Pediatric Therapy Services in Irvine, CA
Occupational therapy, speech therapy, feeding therapy, and sensory integration for children from birth through age 12.
Tumble N' Dots is a boutique pediatric therapy clinic in Irvine, established in 2016. Our occupational therapists, speech-language pathologists, and feeding therapists all work under one roof and collaborate together.
Signs your child may benefit from therapy
Parents usually call because something has been nagging at them for a while. Here is what that often looks like.
Body and movement
- Bumps into things, trips, or seems clumsy
- Avoids swings and slides, or never gets enough
- Struggles with buttons, zippers, scissors, handwriting
- Tires quickly during play or schoolwork
- Dressing or toileting is taking longer than expected
Talking and connecting
- Fewer words than other children the same age
- Hard for people outside the family to understand
- Repeats phrases or scripts from shows and books
- Difficulty joining or staying in play with other kids
- Big frustration when they are not understood
Eating and daily routines
- Eats fewer than about 30 different foods
- Gags at or refuses whole textures or food groups
- Mealtimes have become a standoff
- Strong reactions to noise, tags, haircuts, or lights
- Hard time settling down after a busy day
Any one of these on its own can be typical. When several show up together, or when they start getting in the way of school, meals, or friendships, an evaluation gives you a clear answer instead of a guess.
Therapy services we provide
Every service below runs at our Irvine clinic, and several are also delivered at your child's school. Many children work with more than one of our therapists.
Pediatric Occupational Therapy
Play-based OT for the skills daily life actually asks for: fine motor and handwriting, self-care, motor planning, attention, and emotional regulation. All of our OTs are trained in sensory integration.
Occupational therapy in Irvine
Speech and Language Therapy
For how your child understands and uses language: articulation, expressive and receptive language, fluency, social communication, and AAC. Our speech-language pathologists hold master's degrees and ASHA certification.
Speech therapy in Irvine
Feeding Therapy
For children whose list of accepted foods keeps shrinking, who gag on textures, or for whom every meal is a battle. Sessions run in a kitchen and dining area built for this, using sensory play and oral motor work.
Feeding therapy for picky eaters
Sensory Integration Therapy
For children whose nervous systems over-respond or under-respond to touch, movement, and sound. Swings, crash pads, a climbing wall, a zip line, and obstacle courses, plus coaching so the strategies work at home too.
Sensory integration therapy
Gestalt Language Processing
Some children learn language in whole phrases and scripts rather than single words. We use the Natural Language Acquisition framework to move from scripts toward flexible, self-generated language, treating echolalia as real communication.
Gestalt language processing
Animal Assisted Therapy
Summer, a professionally trained therapy dog, joins occupational therapy sessions to support regulation, motor skills, and social confidence. Led by Dr. Phoebe Yam, OTD, OTR/L, CPDT-KA, C-HAIS.
Animal assisted therapy
Intensive Therapy Programs
Concentrated blocks of therapy over spring, summer, and winter breaks, and year-round through Tumble-N-Grow. Several sessions a week with the same familiar therapists tends to move goals faster than a weekly schedule can.
Intensive therapy programs
Social Skills Groups and Camps
Small, age-banded groups where children practice social skills the way they actually use them, through cooking, board games, music, sports, and play. Ages 2 through 12, with group sizes kept small on purpose.
Social skills groups and camps
School Collaborations and Screenings
Our therapists work inside partner classrooms across Orange County, setting goals alongside teachers so strategies carry into the school day. We also run developmental screenings and workshops for parents and staff.
School collaborations
Evaluations and Consultations
A three-part evaluation: a consult visit with standardized assessments, a clinical observation session, and a family meeting where we walk you through what we found and what we recommend.
Evaluations and consultations
Homeschool Enrichment
Daytime classes built for homeschooling families: art, cooking, all-ability sports and movement, and social groups, taught by our therapists during school hours.
Homeschool enrichment
IEP Support and School Observations
We attend IEP meetings, observe your child in their classroom, and translate what we see into goals the school team can act on. Available to current clients as part of a therapy plan.
How the therapy process worksWhat makes therapy here different
Most clinics see a child for an hour and send them home. We are built the other way around.
- One team, collaborating together. Our OTs, speech-language pathologists, and feeding therapists all work under one roof and collaborate together on your child's care.
- Parents in the room. You are welcome in sessions, and you leave knowing what to try at home.
- Child-led and play-based. We follow your child's interests. Children work harder when the work looks like play.
- Neurodiversity-affirming. Goals are about participation and comfort, not making a child look typical.
- Boutique by design. Caseloads stay small so your therapist knows your family, not just your file.
- One building, built for this. Two sensory gyms, a dedicated group therapy area, a feeding therapy kitchen and dining area, a multi-sensory room, a comfortable waiting room, and a loving team.
Who is behind Tumble N' Dots
Avital Shuster
- BS and MS in Occupational Therapy, University of Southern California
- Post-professional Ayres Sensory Integration training through CLASI
- DIRFloortime trained
- HBCC trained (Helping the Behaviorally Challenging Child)
- Advanced SOS Approach to Feeding training
Avital has been working with children since 2000. She spent about five years as a preschool teacher before going to USC for her bachelor's and master's in occupational therapy, and went on to spend ten years as a pediatric occupational therapist in the public school system with Irvine Unified School District. She founded Tumble N' Dots in 2016.
Those years inside classrooms shape how the clinic runs. It is why our therapists go into partner schools, sit in on IEP meetings, and write goals that a teacher can actually use on a Tuesday morning. It is also why so much of what we do involves parents directly. Avital's approach centers on helping families see their child's strengths and use supportive strategies that hold up in real routines, at the dinner table and in the morning rush, not just in a therapy room.
She has worked with children in clinic, home, school, telehealth, and community settings.
What to expect, from first visit to discharge
Come in for a tour
Start by visiting the clinic and meeting our clinical staff. You will see the gyms and the rooms your child would actually use, and you can talk through what you have been noticing at home and at school.
Evaluation, or send us yours
If your child does not have a valid evaluation from the last 10 months, we start with one. It runs in three parts: a consult visit with standardized assessments, a clinical observation session, and a family meeting where we walk you through the findings. If you already have one that is less than 10 months old, send it over and we will work from it.
Therapy
Sessions run 50 minutes, and most children come once a week. Goals are set at three and six months. We meet with parents every two months to review progress, and re-evaluate formally every six months.
Home program and discharge
When your child is ready, we taper rather than stop. You leave with a final re-evaluation, an updated home program, and a written discharge summary for your pediatrician or school.
Who we work with
We see children from birth through age 12, with a wide range of diagnoses and, often, no diagnosis at all. A referral is not required to start.
Paying for therapy
We are an out-of-network provider and are not contracted with any insurance plan, which means we do not bill your insurance directly. What we do instead:
- You receive a detailed superbill twice a month, on the 1st and the 15th, with every code your insurance needs to consider reimbursement.
- Superbills are always available in your parent portal, so you are never waiting on us for a copy.
- Occupational therapy and speech therapy are generally eligible FSA and HSA expenses.
- Many of our families do receive reimbursement. Rates vary by plan, and insurers pay families directly.
Visit our Irvine clinic
Address
15265 Alton Parkway
Suite 140
Irvine, CA 92618
Contact
Call or text
(949) 835-3746
hello@TumbleNDots.com
Therapy hours
Mon to Fri 8:30am to 7:00pm
Sat 8:30am to 5:00pm
Sun 10:00am to 3:00pm
Office hours
Mon to Fri
9:00am to 6:00pm
Inside you will find two sensory gyms with a climbing wall and a zip line, a kitchen and dining area built for feeding therapy, a multi-sensory room, a dedicated group therapy area, and a comfortable waiting room. Families come to us from Irvine, Tustin, Lake Forest, Newport Beach, Newport Coast, Costa Mesa, Huntington Beach, Long Beach, Mission Viejo, Rancho Mission Viejo, Rancho Santa Margarita, Coto de Caza, Aliso Viejo, and across Orange County.
Frequently asked questions
How long is a therapy session?
What age children do you work with?
Do you take insurance?
Do I need a referral from my pediatrician?
How do I get started?
What happens at the evaluation?
Can my child receive more than one kind of therapy?
How long has Tumble N' Dots been open?
Do you work with schools?
Come see the space
The easiest way to know whether we are the right fit is to walk through it. Book a tour with our clinical staff and bring your questions.