Free Self Screening Tool – Creative Speech Therapy NYC

Risk factors

Family history of speech, language, or feeding delay
Prematurity
Tongue Tie
Hearing Problems
Missing developmental milestones
Being male (2-3x more likely than girls)
Being a quiet baby
Sleep apnea
Snoring
Difficulty latching to breast or bottle

When should I seek professional help?

In the form below, please select all items that apply to your child. Submit this form if you select 2+ boxes in any category below. Please use one form per child if you would like an assessment on more than one child.

Could my child benefit from feeding therapy?

My child is a problem/picky eaterMy child eats less than 20 different foodsMy child has poor weight gain and/or falling percentages on the height/weight scaleMy child is choking, gagging, coughing or vomiting at mealsMy child did not transition to purees by 10 months, solids by 12 months, or off the breast to cup drinking by 16 monthsMy child is avoiding entire categories of food textures or nutrition groups (ie, no meats, no crunchy foods, no chewy foods, no raw fruit)Mealtimes are a battleI have described my child as a picky eater at more than one wellness check

Could my child benefit from language therapy?
My 18-20 month old uses less than 25 wordsMy 21-24 month old uses less than 50 wordsMy 24-30 month old uses less than 100 wordsOr, is not using any word combinations by 24 monthsMy child is/was quiet as a babyMy child has/had reoccurring ear infectionsThere is a family history of speech, language, or academic difficultiesMy child engages in limited sequenced pretend playMy child has a vocabulary consisting of mostly nouns with little or no verbsMy child has difficulty communicating with peersMy child uses limited gesturesMy child makes a limited number of sounds

Could my child benefit from speech therapy?

My 6 month old is not babbling or socially interacting with meMy 12 month old is not stringing vowels together for babbling or saying first wordsMy 18 month old is not saying 10 words or following simple directions. I am not able to understand 25% of their speechMy 24 month old is not combining two words together or using 50 words to communicate. I am not able to understand 50% of their speechMy child is not saying early developing sounds (p,b,m,w,d,t,k,g,h) and vowelsMy child does not sound like children their age

Could my child have any red flags for Apraxia of Speech?

In Birth to 1 year, did your baby;
Have decreased cooing or babblingOthers may comment on what a QUIET BabyMay have feeding difficultiesBaby's first words appear late (after 14 months) or not at all. If first words to appear, they are often EASY sounds, replaced with an even easier one. For example, I instead of HI

In One to Three Years, did your baby;
Understand most of what is said, but cannot verbalize wellCannot correctly use sounds, or has difficulty imitating words and phrasesMessy and distracted eatingMelody of speech is affectedStruggles with SEARCHING for the right word (may see GROPING with their mouth)Leave sounds out of words such as COO-IE for COOKIEThe longer the phrase, the more unintelligible your child isMay have developed an elaborate nonverbal communication system

Could my child have a tethered oral tissue/tongue tie?

My child has;
messy eatingdental caries/tooth decayfatigue from chewing or inefficient chewing/bites that are too bigTongue thrust swallowing pattern or difficulty swallowing pillsExcessive droolingDigestive problemsSleep ApneaSnoringTeeth grindingFood texture aversionPocketing food in the cheeks when eatingAsymmetric smileHeadaches TMJ

Your Child’s Name

Your Child’s Age

Your (Parent/Caretaker) Name

Your contact number

Your Email (required)

Please tell me about any additional concerns you may have;