as handwriting, holding money and scissor skills.


Hand dominance is the consistent favoring of one hand over the other for the skilled part of an activity. For example, the dominant hand holds and uses a pencil whilst the other hand stabilizes the paper.
Hand dominance usually starts to develop between 2-4 years, however it is common at this stage for children to swap hands. Between the ages of 4 to 6 years a clear hand preference is usually established.

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What are the seven senses?

In addition to the five best known senses – taste, touch, hearing, sight and smell, there are also two others that play an important role in a child’s development – the proprioception and vestibular systems.


The tactile system refers to the awareness of touch through receptors in the skin. It consists of two levels – discrimination to tell us where the touch is on our body, and a second level to tell us whether it is a safe or dangerous touch (sometimes known as a ‘fight or flight’ response). When a child is having difficulty in processing touch sensation, their brain may misinterpret the information, and label sensations as dangerous unnecessarily, causing them to overreact to light touch. Deep pressure touch is calming to the sensory system – this is why a massage is so relaxing!


The visual system interprets what we see. It is necessary to recognizing shapes, colors, letters, words, and numbers. It is also important in reading body language and other nonverbal cues during social interactions. Vision guides our movements, and we continually check out actions with our eyes to make sure we move about safely. When children are having difficulty with visual processing, they may have difficultly filtering out the unnecessary details, or may have trouble identifying important information.


We use our auditory system to identify the quality, and direction of sound. It not only hears sound, it also helps us to understand speech. When a child is having problems with auditory processing, they have difficulty with identifying the important information, and blocking out the background noises. They may be very sensitive to loud noises, or easily distracted by small noises (like the sound of the ceiling fan). Children with auditory processing difficulties will often struggle to focus in busy environments, and may need to be told instructions over and over.


Taste and smell are senses very closely linked and work as one integrated system. The sense of smell is one of the oldest and most vital parts of the brain. The two senses together allow us to identify foods that we enjoy, and also tell us what is safe to eat. If a child’s sense of smell or taste is not working properly, they may identify foods as unsafe or dangerous, and refuse to eat. Smell is also directly linked to our emotional brain – we can use smells to access feeling of calm, alertness or pleasure within the brain.


The vestibular system contributes to our balance and our sense of where our body is in space. It provides the most input about movement in the body, and works with the auditory and visual system to give accurate information to the brain about the direction the body is moving. It is important for the development of balance, coordination, eye control, attention, and even some aspects of language development. If a child is not processing vestibular information effectively, they will have difficulty with balance and coordination, and will rely on visual information to give them feedback about their body. Movement input received by the vestibular system is generally alerting and can impact the nervous system for 6-8 hours.


Proprioception or Kinesthetic System refers to the perception of sensation of the muscles and joints enabling the brain to know where each part of the body is and how it is moving. Proprioception was developed by the nervous system as a means to keep track of and control the different parts of the body, using feedback from the movement of joints and muscles. It allows us to know where the edges of our body are – how far away we are from a wall, or how much pressure we are exerting on a pencil. Children with significant proprioceptive needs and decreased awareness of their bodies’ movements often seek out activities that provide them with increased awareness, such as grasping objects very tightly, or jumping onto pillows or furniture. They have difficulty knowing where their body is, in order to move it effectively. Proprioceptive input lasts around 2 hours – it provides both calming sensations to overactive children, and alerting information to under stimulated children.


• Autism
• Tactile Defensiveness
• Speech/Language Disabilities
• Reading/Decoding Phonemes
• Dyslexia
• Writing (Dysgraphia)
• Visual Processing Disorder
• Motor Planning (Motor apraxia and sequencing)
• Emotional/ Behavioral Disorders
• Down’s Syndrome and other genetic disorders
• Cerebral Palsy

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Do I Need an OT?

Children develop at different rates and some variation is typical, however a child may benefit from OT support if showing:

Difficulty with self care tasks beyond what is expected for their age. This includes:

• Toileting (awareness, coordination, completing all the steps)
• Dressing including buttons and zips
• Washing hands, brushing teeth
• Extreme discomfort with haircutting and fingernail trims
• Difficulties using cutlery
• Limited food preferences
• Decreased willingness to try new foods

Specific sensory needs such as:

• Putting hands over ears / startling with loud noises
• Tantrums in the shopping centre
• Anxious about going new places
• Avoiding light touch
• Seeking movement or crashing
• Avoiding certain fabrics (eg: tags in clothes)
• Smelling or licking / chewing nonfood items
• Increased light sensitivity

Difficulties with school:

• Attention and concentration
• Unable to sit still
• Poor reading
• Poor handwriting or fine motor skills
• Letter reversals
• Decreased coordination or clumsiness
• Difficulty learning new movement activities

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Learn The Signs. Act Early. Developmental Milestones.

How your child plays, learns, speaks, and acts offers important clues about your child’s development. Developmental milestones are things most children can do by a certain age.

Check the milestones your child has reached by the end of each age specified below. Talk with your child’s doctor at every visit about the milestones your child has reached and what to expect next.

The American Academy of Pediatrics recommends that children be screened for general development using standardized, validated tools at 9, 18, and 24 or 30 months and for autism at 18 and 24 months or whenever a parent or provider has a concern.

If you are concerned, act early: tell your child’s doctor if you notice any signs of possible developmental delay and ask him about your child’s developmental screening.

*This is a not a substitute for standardized, validated developmental screening tools. Learn the Signs / Act Early materials were adapted from CDC website and are free of copyright restrictions.

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Attention Deficit / Hyperactivity Disorder

Is it ADHD? A Symptom Checklist.

Deciding if a child has ADHD is a several step process. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, and certain types of learning difficulties.

The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth edition (DSM-5) is used by mental health professionals to help diagnose ADHD. It was released in May 2013 and replaces the previous version, the text revision of the fourth edition (DSM-IV-TR). This diagnostic standard helps ensure that people are appropriately diagnosed and treated for ADHD. Using the same standard across communities will help determine how many children have ADHD, and how public health is impacted by this condition.

There were some changes in the DSM-5 for the diagnosis of ADHD: symptoms can now occur by age 12 rather than by age 6; several symptoms now need to be present in more than one setting rather than just some impairment in more than one setting; new descriptions were added to show what symptoms might look like at older ages; and for adults and adolescents age 17 or older, only 5 symptoms are needed instead of the 6 needed for younger children.

The criteria are presented in shortened form. Please note that they are provided just for your information. Only trained health care providers can diagnose or treat ADHD.

If you are concerned about your child’s behavior, it is important to discuss these concerns with the child’s health care provider.

Simply check off the signs or symptoms the child has shown and take the completed checklist to your child’s health care provider.


Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is inappropriate for developmental level:

– Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.

– Often has trouble keeping attention on tasks or play activities.

– Often does not seem to listen when spoken to directly.

– Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (loses focus, gets sidetracked).

– Often has trouble organizing activities. o Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).

– Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).

– Is often easily distracted. o Is often forgetful in daily activities.

Hyperactivity / Impulsivity

Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:

– Often fidgets with hands or feet or squirms in seat when sitting still is expected. o Often gets up from seat when remaining in seat is expected.

– Often excessively runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).

– Often has trouble playing or doing leisure activities quietly. o Is often “on the go” or often acts as if “driven by a motor”.

– Often talks excessively. o Often blurts out answers before questions have been finished. o Often has trouble waiting one’s turn.

– Often interrupts or intrudes on others (e.g., butts into conversations or games).

What do you see?

Ask a relative, friend, coach, teacher, or child care provider to tell you what your child does. Print a blank checklist and forward them.

If you need more information, go to

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A very special school

The South Florida School of Excellence is the first Dade County’s Clinical/Educational, and serves students with several learning special needs such as dyslexia, dysgraphia, dyscalculia, Attention Deficit Disorder (ADD), Attention Deficit Hyperactivity Disorder (ADHD), processing difficulties, learning disabilities, learning disorders, Autism Spectrum Disorder, slow maturation or underachievement, including those who are average, at-risk, have disabilities, gifted and Asperger.

The South Florida School of Excellence – General & Special Education – Gifted & Autism Center is a non-profit organization committed to upholding the excellence in education and is the first and only “One Stop Shop” clinical/educational setting of “Multi-Dimensional Model” located in South Florida.   The school’s well-planned structure and caring teachers trained in special education are the key to helping students succeed, preparing them for productive and successful entry into higher education and the workforce. The SFSE is an independent, non-sectarian, and co-educational school for grades Kg through 12th grades, with the capacity of 200 students – Pre K-3 & Pre K-4, (Coming Soon).

services and high-level security   The SFSE campus has 60,746 square feet in size accommodate a logical separation of the facility and outdoor recreational area. Gated school entrance with 24/7 security guard and surveillance cameras are installed inside and outside the facility. Surveillance cameras are installed in the Autism and Special Needs classrooms as well.

The school is dedicated to serving all the educational and social-emotional needs of students, and provides specialized, high-level therapies under one roof such as Speech and Language Therapy, Occupational Therapy, Applied Behavioral Therapy, Physical Therapy, Mental Health Therapy, as well as Psychological Evaluations, Student Case Management Services, Vocational Rehabilitation Training, Nutrition Monitoring, Dental and Vision screenings by Amee Cohen & Associates Pediatrics and other distinguished providers/subcontractors.

The SFSE offers a structured, academically focused classes with high rigor curricula for Science, Technology, Engineering, and Mathematics (STEM), Project Based Learning (PBL) and Community Based Learning (CBL) skills for college readiness. Instructions provide a combination of personalized curriculum from highly qualified special needs instructors and assistive therapies from certified contracted professionals to comprehensively serve the intellectual, physical, and emotional needs of every general and special needs student.

Arts, sports, fun and intense social life   SFES students also have at their disposal a series of extracurricular activities on and off campus such as Environmental Club, Science Fair Club, Publishing Club, Spelling Bee Club, Vocabulary Bee Club, Politician Association Club, College and Career Prep Clubs, Safety Patrols, Student Council, Music, Chorus, Drama, Dance, Gymnastics, Arts, Karate, Soccer Club etc.   The South Florida School of Excellence is located at 3400 NW 135 ST 33054, near Opa Locka Airport.

Click here to learn more about SFSE

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Does my child have a TS?

Tourette Syndrome, or TS, is a disorder of the nervous system that causes children to have “tics.” Tics are sudden twitches, movements, or sounds that people do repeatedly. A child who has tics cannot stop their body from doing these things. Children with TS have two forms of tics: motor tics, involving movements of the body, like blinking, and vocal tics, involving sounds made with the voice, like grunting.

Tics can be either simple or complex. Simple tics involve just a few parts of the body. Examples of simple tics include squinting the eyes or sniffing. Complex tics usually involve several different parts of the body and can have a pattern. An example of a complex tic is bobbing the head while jerking an arm, and then jumping up.

My child has tics. What now?

Tics are common, but for children to be diagnosed with TS, tics have to occur many times a day, nearly every day, for at least a year. Symptoms usually begin when a child is 5 to 10 years old and can impact how children do in school, their relationships, and their health. The media often portray people with TS as shouting out swear words or repeating the words of other people. These symptoms are rare and they are not required for a diagnosis of TS.

The frequent symptoms often are motor tics that occur in the head and neck area. Tics usually are worse during times that are stressful or exciting. They tend to improve when a person is calm or focused on an activity.

The types of tics and how often a person has tics changes a lot over time. Even though the symptoms might appear, disappear, and reappear, these conditions are considered chronic.

In most cases, tics decrease during adolescence and early adulthood and sometimes disappear entirely. However, many people with TS experience tics into adulthood and, in some cases, tics can become worse during adulthood.

What conditions also occur in children with TS?

More than 4 of 5 children with TS have at least one additional mental, behavioral, or developmental condition. The two most common conditions are Attention-deficit/hyperactivity disorder (ADHD; occurs in 50% to 70% of children with TS), and Obsessive-compulsive disorder (occurs in 30% to 50% of children with TS). People with TS are also more likely to have depression, anxiety, and/or learning disabilities.

How is TS diagnosed and treated?

There is no single test, like a blood test, to diagnose TS. Health professionals look at the person’s symptoms to diagnose TS and other tic disorders. The tic disorders differ from each other in terms of the type of tic present (motor or vocal, or a combination of the both), and how long the symptoms have lasted. TS can be diagnosed if a person has both motor and vocal tics, and has had tic symptoms for at least a year.

Although there is no cure for TS, there are treatments to help manage the tics caused by TS. Many people with TS have tics that do not get in the way of living their daily lives and therefore, do not need any treatment. Medication and behavioral treatments are available if tics cause pain or injury; interfere with school, work, or one’s social life; or cause stress. Management of TS should include timely and accurate diagnosis, education, and behavioral or medication treatment if needed.

Learn more about TS treatments