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SPD Treatment Directory

Facility Registration Form

(If you offer more than one location, please register each separately.)
"*" Denotes a required field
Facility Name*
Address*
City*   State*   ZIP*
Country
Phone*   Fax
Email*   Web Site   http://
Number of Years Facility Has Been Open
Director
Professional Staff Names and Degrees (Staff may choose to register individually as well.)
Number of Staff Members Certified in SIPT
Number of Staff Members Certified in NDT
The Facility’s Philosophy of Intervention (please describe)
Client Information
Age Range of Clients
Number of Children with SPD Treated Annually
Number of Adults with SPD Treated Annually
Typical Size of Waiting List (if any)
Assessments Available
(check all that apply)
Bayley Scales of Infant Development
Bruininks-Oseretsky Test of Motor Proficiency
Clinical Evaluation of Language Fundamentals - 4
Clinical Evaluation of Language Fundamentals - Preschool
Clinical Observations
Comprehensive Assessment of Spoken Language
Developmental Test of Visual Motor Integration
FirstSTEP
Intelligence Testing
Language Processing Test
Leiter International Performance Scale - Revised
Lindamood Auditory Conceptualization Test
Miller Assessment for Preschoolers (MAP)
Neuropsychological Testing
Peabody Developmental Motor Scales
Preschool Language Scale - 4
SCAN Test for Auditory Processing Disorders
School Function Assessment
Sensory Integration and Praxis Test (SIPT)
Sensory Profile
Test for Auditory Comprehension of Language
Test of Auditory Perceptual Skills Revised
Test of Auditory Reasoning and Processing Skills
Test of Language Development - 3
Test of Listening Comprehension and Oral Expression
Test of Problem Solving
Test of Sensory Functions in Infants
Toddler and Infant Motor Evaluation (T.I.M.E.)
Other (please specify)
Disorders Treated
(check all that apply)
Attention Deficit/Hyperactivity Disorder
Autistic Spectrum Disorder
Cerebral Palsy
Developmental Delay
Developmental Coordination Disorder
Down Syndrome
Feeding Disorders
Fragile X Syndrome
Learning Disabilities
Psychiatric Disorders (e.g., OCD, ODD, Bipolar, etc.)
Regulatory Disorders
Sensory Impairment (visual or hearing)
Sensory Processing Disorder
Traumatic Brain Injury
Other
Disciplines That Consult, Treat, Evaluate, or Practice at Your Facility
(check all that apply)
Audiologist
Educator
Learning Specialist
Neurologist
Nutritionist
Occupational Therapist
Pediatrician
Physiatrist
Physical Therapist
Psychiatrist
Psychologist
Social Worker
Special Educator
Speech Therapist
Other
Specific Intervention Strategies Used
Supplemental Programs Offered
Insurance*
Do you accept insurance/Medicaid? Yes No
What types of insurance do you accept?
Equipment and Environment Checklist
(check all that apply)
Physical Environment
Handicap accessible
Equipment arranged for rapid change of physical/spatial environment
Hooks to hang suspended equipment
    # of hooks
Rotational devices attached to ceiling
    # of devices
Set of bungee cords to hang suspended equipment
Quiet space
Large space for physical activity
Total square footage in treatment rooms
Number of rooms

Safety Features
Mats, cushions, pillows for padding
Equipment adjusts to child's size
Accessible equipment monitored for safe use
Unused equipment stored away from children
Documentation of equipment maintenance and upkeep

Available Equipment
Things to climb on
Props/materials to support engagement in play
Hanging inner tube
Scooter/ramp
Tire swing
Trampoline
Visual targets
Therapy balls
Platform swing
Ramps
Ball pit
Creative and fine motor task material
Props/materials for pretend play and practicing skills
Vibrating massagers
Flexion disc
Crash pillow
Spandex hammock
Steps
Ladders
Net swing
Tunnels
Rubber/rope pull strips
Oral motor supplies
Auditory materials
Weighted ball/bean bags
Platform glider swing
Inflatables/air mats
Tactile materials
Barrel for rolling
Frog swing
Bolster swing
Other primary equipment

Additional Features
Written evaluation provided to parent
Written goals and objectives provided to parent
Written progress notes provided to parent
Written discharge summary provided to parent
Flexible scheduling, including late afternoon appointments and Saturdays
Family/parent education included
Home programs included
Intensive programs
Groups
Consultation with schools included
*Insurance eligibility varies depending on diagnosis and other issues. This information does not constitute a guarantee that any individual will be covered by their insurance policy. It is the family’s responsibility to check with their provider to see if insurance coverage is available under their policy.
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DISCLAIMER: The KID Foundation provides this data for informational purposes only. This listing does not constitute an endorsement by the KID Foundation. There is no guarantee that the information above is correct, up-to-date, or complete. Do not rely upon or act on the basis of this information without seeking current information from the individual listed. Obtaining this information from this web site does not create or imply that a professional relationship exists between you and the KID Foundation, or the individual listed herein and the KID Foundation or any of its staff. Use of the KID Foundation SPD Treatment Directory is expressly conditioned on your acceptance of the terms of this Disclaimer.


Questions or comments about the SPD Treatment Directory? Please email our Development Director, or call the KID Foundation at 303-794-1182.

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