20Q: Sensory and Fine Motor Activities for Children with Communication and Sensory Processing Disorders

From the Desk of Ann Kummer

Children with communication disorders often have other neurodevelopmental issues, such as sensory processing disorders (SPD) and fine motor delays. Those who have SPD tend to be either hypersensitive or hyposensitive to various types of sensory stimuli. Because SPD and fine motor deficits impact the child’s communication development and behavior, it is important that speech-language pathologists (SLPs) are aware of the signs of these disorders and facilitate a referral for occupational therapy as needed.  

Although occupational therapists are trained to work with sensory integration issues, SLPs can incorporate various activities into each speech-language therapy session to improve the child’s sensory skills and thus behavior. In this issue, Dr. Celeste Roseberry-McKibbin provides information that SLPs need to recognize these disorders. In addition, she gives us great suggestions of activities to increase sensory integration during speech-language therapy sessions.

In addition to this article, Dr. Roseberry-McKibbin has made many great contributions to our field over the years! Here is more information about her:

Celeste Roseberry-McKibbin received her Ph.D. from Northwestern University.  She is a Professor of Communication Sciences and Disorders at California State University, Sacramento.  Dr. Roseberry is also currently a part-time itinerant speech pathologist in San Juan Unified School District where she provides direct services to students from preschool through high school.  Dr. Roseberry’s primary research interests are in the areas of assessment and treatment of culturally and linguistically diverse students with communication disorders as well as service delivery to students from low-income backgrounds.  She has over 70 publications, including 17 books, and has made over 700 presentations at the local, state, national, and international levels.  Dr. Roseberry is a Fellow of ASHA, and winner of ASHA’s Certificate of Recognition for Special Contributions in Multicultural Affairs as well as the Excellence in Diversity Award from CAPCSD. She received ASHA’s Honors of the Association. She received the national presidential Daily Point of Light Award for her volunteer work in building literacy skills of children in poverty. She lived in the Philippines as the daughter of Baptist missionaries from ages 6 to 17.

Now…read on, learn, and enjoy!

Ann W. Kummer, PhD, CCC-SLP, FASHA, 2017 ASHA Honors
Contributing Editor 

Browse the complete collection of 20Q with Ann Kummer CEU articles at www.speechpathology.com/20Q

20Q: Sensory and Fine Motor Activities for Children with
Communication and Sensory Processing Disorders

Learning Outcomes

After this course, readers will be able to: 

• Describe the nature of sensory processing disorder (SPD) and fine motor deficits and how they impact students’ communication and behavior
• List 2-3 signs of SPD to look for during speech-language screenings to facilitate appropriate referrals to occupational therapists
• Describe at least 10 materials and activities that address SPD and fine motor deficits as well as communication disorders simultaneously during therapy sessions.

Celeste Roseberry-McKibbin

1. How did you as an SLP get interested in the whole topic of Sensory Processing Disorder (SPD)? I thought that SPD was the province of Occupational Therapists (OTs).

My son Mark was diagnosed with SPD in kindergarten. His fine and visual motor skills were in the first percentile. He started kindergarten when he was almost 6. We had him in Montessori during the year before kindergarten.   His verbal skills were quite advanced, but he couldn’t read or write and was diagnosed with dyslexia and dysgraphia as well as ADHD and SPD.  We started him in private OT (he didn’t qualify through the schools) in fall of kindergarten, and I took him weekly for two years. This was my proverbial baptism by fire into the world of SPD and fine motor deficits. The silver lining was that because I learned so much about these issues as a mother, I’ve been able to apply my knowledge to the students on my speech caseload in the schools. It has been tremendously helpful, especially during and after Covid, and I feel blessed to share what I’ve learned with others. (Side note: all that therapy really worked! Mark was academically at the bottom of his public school kindergarten class but recently graduated with a Master’s from University of Oxford in global health care equity).

2. What exactly is SPD?

Let’s start with sensory integration. Sensory integration is the neurological process that organizes sensations from one’s own body and the environment into useable information. Basically, we filter and process information from the outside and also from inside our own bodies (STAR Institute, 2023). Our ability to process sensory data usually doesn’t require conscious thought. We don’t have to concentrate on smelling, tasting, or seeing, for example.

Pioneering OT Dr. Jean Ayres (1979) likened SPD to a neurological “traffic jam” that prevents certain parts of the brain from receiving the information needed to correctly interpret sensory information. Put differently, SPD is an irregularity or disorder in brain function that makes it difficult to integrate sensory input efficiently (Galina-Simal et al., 2020). Soon, we’ll talk more about the eight sensory systems and difficulties that children with SPD can have that involve these systems.  

Among other things, children with SPD often have developmental motor disorder and experience difficulty with gross and fine motor tasks (O’ Gallagher, 2023). For example, my son Mark didn’t walk until he was almost 1.5 years old. He couldn’t zip up his jacket, tie his shoes, or kick a ball until he was older than most children. These children often appear clumsy.

3. What causes SPD?

Possible causes are genetics, maternal substance abuse during pregnancy, birth trauma, viruses, and lack of environmental stimulation. Other possible causes include prematurity and neurological disorders (STAR Institute, 2023).

4. Is SPD associated with other diagnoses?

Yes! It is frequently present in students with autism spectrum disorder.  As previously mentioned, my son Mark had ADHD and severe dyslexia in addition to SPD; this is a common profile (Delgado-Lobete et al., 2020). SPD can also accompany intellectual disability and Developmental Language Disorder (DLD) (Taal et al., 2013). Many of my students over the years with DLD had accompanying SPD.

5. Why do so many of the speech-language students I’m seeing today have SPD and fine motor delays in addition to their speech and language disorders?

We know that during Covid, so many children were isolated and spent many hours on screens (Pearson, 2023). Schools were giving out electronic devices to everyone because school was online. Few children were physically writing, drawing, or coloring, so fine motor skills suffered tremendously. Children weren’t able to go out and play and engage in physical activity at the needed levels. Sensory deprivation was rampant.

6. The behavior problems in my speech kids have skyrocketed in the last few years, and things are so much more challenging these days.  How are sensory and fine motor deficits affecting children’s behavior?

I’ve been an SLP my whole adult life and was blessed to work face to face with children through the pandemic from March of 2020 to March of 2021 with no vaccine. I didn’t get sick, thankfully, during that year, but I was very relieved to get vaccinated in March of 2021!  Thus, I’ve personally experienced working directly with students before, during, and after Covid 19. I’m amazed at how much harder it is for me as an SLP to control students’ behavior. I serve students who are ages 3-18, and even the little children are so much more challenging. I recently was with a 7-year-old girl, “Juanita,” who was pulling on me so hard I was afraid her arm was going to wrench out of its socket. I’ve been on the floor coaxing kids out from under the table…. it’s such a different world.

All that said, there are multiple variables contributing to the behavior issues we are seeing in our students today. We know about the trauma, isolation, lack of stimulation…it’s easy to forget that this includes lack of sensory stimulation as well as lack of activities that promote fine motor skills. Our children have so much screen time that their sensory and fine motor skills have suffered along with their speech and language skills as I said earlier.

Mostly, I’m finding that children today have tremendous difficulty sitting and focusing. Gone are the old days of kids sitting there and quietly doing worksheets! And this may not be all bad. Adding sensory and fine motor activities to our speech-language therapy sessions is so helpful in increasing students’ engagement and behavior. I’m finding that when they are able to “get the wiggles out,” they are much calmer, and that therapy goes more smoothly.

I’ve had to be much more patient and realize that due to the need to manage behaviors, it is harder to accomplish as much progress on speech and language skills as I did before Covid. This has been difficult  to accept, but I’m a lot more at peace because I realize that we are living in a different, more challenging world. I think that as SLPs, we are a hardworking and perfectionistic group that beats ourselves up a lot. Everyone is tired of hearing about self-care, but it’s true. We need to pat ourselves on the back and be proud of what we do accomplish in the midst of the challenging behaviors presented by the students on our caseloads.

7. I’m not an OT and I have enough on my plate without having to worry about sensory and fine motor issues in the students on my speech caseload!

I hear you! Because life isn’t hard enough, right?

Sometimes OT services can be scarce. In the district I worked in before my current one, there was literally one OT per 1,000 students. Though we are not trying to do the OT’s job, it is ideal for our speech-language students if we can incorporate sensory and fine motor activities into our therapy. There are so many fun, inexpensive activities and materials that I have easily incorporated into my speech and language therapy—and they take no extra time or effort. I will share those below. Though these activities are helpful for all students, they are especially helpful for students with SPD and fine motor delays. The ideas have made therapy a lot more fun and brought welcome improvements in my students’ behavior!

8. I know it is the job of the OT to diagnose SPD. But frequently, students who are struggling with learning challenges in the classroom are referred to me first. What signs do I look for? How can I make knowledgeable referrals to OTs and not waste their time?

I continue to find, as a part time public school itinerant SLP, that teachers often refer students to us first. We might not like hearing this, but it’s my personal clinical experience that teachers often find SLPs to be the most approachable individuals on the special education team—whether we like that or not! And no hiding in our therapy rooms at lunch! OK, I’m guilty as charged.

Here are some signs to look for if we think the child may have SPD and need a referral to an OT. We can easily and quickly screen for these things during a routine speech and language screener. We can look for writing difficulties that are more substantial than those of same-age peers. We can quickly screen for fine motor skills by “accidentally” spilling beads onto the therapy table and asking the child to help us pick them up. We can also hand them a doll or action figure and have the child help us button up an outfit. Does the child have difficulty with these tasks? I quickly screen for gross motor skills by having children catch a ball and hop up and down on one foot. Because my therapy room is right by the playground, I will play hopscotch with the children. I may ask them to kick a ball. This takes about 5 minutes and provides me with excellent information for making a knowledgeable referral to an OT. I’m careful to emphasize to OTs that this is their realm, not mine, but I just want to make sure I’m not overlooking anything that might help the child.

9. Wow, this is a lot to take in! Where do I start when I’m conducting speech-language therapy with a child with SPD?

We need to begin by thinking about the eight senses. The distal (far) senses tell us what is going on in the world around us. The five distal senses are visual, auditory, olfactory (smell), gustatory (taste), and tactile.

The three proximal (near) senses that tell us what’s going on in our own bodies are vestibular, proprioceptive, and interoceptive. The vestibular system helps control balance. Proprioception is perception or awareness of the position and movement of the body—our body’s ability to sense movement, action, and location. For example, we can close our eyes and touch our nose with our finger. Without looking, we can tell if we are standing on hard cement or soft grass.

Interoception helps children understand what is going on inside their own bodies. For example, children with SPD may not know that they are hungry or thirsty. They are frequently quite late to potty train. They may not sense that they are hot or cold.

We always want to start with the near senses. Children need to understand what is going on inside them before they are able to interact successfully with the outside environment. Because many children with SPD and DLD have low vocabularies, I like to talk about being hot or cold, hungry or full, thirsty or not, etc. I also ask if they are comfortable in their chairs.  If a child needs to go to the bathroom, I don’t make them wait till the end of the session.

I know it sounds so elementary to make sure that children are physically comfortable! But during our hectic days of back-to-back therapy sessions, it’s easy to forget some of these basics.

A practical tip I learned from a former student is that for many children with SPD, the plastic or wooden therapy chairs we have them sitting on are uncomfortable. Some of us have had much more success by allowing the children to sit on the floor on beanbag chairs. I make sure that the children have access to water. Food is another issue and we must be careful of allergies, so I’m very cautious there. I work with children experiencing substantial poverty and have sometimes given them a warm jacket or sweater because they don’t have one at home that they can bring to school.

Through these strategies, I am able to incorporate stimulation of the near senses so students will be comfortable enough to benefit from the speech-language activities during the therapy session. We all know that hungry, cold students can’t concentrate!

10. Are there any physical activities that I can have students safely engage in during therapy to help them “get the wiggles out” so they will focus better? I do worry about lawsuits in case something happens to a child.

Some SLPs have miniature trampolines with safety bars that they put up against a wall. These are generally very safe. I mentioned that my therapy room is right by the school playground, and sometimes I will walk, run, or play hopscotch with the children. Recently I had an 8-year-old girl drilling /r/ words while she did hopscotch outside. We can also target prepositions (during physical activities) like on, off, in, out, over, under, and others. We can make a hopscotch space in our therapy rooms with masking tape. Sometimes I’ve even had kids just jump or run in place. Children and adults should ideally get up from their chairs every half hour and move—even just a little movement helps maintain alertness.

I work with teen young men sex offenders who are out of Juvenile Hall and live in group homes. I do pushups with them, ballet stretches (some of them like those!), deep knee bends….we frequently walk outside and do therapy (for example, drilling on target sounds or working on increasing overall intelligibility). I realize that not all SLPs have access to outside spaces with sunshine and fresh air, and am grateful for my “outdoor therapy” that seems to work better than sitting at a table for an hour doing worksheets and drill.

Many children with SPD like to chew on things—including therapy materials and even their sleeves (Meier, 2020)! My son Mark used to do this a lot. We can give children Chewlry and other appropriate items to chew on. (Just google Chewlry and specific information will appear.)

11. Do fidget toys help?

I find fidget toys to be extremely helpful in keeping children’s hands busy. We can have them squeeze soft rubber balls, pull rubber bands, play with plastic slinkies….I love kinetic sand from Lakeshore Learning and will bury toys for children to dig out. Even my 5th graders love it! Sensory bins of beans and even shredded paper are fun too. I use Popits with my younger students, and these even work with 3-year-olds. I’ve used Popits (available on Amazon) for articulation drill as well as keeping children’s hands busy.  Play dough is a popular favorite, though it can be messy. For the children I work with, if play dough falls on the carpet, the last part of the therapy session is devoted to picking it up with Scotch tape. This is a great activity for fine motor skills!

12. Will you please explain the term over-responsive and the implications for our speech-language therapy sessions?

A child with SPD who is over-responsive can be thought of as “sensory defensive.” These children are easily overstimulated and may avoid active games, bright sunlight, loud noises, strong smells…they primarily need calming activities and plain environments where there is not too much on the walls (Ginsburg, 2022). These children benefit from therapy materials being brought out one at a time. I’ve worked with so many children who are overwhelmed and distracted if there are two activities or sets of materials on the therapy table simultaneously. I keep therapy materials and activities out of sight until I’m ready to use them. I also speak in soft, measured tones because if I am loud, these children can get very upset.

13. What does the term under-responsive mean and how does this apply to our speech-language therapy sessions?

Children who are under-responsive may appear passive and oblivious to outer stimuli. They manifest an underactive response of the nervous system and need alerting activities. These are typically the students I do physical activities with. I’m a big fan of Brain Gym and will often do physical activities where the students have to cross midline. For example, they and I will touch our left knee with our right hand and vice versa. We do this 10-15 times. We also do the “wave,” where we raise our hands up and wave them back and forth in a left to right motion. These children often like sitting on yoga balls instead of regular chairs because yoga chairs help them stay alert.  These simple activities are helpful for all children (and adults!) but especially for those who are under-responsive.

For articulation therapy with under-responsive children, I use Too Tarts sour candy spray for phonetic placement. This spray, which can be ordered on Amazon, is highly successful in motivating all children to drill on their articulation targets; however, under-responsive children with SPD especially benefit because the spray is so sour that it “wakes up” their articulators.

14. What is a sensory diet?

This term refers to the optimum sensory input that an individual needs to feel alert, exert effortless control, and exhibit optimal performance (Grogan, 2021). A sensory diet should include optimal breaks, routines, and adaptations. For many children, visual schedules are a very helpful part of their sensory diet. Structure and routine are also key components. With children with SPD, I try whenever possible to announce transitions to different tasks. Abrupt change is very difficult for children with SPD, and transitions help a lot.

15. It seems that SPD goes hand in hand with fine motor delays. Though I know OTs primarily handle this, what are my basic goals for addressing these delays during speech-language therapy sessions?

Our primary goals are to help the child 1) achieve appropriate body positioning, 2) achieve good shoulder stability (strength), and 3) increase muscle tone in the small muscles of the hand for improved writing and overall fine motor tasks.

16. What do appropriate body positioning and shoulder stability include?

For appropriate body positioning, when children are sitting at a table, they need to have their feet flat on a surface (not dangling from the chair), and they should be sitting straight with their hips and knees at 90-degree angles.

To help improve children’s shoulder stability, we can do wheelbarrow walks while we work on speech and language targets. We can also encourage them to lie on their stomachs on the floor and prop themselves up on their elbows while reading or practicing speech and language targets. This strengthens the shoulders.

17. What specific language skills can you target while you do sensory and fine motor activities?

There are so many! I focus on listening and following directions, vocabulary, in-depth description of attributes of objects, categories, and parts of speech. I work a lot on basic concepts for the classroom: top-bottom, left-right, first-second-third, over-under, beside, and other spatial and temporal concepts (Roseberry-McKibbin, 2023). I target verbs especially because research is consistent that children with DLD—in any language—manifest specific difficulty with verbs (Roseberry-McKibbin, 2022). I target antonyms and especially synonyms, because the vocabularies of children with DLD are concrete and limited. I also target turn taking and topic maintenance.

18. What sensory and fine motor activities do you recommend that I can easily incorporate into my therapy sessions?

Here are the basic principles: we are trying to incorporate smell, tactile, auditory, and visual stimulation (sensory) while also strengthening the small muscles of the fingers and hand (fine motor).

During the last few minutes of the therapy session, I will spray the therapy table with shaving cream. The kids love smearing the cream around the table! We then spray the table with water from a water bottle and they wipe up the mess with paper towels. They’ve had a fun sensory activity, the table is sanitized, and the room smells heavenly. The school I work in was built in 1958 and the ventilation isn’t great, so this works well! We don’t have a sink in the therapy room, so I take the kids outside and spray their hands with water from a spray bottle—we then dry them. This whole time, we are continuing to work on their speech and language targets.

If you have a sink available, handwashing with fragrant, fun soap sanitizes hands and helps work on sequencing skills. Add to this by having children squeeze fragrant hand cream out of a tube (fine motor exercise that strengthens hand and finger muscles).

Paint dots (also called Do-A-Dots; check on Amazon) are a major favorite with my students because they smell good (sensory) and target fine motor skills. It requires precision for students to press the spongy tips of the “pens” onto paper. The students enjoy the bright colors and I can also incorporate articulation drill.

A favorite is strawberry basket transfer. I get two strawberry baskets and fill one with fun objects. The students must use a clothespin to transfer objects one at a time from one strawberry basket to another. For each object, they must give the label, function, color, and composition (“This is a bottle cap made out of plastic and it’s green; you use it to keep liquid inside a bottle.”) This takes so much finger and hand muscle strength that some of my students have had to use two hands to squeeze the clothespin. This activity definitely strengthens the small muscles of the hand and fingers!

19. Can you recommend some other specific fun activities that target both sensory and fine motor skills?

If you visit my website lovetalkread.com, the home page has a clickable link that says Increasing Fine Motor Skills for Better Writing. There are dozens of activities there! For now, here are some more of my favorites:

Push toothpicks into Styrofoam and target concepts like push, poke, toothpick, wood, hard, soft.

Use flour, food coloring, and a few drops of water to create colorful pastes. Have students use Q-tips to create structures of dots and explain what the structures represent.

Use playdough (mentioned earlier) to roll out “carrots” and target concepts of long-longer-longest. Make playdough pancakes and discuss small—smaller-smallest.

Get bubble wrap and have students pop bubbles! This is so good for increasing finger strength. They can discuss if the popping sounds are loud or soft. For my preschoolers who use final consonant deletion, I encourage them to say “Pop! Pop!”

Have students toss a soft ball back and forth. They can discuss concepts like mine-yours as well as throw, up, down, across, over, under.

Use Melissa and Doug farms and other materials with latches and locks that require opening and closing. I’ve seen severely involved students be mesmerized with these materials for 30+ minutes. The materials definitely target fine motor skills.

Story boards (vinyl, flannel, Velcro) target vocabulary and narrative skills and help with fine motor skills. Go onto google.com and type in “story boards.” Ideas abound!

Have children tear off bits of blue masking tape and affix the pieces of tape to objects in the therapy room. Have children label these objects and describe their functions.

Use sidewalk chalk to write out new vocabulary and spelling words. Sidewalk chalk exercises the small muscles of the hand and fingers much more than other writing materials.

Slappy Hands can be ordered through Amazon. They are so engaging and I use them to target sensory and fine motor skills while children slap the rubber hands onto words in a book. We read the words and target articulation, vocabulary, and print awareness skills.

Remember: in all these activities, we are targeting not only speech and language, but also providing rich sensory experiences and increasing the strength of the small muscles of the hand and fingers.

20. Do you have any last words of encouragement for me? I so often feel overwhelmed with all the speech and language referrals and with how many students have SPD and fine motor deficits that can negatively impact their behavior during speech-language sessions.

I sure do. Remember that you are not alone and that even career veterans like me have had to scale back our expectations of how much we can accomplish during therapy sessions. We all try to hold high standards and obtain as many responses as possible during therapy, but progress is definitely slower with children with SPD and other issues that accompany communication disorders—especially in recent years.

I have learned two major things in recent years: first, improve behavior and communication skills through incorporating sensory and fine motor materials and activities into therapy sessions. I’m so encouraged that my free, fun, easy activities have truly worked for me as a practicing itinerant SLP working with students from ages 3-18!

The second thing that helps so much is to rejoice over the tiniest gains. For example, if I’m pushing into the preschool special day class, I’m elated when a 3-year-old with SPD and Down Syndrome is able to engage in a joint attention activity with me for even two seconds. During Covid I was seeing “Emma,” a 3-year-old with Down Syndrome, and I will never forget when she actually looked at the book Good Night Moon with me for five-six seconds!

Another example is a 3-year-old boy, Christopher, with intellectual disability, SPD, and severe childhood apraxia. When he wanted something, he’d pull on my sleeve and cry. I taught him to say “help please” instead, and was thrilled when he said “eh-ee!” instead of having a tantrum. He felt so empowered by this that when I had to say goodbye to him at Christmas, he cried and clung to me with all this might. Unvaccinated at the time, I hugged him hard back anyway and am so glad I did, because I never saw him again. In my area, families are highly mobile and some are unhoused.

These are examples of small gains that we need to be excited about. If we can do this, we will experience much more job satisfaction and less burnout. Most of all, the students we serve will receive more comprehensive, holistic services that target multiple areas of need.

Best wishes to you as you incorporate sensory and fine motor activities and materials into your therapy. You will enjoy therapy more, the students’ behavior will very likely be better, all their skills will improve, and OTs will love you! Please email me at celeste@csus.edu if you would like more ideas. Together we’ve got this!

References and Recommended Resources

Ahn, R.R., Miller, L.J., Milberger, S., & McIntosh, D.N. (2004). Prevalence of parents’ perceptions of sensory processing disorder among kindergarten children. American Journal of Occupational Therapy, 58, 287-293.

ALTA Language Services (2022). How has the COVID-19 pandemic affected children’s language development? https://www.altalang.com/beyond-words/lockdown-speech-in-english-for-students/

Ayres, J. (1979). Sensory integration and the child. Western Psychological Services.

Delgado-Lobete, L. et al. (2020). Sensory processing patterns in developmental coordination disorder, attention deficit hyperactivity disorder and typical development. Research in Developmental Disabilities, vol. 100. https://doi.org/10.1016/j.ridd.2020.103608t

Galina-Simal et al. (2020). Sensory processing disorder; Key points of a frequent alteration in neurodevelopmental disorders. Cogent Medicine, 7:1736829. https://doi/org/10.1080/2331205X.2020.173682

Ginsburg, J. (2022). Is your client an avoider or seeker? Sensory or bystander? The ASHA Leader, 27(4), July/August 2022, pp. 28-29.

Grogan, A. (2021). Which type of sensory diet does your kid need the most?  https://yourkidstable.com/sensory-diet/.

Karanth, P., Roseberry-McKibbin, C., & James, P. (2017a). Intervention for preschoolers with gross and fine motor delays: Practical strategies. San Diego, CA: Plural Publishing, Inc.

Karanth, P., Roseberry-McKibbin, C., & James, P. (2017b). Intervention for toddlers with gross and fine motor delays: Practical strategies. San Diego, CA: Plural Publishing, Inc.

Meier, M. (2020). Chewing devices for individuals with sensory processing disorder. South Carolina Junior Academy of Science. https://scholarexchange.furman.edu/scjas

Neville, H.J., Coffey, S.A., Holcomb, D.J., & Tallal, P. (1993). The neurobiology of sensory and language processing in language-impaired children. Journal of Cognitive Neuroscience, 5:2, 235-253.

Newmeyer, A.J. et al. (2009). Results of sensory profile in children with suspected childhood apraxia of speech. Physical and Occupational Therapy in Pediatrics, 2, 203-218.

O’Gallagher, A. (2023) Understanding sensory processing disorder in children: A guide for parents. https://www.spdfoundation.net/sensory-processing-disorder-in-children/

Owen, J. et al. (2013). Abnormal white matter microstructure in children with sensory processing disorder. NeuroImage: Clinical, 2, 844-853.

Pearson, F. (2023). ASHA members see more referrals—and communication challenges. The ASHA Leader Live, May 1, 2023.

Piek, J.P., & Dyck, J.S. (2004). Sensory-motor deficits in children with developmental coordination disorder, Attention Deficit Hyperactivity Disorder, and Autistic Disorder. Human Movement Science. Available at https://doi.org/10.1016/j.humov.2004.08.019

Roseberry-McKibbin, C. (2022). Multicultural students with special language needs: Practical strategies for assessment and intervention (6th ed.). Academic Communication Associates.

Roseberry-McKibbin, C. (2023). Love, talk, read to improve your child’s speech and language: Quick tips for busy caregivers. Crescendo Publishing.

STAR Institute (2023). Understanding sensory processing disorder. https://sensoryhealth.org/basic/understanding-sensory-processing-disorder

Taal, M.N., Rietman, A.B., Meulen, S.V., Schipper, M., & Dejonckere, P.H. (2013). Children with specific language impairment show difficulties in sensory modulation. Logopedics, Phoniatrics, Vocology, 38(2), 70-80.

Todihast, S.A., Mansuri, B., Bagheri, R., & Azimi, H. (2020). Provision of speech-language pathology services for the treatment of speech and language disorders during the Covid-19 pandemic: Problems, concerns, and solutions. International Journal of Pediatric Otorhinolaryngology, 13, 110262.