October 2025

• “I want to start at Little Fingers!”- future client
• “Laughter is the best medicine.” -Client in food school

GGRC Translation Services: GGRC prioritizes pairing families with a therapist who speaks their native language. In the event that this is not possible, GGRC provides a translator to allow families access to care.

The Little Hands team is dressing up for Halloween on Wednesday, 10/29. The “Farm Animals” theme was the winner this year!

Starting this month, we’ll be simplifying our end-of-session choices. Moving forward, clients will be able to choose from Pokémon cards or the treasure chest at the end of their session. We’ve decided to phase out treats, as we’ve noticed that having too many options can sometimes feel overwhelming or dysregulating for our clients. By streamlining the choices, we hope to keep the process fun, positive, and consistent for everyone.  Any leftover lollipops will still be available until they are gone on top of the fridge.

All evaluation folders should be filed in the black filing cabinet in the speech storage room.  Working files can be stored in the black filing cabinet in the conference room.

Google Meet sends transcription notes to everyone that is invited so please make sure you uncheck the box for each Google Meet meeting when doing a parent consultation so they receive appropriate notes directly from the therapist and not from Google AI.

We know how important it is to have clarity around both work flexibility and pay. To support this, we’ve created a simple visual that outlines our compensation structure. Our goal is to make things more transparent and easy to understand: Fee for Service Model

We have a Letter of Medical Necessity template on our drive. We’ve had a few family requests to provide additional documentation. Please check in with Kellie or Cierra if you have any questions.

Insurance Reporting Cheat Sheet– this is also on the Therapist Portal for easy access

OTs: We will not be ordering any additional supplies for the versions of the BOT-2 as we will phase out use of that assessment by the end of the year. Best practice is to stop using a previous version of an assessment within 12-18 months after the release of an updated version.  We are working on getting a BOT-3 travel for our public and private school students.  Stay tuned!

Emotional Regulation Games

Therapeutic Skills with Littles

For documentation purposes, if you’re meeting with other providers/teachers/ABA/AT specialist and it’s not going in as a consult charge and just a “met with school SLP in lieu of note” please have it documented in the SOAP section so other people have access and it makes it easier during progress report time.  See the photo linked here for reference.

Cierra’s Office Hours:

12-1 on Tuesdays are available for any sort of clinical support for OTs and STs. Admin is also welcome if in need of support in any way!

• I’m happy to jump into sessions to observe, review session video or case conference to help problem solve
• discuss any challenging cases
• behavior support ideas
• therapy ideas
• provide support/training for any clients using or needing assistive technology/visual supports
• discuss any clients you have language concerns/referral questions about
• support anyone with early invention clients
• review progress reports/IEPs/eval reports
• help navigate any complex family or school relationships
• increase multidisciplinary collaboration
• professional/career growth mentorship
• problem solve/support workplace relationships
• I have adjusted my schedule to take a more active role in director responsibilities so don’t be surprised if you see me in more OT meetings and/or participation in session observations – not meant to be alarming, meant to be supportive!

To keep things smooth and supportive for each other, here’s a quick guide for when to pass an email along from our families:

• Billing questions → Emily
• Clinical questions → Your department director
• Nuanced, tricky, or first-time scenarios → Loop in a director

Remember: When in doubt, ask a director.

Selective Mutism Association Annual Conference