“The Brave New World of the Cyber Speech and Hearing Clinic,” The ASHA Leader, Vol. 6, Dec. 11, 2001

Just imagine ….
A future when patients log on to cyber speech and hearing clinics from the comfort of their homes. Three-dimensional and holographic imaging enable viewing situations similar to face-to-face contact. Parents or spouses of the patient will complete intake forms by answering questions of a computer-generated composite face and voice. The hearing evaluation will be completed in less than a minute. The patient will simply sit in the cyber center with headset and earphones snugly in place while the function and status of the hearing mechanism are tested. Clicks, tones, buzzing sounds, and the sensation of pressure changes will be the only things heard or sensed by the patient. The completed hearing evaluation report will be created including colorful graphic charts of the brain, external, middle, and inner ear.
Speech production will be acoustically analyzed. Each sound will be compared with norms for intelligibility and precision for the patient’s particular language. Each phoneme of the 10,000 languages and dialects of the world will have its specific acoustic parameters analyzed. Technology will permit analysis of the articulation of people suffering from brain damage and neurological diseases, and not only acoustically determine the precision and intelligibility of their motor speech, but also identify the site and nature of the peripheral or central nervous system damage. Although phonetics courses will still be taught, clinicians will rarely use their ears to make judgments about a patient's articulation.
A patient's pitch, loudness, emphasis, shimmer, jitter, spectral characteristic, voice onset times, and other parameters will be automatically assessed and analyzed in seconds. The computer will detect early signs of progressive neurological diseases such as ALS, MS, and Parkinson's disease, as early symptoms of these disorders sometimes show up as minor voice irregularities.
Tests for language delay and disorders will be automatically chosen and adapted to the patient's interests. For children, these interactive tests will use colorful cartoon characters that playfully ask questions and probe for responses. Talking dogs, rabbits, cats, and chipmunks will have the child remember, repeat, name, discuss, describe, and point, while the computer analyzes and categorizes each response. The child's cognitive, linguistic, and social-communicative abilities will be assessed using the latest tests. Phonological process will be identified as well as the speed and accuracy of motor responses and visual scanning times. Length of utterances and vocabulary will be computed in every possible way and charted in three-dimensional bar, pie, and line graphs. Everything from the patients’ cognitive-linguistic functioning to their metalinguistic awareness will be assessed by fun-loving cartoon characters. Aphasia, apraxia of speech, and fluency tests will be similarly conducted and structured around the patient's age and interests.
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The oral facial examination will also be assessed via the Web. The talking cartoon characters will have children open their mouth widely and face the embedded camera. The computer will note salient facts about tongue, lips, teeth, and palatal vault using pattern recognition algorithms. Everything from tongue tremor to speed of ongoing oral-muscular movement will be assessed. A three-dimensional picture of the child's oral structures will be created and added to the ongoing report.
In the future, a simple click of the computer keyboard or voice command will load the appropriate treatment program for each objective listed on the evaluation and merge them into a comprehensive treatment protocol. Goals will be chosen from thousands stored in treatment banks. The treatment program will be specifically adapted to the patient's age, gender, education level, and interests. Daily suggestions and recommendations will automatically be sent to the patient's family, home health agencies, or teachers for their assistance in meeting goals. Via the Web, the clinician will regularly review improvement with parents, physicians, nurses, and teachers and adjust the treatment programs when required.

(Taken from the prologue to Telepractices and ASHA:Report of the Telepractices Team December 2001 with permission from Dennis C. Tanner’s article, “The Brave New World of the Cyber Speech and Hearing Clinic,” The ASHA Leader, Vol. 6, Dec. 11, 2001, based on the author’s original short story ,“Welcome to the Cyber Speech and Hearing Clinic,” in Communication Disorders: A Literature and Media Perspective to be published in 2002 by Allyn & Bacon.)

Helping your child to love reading

Taken from:
www.babycentre.co.uk/toddler/development/stimulating/lovereading/

There are lots of fun ways to help your little one learn to love books and stories. And, surprisingly, not all of them involve sitting down with an actual book.


Use books to bond

It's not all about reading the words. At this age it's more about enjoying the interaction with Mum or Dad. When your child sits in your lap as you read aloud, she doesn't just enjoy books, she also enjoys the security of your undivided attention.


Set up a ritual

A regular reading time establishes a calming routine young children love -- that's why the bedtime story is a time-honoured tradition. But don't forget that many other daily events also provide good reading opportunities. Once in a while try establishing a new ritual with a breakfast story, a bathtime story, a just-home-from-nursery story or even an "on the potty" story. Some toddlers (and older children) who are heavy sleepers are much better able to face the day when their parents "read them awake" rather than hustle them out of bed.


Choose appropriate books

Toddlers love board books, bath books and pop-up books -- any type they can hold easily and manipulate themselves. They love stories accompanied by bright, clear realistic pictures. And, of course, they love rhymes. That's not to say your two-year-old won't appreciate the stories her big brother chooses -- who knows, Harry Potter may end up being her favourite book! Just make sure she has access to simpler books as well.

Repeat, repeat, repeat

Stifle your yawns if you've read The Very Hungry Caterpillar every night for the past month and your child still asks to hear it again. Repetition is a hallmark of the toddler years. The reason children love to read the same stories over and over and over again is that they're so thirsty to learn. You'll soon find that your toddler has memorised her favourite passages and is eager to supply key phrases herself -- both signs of increasing readiness to read.

Ham it up

Lose your inhibitions when you read to your child. Growl like the Papa Bear in Goldilocks, squeak like Piglet in Winnie-the-Pooh. Kids love drama as much as adults do -- in fact, your youngster may love to pretend to be the scary wolf in The Three Little Pigs. Encourage her, even if it slows the story's progress. She'll get more out of the story if she's participating actively.

Follow her interests

Choose books about her favourite activities -- visiting the zoo, swimming, playing catch. Back up her favourite videos and TV programmes with books about the characters. You may be mystified by the appeal of Teletubbies, but if your child loves the cheery little creatures, she'll love the books about their exploits as well. Follow her lead, but do experiment with a wide variety of books. Your little girl who loves dressing up and dolls may, to your surprise, also be the one who asks to hear stories about dinosaurs and monsters again and again, too.

Go to the library

Even babies like library story-hours, and they're wonderful adventures for toddlers. Your child may well discover a new favourite when it's presented by the beguiling librarian with her soothing voice and perhaps some pictures or puppets to illustrate the action. And, of course, libraries allow parents -- and toddlers -- to take home countless stories without spending a penny.

Turn on the tape

Many wonderful books exist on cassette or CD. You can feed your child's eagerness to hear Puss in Boots for the umpteenth time, even though you need to go start dinner, by turning on a cassette, instead (with or without the accompanying picture book). You could also tape books and stories yourself, or ask a beloved friend or relative to do so. Hearing granny's voice reading a favourite story is a special treat.

Don't make books a reward

Don't tell your child she can listen to a story if she finishes her dinner. When reading is associated with systems of reward and punishment, it isn't a positive experience. Instead, pick times to read that feel natural, such as when you want your toddler to quiet down before her nap.

Dealing with a wriggler

Some wriggly youngsters just won't sit still through all of Spot's Birthday Party. Don't worry about it. Just leaf through something short for a few minutes (or even seconds) and then let them go. The next day you can try a slightly longer session. Some children will always be more interested in running around than in reading. If your toddler is the physically active type, she may respond best to the non book-related activities described below.

Make storytelling a part of life

While you're at the dinner table or in the car, tell stories -- standards like Goldilocks and the Three Bears are fine, or anecdotes from your own childhood or stories that feature your child as a central character. Make books of your child's drawings or favourite photos, and tell stories about them -- or ask her to be the narrator.

Point out words everywhere

Wherever you go, you can show your child that words are an important part of everyday life. Even the youngest toddlers quickly learn, for example, that traffic signs say STOP. Alphabet refrigerator magnets are staples in many homes. Other families label objects around the house, such as the shelves that house BLOCKS, DOLLS, and other toys. If your child is in playgroup or nursery, slip a daily note into her lunchbox. Even if she can't yet read CAT, seeing the word printed on a piece of paper, along with a drawing or sticker of a cute kitten, will be a high point in her day and help excite her interest in reading. If this seems too ambitious, try drawing a heart or smiley face with a simple "I love you", which will help get your toddler excited about the meaning behind words.

Talk

Children from families who talk at the dinner table have larger vocabularies, according to researchers at Harvard University in the States. Talk with your toddler, and don't be afraid to use complex words and phrases. Encourage her questions and explanations. Toddlers are curious and wonder endlessly about the world, so don't be shy about trying to explore her interests with her.

Demonstrate your own love of books

Your child wants to imitate you. If she sees books all around the house and knows that you like to settle down with one whenever you have a moment to yourself, she'll learn that books are essential to daily life. Showing her your own love of reading is more powerful than making your child sit through a rigid story time.

Gene Discovered in Childhood Language Disorder Provides insight into reading disorders.

Gene Discovered in Childhood Language Disorder Provides insight into reading

The recent discovery of a gene associated with specific language impairment (SLI), a disorder that delays first words in children and slows their mastery of language skills throughout their school years, offers new insight into how our genes affect language development [Journal of Neurodevelopmental Disorders, 1(4): 264-282]. The finding is the result of a collaborative team effort headed by Mabel Rice, PhD, a University of Kansas professor and NIDCD-funded scientist.
The gene, KIAA0319, appears to play a key role in SLI, but it also plays a supporting role in other learning disabilities such as dyslexia. The finding is important for children with SLI and their families, and it is also likely to improve the classification, diagnosis, and treatment of other language, reading, and speech disorders.

SLI affects an estimated 7 percent of 5-6 year olds. Yet it is often overlooked as a diagnosis because children with SLI typically don't have severe communication problems or an obvious cause for the impairment, such as hearing loss. "These children are less likely to start talking within a normal timeframe," said Dr. Rice. "They may not begin to talk until they're three or four. And when they finally do talk, they use simpler sentence structure and their grammar may seem immature." Language impairments such as SLI also appear to increase the risk for reading deficits.

Often childhood language difficulties are seen as only a mild problem, or something kids eventually grow out of, but Dr. Rice says that's not true. "It persists. We know they don't catch up and their limitations in language continue as they move forward in school and then out into the workplace."

Because SLI tends to run in families, scientists suspected that genes played a role. But tying the presence of a specific genetic mutation to SLI, or to any inherited language impairment for that matter, had eluded researchers until recently.

A total of 322 individuals took part in the study, selected from a large pool of children, parents, and other family members participating in an ongoing investigation of the long-term outcomes of children with SLI. Each individual in the study was put through a battery of tests to assess speech, language, and reading skills. Standard diagnostic tests-the same tests that speech pathologists use to diagnose language and learning disabilities-were used to establish measurable behavioral traits that can act as symptoms of SLI, much as how fever is a symptom of the flu.

Using saliva samples to collect the DNA, the team identified a group of candidate genes-genes that previous studies indicated might have an association with speech or reading disabilities-and looked for mutations that corresponded with SLI's behavioral traits. Dr. Rice and her team scanned millions of letters of genetic code looking for mutations that family members have in common.

They discovered that mutations in one of the candidate genes for reading disability, KIAA0319, had a strong effect on the language traits that are characteristic of SLI, traits that can also be present in dyslexia, some cases of autism, and speech sound disorders (conditions in which speech sounds are either not produced, or produced or used incorrectly).

The next question, according to the researchers, is what does this gene do to affect how we learn language? "It could be a gene that's necessary in the development of the cortex, the area of the brain where we do most of our language processing," said Dr. Rice. "Or maybe it's a gene that's important for setting up neural pathways that are responsible for allowing language to emerge on time. It could be a gene, or one of a family of genes, that sets the stage to make language happen."

Dr. Rice contends that these findings lend support to the idea that difficulties with reading and understanding printed text may be coming from the same genes that influence difficulties in learning language. If this is so, she says, early detection and diagnosis will be the key to helping children with SLI close the reading gap between themselves and their peers. Interventions targeted to the preschool years, she adds, when neural pathways in the brain's language regions are still plastic and open to change, can give preschoolers the chance to develop their vocabulary and language skills in play settings and improve their ability to communicate once they enter school.

Even better, this discovery takes the shame and blame out of SLI. In the past, parents were often blamed for their child's disability and told that they hadn't read to them enough. Children with SLI were called lazy or accused of not working hard enough. Now, with the evidence that SLI is caused by a genetic mutation, parents and children know that talking on time or speaking correctly isn't something that youngsters with SLI can will themselves into doing.