Sherice: Understanding the Unique Developmental Profile of a Toddler with Sensory Processing Differences and Language Delay

Who Is Sherice? A Developmental Snapshot at 28 Months

Sherice is a bright, observant 28-month-old girl enrolled in an inclusive early learning center in Portland, Oregon. Diagnosed at age 24 months by a pediatric developmental-behavioral specialist, she presents with moderate sensory processing disorder (SPD) affecting auditory, tactile, and vestibular systems—and a clinically significant expressive language delay. Her receptive language remains within the low-average range, while her expressive vocabulary stands at just 17 words per the MacArthur-Bates Communicative Development Inventories, Second Edition (CDI-2), administered in March 2024. She uses no two-word combinations consistently and relies heavily on gestures, vocalizations, and eye contact to communicate needs. Sherice’s case exemplifies how sensory regulation challenges directly impact communication, social engagement, and participation in daily routines—yet also highlights robust potential for growth when interventions are precisely calibrated, consistent, and relationship-based.

Assessment Data: Validated Metrics That Guide Intervention

Accurate intervention begins with objective, standardized assessment—not assumptions. Sherice’s team conducted three key evaluations between January and April 2024: the Sensory Processing Measure–Preschool (SPM-P), the MacArthur-Bates CDI-2, and the Assessment, Evaluation, and Programming System for Infants and Children (AEPS®). These tools provide quantifiable benchmarks, not just qualitative impressions.

SPM-P: Identifying Sensory Thresholds and Responses

The SPM-P evaluates eight sensory domains across home and preschool settings. Sherice scored in the clinical range (T-score ≥ 65) in three areas: Auditory Processing (T = 71), Tactile Processing (T = 69), and Vestibular Processing (T = 67). Notably, her scores were significantly higher in the preschool environment than at home—suggesting environmental stressors amplify dysregulation. For example, her auditory sensitivity manifested as covering ears during group circle time (even with volume at 55 dB, measured via Sound Level Meter app by NIOSH), avoiding the music area where background noise averages 62–68 dB, and becoming tearful when the classroom doorbell rang (a sudden 82 dB impulse sound).

CDI-2: Mapping Expressive and Receptive Language Gaps

The CDI-2 parent questionnaire revealed Sherice produced only 17 words spontaneously (e.g., “milk,” “uh-oh,” “ball,” “bye-bye”) and understood approximately 120 words—placing her receptive vocabulary at the 25th percentile for age, but expressive vocabulary below the 5th percentile. She did not use any word + gesture combinations (e.g., “more” + reaching) more than once weekly, nor did she imitate novel words reliably—even after 10+ exposures. This pattern aligns with research showing that children with SPD often experience ‘auditory gating’ disruptions, making it harder to attend to, retain, and reproduce speech sounds (Cascio et al., Journal of the American Academy of Child & Adolescent Psychiatry, 2016).

AEPS®: Tracking Functional Skills Across Domains

The AEPS® assessment, completed by her early interventionist and lead teacher, documented functional skills across six domains: fine motor, gross motor, adaptive, cognitive, social-communication, and social-emotional. At baseline, Sherice scored in the ‘Emerging’ level for 12 of 18 social-communication items—including ‘uses eye contact to request,’ ‘responds to name within 3 seconds,’ and ‘uses gestures consistently.’ She scored ‘Not Observed’ for ‘uses words to request’ and ‘imitates words.’ In social-emotional development, she demonstrated strong attachment behaviors (e.g., seeks comfort from primary caregiver), yet showed elevated avoidance of peer proximity—maintaining >1.5 meters distance during free play, per timed observational coding across five 10-minute samples.

Everyday Behaviors: What Sherice’s Actions Communicate

Behavior is communication—especially for toddlers with limited verbal tools. Sherice’s actions consistently signal unmet sensory or communicative needs rather than defiance or disengagement. Her teachers and family have learned to interpret cues such as: rapid blinking before transitioning to carpet time; pressing her palms firmly against tabletops before snack; and humming softly while lining up toys in strict color order. These aren’t ‘quirks’—they’re self-regulatory strategies. When these supports are unavailable or interrupted, observable stress responses follow: increased mouthing of clothing tags (measured at 4.2 instances per hour during unstructured transitions), brief episodes of toe-walking (lasting 12–45 seconds), and withdrawal behind the bookshelf during large-group activities.

Mealtime Patterns: A Window Into Sensory Integration

At lunch, Sherice eats only seven foods consistently: oatmeal with cinnamon, banana slices, whole-milk yogurt (Fage Total 5%), steamed carrots cut into 1 cm cubes, soft pear wedges, shredded cheddar (Cabot Seriously Sharp), and water served in a 4 oz. Honey Bear squeeze bottle. She refuses all crunchy, slimy, or mixed-texture foods—including applesauce with chunks, cottage cheese, and rice cereal. Texture aversion was formally assessed using the Food Texture Questionnaire (FTQ), where she scored 23/30 (clinical cutoff = 18), confirming oral-sensory hypersensitivity. Her intake is nutritionally adequate (per 3-day food log analyzed via MyPlate Kitchen software), but highly restricted. Importantly, she eats more readily in quiet corners with dimmed overhead lights (reduced from 300 lux to 120 lux using Lutron Maestro dimmers) and when seated on a Wedge Seat (20° incline, size Small, by Special Tomato).

Movement and Play Preferences

Sherice demonstrates clear vestibular seeking behaviors: she climbs stairs sideways, rocks vigorously on therapy balls (Gaiam Balance Ball, 45 cm diameter), and spins in place for up to 90 seconds without dizziness. Yet she avoids swings unless fully supported in a bucket seat (Bumbo Multi-Seat with full torso harness). Her preferred play materials include smooth, cool objects (stainless steel measuring spoons, silicone stacking rings by Oli & Carol), and high-contrast visual stimuli (black-and-white board books from the Look! Look! series by Peter Linenthal). She avoids foam blocks, feather dusters, and scented playdough (including popular brands like Crayola Air-Dry Clay and Colorific Modeling Dough), which trigger immediate avoidance or gagging.

Evidence-Based Strategies That Support Sherice’s Growth

Interventions for Sherice are grounded in three pillars: sensory modulation, aided language stimulation, and predictable structure. None rely on compliance-based techniques. Instead, they prioritize co-regulation, autonomy-supportive scaffolding, and neurodiversity-affirming practices. Each strategy has been tracked for fidelity and outcomes over six months.

• Sound-Reduced Zones: The classroom added two designated quiet zones—one with acoustic panels (Audimute Broadway Panels, NRC 0.85) and noise-dampening rugs (Mohawk SmartStrand Ultra, 45 oz/yd² face weight); the other a tented area lined with cork tiles (Wicanders 4 mm CorkSheet). Average ambient noise dropped from 68 dB to 51 dB in Zone A during peak hours.
• Visual Schedules with Real Photos: Sherice uses a 6-step laminated schedule (8.5" × 11") with actual photos of her classroom spaces and staff. Each photo includes a simple symbol (e.g., a spoon for lunch, a blue mat for circle time). Staff reviewed the schedule with her using the ‘First–Then’ framework 12× daily. Within four weeks, transition latency decreased from 4.7 minutes to 1.3 minutes (timed across 30 trials).
• Augmented Communication Tools: She now accesses a 12-icon PODD (Pragmatic Organization Dynamic Display) mini-book with velcro-backed symbols. Icons include ‘help,’ ‘break,’ ‘more,’ ‘all done,’ ‘juice,’ and ‘book.’ She initiates requests using icons 5.2 times per day (up from 0.3 at baseline), per ABC (Antecedent-Behavior-Consequence) logs.

Collaborative Care: Bridging Home and School

Consistency across environments is non-negotiable for neural integration. Sherice’s family and teaching team meet biweekly via secure Zoom (HIPAA-compliant version) and share digital logs using the HiMama platform. Shared priorities include: building shared attention during book reading, increasing vocal play, and expanding food repertoire through systematic desensitization.

Shared Book Reading Protocol

Using the Hanen Program’s It Takes Two to Talk framework, adults implement ‘pause and wait’ (minimum 5-second silence after each page turn), label objects with exaggerated intonation (“BALL!”), and model expansions (“big red ball”). They avoid questions (“What’s this?”) and instead narrate (“You’re turning the page!”). Over 12 weeks, Sherice increased spontaneous vocalizations during reading from 0.8 to 4.1 per 5-minute session (recorded and coded using the Language Environment Analysis [LENA] system).

Food Exploration Without Pressure

Rather than demanding bites, Sherice’s family follows the ‘SOS Approach to Feeding’ (sequential oral sensory) step-by-step hierarchy. Each meal includes one ‘safe food’ and one ‘learning food’ presented neutrally—on the plate, not on the fork. Learning foods rotate weekly: Week 1: raw cucumber stick (tactile exposure); Week 2: cucumber stick dipped in yogurt (taste introduction); Week 3: small dice of cucumber (bite-size exploration). After 16 weeks, she voluntarily touched 9 new foods, licked 5, and accepted 2 (cucumber and roasted sweet potato) into her mouth—meeting her IEP goal of ‘taste 3 novel foods’ three months ahead of schedule.

Measurable Progress: Six-Month Outcomes

Objective data confirm meaningful gains—not just ‘improvement’ but statistically reliable change. Below is a summary of Sherice’s progress across core domains, measured at baseline (January 2024) and follow-up (June 2024).

These gains reflect fidelity to intervention—not just time passing. For example, her expressive vocabulary increase correlates directly with the number of aided language stimulation opportunities delivered: staff provided 217 modeled utterances per day (via tally counters), totaling 27,342 models over 126 school days. Her first spontaneous ‘more juice’ occurred on Day 89—after 21,144 exposures. This underscores that neuroplasticity in toddlers requires both dosage and precision.

What Sherice Teaches Us About Early Intervention

Sherice’s progress reminds us that ‘delay’ is not deficit—and that sensory differences are not barriers to connection, but invitations to innovate. Her teachers no longer ask, ‘How do we get her to sit still?’ but ‘What does her body need to feel safe enough to listen?’ Her family no longer worries, ‘Will she ever talk?’ but celebrates, ‘She told me “blue sock” today—and pointed to her foot.’ These shifts in framing—from fixing to supporting, from compliance to collaboration—are what transform outcomes.

Importantly, Sherice’s success did not require eliminating her sensory preferences. She still lines up toys. She still rocks before circle time. But now those behaviors occur alongside new capacities: pointing to pictures in books, handing a puzzle piece to a peer, and saying ‘up’ when she wants to be lifted. Her regulation strategies and communication tools coexist—not compete.

Her story also reveals gaps in current systems. While her IEP team included an occupational therapist and speech-language pathologist, no certified behavior analyst (BCBA) was assigned—despite her eligibility under IDEA Part C criteria for ‘autism spectrum disorder features with sensory-communication overlap.’ This delayed access to functional behavior assessments (FBAs) for her mealtime gagging, which resolved only after a BCBA joined the team in Month 4. It underscores that interdisciplinary coordination—not just presence—is essential.

Finally, Sherice reminds educators that inclusion isn’t about physical presence in a room. It’s about designing environments where a child’s nervous system can settle, their voice can emerge, and their curiosity can unfold without penalty. When Sherice hums while sorting red blocks, that’s not off-task behavior—it’s auditory self-regulation enabling visual discrimination. When she presses her hands on the table before snack, that’s tactile grounding preparing her for oral-motor engagement. Seeing behavior as biology—not willfulness—changes everything.

Resources for Educators and Families Supporting Similar Profiles

Supporting toddlers like Sherice requires accessible, actionable resources—not theoretical frameworks alone. Below are vetted tools used successfully in her program:

1. Sensory Diet Generator: Free online tool by STAR Institute (starinstitute.org) that creates individualized daily sensory activity plans based on SPM-P or SPD Checklist scores. Sherice’s plan includes 3× daily proprioceptive input (wall pushes, heavy work with TheraBand resistance bands), 2× vestibular input (spinning on SitFit cushion), and scheduled auditory breaks.
2. Language First Curriculum: Developed by the Center for Literacy and Disability Studies at UNC Chapel Hill, this evidence-based, AAC-integrated curriculum is aligned with ECERS-3 standards. Sherice’s team used Module 2 (‘Building Communication Routines’) to embed 12 targeted vocabulary words across snack, cleanup, and arrival routines.
3. HiMama Daily Notes Template: Customizable digital log with embedded prompts for sensory observations (‘What did child do with hands/mouth/body before transition?’), communication attempts (‘Gesture? Sound? Word? Icon?’), and environmental notes (‘Lighting? Noise level? Peer proximity?’). Used by 92% of staff for daily data capture.
4. LENA Grow Reports: Monthly analytics on adult-child interaction patterns, including conversational turns, vocalizations, and ‘talk time’ duration. Sherice’s reports showed her vocalizations increased 210% from Jan–Jun, with greatest growth during outdoor play (where auditory demands are lower and movement supports regulation).

For families, the Early Start Denver Model (ESDM) Caregiver Coaching Manual (Rogers & Dawson, 2010) proved especially useful—not as a clinical protocol, but as a source of playful, embedded strategies. One activity, ‘Copy Cat Play,’ involved mirroring Sherice’s vocalizations and gestures for 30 seconds, then pausing. Within five weeks, she began initiating reciprocal vocal play—an early marker of joint attention and turn-taking.

None of these resources ‘fixed’ Sherice. Instead, they gave her adults clearer lenses, more responsive tools, and deeper trust in her capacity to grow—on her own neurodevelopmental timeline. Her vocabulary doubled. Her anxiety decreased. Her joy became more visible—in the way she taps her spoon rhythmically during songs, or how she now waits patiently beside the bookshelf for her turn with the pop-up Where’s Spot? book.

Sherice is not a case study. She is a toddler who loves lavender-scented playdough (introduced in Month 5 after olfactory desensitization), who laughs deeply when her teacher wiggles her fingers near her ribs, and who points emphatically at pigeons outside the window while saying ‘bird!’—her 42nd word, spoken clearly on a sunny Tuesday in late May. Her progress is real, measurable, and rooted in respect—not remediation.

Supporting children like Sherice doesn’t demand extraordinary talent. It asks for ordinary consistency, scientific humility, and the courage to replace ‘What’s wrong?’ with ‘What does this tell us?’ That shift—simple in wording, profound in practice—is where transformative early childhood education begins.