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Pediatric Rehabilitation

Billings Clinic Pediatric Rehabilitation is a comprehensive outpatient program that provides diagnosis, treatment and referral services for children up to age 18.

Billings Clinic Pediatric Rehabilitation Program diagnoses include, but are not limited to:

  • Attention Deficit-Hyperactivity Disorder (ADHD)
  • Hearing Impairments
  • Developmental delays
  • Learning difficulties
  • Pervasive Development Disorder (PDD)
  • Motor coordination problems/dyspraxia
  • Orthopedic conditions
  • Speech/Language impairments
  • Central auditory processing problems
  • Autism
  • Cerebral Palsy
  • Spinal Cord Injury
  • Brain Injury
  • Chromosomal abnormalities
  • Congenital anomalies
  • Feeding and swallowing disorders
  • Fetal alcohol syndrome
  • Fragile X syndrome
  • Genetic disorders
  • Juvenile rheumatoid arthritis
  • Neurological disorders
  • Sensory integration dysfunction

Pediatric Rehabilitation Therapists

These Billings Clinic physical, occupational and speech therapists have special training in pediatrics.

Tanya Sciuchetti
Pediatric Occupational Therapist
Sensory Integration Specialist

Krista Bakkedahl
Pediatric Physical Therapist

Kristy Price
Pediatric Speech Language Pathologist

Carol Morse
Pediatric Speech Language Pathologist
Specializes in pediatric feeding and swallow disorders

Occupational Therapy

The following are symptoms (RED FLAGS) which may warrant an Occupational Therapy evaluation:

  • Coordination Difficulties
  • Clumsiness, Frequent falls, bumping into people or objects
  • Frequent fatigue or apparent weakness as compared to peers
  • Difficulty with fine motor skills/handwriting
  • Difficulty manipulating small toys
  • Difficulty with dressing, using utensils, or grooming activities
  • Difficulty with transitions or adjusting to changes in routine
  • Limited play skills
  • Limited Social interaction
  • Tendency to become overwhelmed easily
  • Frequent tantrums

Physical Therapy

Pediatric physical therapists are trained in the treatment and management of conditions of infants, children, and adolescents with a variety of congenital, developmental, neuromuscular, skeletal, or acquired disorders and injuries.

Some of the services our pediatric physical therapists provide to help young patients achieve their goals include:

  • development and enhancement of gross motor skills
  • management of muscle tone
  • building or rebuilding muscle strength
  • improvement of posture/postural control
  • Pre-gait and gait training
  • improve range of motion
  • improve balance and coordination
  • improve body awareness and body alignment
  • building cardiopulmonary endurance
  • relieve or manage pain

Speech-Language Therapy

How does your child hear and talk?

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Hearing and Understanding

Birth –3 Months

  • Startles to loud sounds
  • Quiets or smiles when spoken to
  • Seems to recognize your voice and quiets if crying
  • Increases or decreases sucking behavior in response to sound

4-6 Months

  • Moves eyes in direction of sounds
  • Responds to changes in tone of your voice
  • Notices toys that make sounds
  • Pays attention to music

7 Months to 1 Year

  • Enjoys games like peek-a-boo and pat-a-cake
  • Turns and looks in direction of sounds
  • Listens when spoken to
  • Recognizes words for common items (Cup, Shoe, Juice)
  • Begins to responds to requests (Come here, Want more?)

1-2 Years

  • Points to a few body parts when asked
  • Follows simple commands and understands simple questions (Roll the ball, Kiss the baby, where’s your shoe?)
  • Listens to simple stories, songs and rhymes
  • Points to pictures in a book when named

2-3 Years

  • Understands differences in meaning (Go-Stop, In-On, Big-Little, Up-Down)
  • Follows two requests (Get the book and put it on the table)

3-4 Years

  • Hears when you call from another room
  • Hears television or radio at the same loudness level as other family members
  • Understands simple, “who?, what?, where?, why?” questions

4-5 Years

  • Pays attention to a short story and answers simple questions about it
  • Hears and understands most of what is said at home or in school


Birth – 3 Months

  • Makes pleasure sounds (cooing, gooing)
  • Cries differently for different needs
  • Smiles when sees you

4-6 Months

  • Babbling sounds are more speech-like
  • With many different sounds, including P,B and M
  • Vocalizes excitement and displeasure
  • Makes gurgling sounds when left alone and when playing with you

7 Months – 1 Year

  • Babbling has both long and short groups of sounds “Tata Upup Bibibibi”
  • Uses speech or non-crying sounds to get and keep attention
  • Imitates different speech sounds
  • Has 1-2 words (Bye-bye, Mama, Dada) although they may not be clear

1-2 Years

  • Says more words every month
  • Uses 1-2 word questions (where kitty? Go bye-bye? What’s that?)
  • Puts 2 words together (more cookie, no juice, mommy book?)
  • Uses many different consonant sounds of the beginning of words

2-3 Years

  • Has a word for almost everything
  • Uses 2-3 word “sentences” to talk about and ask for things
  • Speech is understood by familiar listeners most of the time
  • Often asks for or directs attention to objects by naming them

3-4 Years

  • Talks about activities at school or at friend’s homes
  • People outside the family usually understand the child’s speech
  • Uses a lot of sentences that have 4 or more words
  • Usually talks easily without repeating syllables or words

4-5 Years

  • Voice sounds clear like other children’s
  • Uses sentences that give lots of details (E.G., “I like to read my books”)
  • Tells stories that stick to topic
  • Communicates easily with other children and adults
  • Says most sounds correctly except a few (L,S,R,V, Z, J, CH, SH, TH)
  • Uses the same grammar as the rest of the family

*Above information from the American Speech and Hearing Association

*Every child is unique and has an individual rate of development. The above norms represent, on average, the age by which MOST children will accomplish the above listed skills. Children do not typically master all items in a category until they reach the upper age range. Just because your child has not accomplished one skill within an age range does not mean the child has a disorder.

Caring for Kids

Read our new blog called Caring for Kids, written by parents who are also pediatricians.

They tackle challenges you also may have with your children. We’d like to offer advice, insight and assistance - from a source you can trust.

Great topics like fever, bedwetting, tantrums and what to do if you lose your child in Costco.

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