As your child begins to use more complex language, you may notice an increase in dysfluent speech patterns. Preschool-aged children will go through periods of time of what is called normal dysfluencies. Dysfluencies that are common for this age are:
1) revisions: children revise what they have just said
2) interjections: um, uh, like, etc.
3) word repetitions: the-the
4) phrase repetitions: the dog-the dog
As you child nears school age, these dysfluencies should be less frequent. Below is a list of warning signs which may signify a true dysfluency.
1) frequent sound repetition: d-d-dog
2) frequent syllable repetition: do-do-dog
3) syllable repetition in which the vowel “uh” replaces the correct vowel in the word (i.e. “cuh-cuh-cat” rather than “ca-ca-cat”)
4) frequent prolongation that becomes longer in duration (i.e. “mmmmmmy” rather than “my”)
5) secondary characteristics: distracting sounds, facial grimaces, head movements, movements of the extremities
6) tension and struggled behavior while attempting to get out words
7) avoidance in saying certain words
8) a look of fear when trying to say the word
9) stutters for 6 months or longer
10) stutters for more than 10% of speech
If you notice any of the above behaviors, here are some general rules to follow:
1) do not rush the child when they are speaking
2) do not interrupt the child
3) do not talk about the child’s stuttering in front of them
4) do not ask questions and pressure the child to speak
5) do speak in a slower, more relaxed voice around your child
6) avoid telling your child to slow down, take it easy or repeat without stuttering
7) relieve tensions in the home
8) reassure your child with comments, such as “It’s ok. Many people get stuck.”
9) avoid finishing your child’s words or sentences
10) ensure that your child is getting proper rest and diet
If you think your child may have a stuttering disorder, please contact your local speech-language pathologist.
**Information taken from pro-ed (If you think your child stutters) and Disfluent Speech Behavior in Children, by Daniel DeJoy, Ph.D.
A speech-language evaluation measures a child’s communication skills. It is completed by a Speech-Language Pathologist. A referral from the primary care physician is typically required prior to the evaluation.
Before your child is seen for an evaluation, information is gathered, including medical history, developmental history, family history, educational history, therapeutic history, and primary concerns.
Formal tests may be completed during the evaluation, which is a way to compare your child to other children of the same age. A Speech-Language Pathologist may also informally assess your child. Informal tasks can include parental interview, discussion with other professionals (i.e. teacher, occupational therapist, etc.), observing how the child plays, and observing how the child interacts with adults/peers.
During a speech-language evaluation, the following areas may be assessed:
1) Receptive language-what the child understands
2) Expressive language-what the child says
3) Articulation-production of speech sounds
4) Pragmatic language-social use of language
5) Voice
6) Fluency
7) Oral peripheral examination-looks at structure and function of the face, lips, teeth, tongue, and palate
8) Hearing screening
A written report will follow the evaluation, and may include the following information: child’s history, speech-language testing results and recommendations.
At Child and Family Development in Charlotte, NC, an Interpretive Parent Conference is held after the evaluation to discuss findings, recommendations, and discuss normal speech-language skills. The Speech-Language Pathologist and parent/s are present during the meeting.
If you suspect that your child has a communication disorder, please contact your local Speech-Language Pathologist.
**Information shared from The Speech and Language Evaluation by Leslie S. McColgin
As a speech therapist at Child and Family Development in Charlotte, I conduct speech-language evaluations with children under 3 years old regularly.
This 3-part series shares information about receptive language developmental milestones.
Receptive language is what your child understands. It is an important part of early language development and is often forgotten. Some examples of early receptive language skills include following 1-2 step directions, identifying objects/pictures, recognizing actions in pictures/verbs in play, and identifying body parts/clothing. Below is a list of receptive language milestones for kids between ages 2-3 years old (information taken from The Early Intervention Kit, LinguiSystems).
24-27 months
• Points to four action words in pictures
• Understands size concepts (big and little)
• Understands the concept of one (give me just one)
27-30 months
• Responds to simple questions (i.e. Where’s mommy?)
• Understands 2 prepositions/location phrases (i.e. in, on, off, under)
30-33 months
• Follows 2 step unrelated commands
• Understands the concept “all”
• Answers yes/no questions correctly
33-36 months
• Follows 3 step unrelated commands
• Answers “wh” questions
• Identifies parts of objects
As a speech therapist at Child and Family Development in Charlotte, I conduct speech-language evaluations with children under the age of 2 years old regularly.
This 3-part series offers information about receptive language developmental milestones. Part 2 is focused on skills acquired during the second year of life.
Receptive language is what your child understands. It is an important part of early language development and is often forgotten. Some examples of early receptive language skills include following 1-2 step directions, identifying objects/pictures, recognizing actions in pictures/verbs in play, and identifying body parts/clothing. Below is a list of receptive language milestones for kids between ages 1-2 years (information taken from The Early Intervention Kit, LinguiSystems).
12-15 months
• Follows one-step commands during play
• Responds to “give me”
• Identifies 3 body parts of self or doll
• Understands some prepositions, such as up and down
15-18 months
• Identifies 6 body parts or clothing items on a doll
• Chooses 2 familiar objects when asked (gets items as you name them)
• Identifies objects by categories (puts blocks with other blocks, balls with other balls, etc.)
18-21 months
• Identifies 4 body parts and clothing on self
• If mobile, responds to “sit down” and “come here”
• Understands meaning of action words
• Identifies pictures named
21-24 months
• Puts toys away on request
• Follows 2-step related commands
As a speech therapist at Child and Family Development in Charlotte, I conduct speech-language evaluations regularly with children. This 3-part series will contain information about receptive language developmental milestones.
Receptive language is what your child understands. It is an important part of early language development and is often forgotten. Some examples of early receptive language skills include following 1-2 step directions, identifying objects/pictures, recognizing actions in pictures/verbs in play, and identifying body parts/clothing. Below is a list of receptive language milestones for children ages 0-12 months (information taken from The Early Intervention Kit, LinguiSystems).
0-3 months
• Quiets to a familiar voice
• Moves in response to voice.
• Discriminates between angry and friendly voices
3-6 months
• Begins to recognize own name
• Responds to “no”
• Smiles in response to speech
6-9 months
• Responds to “no” most of the time
• Moves toward or looks for family members when named
• Responds to “come here” (if your child is mobile)
9-12 months
• Responds to some verbal requests such as giving objects and gesturing when asked “Want up?”
• Identifies 2 body parts on self
• Participates in speech routine games, such as “So Big”
What is Apraxia?
Apraxia refers to difficulty coordinating the muscles used in speech. It is not caused by muscle weakness. The cause for Childhood Apraxia of Speech or Developmental Apraxia is unknown. In adults, Apraxia is typically caused by a stroke or traumatic brain injury
What are the characteristics of Childhood Apraxia of Speech?
- Receptive language skills (what he/she understands) are typically intact.
- Difficulty producing longer words and using words in connected speech.
- May exhibit groping movements, or moving the muscles used for speech without producing sound.
- Reduced prosody, which refers to rhythm, stress and intonation of speech
- Difficulty with production of vowels
- Says a word once, but then has difficulty producing the same word again when asked to repeat.
- May have feeding difficulties, such as over-stuffing the mouth or drooling.
- May have other coordination problems, such as walking.
If you child is exhibiting signs of Childhood Apraxia of Speech, I suggest scheduling an evaluation with a pediatric speech therapist at Child and Family Development. We have 2 offices in Charlotte, North Carolina.
For more information, please visit www.apraxia-kids.org or www.asha.org
References: (Williams; Nancy, Parent Articles-Enhance parent involvement in language learning)
What does PROMPT stand for? Prompts for Restructuring Oral Muscular Phonetic Targets
What is PROMPT? PROMPT is a technique that involves manipulating/shaping the oro-motor structures to help produce sound. It provides multi-sensory information (tactile, auditory, visual) to the speech system.
What types of disorders does it treat? PROMPT can be used with children and adults with varying speech disorders that are developmental or acquired. PROMPT has been used with apraxia, dysarthria, phonological, fluency, autistic spectrum and hearing impaired disorders.
Who can administer PROMPT? Speech-Language Pathologists who are “trained” or “certified” in PROMPT. I am pleased to announce that I am now PROMPT trained. To find a PROMPT trained or PROMPT certified speech therapist in the Charlotte area, please refer to the following link: https://promptinstitute.com/index.php?page=ReferalMap
Where can I find more information about PROMPT? You can find more information on the PROMPT Institute website: http://www.promptinstitute.com/
There are a growing number of applications that can be downloaded for children with special needs, such as Autism, Down syndrome and developmental delays.
Applications can be purchased to assist with communication, social skills, reading, writing, math, organization, storytelling, music/songs, art, games, sensory needs, etc.
The problem is that there are so many that it becomes overwhelming!
To get you started, here is a great website that allows you to view a variety of applications you are interested in (via video) before you purchase them a4cwsn.com.
Ask your pediatric speech therapist for additional assistance in choosing applications for your child.
I often have parents ask me what therapy materials they can purchase for practicing speech-language skills in the home environment. There are great websites out there for purchasing these materials; however, they can be a bit expensive. For those wanting to go a more economical route, consider using what you already have available. Speech and language skills can be practiced throughout our daily routines, such as getting dressed, eating meals/snacks, bath time, riding in the car, play, getting ready for bed, etc. You can practice a variety of speech-language goals during these daily routines and this is a great way to develop carryover of skills. Practicing skills throughout daily routines is also convenient for busy families, who do not have a lot of time for table work. For best carryover, I suggest choosing a few routines per day to work on communication skills. Some may think that practicing a few times a day will be too time consuming. Keep in mind that you do not have to practice for great lengths, especially if you are working with a very young child. The key is that these routines can be completed daily, which allows you to repeat these skills over a period of time. Ask your speech therapist for more suggestions on how you can incorporate your child’s pediatric therapy goals into their daily routines.
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