Speak to me

My newest and favorite speech therapy tool for kids with articulation problems is to use tongue twisters with their sounds. They can be used with all ages and it makes practicing the sounds less boring because it is trickier and funny when you mess them up. It is great to use once a child has learned to say the sounds in single words, but has not mastered the sounds in spontaneous speech. 

A great example for a child practicing the /f/ sound in the beginning of words: 

Practice words sent home are: Fun, Four, Friends, Fluffy, Fantastic, Family, Food, Fudge, Full, and Fish

Tongue twister made: Four Fun Fluffy Friends got Full eating Fantastic Food, Fudge, and Fish with their Family.

After having worked with so many kids, it is very rare that I go somewhere in Charlotte and do not run into a family I know from treating one of their kids. I enjoy seeing children that I treat or have treated for speech and language problems.  Nothing better than running into a client in a store that I treated when they were 3 years old and they are now 10 years old doing really well. Seeing a child in the natural environment also gives a clinic-based therapist the opportunity to see how the child truly does in social situations, in different environments and with strangers. It can provide us with new ideas for how to take speech therapy to a new level. Not to mention, I love the look on a child’s face when they realize I am a person who needs to shop for groceries too.  Just remember, if I am with anyone, I will introduce them, but cannot introduce you because of HIPAA privacy laws, not because I have forgotten your name or your child; however, you may introduce yourself anytime. Don’t hesitate to speak to your therapist when you see them in a restaurant or store, even if the child is not behaving.

I have parents ask me all the time: What is that baby doing in your lobby? Are they waiting for therapy, too? Aren’t they too young? One of the first things I explain is Child and Family Development is a multidisciplinary practice, and we have speech therapists in addition to occupational therapists, physical therapists, educational specialists, and psychologists on staff. We see kids of all ages and that includes babies who are already developing behind the normal child his/her age or who were diagnosed with a condition that can make it difficult to master developmental milestones. A child can not be too young to receive services in our office.

Work on prepositional phrases (in the pool/bathtub, beside the pool, out of the pool, up the ladder to jump off diving board, jump down/in, in/out of the seat etc.)

Take a walk around the neighborhood and use descriptive concepts big/little, tall/short, fast/slow, colors, shapes, etc.

Blow bubbles-talk about the size, shape, wet/dry, and use quantity concepts (numbers, more, most, less, least, etc)

When driving down the road work on vocabulary (types of cars/trucks, colors, numbers on license tags/signs, shapes, letters on license tags/signs, , music loud/soft, turn up/down, I spy inside the car, etc)

Early readers and even some non readers can read the map and road signs to tell you how to go or how to get where you are going, even if around town…let them pretend they are the GPS

The ideas will grow the more you use your imagination.

Articulation carryover at home:

1.  Read books, have child repeat after you, or read it themselves.
2.  Sing songs with their sounds in it.
3.  Set up a grocery store and have them buy things with their sounds from you.
4.  Have your child cut out pictures from a magazine with their sounds to make a collage.
5.  Write down a bunch of words with your child’s sounds and make up silly stories using all of them.
6.  Play I spy and make them find something that has their sound.
7.  Pretend to pack a picnic or for a trip and pack things with their sound.
8.  Play a regular game and before the child takes a turn have them say a word or come up with a word.
9.  Play a memory matching game or go fish with pictures of words with the child’s sound.
10. .  Have a word of the day and see if the child can say it correctly the whole day…have a prize if they can.

With school out and the summer here, it can be hard to remember to practice speech at home. It is really important to continue to be consistent with speech therapy and home practice during the summer. Many kids will loose skills during the summer because they are not being practiced frequently enough. Make time each day to practice every day and make sure you continue to come to therapy regularly. Regular appointments during the summer allow your therapist to provide you with new “homework” and to monitor your child’s progress. Your therapist does not teach a new idea/skill as quickly in just in 1-2 thirty minute appointments per week, she needs you to do your part at home also. If your child knows that every morning after breakfast they have to practice their “speech homework” then they are more willing and cooperative, because it is expected. Homework and carryover activities can also be done in the car, on vacations, while playing games, at the pool, etc. It does not have to just sitting down and practicing it. Make a note to practice at least 5 minute per day so that your child gets the most from his/her speech therapy.

Kids love bubbles!! Bubble blowing helps strengthen the mouth area and improves coordination of the respiratory system. It shows kids that the mouth can be used for something other than eating. It also helps kids who do not like to be touched around their face by alleviating some of the fears, since it is such a fun activity. It can be a very calming play toy, as well. It can also be great for adding vocabulary words to your child repertoire. Bubbles are usually nontoxic, so if they taste the bubble juice while learning it is not a big deal.

How to use bubbles: Blow a bubble and catch it on the bubble wand, then let the child pop it off the wand. They can pop it with or on their various body parts. Then you can work to have the child blow the bubble off the wand and eventually, blow the bubbles by themselves. If they have difficulty blowing on a regular wand because of difficulty with lip rounding/pucker, you can find the ones that have mouth pieces attached to the wand (that look like horns). These bubble blowers also prevent them from tasting the bubble juice as often. 

Vocabulary to use with bubble blowing to expand vocabulary: more, please, blow, your turn, my turn, bubble, outside, gone, all done, finished, where did they go, various body parts, prepositional phrases (on, under, in, etc), etc.  It is also good for getting kids to answer where questions.

1. Speak with the child in an unhurried way, pausing frequently. Wait a few seconds after he/she finishes speaking before you begin to speak. Your own slow, relaxed speech will be far more effective than any criticism or advice such as "slow down" or "try it again slowly." Try to decrease criticism, interruptions, rapid talking, and questions.

2. Reduce the number of questions you ask the child. This is especially important in times of dysfluent speech. It allows the child to speak more freely because they are not forced to say something specific. As the parent/teacher, you simply comment on what the child has said, thereby letting him/her know you heard.

3. Use your facial expressions and other body language to convey to the child that you are listening. You want to make sure you nonverbal language matches what you are telling the child verbally.

4. Set aside a few minutes at a regular time each day when you can give your undivided attention to the child. Let the child direct the activity and initiate conversation, so that he/she is comfortable. You are showing the child that you enjoy their company and it boosts his/her confidence.

5. Help all members of the family/class learn to take turns talking and listening. At the dinner table, you can pass an object so everyone knows when it is their turn to talk about activities of the day.

6. Above all, convey that you accept the child as he/she is. The child needs your support.

1. Decrease frustration (by giving them a way to get a message across)
2. Build vocabulary (teaches child how to use symbols for objects, actions, etc)
3. Increase social skills (successful communication creates a sense of belonging)
4. Increase early literacy skills (reading)
5. Increase motor development (coordinate hand and body movements)
6. Increase length of utterances (using longer phrases and sentences)

Quite simply, a feeding problem is simply a failure to progress with feeding skills. 

Maybe a child does not move from a suckling (a reflex present at birth) or sucking pattern (learned about 2-3 months, requires lip strength more up and down) to a much (present about 8-12 months more up and down chomping with mouth open), rotary chew pattern (present around 3 years; circular pattern chew). 

Maybe the child holds food in their mouth. 

Maybe the child has difficulty with progressing to different stages of food due to problems along the digestive tract. Problems in the digestive tract can include problems with the oral cavity (mouth), pharynx, esophagus, stomach, and/or intestines.  Maybe a feeding problem is that your child not like certain textures and/or colors of foods. 

As you can tell, a feeding problem can be caused by a wide variety of things. If you have concerns about your child’s eating, growth, or weight a speech therapist may be able to help you figure out where your child’s difficulties are.  Just call one of Charlotte pediatric therapy clinics to schedule an evaluation. 

Dge sound-Jingle Bells

Sh sound-We Wish you a Merry Christmas

F sound-Deck the Halls

    Feliz Navidad

S sound-Santa Claus is Coming to Town

   O Christmas Tree

    Silent Night

    I want a Hippopotamus for Christmas

    I saw Mommy Kissing Santa Claus

    Frosty the Snowman

    White Christmas

    Here Comes Santa Claus

    Sivivon, sov, sov, sov

R sound-Rudolph the Red-Nosed Reindeer

             Grandma Got Run Over by a Reindeer

             Mr. Grinch

             Maoz Tzur

Th sound-I Saw Three Ships

       Over the River and Through the Woods

P, B, M sounds- Little Drummer Boy

L sound- Up on the House Top

      Its Beginning to Look a Lot Like Christmas

               I have a Little Dreidel

               Chanuka, oh Chanuka

All sounds-12 days of Christmas

*Some of the songs work for multiple sounds so print the Lyrics and have some fun while practicing speech sounds!! Happy Holidays!

There are lots of things to talk about around the holidays!  For typically developing children and children with language delays, try some of these conversation starters:
 

1. Make a craft or talk about a craft your child made.  Then, ask who, what, when, where, and how questions about it.
2. Ask the child about family traditions.
3. Discuss special items that they eat for holiday treats and meals.
4. Have them name as many things as they can that have to do with the holiday.
5. Talk about plans- who is going to be there or where they are going.
6. Make cookies and then have them tell the person you gave them to what they did to help.
7. Have the child help wrap presents and talk about the shapes of the boxes, colors of the paper, and ribbon.
8. Have them retell you a story about the holiday after you have read it to them.

The main idea is to promote verbal expression and get the child talking- so avoid yes/no questions and try open-ended and engaging topics. 

This time of year, I have lots of fun holiday talks with children in speech therapy. 

Hearing impairment symptoms are important for a parent to be aware of because hearing problems often lead to speech and/or language delays later on. 

Birth to 6 months:

-Child does not respond to a loud noise nor look in the direction of a noise.

-Child is not soothed by sound of mother’s voice

10 months:

-Child does not respond to his/her name

12 months:

-Child does not respond to familiar sounds (dog bark, car, etc.)

-Child does not produce vowels in loud, long shrieks

-Child does not turn toward someone who is speaking

15 months:

-Child is not imitating sounds and words, when he/she does, speech sound productions is not normal

15 months-5 years:

-Child produces an abnormal tone of voice

-Child doesn’t pay attention to loud voices

-Child frequently says “huh” or “what” when spoken to

-Child is inconsistently responding to sounds, which may lead parent to feel he is stubborn or too focused on another activity

-Child prefers high or low sounds

-Child demonstrates a speech-language delay

What we can do:

-Hearing Screen and appropriate referrals to other professionals in the community

-Evaluation of speech and language skills.

-Work with parents, audiologists, physicians, and teachers to encourage optimum conditions for speech-language development.

-Therapy for delayed language or speech sound production skills

Hearing screening tests are a quick and cost effective way to separate people into an appropritate group: pass or fail.  A hearing screening is only appropriate for children who can stand head phones to be placed on their heads and who can show some sort of response (hand raise, etc) when they hear the sound. If a child passes a hearing screening, they are assumed to have no hearing loss. If they fail a hearing screening then they are referred for a more complete evaluation by an audiologist. Only an audiologist can diagnose a hearing loss.

Early identification of hearing loss leads to better speech, language and learning outcomes for children. Knowledge of the risk factors for late-onset hearing loss and continued vigilance in screening, monitoring and referral are vital. The goal is to insure that the listening and learning needs of all children are met, which is why we perform screenings in our office in Charlotte, NC.

Having spent a long time in school studying to be a speech therapist, one might think it would be an easy question to answer.  The answer is complex and unique for every child.  Each person is different, and it difficult to know who will catch up independently and who continue to have difficulties as they get older.

Parents are usually recommended by me to not to wait, if their child's development does not appear to be typical for kids his/her age.  Get a speech-language evaluation, learn what the strengths and weaknesses are, and follow the recommendations.  The information will only help your child reach his potential. 

 If nothing else, an evaluation by a speech therapist can give the parents peace of mind that their child’s language and communication skills are developing age-appropriately and can provide suggestions for enriching language development in the home.  If speech therapy is recommended, then early intervention is the key to success. Kids who have speech delays, whether articulation or a developmental delay in learning to talk, often have difficulties learning to read and write, expressing themselves verbally, and other learning disabilities. 

No matter what the circumstance, I love to see parents being proactive with their child's development.