Social Peer Group Interest Form: Spring 2022

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Please complete the following information regarding social group opportunities for your neurodivergent kiddo (including Autism, ADHD, Social Language Challenges, etc.). Adult to child ratio will average 1:3 with a tentative maximum of eight children per group.

Our spring session will run for 6 weeks: May 2-June 9, 2022. During the week of June 6th, each group will have a small end of session celebration. Dates for our summer session will be available soon.

Location: 6563 Riverdale Street, San Diego, CA, 92120

Sponsored by: TideSpeak Language & Speech Therapy, Sanford Speech & Learning Center, and Just Once Language & Speech Therapy.

Email address: *

Parent's Name *

Parent's Phone Number *

We offer different groups for kids based on their grade level and/or needs. Please choose the one group that fits your child best. The associated time/instructor is also listed. *

Toddler TidePools age 2-3 (currently Thursdays at 9am)

Preschool age 3-5 (TBD)

Kinder-2nd grade (Mon. 5-6:00pm, TideSpeak)

3rd-5th grade (Tues. 4-5:00pm, Sanford Speech)

6-8th grade (Tues. 5:15-6:15pm, Sanford Speech)

AAC Users and Multimodal Communicators, 6-12th grade (Wed. 5:30-6:30pm, Just Once SLP)

High School Group (9-12th grade) (Thurs. at 5-6:00pm, TideSpeak)

Reading Enrichment Clubs (K-8th grade) TBD

Group Feeding (Picky eaters and/or problem feeders), TBD

Group speech and language, TBD

Community outings (zoo, museums, etc)., TBD

Other:

Required

Please list ages of your child/children: *

Each session will be 60 minutes led by trained professionals (Speech-Language Pathologists, Occupational Therapists, Enrichment Class Teachers, etc.) Each session may include the following types of activities: exercise/movement, targeted social skill each week, games, crafts, science, conversation opportunities, follow up activities for home, etc. *

YES! This is what I am looking for.

We might be interested...

Not what we are looking for, we'll pass

I still have questions...

Required

We offer many ways to participate in our groups. Please let us know which you might prefer. Prices include all materials needed for activities and a small end of session celebration. *

1-session pass, $78

1-month, 4 session pass, $295 (valued at $312)

Entire 6-week session pass, $420 (valued at $468)

Other:

Required

Please list any additional comments/thoughts/ideas: *

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