Welcome to the Children's Speech Therapy Corner

Welcome to a Corner filled with Information related to the Speech and Language disorders seen in Children. Information on assessment, intervention strategies, and the latest updates in research. You will also be able to interact with other professionals and parents.

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Friday, January 22, 2010

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.

Friday, January 15, 2010

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.

Wednesday, November 25, 2009

Telespeech Practice: Reaching the Underserved

Rebbecca is a 4 year-old with a severe language learning disorder. She lives in a remote area where she has access to speech services twice in six months. In another part of the country or the world, an SLP looks for opportunities with flexible hours, avoid traveling costs and tremendous amounts of paper work. How can both their needs be met? This is where ‘Telespeech Practice’ (TSP) comes in. In ASHA's recent position statements (2005), telepractice is defined as "the application of telecommunications technology to delivery of professional services at a distance by linking clinician to client, or clinician to clinician, for assessment, intervention, and/or consultation."
Speech-Language Pathologists are increasingly applying tele-health technology to provide training, education, assessment, and intervention. Here is an example of an existing system for a school environment: the student at the school (with the help of teacher’s aide) will connect to the SLP at her online office with a secure login. The SLP will work on goal-directed activities established in her lesson plan via the webcam and conclude the ses-sion by assigning homework and video messages for later viewing in a Virtual Backpack. The child can login at home or at school and do the assigned homework with a caregiver. Progress notes and reports are generated during and after each session so that the special education team including parents have access to the child’s goals, progress, and related activities.
Benefits and Challenges
Increasing need for services, shortage of personnel in rural areas, and the benefit of receiving services in clients’ home community makes telepractice critical (Kully, 2008). Besides being cost effective and environment-friendly, all documentation can be stored, completed and sent securely online. Students can also avoid missing school days by not travelling to a distant hospital or practice. A good clinical relationship can easily be achieved with the client (Brick, 2008) and active involvement of teachers and parents also helps with generalization of goals beyond the clinical sessions. School administrators welcome the idea of helping a child whose clinical needs might not be met otherwise. The biggest drawback of telespeech practice is the unavailability of hands-on treatment for clients with issues such as articulatory placement. Technical problems can also pose a glitch at any time. Despite these, telespeech therapy for stuttering, articulation, dysphagia, and stroke have shown reliable results in various programs of telespeech practice across the United States (Mashima, Birkmire-Peters, & Holtel,1999; O'Brien, Packman, & Onslow, 2008).
The children I work with are excited each time they see me on the computer and often have others students vying for this online attention! They achieve goals via fun interactive games and often have to be forced to end the session. I have found that telepractice is a wonderful service deliv-ery model that has the potential to fill the gap in speech-language treatment services.


References:
American Speech-Language-Hearing Association. (2005). Speech-Language Pathologists Providing Clinical Services via Telepractice: Position State-ment [Position Statement]. Available from www.asha.org/policy.
Brick, M. (2008). Addressing Rural populations and the Speech language Pathologist shortage with Telepractice. Presented for ASHA 2008, Chicago.
Mashima, P., Birkmire-Peters, D., & Holtel, M. (1999). Telehealth applications in speech-language pathology. Journal of Healthcare Information Man-agement, 13(6), 71–78.
O'Brien, S., Packman, A., & Onslow, M. (2008). Telehealth Delivery of the Camperdown Program for Adults Who Stutter: A Phase I Trial. Journal of Speech, Language, and Hearing Research, 51(1), 184-195.

Saturday, November 21, 2009

Monday, October 26, 2009

Baby Einsteins: Not So Smart After All

The claim always seemed too good to be true: park your infant in front of a video and, in no time, he or she will be talking and getting smarter than the neighbor's kid. In the latest study on the effects of popular videos such as the "Baby Einstein" and "Brainy Baby" series, researchers find that these products may be doing more harm than good. And they may actually delay language development in toddlers.

It's not the first blow to baby videos, and likely won't be the last. Mounting evidence suggests that passive screen sucking not only doesn't help children learn, but could also set back their development. Last spring, Christakis and his colleagues found that by three months, 40% of babies are regular viewers of DVDs, videos or television; by the time they are two years old, almost 90% are spending two to three hours each day in front of a screen. Three studies have shown that watching television, even if it includes educational programming such as Sesame Street, delays language development. "Babies require face-to-face interaction to learn," says Dr. Vic Strasburger, professor of pediatrics at the University of New Mexico School of Medicine and a spokesperson for the American Academy of Pediatrics. "They don't get that interaction from watching TV or videos. In fact, the watching probably interferes with the crucial wiring being laid down in their brains during early development." Previous studies have shown, for example, that babies learn faster and better from a native speaker of a language when they are interacting with that speaker instead of watching the same speaker talk on a video screen. "Even watching a live person speak to you via television is not the same thing as having that person in front of you," says Christakis.Led by Frederick Zimmerman and Dr. Dimitri Christakis, both at the University of Washington, the research team found that with every hour per day spent watching baby DVDs and videos, infants learned six to eight fewer new vocabulary words than babies who never watched the videos. These products had the strongest detrimental effect on babies 8 to 16 months old, the age at which language skills are starting to form. "The more videos they watched, the fewer words they knew," says Christakis. "These babies scored about 10% lower on language skills than infants who had not watched these videos."

This growing evidence led the Academy to issue its recommendation in 1999 that no child under two years old watch any television. The authors of the new study might suggest reading instead: children who got daily reading or storytelling time with their parents showed a slight increase in language skills.

Though the popular baby videos and DVDs in the Washington study were designed to stimulate infants' brains, not necessarily to promote language development, parents generally assume that the products' promises to make their babies smarter include improvement of speaking skills. But, says Christakis, "the majority of the videos don't try to promote language; they have rapid scene changes and quick edits, and no appearance of the 'parent-ese' type of speaking that parents use when talking to their babies."

As far as Christakis and his colleagues can determine, the only thing that baby videos are doing is producing a generation of overstimulated kids. "There is an assumption that stimulation is good, so more is better," he says. "But that's not true; there is such a thing as overstimulation." His group has found that the more television children watch, the shorter their attention spans later in life. "Their minds come to expect a high level of stimulation, and view that as normal," says Christakis, "and by comparison, reality is boring."

He and other experts worry that the proliferation of these products will continue to displace the one thing that babies need in the first months of life — face time with human beings. "Every interaction with your child is meaningful," says Christakis. "Time is precious in those early years, and the newborn is watching you, and learning from everything you do." So just talk to them; they're listening.

Tuesday, October 20, 2009

Nursery Rhymes And Language Development

My son, who is 2.5 years old has been learning a few nursery rhymes over the past 6 months. He has been hearing it since he was a baby. Recently , I bought a second hand book of common nursery rhymes which had a CD in it too. He was just too captivated , listening to the CD and also following the song in the book. It's only been a few weeks and he has learnt 3 rhymes and 2 rhymes (earlier heard and learnt)have become clear, speech vice.
Some observations:
  • He pays more attention to the words and music. Consequently, I have seen he plays more by himself (giving me some time to do things)(Increased attention ans concentration span with creative play)
  • Tries to follow the words in the book for each individual rhyme, thus building awareness of print and sounds heard( building up Phonological awareness). Exploring the illustrations and talking about them.
  • Sings along with the music and has improved catching up with the words.

Some researchers have found that children’s early knowledge of nursery rhymes is related to their development of emergent reading abilities, specifically phonemic awareness skills (i.e. the awareness of sounds and their association with letters within words). Reading skills are the not the only skills they develop. Listening and thinking skills are developed along with singing rhymes.

What you can do:
  1. Expose your child to a rhyme either through you singing or through a CD repeatedly. So they will become familiar to it.
  2. Associate actions along with those that you know. Encourage them to participate but don't force them.
  3. If you have a book with the rhymes , show them and read along with them pointing your finger to each word. Explain the illustration and talk about the rhyme.Stimulating discussions are a great way to build oral language and comprehension skills.
  4. Repeat , Repeat and repeat. Is the key to your child learning and enjoying the rhymes.

Have fun singing and dancing with your children!

Friday, October 2, 2009

Listening to the Whole Sentence

Listening to the Whole Sentence

How to deal with listening and comprehension difficulties caused by complex sentences.

By Susan Zimmerman, MA, CCC-SLP

Many of the students we work with have difficulties with listening and comprehension, especially when they encounter sentences that are longer than five to seven words. They usually can interpret simple declarative and interrogative sentences, but they may need to have them repeated.

What happens to children's ability to listen and comprehend when sentences are longer and more complex and express gradations in meaning? How can they "listen their way" through these sentences and interpret the meaning? We can express great thoughts with simple sentences, such as "Love is kind" or "It hurts to be hungry." But what if we want to talk about relative values or conditional truths? We have to use more complex language, like "Because love is kind, I will show I love you by being kind to you," or "It hurts to be hungry, but it's worse to be hungry and alone."

One of the great rewards of practicing speech therapy is taking complex skills and breaking them down into parts. Not only does this help students learn how to manage the parts of speech and language, it helps them put everything together.

There are many ways to create complex sentences. We typically use coordinating or subordinating conjunctions and adverbs to combine phrases and clauses. I present the main part of a complex sentence and help students understand how to manipulate it to refine meaning.

The first step is to get some sentence strips big enough so all students at the therapy table can see them easily. Write adverbs and conjunctions on individual slips of construction paper or index cards, and give each student a small pile. Each child should have identical stacks of words. I suggest using the following words or phrases: "because," "since," "or," "when," "although," "however," "but," "except" and "even though." I would not put "and" in the stack because it doesn't help with auditory complexity.

Present a simple sentence on the sentence strip. Leave an underscore at the beginning and end of the sentence to allow room for the adverb or conjunction. Read the written sentence, such as "I like apples," to the group, then alter the sentence by saying something like, "Although I like apples, I like oranges better." You then can perform the following steps in any order:

  • Students repeat the expanded sentence.
  • They find the adverb or conjunction in their pile.
  • They identify whether it came at the beginning or end of the original sentence.
  • Question students about the meaning of the sentence. Does this person like apples? Do they like oranges? How do you know? If they had a choice, which one would they pick?
  • Do they agree with the expanded sentence? How would they change it if they could? Would they turn it around? Would they add another fruit?

Depending on the needs of your group, you can stay with this one sentence for the entire session or move on to another sentence, such as "Basketball is fun to watch." You can expand this sentence in the same way depending on the needs of your group. For example, you can say, "Although basketball is fun to watch, I like football better," or you can expand it to say, "Basketball is fun to watch, although it gets very noisy!"

Go through the steps each time you expand a sentence. I do not recommend writing down the expanded sentence because the main point of the lesson is to improve auditory processing. We are working on helping students understand what they hear the first time they hear it, and we want to give them as many trials as possible in the time we have with them. Writing down sentences can come a little later when they are sure of what they have heard.

One reason I like this therapy activity is that all preparation can be done ahead of time and saved for many sessions. Since only the basic sentence is written on the sentence strip, you can expand it differently the next time without the need for more preparation.

You can use this lesson at any age, depending on the needs of your students. They don't have to be able to read. As long as one student in the group can find the written adverb or conjunction, he or she can show the others. Students also can guess until they find it.

After completing a sufficient number of lessons, students will become comfortable with the process and demonstrate an increased understanding of complex sentences. You then can let them make up their own sentences. Either you or the students can suggest a core sentence, and they can take turns expanding it in different ways. Make sure they are listening to and understanding each other. It's important to check for comprehension frequently by asking questions.

I do not use this as a grammar lesson about parts of speech. I don't even use the words "adverb" or "conjunction." I just call them words to help us tell more.

Susan Zimmerman is on staff at Madison Elementary School in Madison, ME. She can be contacted at szimmerman@mes.sad59.k12.me.us.