Charlotte Speech Therapy

Augmentive and Alternative Communication or AAC is a resource available for individuals who are unable to effectively use spoken language.  Children that may benefit from using AAC include those that may have diagnoses such as cerebral palsy, autism, genetic disorders, motor speech disorders and brain injury.  Types of AAC range from low tech to high tech.  Low tech AAC does not require the use of batteries or electronics.  Examples include a simple board of letters, words, phrases and/or pictures of symbols that a person can point to for communication.  High tech devices allow the individual to communicate using speech output.  There are many different companies that specialize in making these types of devices.  Many high tech device have the ability for the user to communicate an unlimited variety of messages.

There are great benefits from using AAC.  It allows the child to communicate with other people in the community and not just family or those familiar with the child.  Using AAC helps with development of language and literacy skills.  For children that are able to use some verbal communication, AAC does not interfere with the development of spoken language and in fact actually aids in language acquisition.

If you feel your child may be able to benefit from AAC, please discuss this with your speech therapist.  A speech therapist can complete an Augmentative Communication evaluation to determine if your child would benefit from using AAC as well as what type of AAC would be beneficial for your child.  In Charlotte, the speech therapy team at Child & Family Development offer evaluations for AAC devices.

I am a speech-language pathologist and recently I had orthodontic braces put on for the second time in my life. I vaguely remember my experience as a child, they were uncomfortable, made my teeth hurt and eating could be difficult at times. Getting braces as an adult has given me the opportunity to look at the experience from a whole different perspective!

At first, I was extremely aware that there was something different in my mouth! The brackets slightly change the position of my lips and make talking a little more interesting. I have noticed that I have to speak a little slower and exaggerate my mouth movements a little to get the same clarity of speech I had without braces.

What I find interesting about these observations is that I can relate them to the children I see for therapy. I have been talking for a long time and know the placements for all of the speech sounds; however, this is not the case for kids. It has reminded me how just the smallest differences in the positioning on the jaw, lips, and tongue can have a big impact on how a sound is produced. I am able to compensate easily, but children who have difficulty making certain sounds, will find this much more challenging. When I do talk faster, I am getting more "whats?" which results in me slowing down and repeating what I said again. Children with speak production issues often have to say the same things multiple times and still may not be understood.  It definitely can be frustrating!

When I decided to get braces for my teeth again, I had no idea that it would give me this little insight. Just something to remind me that speaking is not always easy, especially for children that have oral motor difficulties and/or problems with their sound production. It makes me happy that I am a speech therapist and am able to help make communication easier for children!

• Avoid caffeinated beverages and drink lots of fluids (water).
• Learn how to use an indoor speaking voice.
• Going into the room of the person you want to talk to instead of yelling to the next room.
• Turning down the TV or radio before talking to someone.
• Waiting until it's your turn to talk.
• Giving your child time to do quiet activities (drawing, puzzles) to rest their voice.
• Identifying and treating any medical conditions such as reflux or allergies.

If you have concerns about your child's voice, a speech therapist is trained to identify and treat voice disorders.  Vocal abuse and misuse are the most frequent causes of voice disorders in children.

 

As the holidays approach, I am often asked by parents for ideas about what kinds of toys would be helpful for their children.  There are many new toys such as electronic learning toys and video games that are available; however, the best toys to promote your child's speech and language development are toys that encourage turn taking and interaction.  Examples of toys that encourage interaction include:

• Mr. Potato Head
• Puzzles
• Blocks
• Books
• Play sets (i.e. Fisher Price - Farm set or house set)
• Cars with toy garage
• Kitchen play set with toy foods
• Dress up clothes
• Board games

For additional ideas, Toys "R" Us makes a special catalog called the "Toy Guide for Differently Abled Kids".  The catalog is available in the store by request or online.  All of the toys in the catalog are newer and popular toys that are available for purchase in the store. A great feature of the catalog is that it breaks down skills by index (e.g. Language, Gross Motor, Fine Motor, Tactile, Visual, Social Skills, etc.) and specifies which skills can be addressed with a particular toy.  The catalog includes toys for different age groups and abilities.  It is a great resource for parents that want to find toys to encourage their child's development. 

Keep in mind that while there are many new toys that do lots of exciting things, it doesn't necessarily mean that those toys are the best if you want to work on your child's speech and language or other developmental skills.  If you have a question about whether a particular toy would be helpful for your child, ask a pediatric speech therapist, physical therapist or occupational therapist for input!

One thing that I often recommend to parents of children with speech and language delays is to keep a list or journal of words that their child is saying.  You can buy a small notebook specifically for this purpose or keep a piece of paper handy on the refrigerator. Each time your child says a word, uses a sign or gesture or makes some other attempt to communicate, you can write it down.  When you hear your child use the word again, make a tally mark next to the word on your list.  This will help you to see if your child is using a particular word often, or if it is a word the child said once but has not used again.  There are many benefits that can be gained from writing down information about how your child communicates some of which are listed below. 

• Help you to keep track of the words your child can use.  Parents are often surprised that their child is using more words than they think.
• If your child has difficulty producing sounds clearly, writing down the way your child says a word along with the meaning can help other caregivers understand what your child is saying (this is especially helpful for children with apraxia).
• Understand how your child is communicating.  Your child may not just be using words, but pointing, gestures, signs and other forms of communication.
• Keeping a journal can help you see your child's progress as they begin to use more words and help you report more accurate information to your child's speech therapist.
• Can be a keepsake that you put away and share with your child later.

Being an active participant in your child's speech therapy can make a world of difference.  Keeping a communication journal is one way to become more aware of how your child communicates. 
If you have any questions or concerns about your child's speech development, contact Child and Family Development and ask to speak with a speech-language pathologist.  We have two convenient locations in Charlotte, NC to serve our families.



 

By 18 months your child is really beginning to understanding and use more words to communicate!  The following milestones are typically achieved by the 18 month old child:

• uses 10-20 words consistently
• hears well and discriminates among many sounds
• recognizes pictures of familiar persons and objects
• combines frequently used two word phrases such as "all gone" and "daddy bye-bye"
• uses words to make wants known such as "more" and "up"
• imitates words and sounds more precisely
• points and gestures to call attention to an event or to show wants
• points to several body parts such as eyes, nose and toes
• brings familiar objects from another room when asked
• follows simple commands

If you notice your child having difficulty with some of these skills, it would be worthwhile to consider getting a referral from your pediatrician for a speech and language evaluation.  Child and Family Development has two locations in Charlotte, NC with experienced speech therapists that can determine if you child's speech and language skills are developing appropriately.  Your therapist would also be able to give suggestions for activities you can do at home to facilitate your child's speech and language development.

Developmental milestone information in this post is courtesy of a handout available from Pro-ed publishing company.

I was recently looking for books related to different topics on speech development and disorders.  One that caught my eye was The Late Talker: What to Do If Your Child Isn't Talking Yet by Marilyn Agin M.D., Lisa Geng and Malcolm Nicholl.  The book is written for parents and professionals and is very reader friendly.

One of the prevailing messages in the book was that if you have any concerns about your child's speech and language development, then you should seek help now rather than later.  Parents are often encouraged to "wait and see" by their child's pediatrician or they may hear "Your cousin didn't talk until she was four" by well-meaning family members.  There are many children whose speech skills will catch up; however, 25% of late talking children do not grow out of their speech problem before reaching school.  For these children, valuable time has been wasted during a critical period of language development and they are even further behind than they may have been.

The book also covers information related to what professionals you may encounter when seeking help, basic information on speech and language delays and disorders, getting the right kind of therapy, advocating for the therapy your child needs, nutritional supplements and what you can do at home to help your child.  While the book gives a great overview of general topics, it does focus on the speech disorder of apraxia.

Apraxia is a neurological motor speech impairment.  The child often has good understanding, but has signigicant difficulty forming sounds and words to express themselves.  There are very specific symptoms that are characteristic of apraxia, which are covered in the book.  Children with apraxia will not learn to talk without intensive intervention.

Dr. Marilyn Agin's  book is easy to follow and I highly recommend it for parents and other professionals.  I learned some new information and it is definitely a resource I will share with parents.  As a parent, it is frustrating, confusing and upsetting when your child's speech and language does not develop as expected.  If you have any concerns about your child's speech and language development, contact Child and Family Development to schedule a phone consultation with a speech therapist.

• make lots of different sounds
• laughs, gurgles, and coos with familiar people
• reacts to tone of voice (loud, angry, friendly)
• turns and looks at new sounds
• babbles for attention

• responds to name and pats image of self in mirror
• produces 4 of more different sounds
• frequently babbles simple syllables (i.e. ba, da, ka)
• listens to vocalizations and those of others
• tries to imitate sounds

• may say "mama" or "dada"
• shouts to attract attention
• uses jargon (babbling that sounds like real speech)
• plays peek-a-boo
• says a syllable or sequence of sounds repeatedly (ba-ba-ba)

• recognize their name
• say 2-3 words besides "mama" and "dada"
• imitate familiar words
• understand simple instructions (blow a kiss)
• recognize that words are symbols for objects

Many families have busy schedules filled with work, school, extracurricular activities, driving, managing the household and so on.  Finding even a few extra minutes for practicing speech can be challenging.  The wonderful thing about speech and language is that it can be easily adapted and incorporated into everyday activities.  This is a wonderful time saver for busy families and also the perfect way to help children practice their speech in functional situations.

For young children, daily routines are key.  Children learn through repetition and the daily activities of dressing, bath time and mealtime provide the perfect opportunities to learn language.  Naming and describing objects/actions during these activities helps build vocabulary.  For example, during bath time, you can talk about body parts, descriptive concepts such as wet/dry and cold/hot and actions (wash, splash, float, pour). 

For older children, you can turn a trip to the grocery store into a learning opportunity.  Have the child help make a shopping list and group items into categories.  If your child is practicing a particular sound, try to find different items at the grocery store that begin with that sound.  You can also pick a recipe to make with your child.  After getting the ingredients at the store, you can work on sequencing skills by talking about the different steps of the recipe.

While structured practice can certainly be beneficial, speech and language activities do not require additional time to be set aside in an already full schedule. There are ample opportunities throughout each and every day to build your child's skills.  

Your child's speech therapist at Child and Family Development can give you additional suggestions for practicing speech and language during everyday activities.

Because May is Better Hearing and Speech Month, it is the perfect time to bring attention to current issues that affect speech and hearing. There is a growing trend toward increased hearing loss in children due to the effects of using headphones with various forms of entertainment media. This would include mp3 players, IPods, portable DVD players, gaming devices, cell phones and laptops. A study released by the Kaiser Family Foundation found that in 2009, children between the ages of 8 and 18 were using entertainment media 7 hours and 38 minutes per day. Listening to headphones at high volume for extended periods of time can cause life long hearing loss.

• keep volume down
• limit listening time
• model good listening habits

Communication consists primarily of verbal communication, whether spoken or written words, and nonverbal communication.  Types of nonverbal communication include facial expression, eye contact, tone of voice, gestures, touch, body posture, and proximity(closeness to a person).  These forms of communication actually convey as much, if not more, information than spoken words.  Children with certain diagnoses, including Autism, asperger's syndrome, and language learning disabilities often have difficulties understanding and using nonverbal communication.  As a result, these children also have difficulties forming peer relationships.  They may stand too close, interrupt others or hug people that may not want to be hugged.

One way to see if your child is able to pick up on nonverbal communication is to simply observe them in play with their peers.  You can also turn down the volume of your child's favorite TV show and see if they can explain what is going on without hearing the words.

If your child does have difficulties picking up on nonverbal messages there are different activities you can do at home to increase their awareness and skills at using this type of communication. 

• Look through a magazine together and have your child tell you about how people are feeling in different pictures.
• Mirror Game - stand in front of your child or have your child play this game with another child.  The first child makes faces(happy, angry), uses different gestures (thumbs up, waving), movements (tapping foot) and the other child tries to imitate what this child does.  Then have the children switch places.
• Social Scripts - write out a simple social script for a particular scenario that includes appropriate body language and expression.  Practice the script with your child giving them opportunities to practice nonverbal communication.