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Pediatric Therapy

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Milestone Achiever of the Month

Milestones help measure the healthy development of a child. When a child continues to miss a milestone, Bryan Pediatric Rehab Services is here to help. Our team of physical therapists, occupational therapists and speech language pathologists provide children and their families with guidance, therapies and steps to reach their milestones. Not only that we find a way to make reaching milestones fun for each child! Each month we celebrate a patient that has made great strides due to their efforts and the care and support of our therapists.

November 2018

Libby Hobelman

Meet Libby. She works with a Bryan physical therapist, occupational therapist and speech language pathologist. We celebrate Libby as she increases her vocabulary and continues to strengthen her core. For Halloween, Libby dressed up as Rainbow Brite’s sidekick Twink, which is very fitting because she is an adorable ball of sweetness and silliness. Some of her favorite activities in therapy include singing songs, walking on the treadmill and climbing onto everything.

Below are the milestones Libby has achieved, followed by her current goals going forward.

Goals achieved:

  1. Libby moves from a sitting position to a tall kneeling position.
  2. Libby increased her functional vocabulary to five words.
  3. Libby demonstrates at least one age appropriate gesture (e.g., waving, clapping, blowing kisses).

New goals:

  1. Libby will crawl on hands and knees for 10 feet to increase strength and coordination.
  2. Libby will increase her functional vocabulary to 10 words.
  3. Libby will use at least one exclamatory expression (e.g., uh-oh, no-no, oh-no).

October 2018


Aviana is on a roll! Two months ago she was timid and did not want anything to do with standing. The only walking she did was to get back to her mama, and that was only if someone helped her. Now she’s walking all by herself!

Aviana loves to play! Kitchen is her favorite, but she also likes blocks and farm animals.

She really likes her physical therapist and even brought her a shirt for National Physical Therapy Month. With the progress she’s making, she’ll soon reach her goals and complete physical therapy. Great work Aviana!

Below are the milestones Aviana has achieved, followed by her current goals going forward.

Goals achieved:

  1. Aviana maintains standing still for up to 10 seconds.
  2. Aviana walks forward 10 steps with two hand hold assist.
  3. Aviana cruises five to six steps.

New goals:

  1. Aviana will walk independently for up to 20 feet.
  2. Aviana will transition from sitting on the floor to standing without help to improve strength and increase gross motor skills.
  3. Aviana will stand still for up to 30 seconds to improve balance and increase gross motor skills.

September 2018

Leah Jo Gillispie

"Leah does tremendously well and continues to make progress weekly," says Bryan speech language pathologist Ashley Yates. This month we celebrate her progress as our Milestone Achiever. Leah was 2 years and 3 months old when she had her first session with Ashley. At that time, she could only make typical vowel sounds and did not imitate simple sound combinations or words. Now Leah is almost four years old and speaking in sentences.

After her first few sessions, it was clear she had Childhood Apraxia of Speech (CAS). This is a motor speech disorder that does not allow messages to get from the child's brain to the mouth, but the child knows what they want to say. Often times we do not know why children have CAS because nothing shows up on an MRI or CT scan. Although it is a very common diagnosis in children with brain injuries or genetic conditions. That is not the case with Leah, she is a typically developing child in all other areas.

Leah is very motivated during sessions and loves to play. Her therapist utilizes a very structured approach to her treatment but mixes it up with play so she gets to have fun. Her parents have done a great job of working with her at home. Therapy is instrumental to progress, but the family plays a huge role in getting the child to the therapy sessions and with any home program!

Below are the milestones Leah has achieved, followed by her current goals going forward.

Most recent goals achieved:

  1. Leah will imitate single syllable words in phrases and sentences with models or cues.
  2. Leah is able to produce all developmentally appropriate consonants (i.e., m, b, p, h, w, d, n, k, g, t, f).
  3. Leah will use 2-3 word phrases to communicate.

New goals:

  1. Leah will imitate two syllable words at the phrase level with models or cues.
  2. Leah will use the sounds /k/ and /g/ in words with minimal cues.
  3. Leah will consistently demonstrate use of 3-4 word sentences during play.

August 2018


Annabelle was born at 31 weeks and began therapy shortly after leaving the NICU to work on advancing her bottle feeding skills. As she grows, she continues therapy to improve her feeding and swallowing of more age appropriate food textures and drinks. She is able to get most of her nutrition needs, but uses Boost drinks to help meet these needs due to limited intake of solid foods.

Although, she has a great time throwing food on the floor. We are working on keeping the food on the table to help learn more about food by being able to look, touch and smell it! Below are the milestones Annabelle has achieved, followed by her current goals going forward.

Goals Achieved:

  1. Annabelle will bite foods 75% of the time.
  2. Annabelle shows at least 3 chewing attempts before spitting food out.
  3. Annabelle brings new foods to her mouth for at least taste in 90% of the time.

New Goals:

  1. Annabelle will show at least 5 chewing attempts before spitting out her food 60% of the time.
  2. Annabelle will transfer and swallow age appropriate bites of meltable solid textures, such as veggie straws.
  3. Annabelle will be able to drink from a cup without a lid with little help.

July 2018

Anai Ortega Garcia

3-year-old Anai was born at 25 weeks and stayed in the Bryan NICU for over three months. She works with Bryan physical therapist Brandy Escamilla and occupational therapist Kindra Fox. We celebrate with Anai as she improves her strength, balance and coordination. Her favorite activities in therapy are playing with the toy food and kitchen set, bubbles and dolls. Below are the milestones Anai has achieved, followed by her current goals going forward.

Goals Achieved:

  1. Anai can now walk up to 25 feet on her own.
  2. She can now stand up in the middle of the floor through a squatting position.
  3. Anai now matches puzzle pieces 60 percent of the time. 
  4. Anai imitates vertical lines or gestures to prepare for prewriting skills.

New Goals:

  1. Anai will increase visual motor skills to string beads onto a pipe cleaner.
  2. Anai will imitate circular and vertical motions to prepare for prewriting skills.
  3. Anai will descend steps with the use of one handrail and step to step pattern. 
  4. Anai will stand on an uneven surface reaching for objects for up to 10 seconds without losing balance.

June 2018

Ezekiel Gettemy

3-year-old Ezekiel works with Bryan physical therapist, Brandy Escamilla. We celebrate with Ezekiel as he improves his strength, balance and coordination. His favorite activities in therapy are playing with potato heads, cars and bubbles. Below are the milestones Ezekiel has achieved, followed by his new goals going forward.

Goals Achieved:

  1. Ezekiel can now transfer from one surface to another that are slightly more than an arm’s length apart. 
  2. Ezekiel can step over a balance beam with only one handhold assist.
  3. Ezekiel can climb a standard set of stairs step by step with a handrail and contact assist.

New Goals:

  1. Ezekiel will stand up from a sitting position on the floor three to five times during a therapy session.
  2. Ezekiel will step over four balance beams with only one handhold assist.
  3. Ezekiel will climb a standard set of stairs step by step to show improvements in his strength, coordination and balance for daily activities.

May 2018

Kasen Grubb

Kasen is a twin and a former Bryan NICU baby born at 36 weeks gestation. At 21 months, Kasen had very few consonant sounds and only one intelligible word. His limited vocabulary made it difficult to communicate basic wants and needs to his parents. After his evaluation he began working with Bryan speech pathologists, Ashley Yates and Julie McDaniel. They not only work with Kasen, but also teach his mother how to model for him and encourage the use of his words. Kasen's therapy happens while he plays and he loves to play with animals, cars, bubbles and playdough. His increase in vocabulary has decreased some of his communication frustrations. Below are the milestones Kasen has achieved, followed by his new goals going forward.

Goals Achieved:

  1. Kasen has shown increased sounds that imitate adult speech.
  2. Kasen increased his vocabulary to 25 words.
  3. Given two options, Kasen will use his words to choose 80% of the time. 

New Goals:

  1. Kasen will increase vocabulary to greater than 50 words.
  2. During a therapy session, Kasen will put two words together 10 times.
  3. Kasen will increase his social language skills for daily interactions, such as answering yes/no, asking for help, labeling, gaining attention, requesting an action.

April 2018

Xavier Ludemann

Xavier is an energetic young man who is always smiling. His occupational therapist, Kindra Fox, helps him improve his focus, coordination and organization. Kindra shows Xavier full body exercises to exert just enough energy so he is able to sit at a table and focus. These exercises help with his attention, strengthen his core for good posture and develop gross motor skills. To improve fine motor skills, Xavier uses tweezers to place small pom poms into the mouth of a tennis ball. Xavier loves to make up games and have competitions during therapy. Below are the milestones Xavier has achieved, followed by his new goals going forward.

Goals Achieved:

  1. Xavier can hold a prone extension for 1 minute. This has helped increase his shoulder stability for handwriting and fine motor skills.
  2. Xavier can manage buttons through jean material and small buttons 80 percent of the time.
  3. Xavier is able to tie his shoes, 75 percent of the time with verbal cues.

New Goals:

  1. Xavier will identify when he needs to use the skills he's learned to increase his ability to attend to tasks 80 percent of the time.
  2. Xavier will be able to state three activities to increase a calm, alert state as needed 80 percent of the time.
  3. Xavier will continue to develop his trunk strength by completing a prone extension for one and a half minutes.

March 2018

Jaylee Krauter

Jaylee was a former Bryan NICU baby born at 29 weeks gestation. After leaving the NICU she struggled taking in adequate volumes by her bottle. The placement of a feeding tube has helped her get the necessary nutrition and calories she needs to grow. Now she works with Bryan therapists, Julie McDaniel, MS, CCC-SLP and Stacey Anderson, OTR/L, CPST to eat appropriate table foods. Below are the milestones Jaylee has achieved, followed by her new goals going forward.

Goals Achieved:

  1. Demonstrates appropriate biting of preferred food textures 80 percent of the time.
  2. Moves tongue side to side inside the mouth to manipulate food to be chewed and formed into a ball before swallowing.
  3. Shows the ability to touch wet textured foods without signs of distress.

New Goals:

  1. Jaylee will demonstrate confidence to bring new food textures to her mouth.
  2. Jaylee will move ball of food towards the back of her mouth and swallow.
  3. Jaylee will demonstrate up to three chewing cycles before spitting it out.

February 2018

Tyson Reinboth

Milestone Achiever Tyson

Tyson’s physical, occupational and speech therapists help him improve his balance, develop his fine motor precision and increase his vocabulary skills. He works with Brandy Escamilla, PT, Kindra Fox, OT and Ashley Yates, SLP. This six-year-old knows how to have fun - making up silly stories and playing games like Pop the Pig, Candyland and Perfection. Below are the milestones Tyson has achieved, followed by his new goals going forward.

Goals Achieved:

  1. Tyson is able to sit up while reaching for objects without loss of balance.
  2. Tyson is able to cut paper in half with a little help holding the paper.
  3. Tyson identifies similarities and differences for word use with 75 percent accuracy.

New Goals:

  1. Tyson will walk with forearm crutches for 20 steps.
  2. Tyson will increase his motor skills by cutting a square and staying within 1/2 inch of the line.
  3. Tyson will generate concrete sentences provided with pictures with 50 percent accuracy.

January 2018

Niam Bhakta

Milestone Achiever of the Month - Niam

Two-year-old Niam works with a Bryan physical therapist, NaTosha Siemek and speech pathologist, Julie McDaniel. We celebrate with Niam as he increases his vocabulary and improves his walking with greater speed and balance. His favorite activities in therapy are playing with cars and balls. Below are the milestones Niam has achieved, followed by his new goals going forward.

Goals Achieved:

  1. Niam increased his vocabulary to 20 words.
  2. Niam points to target picture in a simple group of four pictures with 75% accuracy.
  3. Niam walks up and down an incline surface by himself without losing his balance.
  4. Niam demonstrates improved walking speed, keeping up with his mom or physical therapist.

New Goals:

  1. Niam will combine two words and/or signs together in 75 percent of opportunities.
  2. Niam will increase functional vocabulary with word/sign combinations to 50 words.
  3. Niam will walk up four stairs with one handrail assist.
  4. Niam will pedal a trike for 10 feet without assistance.


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