Mommy and Me Language and Learning Group

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Child's Play Therapy Services is hosting a group for children with language delays and their caregivers. We are providing a 6 week session that uses play based intervention to support language, social, and play development. We are creating a space for children and their caregivers to learn together. This group will be led by one of our Speech-Language Pathologists, Dr. Gina Pretzer.

Who: Children aged 36 months or younger who have a diagnosed or suspected language delay, and their parents

When: Tuesdays from 12:00-1:00 pm from November 7th - December 19th (We will be off the week of 11/21)

Cost is $400 for the 6 week program

If you are interested in joining us, please fill out the form below. We will contact you to set up a time for a brief chat to make sure the group is the right fit for you and your child.

Child's Name *

Child's Date of Birth *

YYYY

Child's Age (months) *

Caregiver's name *

Caregiver's phone number *

Caregiver's email address *

How is your child communicating?

Column 1

Using single words

Using signs

Combining 2 words together

Asking for help

Requesting actions or objects

Naming familiar people or objects

Responding to their name

Following routine directions

Identifying familiar people or objects

Making choices

How is your child playing and interacting with others?

Column 1

Greeting others (waving, saying hi/bye)

Responding when others speak to them

Looking at others when they speak to them

Answering simple questions

Playing next to others

Playing with others

Taking turns during play

Imaginary play

Engaging in songs and finger plays (e.g., Itsy Bitsy Spider)

Playing people games (e.g., Peek-a-boo)

Is there anything else you would like us to know about your child?

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Child's Play Therapy Services, PC . Report Abuse

Forms