5 Ways You can Support a Child with an Articulation Disorder in your Classroom.

Once a child has started working with a Speech-Pathologist, and have shown some consistency in therapy, the child will be working on a target sound. The child will now need support outside of the therapy environment in order to produce that target sound correctly. You can help this student in generalizing this sound in the classroom.

5 Tools for Classroom Teachers to Generalize an Articulation Target:

1. Model the Sound, Not the Letter.
1. Ex: “Ruby, Let’s hear your RRRRrr Sound” as opposed to “Ruby, can you say the ‘R’ again?”

2. Hot List.
1. Create a list of 3-5 words that are frequently used words in the classroom that contain the child’s target sound. Reinforce the child’s production of those 3-5 words each time they occur.
1. Ex:  If the child’s target sound is /th/ you might choose:
1. Math
2. Bathroom
3. Thursday
3. Highlight It.
1. During worksheet activities, or written assignments, highlight the target sound for the child each time it occurs. This will increase the child’s awareness and attention to that target sound.

4. Buddy Up
1. The therapist may provide a list of words the child is targeting in therapy. You might Buddy your Articulation Student up with another child who has mastered the target sound. Encourage the 2 friends to practice the word list together as a consistent time in the schedule each day.

5. Secret Visual Cues:
1. The key here to to ask the child to think of a cue that he thinks would work as a reminder for him. This could be a subtle visual cue, such as scratching your nose. The teacher can ;scratch her nose’ when the target sound appears.

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

Chatterboxes Announces 2nd location in Lexington

Chatterboxes is thrilled to announce the opening of a second location located in Lexington, Massachusetts. 

Chatterboxes has been providing best-in-class pediatric speech, language and feeding services to the greater Boston area since 2007 in Newton Centre. Our Team of 8 Pediatric Speech-Language Pathologists continue to be dedicated and passionate about helping kids and families.  We are excited as a group to expand our demographic reach to include our new Lexington location. 

The Services of our Lexington location include:

•  Comprehensive Speech, Language and Feeding Evaluations
•  Individualized Therapy Sessions
•  Written Diagnostic Reports
•  Small Social-Pragmatic & Language Groups  
•  Individualized Home-Programs following each session
•  School & Onsite Visits available for Evaluation & Therapy
•  Complimentary Conferences to discuss Progress & Evaluations
•  Parent/Teacher/Family-Based Education

Chatterboxes is Now Accepting New Clients in Lexington, Massachusetts.

Contact Brittany Doyle, M.S., CCC-SLP for more information or visit us online at www.TeamChatterboxes.com 

iPad and Proloquo2Go AAC Therapy Session

Play-Based Augmentative Communication Session

Segment 1:

During our play based session, the clinician engages Erik with a favorite game (Candy Land Castle). While playing Candy Land, Erik is prompted to announce each player's turn using his iPad via the Proloquo2Go app.  Yes/No questions are also targeted in part 1. Social Phrases, such as "Yes! A Match!" and "Oh No!" are included to promote social commenting.

Segment 2:

Where? Erik is concentrating on answering Where Questions in this segment using a magnet scene. The clinician also provides a visual cue for "Where." Erik selects from pre-programed icons with prepositional phrases.

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

Therapy Spotlight: PROMPT Therapy

PROMPT was developed in the 1970’s by Deborah Hayden, and has been refined over the past 30 years. Chatterboxes’ SLP’s are trained in PROMPT.

Prior to beginning PROMPT, the Speech-Pathologist assesses the child’s motor speech system, in terms of structure, function and integration.

Aspects of the motor speech hierarchy, such as phonatory control, mandibular control and lingual control are all taken into account during the development of a PROMPT therapy plan.

Brittany Doyle M.S, CCC-SLP providing a play-based PROMPT session

Once target sounds, sound combinations, or words are selected, the SLP begins to incorporate these target words into therapy. During a typical PROMPT session, the SLP may be seated on the floor with the child.

Situations are set up within the therapy context which encourage the frequency and use of the predetermined target words.

The child’s head position and clinician’s hand position are essential for supporting and, in some cases restricting unnecessary movements.  The clinician provides the tactile, or PROMPT cues throughout the session to support and facilitate the child’s production of these sounds

The diagram below depicts examples of the points of contact which may be incorporated during the provision of facial prompts by the SLP.

Looking for a PROMPT Trained SLP? Our Team at  www.TeamChatterboxes.com can help. 

What to Do When You Loose a Game- Social Story

It can be tough to teach kids how to loose gracefully.

Talking openly about thoughts and emotions involved in the competitive nature of playing a game can help.

Explain to your child that sometimes we loose because our skills are not a strong as our opponent's skills, or sometimes its just bad luck, or bad timing.

Giving your child specific ideas on what to say and do when they loose can help him or her learn how to be a good sport.

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

Pediatrician's Developmental Stages of Play: Desk Reference

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

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