Click to Call: 425.985.8515
make an appointment
make a payment

susan l. cohn & associates

710 NW Juniper Street Suite 108 Issaquah WA 98027

April 26, 2015

Hug an Occupational Therapist!!!!

Contributed By: Sarah Oarbeascoa MS, CCC-SLP

April is Occupational Therapy Month!

Occupational Therapist with a Speech-Language PathologistDuring the course of a pediatric speech-language evaluation or during therapy, the speech-language pathologist (SLP) may recommend that your child consult with an occupational therapist (OT). Even though SLPs address communication, often there is overlap in areas that SLPs and OTs treat. As therapists, we are often concerned with the “big picture” of your child’s overall development. When one system of development is impacted, it is likely there may be other systems impacted as well.

What is an Occupational Therapist?

Pediatric OTs support and promote the development and engagement of infants, toddlers, preschoolers, and older children/adolescents in everyday routines. These routines include play, rest and sleep, activities of daily living (ADLs), education, and social participation. (Source: The American Occupational Therapy Association).

How could Occupational Therapy affect speech and language development?

  • Postural Stability – Improving a child’s seated position may not only improve attention and safety, it may improve head and trunk stability. If your child’s head and trunk are stable, this will allow them to achieve increased jaw stability, which is critical for feeding and speech production. An OT can help provide tips on the type of chair or cushion that may help increase stability. In our office, you may see a Rifton chair or cushion as part of therapy, providing your child with trunk support.
  • Attention and regulation – These skills are critical to pragmatic language skills. In order to be a successful communicator, a child must be able to focus, attend, and engage across a variety of environments and with peers.
  • Sensory Processing – Sensory processing refers to the way your child’s nervous system receives information about the senses and then how they respond. Sensory Processing Disorder (SPD) is a condition that exists when sensory signals don’t get organized into appropriate responses. An OT may address appropriate responses to sensation in a meaningful and functional manner.   Speech pathologists often integrate sensory activities into treatment that have been suggested by the OT. Activities such as bouncing on a ball, fidget tools, providing a cushion to sit on, swings, movement breaks and adjusting the lighting in the room are just a few things that not only meet the sensory needs of the child, but also stimulate language.  A wonderful resource for parents and one we have in our clinic library is “The Out-of-Sync Child” by Carol Kranowitz.
  • Executive Function – Executive function includes both thinking skills (planning, organizing, and working memory) and behavior (emotional regulation, flexibility, sustained attention). OTs may address motor planning during their treatment sessions. Addressing motor planning may positively impact speech and language by increasing organizing, planning and sequencing skills; skills important for language.
  • Written Language – OTs can assist how your child is able to express his or her thoughts on paper by addressing handwriting skills. OTs target not only handwriting and typing skills, but also organizing thoughts into graphic organizers which further improve narrative and story retelling skills.Combing occupational therapy in conjunction with speech therapy may provide the best overall success for your child's development & well being.

It truly takes a village to raise ALL children.  When it comes to kiddos who present with special areas of need  parents, teachers, caregivers, other therapists, etc. all need to be in the communication loop.  We LOVE the pediatric OT in our building, Carol King, OTR/L.  Carol is the owner of Eastside Occupational Therapy.  We collaborate and refer between clinics ALL of the time!!! Carol was actually the OT who diagnosed Amy Svensson’s daughter (Amy Svensson MA, CCC-SLP is the owner of our practice) with SPD and worked with her for close to 2 years where incredible progress was made!  Amy’s daughter went from HATING slides, car rides, swings, & jeans to a confident spirit thanks to the help of OT in tandem with speech-language therapy.  Check out Amy’s 3-part blog series on her family’s personal journey with SPD ~ enlightening.


Ella, Maui 2015 ~ Water, sand, swimming with Honu!!! THANK YOU OT!!

I can’t stress enough that a team approach is essential!! Hopefully your child’s SLP has already communicated with you if he/she sees red flags for an OT referral, but if not and you want to look into further, talk with your child’s SLP to see if an OT referral is appropriate; even if just to get a screen done. These are often quick and free (Carol offers FREE 15 minute OT screens). If your child is already seeing an OT,  hopefully the therapists are in communication with one another (make sure all HIPPA authorizations are signed). It is always a great idea to talk with your child’s therapists about how to incorporate skills and strategies learned in both therapies into the home to maximize therapy progress because often progress or lack-there-of in one will affect the other.  Always remember that you are your child’s biggest advocate and VOICE!!  Make sure the village is on the same page and willing and able to solve and put the pieces of the puzzle together … TOGETHER!!





April 8, 2015

TALK WITH ME!!!!!!!!

Parenting Advice. Talk to your Kids All the TimeOK, I am a parent so I get it! I get that the days can get VERY long raising children! We all need a break to recharge our mental and physical batteries. No matter if we are caring for our children as a stay-at-home parent, single parent, working full or part-time, etc. there is always mayhem raising kids. This is why the quiet moments when there is opportunity to communicate with one another should not be taken for granted.

I am not a judger and firmly believe we all have a right to parent our own way, but it infuriates me when I am out for a meal and look around and see so many parents staring down at their mobile devices when they could be chatting it up with their kid(s). This pains me to watch not only as a mom, but also as a speech-language pathologist. How annoying it must be for the child when he/she is sitting across from his/her parent eager to talk and all he/she sees is the top of a head!  Surely I am not the only one to witness this all-too-common behavior and have these feelings so I will simply just add to the conversation; one I have spent countless hours talking about with other parents and colleagues lately.

I was recently out to lunch eating solo with extra time to sit and observe and watched a little boy who was trying to get his mom’s attention. He called out “Mom” 20 times (I counted) before she looked up and said “What do you want to say?” He then replied, “Forget it mommy.” As his calls out to her became louder and louder, I had to use every ounce of restraint not to tap Mom to tell her to look up.

Kids are losing out on so many communication opportunities these days. Whether the child is just starting to babble, a preschooler, school-age, in high school… it does not matter! The baby is missing out on the eye contact and inflectional models of the parent babbling back. The preschooler is missing out on building vocabulary and appropriate back-and-forth conversation skills. The school-aged child is missing out on improving  higher level language skills (sarcasm, idioms, etc.) and the teenager is missing the opportunity to actually communicate his/her emotions and not be passive behind texts.

A lot has changed since graduating with my Master’s in speech-language pathology 15 years ago! Of course I want to be part of the progressive technology movement, especially the advances in higher tech augmentative & alternative communication (AAC) systems to assist those who lack verbal communication abilities.  We have come SO far in this arena since I completed my Master’s thesis in 2000 which researched the topic of AAC.  I love technology when it does not override opportunities to improve communication skills verbal or nonverbal.

As a speech therapist & parent I know that being present with your children whenever possible, talking & communicating with them all the time is extremely important for their development.

Again, I am not judging, but I can’t think of ONE good reason any parent or caregiver can give me as to what positive benefit this behavior has on a child’s communication development or emotional bonding. It is detrimental on so many levels. If I was a child with a parent glued to the phone, the biggest thing I would feel is that I am not as important as the phone; my words have no importance or worth. How sad.

My kids are now age 7 and 11, in school full-time. After activities and homework, there is little time left to connect with one another. When they were little this phone frenzy was just starting so I did not have access to it as an outlet when I was about ready to lose my mind with my kids fighting at restaurants and at wits end being a full-time stay-at-home at the time. It would have been super easy to disconnect and read my phone, text, e-mail just to tune it all out. Back then and now though, there is a time and a place for that, but while at a table in a restaurant with a child eager to be with you and talk with you should not be one of them.

Even now that I do have access to all the new features of my phone and could check it every minute, especially owning my own practice with 8 employees often working remotely, I don’t. In fact, I go off the grid a lot, especially on the weekends turning off my phone all weeknights and on Sundays. I could be connected every single second of every single day, but it is a mindful choice not to be. I realize this goes against the grain because everywhere I look people are on their phones but I am not a conformer and know that because of this conscious effort, the relationships I have with my kids, husband, and the meaningful relationships in my life are richer and deeper. Yes, people get annoyed when they can’t reach me right away, but those who know me well, know this is how I roll.

I am grateful my kids do not see me looking at my phone all the time, especially when time is carved out to spend with them and connect emotionally and communicatively. We play Uno, chat, draw, do word searches, etc. It is a standing rule in our family that no form of technology is allowed at the table at home or when we are out to eat. Yes, the days are long, but these years are oh so short. Why waste them staring down from my kids?


February 26, 2015

Let’s Go on a Bear Hunt

Post Contributed by: Sarah Oarbeascoa MS, CCC-SLP

There are many children's books that will help provide speech therapy for your kids. We’re Going on a Bear Hunt is one of my favorites. “We’re Going on a Bear Hunt,” by Michael Rosen, is about a family as they travel through the forest searching for a bear. The book is predictable, with repetitive phrases that allows your child to ‘read’ along with the book. This is one of my favorite books to use the imagination! Have fun creating obstacle courses in your home or going on your own bear hunt outside!

We’re Going on a Bear Hunt

Language and speech elements that can be addressed are:

  • Vocabulary (locations, clothing, outdoor items)
  • Location (forest, cave, river, etc)
  • Sequencing
  • Answering WH questions
  • Adjectives (thick, oozy, narrow, dark, wavy, etc.)
  • Prepositions and Verbs (in, on, through, under, over)
  • /B/: Bear; /G/: Going; /W/: We’re


Ask questions and use what the child already knows to add to the discussion, assisting the child to further understand and enjoy the book.

  1. Look at the cover of the book together ~ Make a guess about what the book might be about. This is a great activity to practice predicting. Also when looking at the cover, discuss the title, author, and illustrator, and what those terms means.
  2. Talk about the items you see on the cover.


  1. As you go through the book, ask WH questions about each page, for example “Where are they going?” “Who lives in the forest?” “Why are they running?”
  2. When reading, make sounds effects with the book: ‘squishy’ mud, ‘splashy’ river, etc.
  3. Point out the descriptive words: “Long wavy,” “Deep cold,” “Thick oozy,” “Big Dark,” etc.
  4. Act out the story as you read ~ Tiptoe through a cave, stomp through mud, etc.


  1. Play “We’re going on a ____ hunt.” Look for items when on a walk, in the car, or at the grocery store.Speech Therapy Books for Kids
  2. Discuss the places in the book for example  “What types of animals live in the forest? In a cave?”
  3. Practice sequencing and retell by discussing the order of events.
  4. Sing the song together. You can find a variety of different versions on Youtube. My favorite version is Greg and Steve.
  5. Go on a ‘bear hunt’ in your house. Place the bear “in”, “on”, “under”, “over”, or “behind” in different spots in your home. If you have a play tunnel, practice going “through.” Have your child use their imagination – could the couch cushions be mountains? Maybe the rug could be squishy mud?
  6. Encourage your child to imagine that they are going on a bear hunt. Ask them to think of different places they could go — like outer space, an island, a jungle, a zoo, etc. What types of experiences might they encounter in these environments?
  7. Discuss what the repetitive phrase “I’m not afraid”, and what it means to be “brave.” When is a time when your child had to be brave (dentist, doctor, new school, etc.)?”
  8. Check out your library for other versions of the book ~ “We’re Going on a Lion Hunt” and “We’re Going on a Leaf Hunt.”












January 13, 2015

That’s Another Wrap ~ 2014 in Review & A Look Ahead

Happy 2015!

Silly Mindfulness!!!

Silly Mindfulness!!!

How in the world did we just wrap up 2014? Whenever I write these reflection posts at the end of one year and start of a new one, it never ceases to amaze me how blazing fast time goes. I love that I have the opportunity to blog and be mindful of my life both personally and professionally throughout the year. In the past, I often found myself saying, “I will get to this/that tomorrow.” All of a sudden ‘tomorrow’ turned into a week, then a week turned into a month and then a month turned into a year. Darn it! I needed to change this cycle. Something needed to give because to continuously have this feeling is not healthy, at least not for me. I did not want to be part of the rat race. As a wife, mom, friend, daughter, & business owner, I wanted to make sure I did not let time pass by with feelings of regret so I have since made a conscious effort to reflect every single day and savor… both personally and professionally. To start, I journal every single morning.

Looking through my 2014 professional journaling …

  • At the start of 2014 we wrapped up a big remodel of the clinic after 7 weeks in a temp suite down the hall in our same building. January brought a lot of unpacking boxes and simply settling. Also in January, I was filmed by a professional videographer to launch video blogs to bring more awareness to speech-language topics. These are available on this blog page as well as on YouTube.
  • In February we hosted an open house in the building along with other tenants (OT, SLP, PT, ABA Specialists). It was so wonderful to collaborate together. Most exciting this month, Courtney Martin MS, CCC-SLP and her husband welcomed their first child, a son!!
  • In March, with the help of Fingerprint Marketing, we launched our bi-monthly e-blasts where we provide brief clinic announcements and blog features. We also learned that we were voted into 2nd place next to Encompass for the Macaroni Kid Snoqualmie Valley/Issaquah Family Choice Award in the “Pediatric Therapy” Category.
  • In April, I attended the NW Children’s Fund Gala as an official sponsor of this amazing 100% non-profit organization. Also in April I, along with 2 other SLPs from Florida, submitted our proposal to the American Speech Hearing Association  (ASHA) National Convention Committee to hopefully present at the National Convention in Orlando, FL later in the year.
  • In May we promoted Better Hearing and Speech Month within the community, including our on-going free speech-language screens. Also in May, we welcomed Tracy Sexton MA, CCC-SLP to the Susan Cohn & Associates team. Tracy works on Thursdays and Fridays as well as assists with Saturday vacation/time off coverage. Also this month, Sarah Oarbeascoa MS, CCC-SLP and her husband welcomed their 2nd son. Since I was the SLP covering for Sarah’s maternity leave, I was able to get to know so many of the clients and their parents even more since the time of the 1st referral call.
  • June was inundated with prepping for and transitioning into the summer caseloads. Once again, Danielle Nelson MS, CCC-SLP added 30 sessions per week to accommodate our increased summer needs. Mid-June we sponsored Snoqualmie Elementary School’s Field Day by renting their 3 sno-cone machines. As a parent of this wonderful school, I volunteered at this event. To see all those red and blue lips and smiling faces made me so happy! Last, but not least, I hired Cassie Callaghan MA, CCC-SLP to join our Susan Cohn & Associates team. Cassie works 10526005_10152220095679499_8559307620759764274_nMondays, Tuesdays, and Wednesdays.
  • July… WOW! Our ASHA presentation proposal was approved so preps were in full swing to get my bit squared away. Fingerprint Marketing assisted me with my layout and PowerPoint. Oh, and Sarah Oarbeascoa, MA CCC-SLP started her 6-month children’s book review series on the blog.
  • It was August that thanks to Toddie Downs MA, CCC-SLP, all the therapists were trained in our new EMR cloud-based software system. Although change can be hard, having everything electronic is so much more efficient.
  • September we welcomed Courtney Martin MS, CCC-SLP back from her 6-month maternity leave. Courtney is now in the clinic Tuesdays/Wednesdays/Thursdays. In addition to Courtney’s return, we welcomed our first graduate student Kimberly Ridenour who is attending Nova Southeastern University. Both Toddie Downs and Sarah Oarbeascoa supervised Kimberly’s 1st semester of clinicals. It is so important to us to assist in the continued training of professionals in our field. Oh, and how can I forget we started social groups in the clinic??? Well, we did and it was super fun.
  • October marked the Snoqualmie Elementary School Walk-a-Thon. As an annual SES PTSA sponsor, my husband and I volunteered at the event as well as donated to this amazing school in support of the amazing programs. This is also the month my family and I brought home our Aussiedor puppy, Isla Ann. Isla is going through training right now to become a therapy dog in the clinic as well as get clearance to visit nursing homes.
  • November was a HUGE whirlwind. Unfortunately I had to take most of the month off from my caseload (Thanks to Sarah Oarbeascoa and Tracy Sexton for covering for me). I was invited to present at The Bear Creek School the 1st Saturday of the month. I prepared 2 talks on speech-language development for both preschoolers and school-age children.   The following weekend I attended the Encompass Gala not only to represent the practice, but also as a parent who is proud to support this organization and what they offer to the Snoqualmie Valley community.Of course I won’t leave out the fact that in November, I was in final prep mode for my ASHA presentation. The date (11/20/14) was drawing super close – yikes! In the midst of everything, I was busy putting together and delivering gratitude baskets. I always want to put time and thought (and support local) for my annual gratitude gifts. Being Super Bowl champs this year, I had extra fun with my ‘Seattle’ theme. It is always better to give than receiveJ.On 11/18/14 my family and I flew to Orlando. With my nerves in check (sort of), the entire team of SLPs in the practice all hands on deck running the day-to-day operations during my week-long absence and my presentation finalized and practiced, it was show time. To present at any level, much less at the national one, was on my professional bucket list. I hope to have the honor to do it again at some point in my career.
  • December reflections include welcoming another student, Crystal Balchuck, who attends the speech-hearing undergrad program at the University of Washington. Thank you Amy Smith MA, CCC-SLP for allowing Crystal to observe you and get her undergraduate clinical observation hours under your expertise.It makes me sad to say though that December also brought Sarah Oarbeascoa’s decision to head back into the Issaquah School District full-time. She is one amazing person and therapist. The glass half full though is Sarah is remaining on staff to cover on a PRN basis as well as contribute to our blog and Facebook posts.Oh, and just in the knick of time before ringing in the New Year, I was able to squuuueeeeezzzeee in one more thing that was on my 2014 action item list… I was able to get an A-frame up at the clinic’s intersection with the landlord’s approval to assist parents in finding us more easily.

Holy cow, that’s quite a wrap!!! So now what? What is in store for 2015? Since I can’t be idle for long …  Well, A LOT.charlotte-new-years-eve-2015


  1. We are expanding our current space to add 2-3 more rooms as we are now paying additional rent for more space in the OT clinic down the hall. Thank you to Eastside Occupational Therapy for providing us with the space to help up accommodate our constant growth.
  2. We will continue with our free 15-minute screens throughout 2015 to bring awareness and promote early intervention.
  3. Kindness matters! Each month we will be doing a drawing amongst our ‘active’ families to receive a copy of one of my favorite books, “Have You Filled Your Bucket Today?” The monthly winners will be mailed their copy at some point in the month as part of our ‘Random Acts of Kindness.’ Surprise!
  4. We will offer social groups this summer. Please e-mail me at if you are interested in getting your child signed up.
  5. We will continue to offer sessions in Spanish. A big THANK YOU to Jessie Kellogg-Smith MS CCC-SLP who provides these sessions.
  6. I am working with the volunteer coordinator at the Mt Si Food Bank to offer free speech-language screens 9-11 on Tuesdays 4 times out of the year. Since Issaquah is far away for many of the families who come to this food bank, I will come to them. Encompass’ Main Campus is across the street. If needed, I will refer to this amazing place for further diagnostics and treatment. It is about early identification and getting children the help they need.
  7. In August, I will celebrate the 5th year of ownership of the practice. I remember the Merger and Acquisition like it was yesterday. Throughout the month of August we will have giveaways and special things going on to celebrate this milestone anniversary.
  8. Kimberly, our graduate student, will complete her 2nd year of clinicals with us!!
  9. Last, but definitely not least … each year we choose a local charitable organization to throughout the year. Over the past 4 years we have supported local food banks, Encompass, and the Northwest Children’s Fund twice. There are SO many wonderful organizations to support and it is always so hard to choose, but after much consideration, I have decided that moving forward Northwest Children’s Fund is going to be the organization we will officially sponsor every year. This is why : The mission of NW Children’s Fund is to end the cycle of child abuse and neglect by investing in programs for at-risk children and their families, and inspiring informed philanthropy devoted to improving child welfare. They know that breaking this complicated cycle requires a multi-point strategy. Not only must intervention happen when abuse or neglect has already occurred and help the fragile victims heal, they also work to keep it from happening at all.NW Children’s Fund impacts several critical points in the complex cycle of abuse and neglect. By supporting therapeutic foster care, youth mentoring, family stability and so much more, we’re providing the support systems children need to be in a safe, nurturing environment, and working with families to alleviate the stresses and deficiencies that can lead to abuse and neglect. It is 100% non-profit and run solely by volunteers. Donations stretch all over the Puget Sound region. As part of my commitment to this organization, I plan to go on at least one site visit with one of the Board Members to see exactly how every dollar matters and helps.



On a personal note, I will turn 40 this year!! Bring it on!!! Here’s to an awesome 2015 to ALL!!


My AWESOME Dad and I when I was 2 years old ~ 1977






































December 28, 2014

She has a name …

I was planning on typing up a blog post on a completely different topic tonight, however I had to change gears. Out of the insane amount of love I have for my daughter, Ella Lyn, I felt this incredible need to share my experience recently in tonight’s post. If you are familiar with the 3-part blog series I did on our personal journey with Sensory Processing Disorder (SPD), then you know my very deep roots with this disorder and that my daughter Ella faces it every single day. As her Mom, I do too. Every day brings on something new as we navigate her SPD and even though the intense therapy she has had over the years, we are in a new chapter with it now that she is a ‘tween.’

So we recently had ‘Parent Participation/Observation Night’ at the gym where Ella attends weekly gymnastics class. With so much pride and love, I sat and watched my daughter socialize, jump, bounce, and balance. These are things she was not so keen on doing in her earlier years. She has come so far in her 10.5 years. She is very driven (wonder where she gets that from?)!!!

Parental Challenges with Sensory Processing DisorderAt the start of class it was warm-up time. Ella was so excited to have me there completely connected watching her accomplishments. My face must have said a million words to her. Nonverbal language can speak so much louder than actual words – so I think.  I was smiling so big! The people around me did not know her … OUR story. The Coach’s instructions were to “skip.” I think I may have forgotten to mention that Ella also has Central Auditory Processing Disorder (CAPD) so it takes her a bit longer to process verbal instructions. So not to sit there and allow her brain time to process, she ran. She did not skip. She ran with such a smile and confidence; a self-confidence my husband and I strive so hard to improve every single day. As I smiled and felt such a warm feeling in my heart watching her, I overheard a parent of another child in Ella’s class say to the girl’s dad… “That girl is running. She is not skipping. Does she not know how to skip? Don’t they learn that in school?” I was biting my tongue knowing it was MY Ella they were taking about. I let them carry on. Believe me,  I wanted to jump in RIGHT THERE AND THEN, but every bit of self-control made me stop. Was I planning on leaving without ‘enlightening’ them in some way or another by the end of the hour?  I think not.  Make that HECK no, but I knew the moment was not right then in that particular moment.

The girls moved onto the beams … Ummmmm… Ella used to want NOTHING to do with the beam … low, medium, high it didn’t matter. She was 4 years old enrolled in a local gymnastics class. She would kick, scream, and have nothing of it; the floor and mat activities she was quite OK with, the beam = NO WAY!! 6 years later (yes, 6 years) here I was watching Ella on the high beam dipping and turning. Then I watch her amazing Coach guide her in doing a backward roll ON.THE. HIGH.BEAM!!! I wanted to scream, “YAY Ella!!!” My heart continued to sing, but it was also tugging. I overheard that same Mom say to the Dad, “That is the girl who couldn’t skip!” Did that MOM just say that? Did she just say that not knowing MY little girl’s story?Being a parent to a child who suffers from Sensory Processing Disorder is not always easy. We face many parenting challenges but in the end it's all worth it.

Yes she did ☹

Cringing and biting my tongue I stood beaming a big smile and Ella smiled right back at me. A brief moment later, THAT mom looked at me and asked, “So which one is your daughter?” Here was my chance to stop biting my tongue…. the moment had come.  I looked right at her and said proudly, “My daughter is the girl who can’t skip. I overheard you two talking about my daughter. It hurt my feelings. I should not have to explain, but I will to bring awareness. She has Central Auditory Processing Disorder and Sensory Processing Disorder. She has come so far in the past 6 years. I suggest that should you wish to stoop to a level of judging a child in such a negative way that you do it more discretely and not in earshot since you may just be sitting next to the child’s very proud Mother. “ All she could do was look at me and say, “I’m sorry. I did not know.” She and the dad tried to make small talk with me to break the silence and pass the remainder of the time.


Was the last 30 minutes of “Parent Observation Night” awkward? Indeed it was, but I could have cared less. As long as I can breathe, I will be the proud Mom of ‘the girl who can’t skip.’ Her name is Ella Lyn Svensson and for the record, she CAN skip!

Bring on 2015 and our family’s continued journey!


“From the moment they placed you in my arms, you snuggled right into my heart.” ~ Author Unknown






Do NOT follow this link or you will be banned from the site!