Speech Therapy
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.
Autism Awareness – Language Processing and Social Skills
Autism awareness requires an understanding of the importance of addressing language processing and social skills deficits.
As we enter Autism Awareness Month, we want to help parents understand the importance of a multi-disciplinary approach to working therapeutically with children on the spectrum.
Children on the spectrum are at risk for language and social challenges, often due to their individual processing challenges. Finding a team of professionals, (Occupational Therapist, Speech Therapist) who can identify the root of a child’s struggles is the first step to creating a plan on how to build a base for development in these areas.
By taking into consideration the “whole child”, Occupational Therapists and Speech Therapists, working collaboratively under one roof, are able to help parents prioritize next steps to maximizing their child’s development and potential. The skilled clinicians will evaluate a child, determining his/her interests, personality, goals, motivation and strengths, as well as areas that can be improved. Using this information, they can plan an engaging program of intervention to target and remediate the child’s difficulties, and strengthen language processing and social skills concepts such as collaborative play, cooperation and negotiation.
The compassionate therapists will work hard to form a solid, trusting and fun relationship with each child. They will pivot and evolve therapeutic strategies and implementations, to help a child generalize skills across the disciplines.
Social Pragmatic Language and Autism
Pragmatic language is the use of appropriate communication in social situations. Language deficits in children with autism will contribute to their difficulties with social interaction with peers, as they do not intuitively understand and use social communication concepts, and must be guided in the learning of these skills.
Because language is the vehicle that drives social interaction , difficulties with literal language comprehension and use will hinder success in turn taking, perspective taking, and reading social cues. Additionally, when a child cannot easily access language “on demand” during peer interactions, anxiety can form, and this can affect their self-confidence.
Bringing a child into a sensory gym allows the speech and occupational therapists to also observe and analyze a child’s behaviors as they engage in play, both solitary and peer-to-peer. The therapists use this environment to encourage use of language to facilitate successful play and engagement, resulting in a positive and confidence-building outcome for the child.
This interaction between language and social engagement, will also exercise and strengthen executive functioning, appropriate behavior, conversation and narrative language, reasoning, social problem solving (organization of thought), perspective taking, whole body listening, and humor.
During Autism Awareness Month, if your child is struggling on the spectrum, consider reaching out and learn more about learning opportunities facilitated by informed, knowledgeable and compassionate mentors, including teachers and therapists. Together, we can bridge the gap for your child and help him/her build the “scaffold” needed to move to higher learning and more successful social engagements.
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.
The Importance of Communication Skills for Academic Success
Well developed communication skills are vital to a child’s academic success
At all levels of education, students must be able to communicate effectively. Without well developed communication skills, children run the risk of falling behind their peers or becoming emotionally overwhelmed or withdrawn at school.
Academic success depends on solid communication skills, beginning with clear oral communication. Students are often called upon in class to answer questions. These questions may range from those with simple factual answers to questions that involve putting thoughts together and making arguments. Answers to questions need to be communicated effectively so teachers can assess a student’s knowledge. Students with oral challenges may also become embarrassed if they are unable to communicate on par with their peers. If a student stutters or mumbles they may become fearful of speaking up in class, and this in turn can lead to lowered grades and diminished self-esteem.
Oral Communication Skills
A second aspect of oral language communication is pragmatic and social language, used in daily interactions with others. This includes what is said, how it’s said and non-verbal communication, such as eye contact, facial expressions and body language. We navigate our world and our social relationships through language. Understanding how to communicate effectively with peers sets the stage for positive self-esteem. Students feel empowered when they can “talk the talk” in their social lives.
Effective use of oral communication also allows students to advocate for themselves. They must be able to articulate when and how their academic needs are not being met. A student who can effectively ask questions and get help from a teacher will often be more successful than students who remain silent even when they are unsure of what is being asked of them.
Written Communication Skills
In addition to oral communication, a child must also develop the ability to communicate effectively with the written word. As students progress through the school years, they are expected to present more of their work in written form. They need to know how to clearly write arguments, summaries, hypotheses, and be able to synthesize complex ideas and concepts. Thoughts and ideas need to be expressed clearly, with effective use of tone and language for the intended audience. Composing a compelling essay is dramatically different than writing a text to a friend.
Treating Communication Disorders
While it is easier, more effective, and less costly to treat speech and language disorders early, in the toddler years, it is never too late to get treatment. If a parent has concerns about their child’s ability to communicate, they should seek an evaluation by a speech and language pathologist.
With the support of a speech therapist and an educational therapist, students who struggle with the academic aspects of language can become stronger students and learn the communication skills they need to be successful in school and in life.
Related: Taking a Look at Speech Therapy
Firing Up Your Child’s Language and Speech Skills for the New School Year
Language and speech development issues can lead to reading and writing difficulties, impeding a child’s ability to enjoy learning and to experience successful academic outcomes.
Poor readers often have an early history of spoken language deficits. Not all communication challenges are rooted in a language and speech disorder, but it is important to make that determination, one way or the other, via a thorough assessment process. If a language and speech challenge is the issue, the summer is a good time to get your child the help he or she needs to be prepared to meet the expectations of the next grade level with confidence and the right tools for success.
Our Speech Therapists implement the most effective language and speech strategies available utilizing individualized play-based treatment plans. Therapies provide the child the language processing skills needed to be a friend, a learner, and productive group member.
More than 70% of teachers believe that students who receive language and speech therapy demonstrate improved pre-reading, reading, or reading comprehension skills.
The stress free environment of a summer enrichment speech therapy program provides a child with the support needed, combining learning with play. Without all the expectations of school looming, a child can relax, enjoy and retain skills learned during each session.
The development of communication skills begins in infancy. Any communication issue is likely to have a significant effect on the child’s behavior and academic skills. The earlier a child’s speech and language problems are identified and treated, the less likely it is that problems will persist or get worse.
This year use the summer break as an opportunity to advance your child’s communication skills.
To continue current speech therapy over the summer or to set up a speech and language assessment, please give our office a call. We look forward to hearing from you.
Speech and Language Therapy – Helping Children Communicate
How Can My Child Learn Social Skills?
Social brain building to become a “we thinker”, a successful group participant and a friend, is one of the hardest jobs of childhood.
Weather your child is 4, 10 or 15, being a competent social learner does not always happen intuitively. Learning social skills will require that your child is able to attend to a lot of data and decide what are the most important pieces of information, and use emotion, language and motor skills to respond in an appropriate manner within a relationship. A child can acquire those tools when he/she is given the opportunity to experience interactions with others that result in positive and negative outcomes, and is supported throughout the learning process. These learning opportunities can be facilitated by informed, knowledgeable and compassionate mentors, including parents, teachers and therapists. They can bridge the gap for the child and help him build the “scaffold” needed to move to higher learning.
It is often confusing when we see a child, of any age, struggling. We often think first about the psychology behind the child’s temperament and behavior – does it stem from environment, living situation, relationships? In reality, learning to be a social being and be socially competent is really based on a highly complicated neurological process – a process that is automatic for most and creates stress and struggle for some.
Social learning relies heavily on foundations in development that have been put in place to regulate how the brain perceives and processes incoming sensory information, and how it then organizes and delivers an output that is expected and connected, resulting in a positive social outcome. The Social Thinking® (Attributed to Michelle Garcia Winner as creator of the Social Thinking Methodology)Social Competency Model, shown here, uses an iceberg as an analogy. The visible part of an iceberg and what we see above the water, represents the things we can see people do, such as their social skills and behaviors. Yet the entire iceberg is much bigger than that, having a large foundation that goes far and wide into the depth of the sea, correlating to the knowledge, experience and development we hold – the collective information we draw upon and use to interpret and respond to social information that we experience.
As parents, we unknowingly assume our child inherently owns the skills to be a social thinker and adapt collaboratively in any environment. We think that our child’s social learning will just happen on its own.
The fact is that up to 20% of children will struggle with the jobs of childhood due to underlying processing challenges stemming from brain development. They may or may not have functional development and or learning challenges that lead to a diagnosis of speech and language disorder, sensory integration dysfunction, ADD, autism etc. These children are at risk for social challenges often due to their individual processing challenges. Finding a team of professionals, (Occupational Therapist, Speech Therapist, child psychologist) who can identify why your child struggles is the first step to creating a plan on how to build their base of social development.
Red flags that your child might be struggling to build friendships and to develop social skills:
- Prefers to play alone and does not play interactively with other children
- Difficultly understanding how to gain attention appropriately
- Difficulty initiating interactions
- Difficulty staying on topic during conversations
- Difficulty making relevant comments during conversations
- Difficulty following game rules
What types of therapy help a child develop social skills?
During a child’s time as a pre-schooler, an Occupational Therapist can determine if sensory and/or sensory motor processing challenges exist. The OT can also determine if a child is having difficulty with self-regulation, joint attention and intention for a shared play experience. A Speech Therapist can work with a child with language processing issues, and a “peer to peer” or “social brain building” group can be facilitated by both OT’s and ST’s to teach concepts such as collaborative play, cooperation and negotiation.
In elementary school, a Speech Therapist can determine a child’s level of receptive and expressive language, auditory processing abilities, and his use of social-pragmatic language. If language processing and sensory/sensory motor integration issues have been ruled out, small groups facilitated by a psychologist, are helpful in honing a child’s emotional and attention regulation skills.
At Child Success Center, once a therapist has made an assessment and determined the root of a child’s social struggles, then a recommendation is made for the “right fit” therapy.
Options include:
- Individual Occupational Therapy and/or Speech Therapy: One child working with one therapist as part of OT session or collaborative session with ST, with opportunity for peer to peer play experiences in our sensory motor gym to build foundational social skills.
- Paired Peer Speech and Language Sessions: 2 children who have been matched for optimal outcome success, working with a Speech and Language Pathologist.
- Friendship Club: Small group of 4-6 children matched for group skill building needs utilizing social thinking and supporting inside out social emotional development- Led by psychologist.
Ultimately, we want our children to be able to relate to other people’s feelings and to experience a sense of belonging in their classrooms, homes and community. With a solid foundation of social skills, any child can be the key to his own success.
Learn more about Social Learning Programs, peer-to-peer play, and Friendship Club at Child Success Center
This program, including its teacher or leader, is not affiliated with, nor has it been reviewed, approved, or endorsed by Michelle Garcia Winner and Think Social Publishing, Inc.
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
