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My Toddler Isn’t Talking Yet! Will He Catch Up?

Parents often worry when their child reaches 18 months or 2 years of age and does not talk much or at all. Some children exhibit late language emergence, also known as late talking or a languageBlog-Late-Talking-Main-Landscape delay. Approximately 10-20% of 2-year-old children exhibit late language emergence. A late-talking toddler is typically defined as a 24 month old who is using fewer than 50 words and no two-word combinations. While research shows that late talkers catch up to peers by elementary school, approximately one in five late talkers will continue to have a language impairment at age 7. For some children, the late emergence of language may indicate a persistent language disorder, also called a specific language impairment. For other children, late language emergence may indicate a related disorder such as a cognitive impairment, a sensory impairment, or an autism spectrum disorder. Many parents wonder if their late-talking toddler will catch up naturally or whether speech-language therapy is recommended.

The following signs may indicate that a child will not naturally “catch up” in language and therefore may require therapeutic intervention:

  1. Language production: The child has a small vocabulary and a less diverse vocabulary than peers. A child who uses fewer verbs and uses primarily general verbs, such as make, go, get, and do is at risk for a persistent language disorder.
  2. Language comprehension: The child has deficits in understanding language. The child may be unable to follow simple directions or show difficulty identifying objects labeled by adults.
  3. Speech sound production: The child exhibits few vocalizations. The child has limited and inaccurate consonant sounds and makes errors when producing vowel sounds. The child has a limited number of syllable structures (e.g., the child uses words with two sounds, such as go, up, and bye instead of words with three to four sounds, such as down, come, puppy, black, or spin).
  4. Imitation: The child does not spontaneously imitate words. The child may rely on direct modeling and/or prompting to imitate (e.g., an adult must prompt with, “Say ‘dog,’ Mary” instead of a child spontaneously imitating “dog” when a parent says “There’s a dog”).
  5. Play: The child’s play consists mostly of manipulating or grouping toys. The child uses little combination or symbolic play, such as using two different items in one play scheme or pretending that one item represents another.
  6. Gestures: The child uses very few communicative gestures, especially symbolic gestures. The child may use pointing, reaching, and giving gestures more than symbolic gestures such as waving or flapping the arms to represent a bird.
  7. Social skills: The child has a reduced rate of communication, rarely initiates conversations, interacts with adults more than peers, and is reluctant to participate in conversations with peers.

The following risk factors exist for long-term language disorders:

  1. Males
  2. Otitis media (middle ear infection) that is untreated and prolonged
  3. Family history of persistent language/learning disabilities
  4. Parent characteristics including less maternal education, lower socioeconomic status, use of a more directive instead of responsive interactive style, high parental concern, and less frequent parent responses to child’s language productions

For children displaying any of the above signs or risk factors, a comprehensive speech-language evaluation is recommended.

References:

  • Paul, R. (2007). Language Disorders from Infancy through Adolescence: Assessment & Intervention. Elsevier Health Sciences.
  • http://www.asha.org/Practice-Portal/Clinical-Topics/Late-Language-Emergence/

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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5 Best Apps to Work on Speech and Language at Home

  1. My PlayHome by PlayHome Software LtdBlog-Speech-Apps-Main-Landscape
    • A digital doll house that lets your child use everything inside. You can fry an egg, feed the family pizza, pour drinks, feed the pets, and more! This app does not specifically target speech
      and language skills; however, there are many ways it can be used to work on speech/language at home. While playing with the doll house, you can work with your child on pronouns, identifying actions (e.g., cooking, sitting), present progressive –ing (e.g., drinking), plurals (e.g., two apples), vocabulary (around the house), formulating complete sentences, etc. I also like to use this app as a motivating activity for children working on speech sounds. For example, I will say, “Tell me what the doll is doing with your good ‘r’ sounds.” There is also My PlayHome Hospital, My PlayHome School, and My PlayHome Stores.
  2. Articulation Station by Little Bee Speech
    • This app is fantastic for children working on speech production skills. The whole app is pricey, but beneficial for a child working on more than one speech sound. It is also possible to download individual speech sounds to target a specific sound at home. This app is motivating and excellent for home practice!
  3. Following Directions by Speecharoo Apps
    • Excellent app for working on following directions. Choose from simple 1-step directions, 2-step directions, or more advanced 3-step directions. These funny directions will have your child laughing and wanting to practice more.
  4. Peek-A-Boo Barn by Night & Day Studios, Inc.
    • My favorite app for toddlers working on expressive language skills. First, the barn shakes and an animal makes a noise. Have your child say “open” or “open door” before pressing on the door. You can also have your child guess which animal it is or imitate the animal noises. When the animal appears, have your child imitate the name of the animal.
  5. Open-Ended Articulation by Erik X. Raj
    • This app contains over 500 open-ended questions to use with a child having difficulty producing the following speech sounds: s, z, r, l, s/r/l blends, “sh”, “ch”, and “th”. It is great for working on speech sounds in conversation. Have your child read aloud the question and take turns answering. The open-ended questions are about silly scenarios that will facilitate interesting conversations.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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What Can a Child with Autism Expect in Speech Therapy?

If you are a parent or a professional who has had experience with a child diagnosed with autism, you know that they are all as different as the colors under the sun. Speech therapy services areBlog-Autism-and-Speech Therapy-Main-Landscape typically recommended and necessary for kids diagnosed with autism, as they may have difficulty communicating effectively. These services will be tailored to the individual to ensure the child is making progress and achieving developmental milestones. No two speech therapy sessions are the same, as will be the case for your child. However, there are overarching goals that you can expect your child to be working towards.

Here are factors you should expect to be consistent for a child diagnosed with autism that is receiving speech therapy services:

  1. Speech therapy will be individualized.

The speech language pathologist will complete an evaluation of the child’s current speech and language skills. Based on the results of the evaluation and any observations made, goals will be formulated to target areas to improve.

  1. Speech therapy will target functional communication.

This may mean different things depending on the level of the child. Whether the child is verbal or nonverbal, therapy will address making sure the child is effectively communicating their needs and wants. If the child is nonverbal or has significant difficulty utilizing verbal language, Augmentative and Alternative Communication (e.g., pictures, sign language, iPad, etc.) may be implemented. Therapy may also target talking about events, telling stories, answering questions, asking questions, commenting, expressing opinions, and participating in conversations.

  1. Speech therapy will target social language.

Social language is also known as pragmatic language and includes using language for a variety of purposes (i.e., greetings, informing, demanding, etc.), changing language according to the needs of the listener or situation, and following rules for conversation and storytelling. In order to warrant a diagnosis of autism, the child has already been determined to have a deficit in social communication and interaction. Treatment goals may include maintaining eye contact, initiating and terminating conversations, maintaining topics of conversation, identifying emotions, and utilizing appropriate body language.

The above goals are targeted in a variety of ways, again dependent on your child. Sometimes direct education is provided prior to practicing skills in activities, role-play scenarios, or structured real-life situations. Other times, skills are targeted during play and motivating activities for the child. No matter the skill level of your child with autism, speech therapy is an integral piece to their progress and successful functioning.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, and Hinsdale! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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How to Get Your Baby Talking

A baby typically starts babbling, using speech-like sounds, between four to six months of age. Usually, the sounds p, b, and m are the first to develop. Additionally, in this age range, a baby is more Blog-Baby-Talking-Main-Landscapeinteractive with the parent or caregiver, laughing and vocalizing displeasure or excitement. Between seven months to a year of age, communication will expand and most babies are producing repetitive consonant-vowel combinations such as baba or dada, using gestures for communication, using vocalization to gain and maintain attention, and by one year of age a baby typically has one or two words or word approximations.

A parent or caregiver can support their baby’s language development or “talking” by encouraging all communication, interacting on their baby’s level, and making communication opportunities.

  • Match your child’s communications and interaction attempts, including repeating his/her vocalizations and gestures. By matching your baby’s vocalizations, you are communicating on a level that allows them to maintain communication turn-taking. Additionally target speech games and songs such as itsy-bitsy spider, peek-a-boo, and gestures such as clapping, blowing kisses, and waving hi/bye.
  • Talk through daily routines such as bath time, bedtime, get dressed, and feedings. You are providing your baby with the associated language during these daily routines. Talk through the plan for the day, what will you be doing, where you are going, who are they seeing, etc.
  • Teach your child gestures and signs to support language development.
  • Teach your child animal sounds (e.g., moo, baa) and environmental sounds (e.g., vroom, beep).
  • Spend time reading to your child and labeling pictures in books.
  • Reinforce your baby’s communication attempts by giving them eye contact and interacting with him or her.
  • Simplify your language during communication interactions with your baby.
  • Make communication opportunities within routines and daily activities.
  • Limit your baby’s exposure to television and/or videos. A 1:1 interaction between a parent and child is preferable to support turn-taking communication.

Remember there is a range of typical development. Not all babies will have their first words around one year of age!

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

What is a Tongue Thrust?

A tongue thrust is the most commonly known type of Orofacial Myofunctional Disorder. According to the American Speech-Language Hearing Association, this is when “the tongue moves forwardblog-tongue-thrust-main-landscape in an exaggerated way during speech and/or swallowing. The tongue may lie too far forward during rest or may protrude between the upper and lower teeth during speech and swallowing and at rest.”

A tongue thrust or an Orofacial Myofunctional Disorder may impact speech, chewing and swallowing as well as create changes in the dental pattern. An improper tongue resting pattern may develop as a result of enlarged tonsils or adenoids, allergies, extended thumb, finger, or pacifier sucking. It may also be related to restrictions in tongue movement, lip movement or the shape and size of the mouth.

Who Can Help With A Tongue Thrust?

This issue may be identified by a pediatric dentist or orthodontist due to the bite pattern seen in the child. An open bite (where the front teeth do not meet creating an open space) may indicate that there is a tongue thrust or an abnormal tongue resting position. A Speech-Language Pathologist trained in the area of orofacial myology or a Certified Orofacial Myologist (who may be a speech-language pathologist or a dental professional) are among the professionals who can diagnose an OMD.

To screen for the possibility of an OMD, it is beneficial to look at all the underlying factors including:

Habits – Thumb sucking, finger sucking, tongue sucking, extended bottle use and overuse of a “sippy cup.”

Airway – Open mouth breathing, enlarged adenoids and/or tonsils, allergies.

Lips – Do the lips rest apart or together habitually? Are there structural restrictions that don’t allow comfortable lip closure?

Tongue – Any difficulty moving the tongue to the roof of the mouth? Does the tongue appear to move forward during speech? Any structural restrictions impacting the movement? Sometimes the “lingual frenum” which is the attachment under the tongue is too short or tight and creates issues with tongue movement.

Teeth – What does the bite pattern look like? Is there an “anterior open bite” (the upper and lower incisors don’t meet when the teeth are together)? The “anterior open bite” is a very common pattern seen with tongue thrusts and other OMDs.

Speech – Speech may sound distorted especially the sounds “s,” “z,” “sh” and “j.”

Chewing and Swallowing – May show up as eating too quickly, too slowly, messy eater, as the swallow pattern is altered. This is sometimes referred to as a “reverse swallow.”

How is tongue thrust treated?

The approach to treatment involves first the proper diagnosis and designing a tailored approach to the particular OMD and how it is presenting in the individual patient. The therapist works closely with the rest of the OMD team, which may include the physician, ENT, gastroenterologist, oral surgeon, dentist and orthodontist. Any habits, structural issues, allergies or airway restrictions are addressed by the appropriate professionals.

Using tailored exercises, the treating therapist addresses forming correct placement of the lips, tongue and jaw at rest and the habituation of this over time. Addressing correct swallow patterns and the carryover into the ability to do this on an everyday basis with all foods is also addressed. Also addressed by the speech-language pathologist are any speech articulation issues with increased emphasis of the correct placement of the tongue and the appropriate tongue pattern.

Successful treatment involves ongoing treatment in weekly therapy, daily exercises done in the home and a collaborative approach with the family and the other professionals on the team.

Resources:

The American Speech-Language Hearing Association’s website information page: http://www.asha.org/public/speech/disorders/OMD/

International Association of Orofacial Myology information page: http://www.iaom.com/OMDisorders.html

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Age Appropriate Toys for Motor Development

It’s the holiday season! As we approach the end of December, plenty of parents have been inquiring about appropriate and educational toys and games that encourage speech and language growth, blog-motor development-main-landscapefine and gross motor development, and problem solving skills. Below are some of our favorite toys that we believe would make great additions to the family toy closet:

Baby toys (birth-24 months):

  • Fisher-Price Brilliant Basics Rock-a-Stack
    • Why we love it for infants: brightly lit colors encourage basic skills such as eye tracking which helps facilitate gross motor skills like rolling and reaching across the body’s midline. These multi-sized rings are also the perfect size to encourage the baby to start using a gross grasp and release pattern, which is integral for fine motor development. The baby can learn basic discrimination skills related to sizing and colors which is necessary to develop basic problem solving skills. These rings allow the baby opportunity for oral exploration without hazard of choking, and the product boasts that the material is safe for teething.
  • Melissa & Doug Stack and Sort Board – Wooden Educational Toy With 15 Solid Wood Pieces
    • Why we love it: Facilitates tactile discrimination, encourages basic language skills by introducing names of basic shapes as well as different colors, facilitates fine motor development (particularly pincer , tripod, and lateral tripod grasp usage), and requires basic eye hand coordination to stack and unstack items on and off the centerpiece.
  • More suggestions: Caterpillar Play Gym, Fisher-Price Little People Lil’ Movers Airplane, Busy Poppin’ Pals, Fisher-Price Laugh & Learn Count and Color Gumball

Toddler Toys (3-5 years):

  • Pop Up Pirate
    • Why we love it: This is a fan favorite for kids and therapists. We use it in OT, PT, and Speech, and the kids love it because of the uncertainty of who is going to make the pirate pop out of the barrel. Therapists enjoy using this toy to encourage direction following, visual motor integration skills, and fine motor coordination. When played in a small group, it provides a great opportunity to learn some basic impulse control and encourages turn taking. This is a great game for kids who may still have difficulty playing games with 2 or 3 step directions, as there are no rules other than waiting your turn to place the sword when directed.
  • Sneaky Snacky Squirrel 
    • Why we love it: Great game to address basic social skills and direction following. This game can be played with 2-4 individuals, and can help to encourage turn taking and fine motor control to manipulate a set of squirrel-shaped tweezers. This game also helps to build frustration tolerance, as children must learn how to react when losing their turn, or having a peer take away one of their acorns. It’s also easy to understand, and there is no reading required.
  • More suggestions: Wooden Shape Sorting Clock, Pop the Pig, Spot It, Zingo, Elefun, Hungry Hungry Hippos

Grade school toys and games (6-9 years):

  • Games for balance, coordination, and core strength: Zoomball, Twister, Labyrinth Balance Board
  • Games for fine motor development: Operation, Barrel of Monkeys, KerPlunk, Angry Birds, Jenga, Operation
  • Games for visual perceptual and problem solving skills: Rush Hour, Rush Hour Junior, S’Match, Marble Runs, Cartoon It
  • Games for Social skill and cooperative play: Race to the Treasure, Stone Soup, Don’t Let the Pigeon Drive the Bus

Adolescent games (10-15):

  • Games for Executive Functioning : Logic Links, Qwirkle, Mastermind, Labyrinth
  • Games for Visual perceptual and problem solving skills: Knot so Fast, Blokus, Rush Hour
  • Games for Social development: Life, Scattergories, Scrabble, Apples to Apples

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to  help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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5 Tips on How to Respond to Articulation Errors

A child who is still developing his or her articulation skills may need some feedback in order to fix speech errors and improve intelligibility. blog-articulation-errors-main-landscape

The following tips will help you respond to a child who produces articulation errors:

  1. Repeat the misarticulated word in your response with a slight emphasis on the target word. For example, if the student says, “I want the wed pencil,” you can respond, “Okay—here is the red
  2. Describe features about the misarticulated sound. For example, “The /s/ is a hissy sound. The air goes sssss like a snake hissing” or “The /v/ is made when our teeth bite down on our lip.”
  3. Give the child a consistent visual cue for the target sound, such as dragging a finger across the lips for /m/ or putting a thumb under the chin for /k/ or /g/.
  4. For a child who can read, contrast sounds that contain the correct sound and the incorrect sound by writing them out. For example, you can write out thin fin and show the child that one is made with a th and the other with an f.
  5. If you know that the child is able to produce the target sound, give him or her feedback on what you heard. You can say, “I heard you say doe, did you mean doe or go?” or feign difficulty understanding, such as, “You want to doe home? What do you mean, doe home?”

If you are unable to determine what word the child is trying to say, refer to this article for more tips: https://nspt4kids.com/parenting/helping-your-child-with-articulation-difficulties/.

As a parent or a teacher, it is important to acknowledge attempts at communication while providing feedback on speech sound production. If your child continues to demonstrate speech sound errors or is frustrated with his or her speech, seek out the advice of a speech-language pathologist.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Pragmatic Language: An Introduction

Social communication with others requires a complex integration of skills in three areas:blog-pragmatic language-main-landscape

  1. Social interaction
  2. Social cognition
  3. Pragmatic language skills

A social worker often addresses social interaction skills (e.g., understanding social rules, such as how to be polite) and social cognition skills (e.g., understanding the emotions of oneself and others). A speech-language pathologist often targets pragmatic language skills, which are the verbal and nonverbal behaviors used in social interactions.

A social interaction typically requires the ability to understand and use the following pragmatic language skills:

  1. Expression of a variety of communicative functions. Does the child communicate for a variety of reasons, such as attempting to control the actions of others, asking questions, exchanging facts, or expressing feelings?
  2. Use of appropriate frequency of communication. Does the child use an equal number of messages as his or her communication partner?
  3. Discourse (conversation) skills. Can the child initiate conversation, take turns, maintain and shift topics, and repair communication breakdowns?
  4. Flexible modification of language based on the social situation. Can the child switch between informal vs. formal language based on the setting and listeners?
  5. Narrative storytelling. Can the child tell coherent and informative stories?
  6. Nonverbal language. Can the child understand and use body language, gestures, facial expressions, and eye contact?
  7. Nonliteral language skills. Does the child understand figurative language, jokes, words with multiple meanings, and inferences?

A child with a social communication disorder, also known as a pragmatic language impairment, may present with difficulties using language to participate in conversations. Impairments in pragmatic language can impact a child’s ability to make and keep friends. It is important that social language skills are viewed within the context of an individual child’s cultural background. A speech-language pathologist can identify and treat pragmatic language difficulties in children.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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How Multidisciplinary Treatment Helps Children with Autism

There are many benefits to providing children with Autism a collaboration of different therapies in addition to Applied Behavior Analysis services. blog-autism-main-landscape

  • Occupational therapy (OT) provides children with skills to help regulate themselves. These skills may help decrease inappropriate stims and help provide children with more socially acceptable skills for regulation.
    • OT can provide children with strategies to help with motor skills.
    • OT can have a different perspective on activities of daily living and as such can provide different and alternative interventions to increase independence on self-care activities.
    • OT improves children independent living skills, such as self-care.
  • Speech therapy can help children with functional communication skills. Speech and Language Pathologists (SLPs) can provide additional support to the children to develop communication skills.
    • SLPs may also provide education and the introduction of alternatives to vocal communication in the form of augmentative devices or picture exchange communication system (PECS).
  • Applied Behavior Analysis (ABA) develops personal one-on-one interventions for children to develop functional skills.
    • ABA focuses on helping children with social, academic, and behavioral concerns.
    • ABA will also focus on providing children with skills for functional communication.
  • Physical therapy (PT) can help provide children with additional motor function and can help with children who have low muscle town or balance issues.
    • PT can also help with coordination for children.
  • Collaboration of all therapies can help ensure that the most effective treatment is provided to the child in all settings.

Fusion of all therapies will provide children exposure to different strategies and interventions in different settings to help with day-to-day life.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Is a Lisp Normal in Preschool?

As children begin to develop their speech and language skills, it is important to remember that speech sounds are acquired in specific patterns around approximate age ranges. Therefore, most Blog-Lisp-Main-Landscapechildren go through periods of development where their overall speech intelligibility is reduced.

In order to understand if a lisp is considered normal, one must first understand what a lisp actually is. Lisps can present themselves in a different manner, primarily as lateral and interdental, with misarticulations primarily on /s/ and /z/, though productions of “sh,” “ch,” and “j” are typically impacted as well. In order to accurately produce these speech sounds, airflow needs to be channeled down the middle of the tongue.

A lateral lisp occurs when the airflow passes over the sides of the tongue, which causes significantly distorted production of the targeted speech sounds. The manner of the production will have a “slushy” quality, and lateralized productions of speech sounds can be difficult to correct.

Another common lisp is the interdental lisp, in which the tongue protrudes between the upper and lower teeth distorting the airflow that is forced through the space during speech production. This type of lisp is often heard as a substituted “th” rather than an accurate /s/ or /z/.

In the preschool years, children are expected to have mastery of early speech sounds, and errors on later-developing speech sounds are considered typical. Therefore, distortions of /s/ and /z/ that present themselves as a lisp are often seen in children this age. However, around the age of five when children enter kindergarten, they should be more accurate with their speech sound production skills.

If a child continues to present with difficulty on particular sounds, further assessment may be beneficial. This is particularly true if the child presents with a lateralized lisp, as speech-language therapy is warranted to help re-mediate the place and manner of the errors. Evaluation is also recommended if the child presents with either inconsistent productions of speech sounds, or is significantly difficult to understand, regardless of age.

Read our blog on what to expect in a pediatric speech and language evaluation.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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