Feeding Therapy 101

Hello all- Cara here! This week, I am guest blogging on a topic I am very passionate about- feeding therapy! During my years as a practicing speech-language pathologist, I have completed specialized training and gained invaluable experience within the area of feeding disorders. It is an area of practice that I find especially rewarding. I began working at OWLS Therapy in July 2018 and have loved working with children and their families in the home environment. This treatment model works incredibly well with feeding therapy, as treatment sessions involve both the child and their family members. I am passionate about making feeding therapy FUN and FUNCTIONAL! 

Have you ever wondered if your child may need feeding therapy? Below, I have answered some commonly asked question about feeding therapy and concerns you may have. 

What is feeding therapy?

Feeding therapy helps a child learn how to eat or how to eat more efficiently and effectively. It targets oral motor skills and/or expanding a child’s diet to provide for more variety in fruits, vegetables, meats, etc. 

 How do I know if my child needs a feeding evaluation?

Red flags to be aware of:

  •   Decreased oral motor skills, such as:

    • Difficulty chewing different textures

    • Difficulty drinking from an open cup or straw

  • Minimal consumption at meals

  • Transitioning from G-tube feedings to oral feedings 

  •  Difficulty swallowing or refusing to swallow certain foods or textures

  • Gagging, choking or vomiting during meals 

  •  Arching of the body during feeding 

  • Avoidance of total food groups

  • Difficulty accepting changes in familiar foods, such as changes in:

    • Shapes

    • Textures

    • Temperatures 

    • Colors

  • Difficulty transitioning from one texture to another, such as puree to a mixed consistency 

  •  Brand specific, such as ONLY eating Wendy’s chicken nuggets

  • Mealtime taking longer than 30 minutes

  •  Physical reactions to food, such as crying, screaming, or refusing to sit at the table

 What’s the typical development of oral motor skills?

Below is a brief list of skills a child should have by a given age. NOTE: this is not an extensive list and doesn’t fully capture all of the skills a child should have, nor is every child exactly alike with their development. 

Around 6 months

o   Spoon feeding introduced, starts to accept pureed baby foods

o   Cup drinking introduced 

o   Holds bottle with both hands

6- 9 months: 

 o   Increases lip closure on spoon and helps caregiver with spoon

o   Sucks liquids from cup

o   Around 9 months, the child should be accepting table foods and chewing with an up down (munch) motion. 

9- 12 months

o   Drinks from an open cup with hand-over-hand assistance. (Personally, I am not a big fan of a sippy cup, but I recognize that it may have a time and place.) 

o   Gag is less sensitive, moving foods more posteriorly 

o   Consumes lumpier or thicker foods

o   Drinks from a cup with a straw

12-18 months:

 o   Develops a more mature, rotary chew and ability to transfer foods from one side of the mouth to the other

o   Uses pincer grasp to self-feed 

o   Clears lower lip with teeth

o   Increased stability to take bite from a larger piece of food 

18- 24 months:

o   Chews a variety of textures with their lips closed, controls bite on hard food (i.e. pretzel)

o   Decreased tongue extension during swallowing

o   Self-feeding with spoon 

o   Holds cup with one hand 

24+ months:

o   Eats a variety of foods. Continue to avoid choking hazards, such as whole grapes or hot dogs.

o   Drinks from open cup without spilling

o   Tongue retraction for swallowing 

o   Chews meats adequately 

o   “Fine tuning” all of their oral motor skills 

Who provides feeding therapy?

Either a pediatric speech-language pathologist (SLP) or occupational therapist (OT) provide feeding therapy. It is important to note that not all pediatric therapists are trained to provide feeding therapy services. Because it is an area of specialty, the treating therapist should have completed additional education courses and have experience working with this population. Also, the SLP or OT treating a child with a feeding disorder will often consult with a nutritionist/ dietician, pediatrician, or another specialist involved in the child’s care. 

 What do feeding therapy sessions look like? 

Feeding therapy sessions are family focused. Sessions can be done with the therapist and child or therapist, child and family member.

How long does feeding therapy take?

Session length and frequency depend upon the child’s individual needs. In general, feeding therapy sessions occur once a week and are typically between 30 to 60 minutes long. Prior to initiating feeding therapy, a feeding evaluation must be completed to obtain a past medical history, assess the child’s oral motor abilities, and analyze the child’s current diet. 

If you have additional questions, please contact us at OWLS Therapy to discuss more. I believe feeding therapy is extremely beneficial, as it helps your child create a healthy relationship with food. I want mealtimes to become less stressful, eating to become easier, and food to become FUN! 

Commonly Asked Questions: Part II: Is Speech Homework Really that Important?

Welcome back to Part II of this multi-part blog series that answers frequently asked questions.  Up this week: 

 2. Is the speech homework my speech therapist provided really that important?

In one word, YES!!! However, I do know how hard this one actually is from personal experience.  As mentioned in previous posts, I have suffered from back issues for several years. And as a result, I have spent my fair share of time at the physical therapist’s office.  Where they assigned homework.  Where I was really good about doing it for the first 3 days and then literally forgot until I was walking into the next session a week later. Believe me, I get it!   Doing the assigned homework is going to take effort to get it done.  However, your child’s speech therapist can tell which families consistently do the homework and which ones don’t. Just like I am sure that my physical therapist could tell when I had consistently (key word being “consistently!”) been doing my exercises, just like your dentist knows if you only floss the day of your dental exam.  So why do I harp on homework?  To start, we typically see your child for an hour a week.  Now if you take out time spent sleeping (I’m being generous and saying your child sleeps for 12 hours a day), that leaves 84 hours of time spent awake each week.  We see your child for one of these 84 hours.  That means we see your child for less than 1.2% of their week.  If we want generalization to occur, we need to be practicing these skills for more than 1% of the time!

 

So, what is the best way of going about doing this? Great question!!

 

1.     Pair speech homework with another activity that you never skip (i.e., brushing teeth, bedtime stories, driving to school in the morning).   From asking families that have found a way to incorporate their speech homework into their daily lives, this seems to be one of the top ways to do so.  If your child is working on articulation (how they pronounce words), have a list of words written on a post-it note on the bathroom mirror and have your child say each word after they brush their teeth (please be present for this to make sure they are actually practicing them correctly!) Want to make you child really like this activity?  If they are old enough, have them write the word with lipstick, eye liner, lip liner, etc on the mirror (buy a cheap brand at the drugstore).  I don’t know a child who doesn’t love writing on things they are not technically suppose to! It will be one big, sloppy reminder to practice! Let’s say your child is working on using correct irregular past tense verbs.  On the drive to school, have them create past tense sentences about what they saw going down the road (ex., I just sawa dog.  The man rodehis bike. She wentinto the store.)  

 

2.    Make it fun! You have probably noticed by now that your child typically will play a game during their speech session.  While speech pathologists love a good game, for us, games are used as a reinforcement tool.  Research suggests that for generalization of articulation skills to form, 150 correct trials need to be produced in a 30-minute window.  And as you can probably guess, just saying words over and over and over, gets pretty old, pretty fast to little bodies.  Thus, games and other activities.  Practicing at home can be the same way!  Choose a game that you can play with your child. Games where you each take a turn and can stop between turns work best.  Have your child say their word, make a sentence, whatever you are targeting in speech before they take their turn of the game.  When the game is over, speech practice is over.  There are many children’s games that take about 15 minutes to complete.  

 

3.    Implement a reward system. We all get rewarded for working.  As adults, it comes in the form of a paycheck.  For kids, it might be something like: for every day you do your speech homework, you get a star.  Once you reach 10 stars, you get to choose dessert that night, an extra 30 minutes of screen time, etc.  Another reward system I like is placing words that are being targeted in speech (could be for articulation or expressive/receptive language) on slips of paper.  Fold them up and put them in a bowl.  On one slip of paper, put a star or smiley face.  When this paper is pulled out, the reward has been earned.  This will keep little hands reaching in trying to get that golden ticket!   

 

4.    Make it a family event!  There is no reason that your child’s speech homework can’t be done with other members of the family.  Everyone can play a game and say a word before their turn.  Your child benefits from hearing other models and siblings benefit by learning that what might have come easy for them, is not easy for everyone. 

 

5.    Set a reminder on your phone.  If all else fails, set a daily reminder to go off for when you know that you are with your child.  Even if you can only get a couple practices in, it can add up throughout the week!  

 

6.    Strive for just 5 minutes each day.  We don’t expect you to sit down with your child and practice for an hour each day. Would that be amazing? Absolutely! Is it necessary? Nope!  If you can commit to 5 minutes in the morning or 5 minutes at night.  You would have one content speech pathologist on your hands!  

Commonly Asked Questions: Part 1: How Long Will My Child be in Speech?

In this multi-part blog series, I am going to cover the answers to questions I get asked consistently. These may be questions I get before a child begins speech therapy or they might be questions that I get once speech therapy has begun.  Regardless, they are clearly questions that need to be answered!  

 

1.     How long is my child going to need to do this?  

 

This is by far the question that I get asked the most.  Let me start by saying that speech therapy is a process and thus is typically not a quick fix.  When you think about what we are actually trying to do, it is much easier to understand why speech and language disorders do not typically clear up in a couple of months.  For example, if you take a child who has articulation errors (substituting one sound for another sound within a word), this may be the easiest way to demonstrate this.    Let’s take imaginary child, Peter.  Peter’s parents contact me because Peter has been struggling to say his “R” sound correctly. “Rabbit” becomes “wabbit,” “ring” becames “wing,” and this occurs for every word with an “R.”  Peter is now 8 and while it was adorable when he was 3, it’s not quite so adorable at the age of 8.  Peter’s parents understand that he needs some professional help.  He has received some speech therapy in the school system, but he was dismissed because it wasn’t impacting him academically. Thus, they are going the private speech therapy route.  When Peter was seen in the school system, he was seen with a group of 5 other students, so they are hoping that having individual therapy will really speed things up! And while having an entire session that has been planned and organized solely for your child’s specific needs will help, it’s not quite that easy.   This is where speech therapy becomes a process.  Right now, when Peter goes to say an “R,” he has a motor plan in his brain that tells him to round his lips for the sound.  This obviously results in a “W” which is not the correct sound.  The goal of speech therapy is to override this old plan and replace it with a new, correct motor plan.  The new motor plan would have Peter retract his tongue and spread it out wide in his mouth touching his upper molars.  Currently, Peter’s old, incorrect motor plan is very strong.  He has been using it for about 7 years and it is a well-traveled path. His new plan that he has learned in speech is very weak and is definitely not the “go to” motor plan. The goal of therapy is to strengthen this new motor plan to the point where the old, incorrect motor plan is ultimately eliminated when he produces the “R” sound and the new, correct motor plan is the dominant plan.  As you can imagine, this takes time.  It takes continual, consistent, copious practice.  It takes a lot of hard work.  It takes rewiring the brain.  The average child is in speech therapy for about 2-3 years.  Some are dismissed quicker; others stay in longer.  It really is child-dependent based on what is going on with their speech and language system.   As a result, can I ever give parents a definitive exit date?  Sadly, I can’t.  I would love to be able to but there are too many variables, both known and unknown, that will determine how long a child will need to attend speech therapy.  However, what I can tell parents is that starting speech therapy is the best thing you can do for your child and progress will be made.     

Why I’ll Never Tell a Child that He is Smart

Ouch!  Even writing that title sounds harsh.  But it’s true.  The words “You’re so smart” or any iteration of it, will never cross these lips. It doesn’t mean that I might not think it about a child that I am working with.  Far from it!  My clients blow me away with how their minds work on a daily basis.   However, how I praise them will never include the word “smart.”  Now before you start thinking that I am cold-hearted and need to find a new profession that doesn’t include working with small, impressionable children, hear me out.   

I am a HUGE believer in building a child’s confidence.  Confidence and competence are pretty much equally important when it comes to achievement. Research has shown that when you are confident, you take more risks and are better able to recover from setbacks. Confidence also enhances your ability to think creatively and push yourself harder.  Creativity, drive, stamina.  All things I want instilled in my clients.  So how does this all relate to not using the word “smart?”  It all comes down to what psychologists refer to as “growth mind-sets.”  

A growth mind-set is the belief that one can be good at something, regardless of initial skill level. People who have a growth mind-set are typically more confident that those who think skills are innate.  As a result, they move past failures and take more encouragement from success.  Thus, I won’t praise a child by pointing out an “innate” quality they possess (aka being “smart”) but rather I praise them on a quality that they can “grow” (ex. “I love how you kept trying to sound out that word even when it got tough.  You stuck with it! That’s awesome!”)  I praise them on whatever skill helped them achieve the answer.  The idea is that my clients walk away from a speech session thinking about themselves in terms of being someone who perseveres when things are tough, who can look at a problem from another view point, who uses previous knowledge to look at a new problem. I don’t want them to internalize the belief that they are someone who only got a problem right because they were smart or got it wrong because they were dumb. I want my students to see their successes as something they achieved by qualities they worked on and their failures as something to learn from.  I want them be able to apply the successes and failures of that event to the future. 

And that sounds pretty smart to me! ;)

Summer Slide

Summer slide.  Sounds fun, right?!  Well, sadly this is not the kind of slide that results in fun twists and turns and maybe splashing into a refreshing pool of water at the very end. Today’s blog post is about the term Summer Slide and what it means for children.  While it may only be April, everyone knows that Memorial Day is just around the corner and summer is just a hop, skip, and jump away!  

So, what is Summer Slide? Summer Slide is the term used to describe the toll that summer vacation can take on a child’s academic knowledge. Research has shown that children score lower on standardized tests after summer vacation than they did on the sametest BEFORE summer vacation.  Children fall behind an average of 2 months of reading and, sit down for this, lose about 2.6 years of math computational skills over the summer.  2.6 YEARS?!?!?  So now that we have established that Summer Slide is real and something to worry about, where do we go from here?  

First, just because school is out, doesn’t mean that all academics should stop.  The most important thing that children can do is read, read, and read some more.  More than half of the 9thgrade achievement gap in reading can be explained by unequal learning opportunities during elementary school summers.  While summer might be filled with trips to the pool and beach, make sure that they are also equally filled with trips to the library and book store.  We’re supposed to avoid the sun when it’s at its hottest so implementing an afternoon reading time could be just the break needed!  Children’s magazines are another great way to incorporate reading and some learning without it feeling like work.  Ranger RickHighlightsSports Illustrated KidsNational Geographic KidsLego Cluband American Girlare just a few of the titles out there.  Plus, I don’t know a single child who doesn’t enjoy receiving something in the mail!  

While it may be hard to set aside a distinct time for working on academic skills, get creative with how you can incorporate learning into everyday activities.  When you are at the grocery store, have your child calculate simple math problems like “if I buy 3 packages of strawberries when they are priced at 2/$5, how much would that be?”  or reading the back of cereal boxes for which one has, for example, the least amount of sugar. Baking and cooking with your child is another excellent opportunity to expose your child to real world use of math and reading. Following a recipe’s directions requires not only reading the recipe but also doing the math to measure out ingredients (i.e., which measuring cups do you need to use to make ¾ cup?)

And lastly, while we don’t want to slide backwards in the summer, if your child is experiencing difficulty with reading or their speech and language skills, summer is an excellent time to continue to develop those skills and potentially get ahead.   Schedules are not as packed and brains are not as tired from a full day at school.  

Self-Love

As I am writing this, the 4th Nor’easter of the month is swirling outside, forcing me to take the day off.  So while I am not seeing the children that I typically treat today, I am also missing my first personal training session.  Even writing that makes me sound more fancy than I actually am.  A personal trainer?  Who has the luxury of having one of those?  Those are reserved for celebrities, right?  Wrong!  I recently decided to invest in having a personal trainer after suffering through repetitive back spasms that would leave me either canceling therapy or hobbling in and out of client’s homes.  A couple of years ago, I was diagnosed with “gluteal amnesia” or “dead butt syndrome.” Sounds made up, right?  I only wish I was joking.  Gluteal amnesia is when your glutes literally forget how to fire properly and thus other muscles end up having to take over the workload the glutes were supposed to be doing.  It is often triggered by the sedentary lifestyle we live which forces us to be seated for too many hours a day.  The result is lower back pain and when you are hauling your office in and out of people’s houses, the good times are not rolling.  I have been in physical therapy for this, I have tried increasing my workouts, but just when I would think I had the magic combination figured out, my back would lock up again and I would be in tears.  After this last lockup, about two weeks before I was set to run a half marathon, I decided that enough was enough and I needed a professional.  As a speech pathologist, I am the professional that parents reach out to for speech and language concerns, yet somehow it escaped me to reach out to someone trained in exercise physiology for my concerns.  Luckily for me, a client’s mother happens to own a gym, is in amazing shape and who I happen to have a #wcw on every week.  Thus, a quick phone call got me all set up.  So where I am going with this long-winded story that has nothing to do with speech therapy?  The importance of self-love.  And more importantly, self-love is not being self-ish.

Self-love, self-care, “me time,” whatever you want to call it, is something that is sadly pushed to the side and neglected in professions that help others.  And from my vantage point, as a speech pathologist working in homes, it is also something that many parents of children with disabilities push to the side.  (I could probably broaden that statement to parents in general!)  However, there is so much research that says that this time is healthy, warranted and NEEDED!  It really is true; how can you help someone if you don’t help yourself first?!  If you keep giving and giving and giving, but never stop to refill, eventually you run out and can give no more.  This is commonly referred to in the working environment as “burn out.”  And I would venture to say that the majority of speech pathologists and parents have experienced it at some point. So instead of waiting to “refill” your cup before it is completely depleted, strive to add a little bit to the cup every day.   I know that there are much more eloquently written articles about this on the internet, written by people with a degree in the field but this is what I have found works for me in my little corner of the speech world.

1.      Workout.  Regularly.  I know that I am a much more sane, calm, human being when I run regularly.  My husband has even mentioned to me in the past, when I am all riled up about something, that perhaps I could use a run, as he slid me a chocolate bar.  While I try not to get to the point that I need this reminder, I am grateful that I have found an exercise that I enjoy and does a body good.  However, I feel the key to actually working out is being realistic about what you will actually do.  I, for example, hate gyms.  I see friends go to them and love them, but the second I walk through the door, I am already in a bad mood.  I would take running outside in 20 degrees over a treadmill any day.  I have about 3 failed gym memberships to prove this point. 

2.     Make time for friends.  Can’t stress this one enough!  Every month I see my best friend who lives about a 2-hour drive away.  We plan our monthly get togethers a year in advance and unless something crazy comes up, we don’t cancel.  This is “food for the soul” time and I leave our day together feeling motivated, confident, and content.  My cup is full.  I have another friend who I have known since I was 4 and we have monthly cupcake dates where we go to Georgetown Cupcakes in Georgetown, get a couple of cupcakes, a coffee, and then we go down to the waterfront and catch up.  We do this year round, regardless of how cold it is outside.  Again, good for the soul. 

3.     Start to notice what you actually like versus what you somehow fell into a habit of.  I noticed this with TV.  I would get home from work and after dinner, just mindlessly watch TV, sometimes staying up later than I wanted.  When I actually became conscious of this habit I had fallen into, I realized that how I actually wanted to spend my down time wasn’t watching some home improvement show but reading, whether that be a book or a magazine.  Now, I watch the shows I actually am interested in or I read.  I end up feeling that I didn’t waste my precious, limited downtime on something I didn’t care about. 

4.     Eat healthy-ish.  I add the “ish” because while I do notice a difference in my energy if I eat lean, clean, and green, I also notice when I take the time to enjoy my nightly dessert.  That’s right.  I eat dessert every day.  It ranges from Java Chip ice cream, to Girl Scout cookies, to dark chocolate, but I have a sweet treat every night.  And when I take the time to pay attention to what I am eating, that moment of appreciation is noticed and that much sweeter.

5.     Don’t do things that are “good” for you but feel like a chore.  I bought a 5 minute journal a while ago.  The idea behind it is to take a couple of minutes in the morning and a couple of minutes at night to reflect on your day ahead and notice the wonderful things in your life and the things that you can do to improve.  A fantastic idea and for some people, I know a great tool to decompress and be more present.  I thought maybe I would stick with it because my attempts at journaling always went nowhere.  Well, sadly this fell into the same category.  Even though it only took a short amount of time, it felt like another to-do item on my list and thus caused me more stress than it helped alleviate.  It had to go. 

So while I am no expert, I do know that for the amount that I give my clients every day, I have to make sure that I give to myself first.  And that doesn’t make me selfish.  It just means I am giving myself some much needed self-love. 

Developmental Stuttering

Today I thought I would write about something that I have had an increase in phone calls from parents about: developmental stuttering.  I would say in the last two weeks I have had about 6 phone calls concerning stuttering events in preschool age children.  The aim of this blog post is to provide some education regarding what developmental stuttering is and some tips for parents and teachers when encountering stuttering. 

To start off, what exactly is developmental stuttering?  Developmental stuttering is stuttering that typically appears between the ages of 2-5 and clears up by the time the child has reached Kindergarten.  This time during childhood development coincides with an increase in the child’s expressive language skills.  We typically expect a 2-year-old to have a minimum of 50 words and by the age of 6, about 2,600 with a receptive vocabulary of around 25,000 words.  Needless to say, that is a lot of language growth in a relatively short amount of time and as a result, things can get bumpy (horrible pun intended!)  The general thought behind developmental stuttering is that the child’s increase in expressive language skills results in their mind working faster than what they can motorically keep up with.  As a result, stuttering occurs. One of the first questions that I ask parents is if there is a family history of stuttering.  If there is, I do recommend starting therapy.  If there is not, the child is in this age range, it hasn’t been perseverating for 6 or more months, I recommend the parent and I stay in contact.  I also tell parents that it is typical to see an increase in stuttering behavior around big life changes.  For example, this can be the birth of a sibling, starting school, transitioning to a big kid bed, or sadly, the death of a grandparent.  Now, it is important to note that some children who begin stuttering during this time frame will not outgrow it and it is important to contact a speech pathologist to discuss what you are seeing with your child and your family history. 

Lastly, one of the big issues that I have come across is that both parents and teachers often do not know what to do, especially if starting therapy isn’t warranted.  This is especially the case for many preschool teachers who may have never had a child who stutters in their classroom.  As a result, I provide these tips to parents and teachers found on The Stuttering Foundations website (they are phenomenal resource and I recommend anybody and everybody check them out!):

1.      Don’t tell the student to “slow down” or “just relax.” 

While this is said with well-meaning intent, it sadly doesn’t help.  Instead, reduce the pace at which you speak.  For some children, a more relaxed environment in general is helpful. 

2.     Don’t complete the words for the student. 

They know what they want to say.  How frustrated would you be if someone was always trying to talk for you?

3.     Help everyone in the classroom/household learn to take turns and listen. 

Everyone benefits when they aren’t being interrupted or fighting to be heard. 

4.     Expect the same amount of work/behavior from a child who stutters versus those who do not. 

Stuttering has nothing to do with intelligence and ability. 

5.     Convey that you are listening to the content of the message and not how it is being said. 

Remember that what they are saying is what is important, not how they are saying it. 

6.     Don’t make stuttering something to be ashamed of. 

It is okay to talk about stuttering.  While we may refer to it as “bumpy speech” because that is a more child friendly term, talk about stuttering how you would talk about any other matter that may bother or upset your child. 

And remember, if you ever have any questions, please don’t hesitate to contact a speech pathologist.  We love to talk and are always happy to answer any questions parents or teachers may have! 

My love affair with games

Well I think it is safe to say that we have established that I am horrible at being a consistent blogger.  I have had the idea for writing this blog since August!  August people!!! I have probably written it in my head about 17 times but sitting down and actually putting fingers to keyboard has apparently been extremely difficult for me.  The topic that has taken me 6 months to finally write about you ask? Games and why I play them in 99% of my therapy sessions.  I actually had a parent ask me a couple months ago if the reason I became a speech pathologist was so that I could play games all day.  A valid question since I play games all day, every day and I have no plans of changing my therapy strategy of incorporating them.  So why am I such a fan of games and why does my office and trunk of my car rival the game aisle at Target?  For a multitude of reasons:

 

1.     It keeps children engaged!

Ask any speech language pathologist and many of them will say that articulation therapy is not their cup of tea (I’m the opposite, I could have a caseload of only articulation and be quite content).  But why is articulation therapy the proverbial thorn in a speech pathologist’s side? Because it requires repetition, repetition, and more repetition.  Research suggests that to see progress you need 150 correct trials in a 30-minute session.  That is a lot of words in a short amount of time.  And now if you take it from the perspective of a child, they are repeating word after word after word and not always getting it correct.  It can be frustrating, boring, and it can get dry, fast.  Enter games.  I chose games where my turn and the child’s turn takes about 30 seconds to complete so that I am not spending more time playing games than actually doing therapy.  But a quick flip of a card to each take a turn at Sorry is rewarding and quick, especially when they get to “sorry” the teacher.  Sometimes I worry about the amount of glee children feel when they send me back to start but that is another post…

 

Playing games can also help parents when they are doing their speech homework with their child.  I have had many parents report that their child loves speech but refuses to practice with them throughout the week.  Playing a game can help with the motivation factor since they get one on one time with their parent and some fun at the same time. 

 

2.     It teaches turn taking.

This is obviously a skill that young children need to be taught, but having been a speech pathologist for 10 years, I am, for some reason, still shocked when I get elementary age students who have not developed this skill.  So, young or old, this a great way to teach turning taking and impulse control in an environment that is fun and engaging. 

  

3.     It helps with higher order thinking skills like strategy, organization, attention and planning.

Depending on the game that you choose, higher order thinking skills like strategy, organization, attention, and planning can all come into play.  And this isn’t just for older students.  There are many preschool games that target these skills in younger children.  For preschool age children, I like Sneaky Snacky Squirrel and Race to the Treasure.  Both games actually benefit from some planning and strategy and these games provide an easy opportunity to demonstrate these skills.  For older students, games such as Skip-Bo and Sorry require strategy, organization, and planning. 

 

4.     It teaches kids how to lose and win (and be a good sport about it). 

A question that always goes around when speech pathologists get together is “do you let your kids win?”  My answer, no.  Writing that makes me sound heartless but I don’t purposely throw a game because that is not life.  Life is unfair and the sooner you learn that sometimes you win and sometimes you lose, life gets a whole lot easier.  Now, am I going to play with the same amount of strategy that I would if I was playing with my own peers?  Of course not, but I am also going to be there to help my students know the correct way to show happiness about winning and sadness about losing.  It is a lot easier for children to learn how to lose a game with me than to lose with their peers who may judge them for their tears or outbursts. 

 

There you have it, the blog post that took me 6 months to write.  Hopefully it was worth it! Till next time…

Simple Strategies to Help Elicit Language

Last week I talked about some speech and language red flags and when contacting a speech pathologist is warranted.  Today, I want to provide simple strategies to help elicit language.  These tips work great for any child, from those that don't stop talking to those that need a nudge! 

 

If you are concerned about how your child’s pronouncing words (articulation), try these tips:

Model correct speech: While your child might have some adorable ways of saying certain words, it is best to not re-inforce these errors.  You also want to avoid correcting mistakes. Instead, repeat the words correctly to your child (ex. child: “The toy is in my woom.”; adult: “Yes, your toy is in your room.”)

Face-to-face: While it might not seem like it, your child learns a lot about how to correctly produce sounds just by looking at your mouth.  When possible, gain your child’s attention and get face-to-face when talking so that your child can watch your mouth.

 

If you are concerned about how much your child is talking (expressive language), try these tips:

Narrate everything: You might feel silly doing this, but just exposing your child to language is huge! For example, if you are in the grocery store with your child, talk about what you are doing, what you see, why you are putting an item in the basket, where you are going to go next, what you are going to do, etc.           

Expand your child’s language:  Add one or two more words to your child’s utterances (ex. child: “Dog"; adult: "A big dog”).

Model correct language: Repeat back to your child their utterances that they have said incorrectly in the correct way (e.g. child: "Me want that one"; adult: "I want that one").

 

If you are concerned about what your child is understanding (receptive language), try these tips:

Eye-contact: Make eye contact with your child before giving them an instruction.

Minimal instructions: Refrain from giving too many instructions at once. This can overwhelm your child. 

Simplify your language:  Speak at a level your child can understand (usually just above their expressive language level).

Emphasize the target word: And repeat the concept in a variety of situations (ex. “Lights on,” “On the table”).

Reduce background noise: Turn off the TV, tablet, etc.  This helps reduce and minimize distractions.

           

If you are concerned about your child’s fluency (stuttering), try these tips:

Keep eye contact: Let your child know that they have enough time to finish speaking.

Don’t speak for your child: They know what they want to say, try not to fill in words or sentences.

What vs. how: Let your child know by your manner/actions that what they say, not how they say it, is important to you.

Model wait time: Take two seconds before you answer your child's question and insert more pauses to reduce speech pressure. This will help them realize they do not need to rush to get their thoughts/ideas out.

No remarks:  Comments like “slow down,” “think about what you want to say, then say it” don’t help. Stuttering is a complicated issue that is not remedied with these well-meant reminders. 

 

Next time: Why I love games...for more than motivation!

Red Flags...and when to contact a speech pathologist

Well I haven’t been the greatest about blogging! But that is about to change!  I have set a goal for a new blog every other week so here we go! 

As I mentioned in my previous blog post, I wanted to talk about red flags that warrant a call to a speech pathologist.  I have been a speech pathologist for almost a decade and I have heard many of the same comments from parents.  One of the most frequent being, “I didn’t even know that something wasn’t right. Now I feel I have wasted all of this time.”  First, I never want parents to feel like they have wasted time or all is lost.  The important thing is that they have reached out now!  Now, having said that, when should you reach out?  Below is a list of milestones that young children should be meeting.  If they are not, it is a good idea to call a speech pathologist (OWLS Therapy offers free phone consultations) to see if what you are seeing is a cause for concern and if a more in-depth screening or evaluation is necessary.  There are many factors that can impact a child’s language development such as exposure to multiple languages that need to be weighed in to the picture. 

 

What Children Should be Understanding:

Age 2-3                                                 

  • Contrasting concepts: (ex. stop-go, in-on, big-little, up-down)
  • Follows two requests (get the book and put it on the table
  • Identifies actions (run, jump)
  • Simple prepositions (in, on, under)

Age 3-4

  • Hears you when you call from another room
  • Answers simple who, what, where, and why questions
  • Identifies main colors (red, blue, yellow, green)
  • More contrasting concepts (rough-smooth, hard-soft)

Age 4-5

  • Pays attention to a short story and answers simple questions about it
  • More contrasting concepts (same-different, long-short, loud-quiet)

 

What Children Should be Saying:

Age 2-3

  • Has a word for almost everything (200-500 words)
  • Uses 2-3 words to talk about and ask for things
  • Speech is understood by familiar listeners most of the time
  • Often asks for or directs attention to objects by naming them
  • Uses pronouns (I, me, my/mine, you)

Age 3-4

  • Talks about activities at school or at a friends’ homes
  • People outside of family usually understand child’s speech
  • Uses a lot of sentences that have 4 or more words
  • Usually talks easily without repeating syllables or words
  • Uses possessives (his, her) and pronouns (he, she)

Age 4-5

  • Answers/asks “When” questions
  • Uses sentences that give lots of details (ex. I like to read my books on the bean bag chair)
  • Tells stories that stick to the topic
  • Communicates easily with other children and adults
  • Says most sounds correctly except a few (l, s, r, v, ch, sh, th)
  • Uses the same grammar as the rest of the family

 

While this is just a short list, these are things that I have found provide a good jumping off location to see if a child is on target with meeting developmental norms.  Again, if you are ever concerned please do not hesitate to just reach out.  If there is something going on, a treatment plan can be designed and if nothing is going on, then you can stop waking up at 3am worried! 

 

Next time, simple strategies to help elicit language! 

Welcome to OWLS Therapy!

Thank you for checking out the blog. It is the hope that here you can find information, fun activities, and useful tips to help aid in your child’s speech and language development! Today, I wanted to go over what exactly speech therapy is. Sometimes it feels that all we are known for are lisps and stuttering! While those children are definitely part of our caseloads, we are so much more!

A speech language pathologist can help with:

  • play skills

  • attention difficulties

  • cognitive skills 

  • literacy skills

  • voice difficulties 

  • difficulties with feeding and swallowing

  • receptive and expressive language delays

  • articulation errors

  • and of course, lisps and stuttering! 

A licensed speech language pathologist (commonly referred to as a speech therapist or a speech teacher) must hold a Master’s degree in communication disorder sciences and a current, valid state license. We are required to maintain our knowledge and stay up to date with current research with continuing education classes. All this training provides us with a wealth of knowledge that allows us the ability to assess your child with a multi-faceted approach. We have training in anatomy, child development, and neuroscience. We also collaborate with teachers, doctors, dentists, nurses, physical therapists, occupational therapists, and audiologists to evaluate the whole child. For more information please click here.  

Next time: Red flags and when you should contact a speech language pathologist!