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Ask The Expert: Mary Washington Pediatric Therapy

Mar 18, 2022 06:00AM ● By Emily Freehling

One in 44 children in the U.S. has been diagnosed with Autism Spectrum Disorder (ASD), according to the Centers for Disease Control and Prevention (CDC). In addition, 1 in 6 children in the U.S. are diagnosed with some type of developmental disability, according to the CDC. When parents notice that their children aren’t meeting typical milestones, or exhibiting the same language or social behaviors as their peers, evaluation and intervention by clinicians trained in speech, occupational, feeding and other related therapies can make a world of difference.

Dr. Stacie Fox, SLPD, CCC-SLP, leads a team that has been providing these services to area families since 2010. Her practice is now part of the Mary Washington Healthcare family of providers serving families and children in the Fredericksburg region.

“Our team is so excited and grateful for the opportunity to be joining the Mary Washington team so that we can continue serving our community and growing to meet future needs,” Dr. Fox said.

Dr. Fox built the practice to be responsive to the specific needs of families with children who have an Autism diagnosis, who struggle with speech development, functional communication, sensory, and social skill needs. As our March Expert, Dr. Fox talks about speech therapy, occupational therapy, and how her team makes these experiences fun and convenient for children and families.


Q: What kinds of services are available at Mary Washington Pediatric Therapy?

Dr. Fox: We started out providing speech therapy services, and over the years we have added other specialties to meet the need that exists in our community. Today, we offer speech therapy, occupational therapy and feeding therapy. We offer cotreatments with combined disciplines working together to help a child meet their milestones.

We also offer augmentative and alternative communication (AAC) options, which includes all types of non-verbal communication, from signing to tech-assisted communication, to help children express their wants and needs and interact socially.

Feeding therapy services are also offered to help children be able to increase their acceptance of food. Our skilled therapists work together to help children improve their oral motor skills needed for eating and drinking, improve tolerance and acceptance for differing food types and textures, in order to help them eat more food choices. This is done is a fun and engaging environment with parent support and education for the most success.

Orofacial myology is another specialty we offer. This practice uses specialized knowledge of the muscles of the mouth and face to pinpoint habits or conditions that are interfering with speech, feeding and normal dental development.

It’s common for families—especially families who have children with an autism diagnosis—to need several of these therapies at the same time. This can put a lot of stress on a family if services require travel to different clinicians that may not all be located in Fredericksburg. Having all of these services under one roof right here in the Fredericksburg community cuts down on that travel time, creating less stress and letting these families focus on their child’s progress.


Q: Your practice was the first therapy center in Virginia to become a Certified Autism Center. What does this mean?

Dr. Fox: The certification comes from the International Board of Credentialing and Continuing Education Standards (IBCCES). It means that everyone in our practice—from the front-office staff to the clinicians—has received rigorous, specialized training in understanding and assisting children with autism. It was something we sought out to ensure that we are doing all we can to serve our families of children with autism, as we see a growing need for this in our community.


Q: Does a child need to have an autism diagnosis to receive your services?

Dr. Fox: No. We serve all children with speech needs and occupational therapy needs. We also do not diagnose autism. That is be done by a developmental pediatrician or a psychologist. But we are often the first to notice some of the signs and symptoms of autism, and we will refer parents to other practitioners as necessary to get a diagnosis. Our services assist children with autism with improving their communication, self-regulation, and social skills.

If you are concerned your child may have autism, some of the signs to look for include:

  • No words by 16 months, or no meaningful phrases by 24 months.
  • Any regression in speech or related skills; any loss of speech.
  • Lack of eye contact and a constant preference to be by themselves. Not noticing when other people are around.
  • Lack of pretend play, or a constant focus on stacking or lining up items.
  • For older children, not understanding jokes, and interpreting everything strictly literally can be a sign.

Q: Do children need a prescription or referral from a pediatrician for your services?

Dr. Fox: For occupational therapy, we do require a prescription, so usually we get referrals from pediatricians, developmental pediatricians or psychologists. For speech therapy, a prescription is not typically required. We do get referrals from pediatricians for speech when they notice that children aren’t meeting developmental milestones at a well check.


Q: What signs should parents look for to determine whether their child might need speech or occupational therapy?

Dr. Fox: If you are concerned about your child, it never hurts to get an evaluation. That can be a very helpful baseline for a parent, even if we determine that no services are needed. For speech, signs that therapy may be needed include:
  • Not saying first words by 12 months of age.
  • Having fewer than 20 words by 18 months of age.
  • Not combining words by 20 months of age.
  • Throwing tantrums because the child can’t communicate sufficiently to get his or her wants or needs met.
For occupational therapy, many of the children we see are lacking age-appropriate play skills. Parents may also notice that their children are sensitive to sounds, lights, are picky and don’t like to wear certain fabrics or don’t like to get messy. They may also have difficulties with self-regulation skills, and we  can investigate their sensory system and develop sensory strategies to help the child and family. If children have trouble with daily functional activities like zipping, tying shoes, buttoning, or handwriting skills—these are some of the fine-motor skills that our occupational therapists can help children develop as well.

To learn more, visit and search “pediatric therapy.”

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