Tuesday, July 31, 2012

Articulation Station for the iPad

Check out one of our favorite iPad apps for articulation therapy - Articulation Station by Little Bee Speech!

Here are some features of the app:

Flashcards - Flashcards, with high-quality images that children will enjoy, help target sounds. Children can tap the card if they don't remember the word, and the app can repeat the word to serve as auditory reinforcement.

Rotating sentences - These sentences are sentences that repeat, with only the target word changing. Each sentence has picture prompts and audio reinforcement.

Unique sentences - The unique sentences are new sentences for every target word in the application, which adds up to over 1,300 unique sentences. Each unique sentence has on average 3 words with the target sound in it. For example in the sentence, “Penny rode the pony in the park.” “Pony” is the target word but the initial p sound can also be practiced on “Penny” and “park.”

Level 1 stories -  Repetitive stories are paired with picture prompts and audio reinforcement. Each story has multiple target words which maximizes practice opportunities of the target sound in a story environment. At the end of each story there are comprehension questions which helps the child with spontaneous speech.

Level 2 stories - These stories are designed for more advanced readers. They are longer stories with larger vocabulary and provide even more opportunities to practice the target sound in a story environment.

Data collection - The data collection feature makes tracking your child's progress a breeze. You can sort scores based on date, sound and position, passed, or notes taken. You can also access specific session details and repeat words, sentences, or stories not passed in that session.

Mommy Speech Therapy's app details
App store

Monday, July 30, 2012

Speech stickers

Check out this new iPad application from Serious Tree called Speech Stickers. Fun characters and a simple interface make this app great for helping young children with Childhood Apraxia of Speech or severe articulation disorders. The app works on the most basic phonemes as well as CV and VC syllables.

Friday, July 27, 2012

Tips for managing picky eaters

Many parents experience the woes of picky eating at some point in their child's development.
A child's negative eating behavior can adversely affect the mealtime experience and can have a
detrimental effect on the child's health and development. There are a number of strategies that can be utilized to best manage picky eaters, including:
  • When introducing a new food, it's OK if your child is not ready to eat it. Try encouraging him to interact with the food in a less invasive way. Consider introducing a food interaction hierarchy for introduction of novel foods. Gradually progress through the following levels: tolerating on the table/plate, touching, smelling, kissing, licking, biting, chewing, and swallowing.
  •  Create eating tasks that are challenging yet accomplishable so that your child can experience success. For instance, with a novel food, encourage your child to start with kisses and licks instead of bites.
  •  Gradually increase demands of eating tasks over time. For example, while your child’s first interaction with a novel food may be taking five licks, her next interaction may be two bites.
  •  Introduce an “all done” bowl. Do not allow your child to leave the table until all of the food on his plate is either ingested or interacted with (pick up, kiss, lick, etc.) and placed into the all done bowl.
  • Continue offering new foods many times, even if these foods were refused in the past. It may take children longer than expected to become comfortable with new foods. Be patient and persistent.
  • Verbally praise all positive mealtime behaviors. These can include sitting at the table, picking up a spoon, tasting a new food, or taking bites of a preferred food.
  • Ignore any negative mealtime behaviors. These include verbal protesting, pushing foods away, letting food fall to the floor, etc. Use timeouts when necessary in the event of disruptive mealtime behaviors.
  • Use a timer or visual schedule to encourage your child to stay at the table for the duration of the meal.
  • Make sure that all family members are on board with strategies used at home. The more consistent the mealtime rules and routines are, the more effective they will be in promoting positive feeding behavior.

Thursday, July 26, 2012

Laugh & Learn Apptivity Case for the iPad

Does your baby want to play with your newest toy? Try out the new Laugh & Learn Apptivity Case for the iPad, and now everyone can play with it!

The sturdy case will protect your iPad from dribbles, drool, and sticky little fingers. Busy beads and a handle are great for go-anywhere play, and free Laugh & Learn apps mean plenty of learning fun!

Check it out here: http://www.fisher-price.com/en_us/brands/babytoys/products/66016

Wednesday, July 25, 2012

Fostering independent eating

Children have a natural drive for independence and control from a very young age, especially when it comes to eating. By allowing your child to self-feed and participate as fully as possible in the meal, you create valuable opportunities for children to be exposed to a variety of foods and practice essential skills. 
To foster independent eating, provide your child with the right tools:
  • Provide utensils that are easy for children to manipulate.
  • If using a plate, choose a small plastic one. Use small plastic bowls and cups too. Use child sized spoons and forks made of metal or plastic. If children have not yet mastered spoons and forks, allow them to eat with their hands. Self-feeding facilitates acceptance of foods.
  • Children learn skills by watching others and by trying the skills themselves. Model positive eating behaviors for your child. This means showing your child exactly what to do rather than just telling him what to do.
  • After age 18 months, try to avoid feeding your child as much as possible. Developmentally, children at this age are ready to be fully independent eaters.
  • Sassy Less Mess Toddler Self-Feeding Spoon
  • It's OK to get messy! The sensory experience of getting messy can foster greater exposure to and acceptance of foods. Allow your child to attempt self-feeding as much as possible, even it means making a mess.

Tuesday, July 24, 2012

Classroom Strategies For Bilingual/Multilingual Newcomers

Have new students entered your classroom who speak little to no English? Here are some tips you can use in your classroom to help your new student out.

1.     You might first introduce colors, numbers, shapes, body parts, and survival vocabulary. Once your new students know these words they can do a variety of classroom activities.

2.      Next, introduce with the school environment vocabulary. You might make flash cards of the items they see in their classroom.

3.      Perhaps assigning the new student with a buddy will help! The ideal situation would be to pair an older bilingual student with a same-language newcomer. During the adjustment phase, the buddy can explain what's going on. This is a good self-esteem builder for a bilingual buddy and a new friend for the newcomer. You may want to rotate buddies so that students do not become too dependent on one person and the bilingual buddy does not miss too much work.

      The newcomer’s buddy might:
  • Help them learn the classroom routine.
  • Sit with them at lunch.
  • Learn how to communicate with them using gestures and short phrases.
  • Teach them the beginning vocabulary.
  • Include them in games on the playground.
  • Play student-made vocabulary games with them.
  • Learn a few words of the newcomer's language
4.      Make a picture dictionary. To make a picture dictionary, staple sheets of construction paper together and have students cut pictures out of magazines. Use categories which complement your curriculum. Encourage students to add to their Dictionary whenever possible. This is an excellent cooperative learning activity that mainstream students can also do!

5.      Make a vocabulary poster. Have students work in groups. Assign each group to a particular category. Have kids cut out pictures from magazines and label them to create large posters of categories of common vocabulary words. Categories might include food, clothing, body parts, colors, animals, playground scenes, family groups, classroom, street scenes, house and furniture, or transportation. Display the posters in your classroom!

Learn more about raising bilingual children here.

Monday, July 23, 2012

Brain scans can help with early intervention for autism

New National Institutes of Health findings published in the American Journal of Psychiatry reveal significant differences in brain development in high-risk infants who develop autism starting as early as 6-months-old. Although autism is typically diagnosed around ages 2 or 3, this abnormal brain development can be detected during the infant's first year of life, before the appearance of autism symptoms.

From an article in Autism Society about the findings:
"The study followed 92 infants from 6 months to age 2. All were considered at high-risk for autism, as they had older siblings with the developmental disorder. Each infant had a special type of MRI scan, known as diffusion tensor imaging, at 6 months and a behavioral assessment at 24 months. The majority also had additional scans at either or both 12 and 24 months.

At 24 months, 30 percent of infants in the study were diagnosed with autism. White matter tract development for 12 of the 15 tracts examined differed significantly between the infants that developed autism and those who did not. Researchers evaluated fractional anisotropy (FA), a measure of white matter organization based on the movement of water through tissue. Differences in FA values were greatest at 6 and 24 months. Early in the study, infants who developed autism showed elevated FA values along these tracts, which decreased over time, so that by 24 months autistic infants had lower FA values than infants without autism."

These differences can be used as clues for early intervention, which can improve symptoms of autism such as problems with social interaction, behavior, and communication.

The article in Autism Society
Typical signs of autism

Friday, July 20, 2012

Articulation and ages of sound development

Do you know when to expect your child to produce certain sounds?

The easiest sounds for a child to begin with are vowels. Generally, the first consonants that a child produces include the /m/, /n/, /h/, /w/, /p/, /b/, /k/, and /d/. Other sounds, such as /t/, /g/, and /sh/ come later. The most difficult sounds for children to master include /th/ (as in thumb) and /zh/ (as in measure).

Here is some information about articulation of speech sounds:

- Consonant sounds are made by either stopping the flow of air in the oral cavity ("stops", such as the sounds /p/, /b/, /t/, /d/, /k/, and /g/) or by letting the air flow through restricted areas which are formed by changing the position of the lips, tongue, teeth and palate ("fricatives", such as the sounds /f/, /v/, /s/, /z/, and /th/. Some sounds, called affricates, are a combination of a stop and a fricative; examples include /j/ and /ch/.

- Nasal sounds (/n/, /m/, and the /ng/ at the end of the word "sing") are made by forcing air through the nasal cavity.

- Sounds that are produced by vibrating the vocal cords are called "voiced", while sounds that are produced without vibrating the vocal cords are called "unvoiced" or "voiceless". There are many pairs of consonants that are identical in every feature except for the voicing; examples of these pairs include /p/ and /b/, /t/ and /d/, /d/ and /g/, /f/, and /v/, /th/ and /th/, /sh/ and /j/, /s/ and /z/. Try pronouncing each of the pairs while touching your throat; you will be able to feel your vocal cords vibrating for one sound in each pair.

- The respiration used in speech and quiet breathing are different. Regular breathing is easier than breathing for speech. For speech, the diaphragm and muscles of the rib cage and between the ribs pull the ribs out and up to draw air into the lungs then the muscle of exhalation push the extra air that is needed for speech out of the lungs. Respiration for speech develops as the child learns to push up with their arm, sit, crawl, stand, and walk. 

To learn more, check out this blog post.

Thursday, July 19, 2012

Childhood apraxia of speech - do you know the signs?

Do you know the signs of childhood apraxia of speech (CAS)? CAS, also known as verbal apraxia or dyspraxia, is a speech disorder in which a child has trouble saying what he or she wants to say correctly and consistently. It is a motor speech disorder, as the child's brain has difficulty coordinating the oral muscles used for speech; it is not due to weakness or paralysis of the speech muscles. Children with CAS have difficulty saying sounds, syllables, and words. The severity of apraxia of speech can range from mild to severe.

Although not all children have the same symptoms of CAS, here are some signs of CAS in young children:

- The child does not coo or babble as an infant
- Late onset of first words
- Missing sounds
- A small inventory of consonant and vowel sounds
- Problems combining sounds or long pauses between sounds
- Frequent deletion of difficult sounds or sound simplification
- Problems eating
- Expressive language problems like word order confusions and word recall

Here is an excerpt from an ASHA article on CAS:

"Research shows the children with CAS have more success when they receive frequent (3-5 times per week) and intensive treatment. Children seen alone for treatment tend to do better than children seen in groups. As the child improves, they may need treatment less often, and group therapy may be a better alternative.

The focus of intervention for CAS is on improving the planning, sequencing, and coordination of muscle movements for speech production. Isolated exercises designed to "strengthen" the oral muscles will not help with speech. CAS is a disorder of speech coordination, not strength.

To improve speech, the child must practice speech. However, getting feedback from a number of senses, such as tactile "touch" cues and visual cues (e.g., watching him/herself in the mirror) as well as auditory feedback, is often helpful. With this multi-sensory feedback, the child can more readily repeat syllables, words, sentences and longer utterances to improve muscle coordination and sequencing for speech ... Practice at home is very important. Families will often be given assignments to help the child progress and allow the child to use new strategies outside of the treatment room, and to assure optimal progress in therapy."

To learn more, read this ASHA article on CAS or talk to one of our speech-language pathologists.

Wednesday, July 18, 2012

Early identification: Late bloomer or language problem?

Wondering whether your 18 to 30-month-old child is a late bloomer or may have a language problem? There are some factors to look out for that can help a parent differentiate between the two. Do they understand language? Can they get their point across using gestures and other non-verbal communication? Are they rapidly progressing with language between 24-30 months of age? And lastly, if they seem to be delayed, are they still making some progress? If you've answered "no" to one or more of these questions, you may want to consider an evaluation with a speech-language pathologist.

Here is an excerpt from an ASHA article on the topic:

"Although the stages that children pass through in the development of speech and language are very consistent, the exact age when they hit these milestones varies a lot. Factors such as the child's inborn ability to learn language, other skills the child is learning, the amount and kind of language the child hears, and how people respond to communication attempts can slow down or accelerate the speed of speech and language development. This makes it difficult to say with certainty where any young child's speech and language development will be in 3 months, or 1 year.

There are, however, certain factors that may increase the risk that a late-talking child in the 18- to 30-month-old age range, and with normal intelligence, will have continuing language problems. These factors include:  
* Receptive language: Understanding language generally precedes expression and use. Some studies that have followed-up late-talking children in this age range have found, after a year, that age-appropriate receptive language discriminated late bloomers from children who had true language delays. Other researchers doing follow-up studies included only children whose receptive language was within normal limits because they believed that delay in this area was likely to produce worse outcomes.   

* Use of gestures: One study has found that the number of gestures used by late-talking children with comparably low expressive language can indicate later language abilities. Children with a greater number of gestures used for different communication purposes are more likely to catch up with peers. Such a result is supported by findings that some older children who are taught non-verbal communication systems show a spontaneous increase in oral communication.
* Age of diagnosis: More than one study has indicated that the older the child at time of diagnosis, the less positive the outcome. Obviously, older children in a study have had a longer time to bloom than younger children but have not done so, indicating that the language delay may be more serious. Also, if a child is only developing slowly during an age range when other children are rapidly progressing (e.g. 24-30 months) that child will be falling farther behind.
* Progress in language development: Although a child may be slow in language development, he or she should still be doing new things with language at least every month. New words may be added. The same words may be used for different purposes. For example, "bottle" may one day mean "That is my bottle," the next, "I want my bottle," and the next week, "Where is my bottle? I don't see it." Words may be combined into longer utterances ("want bottle" "no bottle"), or such longer utterances may occur more often.
It should be re-emphasized that negative aspects of these factors increase the risk of a true language problem but do not mandate its presence. For example, one research group found that one of their 25- or 26-month-old children with the worst receptive language had the best expressive language outcome 10 months later. On the other hand, children on the positive side of these factors may turn out to show less progress than predicted. The research group found that the child with the poorest outcome had the best receptive language and the largest vocabulary at the beginning of the study.
One study has found that the number of gestures used by late-talking children with comparably low expressive language can indicate later language abilities."

So what should you do if you are concerned about your child's speech and language development?

Come see one of our speech-language pathologists, and we will answer any questions you have about your child's language development. Research has shown that the time between birth and 36 months is an extremely critical period of development, so our work in early intervention allows us to both identify and treat very young children in an effort to minimize any potential speech and language developmental issues.

Helpful Links:
ASHA article
Developmental Speech & Language Milestones, Birth - 5 Years of Age  
Warning signs for communication disorder in young children

Tuesday, July 17, 2012

Treating Children With Feeding Disorders

Is mealtime a struggle with your child? Do they reject new foods, textures and tastes with gagging and fits? If so, they may benefit with help from a speech-language pathologist. SLPs work with a wide variety of feeding disorders in infants and children, usually as part of a team approach including the physician, occupational therapist, physical therapist and behavioral analyst.

From a 2003 article in the ASHA Leader:

"Justine Joan Sheppard, an SLP from Nutritional Management Associates and Columbia University, notes that behavioral problems associated with feeding may be called conditioned dysphagia. Conditioned dysphagia is a learned disorder or maladaptive habit that maintains a behavior beyond the physiological need. Feeding aversion, failure to advance to age-appropriate foods, food selectivity, negative mealtime behaviors, and gagging are examples of conditioned dysphagia and may lead to problems such as failure to thrive. ... When instituting a behavioral feeding program, it is essential that the clinician remember that nutrition is the primary issue."

Our goal as SLPs is to prevent problems such as failure to thrive and malnutrition.

ASHA article
Overview of our feeding therapy
Our feeding therapy FAQ
Feeding developmental milestones