Language
The Role of Play in Speech Therapy
The Symbiotic Relationship of Play and Speech Therapy
You may have wondered why your child’s speech therapist spends so much time playing with your child. We are often on the floor being silly, making animal sounds, talking into a banana, or pretending to make a fabulous spaghetti and meatball feast. It looks too fun to be therapeutic, right? But in reality, those are the moments where the magic happens. To understand why speech therapy involves so much playing, it helps to know why and how children play.
Why do kids play?
Play helps children to understand their world. A child can pretend to be an astronaut without ever leaving the ground, or they can pretend to be a doctor before they have started elementary school. Play helps children try new things, test out theories, and imagine new worlds. Communication is an essential piece of this process. A child who plays with another child or with an adult will use language to craft a shared, imaginary world. Delayed play skills may be a red flag that a child may also have delayed language skills.
Play skills develop in tandem with language skills.
Children typically say their first word at about one year of age. Before then, they ‘practice’ language when they watch others speak and when they babble. A one year old is likely to understand more than they say, and they may be able to respond to a simple request such as, “bring me your shoe.” That same one year old is starting to realize that objects they can’t see still exist. In other words, they may be able to retrieve those shoes even if they are out of sight, in another room.
By age two, a typically developing child will be expressing their wants and needs using spoken words. They may still do a lot of pointing and crying, but they can also combine two words for a variety of purposes, such as to greet someone (e.g., “Hi Mommy”), label objects (e.g., “big dog”), or to make requests (e.g., “want banana”). A two-year-old uses play to connect with another person and to practice using new words and phrases.
As children continue to grow, they express themselves using more complex words – learning to use words to describe concepts such as time, location, and size as well as to discuss abstract ideas and feelings. When language becomes more detailed and complex, play also becomes more sophisticated. Children progress from observing play, to playing by themselves, to playing next to other children (but separately), and ultimately to playing interactively with others. By the time a typically developing child is three years old, they are able to engage in imaginary play, and their play schemes may follow a sequence. For example, a child might pretend to choose ingredients, cook food, and then eat it. Or, they might pretend to be a doctor – inspecting and treating an injury.
How and why play is used during speech therapy.
Since play and language skills develop in tandem, we often play during speech therapy to encourage language. Rule-based “game play” is often built into speech activities and/or combined with other forms of play to entice children to join in. We use “symbolic play” (pretend play) to get a children talking, since pretending requires the use of language in order to build a shared understanding. We also utilize our sensory motor gym, where we have the option to collaborate with our occupational therapists to engage in “practice play” (play that involves a lot of movement), which has the added benefit of helping children to maintain a state of sensory regulation, or optimal band of arousal, so they are happy and having fun while engaging in speech learning activities. During all these different forms of therapeutic play, we can incorporate gestures, facial expressions, and signed language in order to help build language skills in children whose verbal skills are delayed.
So, the next time you see your giggling child on the floor sitting next to a speech therapist who has a banana phone in her hand, rest assured that play is the fun way to build communication and language skills.
Helping a Child Learn About Non-Verbal Communication
Like all things topsy turvy in this strange new world we’re learning to live in, learning to learn, itself, has been turned upside down.
As occupational therapists working with children, we talk a lot about and address challenges common for children with sensory processing disorder – or the difficulty in dealing with sensory overload. Now, with parents, teachers, caregivers and peers all wearing masks, suddenly the problem is a lack of enough sensory input, in this case, visual input, making it difficult for young children developing early social skills, to understand feelings and expectations being communicated to them.
Our whole body is responsible for non-verbal communication, with verbal communication only accounting for 10%-30% overall. For young children or children with neuro-developmental differences, interacting with others in masks can be challenging – but our smile or frown, or anything in between, only accounts for a small amount of our non-verbal communications.
Now is a good time to encourage and guide your child to become a “social detective”, looking for whole body language (non-verbal) cues that hold the clues to ideas, thoughts, feelings, attitude and state of mind being communicated, much of which is produced subconsciously. While eyes opened wide or brows furrowed are pretty obvious indicators of feelings, many children have difficulty with the intimacy of sustained eye contact. The “social detective” will need to pay closer attention to a person’s posture, movements, and arm placement (crossed or open, for example), for bigger and easier indicators to use when determining friendship and attention.
To support a child’s critical early social development during this time of masks and social distancing, parents might try role playing with their children, pointing out different body postures and positions, and discussing what information those positions might be relaying. Practicing guessing how family members are feeling at home with and without masks can help with feelings of anxiety when venturing out of the house. Using favorite TV shows or YouTube characters can be helpful as well! Pause the show, cover up the character’s face on the screen and see if the posture of the character matches the emotion they are feeling. A few non-verbal check-ins a day will help grow your child’s awareness and understanding of non-verbal communication, and how to connect to those communications and the people sending them.
Speech Therapists Use Telehealth to Support Families
During the Covid crisis, speech therapists are using telehealth to support kiddos and their families during extended at home time.
At this time, perhaps more than ever, we count our blessings, and we are indeed blessed to have at Child Success Center, an extraordinary team of therapists. This May, as usual, we honor our speech therapists during Better Hearing and Speech Month.
Two of our speech therapists, Jeni and Samar, recently spoke via Zoom with CSC Director, Melissa Idelson, about their use of telehealth therapy sessions during the “shelter-at-home” period associated with the Covid-19 crisis, and how they have benefited both therapist and client.
Jeni talks about why she became a speech therapist, and how she uses various methods of therapy, including Augmentative Alternative Communication (AAC) to help children communicate and build their social brain. She also shares the ways she’s currently using telehealth to support her clients during the Covid-19 crisis.
Samar shares her experiences using telehealth to conduct speech therapy sessions during “shelter-at-home” period. She has discovered a plethora of new online resources that she is utilizing in her sessions, and feels strongly that many of them will continue to be useful, even after in-person therapy resumes. She is looking forward to having teletherapy as a future alternative when children are unable to make an appointment in person, like during a vacation or when mild illness makes staying home preferable.
Meet the entire CSC Speech Therapy Team
What is a Pre-School Speech and Language Screening?
It’s that time again, summer is winding down and schools are back in session! For all you pre-school parents it’s a big time of change and transition. There’s so much to balance that it’s hard to keep track of everything! Lucky for parents SLPs (Speech/Language Pathologists) are here to make part of that process a little easier with preschool speech and language screenings.
What is a pre-school speech and language screening?
A pre-school speech and language screening is a way for an SLP to observe children (approximately ages 2.5-5) in the school environment to determine if they demonstrate appropriate understanding and use of language, production of speech sounds, attention, and social skills with peers. The SLP will then determine if the child passed the screening or if they will recommend a full speech and language evaluation.
What does it mean if my child does not pass?
Being recommended by a pre-school language screener is an open conversation to talk about your child’s needs. As a parent you should be aware, but not alarmed! Early intervention is a wonderful opportunity to address areas where your child is struggling and give them the extra help they need before academic and social demands increase as they get older. Research continues to show that identifying children with language disorders as early as possible is important because the earlier children receive speech and language intervention, the better their language outcomes will be.
>Speech and Language Screenings
>A look at Speech and Language Therapy
Each child develops at their own pace, so SLPs use typical age ranges of speech and language development as a guideline to recommend assessment.
>Typical ages of development for speech sounds
>Development Chart for Speech and Language Skills
6 hidden speech and language skills that SLPs look for and why:
- Speech intelligibility (in words and conversation) – Often it’s easier for close family members and familiar adults to understand kids, but if less familiar people have trouble understanding your child’s speech it could mean their speech is somewhat unintelligible. This can make it hard for children to be understood by peers and teachers, which can impact their communication at school. It can also be indicative of phonics or reading issues down the line if left untreated.
- Attention to tasks – Can the child sit and listen during story time? Are they able to focus and listen when the teacher is talking? This can appear like the child struggles to follow directions when they may just need help learning how to focus and maintain their attention at the same level as their peers. Without appropriate attention skills, children can miss important things going on around them at school.
- Early social skills (relating to peers, pretend play, functional play) – Are they able to initiate games and social interactions with their peers? Are they playing with toys functionally, such as stacking blocks or putting shapes in a shape sorter? Are they engaging in pretend play with their peers, like feeding their animal dolls or making their toys go on adventures? If not, they may need some help to gain these skills! If left untreated, this can lead to trouble relating to their peers and losing out on opportunities for social interactions.
- Emotional regulation – Is your child able to react and respond appropriately when things do not go according to plan? Are they self-directed and on their own agenda or can they follow along and participate in what the group is doing? If not, it could mean that they need some help learning how to regulate their emotions.
- Vocabulary development – SLPs take a look at the content and vocabulary your child is using in their speech. Preschool-age children are expected to understand and express a variety of concepts and word forms (e.g. verbs, adjectives, location words) at the same level as their peers. If your child is not using age-appropriate vocabulary or using only limited phrases or sentences, they might need help to expand their expressive skills.
- Clear communication – Is your child able to clearly communicate their thoughts and their wants and needs? Are you noticing breakdowns in communication? Your child might need help in this area in order to help them be clearer communicators and to prevent frustration that breakdowns in communication can often cause.
Taking a Look at Speech Therapy
Paying Special Recognition to Speech Therapists during Better Hearing and Speech Month
Communication is a fundamental skill that lays the foundation for how each of us will flourish and interact in society. Its importance cannot be understated, which is why every May we pay special recognition to Better Hearing and Speech Month, and the therapists that do the amazing work with our kids.
Our speech therapists shine a light on some common challenges that can affect a significant percentage of children during their key developmental years – and if left untreated, can have severe physical and psychological implications.
Speech challenges in children can exhibit overt symptoms such as delayed language development, but they also can lead to behavioral, self-esteem and de-motivational issues. Some speech challenges can be ‘grown out of,’ however, others left untreated can lead to more severe problems down the road. To better understand Speech Articulation and the therapy process, Child Success Center’s Licensed Speech Pathologists share keen insights about the potential challenges and successes – and general information – that parents want regarding ways to help their child’s specific needs in this area. Here are their responses to several essential questions surrounding these issues:
What are the greatest challenges you deal with as a therapist?
“As therapists, we are always challenged with coming up with new and creative ways to do therapy. Some children are very receptive to therapy and are very compliant. Other children demonstrate avoidance behaviors, may lack internal motivation or challenge the therapist behaviorally. It takes a special therapist to have patience, understanding, compassion and creativity to pull out the best in each child. This is the beauty of experience.”
What has been your greatest success story?
“I worked with a child years ago who was 2 years of age and had apraxia of speech – with only 10 words at the time. Most 2 year olds have 200-300 words. His father was a very involved parent, but needed a lot of guidance in understanding how to communicate with his son. He often drilled him with questions putting him on the spot, causing him to “shut down” when he talked to him. The father was very educated and successful in his career, however, I could sense that he did not feel success with being a parent due to this child’s communication deficit. After 6 months of treatment, both the child and the father, who also attended the weekly sessions, made huge gains. The father learned how to be a better communication partner with his son and the experience significantly changed the dynamics between them. With therapy a success, I formally assessed the little boy and his communication skills were above his peers. On the last day of therapy, his father cried and was so grateful. That was beyond rewarding for me!”
“Hearing a 3-year old child with a diagnosis of apraxia of speech say his nanny’s name for the first time without any help was one of the highlights for me. This child was known to simplify the words in his vocabulary to very similar and short words (mama, dada, nana, pa, ba, etc.). In (therapy), he was trying to share a story about his former nanny after Skyping with her the previous evening, and independently said his nanny’s full name. His mother began to tear up. It was that feel good moment that you want as a therapist with every client you treat.”
So parents can better understand the process, for the most common cases, what changes, other than in speech, do you observe in clients you work with?
“We can see more confidence and less frustration with most of the kids. Some children are teased by their peers because of their communication problems. I find that kids can become more confident in interacting with their peers too.”
“One of the most amazing and beautiful things that speech therapy does, is it helps children learn to be comfortable in uncomfortable situations. In therapy, you have to help kids learn new skills and sometimes they don’t want to do the work. It gives them the confidence to work through their discomfort and know that they will eventually be successful with practice.”
“Therapy is a confidence booster for parents too. Some parents are shocked by what we can get out of their kids. They can’t believe that their child is willing to do the work and be pushed at times. It gives a parent a sense of pride in their child.”
“As children progress through therapy they begin to show more confidence in their skills. We see children start to stand taller, walk taller, and use a louder, more appropriate voice when unfamiliar faces are near. However, these are also the children who teach us as therapists to “think on our toes,” or else they may use their new found skill to escape their work task.”
What are the most common questions parents will ask?
“Parents typically want to know how long the therapy process will take? This is always a difficult question to answer as the time varies from child to child. It may take 3 months, but it could take over a year. It depends on why the child is coming to therapy, what are the speech errors, how many errors, what type of errors, etc. There are a lot of factors to consider which makes that question one of the most difficult to answer.”
“They ask what therapy is like and how will they get their child to do the work. They also want to know what reason they should give their child for going to speech therapy. They ask if the problem will go away on its own – without therapy. They often ask if they have done something to create this problem (parents often blame themselves).”
What are the most common questions kids will ask, if any?
“Kids often want to understand why they are coming to speech therapy (especially the older ones). As they continue to come and they are in the final stages of therapy, they want to know when they will be graduating and what we do for graduation parties. They often ask about the kind of toys and games we play?”
Child Success Center is unique from other therapy facilities because it features a fully equipped and kid friendly gymnasium that the kids love to explore. How do you use the gym to help clients and why is it effective?
“The gym is a great tool to motivate kids. We sometimes use the gym as a reward in the middle or end of our sessions. It’s also great for children who are not regulated and need movement to help them feel more regulated in their bodies. Children that have high arousal levels and children who are under aroused benefit from speech work in the gym to help them stay internally organized and regulated. This helps them to attend more to the speech work and also helps motivate them. Physical movement helps jump start the communication centers in the brain.
“We see many children ranging in age from 2 years old to 12 years old. These children always enjoy knowing that they have gym time after working hard in speech. For other children, the gym is used to help the child during the speech session. These children typically benefit from the repetition of drilling for specific sounds, requesting by using language, and by utilizing the gym equipment. For these children, sitting in a chair at a desk is not the ideal situation because their body may need vestibular and proprioceptive input. When working with these children, the occupational therapists are amazing at providing tips to help improve a speech session. These tips may include providing the child with heavy work (e.g. climbing, moving pillows around) to help regulate a child or swinging in a specific manner (e.g. linear movement, spinning, etc.) and even jumping.”
More information on Better Hearing and Speech Month
More information on Speech Therapy at Child Success Center
My Life as a Speech Language Pathologist
by Gina Costello, Director, Speech Dept., Child Success Center
The joy, intrigue and satisfaction of working with children as a speech-language pathologist.
Working as a Speech Language Pathologist, it’s hard to believe that I saw my first client 18 years ago. I remember the feeling I had leading up to that first session. It was a mixture of excitement, anticipation and a bit of anxiety knowing that I could help an individual communicate in their world and could have a positive impact on their life. It felt extraordinary!
After all of these years working as a speech language pathologist, I continue to feel the same level of joy and intrigue that I did when I was a new therapist. The difference is, now I have the experience,
patience and understanding to help my clients overcome their communication challenges. In essence, I have more “tools” in my toolbox!
There are many reasons why I love what I do! I’m always excited to try the latest therapy techniques and share new educational tools and tips with parents. I find great satisfaction giving parents
strategies and tips to try at home. As a result, families feel more empowered and so does the child.
Recently, a parent expressed how her relationship with her daughter has significantly improved since they started coming to therapy. She thanked me for being a partner in this process. It felt very gratifying to know that we worked as a team to improve her child’s life.
As a speech language pathologist, I’m constantly being challenged to come up with new and creative therapy activities. I love the freedom that I have in creating a session that suits the specific needs of a child. There’s no better experience than greeting a child in the waiting room and watching them race down the hall to my
therapy room with eager anticipation for the session.
One of my favorite parts of my job is the collaboration with other therapists and professionals in the community. The saying, “It takes a village to raise a child,” couldn’t be more appropriate when it comes to supporting a child who has a communication deficit.
Over the years the expertise, knowledge, advice and encouragement that I’ve received from other professionals has been invaluable. The best part of my job is watching a child grow into a confident and effective communicator. I have watched children go from being nonverbal to talking in sentences. I have seen children who were once very shy and timid become more confident and enthusiastic when communicating with their peers. Every day I work with families is a gift and a reminder of the positive impact I can have on their lives. I am continuously reminded of how fortunate and honored I am to have this opportunity!
More with Gina Costello and recognition of May – Better Hearing and Speech Month
Additional Resources for Parents:
Back-to-School – Working with Teachers to Identify Speech and Language Problems
Kids are Going Back to School – Working with your child’s teacher to identify speech and language problems early on is critical to ensuring his/her success at school.
As children return to the school classroom and play yard this year much will be expected of them in the areas of oral communication and listening skills. While the summer time offered great opportunity for children to build the sensory motor skills needed for playing and learning, they also had a break from the often complicated auditory and language world that school presents them.
If you have had concerns about the rate of your child’s speech acquisitions, their attention, socialization, ability to follow direction, answer questions, verbally problem solve, express themselves and emotionally handle communicating with their environment and those in it, we suggest you talk to your teachers at the beginning of the school year to make them aware of your concerns and to discuss ways to help your child be successful. As parents we know more about our children’s strengths and challenges than anyone else. Give your teacher a head start by meeting with them either before school starts or within the first 4 weeks. Often when children struggle with sensory motor and or speech and language processing their behaviors can be misinterpreted as personality traits; Controlling, sensitive, shy, aggressive, avoidant, rigid. Truth be told, these behaviors, if not properly identified, can hamper a child’s academic success as early as pre-school. We are setting students up for success if we identify and support as early as possible.
Knowing who to turn to for information is key. Seek guidance from your school, pediatrician, friends and online. You will find answers. Sometimes it is very clear what your child’s speech and language needs are… “my child cannot say the “s “sound.” Other times it is not so clear… “My 3 year old is hitting at school, not using words to communicate easily and is always on the go.” The combination of Sensory Integration trained Occupational Therapists and Speech and Language Therapists working together is often critical when searching for the underlying root of the challenges your child is presenting with. A collaborative therapy center offers you, the parent, with guidance and a whole child approach as your child grows.
Not all communication challenges are rooted in a speech and language disorder. But it is imperative that this be ruled in or out through a thorough assessment process. If you child is under the age of 5 it should be a play based assessment and your child should be made to feel as relaxed and comfortable as possible in a new environment. Make sure that the environment has play space and is not a small office. If your child is older make sure the therapist is skilled in identifying language based learning challenges and works closely with an educational therapist as these services often work side by side.
For more information on speech and language development and age related indicators that your child may need help please refer to this chart .
Speech and Language issues by the numbers:
Speech or language problems can lead to reading and writing difficulties which in turn lead to serious educational consequences.
- Some 17-20% of children in the United States have difficulties learning to read.
- More than 70% of teachers believe that students who receive speech and language services demonstrate improved pre-reading, reading, or reading comprehension skills.
- Most poor readers have an early history of spoken language deficits.
- A recent study reported that 2nd graders who read poorly had phonemic awareness or spoken language problems in kindergarten.
- About 41% of fourth grade boys and 35% of fourth grade girls read below grade level.
- Overall, communication disorders affect approximately 42 million Americans. Of these, 28 million have a hearing loss and 14 million have a speech or language disorder.
***Statistics provided by ASHA (American Speech-Language-Hearing Association http://www.asha.org/)
May is National Speech Month
Child Success Center sheds some light on speech and articulation issues in children.
Communication is a fundamental skill that lays the foundation for how each of us will flourish and interact in society. Its importance cannot be understated, which is why we pay special recognition to National Speech Month. We are happy to present a special interview with noted speech pathologists Gina Costello, M.S., C.C.C., and Micaela Sulham, M.S., C.C.C.-SLP, who will help to shine a light on some common challenges that can affect a significant percentage of children during their key developmental years – and if left untreated, they can have severe physical and psychological implications. Speech challenges in children can exhibit overt symptoms such as delayed language development, but they also can lead to behavioral, self-esteem and de-motivational issues.
Some speech challenges can be “grown out of”, however others, left untreated, can lead to more severe problems down the road. To better understand Speech Articulation and the therapy process, Child Success Center’s licensed speech pathologists Gina Costello, M.S., C.C.C. and Micaela Sulham, M.S., CCC-SLP , share keen insight about the challenges, successes and the general information that parents want regarding the help their child needs. Here are their responses to several essential questions surrounding these issues.
What are the greatest challenges you deal with as a therapist?
Micaela – My most challenging client is the client who understands how difficult it is for him/her to talk. Those clients tend to use “compensatory behaviors” to avoid speaking which become secondary behaviors. Some of the strategies include tantrums, avoidance, distractions, etc. The secondary behaviors tend to mask the real problem. As a therapist, we have to work on the problem while dealing with the secondary behaviors. This task is very difficult especially with children who have been using the compensatory behaviors for quite some time.
Gina – In all honesty, there are two clients-the parent and the child. I find parents that are in denial of their child’s problem to be the most challenging. The parent can become very defensive in this situation. I have complete understanding and compassion about how difficult it must be to accept that their child needs help. However, I have actually seen parents not get help for their child due to their own fears or ego. This really makes me sad for the child.
As a therapist, you are always challenged with coming up with new and creative ways to do therapy. Some children are very receptive to therapy and are very compliant. Other children demonstrate avoidance behaviors, may lack internal motivation or challenge the therapist behaviorally. It takes a special therapist to have patience, understanding, compassion and creativity to pull out the best in each child. This is the beauty of experience.
What has been your greatest success story?
Gina – I worked with a child years ago who was 2 years of age and had apraxia of speech – with only 10 words at the time. Most 2 year olds have 200-300 words. His father was a very involved parent, but needed a lot of guidance in understanding how to communicate with his son. He often drilled him with questions putting him on the spot, causing him to “shut down” when he talked to him. The father was very educated and successful in his career, however, I could sense that he did not feel success with being a parent due to this child’s communication deficit. After 6 months of treatment, both the child and the father, who also attended the weekly sessions made huge gains. The father learned how to be a better communication partner with his son and the experience significantly changed the dynamics between them. With therapy a success, I formally assessed the little boy and his communication skills were above his peers. On the last day of the therapy his father cried and was so grateful. That was beyond rewarding for me!!
Micaela – Hearing a 3 year old child with a diagnosis of apraxia of speech say his nanny’s name for the first time without any help. This child was known to simplify the words in his vocabulary to very similar and short words (mama, dada, nana, pa, ba, etc.). In (therapy), he was trying to share a story about his former nanny after Skyping with her the previous evening, and independently said his nanny’s full name. His mother began to tear up. It was that feel good moment that you want as a therapist with every client you treat.
So parents can better understand the process, for the most common cases, what changes, aside from what you are treating, do you observe in clients you help?
Gina – I definitely see more confidence and less frustration with most of my kids. Some children are teased by their peers because of their communication problems. I find that kids can become more confident in interacting with their peers too.
One of the most amazing and beautiful things that speech therapy does, is it helps children learn to be comfortable in uncomfortable situations. In therapy, you have to help kids learn new skills and sometimes they don’t want to do the work. It gives them the confidence to work through their discomfort and know that they will eventually be successful with practice.
I also think that it is a confidence booster for parents too. Some of my parents are shocked by what I can get out of their kids. They can’t believe that their child is willing to do the work and be pushed at times. I think it gives a parent a sense of pride in their child.
Micaela – As children progress through therapy, they show more confidence in their skills. I have seen children start to stand taller, walk taller, and use a louder, more appropriate voice when unfamiliar faces are near. However, these are also the children who teach us as therapists to “think on our toes”, or else they may use their new found skill to escape their work task.
What are the most common questions parents will ask?
Gina – Parents typically want to know how long the therapy process will take? They also want to know what reason they should tell their child for going to speech therapy? They ask what therapy is like and how will I get their child to do the work? They always ask if the problem will go away on its own – without therapy? They often ask if they have done something to create this problem (parents often blame themselves).
Micaela – How long will this process take my child? Many parents are balancing a busy life with work and family. They always ask how long the process will take. This always is a difficult question to answer as the time varies from child to child. It may take 3 months, but it may take over a year. It depends on why the child is coming to therapy, what are the speech errors, how many errors, what type of errors, etc. There are a lot of factors to consider which makes that question one of the most difficult questions to answer.
What are the most common questions kids will ask, if any?
Gina – Kids often want to understand why they are coming to speech therapy (especially the older ones). As they continue to come and they are in the final stages of therapy, they want to know when they will be graduating and what we do for graduation parties. They often ask about the kind of toys and games we play?
Micaela – Kids ask some silly questions, the saying “Kids say the darnedest things” truly applies in my line of work. However, some of our older kids who have been in therapy for a while or have seen other children finish and leave therapy may start to ask when will they “graduate”?
Child Success Center is unique from other therapy facilities because it features a fully equipped and kid friendly gymnasium that the kids love to explore. How do you use the gym to help clients and why is it effective?
Gina – The gym is a great tool to motivate kids. We sometimes use the gym as a reward in the middle or end of our sessions. It’s also great for children who are not regulated and need movement to help them feel more regulated in their bodies. Children that have high arousal levels and children that are under aroused benefit from speech work in the gym to help them stay internally organized and regulated. This helps them to attend more to the speech work and also helps motivate them. Physical movement helps jump start the communication centers in the brain.
Micaela – The gym is often used as a special reward for students. We see many children ranging in age from 2 years old to 12 years old. These children always enjoy knowing that they have gym time after working hard in speech. For other children, the gym is used to help the child during the speech session. These children typically benefit from the repetition of drilling for specific sounds, requesting by using language, etc., by utilizing the gym equipment. For these children, sitting in a chair at a desk is not the ideal situation because their body may need vestibular and proprioceptive input. When working with these children, the occupational therapists are amazing at providing tips to help improve a speech session. These tips may include providing the child with heavy work (e.g. climbing, moving pillows around) to help regulate a child or swinging in a specific manner (e.g. linear movement, spinning, etc.) and even jumping.
Child Success Center is offering an impactful and fun program to help your children improve speech and articulation skills through a special series of summer articulation classes. The process starts with a brief assessment of your child’s speech needs, age and schedule availability so that a summer program can be created to support you and your child. Click here for more info or call our office to set up an appointment.
Additional reading: Incidence and Prevalence of Communication Disorders and Hearing Loss in Children
Are Spoken Language and Literacy Connected?
YES! Spoken language is the foundation for the development of literacy skills. The experiences with talking and listening gained during the toddler and preschool years prepare children to learn to read and write. This means that children who enter school with weaker verbal abilities are much more likely to have trouble learning to read and write. Phonological awareness, the recognition that words are made up of separate speech sounds, is one skill that is very strongly connected to reading and writing. Phonological awareness skills include, but are not limited to, rhyming, blending sounds (e.g., combining the separate sounds b, a, and t into bat), alliteration (e.g., big bouncy bubbles), and isolating sounds (e.g., c is the first sound in cat). Children who perform well on these tasks are less likely to have difficulty learning to read.
Language Development
Hearing your child speak their first word is exciting. Each parent anticipates their child calling their name first and then using new and different words; however, as a child builds his/her vocabulary and begins to put words together to produce phrases and sentences, what comes next? How does a parent know what typical language development looks like until we begin to compare to children? What child is the best “typical” language model? Let’s review narrative development to understand the stages of language development
According to Hedberg & Westby (1993), there are several types of narratives.
• Scripts: This form of narrative is used to express knowledge of a familiar, recurring event. It is usually told using the second person pronoun you and the
present tense.
• Recounts: This involves telling about a personal experience when prompted most often using the past tense.
• Accounts: We explain a personal experience without a prompt. The experience is usually not shared by the listener.
• Event Casts: Explaining an ongoing activity, reporting on a factual scene, or telling about a future plan.
• Fictional Stories: Relating past, present, or future events that are not real. The events being described focus on someone or something attempting to carry
out a goal.
According to Hedburg & Stoel-Gammon (1986), the stages of narrative development are broken into three different stages; however, stage III has a few sub-stages. Review the following stages:
Stage I: 2 years old Heaps
After a child builds his/her vocabulary using a variety of words, including nouns, action words (i.e. verbs), location words (i.e. prepositions), descriptive words (i.e. adjectives, adverbs), early pronouns, and social function words, a child will begin to form phrases and eventually sentences. These “stories” consist primarily of labels and descriptions of events and/or actions. There is no central theme or organization among the propositions. Sentences are usually simple declaratives. This stage consists of a collection of unrelated ideas. The topic of discussion frequently changes and the cohesive devices are not utilized to connect the story. Simple present progressive tense is used. This is considered a heap story.
Example: “A girl is eating cookies. The man is going to the car. The baby is sleeping.”
Stage II: 2-3 years old Sequences
As language continues to develop, a child will enter into the stage of sequenced stories. Sequenced stories consist of labeling events around a central theme, character, or setting. There is a description of what a character has done, but there is nothing in the story that is considered a plot and the events do not typically follow temporally or casually from one another. A child may begin to link story elements together.
Example: “She lives with her dad. She lives with her mother. Grandma and Grandpa live together. And these three children live with their grandma. And these two animals live with them.”
Stage III: 3-4 years old Primitive Narratives
After a child has developed his/her sequenced stories, a child begins to develop primitive narratives. These stories have a core/central person, object, and/or event. They contain 3 of the story grammar elements: an initiating event, an attempt or action, and some consequence around the central theme. These stories do not have a solid resolution or ending and contain little to no evidence of the characters’ motivation. These narratives build on the sequenced stories. It contains a central character, topic, or setting; however, the child begins to discuss the character’s facial expressions or body postures.
Example: “My dad, he went up to go to work. My mom stayed and sleep in. My two brothers, they went to go play with the toys. My dog, she went outside. My kitty cat came up and he tickled me and came up and started to meow. And then I started to cry because he bit me. And my brothers came runnin’ in and Mike said, “What happened?” They said, “What happened?” “My kitty cat just bit me.” So mom comes runnin’ in and she said, “What happened? Oh the kitty cat bit you. O.K.”
Unfocused Chains: 4-4 ½ years old
A chain narrative is a story that shows some evidence of cause/effect and temporal relationships; however, the plot is not strong and does not build on the attributes or motivations of characters. Although, there may be some notion of plan or character motivation present. The ending does not necessarily follow logically from the events. The story may be very abrupt. These stories contain 4 story grammar elements, which include those found in the primitive narrative level: initiating the event, attempt or action, and some consequence around the central theme. An unfocused chain does not utilize a central character. It is a sequence of events linked together logically or with a cause-effect relationship. Conjuctions, such as “and”, “but”, and “because” may be used when telling an unfocused chain story.
Example: “This man is walking. He saw a dog and a cat and he saw a girl too, with the cat and the dog. He said, “Hello.” He walked back and he said, “Brother, come here.” So her grandmother walked up to her and said, “You wanna go dancing?” They went dancing. And so it was a slow dance. And then they went back. And then these two children came. And then first he said, “I’m not.” And then he said, “What?” “I want to go out to eat.” So they went out to eat.”
Focused Chains: 5 years old
A focused chain contains a central character and a logical sequence of events; however, the listener must interpret the ending to this story. The sequences described during these accounts take the form of “adventures”.
Example: “Once upon a time there was a mother named Christie. And she had a husband named Tom. And they had some children named Heather and Christie. And they had a boy named Ronnie. And the mother told the boy to go outside to play. And then the boy came in and said, “Mother, mother, our dog’s outside and he’s barking.” “I will go see.’ “What are you barking at?” “I don’t know what he was barking at, Tommy, Ronnie, Ronnie. I don’t know what he was barking at. You go out there and see.” “He wants in.” “I’ll go let him in.” “There, I let him in.”
True Narratives: 5 + years old
By the age of 5, a child may be emergent in the true narrative story telling. These stories have a central theme, character, and plot. It includes the motivations behind the character’s actions, as well as logical and temporally ordered sequences of events. The ending of the story indicates a resolution to the problem. These stories include at least 5 story grammar elements, including an initiating event, an attempt or action, and a consequence.
Example: “One day there was a boy named Bobby and a girl named Sharon. They found a cat in their front yard and they brought it into the house. They fed the cat and they gave it some milk. They played and played with it and then a little while after a lady called and asked if anybody had seen her cat. And then they said that they had it at their house. And they brought it to the lady’s house. And she gave them each five dollars for finding the cat and having them feed it and give it milk.”
Story Grammars
Story Setting + Episode structure
Episode Initiating event+ internal response + plan + attempt +consequence + reaction
Setting Introduces the main characters, the protagonist, and the context of time and place
Initiating event The occurrence that influences the main character to action. It may be a natural event, an action, or an internal event such as a thought, perception, or wish
Internal response Indicates the thoughts and feelings of the main character in response to the initiating event. It may include an interpretation of the event, formulation of a goal or some other response.
Plan Indicates the intended action of the main character
Attempt Indicates the actions of the main character in pursuit of the goal
Consequence Indicates the achievement or non-achievement of the main character’s goal, as well as any other events or states that might result from the attempt
Reaction Includes any emotional or evaluative responses of the main character to the preceding chain of events
As a parent you may be thinking, “Wow, this is awesome, but how do I apply this knowledge to my child in our daily life!?!” Below is a chart that a parent and/or caregiver can do to further develop these skills in the home environment:
Activity What I can do to help:
Read a book:
• When reading a book, discuss the details on a specific page (e.g. what happened, who was involved, and where it happened)
• After the story, discuss these questions again and review the events in the book when reviewing the pictures- Do NOT expect your child to have the entire story memorized
Review a photo album:
• Review family members or past events telling the story of day your family spent camping or touring Disneyland, etc.
• This is helpful when relatives will be visiting from another city/state as their visits may be more infrequent
Retell events to the child’s day:
• Review the main points: Use words like “First, Next, Last” and remember to keep it simple. Children do not need an elaborate explanation. They need the facts.
• Work on sequencing getting dressed, or morning routines
• Daily routines are always exciting to practice sequencing
Retell events during a specific activity:
• If you are working on a craft, review how you created the craft (e.g. First, we cut the shapes out, then we glued the shapes together, and last, we cleaned our mess).
• Bake cookies and discuss the steps to make the cookies (Please, don’t go into the details of the ingredients—this will also help build a child’s vocabulary to discuss the meaning of new words (e.g. ingredients, recipe, etc.).
Story telling
• Before bed, make it a routine to tell stories using the theme, the characters, and the plot (e.g. teaching through a model).
If a child seems to have difficulty with developmentally appropriate tasks, caregivers may want to contact the primary educators and/or a speech-language pathologist for additional tips and help.
Remember, these ideas may work on building a child’s vocabulary, answering simple questions (e.g. yes/no, what, who, where), and sequencing events in the story through story telling/retell. Here are a few specific examples that may be helpful depending on the age of your child:
• Sequence the steps to the following activities
o Bake your favorite cookies
o Make rice krispie treats
o Make some homemade play doh:
http://www.instructables.com/id/How-to-Make-Playdough-Play-doh/
http://www.ehow.com/how_2001321_make-playdoh.html
http://babyparenting.about.com/cs/activities/a/playdough.htm
o Create a trail mix to sequence steps: As there are many allergies out there, it may be best to create your own that is appropriate for your child and his/her needs
o If you plan on going on a trip, sequence the steps to packing your suitcase
o Play a game and sequence the steps for setting up, playing, and cleaning up (simplify when needed)
o Laura Numeroff books: If you Give your Mouse a Cookie; If you Give a Mouse a Muffin, If you Give a Pig a Pancake; If you Give a Dog a Doughnut; etc.
Sequence the parts of the story using a few visuals:
• http://tcdn.teacherspayteachers.com/thumbitem/If-You-Give-a-Mouse-a-Cookie-Sequencing-Activities/original-268377-1.jpg
• http://img0.etsystatic.com/000/0/5565820/il_fullxfull.282713824.jpg
• http://media-cache-ec4.pinterest.com/upload/74168725082772822_8TXIdfKB_b.jpg
o Pintrest would be another great craft idea option
• Thanksgiving Crafts
o Discuss Pilgrims: http://www.dltk-holidays.com/thanksgiving/crafts-pilgrims.htm
o Gather Fall Leaves and a pinecone; Discuss the Fall season and the leaves falling/changing colors (Even if this does not typically happen in California, it is fun to discuss and may lead to researching the Fall Foliage around the country): http://www.dltk-holidays.com/thanksgiving/mleafturkey.htm
o Turkey Crafts: http://www.dltk-holidays.com/thanksgiving/turkey_crafts.html
• Holiday crafts
o http://www.dltk-kids.com/
• DLTK is a helpful site and a great start to finding crafts, but the internet has endless ideas and it is always helpful to explore the internet and expand your own resources.
Information and specific examples gathered from:
Hutson-Nechkash, Peg (2001). Narrative Toolbox: Bleprints for Storbuilding. Eau Claire, WI: Thinking Publications.
