Are you concerned that your baby may have a developmental delay? Do you have questions about your child’s feeding disorder, or are you looking for a new speech therapist? Since 2004, Fleming Therapy Services has supported families using a unique in-house collaborative approach. This family-owned business covers several areas of therapy in four separate locations — two in Fredericksburg and two in Northern Virginia.
Carrie Fleming M.Ed., CCC-SLP, CEO and president of Fleming Therapy Services, talked about her company’s approach to treatment.
Q Please tell us a little about Fleming Therapy Services.
Fleming Therapy Services, Inc. is a private, locally-owned and operated pediatric practice providing speech, occupational, and physical therapy to children 12 months to 18 years old. We also provide feeding and augmentative alternative communication therapy. Augmentative alternative communication includes all forms of communication (other than oral speech) that is used to express thoughts, needs, wants, and ideas. Starting in summer 2016, we will be offering aquatic therapy as well.
Our focus is on helping families with children who have difficulty with articulation, language, sensory processing, fine motor, gross motor and overall developmental milestone challenges. We also have the capability to manage and oversee multiple therapies in complex and medically-involved children who would benefit and grow from all three main services, speech, OT and PT. Our services are often provided in a one-on-one setting; however, if appropriate and desired by families, we can provide these services in a small group setting to increase social interactions amongst the children of the same age and similar conditions.
QWhat areas do you specialize in?
We have a superior team of over 35 therapists across Northern Virginia who are available to provide assistance on any one case in a collaborative, nurturing and caring environment. Our team specializes in working with children who have autism, Down syndrome, cerebral palsy and a range of medically fragile needs. We have therapists who specialize in treating apraxia, feeding disorders, interactive metronome, neuromuscular disorders and reading difficulties, and who have prompt training, PECS training, early childhood development training or certification, Fluency, ABA (applied behavior analysis) and Aquatic Therapy training or certification. Those with Fluency training have had additional courses and interests in gaining the knowledge on how to provide treatment for those that stutter. With over 100 years of therapy experience across our Northern Virginia offices, we pride ourselves on focusing this knowledge, keeping therapy in sync and meeting milestones.
QFleming Therapy Services offers a family-friendly environment. What does that mean?
Our family-friendly environment is something I feel is unique. As the owner of Fleming Therapy, mother of six children and a military spouse, I am proud of how I have been able to shape my company to ensure that our families feel at home and know their children are well taken care of by our staff. Not only do the therapists take this loving, nurturing approach, but our front office administration and billing departments take the approach in making sure our families are heard and taken care of from a scheduling to a financial perspective. As a parent, there’s nothing more meaningful than knowing you are taking your child to a place where people truly care for your child’s entire well-being, your family and your family’s financial need. It’s more than customer service. It’s understanding and caring for our families that set us apart. We have a history of our families making long-lasting friendships with other families and with us at Fleming Therapy Services.
QWho would be a good candidate for speech therapy?
A good candidate for speech therapy is a child who may not be developing their vocabulary or language on an age appropriate level. A rule of thumb is 18 words by 18 months. A good candidate is a child who may not be using their speech sounds by age 3-4 correctly or a child who may not be putting words together or beginning to exchange in a small dialogue back and forth by 2-3 years of age. Another candidate is a child with medical diagnosis that impacts his overall speech and language development. We see children who need additional services after school. If a parent is unsure if their child needs speech therapy, we offer free consultations with our assistant directors who will discuss the concerns and make a determination if or what can be done next.
QWhat are PROMPT techniques?
PROMPT therapy is a method used in speech therapy to assist children with the oral sequential movements for speech sounds. This approach provides tactile cueing to the lips, cheeks and jaw to assist in the facilitation of speech sounds. Many of our speech therapists are trained in this approach; however, this is not our only approach to treating a child with a speech disorder. We screen each child to determine which approach would work best.
QHow do I know if my child needs pediatric physical therapy?
Pediatric physical therapy is our newest department and we are pleased to see how much this service has helped so many children. Pediatric physical therapy assists children with sitting, standing, crawling, walking and climbing. We see many children with varying global developmental disabilities and medical diagnoses. Physical therapists use many different methods such as the use of treadmills, bicycles and stairs. They will provide stretching techniques for those children with tight muscles related to their medical diagnosis. Our physical therapists also work to assist our families in getting their children wheelchairs, walkers and standers as deemed appropriate. If a child is having difficulty with any of the above areas, it would be appropriate to consult with the family physician to see if pediatric physical therapy would be beneficial.
QWhat is occupational therapy? Is the focus of occupational therapy different in children than in adults?
Pediatric occupational therapy focuses on addressing a child’s sensory processing deficits and developmental milestones related to basic self-help skills, as well as fine motor difficulties. The occupational therapists help the children with sensory processing deficits to learn to take in the environment around them. These children may have difficulty with sounds, lighting and touch. These children may have difficulty being in a crowd of people, difficulty with emotions, or difficulty with transitions and overall difficulty making friends. Our occupational therapists work very hard to address these sensory processing areas to assist the children and families on coping mechanisms. They assist children in self-help skills related to sequential steps in dressing, washing hands, tying shoes and brushing hair. They also assist children with handwriting, drawing, cutting and overall fine motor difficulties associated with the use of their hands and fingers. These services vary slightly when working with adults.
QWhat causes feeding disorders?
We see many children with feeding difficulties. These feeding difficulties range from being a picky eater to having difficulty orally manipulating the food in the mouth to swallow. We don’t have an answer as to how or why a child has a feeding disorder. Many factors can play a role including a medical diagnosis, a child on a feeding tube, a child may have sensitivity to a type of texture of a food, or a child may have limited tongue and lip movement to be able to move the food around. Upon our initial consultation, we are able to determine which of these areas is most impacting the child in order to determine if a speech therapist or occupational therapist would best help the child. Our therapists are trained in many different approaches and use many different techniques to help the child learn to eat better. The family is an active participant throughout the treatment in order for these skills to be transferred to the home.
QIs it common for children to need to see more than one type of specialist?
It is not uncommon for a child to receive multiple services. We have the opportunity to collaborate extensively amongst the disciplines in order to better assess each child’s needs and design the treatment for each child in the best collaborative environment, keeping the therapy in sync. We look at the entire child upon our initial consultation. We look to see the child's balance and stability in standing and walking, how the child uses their hands and fingers, and how the child uses their mouth to speak. We recognize how important the balance is to overall speech clarity and ability to articulate.
Often parents will come in and have concerns with a child’s articulation skills. While we assess the child for articulation, we will also screen the child’s overall gross stability because we have to have stability to get mobility of speech. In this case, we may consult with one of our physical therapist or occupational therapist to assist us to achieve the goals and in most cases at a quicker pace. When a child receives multiple services, we provide additional management and oversight for our team. This keeps therapy in sync as they work closely to ensure the child’s goals are being targeted while receiving all services. This collaborative approach, called “Therapy in Sync” is something we at Fleming Therapy Services, Inc. are proud to offer and look forward to continuing as we help families throughout Northern Virginia and Fredericksburg.
Do you have questions for Fleming Therapy Services, Inc? Join us for a live Q&A on our Facebook page, May 12 at 8:00 pm.