Frequently Asked Questions

No, speech therapists can provide assessments and treatment without a doctor’s referral.However, some health insurers require a referral from your child’s primary physician before they will provide coverage.

Speech sound development is a gradual process. Babies typically start by cooing and making gurgling sounds. By their first birthday, they can often say a few simple words.

During toddlerhood, vocabulary expands rapidly, and by age 3 or 4, most children can use sentences and understand most of what's said to them.

Mastering all speech sounds may take until they're 7 or 8. Remember, children develop at different rates, and that's okay.

Most babies start babbling between 6 and 9 months. It's an exciting milestone when your baby begins to experiment with sounds, which can include "ba", "da", "ma", and more.

They are learning how to use their vocal cords, lips, and tongue. It's a significant step toward the development of meaningful speech.

Children experience an exciting language burst between the ages 18 months-3 years, with two-word sentences (“Daddy go”) beginning to emerge around age 2. By age 3, most toddlers can use sentences of at least 3 words or more, understand simple instructions, and be understood by familiar adults most of the time.

Children’s language becomes more complex between the ages of 3-5. They start to use longer sentences, can carry on conversations, and their speech is usually understandable to most (with some sounds still mispronounced).

They begin to understand and use prepositions, possessives, and often start to understand the concept of past, present, and future tenses.

• Explain the concept of neurodiversity and its importance.
• Highlight the focus on strengths and capabilities, rather than deficits.
• Discuss the respect for individual differences and communication styles.
  
  It means supporting each child's unique strengths and communication styles. This approach is not about 'fixing' someone, but rather about understanding and respecting the diverse ways of experiencing the world that comes with Autism. We focus on enhancing their abilities and providing tools to navigate challenges.
  

You have two ways; Meet & Greet or Initial Evaluation. The Meet & Greet is a free 20 minute video chat where we can get to know each other. You can voice your concerns, and determine if Teletherapy is right for your family. 

But If you already know you’d like an assessment, and want to get on the schedule faster, book an Initial Evaluation. Use the online scheduling system for both.  Please reach me at heather@bravospeechtherapy.com with any questions.

If your child struggles to make certain sounds, is consistently difficult to understand compared to same aged peers, or has frustration when not understood, they may have a speech sound disorder.
‍

For example, they might substitute one sound for another (”wabbit” for “rabbit”). It’s normal for children to mispronounce sounds as part of their development, but when these patterns persist past the typical age range, treatment may be necessary.
‍

It’s important to get a speech evaluation to determine the need for therapy. Early intervention can make a big difference!

It's common to be concerned about your baby's speech. Babies typically start babbling between 6 and 9 months.

If your baby isn't exploring their voice by 7 months, it would be best to consult with a speech therapist and learn more.

Your baby’s hearing may be an underlying issue that could go unnoticed at this age. This is something worth ruling out!

While it’s normal for children to develop at their own pace, significant delays in speech and language development should not be ignored. If your toddler uses fewer words than most children their age, doesn’t make eye contact, doesn’t understand simple instructions, or isn’t combining words to make sentences, it may be beneficial to consult with an SLP.

Engage your child in conversations, ask open-ended questions, and introduce new vocabulary. Reading together is particularly beneficial at this age. Encourage story-telling and imaginative play to promote narrative skills.

• Outline what sensory processing support entails.
• Explain the impact of sensory sensitivities on communication and behavior.
• Describe examples of sensory accommodations and their benefits.
  
  By identifying and adapting to each child’s sensory needs, we can create a more comfortable space for them. This support helps in reducing distractions and enhancing their ability to focus and engage during therapy sessions.
  

I often experience a high demand for after-school appointments and may have a waiting list for 3:00pm or 4:00pm appointments.

You can use the online scheduling system to request a Meet & Greet or Initial Evaluation.

Reading together, singing songs, and playing rhyming games are all excellent ways to help your child practice their speech sounds. You can also practice specific sounds using toys or pictures (”lets find all the toys that start with /s/”). Your therapist can provide you with specific ideas or worksheets to help at home.
‍

Make it fun and part of your everyday activities. Remember, practice, patience, and positive reinforcement are key.

One of the best ways to encourage language development is through interaction. Talk to your baby often, describe your actions, sing songs, and read picture books. Imitate your baby's sounds (babble back to them!) and maintain eye contact.

Your voice and attention not only help language development but also strengthen your bond.

Create plenty of opportunities for your child to talk during your everyday routines. Engage them in conversation, ask open-ended questions, and use a variety of words to describe things in the world around you.

Reading together and using play as learning time can be especially beneficial, and fun!

Absolutely, having an imaginary friend is a normal part of childhood for many kids. It’s a sign of a healthy imagination and can be a tool for children to practice their social and language skills.

As they get older, they will more clearly learn the difference between fantasy and reality.

• List typical challenges like literal interpretation of language and difficulty with non-verbal cues.
• Address the variability in communication abilities among individuals with ASD.
• Emphasize the importance of personalized approaches to address these challenges.

Some challenges might be interpreting language literally, difficulties with social cues and non-verbal communication, and varied verbal abilities. My role is to identify and understand these challenges for each individual and tailor our therapy sessions to address and support these specific needs

I am currently licensed to provide services to families residing in Washington State, Oregon, and California.

A Speech-Language Pathologist, or SLP, works with children to identify speech sound issues, develop a customized therapy plan, and provide targeted exercises to improve their speech.
‍

The traditional articulation therapy approach may involve demonstrating how to make certain sounds, practicing syllables, words, and sentences, and conversational speech. They use games or activities to make the process fun!
‍

The SLP will also provide you with education and guidance to  help your kiddo at home.

• Use simple language to label your toddler’s emotions (“You’re happy because…”) and validate their feelings.
• Picture books and stories are a great way to talk about different emotions.
• You can teach simple signs or use pictures to help your child express different feelings.
• Some children enjoy drawing their emotions on paper.

Read to your child every day! Point out letters and words in their favorite books, and environment. Encourage your child to draw and write also.

Enjoyment and interest in reading at this age is the primary goal, as your child gains early phonic skills (understanding how letters  or groups of letters are associated with a sound). Make it fun!

It's natural to be concerned! Some babies are more responsive and engage frequently, while others are naturally more observant & quiet, processing information internally.

Remember, your baby typically starts to respond to you in the first 3 months of life. They will startle to sounds and respond to your voice. As they get into the 7 to 12 month range they are turning in the direction of their name being called. Their demeanor becomes more and more interactive as they approach one year. 

‍

An occasional lack of engagement is normal, but if it's frequent and you're feeling concerned, reaching out to a speech therapist to ask more questions is a great next step.

‍

• Offer practical tips for creating a supportive environment.
• Suggest activities that can enhance communication skills.
• Emphasize the role of parents in reinforcing therapy practices.

I recommend creating a supportive environment at home that encourages communication. This can include engaging in activities that promote language skills, reinforcing therapy practices, and being patient and responsive to your child’s communication attempts.

I offer speech and language services to children between the ages of 18 months to 18 years

Techniques vary based on the specific sound and the child’s needs. Some strategies include auditory awareness (listening to sound differences), visual cues (like watching the therapist’s mouth or looking at picture cards), and tactile feedback (like feeling the throat vibrate for certain sounds).
‍

They might find success with playful techniques too, like pretending to be animals or robots.

Your baby will begin to explore more and more consonant + vowel combinations, and eventually these expressions will turn into meaningful words! 

Yes, occasional stuttering (disfluent speech) can be a part of normal language development for toddlers as they learn to speak in more complex sentences. They have so many smart and creative thoughts running through their minds! However, if it persists, they appear aware of their disfluencies and it causes frustration, or is accompanied by other speech issues, it’s a good idea to seek advice from a speech-language pathologist.

Break down your instructions into simpler steps, using familiar vocabulary words during daily routines, such as:

• getting dressed
• cooking a meal
• playing a game

Using visual picture cues along with your verbal instructions can improve your child’s understanding, too.

‍

• Discuss the convenience and accessibility of teletherapy.
• Highlight how teletherapy can be as effective as in-person sessions.
• Mention the comfort for the child in being in a familiar environment.

Teletherapy allows children to receive therapy in the comfort and security of their home, which can be particularly beneficial for those with ASD. Teletherapy also offers flexibility in scheduling and can be just as effective as in-person sessions, making it a great option for many families

I help children with..

• Down Syndrome
• Autism Spectrum
• Down Syndrome
• Genetic Disorders

• Social Skills
• Communication Skills

• Speech Delays
• Articulation Disorders
• Motor Speech/Apraxia
• Language Comprehension
  
• Stuttering and more...

Speech sound disorders can impact reading and writing skills because they involve phonetic awareness, or the understanding that words are made up of individual sounds.
‍

If a child has trouble with certain speech sounds, they may struggle to sound out words when reading or spell words correctly when writing. It’s important to address these issues as early as possible to support your child’s academic success.

• Explain the assessment process to identify individual needs and strengths.
• Describe how therapy plans are personalized.
• Discuss the ongoing evaluation and adjustment of therapy strategies.

‍

It begins with a thorough assessment to understand their individual strengths and challenges. From there, I develop a personalized therapy plan that evolves over time. Regular evaluations ensure that we are always working in the most effective way to support their communication growth.

If your child has been evaluated by another certified speech-language pathologist within the last year, I can review it. This will determine if there is adequate information to be able to establish a plan and begin treatment, without conducting another evaluation.

• Discuss the methods used to track and evaluate progress.
• Explain how goals are set and adjusted over time.
• Mention any tools or assessments used to measure improvements.

Progress is measured through a combination of standardized assessments, observational evaluations, and regular check-ins with both the child and their family. Goals are set collaboratively and reviewed regularly to ensure they remain relevant and achievable. I also use specific tools designed for tracking speech and language development in children with ASD.

The Initial Evaluation allows 90 minutes to assess multiple areas for an accurate understanding of your child's skills. Test scores may not be obtained within that timeframe, but I can still create a treatment plan using other sources like parent reports, clinical observation, and oral motor exams.

Assessment of your child’s progress is an ongoing process and I continue it throughout your child’s plan of care.

Siblings can be wonderful allies in therapy. They can engage in recommended activities at home, serve as role models for communication, and participate in joint therapy sessions when appropriate. I encourage inclusive activities that foster a supportive environment and help siblings understand and empathize with each other.

I'll help you incorporate home practice into your daily routine! With my suggestions, your child's skills will transfer more easily in your home, community, and other settings. 

For example, you can write 5 speech words on a sticky note and say them before or after brushing teeth each night. Encourage your child to do this 7 days a week and you’ve helped them practice 40 times that week!

• Elaborate on how speech therapy can impact social skills.
• Discuss the integration of social skill training in therapy sessions.
• Explain the connection between communication abilities and social interaction.

Absolutely. While the primary focus is on communication, speech therapy naturally extends to social skills. We work on understanding social cues, turn-taking, and appropriate responses in social situations. These skills are vital for building relationships and interacting effectively in various settings.

Yes, I provide a comprehensive written report of your child’s Initial Assessment which includes background information/parent concerns, test scores, clinical observations, long and short-term goals, a general plan of care, and therapy recommendations. Then, a 6 month Progress Report with updates on goals will be written, and after 12 months, a Re-Evaluation will be completed.

No, I do not provide swallowing or feeding therapy at this time. I’m happy to pass along a referral in your area, if needed.

The number of sessions per week will vary depending on your child’s needs. Typical frequency of treatment is 1x/week at 45 minutes in length.After a thorough assessment, I will develop your child’s treatment plan and determine frequency.

• Share your commitment to continuous learning and professional development.
• Mention any specific journals, conferences, or networks you engage with.
• Explain how new findings are integrated into your therapy approach.
  

I'm committed to lifelong learning. Aside from the continuing education that is required to maintain my credentials through the American Speech & Language Association, I also participate in professional networks, and stay updated through academic journals and conferences. This  education ensures my therapy approaches remain current and effective, integrating the latest research and best practices.

A Speech-Language Pathologist (also known as SLP or Speech Therapist), is an expert in communication who holds a masters degree in an accredited program. SLPs prevent, assess, and treat adults and children who experience problems with; speech sounds, language skills, social communication, voice, fluency, feeding and swallowing.

My clients are often surprised at just how well online speech therapy works for them. Studies show that it achieves the same or better results as in-person treatment.

Being present inside your child's home environment offers me valuable insight, and more directly connects parent involvement!

• High speed internet connection 

• Computer or laptop preferred (Ipad or mobile device can be an alternative option)
• You don’t need any extra special equipment

No, Bravo Online Speech Therapy is a Teletherapy only practice.

Not much different at all actually! This is my specialty, and the pure mission of Bravo! Speech Therapy. 

I use many of the same materials (toys, games, books, etc) that I would use in an In-Person session. I provide individualized evaluation and treatment with the same quality of care. You, as the parent, will have a stronger presence during Teletherapy sessions, assisting your child for improved motivation and participation.

Your involvement allows for an ease in carryover of your child’s skills into the home setting. As your therapist, being able to have a window into your child’s natural environment gives me a unique and valuable perspective. This allows me to provide a more individualized plan of care for your family.

Teletherapy allows for more flexibility in scheduling, ease in carryover of home practice, and prompt communication with Heather during the session. All of this can add up to more effective therapy for your child.

People also enjoy being in the comfort of their own home, and decreased travel time.

As a professional SLP of 14 years, I take privacy seriously. 

Bravo Online Speech Therapy LLC protects personal health information by adhering to strict confidentiality policies and taking necessary precautions to safeguard the information from unauthorized access or disclosure.

Bravo maintains a secure, fully HIPAA compliant data storage system via SimplePractice platform.

No, I don’t accept insurance currently. Bravo accepts private pay clients only. Upon request, I can provide you a 'Superbill' that is formatted for insurance companies to provide coverage retroactively.

• 20 minute Meet & Greet = no cost
• 90 minute Initial Evaluation + written report = $150
• 45 minute Treatment Session + home programming = $90

Private payment for speech services is made via credit card through Bravo’s payment processor (Stripe). After you’ve scheduled your Initial Evaluation, you will complete required paperwork in your client portal. You will fill out your credit card information and sign a form to authorize payments via credit card.

Payment will be processed at the completion of each therapy session.

Soon after your credit card is charged, you will receive an updated invoice detailing service and payment information. The invoice will be available to you in your client portal.

A Superbill is a document provided to you containing information you need, to work directly with your insurance plan.

It is different from a typical invoice or receipt because it provides additional information, including; Client’s contact information, speech therapist name and credentials, CPT code for the service, ICD-10 code for diagnosis, fee for the service paid by the client, and more.

A Superbill can be provided at any time after your child’s completed service. You can then fill it out and submit it to your insurance company for possible reimbursement.

Early intervention with a therapist is best, to learn how your child can improve their speech skills.

You can also practice with your child at home by responding positively to all of their communication attempts; repeating what they do/say or giving verbal praise 'I like how you tried to tell me!'.

Babies aged 7 months to 1 year are babbling long strings of sounds, like bababa, mamama, dadada. They begin saying a few meaningful words around age 1 to express themselves, like dada, mama, dog, hi, up. The ‘words’ they try to say may not be clear to the listener, as many sounds are still developing. 

By 18 months, a child is speaking anywhere between 20 to 200 words. This can vary greatly from child to child, as some children spend more of their developmental energy on motor or other communication skills.

Consult an SLP if your child does not speak at least 50-75 words by 2 years old.

It’s common to compare your older child to your younger child, however, every child develops at a different speed! Boys tend to develop a little slower than girls, but this difference is very insignificant. 

If you have concerns for your younger child, having an evaluation done is a great way to discover if they’re in need of speech therapy. Learning more can be helpful in decreasing worry you may feel. 

A frontal lisp is when the tongue pokes out between the front teeth (sometimes sounding like a ‘th’ sound). This type of lisp is considered normal in children until about age 4 ½  years. It may be appropriate to treat this type of lisp earlier than 4 ½ depending on the child’s abilities, speech understandability, etc. A speech evaluation can be a great way to determine if therapy is recommended.

A lateral lisp is when the air travels across the sides of the tongue and escapes into the cheeks, making a ‘slushy’ sound. This type of lisp is not considered part of normal development and should be treated as soon as possible. I recommended scheduling an appointment right away to determine if treatment is needed. 

Some types of disfluencies (stuttering) are considered typical at certain ages and there’s no need to worry. Stuttering typically begins around 2-6 years of age, lasting less than 6 months. It usually presents as repeated phrases or words with little to no awareness, and during a natural peak in speech-language development. 

Oftentimes disfluencies increase when a child is tired, excited, or feeling rushed. However, an evaluation is recommended if your child’s stuttering increases, they exhibit frustration or avoidance in speaking situations, they tense up their face or body when speaking, or there is a family history of stuttering.

Your child’s hearing is an important part of speech-language development and should be tested if you have concerns. 

Seek an appointment with a certified Audiologist if your child exhibits the following warning signs; not responding to loud background noise, not responding to their name being called, reduced verbal speech skills or development, preferring the TV to be very loud.

Using sign language, or gestures, with any child will not inhibit their verbal speech. In fact, it could even enhance your child’s ability to communicate. 

Current research shows that providing your child with a different/alternative way to express themselves (sign language, gestures), can decrease communication frustration (reduced meltdowns) and may actually improve motivation for verbal communication.

Chat with me if you’d like to discuss further!

Each child’s plan of care is unique to them. Some children require an Initial Evaluation only, followed by home recommendations to the family. But for many, treatment sessions are recommended.

The duration of therapy depends on many factors; severity of the child’s difficulties, diagnosis, health history, and progress in therapy.

Yes! Bravo Online Speech Therapy is a private pay service and separate from school services.

‍

Getting private therapy in tandem with existing services through your school district can be very beneficial!School therapy focuses more on communication skills as they relate to the educational setting, whereas private therapy can focus on more functional communication needs in home and community settings.

‍

I work collaboratively with your school speech therapist to make sure therapy goals are in alignment with your child's plan of care.

No, speech therapists can provide assessments and treatment without a doctor’s referral.However, some health insurers require a referral from your child’s primary physician before they will provide coverage.

Speech sound development is a gradual process. Babies typically start by cooing and making gurgling sounds. By their first birthday, they can often say a few simple words.

During toddlerhood, vocabulary expands rapidly, and by age 3 or 4, most children can use sentences and understand most of what's said to them.

Mastering all speech sounds may take until they're 7 or 8. Remember, children develop at different rates, and that's okay.

Most babies start babbling between 6 and 9 months. It's an exciting milestone when your baby begins to experiment with sounds, which can include "ba", "da", "ma", and more.

They are learning how to use their vocal cords, lips, and tongue. It's a significant step toward the development of meaningful speech.

Children experience an exciting language burst between the ages 18 months-3 years, with two-word sentences (“Daddy go”) beginning to emerge around age 2. By age 3, most toddlers can use sentences of at least 3 words or more, understand simple instructions, and be understood by familiar adults most of the time.

Children’s language becomes more complex between the ages of 3-5. They start to use longer sentences, can carry on conversations, and their speech is usually understandable to most (with some sounds still mispronounced).

They begin to understand and use prepositions, possessives, and often start to understand the concept of past, present, and future tenses.

• Explain the concept of neurodiversity and its importance.
• Highlight the focus on strengths and capabilities, rather than deficits.
• Discuss the respect for individual differences and communication styles.
  
  It means supporting each child's unique strengths and communication styles. This approach is not about 'fixing' someone, but rather about understanding and respecting the diverse ways of experiencing the world that comes with Autism. We focus on enhancing their abilities and providing tools to navigate challenges.
  

You have two ways; Meet & Greet or Initial Evaluation. The Meet & Greet is a free 20 minute video chat where we can get to know each other. You can voice your concerns, and determine if Teletherapy is right for your family. 

But If you already know you’d like an assessment, and want to get on the schedule faster, book an Initial Evaluation. Use the online scheduling system for both.  Please reach me at heather@bravospeechtherapy.com with any questions.

If your child struggles to make certain sounds, is consistently difficult to understand compared to same aged peers, or has frustration when not understood, they may have a speech sound disorder.
‍

For example, they might substitute one sound for another (”wabbit” for “rabbit”). It’s normal for children to mispronounce sounds as part of their development, but when these patterns persist past the typical age range, treatment may be necessary.
‍

It’s important to get a speech evaluation to determine the need for therapy. Early intervention can make a big difference!

It's common to be concerned about your baby's speech. Babies typically start babbling between 6 and 9 months.

If your baby isn't exploring their voice by 7 months, it would be best to consult with a speech therapist and learn more.

Your baby’s hearing may be an underlying issue that could go unnoticed at this age. This is something worth ruling out!

While it’s normal for children to develop at their own pace, significant delays in speech and language development should not be ignored. If your toddler uses fewer words than most children their age, doesn’t make eye contact, doesn’t understand simple instructions, or isn’t combining words to make sentences, it may be beneficial to consult with an SLP.

Engage your child in conversations, ask open-ended questions, and introduce new vocabulary. Reading together is particularly beneficial at this age. Encourage story-telling and imaginative play to promote narrative skills.

• Outline what sensory processing support entails.
• Explain the impact of sensory sensitivities on communication and behavior.
• Describe examples of sensory accommodations and their benefits.
  
  By identifying and adapting to each child’s sensory needs, we can create a more comfortable space for them. This support helps in reducing distractions and enhancing their ability to focus and engage during therapy sessions.
  

I often experience a high demand for after-school appointments and may have a waiting list for 3:00pm or 4:00pm appointments.

You can use the online scheduling system to request a Meet & Greet or Initial Evaluation.

Reading together, singing songs, and playing rhyming games are all excellent ways to help your child practice their speech sounds. You can also practice specific sounds using toys or pictures (”lets find all the toys that start with /s/”). Your therapist can provide you with specific ideas or worksheets to help at home.
‍

Make it fun and part of your everyday activities. Remember, practice, patience, and positive reinforcement are key.

One of the best ways to encourage language development is through interaction. Talk to your baby often, describe your actions, sing songs, and read picture books. Imitate your baby's sounds (babble back to them!) and maintain eye contact.

Your voice and attention not only help language development but also strengthen your bond.

Create plenty of opportunities for your child to talk during your everyday routines. Engage them in conversation, ask open-ended questions, and use a variety of words to describe things in the world around you.

Reading together and using play as learning time can be especially beneficial, and fun!

Absolutely, having an imaginary friend is a normal part of childhood for many kids. It’s a sign of a healthy imagination and can be a tool for children to practice their social and language skills.

As they get older, they will more clearly learn the difference between fantasy and reality.

• List typical challenges like literal interpretation of language and difficulty with non-verbal cues.
• Address the variability in communication abilities among individuals with ASD.
• Emphasize the importance of personalized approaches to address these challenges.

Some challenges might be interpreting language literally, difficulties with social cues and non-verbal communication, and varied verbal abilities. My role is to identify and understand these challenges for each individual and tailor our therapy sessions to address and support these specific needs

I am currently licensed to provide services to families residing in Washington State, Oregon, and California.

A Speech-Language Pathologist, or SLP, works with children to identify speech sound issues, develop a customized therapy plan, and provide targeted exercises to improve their speech.
‍

The traditional articulation therapy approach may involve demonstrating how to make certain sounds, practicing syllables, words, and sentences, and conversational speech. They use games or activities to make the process fun!
‍

The SLP will also provide you with education and guidance to  help your kiddo at home.

• Use simple language to label your toddler’s emotions (“You’re happy because…”) and validate their feelings.
• Picture books and stories are a great way to talk about different emotions.
• You can teach simple signs or use pictures to help your child express different feelings.
• Some children enjoy drawing their emotions on paper.

Read to your child every day! Point out letters and words in their favorite books, and environment. Encourage your child to draw and write also.

Enjoyment and interest in reading at this age is the primary goal, as your child gains early phonic skills (understanding how letters  or groups of letters are associated with a sound). Make it fun!

It's natural to be concerned! Some babies are more responsive and engage frequently, while others are naturally more observant & quiet, processing information internally.

Remember, your baby typically starts to respond to you in the first 3 months of life. They will startle to sounds and respond to your voice. As they get into the 7 to 12 month range they are turning in the direction of their name being called. Their demeanor becomes more and more interactive as they approach one year. 

‍

An occasional lack of engagement is normal, but if it's frequent and you're feeling concerned, reaching out to a speech therapist to ask more questions is a great next step.

‍

• Offer practical tips for creating a supportive environment.
• Suggest activities that can enhance communication skills.
• Emphasize the role of parents in reinforcing therapy practices.

I recommend creating a supportive environment at home that encourages communication. This can include engaging in activities that promote language skills, reinforcing therapy practices, and being patient and responsive to your child’s communication attempts.

I offer speech and language services to children between the ages of 18 months to 18 years

Techniques vary based on the specific sound and the child’s needs. Some strategies include auditory awareness (listening to sound differences), visual cues (like watching the therapist’s mouth or looking at picture cards), and tactile feedback (like feeling the throat vibrate for certain sounds).
‍

They might find success with playful techniques too, like pretending to be animals or robots.

Your baby will begin to explore more and more consonant + vowel combinations, and eventually these expressions will turn into meaningful words! 

Yes, occasional stuttering (disfluent speech) can be a part of normal language development for toddlers as they learn to speak in more complex sentences. They have so many smart and creative thoughts running through their minds! However, if it persists, they appear aware of their disfluencies and it causes frustration, or is accompanied by other speech issues, it’s a good idea to seek advice from a speech-language pathologist.

Break down your instructions into simpler steps, using familiar vocabulary words during daily routines, such as:

• getting dressed
• cooking a meal
• playing a game

Using visual picture cues along with your verbal instructions can improve your child’s understanding, too.

‍

• Discuss the convenience and accessibility of teletherapy.
• Highlight how teletherapy can be as effective as in-person sessions.
• Mention the comfort for the child in being in a familiar environment.

Teletherapy allows children to receive therapy in the comfort and security of their home, which can be particularly beneficial for those with ASD. Teletherapy also offers flexibility in scheduling and can be just as effective as in-person sessions, making it a great option for many families

I help children with..

• Down Syndrome
• Autism Spectrum
• Down Syndrome
• Genetic Disorders

• Social Skills
• Communication Skills

• Speech Delays
• Articulation Disorders
• Motor Speech/Apraxia
• Language Comprehension
  
• Stuttering and more...

Speech sound disorders can impact reading and writing skills because they involve phonetic awareness, or the understanding that words are made up of individual sounds.
‍

If a child has trouble with certain speech sounds, they may struggle to sound out words when reading or spell words correctly when writing. It’s important to address these issues as early as possible to support your child’s academic success.

• Explain the assessment process to identify individual needs and strengths.
• Describe how therapy plans are personalized.
• Discuss the ongoing evaluation and adjustment of therapy strategies.

‍

It begins with a thorough assessment to understand their individual strengths and challenges. From there, I develop a personalized therapy plan that evolves over time. Regular evaluations ensure that we are always working in the most effective way to support their communication growth.

If your child has been evaluated by another certified speech-language pathologist within the last year, I can review it. This will determine if there is adequate information to be able to establish a plan and begin treatment, without conducting another evaluation.

• Discuss the methods used to track and evaluate progress.
• Explain how goals are set and adjusted over time.
• Mention any tools or assessments used to measure improvements.

Progress is measured through a combination of standardized assessments, observational evaluations, and regular check-ins with both the child and their family. Goals are set collaboratively and reviewed regularly to ensure they remain relevant and achievable. I also use specific tools designed for tracking speech and language development in children with ASD.

The Initial Evaluation allows 90 minutes to assess multiple areas for an accurate understanding of your child's skills. Test scores may not be obtained within that timeframe, but I can still create a treatment plan using other sources like parent reports, clinical observation, and oral motor exams.

Assessment of your child’s progress is an ongoing process and I continue it throughout your child’s plan of care.

Siblings can be wonderful allies in therapy. They can engage in recommended activities at home, serve as role models for communication, and participate in joint therapy sessions when appropriate. I encourage inclusive activities that foster a supportive environment and help siblings understand and empathize with each other.

I'll help you incorporate home practice into your daily routine! With my suggestions, your child's skills will transfer more easily in your home, community, and other settings. 

For example, you can write 5 speech words on a sticky note and say them before or after brushing teeth each night. Encourage your child to do this 7 days a week and you’ve helped them practice 40 times that week!

• Elaborate on how speech therapy can impact social skills.
• Discuss the integration of social skill training in therapy sessions.
• Explain the connection between communication abilities and social interaction.

Absolutely. While the primary focus is on communication, speech therapy naturally extends to social skills. We work on understanding social cues, turn-taking, and appropriate responses in social situations. These skills are vital for building relationships and interacting effectively in various settings.

Yes, I provide a comprehensive written report of your child’s Initial Assessment which includes background information/parent concerns, test scores, clinical observations, long and short-term goals, a general plan of care, and therapy recommendations. Then, a 6 month Progress Report with updates on goals will be written, and after 12 months, a Re-Evaluation will be completed.

No, I do not provide swallowing or feeding therapy at this time. I’m happy to pass along a referral in your area, if needed.

The number of sessions per week will vary depending on your child’s needs. Typical frequency of treatment is 1x/week at 45 minutes in length.After a thorough assessment, I will develop your child’s treatment plan and determine frequency.

• Share your commitment to continuous learning and professional development.
• Mention any specific journals, conferences, or networks you engage with.
• Explain how new findings are integrated into your therapy approach.
  

I'm committed to lifelong learning. Aside from the continuing education that is required to maintain my credentials through the American Speech & Language Association, I also participate in professional networks, and stay updated through academic journals and conferences. This  education ensures my therapy approaches remain current and effective, integrating the latest research and best practices.

A Speech-Language Pathologist (also known as SLP or Speech Therapist), is an expert in communication who holds a masters degree in an accredited program. SLPs prevent, assess, and treat adults and children who experience problems with; speech sounds, language skills, social communication, voice, fluency, feeding and swallowing.

My clients are often surprised at just how well online speech therapy works for them. Studies show that it achieves the same or better results as in-person treatment.

Being present inside your child's home environment offers me valuable insight, and more directly connects parent involvement!

• High speed internet connection 

• Computer or laptop preferred (Ipad or mobile device can be an alternative option)
• You don’t need any extra special equipment

No, Bravo Online Speech Therapy is a Teletherapy only practice.

Not much different at all actually! This is my specialty, and the pure mission of Bravo! Speech Therapy. 

I use many of the same materials (toys, games, books, etc) that I would use in an In-Person session. I provide individualized evaluation and treatment with the same quality of care. You, as the parent, will have a stronger presence during Teletherapy sessions, assisting your child for improved motivation and participation.

Your involvement allows for an ease in carryover of your child’s skills into the home setting. As your therapist, being able to have a window into your child’s natural environment gives me a unique and valuable perspective. This allows me to provide a more individualized plan of care for your family.

Teletherapy allows for more flexibility in scheduling, ease in carryover of home practice, and prompt communication with Heather during the session. All of this can add up to more effective therapy for your child.

People also enjoy being in the comfort of their own home, and decreased travel time.

As a professional SLP of 14 years, I take privacy seriously. 

Bravo Online Speech Therapy LLC protects personal health information by adhering to strict confidentiality policies and taking necessary precautions to safeguard the information from unauthorized access or disclosure.

Bravo maintains a secure, fully HIPAA compliant data storage system via SimplePractice platform.

No, I don’t accept insurance currently. Bravo accepts private pay clients only. Upon request, I can provide you a 'Superbill' that is formatted for insurance companies to provide coverage retroactively.

• 20 minute Meet & Greet = no cost
• 90 minute Initial Evaluation + written report = $150
• 45 minute Treatment Session + home programming = $90

Private payment for speech services is made via credit card through Bravo’s payment processor (Stripe). After you’ve scheduled your Initial Evaluation, you will complete required paperwork in your client portal. You will fill out your credit card information and sign a form to authorize payments via credit card.

Payment will be processed at the completion of each therapy session.

Soon after your credit card is charged, you will receive an updated invoice detailing service and payment information. The invoice will be available to you in your client portal.

A Superbill is a document provided to you containing information you need, to work directly with your insurance plan.

It is different from a typical invoice or receipt because it provides additional information, including; Client’s contact information, speech therapist name and credentials, CPT code for the service, ICD-10 code for diagnosis, fee for the service paid by the client, and more.

A Superbill can be provided at any time after your child’s completed service. You can then fill it out and submit it to your insurance company for possible reimbursement.

Early intervention with a therapist is best, to learn how your child can improve their speech skills.

You can also practice with your child at home by responding positively to all of their communication attempts; repeating what they do/say or giving verbal praise 'I like how you tried to tell me!'.

Babies aged 7 months to 1 year are babbling long strings of sounds, like bababa, mamama, dadada. They begin saying a few meaningful words around age 1 to express themselves, like dada, mama, dog, hi, up. The ‘words’ they try to say may not be clear to the listener, as many sounds are still developing. 

By 18 months, a child is speaking anywhere between 20 to 200 words. This can vary greatly from child to child, as some children spend more of their developmental energy on motor or other communication skills.

Consult an SLP if your child does not speak at least 50-75 words by 2 years old.

It’s common to compare your older child to your younger child, however, every child develops at a different speed! Boys tend to develop a little slower than girls, but this difference is very insignificant. 

If you have concerns for your younger child, having an evaluation done is a great way to discover if they’re in need of speech therapy. Learning more can be helpful in decreasing worry you may feel. 

A frontal lisp is when the tongue pokes out between the front teeth (sometimes sounding like a ‘th’ sound). This type of lisp is considered normal in children until about age 4 ½  years. It may be appropriate to treat this type of lisp earlier than 4 ½ depending on the child’s abilities, speech understandability, etc. A speech evaluation can be a great way to determine if therapy is recommended.

A lateral lisp is when the air travels across the sides of the tongue and escapes into the cheeks, making a ‘slushy’ sound. This type of lisp is not considered part of normal development and should be treated as soon as possible. I recommended scheduling an appointment right away to determine if treatment is needed. 

Some types of disfluencies (stuttering) are considered typical at certain ages and there’s no need to worry. Stuttering typically begins around 2-6 years of age, lasting less than 6 months. It usually presents as repeated phrases or words with little to no awareness, and during a natural peak in speech-language development. 

Oftentimes disfluencies increase when a child is tired, excited, or feeling rushed. However, an evaluation is recommended if your child’s stuttering increases, they exhibit frustration or avoidance in speaking situations, they tense up their face or body when speaking, or there is a family history of stuttering.

Your child’s hearing is an important part of speech-language development and should be tested if you have concerns. 

Seek an appointment with a certified Audiologist if your child exhibits the following warning signs; not responding to loud background noise, not responding to their name being called, reduced verbal speech skills or development, preferring the TV to be very loud.

Using sign language, or gestures, with any child will not inhibit their verbal speech. In fact, it could even enhance your child’s ability to communicate. 

Current research shows that providing your child with a different/alternative way to express themselves (sign language, gestures), can decrease communication frustration (reduced meltdowns) and may actually improve motivation for verbal communication.

Chat with me if you’d like to discuss further!

Each child’s plan of care is unique to them. Some children require an Initial Evaluation only, followed by home recommendations to the family. But for many, treatment sessions are recommended.

The duration of therapy depends on many factors; severity of the child’s difficulties, diagnosis, health history, and progress in therapy.

Yes! Bravo Online Speech Therapy is a private pay service and separate from school services.

‍

Getting private therapy in tandem with existing services through your school district can be very beneficial!School therapy focuses more on communication skills as they relate to the educational setting, whereas private therapy can focus on more functional communication needs in home and community settings.

‍

I work collaboratively with your school speech therapist to make sure therapy goals are in alignment with your child's plan of care.

No, speech therapists can provide assessments and treatment without a doctor’s referral.However, some health insurers require a referral from your child’s primary physician before they will provide coverage.

Speech sound development is a gradual process. Babies typically start by cooing and making gurgling sounds. By their first birthday, they can often say a few simple words.

During toddlerhood, vocabulary expands rapidly, and by age 3 or 4, most children can use sentences and understand most of what's said to them.

Mastering all speech sounds may take until they're 7 or 8. Remember, children develop at different rates, and that's okay.

Most babies start babbling between 6 and 9 months. It's an exciting milestone when your baby begins to experiment with sounds, which can include "ba", "da", "ma", and more.

They are learning how to use their vocal cords, lips, and tongue. It's a significant step toward the development of meaningful speech.

Children experience an exciting language burst between the ages 18 months-3 years, with two-word sentences (“Daddy go”) beginning to emerge around age 2. By age 3, most toddlers can use sentences of at least 3 words or more, understand simple instructions, and be understood by familiar adults most of the time.

Children’s language becomes more complex between the ages of 3-5. They start to use longer sentences, can carry on conversations, and their speech is usually understandable to most (with some sounds still mispronounced).

They begin to understand and use prepositions, possessives, and often start to understand the concept of past, present, and future tenses.

• Explain the concept of neurodiversity and its importance.
• Highlight the focus on strengths and capabilities, rather than deficits.
• Discuss the respect for individual differences and communication styles.
  
  It means supporting each child's unique strengths and communication styles. This approach is not about 'fixing' someone, but rather about understanding and respecting the diverse ways of experiencing the world that comes with Autism. We focus on enhancing their abilities and providing tools to navigate challenges.
  

You have two ways; Meet & Greet or Initial Evaluation. The Meet & Greet is a free 20 minute video chat where we can get to know each other. You can voice your concerns, and determine if Teletherapy is right for your family. 

But If you already know you’d like an assessment, and want to get on the schedule faster, book an Initial Evaluation. Use the online scheduling system for both.  Please reach me at heather@bravospeechtherapy.com with any questions.

If your child struggles to make certain sounds, is consistently difficult to understand compared to same aged peers, or has frustration when not understood, they may have a speech sound disorder.
‍

For example, they might substitute one sound for another (”wabbit” for “rabbit”). It’s normal for children to mispronounce sounds as part of their development, but when these patterns persist past the typical age range, treatment may be necessary.
‍

It’s important to get a speech evaluation to determine the need for therapy. Early intervention can make a big difference!

It's common to be concerned about your baby's speech. Babies typically start babbling between 6 and 9 months.

If your baby isn't exploring their voice by 7 months, it would be best to consult with a speech therapist and learn more.

Your baby’s hearing may be an underlying issue that could go unnoticed at this age. This is something worth ruling out!

While it’s normal for children to develop at their own pace, significant delays in speech and language development should not be ignored. If your toddler uses fewer words than most children their age, doesn’t make eye contact, doesn’t understand simple instructions, or isn’t combining words to make sentences, it may be beneficial to consult with an SLP.

Engage your child in conversations, ask open-ended questions, and introduce new vocabulary. Reading together is particularly beneficial at this age. Encourage story-telling and imaginative play to promote narrative skills.

• Outline what sensory processing support entails.
• Explain the impact of sensory sensitivities on communication and behavior.
• Describe examples of sensory accommodations and their benefits.
  
  By identifying and adapting to each child’s sensory needs, we can create a more comfortable space for them. This support helps in reducing distractions and enhancing their ability to focus and engage during therapy sessions.
  

I often experience a high demand for after-school appointments and may have a waiting list for 3:00pm or 4:00pm appointments.

You can use the online scheduling system to request a Meet & Greet or Initial Evaluation.

Reading together, singing songs, and playing rhyming games are all excellent ways to help your child practice their speech sounds. You can also practice specific sounds using toys or pictures (”lets find all the toys that start with /s/”). Your therapist can provide you with specific ideas or worksheets to help at home.
‍

Make it fun and part of your everyday activities. Remember, practice, patience, and positive reinforcement are key.

One of the best ways to encourage language development is through interaction. Talk to your baby often, describe your actions, sing songs, and read picture books. Imitate your baby's sounds (babble back to them!) and maintain eye contact.

Your voice and attention not only help language development but also strengthen your bond.

Create plenty of opportunities for your child to talk during your everyday routines. Engage them in conversation, ask open-ended questions, and use a variety of words to describe things in the world around you.

Reading together and using play as learning time can be especially beneficial, and fun!

Absolutely, having an imaginary friend is a normal part of childhood for many kids. It’s a sign of a healthy imagination and can be a tool for children to practice their social and language skills.

As they get older, they will more clearly learn the difference between fantasy and reality.

• List typical challenges like literal interpretation of language and difficulty with non-verbal cues.
• Address the variability in communication abilities among individuals with ASD.
• Emphasize the importance of personalized approaches to address these challenges.

Some challenges might be interpreting language literally, difficulties with social cues and non-verbal communication, and varied verbal abilities. My role is to identify and understand these challenges for each individual and tailor our therapy sessions to address and support these specific needs

I am currently licensed to provide services to families residing in Washington State, Oregon, and California.

A Speech-Language Pathologist, or SLP, works with children to identify speech sound issues, develop a customized therapy plan, and provide targeted exercises to improve their speech.
‍

The traditional articulation therapy approach may involve demonstrating how to make certain sounds, practicing syllables, words, and sentences, and conversational speech. They use games or activities to make the process fun!
‍

The SLP will also provide you with education and guidance to  help your kiddo at home.

• Use simple language to label your toddler’s emotions (“You’re happy because…”) and validate their feelings.
• Picture books and stories are a great way to talk about different emotions.
• You can teach simple signs or use pictures to help your child express different feelings.
• Some children enjoy drawing their emotions on paper.

Read to your child every day! Point out letters and words in their favorite books, and environment. Encourage your child to draw and write also.

Enjoyment and interest in reading at this age is the primary goal, as your child gains early phonic skills (understanding how letters  or groups of letters are associated with a sound). Make it fun!

It's natural to be concerned! Some babies are more responsive and engage frequently, while others are naturally more observant & quiet, processing information internally.

Remember, your baby typically starts to respond to you in the first 3 months of life. They will startle to sounds and respond to your voice. As they get into the 7 to 12 month range they are turning in the direction of their name being called. Their demeanor becomes more and more interactive as they approach one year. 

‍

An occasional lack of engagement is normal, but if it's frequent and you're feeling concerned, reaching out to a speech therapist to ask more questions is a great next step.

‍

• Offer practical tips for creating a supportive environment.
• Suggest activities that can enhance communication skills.
• Emphasize the role of parents in reinforcing therapy practices.

I recommend creating a supportive environment at home that encourages communication. This can include engaging in activities that promote language skills, reinforcing therapy practices, and being patient and responsive to your child’s communication attempts.

I offer speech and language services to children between the ages of 18 months to 18 years

Techniques vary based on the specific sound and the child’s needs. Some strategies include auditory awareness (listening to sound differences), visual cues (like watching the therapist’s mouth or looking at picture cards), and tactile feedback (like feeling the throat vibrate for certain sounds).
‍

They might find success with playful techniques too, like pretending to be animals or robots.

Your baby will begin to explore more and more consonant + vowel combinations, and eventually these expressions will turn into meaningful words! 

Yes, occasional stuttering (disfluent speech) can be a part of normal language development for toddlers as they learn to speak in more complex sentences. They have so many smart and creative thoughts running through their minds! However, if it persists, they appear aware of their disfluencies and it causes frustration, or is accompanied by other speech issues, it’s a good idea to seek advice from a speech-language pathologist.

Break down your instructions into simpler steps, using familiar vocabulary words during daily routines, such as:

• getting dressed
• cooking a meal
• playing a game

Using visual picture cues along with your verbal instructions can improve your child’s understanding, too.

‍

• Discuss the convenience and accessibility of teletherapy.
• Highlight how teletherapy can be as effective as in-person sessions.
• Mention the comfort for the child in being in a familiar environment.

Teletherapy allows children to receive therapy in the comfort and security of their home, which can be particularly beneficial for those with ASD. Teletherapy also offers flexibility in scheduling and can be just as effective as in-person sessions, making it a great option for many families

I help children with..

• Down Syndrome
• Autism Spectrum
• Down Syndrome
• Genetic Disorders

• Social Skills
• Communication Skills

• Speech Delays
• Articulation Disorders
• Motor Speech/Apraxia
• Language Comprehension
  
• Stuttering and more...

Speech sound disorders can impact reading and writing skills because they involve phonetic awareness, or the understanding that words are made up of individual sounds.
‍

If a child has trouble with certain speech sounds, they may struggle to sound out words when reading or spell words correctly when writing. It’s important to address these issues as early as possible to support your child’s academic success.

• Explain the assessment process to identify individual needs and strengths.
• Describe how therapy plans are personalized.
• Discuss the ongoing evaluation and adjustment of therapy strategies.

‍

It begins with a thorough assessment to understand their individual strengths and challenges. From there, I develop a personalized therapy plan that evolves over time. Regular evaluations ensure that we are always working in the most effective way to support their communication growth.

If your child has been evaluated by another certified speech-language pathologist within the last year, I can review it. This will determine if there is adequate information to be able to establish a plan and begin treatment, without conducting another evaluation.

• Discuss the methods used to track and evaluate progress.
• Explain how goals are set and adjusted over time.
• Mention any tools or assessments used to measure improvements.

Progress is measured through a combination of standardized assessments, observational evaluations, and regular check-ins with both the child and their family. Goals are set collaboratively and reviewed regularly to ensure they remain relevant and achievable. I also use specific tools designed for tracking speech and language development in children with ASD.

The Initial Evaluation allows 90 minutes to assess multiple areas for an accurate understanding of your child's skills. Test scores may not be obtained within that timeframe, but I can still create a treatment plan using other sources like parent reports, clinical observation, and oral motor exams.

Assessment of your child’s progress is an ongoing process and I continue it throughout your child’s plan of care.

Siblings can be wonderful allies in therapy. They can engage in recommended activities at home, serve as role models for communication, and participate in joint therapy sessions when appropriate. I encourage inclusive activities that foster a supportive environment and help siblings understand and empathize with each other.

I'll help you incorporate home practice into your daily routine! With my suggestions, your child's skills will transfer more easily in your home, community, and other settings. 

For example, you can write 5 speech words on a sticky note and say them before or after brushing teeth each night. Encourage your child to do this 7 days a week and you’ve helped them practice 40 times that week!

• Elaborate on how speech therapy can impact social skills.
• Discuss the integration of social skill training in therapy sessions.
• Explain the connection between communication abilities and social interaction.

Absolutely. While the primary focus is on communication, speech therapy naturally extends to social skills. We work on understanding social cues, turn-taking, and appropriate responses in social situations. These skills are vital for building relationships and interacting effectively in various settings.

Yes, I provide a comprehensive written report of your child’s Initial Assessment which includes background information/parent concerns, test scores, clinical observations, long and short-term goals, a general plan of care, and therapy recommendations. Then, a 6 month Progress Report with updates on goals will be written, and after 12 months, a Re-Evaluation will be completed.

No, I do not provide swallowing or feeding therapy at this time. I’m happy to pass along a referral in your area, if needed.

The number of sessions per week will vary depending on your child’s needs. Typical frequency of treatment is 1x/week at 45 minutes in length.After a thorough assessment, I will develop your child’s treatment plan and determine frequency.

• Share your commitment to continuous learning and professional development.
• Mention any specific journals, conferences, or networks you engage with.
• Explain how new findings are integrated into your therapy approach.
  

I'm committed to lifelong learning. Aside from the continuing education that is required to maintain my credentials through the American Speech & Language Association, I also participate in professional networks, and stay updated through academic journals and conferences. This  education ensures my therapy approaches remain current and effective, integrating the latest research and best practices.

A Speech-Language Pathologist (also known as SLP or Speech Therapist), is an expert in communication who holds a masters degree in an accredited program. SLPs prevent, assess, and treat adults and children who experience problems with; speech sounds, language skills, social communication, voice, fluency, feeding and swallowing.

My clients are often surprised at just how well online speech therapy works for them. Studies show that it achieves the same or better results as in-person treatment.

Being present inside your child's home environment offers me valuable insight, and more directly connects parent involvement!

• High speed internet connection 

• Computer or laptop preferred (Ipad or mobile device can be an alternative option)
• You don’t need any extra special equipment

No, Bravo Online Speech Therapy is a Teletherapy only practice.

Not much different at all actually! This is my specialty, and the pure mission of Bravo! Speech Therapy. 

I use many of the same materials (toys, games, books, etc) that I would use in an In-Person session. I provide individualized evaluation and treatment with the same quality of care. You, as the parent, will have a stronger presence during Teletherapy sessions, assisting your child for improved motivation and participation.

Your involvement allows for an ease in carryover of your child’s skills into the home setting. As your therapist, being able to have a window into your child’s natural environment gives me a unique and valuable perspective. This allows me to provide a more individualized plan of care for your family.

Teletherapy allows for more flexibility in scheduling, ease in carryover of home practice, and prompt communication with Heather during the session. All of this can add up to more effective therapy for your child.

People also enjoy being in the comfort of their own home, and decreased travel time.

As a professional SLP of 14 years, I take privacy seriously. 

Bravo Online Speech Therapy LLC protects personal health information by adhering to strict confidentiality policies and taking necessary precautions to safeguard the information from unauthorized access or disclosure.

Bravo maintains a secure, fully HIPAA compliant data storage system via SimplePractice platform.

No, I don’t accept insurance currently. Bravo accepts private pay clients only. Upon request, I can provide you a 'Superbill' that is formatted for insurance companies to provide coverage retroactively.

• 20 minute Meet & Greet = no cost
• 90 minute Initial Evaluation + written report = $150
• 45 minute Treatment Session + home programming = $90

Private payment for speech services is made via credit card through Bravo’s payment processor (Stripe). After you’ve scheduled your Initial Evaluation, you will complete required paperwork in your client portal. You will fill out your credit card information and sign a form to authorize payments via credit card.

Payment will be processed at the completion of each therapy session.

Soon after your credit card is charged, you will receive an updated invoice detailing service and payment information. The invoice will be available to you in your client portal.

A Superbill is a document provided to you containing information you need, to work directly with your insurance plan.

It is different from a typical invoice or receipt because it provides additional information, including; Client’s contact information, speech therapist name and credentials, CPT code for the service, ICD-10 code for diagnosis, fee for the service paid by the client, and more.

A Superbill can be provided at any time after your child’s completed service. You can then fill it out and submit it to your insurance company for possible reimbursement.

Early intervention with a therapist is best, to learn how your child can improve their speech skills.

You can also practice with your child at home by responding positively to all of their communication attempts; repeating what they do/say or giving verbal praise 'I like how you tried to tell me!'.

Babies aged 7 months to 1 year are babbling long strings of sounds, like bababa, mamama, dadada. They begin saying a few meaningful words around age 1 to express themselves, like dada, mama, dog, hi, up. The ‘words’ they try to say may not be clear to the listener, as many sounds are still developing. 

By 18 months, a child is speaking anywhere between 20 to 200 words. This can vary greatly from child to child, as some children spend more of their developmental energy on motor or other communication skills.

Consult an SLP if your child does not speak at least 50-75 words by 2 years old.

It’s common to compare your older child to your younger child, however, every child develops at a different speed! Boys tend to develop a little slower than girls, but this difference is very insignificant. 

If you have concerns for your younger child, having an evaluation done is a great way to discover if they’re in need of speech therapy. Learning more can be helpful in decreasing worry you may feel. 

A frontal lisp is when the tongue pokes out between the front teeth (sometimes sounding like a ‘th’ sound). This type of lisp is considered normal in children until about age 4 ½  years. It may be appropriate to treat this type of lisp earlier than 4 ½ depending on the child’s abilities, speech understandability, etc. A speech evaluation can be a great way to determine if therapy is recommended.

A lateral lisp is when the air travels across the sides of the tongue and escapes into the cheeks, making a ‘slushy’ sound. This type of lisp is not considered part of normal development and should be treated as soon as possible. I recommended scheduling an appointment right away to determine if treatment is needed. 

Some types of disfluencies (stuttering) are considered typical at certain ages and there’s no need to worry. Stuttering typically begins around 2-6 years of age, lasting less than 6 months. It usually presents as repeated phrases or words with little to no awareness, and during a natural peak in speech-language development. 

Oftentimes disfluencies increase when a child is tired, excited, or feeling rushed. However, an evaluation is recommended if your child’s stuttering increases, they exhibit frustration or avoidance in speaking situations, they tense up their face or body when speaking, or there is a family history of stuttering.

Your child’s hearing is an important part of speech-language development and should be tested if you have concerns. 

Seek an appointment with a certified Audiologist if your child exhibits the following warning signs; not responding to loud background noise, not responding to their name being called, reduced verbal speech skills or development, preferring the TV to be very loud.

Using sign language, or gestures, with any child will not inhibit their verbal speech. In fact, it could even enhance your child’s ability to communicate. 

Current research shows that providing your child with a different/alternative way to express themselves (sign language, gestures), can decrease communication frustration (reduced meltdowns) and may actually improve motivation for verbal communication.

Chat with me if you’d like to discuss further!

Each child’s plan of care is unique to them. Some children require an Initial Evaluation only, followed by home recommendations to the family. But for many, treatment sessions are recommended.

The duration of therapy depends on many factors; severity of the child’s difficulties, diagnosis, health history, and progress in therapy.

Yes! Bravo Online Speech Therapy is a private pay service and separate from school services.

‍

Getting private therapy in tandem with existing services through your school district can be very beneficial!School therapy focuses more on communication skills as they relate to the educational setting, whereas private therapy can focus on more functional communication needs in home and community settings.

‍

I work collaboratively with your school speech therapist to make sure therapy goals are in alignment with your child's plan of care.

No, speech therapists can provide assessments and treatment without a doctor’s referral.However, some health insurers require a referral from your child’s primary physician before they will provide coverage.

Speech sound development is a gradual process. Babies typically start by cooing and making gurgling sounds. By their first birthday, they can often say a few simple words.

During toddlerhood, vocabulary expands rapidly, and by age 3 or 4, most children can use sentences and understand most of what's said to them.

Mastering all speech sounds may take until they're 7 or 8. Remember, children develop at different rates, and that's okay.

Most babies start babbling between 6 and 9 months. It's an exciting milestone when your baby begins to experiment with sounds, which can include "ba", "da", "ma", and more.

They are learning how to use their vocal cords, lips, and tongue. It's a significant step toward the development of meaningful speech.

Children experience an exciting language burst between the ages 18 months-3 years, with two-word sentences (“Daddy go”) beginning to emerge around age 2. By age 3, most toddlers can use sentences of at least 3 words or more, understand simple instructions, and be understood by familiar adults most of the time.

Children’s language becomes more complex between the ages of 3-5. They start to use longer sentences, can carry on conversations, and their speech is usually understandable to most (with some sounds still mispronounced).

They begin to understand and use prepositions, possessives, and often start to understand the concept of past, present, and future tenses.

• Explain the concept of neurodiversity and its importance.
• Highlight the focus on strengths and capabilities, rather than deficits.
• Discuss the respect for individual differences and communication styles.
  
  It means supporting each child's unique strengths and communication styles. This approach is not about 'fixing' someone, but rather about understanding and respecting the diverse ways of experiencing the world that comes with Autism. We focus on enhancing their abilities and providing tools to navigate challenges.
  

You have two ways; Meet & Greet or Initial Evaluation. The Meet & Greet is a free 20 minute video chat where we can get to know each other. You can voice your concerns, and determine if Teletherapy is right for your family. 

But If you already know you’d like an assessment, and want to get on the schedule faster, book an Initial Evaluation. Use the online scheduling system for both.  Please reach me at heather@bravospeechtherapy.com with any questions.

If your child struggles to make certain sounds, is consistently difficult to understand compared to same aged peers, or has frustration when not understood, they may have a speech sound disorder.
‍

For example, they might substitute one sound for another (”wabbit” for “rabbit”). It’s normal for children to mispronounce sounds as part of their development, but when these patterns persist past the typical age range, treatment may be necessary.
‍

It’s important to get a speech evaluation to determine the need for therapy. Early intervention can make a big difference!

It's common to be concerned about your baby's speech. Babies typically start babbling between 6 and 9 months.

If your baby isn't exploring their voice by 7 months, it would be best to consult with a speech therapist and learn more.

Your baby’s hearing may be an underlying issue that could go unnoticed at this age. This is something worth ruling out!

While it’s normal for children to develop at their own pace, significant delays in speech and language development should not be ignored. If your toddler uses fewer words than most children their age, doesn’t make eye contact, doesn’t understand simple instructions, or isn’t combining words to make sentences, it may be beneficial to consult with an SLP.

Engage your child in conversations, ask open-ended questions, and introduce new vocabulary. Reading together is particularly beneficial at this age. Encourage story-telling and imaginative play to promote narrative skills.

• Outline what sensory processing support entails.
• Explain the impact of sensory sensitivities on communication and behavior.
• Describe examples of sensory accommodations and their benefits.
  
  By identifying and adapting to each child’s sensory needs, we can create a more comfortable space for them. This support helps in reducing distractions and enhancing their ability to focus and engage during therapy sessions.
  

I often experience a high demand for after-school appointments and may have a waiting list for 3:00pm or 4:00pm appointments.

You can use the online scheduling system to request a Meet & Greet or Initial Evaluation.

Reading together, singing songs, and playing rhyming games are all excellent ways to help your child practice their speech sounds. You can also practice specific sounds using toys or pictures (”lets find all the toys that start with /s/”). Your therapist can provide you with specific ideas or worksheets to help at home.
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Make it fun and part of your everyday activities. Remember, practice, patience, and positive reinforcement are key.

One of the best ways to encourage language development is through interaction. Talk to your baby often, describe your actions, sing songs, and read picture books. Imitate your baby's sounds (babble back to them!) and maintain eye contact.

Your voice and attention not only help language development but also strengthen your bond.

Create plenty of opportunities for your child to talk during your everyday routines. Engage them in conversation, ask open-ended questions, and use a variety of words to describe things in the world around you.

Reading together and using play as learning time can be especially beneficial, and fun!

Absolutely, having an imaginary friend is a normal part of childhood for many kids. It’s a sign of a healthy imagination and can be a tool for children to practice their social and language skills.

As they get older, they will more clearly learn the difference between fantasy and reality.

• List typical challenges like literal interpretation of language and difficulty with non-verbal cues.
• Address the variability in communication abilities among individuals with ASD.
• Emphasize the importance of personalized approaches to address these challenges.

Some challenges might be interpreting language literally, difficulties with social cues and non-verbal communication, and varied verbal abilities. My role is to identify and understand these challenges for each individual and tailor our therapy sessions to address and support these specific needs

I am currently licensed to provide services to families residing in Washington State, Oregon, and California.

A Speech-Language Pathologist, or SLP, works with children to identify speech sound issues, develop a customized therapy plan, and provide targeted exercises to improve their speech.
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The traditional articulation therapy approach may involve demonstrating how to make certain sounds, practicing syllables, words, and sentences, and conversational speech. They use games or activities to make the process fun!
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The SLP will also provide you with education and guidance to  help your kiddo at home.

• Use simple language to label your toddler’s emotions (“You’re happy because…”) and validate their feelings.
• Picture books and stories are a great way to talk about different emotions.
• You can teach simple signs or use pictures to help your child express different feelings.
• Some children enjoy drawing their emotions on paper.

Read to your child every day! Point out letters and words in their favorite books, and environment. Encourage your child to draw and write also.

Enjoyment and interest in reading at this age is the primary goal, as your child gains early phonic skills (understanding how letters  or groups of letters are associated with a sound). Make it fun!

It's natural to be concerned! Some babies are more responsive and engage frequently, while others are naturally more observant & quiet, processing information internally.

Remember, your baby typically starts to respond to you in the first 3 months of life. They will startle to sounds and respond to your voice. As they get into the 7 to 12 month range they are turning in the direction of their name being called. Their demeanor becomes more and more interactive as they approach one year. 

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An occasional lack of engagement is normal, but if it's frequent and you're feeling concerned, reaching out to a speech therapist to ask more questions is a great next step.

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• Offer practical tips for creating a supportive environment.
• Suggest activities that can enhance communication skills.
• Emphasize the role of parents in reinforcing therapy practices.

I recommend creating a supportive environment at home that encourages communication. This can include engaging in activities that promote language skills, reinforcing therapy practices, and being patient and responsive to your child’s communication attempts.

I offer speech and language services to children between the ages of 18 months to 18 years

Techniques vary based on the specific sound and the child’s needs. Some strategies include auditory awareness (listening to sound differences), visual cues (like watching the therapist’s mouth or looking at picture cards), and tactile feedback (like feeling the throat vibrate for certain sounds).
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They might find success with playful techniques too, like pretending to be animals or robots.

Your baby will begin to explore more and more consonant + vowel combinations, and eventually these expressions will turn into meaningful words! 

Yes, occasional stuttering (disfluent speech) can be a part of normal language development for toddlers as they learn to speak in more complex sentences. They have so many smart and creative thoughts running through their minds! However, if it persists, they appear aware of their disfluencies and it causes frustration, or is accompanied by other speech issues, it’s a good idea to seek advice from a speech-language pathologist.

Break down your instructions into simpler steps, using familiar vocabulary words during daily routines, such as:

• getting dressed
• cooking a meal
• playing a game

Using visual picture cues along with your verbal instructions can improve your child’s understanding, too.

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• Discuss the convenience and accessibility of teletherapy.
• Highlight how teletherapy can be as effective as in-person sessions.
• Mention the comfort for the child in being in a familiar environment.

Teletherapy allows children to receive therapy in the comfort and security of their home, which can be particularly beneficial for those with ASD. Teletherapy also offers flexibility in scheduling and can be just as effective as in-person sessions, making it a great option for many families

I help children with..

• Down Syndrome
• Autism Spectrum
• Down Syndrome
• Genetic Disorders

• Social Skills
• Communication Skills

• Speech Delays
• Articulation Disorders
• Motor Speech/Apraxia
• Language Comprehension
  
• Stuttering and more...

Speech sound disorders can impact reading and writing skills because they involve phonetic awareness, or the understanding that words are made up of individual sounds.
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If a child has trouble with certain speech sounds, they may struggle to sound out words when reading or spell words correctly when writing. It’s important to address these issues as early as possible to support your child’s academic success.

• Explain the assessment process to identify individual needs and strengths.
• Describe how therapy plans are personalized.
• Discuss the ongoing evaluation and adjustment of therapy strategies.

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It begins with a thorough assessment to understand their individual strengths and challenges. From there, I develop a personalized therapy plan that evolves over time. Regular evaluations ensure that we are always working in the most effective way to support their communication growth.

If your child has been evaluated by another certified speech-language pathologist within the last year, I can review it. This will determine if there is adequate information to be able to establish a plan and begin treatment, without conducting another evaluation.

• Discuss the methods used to track and evaluate progress.
• Explain how goals are set and adjusted over time.
• Mention any tools or assessments used to measure improvements.

Progress is measured through a combination of standardized assessments, observational evaluations, and regular check-ins with both the child and their family. Goals are set collaboratively and reviewed regularly to ensure they remain relevant and achievable. I also use specific tools designed for tracking speech and language development in children with ASD.

The Initial Evaluation allows 90 minutes to assess multiple areas for an accurate understanding of your child's skills. Test scores may not be obtained within that timeframe, but I can still create a treatment plan using other sources like parent reports, clinical observation, and oral motor exams.

Assessment of your child’s progress is an ongoing process and I continue it throughout your child’s plan of care.

Siblings can be wonderful allies in therapy. They can engage in recommended activities at home, serve as role models for communication, and participate in joint therapy sessions when appropriate. I encourage inclusive activities that foster a supportive environment and help siblings understand and empathize with each other.

I'll help you incorporate home practice into your daily routine! With my suggestions, your child's skills will transfer more easily in your home, community, and other settings. 

For example, you can write 5 speech words on a sticky note and say them before or after brushing teeth each night. Encourage your child to do this 7 days a week and you’ve helped them practice 40 times that week!

• Elaborate on how speech therapy can impact social skills.
• Discuss the integration of social skill training in therapy sessions.
• Explain the connection between communication abilities and social interaction.

Absolutely. While the primary focus is on communication, speech therapy naturally extends to social skills. We work on understanding social cues, turn-taking, and appropriate responses in social situations. These skills are vital for building relationships and interacting effectively in various settings.

Yes, I provide a comprehensive written report of your child’s Initial Assessment which includes background information/parent concerns, test scores, clinical observations, long and short-term goals, a general plan of care, and therapy recommendations. Then, a 6 month Progress Report with updates on goals will be written, and after 12 months, a Re-Evaluation will be completed.

No, I do not provide swallowing or feeding therapy at this time. I’m happy to pass along a referral in your area, if needed.

The number of sessions per week will vary depending on your child’s needs. Typical frequency of treatment is 1x/week at 45 minutes in length.After a thorough assessment, I will develop your child’s treatment plan and determine frequency.

• Share your commitment to continuous learning and professional development.
• Mention any specific journals, conferences, or networks you engage with.
• Explain how new findings are integrated into your therapy approach.
  

I'm committed to lifelong learning. Aside from the continuing education that is required to maintain my credentials through the American Speech & Language Association, I also participate in professional networks, and stay updated through academic journals and conferences. This  education ensures my therapy approaches remain current and effective, integrating the latest research and best practices.

A Speech-Language Pathologist (also known as SLP or Speech Therapist), is an expert in communication who holds a masters degree in an accredited program. SLPs prevent, assess, and treat adults and children who experience problems with; speech sounds, language skills, social communication, voice, fluency, feeding and swallowing.

My clients are often surprised at just how well online speech therapy works for them. Studies show that it achieves the same or better results as in-person treatment.

Being present inside your child's home environment offers me valuable insight, and more directly connects parent involvement!

• High speed internet connection 

• Computer or laptop preferred (Ipad or mobile device can be an alternative option)
• You don’t need any extra special equipment

No, Bravo Online Speech Therapy is a Teletherapy only practice.

Not much different at all actually! This is my specialty, and the pure mission of Bravo! Speech Therapy. 

I use many of the same materials (toys, games, books, etc) that I would use in an In-Person session. I provide individualized evaluation and treatment with the same quality of care. You, as the parent, will have a stronger presence during Teletherapy sessions, assisting your child for improved motivation and participation.

Your involvement allows for an ease in carryover of your child’s skills into the home setting. As your therapist, being able to have a window into your child’s natural environment gives me a unique and valuable perspective. This allows me to provide a more individualized plan of care for your family.

Teletherapy allows for more flexibility in scheduling, ease in carryover of home practice, and prompt communication with Heather during the session. All of this can add up to more effective therapy for your child.

People also enjoy being in the comfort of their own home, and decreased travel time.

As a professional SLP of 14 years, I take privacy seriously. 

Bravo Online Speech Therapy LLC protects personal health information by adhering to strict confidentiality policies and taking necessary precautions to safeguard the information from unauthorized access or disclosure.

Bravo maintains a secure, fully HIPAA compliant data storage system via SimplePractice platform.

No, I don’t accept insurance currently. Bravo accepts private pay clients only. Upon request, I can provide you a 'Superbill' that is formatted for insurance companies to provide coverage retroactively.

• 20 minute Meet & Greet = no cost
• 90 minute Initial Evaluation + written report = $150
• 45 minute Treatment Session + home programming = $90

Private payment for speech services is made via credit card through Bravo’s payment processor (Stripe). After you’ve scheduled your Initial Evaluation, you will complete required paperwork in your client portal. You will fill out your credit card information and sign a form to authorize payments via credit card.

Payment will be processed at the completion of each therapy session.

Soon after your credit card is charged, you will receive an updated invoice detailing service and payment information. The invoice will be available to you in your client portal.

A Superbill is a document provided to you containing information you need, to work directly with your insurance plan.

It is different from a typical invoice or receipt because it provides additional information, including; Client’s contact information, speech therapist name and credentials, CPT code for the service, ICD-10 code for diagnosis, fee for the service paid by the client, and more.

A Superbill can be provided at any time after your child’s completed service. You can then fill it out and submit it to your insurance company for possible reimbursement.

Early intervention with a therapist is best, to learn how your child can improve their speech skills.

You can also practice with your child at home by responding positively to all of their communication attempts; repeating what they do/say or giving verbal praise 'I like how you tried to tell me!'.

Babies aged 7 months to 1 year are babbling long strings of sounds, like bababa, mamama, dadada. They begin saying a few meaningful words around age 1 to express themselves, like dada, mama, dog, hi, up. The ‘words’ they try to say may not be clear to the listener, as many sounds are still developing. 

By 18 months, a child is speaking anywhere between 20 to 200 words. This can vary greatly from child to child, as some children spend more of their developmental energy on motor or other communication skills.

Consult an SLP if your child does not speak at least 50-75 words by 2 years old.

It’s common to compare your older child to your younger child, however, every child develops at a different speed! Boys tend to develop a little slower than girls, but this difference is very insignificant. 

If you have concerns for your younger child, having an evaluation done is a great way to discover if they’re in need of speech therapy. Learning more can be helpful in decreasing worry you may feel. 

A frontal lisp is when the tongue pokes out between the front teeth (sometimes sounding like a ‘th’ sound). This type of lisp is considered normal in children until about age 4 ½  years. It may be appropriate to treat this type of lisp earlier than 4 ½ depending on the child’s abilities, speech understandability, etc. A speech evaluation can be a great way to determine if therapy is recommended.

A lateral lisp is when the air travels across the sides of the tongue and escapes into the cheeks, making a ‘slushy’ sound. This type of lisp is not considered part of normal development and should be treated as soon as possible. I recommended scheduling an appointment right away to determine if treatment is needed. 

Some types of disfluencies (stuttering) are considered typical at certain ages and there’s no need to worry. Stuttering typically begins around 2-6 years of age, lasting less than 6 months. It usually presents as repeated phrases or words with little to no awareness, and during a natural peak in speech-language development. 

Oftentimes disfluencies increase when a child is tired, excited, or feeling rushed. However, an evaluation is recommended if your child’s stuttering increases, they exhibit frustration or avoidance in speaking situations, they tense up their face or body when speaking, or there is a family history of stuttering.

Your child’s hearing is an important part of speech-language development and should be tested if you have concerns. 

Seek an appointment with a certified Audiologist if your child exhibits the following warning signs; not responding to loud background noise, not responding to their name being called, reduced verbal speech skills or development, preferring the TV to be very loud.

Using sign language, or gestures, with any child will not inhibit their verbal speech. In fact, it could even enhance your child’s ability to communicate. 

Current research shows that providing your child with a different/alternative way to express themselves (sign language, gestures), can decrease communication frustration (reduced meltdowns) and may actually improve motivation for verbal communication.

Chat with me if you’d like to discuss further!

Each child’s plan of care is unique to them. Some children require an Initial Evaluation only, followed by home recommendations to the family. But for many, treatment sessions are recommended.

The duration of therapy depends on many factors; severity of the child’s difficulties, diagnosis, health history, and progress in therapy.

Yes! Bravo Online Speech Therapy is a private pay service and separate from school services.

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Getting private therapy in tandem with existing services through your school district can be very beneficial!School therapy focuses more on communication skills as they relate to the educational setting, whereas private therapy can focus on more functional communication needs in home and community settings.

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I work collaboratively with your school speech therapist to make sure therapy goals are in alignment with your child's plan of care.