Tidbits of Information

Over the last few years the term Auditory Processing Disorder (APD) has become a term used to describe children with different behaviors which has lead to the label APD being applied (often incorrectly) to a wide variety of disorders. The symptoms of auditory processing disorder are similar to those associated with ADHD, language processing disorders, autism as well as a number of other disorders.    This article is going to focus on language processing and how it isn’t APD.    

Remember your first day in Spanish class and the Spanish teacher came in saying everything in Spanish…you recognized all of the sounds and possibly some of the words, but generally speaking you felt “lost.”  This phenomena is due to your not being able to process the language—not an auditory processing problem.  Children with a language processing disorder will experience difficulties with expressing themselves, following directions, reading and writing.  

A language processing disorder can only be assed by a Certified Speech-Language Pathologist.  The testing should encompass a comprehensive assessment that looks at expressive and receptive language skills and how the child is able to apply these skills at different levels-single word as well as in connected speech. 

It may surprise some, but as a Certified Speech Language Pathologist who works with children with possible auditory processing disorders, I am not able to diagnose an auditory processing disorder.  This diagnosis can only be made by a certified audiologist and it entails much more than a simple hearing test.  The testing does not look at the child’s ability to process language but does entail the child’s ability to process incoming auditory information. 

If you suspect your child if having difficulty with processing language or sounds you should contact a speech-language pathologist to determine what type of evaluation maybe appropriate for your child.       

This is a frequent statement that I hear from parents when they are concerned about their child’s speech production.  Some children have difficulty learning how to produce sounds correctly. The result can be speech that is unclear or hard to understand. 

The production of speech is a complicated motor task.  Children can’t learn to say sounds until they are old enough for muscle growth and fine motor ability to support the very intricate motor skill of sound production. 

Between one and three years of age, children use a variety of vowels and consonants for “sound play”—or—babbling.  They begin using and combining these sounds at about 2-3 months of age and continue to refine and develop these sounds until they begin to combine them to form meaningful words.  Those first words may not be perfect, but using them to communicate is amazing!    For example, your child may say “mi” or “milk”---to request “milk” or to request more milk.  Say-“Oh, you want more milk” and then your child has been provided with an accurate model and eventually, your child learns to “refine” and their production becomes more clear. 

The first sounds you will hear your child pronounce use the lips “p, b, m, h and n”—words like “ball” and “mom” will be produced more clearly earlier.  Keep in mind that sounds that are in the middle or at the end of words are harder to produce than sounds at the beginning of the words.   In some instances, the correction of these errors may be quite quick if the child is physically ready to make the correct sounds.

Below is a chart to use as guidance for sound development.  There are a variety of charts to determine the age of sound acquisition—this is a brief sample of one.

Age 3:  p, m, w, n, h

Age 4:  b, d, k, g, y (as in yes), f

Age 6:  t, l, r, ng

Age 7:  j (as in jump), ch, sh, th (unvoiced as in think)

Age 8:  v, th (voiced as in the) s, z

            (zh is mastered later than 8)

Sanders (1972) Norms for Speech Sound Mastery

By the time your child is 7, they should be able to produce all sounds without difficulty.  If you have any concerns about your child’s speech production or if your child is 3 years or older and difficult to understand, contact a speech therapist at Child and Family Development.  An assessment will determine if speech therapy is necessary to help your child develop sounds for clear speech. 

When talking with parents, I often hear the comment “My son/daughter doesn’t have any problems saying his/her sounds why do I need speech therapy?” Children receive speech therapy services for more than sounds errors in their speech. 

What is speech therapy? Speech therapy is a specialized service provided by a Speech-Language Pathologist (SLP). Speech therapists help people across the lifespan with conditions that affect speech, language, voice, swallowing, fluency and other disorders that affect communication skills. 

Speech and language disorders include the following problems, according to the American Speech-Language-Hearing Association (ASHA):

Speech Disorders can include the following: 

• Articulation disorders include difficulties producing sounds in syllables or saying words incorrectly to the point that other people can't understand what's being said.
• Fluency disorders include problems such as stuttering, the condition in which the flow of speech is interrupted by abnormal stoppages, repetitions (st-st-stuttering), or prolonging sounds and syllables (ssssstuttering).
• Resonance or voice disorders include problems with the pitch, volume, or quality of the voice that distract listeners from what's being said. These types of disorders may also cause pain or discomfort for the child when speaking.
• Dysphagia/oral feeding disorders, including difficulties with eating and swallowing.

Language disorders can be either receptive or expressive:

• Receptive disorders refer to difficulties understanding or processing language.
• Expressive disorders include difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way

If you think your child may have difficulties with any of the above please do not hesitate to contact a certified Speech Language Pathologist. 

As a pediatric speech therapist, I am always interested in expanding my clinical skills.  Recently, I attended a training class in the SOS Approach for children with eating or feeding difficulties.   The program was developed by Dr. Kay Toomey and her feeding team in Denver.  SOS stands for Sequential Oral Sensory Program which integrates sensory, motor, oral, learning and nutritional factors to feeding treatment.  The course was so insightful.  I learned a new approach to helping children and families deal with feeding issues and now look at food aversions a little differently. 

In the SOS approach, the evaluation includes an assessment of the jaw, lip, and tongue movements during presentation of different food textures and sensory issues in relation to eating and food, as well as respiration.   The program is non-invasive and focuses on increasing the child’s comfort level exploring the different properties of foods, including, color, texture, smell, taste and consistency. This approach allows a child to interact with food in a playful, non-stressful way.   It follows a 32-step hierarchy to eating food, beginning with simply tolerating the food in the room and slowly progressing---at the child’s pace--to eating.

If you think your child has a feeding problem, please do not hesitate to contact a speech therapist or occupational therapist with SOS training to assess your child and begin a program that will bring joy to your child and mealtime!  

Do you think your child is a “picky-eater”?   

Does your child----

v     only eat only a few foods?  (such as chicken nuggets from McDonald’s)

v     refuse food groups

v     get upset when a new food is placed on his/her plate

v     gag or spit out food during meals?

v     fall into low percentiles for weight?

These are all signs that your child could have a feeding or eating problem.  Feeding and eating are important components to growing up healthy. Mealtime should be a social occasion—not battles to have your child try a new food.   

A speech therapist and occupational therapist can assist in evaluating and treating a child with feeding, eating or swallowing difficulties.