Pumpkin Language!

Halloween, fall, and harvest time are ripe for language and speech learning opportunities for kids.  No, the title isn't referring to some secret gourd dialect that's only spoken in the pumpkin patch after everyone leaves for the night, though that would be super cool.  I'm talking about all the great ways to use this time of year (and fall's favorite squash) to enhance learning language and speech at home!

Here are some of my favorite speech and language things to do with pumpkins this time of year:

1. Pumpkin Carving Sensory and Language Exploration

Whether your pumpkins trend toward the scary, the silly, or the traditional, this is a great way to get kids digging into the season with some great sensory and language play. 

Sensory:

While carving the pumpkin, invite the little ones to help scoop out the guts.  Getting messy is an important part of childhood, and pumpkin innards provide a ton of great input.  You can squish them, pull them, stretch them...you name it, really.  For some extra fine motor fun, have a little contest to see who can get the most seeds out of the pumpkin.  They're great for roasting later, and who doesn't enjoy eating the fruits of their labor?

Language:

Choosing eyes, a nose shape, a mouth, and/or a picture to carve provides great opportunities for making choices and describing things.  Encourage your tykes to not only say "that one," but to tell you why they like it, or what shape it is.  It's okay to play dumb to get them a little more into telling you ABOUT what they choose.  Trust me, it works wonders.  And when you get to the actual carving, there's even more to talk about!

2. Pumpkin Patch Adventure

The pumpkin patch is a great place for language in the fall.  Whether it's in a parking lot, a farm stand, or out in the country, there are lots of things to see and do.  

Any pumpkin patch (or stand) worth its salt will have many different shapes and sizes to choose from.  It's a great opportunity to talk adjectives with your kiddos.  Do you want tall, short, fat, round, etc?  

Most pumpkin patches will also have a variety of types of pumpkins, gourds, and squash to purchase.  Investigate the size differences, the textures (the little bumpy ones are my favorite), and shapes (I also love the swan neck gourds).  See if you can find a Cinderella or Fairytale Pumpkin and talk about why it might be named that!

3.  Pumpkin Flavored Everything

Fall is the time when it seems like every major brand has a pumpkin SOMETHING.  A grocery store hunt for pumpkin foods is the perfect way to discover and celebrate all these seasonal delights!

When you bring your selections home, you can cook/serve them up and talk about what makes them great, not-so-great, or downright icky (I'm looking at you Pringles Pumpkin Pie Spice).  With kids (of all ages), it's so important to foster an atmosphere and attitude of adventure and comfort with trying new things, especially foods.  For the especially picky or problem eaters, this is much easier said than done. 

The most important thing to remember is to start where your child is, and then lead them a little further.  If they are absolutely against touching pumpkin guts (I was, and I still get a little ishy), let them choose the eyes or the nose. Offer then a pumpkin seed instead of the stringy innards.  

If you have a picky/problem eater, start with a food that's orange, or a favorite snack in a different shape.  Make it fun and non-threatening, and never force.  If it comes to a battle of wills, yo're going to lose.  Every time.  

Looking for some more ideas for fun fall snacks?  Head on over to the Bento of the Week blog  and check out their pumpkin-themed offerings.  

Enjoy the brisk weather!  I'll be back next week with some Halloween fun!

Articulation Development - Is my kid normal?

I get a lot of questions from parents, caregivers, and relatives asking if their child's speech is normal.  The simple truth is, there is a wide range of normal and every single child falls in a slightly different place on that spectrum.  There are some guidelines you can follow though.  Most children acquire certain sounds at around the same age.  Norms are calculated by these trends, and a sound is considered delayed when a child is passes the age where 85% of children have acquired a given sound without having the sound in their repertoire.  That sounds complicated, so I'll give you an example.

Bryce is 4 years old, and consistently substitutes the /d/ sound for the /g/ sound when he speaks ("dog" sounds like "dod" and "grandma" sounds like "drandma"). 90% of children acquire the /g/ sound consistently by 3 years old.  This means Bryce's errors would be considered a delay.

Here's a handy chart that gives the broad ranges of normal for articulation development, taken from the Goldman-Fristoe Test of Articulation 2nd Edition (a test I use frequently to evaluate articulation).

Articulation delays and disordered sounds can happen for any number of reasons (or what seems like no reason at all).  Some errors happen consistently as kids are learning to talk are classified as phonological processes.  They usually follow a pattern rather than being very phoneme-specific like Bryce's error above.  We'll talk more about phonological processes next week.

I hope this handy chart is helpful.  And, as always, I wish you and yours the very best in becoming better communicators every day!

Back to School for Special Needs Kids

So I looked at my calendar today and realized that tomorrow is August!  Here in Oklahoma, that means that school will be back in session for all of our students in a few short weeks!  In addition to the challenges every kid faces in getting back into the groove, special needs kids have a whole other set of challenges.  

New teachers, new classmates, new routines, and even new schools can be really tough for our kids. This post focuses on some things can do to make those first days back at school go smoothly.

Team up with school staff.  You know your child better than any me class time.  Reach out to your child's classroom teacher and make sure they know about your child's services and accommodations.  Give teachers and administrators some insight as to how to react in certain situations.  Make sure they know your child's strengths and challenge areas.  Also reach out to your child's special education providers (resource teachers, speech therapist, occupational therapist, physical therapist, etc).  As a former public school SLP, I can tell you that information from parents is a precious commodity, and helps a lot when it comes to getting our special kids off to a great start.

Get your child involved in back to school prep.  Take your child shopping with you for back to school supplies, let them choose their first day outfit.  Remember that you will not be in the classroom with your child all the time.  Let them take the reins on as many school preparation activities as possible.  For kids on the spectrum and kids who need routines, it might be wise to do a dry run or two before the actual first day.  That might include going through the morning routine and driving to school, or reading through a social story to get kids prepared.

Listen to your child's feelings.  If and when your child shows anxiety about going back to school, the worst thing you can do is brush it off.  Telling your special needs child, "Don't worry about it" may let those insecurities and anxieties grow into fears about going back to school.  This can cause problems.  My best advice is to slowly bring up the idea of going back to school a few weeks in advance.  Talk about any worries and anxieties as they come up, and help your child work through them.  

Ease Into Routines. Providing some structure to your child's summer days is a good thing.  The closer it gets to the first day of school, the more important having some of those routines in place becomes.  Start really enforcing that bed time, and helping your kids wake up around the same time every day.  Getting these things in place before the "big day" can help that first day of school go off without a hitch.  

Back to school is a big time of transition for kids of all ages, and especially for special needs kids.  With a little bit of prep work and some consistency, we can make it that much easier for our kids on the first day and beyond.  

Cooking with Language - Sandwich Skewers

Summer is in full swing here in Green Country.  With the sun beating down outside, we place a high priority on refreshing snacks and meal around here in the summer months.  Lots of my patients are kiddos who are really interested in food and cooking.  And who doesn't love something on a stick?

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My favorite summer lunch with kids is the Sandwich on a Stick.  It's a nifty deconstructed version of the standard brown bag lunch that makes it a lot more fun than just a boring old sandwich.

You can use pretty much any ingredients you want for these, which is one of the reasons I love them.  The key to making these a healthy snack or meal is to make sure you're:

• Using whole grain bread
• Using a lean protein - keep an eye on sodium content with deli meats
• Including fruits and veggies.

Some of my favorite ingredients for sandwich skewers are:

• Veggies:  snap pea pods (halved), cucumber, cherry or grape tomatoes, spinach leaves
• Fruit: red or green grapes, apple slices (I love Granny Smiths for this), kiwi, pineapple, strawberries
• Bread/Grain: whole wheat pita, lightly toasted whole grain bread
• Cheese: Marble Jack and Provolone are my go-to, but anything works. 
• Meat:  Rotisserie chicken slices, low-sodium turkey, low-sodium ham, turkey ham

Lay out all the ingredients beforehand, and make sure everything is cut to size before you let the kids go crazy with the skewers.  I cut my skewers in half and blunt the ends to minimize ouchies.  Then let them have it!

The kids will have a great time assembling their own lunches.  Talk about what's going where and why, what each ingredient feels and tastes like, and talk about sequencing as you assemble the skewers.  You can make patterns with your ingredients too!

Enjoy!

Vocal Nodes and Polyps: A Pain in the Neck

Disorders of the voice are among the most prevalent problems in the US that fall under the umbrella of speech-language pathology.  According to one study, the lifetime prevalence of voice disorders is nearly 30% (1).  Studies trying to pinpoint general voice problems among adults vary, but it is estimated that 5-10% of the workforce would be classified as heavy occupational voice users (2).  These occupations include careers such as teachers, flight attendants, salespeople, customer service, coaches, and many other jobs.  Approximately 28 million working Americans say they experience daily voice problems.  These problems can range from soreness to loss of voice, coughing, hoarseness, and impaired voice quality.  Some voice disorders, such as functional and spasmodic dysphonia along with voice disorders secondary to another pathology, are not directly related to vocal over- or misuse.  However, vocal overuse and misuse can lead to a host of problems in and of themselves.

Vocal polyps can take a number of forms, and are sometimes caused by vocal misuse.  They may look like a small reddish bump or swelling on one or both sides of the vocal folds, a stalk-like growth, or a blister-like lesion.  Most polyps are larger than nodules (which will be covered later), and they can be called by a number of names.  The best way to think about vocal polyps, is that they're like blisters on your vocal folds.

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Vocal nodules, on the other hand, are benign (meaning non-cancerous) growths on one or both sides of the vocal folds (also called vocal cords).  They are relatively hard and usually positioned on the area of the vocal folds that receives the most use.  They are equivalent to callouses on your vocal folds.  Over time, when repeated misuse of the vocal folds occurs, these callouses form (often starting as blister-like growths or polyps) and grow into the harder callous-like bumps as misuse continues.  So long as the vocal misuse continues, the nodules will continue to get larger and harder.  Since they took longer to form, vocal nodules are harder to manage and get rid of.

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While many people experience at least occasional vocal problems, there are risk factors that make you more susceptible to developing things like polyps or nodes.  

The signs and symptoms of vocal polyps and nodes are similar, and include:

• hoarseness
• breathiness (think Marilyn Monroe voice, only not on purpose)
• a "rough" or "scratchy" voice (Clint Eastwood)
• harsh voice
• shooting pain from one ear to another
• neck pain
• voice fatigue or loss of voice
• decreased pitch range
• a "lump in the throat" sensation

I don't want you to look at the above list and immediately run to an ENT.  Many of these symptoms can be caused by other things too.  However, if these symptoms persist outside for more than two weeks outside of a cold it's a good idea to get checked out.

While most of us still have to use our voices as a big part of our jobs (myself included), there are several things we can do to minimize the risk of developing voice problems.

1. Use amplification whenever possible if you're going to be talking in a noisy environment or to a large group of people.  Yelling is a very common form of vocal misuse.
2. Manage your allergies and minimize throat clearing.  That harsh noise you produce when you clear your throat with a cough is your vocal cords slamming together.  
3. Stop smoking, or switch to e-cigarettes.  While e-cigarettes won't cure your nicotine addiction, you aren't inhaling smoke and tar into your lungs (and past your vocal cords), which will help you reduce coughing and throat clearing.
4. Use an appropriate and natural voice.  One of the reasons I work with transgender women is that there is potential for lots of problems when trying to change your habitual pitch, and it's important for your vocal health and your presentation to adjust your pitch and voice safely.
5. Hydrate!  Drink water throughout your day.  Minimize alcohol and caffeine intake, and continue to drink water while you drink alcohol. 
6. Take a period of vocal rest, especially if your throat is feeling raw or scratchy.  If you nip voice issues in the bud, they will be able to resolve before turning into polyps or nodules.

So, if you use your voice a lot throughout the day, make sure you're caring for it.  If you regularly get the scratchy or raw voice feeling, it may be that you're engaging in some vocal misuse.  Getting checked out by an ENT and/or having a consult with a speech pathologist wouldn't go amiss.  

Good vocal health everybody!

References

1. Roy, N., Merrill, R.N., Gray, S.D., & Smith, E.M. (2005, November). Voice disorders in the general population: Prevalence, risk factors, and occupational impact. Laryngoscope, 115 (11): 1988-1995.

2. Roy, N., Weinrich, B., Gray, S.D., et al. (2003, June). Three treatments for teachers with voice disorders: A randomized clinical trial. Journal of Speech, Language, and Hearing Research, 46, 670-688.

3. Verdolini, K., & Ramig, L.O. (2001). Review: occupational risks for voice problems. Logopedics, Phoniatrics, Vocology, 26 (1): 37-46.

Good Conversation: How to Be A Good Conversational Partner to a Person Who Stutters

Stuttering is a speech disorder that affects over 300 million Americans today.  That's 1 or every 100 people in the US.  People who stutter encounter more problems than their own speech difficulties when they talk with other people.  It's easy to be thrown off-guard when speaking with speech and language problems, whether it's stuttering or something else.  Here are several important things to keep in mind when speaking with someone who stutters.

Firstly, a little information about stuttering.  Stuttering is a motor speech disorder where speech is disrupted at the beginning, middle, or even the end of words and sentences.  Some dysfluencies are repetitions of part or all of a word (li-li-light, or maybe-maybe-maybe for instance), some are stops or blocks, where the stutterer seems to get "stuck" on a single sound or movement.  Stuttering may also be accompanied by facial grimaces, rapid blinking, tics, or other movements.  There is no "cure" for stuttering.  Some people who stutter may overcome it to the point where it doesn't affect their everyday life, but there is no magic pill or therapy.

Secondly, a little mythbusting.  Stuttering does not mean someone is not smart.  It does not mean that they are nervous, ill-prepared, shy, timid, or damaged.  People who stutter are no more likely to have psychological problems than people who do not stutter (Stuttering Foundation).  Stuttering is not contagious.  Stuttering affects approximately 1% of the general population.  ~20% of children will go through a period of development where they have frequent stuttering behaviors that are severe enough to concern their parents.  5% of those kids will have dysfluent periods that lasts 6 months or more.  All but 1% of children will outgrow this period of dysfluency.

Quick Tips for Talking to People Who Stutter:
1.  First and foremost, treat the stutterer with the same dignity and respect you afford to all of your conversation partners.  RESPECT is key.
2.  Pay attention to the CONTENT of what the person is saying, not the way it is coming out.
3.  Resist the temptation to finish your conversation partner's sentences or fill in words.  People who stutter know what they want to say, they just need more time to get it out.
4.  Telling a stutterer to slow down, relax, or take a deep breath usually does NOT help and often demeans them.
5.  Keep natural eye contact with your conversational partner.  Natural does not mean staring at them or avoiding eye contact.  Be mindful of how long you typically hold eye contact while talking, and do that.
6.  Use a more relaxed and slightly slower speech rate yourself.  This does not mean an exaggerated slow rate, but relax and slow down a bit.  This may help relieve the "time pressure" of rapid conversations.
7. People who stutter often have more difficulty speaking on the phone.  If you answer the phone and hear a gasping or sputtering sound, you may be talking to a stutterer.  Be patient.
8.  Allow pauses.  We often feel a need to fill every pause in a conversation.  People who stutter may need a bit longer to respond.  Let them have that time.  Pauses are okay.
9. FOR KIDS:  Use shorter, simpler sentences when talking to kids.  Longer sentences are more difficult to listen to and to understand.
10.

I really tried to come up with a tenth, but then I decided to ask you instead.  Stutterers out there, what else do you wish people knew or did when talking to you?  People who know and love stutterers, any more tips?

Summer Speech And Language Fun - Outdoors Edition

Happy Summer everyone!  It is finally starting to feel like summer at my house now that the rains have let up a little and the sun is shining.  When the heat doesn't keep me indoors, outside is where I spend a lot of my time.  I have a yard to take care of for the first time in my life, and I've been spending a lot of time digging in the dirt, mowing, trimming, and pruning to keep it looking great.  If I manage to keep everything alive this summer, next year I'm putting in a garden.  I cannot wait!

Last time I posted I gave a lot of ideas for things to do indoors to give kids some sensory exploration, opportunities for language enrichment, and hours of entertainment when the weather outside is nasty or sweltering.

Today is all about my other favorite place to be during the summer.  The great outdoors offers lots of natural opportunities for sensory exploration and language enrichment, and with a little creativity and prep, there are TONS of sensory things you can do outside!

Here are some of my favorites:

1)Digging for Treasure
Materials Needed: sand or loose dirt; plastic tub or kiddie pool (something for the dirt to go in); plastic dinosaurs, coins, cars, etc for "discovering; toy shovels, brushes, pails, etc for digging tools
Keep an eye on kids who are still mouthing everything for this activity.
Fill your chosen vessel with dirt or sand and toss in several toys to be the "loot".  You can bury them at varying depths to keep it interesting for older kids.  Set your kids up with shovels (or better yet, bare hands) to dig around and find everything.  This activity is great for sensory input.  Kids can get their large muscles going while they dig (especially kids that need that deep or heavy pressure, let them DIG), some fine motor practice cleaning off their treasures, and global input sifting through dirt, squishing it between their toes, and generally getting dirty.

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2)Ice Painting

Materials Needed: Tempura paint or food coloring, water, ice cube trays (in fun shapes?), posterboard or smooth concrete surface, popsicle sticks (optional)

Mix together several colors of  tempura paint with water (a 50/50 mix is a good start, or use more paint for brighter colors) in small bowls and pour them into ice cube trays.  If desired, put halved popsicle sticks into each cube to give your paint a "handle."  Pop them in the freezer for a few hours until they're completely frozen.  When they're done, head outdoors with your posterboard and ice cube trays (I like to bring one at a time so I don't end up with paint soup quite so quickly).  Kids can get creative painting with their ice cubes either on posterboard or on concrete.  If you bring along a few little tubs of water you can have fun mixing colors as the cubes melt too!

One of the things I love about this activity is the temperature and texture of the ice cubes.  You get cold/hot contrast to talk about and experience, and you can have great fun with the slippery paint cubes.  If you use shaped cubes, you can also talk about the ways the shapes change as the ice melts.  

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3) Bubble Pool

Materials Needed:  Kiddie pool or large shallow tub (if the kids are small), popsicle stick or something to stir with, bubble bath, food coloring, water, bath/pool toys (optional)

Fill your tub with water and bubbles, then put a few drops of food coloring on each bubble "mound."  Use your stirrer to mix the color into the mounds.  Then let the exploration begin!  Once in the water, you can talk about the different colors you see, kids can get some sensory play blowing the bubbles, painting themselves with bubbles, and splashing around.  You can add bath or pool toys for even more fun (slippery toys make for great sensory play and fine motor skills) if you'd like, but I promise this activity is plenty of fun all on its own.  

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4)Mud Kitchen

Materials Needed:  Pots, pans, plastic tubs, mud, water, grass, leaves, sticks, twigs, rocks, etc.

Dig some dirt, mix it with water, and let your imagination do the rest.  I use rinsed out yogurt and butter containers for most of my "pots" for this activity, and I get mixing spoons at dollar tree.  Let your kiddos mix things you find around the yard into their mud "soup."  Make sure the "tasting" is pretend, but let your kids mix with spoons, sticks, hands, whatever.  

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5) Sound and Sensory Walk

Materials Needed:  Outdoor space!

This is the easiest activity to "set up" I have ever done.  If you don't have a good place to go for a walk near your house, parks are prime spots for sensory walks.  As you walk, listen for and talk about all the different things there are to hear.  Splash in the puddles, dig in the dirt, feel the grass on your feet, or the leaves as they blow in the wind.  This is a great low-key activity for a leisurely afternoon.  It's also a fantastic trick to keep your kid interested and keep the conversation going if you're walking TO somewhere (like the playground or pool).  

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6) Shaving cream sensory play

Materials needed:  shaving cream (at least one can), ice paint (optional), plastic tub or bin of choice.

Shaving cream makes for great sensory play and exploration for a lot of reasons.  It's foamy and light, it squishes REALLY well, and it changes texture as you play with it.  Scoop it, spread it, throw it, squish it, and have a blast!  Shaving cream makes for pretty good building material for plop monsters too!  If you want to put some of your ice paint cubes in it, it also makes a great color and painting exploration activity.    

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So there we have it.  Some of my favorite outdoor sensory and language activities.  As with any activity you do with kids, the most important thing is to have FUN!  An invitation to play is what you create with these activities.  If you have a sensory shy kid, they may only be comfortable with one touch the first time you introduce an activity.  Don't be discouraged!  Every kid can have fun in their own way with sensory play.  

What are your favorite outdoor sensory activities for the summer?