MetroEHS Joins WDIV for Autism Awareness Month

a young woman surrounded by diverse group of happy kids

We are proud to sponsor Live in the D, and excited to have joined them this month to bring Autism Awareness.

Tati Amare:
As we watch children grow, we see them develop in many different ways, from infant to toddler to child. As they grow, we celebrate milestones like first steps or first words, but what if the child in your life hasn’t reached a milestone by a certain age or at all? That’s where our sponsor, MetroEHS can help families and children thrive when developmental challenges present themselves. Joining us now here from MetroEHS is our sponsor for Autism Awareness Month is Dawn Sterling, a board certified behavioral analyst with MetroEHS Pediatric Therapy. Good morning and thank you for being with us.

Dawn Sterling:
Good morning. Thank you for having me.

Tati Amare:
This is a lot to think about, but MetroEHS prides itself as a neighborhood therapy company that is accessible to everyone because you have 14 locations and 3 more on the way. Explain the work that you do with families and what makes MetroEHS unique.

Dawn Sterling:
Yes, so we are a pediatric therapy service provider and what really makes us unique is the different variety of services that we offer all in one location. So each neighborhood therapy center has a speech and language pathologist, occupational therapy, physical therapy, applied behavior analysis. We also have dieticians and mental health professionals working with us, and what really sets us apart is our feeding therapy program. So what we do, and its uniqueness, is this wrap around the whole child. So we focus on the whole child developmentally. So whatever a family may be concerned with or struggling with, we’ve got services and support for those families.

Tati Amare:
For every need. I like that. Now if I’m a parent at home and for family members of children, what are some signs that we should look for that may indicate that there may be developmental concerns with our children?

Dawn Sterling:
That’s a great question. So we look for what is called developmental milestones. So your pediatrician is a great person to get that resource from. So if you are at all concerned about your child meeting milestones, maybe they’re not meeting them in the timeframe that you expected, or maybe they had some of these milestones and they’re dropping off, you’re going to start with your pediatrician. They may recommend evaluations. Always pursue those. It’s better to rule out any concerns than to perhaps miss it.
Sometimes what’s recommended is behavior therapy. Applied behavior analysis is one type of therapy that can really help with children with developmental disabilities, and not just autism. These therapies, speech therapy, feeding therapy, occupational therapy, they are for a variety of diagnoses, global childhood developmental delay, any sort of developmental delay that your evaluators may see, there is a related service that can support these families.

Tati Amare:
All right. Now you’ve brought in some example of the items that you use to work with children. So walk us through these tools. I’m going to hold these up.

Dawn Sterling:
Thank you, Tati.

Tati Amare:
Of course.

Dawn Sterling:
MetroEHS is a collaborative pediatric center, so we collaborate with all of our service providers such as SLPs, or Speech Language Pathologists, that may help us design core boards for learners that are not communicating fully with their words yet. We also will collaborate with our occupational therapists on staff for things that may meet a young child’s sensory needs. We are movers and shakers, so sometimes we need to have things that we can play with in our hands, it might be scented to wake up some of those senses. We also have sensory oral chews. We work with a lot of very young kids and we know developmentally young children like to mouth on things.

Tati Amare:
Yeah, this is perfect.

Dawn Sterling:
So this is food grade silicone, it’s safe, it’s safer than the wooden puzzle piece that your toddler might be putting in their mouth. And then we do work on daily living skills, and this is from our OT department, as well. When children are learning to utilize a straw, this cup can be very helpful because we can squeeze it to give them a little bit of that liquid and really show them this is something you might want as we build up their ability to have independence with eating, drinking.

Tati Amare:
And all of that stuff.

Dawn Sterling:
Again, the whole child.

Tati Amare:
Yeah, definitely. Definitely. Okay, so I have to ask you before, because we’re just about running out of time, how rewarding is it for you to be in this position and have the impact with these kids?

Dawn Sterling:
It is the most incredible experience. We get to partner with families. The parents are a viable and valuable member of our treatment team, so we get to work with them and really see what their children and their families are achieving as a result of our therapies. So that is the biggest impact, is seeing progress with our kids.

Tati Amare:
That’s awesome. Dawn, thank you so much for being with us.

Dawn Sterling:
Thank you. Thank you for having me.

Tati Amare:
This is going to be helpful for a lot of families out there. Remember, MetroEHS has 14 locations and 3 more on the way across Metro Detroit. To find a location near you and to see how they can help your family, go to metroehs.com.

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April 14, 2026

When Should Physicians Refer a Child for Integrated Pediatric Therapy?

Why Integrated Therapy Models Can Improve Functional Outcomes in Pediatric Patients

Pediatric patients with developmental, neurological, behavioral, and sensory conditions rarely present with isolated deficits. In clinical practice, delays in motor function, communication, regulation, feeding, and adaptive behavior frequently overlap, influencing one another in ways that can complicate both diagnosis and treatment planning. Yet despite this reality, many children still enter care through fragmented referral pathways, receiving services across separate disciplines without a unified plan of care.

For physicians, this can create a familiar challenge: a child may be referred for speech concerns, but underlying sensory processing difficulties, motor impairments, or behavioral barriers may be limiting progress. Another patient may be receiving occupational therapy while untreated communication deficits continue to interfere with participation, safety, and family routines. When care is siloed, treatment goals may be addressed in isolation rather than in the context of the child’s overall functional development.

An integrated therapy model offers a more clinically aligned approach. By coordinating services such as Applied Behavior Analysis (ABA), Occupational Therapy (OT), Speech-Language Pathology (SLP), and Physical Therapy (PT) under one interdisciplinary framework, integrated care supports shared functional outcomes rather than disconnected discipline-specific objectives.

The Clinical Problem With Fragmented Pediatric Therapy

Children with autism spectrum disorder, global developmental delays, neurological diagnoses, genetic syndromes, feeding disorders, and sensory-behavioral challenges often require support in multiple developmental domains at the same time. Traditional referral patterns, however, can delay this process. Families may be referred sequentially, moving from one specialty to another over the course of weeks or months. In the meantime, opportunities for early, coordinated intervention may be missed.

This fragmented model can contribute to delayed progress, duplication of effort, inconsistent treatment strategies, and increased caregiver burden. Parents may be left trying to reconcile different home programs, communication methods, and therapeutic priorities across providers. Physicians, in turn, may receive updates from multiple sources without a single cohesive picture of the child’s functional status or trajectory.

What Is an Integrated Therapy Model?

An integrated therapy model brings multiple pediatric disciplines together within a coordinated plan of care. Rather than treating communication, mobility, sensory regulation, and behavior as separate issues to be addressed in parallel but independent tracks, the interdisciplinary team collaborates around shared goals tied to everyday function.

These goals may include functional communication, feeding independence, improved transitions, school readiness, social participation, gross motor mobility, or greater independence with activities of daily living. The emphasis is not simply on increasing therapy volume, but on aligning interventions so that each discipline reinforces the others.

For the referring physician, this model can improve both clinical clarity and continuity of care. Instead of scattered recommendations, the result is a more streamlined treatment course centered on measurable, meaningful progress.

Why Integrated Care Can Produce Faster Functional Gains

One of the primary advantages of integrated pediatric therapy is simultaneous skill development. A child is not required to “complete” one form of therapy before another begins. Instead, deficits across domains can be addressed concurrently, which is often more reflective of how development actually occurs.

For example, a child working on expressive language in speech therapy may also need occupational therapy support for sensory modulation and motor planning, while ABA helps reinforce communication attempts across routines and environments. In a coordinated model, those interventions are not separate—they are mutually reinforcing. This kind of overlap can accelerate the acquisition and generalization of functional skills.

Integrated care also improves goal setting. When therapists across disciplines are aligned around outcomes such as feeding, social participation, transitions, mobility, or independence, treatment tends to be more efficient. This reduces contradictory strategies, minimizes duplication, and makes progress easier for both families and physicians to follow.

Another important factor is treatment intensity without fragmentation. Children with complex needs often benefit from more frequent intervention, but high therapy intensity can become burdensome when services are spread across unrelated systems, schedules, and locations. Integrated models can increase intensity while preserving continuity, making it easier for children to receive comprehensive care without overwhelming families.

Reinforcement Across Disciplines Improves Generalization

Generalization remains one of the most important markers of meaningful pediatric progress. A skill demonstrated in a single therapy session has limited value if it does not transfer into the home, school, or community environment. Integrated care helps close this gap.

When one provider introduces a communication strategy, self-regulation support, mobility goal, or feeding intervention, the rest of the team can reinforce that same skill during their own sessions. A child who practices requesting in speech therapy may use the same communication system during ABA and OT. A sensory regulation strategy introduced in occupational therapy may support participation during speech sessions or improve tolerance for physical therapy tasks.

This consistency can speed carryover and reduce the risk that gains remain context-dependent. For physicians monitoring developmental progress, that translates into more functional outcomes rather than isolated clinical wins.

The Importance of Early Multidisciplinary Access

Early intervention is well established as a major factor in pediatric outcomes, but access delays across disciplines remain common. A child may begin one service while waiting for another referral, evaluation, or authorization, even when needs in multiple domains are already evident.

Integrated models reduce that lag by allowing children to access multiple specialists earlier in the care process. This is especially important for patients whose communication, sensory, behavioral, and motor needs are intertwined. Earlier multidisciplinary involvement can support developmental momentum, reduce avoidable decline in function, and improve long-term participation outcomes.

For physicians, this means that an integrated referral may be appropriate not only when a child is already receiving multiple therapies, but also when the clinical presentation strongly suggests interconnected needs from the outset.

Which Patients May Benefit Most From an Integrated Referral?

Integrated therapy is particularly valuable for pediatric patients whose presentation crosses traditional discipline boundaries. This often includes children with autism spectrum disorder, global developmental delay, speech and language delays with behavioral or sensory components, neurological conditions, genetic disorders, feeding difficulties, and motor impairments that affect participation in daily routines.

It may also be the right model for children whose progress has plateaued in a single-discipline setting, especially when underlying barriers appear to involve multiple systems. In these cases, coordinated treatment can help identify whether communication, regulation, sensory processing, strength, endurance, or adaptive functioning is limiting advancement.

What Referring Physicians Can Expect

From the physician’s perspective, integrated care can simplify the referral and follow-up process. Instead of navigating feedback from multiple unconnected providers, physicians can expect more coordinated communication, a unified plan of care, and reporting that reflects cross-disciplinary collaboration.

Families also benefit from reduced navigation burden. When care is organized around the child rather than around separate service lines, it becomes easier for caregivers to understand treatment priorities and implement strategies consistently. This can improve adherence, engagement, and follow-through outside the clinic.

Most importantly, integrated care better reflects how children function in the real world. Development does not occur in isolated domains, and pediatric therapy is often most effective when treatment recognizes that reality.

A More Functional Model for Pediatric Referral

For pediatric patients with complex developmental, behavioral, sensory, and physical needs, integrated therapy models offer a more coordinated and clinically meaningful path forward. By aligning ABA, OT, SLP, and PT around shared functional outcomes, interdisciplinary care can reduce fragmentation, support faster skill acquisition, and improve generalization into daily life.

When multiple developmental domains are affected, a multidisciplinary referral is not simply convenient—it may be the most appropriate model of care.

To refer a patient, visit https://www.metroehs.com/referrals

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June 30, 2019

How do I Know if My Child has a Feeding Disorder?

Feeding disorders are very common. Though it is hard to quantify, “[a]pproximately 20-50% of normally developing children, and 70-89% of children with developmental disabilities” (1) have a feeding disorder. How does this happen so frequently?!

According to Dr. Kay Toomey’s research and reviews of other studies, of children who have feeding disorders, between 65-95% of cases are caused by both behavioral and natural, organic causes (2017) (2). In other words, more often than not, a feeding disorder is not just behavioral! For example, a child that has undiagnosed reflux or allergies has learned to refuse food, because they have learned that food causes them to have an upset stomach. They may continue to refuse food even after receiving treatment for the initial physiological problem. A child that has choked on some solids because of undiagnosed oral dysphagia will begin to only eat liquid and purees to avoid choking. A child that is refusing crunchy foods could have sensory processing disorder and benefit from desensitization. A child that is having a hard time breathing will refuse food in order to get enough oxygen to survive. The examples could go on and on. Every child is different, and needs to be diagnosed and treated holistically.

Some signs that may indicate your child could have a feeding disorder include:

  • If your child eats less than 20 foods
  • If mealtimes take more than 30 minutes
  • If they refuse all of food of a certain texture or color, or are they having difficulty transitioning to solids
  • If they are choking, coughing, or gagging while eating
  • If they are demonstrating a lot of negative behaviors during meal times
  • If they have difficulty with mealtime routines or have a hard time sitting at the table
  • If they have difficulty chewing or swallowing (example: food left in their mouth after they’ve finished eating)

If you think your child could have a feeding disorder, or you feel that you’ve exhausted your options at home and don’t know where else to go, your child could likely benefit from a feeding evaluation and possibly feeding therapy. A pediatric feeding specialist can help you determine the cause, if a cause is present, make appropriate referrals, and plan the best course of treatment. Slowly, your child will become an adventurous and independent eater!

Sources:

  1. 2013. June 13. Banchaun Benjasuwantep, Suthida Chaithirayanon, and  Monchutha Eiamudomkan. Feeding Problems in Healthy Young Children: Prevalence, Related Factors and Feeding Practices. Published online 2013 Jun 13. doi: 10.4081/pr.2013.e10
  2. Toomey, Kay (2017). Top Ten Myths of Mealtime in America. SOS Approach to Feeding. https://sosapproach-conferences.com/resources/top-ten-myths-of-mealtime-in-america/

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January 27, 2025

How Does Early Intervention Therapy Help Children?

Greetings, fellow guardians of childhood! Today, we embark on an epic quest to uncover why early intervention in pediatric therapy is the ultimate secret weapon in the battle for our little heroes’ futures. Grab your capes, as we delve into the extraordinary world of neuroplasticity!

What is Neuroplasticity?

Imagine your brain as a high-tech superhero headquarters, constantly adapting and evolving with every new challenge and adventure. Neuroplasticity is the brain’s superpower that allows it to reorganize itself by forming new neural connections throughout life. This means that even if our tiny champions face developmental hurdles, with the right support and early intervention, their brains can reroute and expand like an elastic superhero — ready to tackle any villain that stands in their way!

The Sidekick Advantage: Why Early Intervention is Key

Just like every superhero has a trusty sidekick, children thrive when they receive early intervention in therapy. Research shows that the earlier kids receive therapeutic services, the more they can harness the powers of neuroplasticity to strengthen their skills, build resilience, and achieve their personal goals. Waiting too long can mean allowing obstacles to grow larger than life, much like letting a villain strengthen their force field!

Fighting Supervillains: Common Developmental Challenges

From speech delays, motor skill challenges to difficulties in feeding, utilizing early intervention means therapists swoop in like The Flash, delivering focused support to help children navigate these hurdles. With specialized tactics, our tiny heroes can battle their challenges and emerge triumphant, all whilst building confidence and unlocking their hidden potential!

The Dynamic Duo: Parents and Therapists Unite!

In this superhero tale, parents are the ultimate allies, teaming up with skilled therapists to devise personalized action plans tailored to each child’s unique needs. The synergy created by early intervention turns this duo into an unstoppable force—ready to level up skills in communication, socialization, and physical abilities. Together, they create a supportive environment where our little champions can flourish!

MetroEHS prioritizes early intervention in pediatric therapy because it isn’t just best practice; it’s a superhero saga ready to unfold with amazing successes! Using the incredible force of neuroplasticity, our little ones can script a future filled with hope, happiness, and triumph.