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Category Archives: Children

4 Reading Strategies that Facilitate Language Development

Are you looking for a simple, effective way to facilitate your child’s language development?  Reading to the rescue!

Did you know that reading to children allows for vocabulary and language growth?  Research shows that a child’s exposure to books has direct impact on his communication and academic skills.  Therefore, reading is an important activity for your daily routine.  Try these 4 simple strategies that can be incorporated into book reading to enhance and facilitate language development.

Read to your child with CARE

Comment

Comment on pictures and actions occurring in the story.  For example, you could say, “Look! Curious George is climbing the tree.”

Ask Questions

Ask questions about the story and its associated pictures. For instance, you could ask, “What is George doing?” Try to vary the types of wh- questions you ask (who, what, where, when, why).  Additionally, you can ask questions about events that haven’t occurred yet in the story to assist your child with making predictions.  For example, you could ask, “What do you think will happen to George at the end of the story?”

Respond

Respond to your child’s communication during the story.  If your child asks a question about the story, you can provide an answer.  If your child makes a comment or prediction, you can provide a response.

Expand

Expand on what your child says by adding more words to what s/he has said.  For example, if your child says “George banana,” you could expand by saying, “George is eating the banana.”

Here is a great video from Dr. Roseberry-McKibbin showing CARE in action.

References:

Roseberry-McKibbin, C. (2014). Multicultural students with special language needs: Practical strategies for assessment and intervention (4th ed.). Oceanside, CA: Academic Communication Associates.

Literacy Activities to Try at Home

In honor of Dr. Seuss’s upcoming birthday, I thought I’d do a post about literacy activities.  Did you know that a child’s exposure to books greatly impacts his/her communication and academic skills?  Through this post, I hope to share some easy-to-implement literacy activities.  These activities will help your child improve his communication, vocabulary, and literacy skills.

4 Easy Literacy Activities

1. Engage your child in rhyme

There is probably no one more famous than Dr. Seuss when it comes to rhyme.  Take, for example, one of his most popular books, The Cat in the Hat.  There are rhymes abound on every page.  Keep in mind, though, you don’t just have to rely on Dr. Seuss or other rhyming books to encourage or develop this skill.  Aside from books, other great tools to encourage rhyme are nursery rhymes and children’s songs.  Whether it be a familiar story or song, try pausing at crucial parts to see if your child can fill in the appropriate word (e.g., The cat in the _____).

2. Use wordless picture books

Have you ever heard of a wordless picture book?  If not, it’s exactly as it sounds.  It’s a picture book with absolutely no words.  Now, I’m sure you’re wondering how a book with no words could encourage literacy development, but hear me out.  By using wordless picture books, children can practice making up their own stories and developing narrative skills that are so important for both understanding and telling stories.  If the idea of telling a story is new to or difficult for your child, you can make up the story first and then give your child a turn.  Two great books that I use in therapy are The Boy, the Dog, and the Frog by Mercer Mayer and Pancakes for Breakfast by Tomie DePaola.

3. Have a letter/word scavenger hunt

Who doesn’t love a good scavenger hunt?  Scavenger hunts are activities I use a lot in therapy because many different skills can be practiced while allowing children to run around and have fun.  If your child is just beginning to learn and recognize letters, see if she can find specific ones when you’re out at the grocery store or driving in the car.  This is a game my son absolutely loves.  If your child is learning to read words, you look for familiar words in books, magazines or even on food containers (e.g., the cereal box).

4. Role play your favorite story

Does your child have a story or book that he makes you read over and over and over again?  I know mine sure does.  Whether it’s your child’s favorite book or one that is fairly new, use role play to bring the story to life.  For some children, sitting for a story can be a difficult task, so by bringing puppets or costumes into the mix you can grab their attention.  There are many story kits you can buy to accomplish this task, but I suggest looking for things you already have around the house to act out the story.  The more you and your child use your imaginations, the better the learning experience will be!

 

This is certainly not an exhaustive list of literacy activities, but I hope it’ll get your mind thinking of other ways you can engage your child in the magical world of story.  For some more inspiration, visit Seussville.

 

5 Household Objects that can Double as Toys

Children learn many things through play.  Unfortunately, though, toys can be expensive.  If you’re looking for some inexpensive play activities, look no further!  Check out this list of 5 household objects that can double as toys.

  • Cups
  • Toilet paper/paper towel roll
  • Tongs
  • Bowl/Container
  • Spoon

Watch this video to see how you can use these objects with your kids.  Remember the sky’s the limit and your imagination is endless!

Let’s Go Bowling: Supporting Communication at the Bowling Alley

It might seem odd that I’m writing a post about bowling on a beautiful, sunny spring day when most people are thinking about spending time outside, but it’s always good to think of activities we can do when the weather isn’t so great (in fact this holiday weekend, the forecast in northern NJ is all rain!).  Bowling to the rescue!  There is actually a great nationwide program for children to enjoy bowling all summer long — for free — called Kids Bowl Free.  Although adults don’t have the option to bowl completely free, there are package options where parents, grandparents, caregivers, etc. can bowl with their children at a significantly reduced cost.

Now that you know about the Kids Bowl Free program, I’m sure you’re wondering what on Earth bowling has to do with supporting communication. Am I right?  It’s not the first activity that comes to mind when you think of supporting communication; however, bowling is a social activity and any social activity is a great opportunity to encourage communication.  The best thing about bowling is that it can be enjoyed by children and adults alike, so any person, young or old, regardless of communication level or type of disability, can enjoy some time at the bowling alley and practice his/her skills.

At the bowling alley, we can support communication by:

  • Socializing with existing friends and making new ones
  • Practicing sharing and taking turns (e.g., It’s your turn.)
  • Talking about colors, shapes and sizes (e.g., red ball, round ball, big ball)
  • Learning about sequence (e.g., I go first, you go next, he goes last.)
  • Using exclamations (e.g., Strike! Good job!)
  • Talking about what’s happening (e.g., The pins fell down.  The ball rolled down the lane.)

That’s just a few ways you can work on communication skills at the bowling alley.  What indoor activities do you enjoy for practicing communication skills?

 

Introduction to Telepractice

Telepractice (AKA telemedicine, teletherapy, telehealth, telespeech, telerehabiliation, virtual speech therapy) is the delivery of health services via a telecommunications system. This service model is becoming increasingly more popular in the fields of speech-language pathology and audiology. Large factors that have driven the use of telepractice are reducing travel time for the client and/or professional and expanding the reach of services. Telepractice is becoming a more widely used and accepted method of providing speech-language pathology and audiology services. However, many families are skeptical that the services provided through a computer could be beneficial or equally as productive as those provided face-to-face. Despite family reservations, researchers (e.g., Gorgan-Johnson and colleagues) have found that children receiving virtual speech therapy do as well as those receiving services in person.

Benefits of Telepractice

  • Decreases the rate of cancelations or no shows
    • Sessions can still occur in bad weather or when the speech-language pathologist (SLP) or client are sick.
  • Allows underserved populations to receive evaluations and treatment
    • Individuals living in rural towns may struggle to find local in-person services for their needs. Furthermore, individuals from culturally or linguistically diverse backgrounds may struggle to find appropriate services in their area. By using telepractice, these clients are able to receive the services they deserve.
  • Increases family involvement in the sessions
    • Family members can have a more active involvement by assisting clients with the session activities.
  • Increases interest or attention with clients that are motivated by and/or more comfortable in front of computers
    • Clients may be more engaged during their sessions because they enjoy being on the computer. They may also feel more comfortable asking and answering questions and performing difficult tasks with the computer screen as a safety net.
  • Allows clients to connect with professionals who specialize in their disorder or disability and/or can provide services in their native language
    • Speech-language pathology is a broad field. Although all SLPs receive some degree of training in all aspects of speech, language, and swallowing disorders, most  specialize in certain areas over areas.  For example, some SLPs may specialize in working with children with autism while others may have extensive training in treating adults who have aphasia. In addition, the majority of SLPs are monolingual and/or do not have the training to provide appropriate services to a bilingual client.
  • Makes sharing information easier
    • Clients and SLPs can share their computer screens and upload files to enhance the therapy session.
  • Helps clients and families to remember and understand what occurred during the session
    • Virtual therapy sessions can be recorded (with permission) and used for later review. By recording the sessions, clients and family members can watch what occurred. Watching the recordings assists clients with practice and carryover of skills. Moreover, watching previously recorded sessions allows everyone to observe the progress that has occurred.

How can we help?

At Liberty Speech Associates LLC, we provide telepractice sessions for the following purposes: accent modification, counseling, speech-language evaluations and treatment, speech-language screenings, and collaboration with related professionals. For more information on our telepractice services, contact us today.

References

  1. Grogan-Johnson, S., Alvares, R., Rowan, L., & Creaghead, N. (2010). A pilot study comparing the effectiveness of speech language therapy provided by telemedicine with conventional on-site therapy. Journal of Telemedicine and Telecare, 16(3), 134139.
  2. Grogan-Johnson, S., Gaebel, R., Taylor, J., Rowan, L. E., Alvares, R., & Schenk er, J. (2011). A pilot exploration of speech sound disorder intervention delivered by telehealth to school-age children. International Journal of Telerehabilitation, 3(1), 3141.
  3. Grogan-Johnson, S., Schmidt, A. M., Schenker, J., Alvares, R., Rowan, L. E., & Taylor, J. (2013). A comparison of speech sound intervention delivered by telepractice and side-by-side service delivery models. Communication Disorders Quarterly, 34(4), 210220.

Understanding Eligibility Criteria for School-Based Speech Therapy

Children (age 3 and up) are allowed to receive speech-language therapy and related services through their local public school district. However, students must meet specific criteria in order to be eligible for these services. The eligibility criteria vary from state to state. Because my practice is based in New Jersey, the purpose of this post will be to discuss the eligibility criteria for speech-language therapy in NJ Public Schools.

 

Speech-language therapy and related services in NJ Public Schools is mandated by Chapter 14 of the New Jersey Administrative Code. If you have a child in need of services or already receiving services, it’s important that you read and familiarize yourself with the Code to ensure your child is getting the services s/he deserves.

 

Preschool child with a disability” is the classification used for children between the ages of 3 and 5, who present with developmental delays. A developmental delay is described as a 33% delay in one area of development or a 25% delay in two or more areas of development. Areas of development include: physical (gross and fine motor), intellectual, communication, social-emotional, and adaptive/self-help. A child may also qualify for speech-language therapy and related services under this classification if s/he has a diagnosed disabling condition that could impact education.

 

 

Communication Impaired” is a classification used for children older than 5. A child receives this classification if s/he presents with a language disorder that negatively affects his/her ability to learn. A child may have difficulties in any or all of the following areas: morphology, syntax, semantics, pragmatics. To determine if a child falls under the “communication impaired” classification, s/he should undergo functional assessment outside of the testing situation and participate in at least two standardized language tests (when appropriate). If the child’s performance is more than 1.5 standard deviations below the mean, s/he is eligible for speech-language services.

 

 

In addition to the two aforementioned classifications, a child may also qualify for speech-language therapy as a result of a speech disorder. A speech disorder is a disorder in any or all of the following areas: articulation, phonology, fluency, voice. Difficulties in any of these areas should be considered unrelated to dialectal or cultural differences or influences from a foreign language. Criteria for classification of a speech disorder are listed below:

 

  • Articulation/phonology: Using a standardized articulation or phonology test, a child must present with one or more sound production errors on sounds that 90% of children of the same age have reached mastery. A child must also consistently produce the errors in a speech sample.
  • Fluency: A child must display a mild rating or higher on a fluency rating scale and in a speech sample. A child must also exhibit dysfluencies on at least 5% of words spoken.
  • Voice: A child must perform below the expected level for vocal quality, pitch, resonance, loudness and/or duration using a voice rating scale. The voice difficulties must be present on two separate testing sessions held at least three sessions apart.
 
This post is only a short summary regarding the eligibility criteria for speech-language therapy for preschool and school-aged children. It is solely meant to be an informational resource for parents and should not be considered a replacement for carefully reviewing the complete Code and speaking with relevant Board of Education personnel.

 

5 Tips for Communicating with Students who Stutter

 

School is finally back in session! With every new school year come new stresses, expectations, and faces. In speaking to a few teacher colleagues and friends, it’s become apparent that teachers are often not taught how to communicate with students with disabilities, particularly students who stutter. Without this knowledge, both students and teachers are put in an uncomfortable situation. For that reason, I decided to write this blog post to provide teachers with 5 tips on communicating with students who stutter and, in turn, help all students feel more comfortable speaking in the classroom. This blog post is based off of my YouTube video 5 Stuttering Tips for Teachers.

 

Here are the 5 tips:

1) Avoid saying, “slow down” or “think about what you want to say”

 

  • This is probably the most important of the 5 tips. Stuttering is not an issue of speaking too quickly or not thinking, so using these phrases with a student who stutters will have no positive effect. In fact, using these phrases may cause frustration or anxiety for the student who stutters. 

 

 

2) Don’t complete your student’s sentence/thought

 

  • If your student is in the midst of a stutter, completing his sentence/thought is not going to help the situation. Your student has his own unique thoughts and ideas and likely wants to share them like any other student. Although it may take a student who stutters longer to express himself, doesn’t mean he shouldn’t be afforded the opportunity. The best thing you can do as a teacher is to be patient and give the student ample time to speak. 

 


3) Give your student an opportunity to educate his peers about stuttering

 

  • Unfortunately many children with disabilities are bullied or mocked because their peers don’t understand their situations. It could be helpful to do lessons on disabilities and/or acceptance, as well as allow your student who stutters to present or do a project on the topic. 

 

 

4) Monitor your own body language when communicating with a student who stutters

 

  • You may feel uncomfortable communicating with your student who stutters because you don’t know how to help. If you feel this way, it could be evidenced in your body language by avoiding eye contact, looking away, etc., so be mindful of how you are reacting to the stutter both verbally and nonverbally. 

 

 

5) Model slow, relaxed speech

 

  • By modeling slow, relaxed speech your student may feel more comfortable communicating with you and may also try and imitate your rate which, in turn, may have a positive effect on the student’s stuttering episode.

 

 

I hope you find these tips helpful in communicating with your students who stutter. Please leave a comment with tips you’ve found to be the most helpful when communicating and interacting with students with disabilities.

 

Learning to Talk: Speech and Language Milestones Birth to 3

The first 3 years of a child’s life are crucial to overall development. A lot of changes occur in just 3 short years. For example, a child begins walking, talking, and developing a unique personality. It can be an exciting time for families as they watch their children develop new and exciting skills. While it is an exciting time, it can also be scary if you don’t know what to expect. How do you know if your child is developing “normally” (especially if this is your first child)? I’m here to help you navigate through the first 3 years with this blog post about speech and language milestones.

Before discussing the milestones, I’d like to briefly explain the terminology used to describe communication. Understanding the differences between these terms is important in monitoring your child’s development.

 

 

There are two types of language: receptive and expressive. Receptive language is our ability to understand words. Receptive language is fundamental in the development of expressive language and speech. A child’s ability (or inability) to understand sounds and words will impact how s/he uses those words. Expressive language is our ability to express ourselves. Many people think that expressive language is synonymous with speech, but that, in fact, is not true. Expressive language is a broader term. It’s how we express ourselves in all modalities, whether it be speaking, writing, gesturing. Speech, however, is the physical act of talking; it is the way we make sounds.

 

So now that you understand the different aspects of speech and language, let’s see how your child is doing:

 

 

Before 6 months, a child typically:

Vocalizes and coos

Varies vocalizations based on needs

Begins babbling

By 1 year, a child typically:

Follows some simple directions

Identifies familiar objects

Enjoys Peek-a-Boo

Imitates sounds and words

Says a few words

Waves and uses gestures

Between the ages of 1 and 2, a child typically:

Points to objects/pictures upon request

Pays attention to books and pictures

Answers simple questions

Uses new words frequently

Begins combining words

Uses words instead of crying or gesturing

Says the b, d, p, m, n, and h sounds correctly

Is understood 50% of the time by age 2

Between the ages of 2 and 3, a child typically: 

Follows two-step directions

Uses 2- and 3-word phrases and sentences

Tries to have a conversation

Is understood 75% of the time by age 3

Says the w, t, k, g, and f sounds correctly

 

Although these milestones are agreed upon by many in the field, it’s important to keep in mind that all children are different. Speech and language development can vary slightly from child to child. Therefore, it’s important to think about your child in comparison to other children in your family or in your community that are around the same age.

If your child is not following the pattern described above, or a pattern similar to those of the children in your family or community, your first step should be to have your child’s hearing tested by an audiologist. An audiologist is a hearing doctor and can complete a thorough examination of your child’s hearing ability (a pediatrician cannot perform this type of test). Hearing loss (even very mild hearing loss), as well as frequent ear infections or fluid in the ear, can impact a child’s speech and language development.

After you’ve had your child’s hearing tested, your next step should be to contact a speech-language pathologist to have your child’s speech and language skills evaluated.

 

References:

ASHA (n.d.). How does your child hear and talk? http://www.asha.org/public/speech/development/chart/

Coplan, J., & Gleason, J.R. (1988. Unclear speech: recognition and significance of unintelligible speech in preschool children. Pediatrics, 82,447-452.

McLeod, S. (2009). Speech sound acquisition. In J.E. Bernthal, N.W. Bankson & P. Flipsen Jnr (Eds.), Articulation and phonological disorders: Speech sound disorders in children (6th ed., pp. 63-120 + 385-405). Boston, MA: Pearson Education.

What to Expect During a Pediatric Speech and Language Evaluation

Although all speech-language pathologists structure their evaluations a little differently, there are crucial components that should be expected as part of all pediatric speech and language evaluations. These components include a family interview, an oral mechanism examination, assessment of articulation/phonology, assessment of voice, assessment of fluency, assessment of receptive and expressive language, and a discussion of the results. Depending on your child’s age, his reported difficulties, and/or the location of the evaluation, additional components of the evaluation may include: a teacher interview, a hearing screening, a play assessment, a feeding/swallowing assessment, and/or a narrative assessment. Each of the crucial components will be described in detail below:

Family Interview

The purpose of the family interview is to gather information about your child’s background, such as birth and medical history, speech and language concerns, past evaluations and/or therapies, developmental milestones, languages your child speaks and/or hears.

Oral Mechanism Examination

The purpose of an oral mechanism examination is to assess the structure and function of your child’s oral mechanism (e.g., lips, tongue, teeth, hard/soft palate) to support speech and/or feeding. Examples of tasks your child may be asked to do during this portion of the evaluation include moving his tongue from side-to-side, opening his mouth and saying “ah,” and raising his tongue to try and reach his nose.

Assessment of Articulation/Phonology

Articulation refers to the way we produce sounds using our oral mechanism and phonology refers to the way we organize sounds to form words. The purpose of assessing articulation and phonology is to observe what sounds your child can say, as well as to determine if your child has any errors in his speech and if there are patterns to those errors. For young children (under the age of 3), assessment of articulation and phonology is primarily done through a speech sample obtained during various play activities. A speech sample is exactly how it sounds – it is a sample of your child’s naturally occurring speech. For older children (above 3), assessment of articulation and phonology typically includes analysis of a speech sample obtained through conversation and/or play, as well as administration of a standardized test. During the standardized test, your child will look at pictures and/or objects, which represent all of the consonants (and depending on the test, also vowels) in Standard American English, and be asked to name them. The evaluator will transcribe what your child says for analysis.

Assessment of Voice

Voice refers to the quality, loudness, pitch, resonance and prosody of one’s speech. For most pediatric evaluations, especially for young children or when vocal characteristics are not a concern, assessment is done through a speech sample. The evaluator listens to your child’s speech to see if it appears appropriate for his age or gender. However, for older children and/or for those with vocal concerns, assessment may include a discussion of how your child is using his voice and his feelings about his voice, use of computerized software to analyze your child’s speech compared to same-age children, and/or laryngeal imaging.

Assessment of Fluency

Fluency refers to fluidity of one’s speech. The purpose of a fluency assessment is to determine if your child experiences stuttering and/or cluttering. For young children, assessment of fluency focuses on obtaining a speech sample to analyze any disruptions in the flow of your child’s speech. For older children with fluency concerns, assessment involves obtaining a speech sample, as well as discussing feelings about the fluency difficulties and situations when fluency skills are better/worse and administering a standardized fluency test. During the standardized test, your child may be asked a series of conversational questions, instructed to read different passages, and/or asked to describe various picture scenes.

Assessment of Receptive/Expressive Language

The purpose of a language assessment is to determine your child’s ability to understand and use language for a variety of purposes. Assessment of language includes obtaining a language sample, as well as administering standardized tests. The tasks your child is asked to do would depending on the test(s) administered; however, like with most standardized tests, your child is likely to be asked questions about different pictures, objects, and stories. For example, he may be asked to find a picture described by the evaluator (e.g., show me the big black dog).

Discussion of the Results

At the conclusion of the evaluation, there should be a discussion of results with the evaluating speech-language pathologist. The speech-language pathologist should share her findings (diagnoses, observations), inform you if additional testing by a speech-language pathologist or related professional is recommended or required, discuss if speech/language therapy is warranted, and answer any questions you may have.

 

 

Is it Apraxia?

Apraxia, also known as childhood apraxia of speech (CAS), has become the go-to diagnosis for many children in Early Intervention (under 3 years of age). However, many of these children do not have apraxia or are too young to receive a true diagnosis. So what is apraxia?

 

Apraxia is a motor speech disorder that makes it difficult for a person to coordinate the movements of the mouth for speech. Apraxia can occur in children or adults, but for the purpose of this post, I will focus on CAS. There is some debate over the exact diagnostic features of CAS, but some commonly described symptoms are:
  • Inconsistent errors 
  • Inappropriate prosody 
  • Vowel errors 
  • Limited inventory of consonants and vowels 
  • Increased difficulty with longer, more complex words and utterances

 


Additionally, children with CAS tend to be “late talkers;” however, late talking in and of itself does not warrant a diagnosis of CAS. As can be seen by the aforementioned symptoms, the characteristics of CAS are described with regards to talking, so if a child is not yet talking or not talking much, a clear diagnosis of CAS cannot be made. In fact, the American Speech-Language-Hearing Association goes so far as to say that “diagnosis below age 3 is best categorized under a provisional diagnostic classification, such as ‘CAS cannot be ruled out,’ ‘signs are consistent with problems in planning the movements required for speech,’ or ‘suspected to have CAS.’ 

If you have concerns with any aspect of your child’s speech or language development, it is suggested that you contact a local speech-language pathologist so that a thorough evaluation can be completed.

 

Resources: