Fluency Strategies for Parents

The way you speak to your child can have an impact on his speech and stuttering behavior. Children who stutter tend to stutter more in stressful speaking situations or when high speaking demands are placed on them. Parents can decrease the communication demands placed on their child by modifying the way they speak to them.

Strategies include:

• Speak slowly
• Use a soft voice
• Pause frequently in conversation
• Use simple vocabulary and grammar
• Avoid asking lots of questions
• Be patient, don’t interrupt your child or finish his sentences for him
• Allow time to pass between speaking turns, don’t rush your child
• Maintain natural eye contact, even in a moment of stuttering
• Avoid criticizing speech or using language like "slow down!" or "You’re taking too fast!"
• Talk openly about stuttering with your child and acknowledge that it can be difficult. You can use language like "sometimes speech is bumpy" or "that was a hard one."
• Listening Time: Set aside 15 minutes of time each day that your child can speak to you without time pressure. Your role is to listen to your child.

Home Program:

It is very important to set aside time each day to practice the strategies learned during each therapy session. Set up a period of time each day that you will practice with your child!

For more information on our Evaluations & Therapy, or to schedule a visit, go to:

 www.TeamChatterboxes.com 

My Son is 20 Months & Not Talking Much. Should I Worry?

"My Son is 20 months old, and not talking much. Should I wait to give him some more time to catch up, or have him Evaluated by a Speech-Language Pathologist?"

There is great variation in language development, especially in children between one to two years of age. Is your son following directions? Does he appear to understand what you are saying? Does he have strong social-interaction skills? If you answered 'yes' to each of these questions, it's possible that your son may have stronger receptive language abilities than expressive abilities.  The ability to understand language, is known as receptive language while the ability to use language (produce words) is known as expressive language.

However, it is important to note that your son has surpassed the important milestone for language development of eighteen months. Between 18-24 months of age, a child is expected to have an expressive vocabulary of about 40-50 words, and to begin combining words into two-word combinations, e.g., “My ball.” That said, it would be beneficial to have your son evaluated by a Speech-Language Pathologist, to obtain a clear picture of where he stands in terms of his overall speech and language abilities and determine strategies for you to use with him at home, that will be beneficial for encouraging his language growth.

For more information on our Evaluations & Therapy, or to schedule a visit for your child, visit  www.TeamChatterboxes.com 

Executive Function: Skills for Life and Learning

Did you know that your child’s early experiences build the foundation for a responsible community, a skilled workforce and a thriving economy?

Executive functioning, or self-regulation, is a set of skills that rely on three types of brain function: working memory, mental flexibility, and self-control. Children are not born with these skills, however, they are born with the potential to develop them. The full range of abilities continues to grow and mature as they the child enters their teenage years and early adulthood.

In order to ensure that your child develops these capacities, it is important to understand how the quality of the child’s interactions and experiences that our communities provide for them either strengthen or undermine their emerging skills.

School Achievement:
Executive function skills help the child:

1. Remember and follow multi-step instructions
2. Avoid distractions
3. Control rash responses
4. Adjust when rules change
5. Persist at problem solving
6. Manage long-term assignments 

Positive Behaviors:
Executive Functions help the child develop skills of:

1. Teamwork
2. Leadership
3. Decision-making
4. Working toward goals
5. Critical thinking
6. Adaptability
7. Being aware of our own emotions as well as other’s emotions 

Executive Function skills help People:

1. Make more positive choices about nutrition and exercise
2. Engage in activities in which they practice skills
3. Provide a consistent, reliable presence that young children can trust
4. Guide them from complete dependence on adults to gradual independence
5. Protect them from chaos, violence and chronic adversity because toxis stress stimulated by these environments disrupts the brain circuits that are required for executive functioning and triggers impulsive behavior

Building these abilities in young children requires caregivers and communities to provide and support the child’s experiences that promote emotional, social, cognitive and physical development broadly, including a range of strategies that:

• Reduce stress
• Foster social connection
• Incorporate vigorous physical exercise
• Increase  complexity of skills
• Successful work

Executive function skills increase our potential for economic success because we are better organized, able to solve problems that require planning, and prepared to adjust to changing circumstances

For more information on our Evaluations & Therapy, or to schedule a visit for your child, visit  www.TeamChatterboxes.com 

Language Development from Birth to 18 Months

Infants don’t talk, or begin communicating until later on in their development, right? 

Technically, speaking, most children won’t speak their first real word until around the time of their first birthday. Often times, it is when their child says their first word around 12 months, that parents begin tuning in to their child’s language development. Many parents don’t realize that their babies, from day one, are absorbing a tremendous amount of information from the world around them, and much of this information will serve as the cornerstone of language development.

Verbal vs. Non-Verbal

Communication and the development of language can be classified into verbal language, or the language and words that we speak and can also be classified as non-verbal communication or the messages that are sent by facial expressions, gestures, or body language. For example, babies gather information from birth based upon their parent’s facial expressions. By gazing into their parent’s eyes, babies are absorbing the emotions on their parent’s faces, and reading the messages that their parents are sending.  These non-verbal attributes of communication, such as making eye contact, interpreting facial expressions and taking turns are precursors to conversational skills and language development.  Generally speaking, a good conversationalist makes appropriate eye contact, offers good back-and-forth talk-time versus listen-time and is an active listener. These very skills can begin to be cultured with newborn babies during their daily care such as during mealtimes and bedtime routines.

Expressive & Receptive Language

Language is also classified as receptive and expressive language. Receptive language is the language that babies understand, and expressive language, is the language that babies use. For example, if you say to your baby, “Oh! Daddy’s home!” and your baby begins to react, or look around for Daddy, he or she has just shown the receptive understanding of your statement, Dad is home. Alternatively, if you call out your baby’s name and your baby replies vocally using jargon or vowels, “ooh-daahh,” although your baby’s sounds may not be ‘real words’, he or she has just responded to you using expressive language and in his or her own words said, “I’m over here, Mom!”

Language Milestones

Speech-Language Pathologists often use developmental milestones to determine if children are meeting specific receptive and expressive language milestones. Knowing these general guidelines may be helpful for parents to gather more information about their child’s language skills The American Speech-Language and Hearing Association (ASHA) offers the following milestones. The ASHA milestones are as follows:

Birth to 3 Months: (Receptive)

§  Will startle to loud sounds

§  Smile or quiet down when spoken to

§  Seems to recognize parent’s voice

§  May increase or decrease sucking behavior in response to sound.

Birth to 3 Months: (Expressive)

§  Makes sounds of pleasure, like cooing.

§  Cries differently depending on needs, (hunger, tired)

§  Smiles when sees parents

4 to 6 Months: (Receptive)

§  Moves eyes in the direction of sound

§  Responds to changes in your voice

§  Attends to music and toys that make sounds

4 to 6 Months: (Expressive)

§  Babbling with more consonant sounds (p,b,m)

§  Laughs

§  Vocalizes to show excitement

7 to 12 Months: (Receptive)

§  Likes people games, like peek-a-boo

§  Turns to locate sounds

§  Recognizes common words (shoe, cup)

7 to 12 Months: (Expressive)

§  Babbling using vowels and consonants in long and short bursts

§  Uses sounds to get attention, rather than crying

§  Uses gestures, such as two arms up to indicate “pick me up!”

§  Has 1-2 single words, such as Momma, or Hi!

One to Two Years: (Receptive)

§  When asked, can point to several body parts

§  Follows simple 1 step command “Give me the ball”

§  Listens to simple stories, and songs

§  Points to pictures in a book when named

One to Two Years: (Expressive)

§  Says more single words every month

§  Uses some 2 word combinations, (more milk)

§  Uses many different consonant sounds at the beginning of words.

A Parent’s Role

Parents can begin to encourage their baby’s language development by using a variety of techniques. Often times, these strategies can be employed during everyday activities. Some examples of how parents can help are as follows

1. Get down to your baby’s level.  This may mean sitting or laying on the floor so that you and your baby can be face to face.
2. Follow your child’s lead; tune into his or her interests.  Your child will be more motivated to communicate when engaged with something that interests him or her.  It does not need to be a toy and can be something as unconventional as opening and closing a box or looking out the window.
3. Simplify your language; match it to your child’s language.  Use language at a level or slightly above your child’s level.
4. Add melody to your language to make it more fun and interesting.
5. Imitate what your child does or says to keep the interaction going.
6. Repeatedly model simple words or fun sounds for your child to imitate.
7. Teach your child to use signs. Pair signs with words to facilitate development of single words.
8. Teach your child the power of communication: require him or her to communicate in order to get what he or she wants.  This could be simply making eye contact, signing, or saying a single word.
9. Expand on your child’s utterances to help them get to the next level.  For example, if your child says “more,” you can respond with “more juice.

For more information on our Evaluations & Therapy, or to schedule a visit for your child, visit  www.TeamChatterboxes.com 

Understanding Your Child’s Standardized Test Scores

Understanding speech and language testing scores takes you back to the basics of statistics and the bell curve.  Typically, speech-language testing scores are based on normative sampling in which test makers administer the test to a large group of children.  Your child’s scores are compared to the sample to see how their skills compare to peers.  With most speech-language tests, you can expect to derive the following scores:

Raw Score:  The raw score is typically either the total number correct or the total number of errors. 

Standard Score:  The standard score is determined by the raw score and is a conversion that allows for comparison to the normative sample.  The median standard score is 100.  The standard score and percentile rank essentially provide the same information, but most people find the percentile rank to provide a clearer benchmark for their child. 

Percentile Rank:  The percentile rank is also determined by the raw score.  It tells you the percentage of peers your child scored above.  For example, a percentile rank of 40% means that your child performed higher than 40% of peers.  The median percentile rank is 50%.  The following guideline can be used for understanding the significance of percentile ranks:

1-16%	Below Average	Your child may have a severe delay.
17-49%	Low Average	Your child may have a mild or moderate delay.
50-99%	High/Above Average	Your child does not have a delay.

Test Age-Equivalent:  A test age equivalent is also derived from the raw score.  It indicates the age to which your child’s skills can best be most compared.  This score should be interpreted with some caution since sometimes a delay in skills also involves a difference in skills.  For instance, a child who is 4 years old and receives an age-equivalency of 3 years old may present differently than a typical 3-year-old child.  Age equivalencies are best used as severity measures for this reason. 

For more information on our Evaluations & Therapy, or to schedule a visit for your child, visit  www.TeamChatterboxes.com 

8 Strategies for Conversation with Children who have Childhood Apraxia of Speech (CAS):

Children with CAS tend to communicate more easily when there is less communication pressure.  You might try these techniques-

  

• Comment, Don't Question- Make more comments in conversation than questions.  When you ask a question, it is demanding that the child responds right away and with particular information. Only ask questions when necessary.

• Go with the Flow- Reduce the frequency of asking the child to repeat something he has said, as this can lead to increased frustration and communication breakdown.  When you do not understand what your child has said, it’s OK to “go with the flow” and make a general comment (e.g., That’s cool!) to keep the interaction going.

• Focus on the Activity, Not the Words- Make comments that are related to the activity you are engaging in with the child instead of aspects of the child’s speech.  For instance, while playing with dolls, you might say, “Oh no the baby’s crying,” or “She’s sleepy” rather than “Nice job talking,” or “You had a hard time saying that.”

• Turn off the Spotlight- Avoid putting your child on the spot when greeting other people. For example, telling your child to say “Hi” or “Good morning” to someone can be a very demanding task with which your child may have difficulty, resulting in communication breakdown. Avoid putting your child on the spot in front of an audience by asking him to tell other people about something (e.g., Tell Sarah about your birthday party, Tell James what you did at school). 

• Turn up the Fun- Try not to focus on “getting your child to talk” and rather focus and having fun with your child in conversation and play.

• Talk About Their Interests- Talk about Sophie the First, or Cement Trucks, keep the topics centered around what is interesting to him. When you do so, your child may be more likely to make a comment.  Just as adults enjoy talking about particular subjects, oftentimes so do children.

• Get Silly- Make conversation fun and light-hearted and maybe even silly, as this can reduce tension and create a more relaxed atmosphere, thereby increasing the likelihood of your child participating in conversation. 

For more information on our Evaluations & Therapy, or to schedule a visit for your child, visit  www.TeamChatterboxes.com 

The Business of Play

Play is a powerful vehicle for learning in the early childhood years and a critical source for expanding cognitive, language, motor and play skills. Play is an activity that children do naturally at home, at school and in the community, as it is highly motivating and fun! For these reasons, Chatterboxes SLP's feel that play is an ideal platform for speech and language therapy for young children. 

Play-based therapy is a model of intervention that targets speech and language objectives within the context of play. Therapeutic play, such as this, is characterized by the use of toys and play scenarios within the context of play. Therapy occurs in a natural context, which often facilitates increased generalization of speech and language skills. Play-based therapy is often times less structured than other more standard approaches, and requires creative and flexible thinking on behalf of the SLP (Speech-Language Pathologist). It's these quick thinking SLP's that truly make play-based therapy a success for kids, as they transform arising play scenarios into learning experiences.

The following example of Play-Based Speech & Language Therapy can be illustrated via a previous session with a child whom we'll call Tommy: (Note: One of Tommy's Speech-Language Goals is to begin to use the pronoun "I" in connected speech).

First, Tommy chooses a toy from those available in the SLP's room. Today, Tommy chooses the Farm Set. Tommy, a creative and playful boy, who loves pretend play takes the lead. He implies that all of the farm animals want to play in the mud! The SLP sees an instant opportunity to target Tommy's goal of using the pronoun, "I."

The SLP notes, "All the animals are going to take turns jumping into the mud!" From here, the child and SLP say with great animation, "I jump in the mud!!" as each animal independently jumps into the mud. The animals love playing in the mud and, the SLP explains, "OH NO! The animals are so dirty; They need to take a bath!" As each animal gets in the bathtub he says, "I take a bath!" or "I need soap!" and then "I dry off!"


Aside from using the the pronoun "I" in the context of the play-sequence, the child is learning to take turns, (a precursor to conversational skills), while using imagination and higher levels of thought processes.

For more information on our Evaluations & Therapy, or to schedule a visit for your child, visit  www.TeamChatterboxes.com 

 Such a play-based scenario promotes carryover of skills learned in therapy to everyday life.

Classroom Strategies For Bilingual/Multilingual Newcomers:

1.     For newcomers who speak little to no English, 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, start 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!

For more information on our Evaluations & Therapy, or to schedule a visit for your child, visit  www.TeamChatterboxes.com