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?

source

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!

Speech Delays and Summer - Maintenance vs Progress

Summer is upon us yet again, and I don't know about you, but the year for me has FLOWN by.  You want your kids to relax and have fun over the summer, you think about next school year and how your kids could continue to move ahead over the summer.

It's unfortunate that, in the public schools, summer goals for kids with special needs don't extend beyond reasonable maintenance of skills gathered over the previous year.  The vast majority of special needs children being served in schools cannot get therapy through the school over the summer.  It is difficult to find summer therapists through the schools, and even harder to prove the kind of regression it takes to get a student qualified for summer services.  I used to give the speech myself as a school-based SLP.

If you ask me, there's something amiss there.  Kids with speech delay take a three-month break over the summer, come back to school with the same delays they had the year before (minus typical regression), and the cycle starts all over again.  It's one of the reasons that kids who only get school services have a tendency to stay in speech for so long.  Add in a new teacher who may not know your child's history very well, possibly a new speech teacher (school therapists get moved around a lot), and it gets even more complicated.

Many different studies have shown that students with communication disorders are perceived as less successful in the classroom (Bennett & Runyan, 1982; Cummins, 1986).  There has also been a demonstrated mismatch between teachers' expectations of children with communication disorders, and what those children are actually capable of.  Research has even shown that a connection between teachers' expectations and student classroom performance, which can lead to self-fulfilling prophecies (Braun, 1976; Brophy & Good, 1970; Good, (1970).  

Language disorders affect how well a child is able to express themselves and understand expectations in the general classroom, but that does NOT mean that they are not capable of performing in the classroom.  

So what do you do?  While summer needs to be a bit of a break from all the pressures of school, summer should not be a time to push aside your child's needs and education.

Private speech therapy over the summer can be a great option for kids.  1-3 visits per week with a therapist can help to take the summer from reasonable maintenance to reasonable progress.  Alternatively, you can have a speech pathologist take a look at your child and their goals and develop a home program for the summer.  This option takes more personal commitment on the part of the parents, since the entire burden of summer practice rests with you and the people caring for your child over the summer.  At the very least, you should spend a lot of time over the summer talking to and with your child - about everything you do!

When it comes to language, children are often able to learn through experience rather than things like drills.  Summer is a fantastic time to have new experiences.  Visit a museum, an aquarium, the zoo, the pool!  You can have new experiences even at your own home.  Bubbles in the backyard, playing in the sprinkler, even walking around the neighborhood or riding a bike is perfect for language enrichment.

Articulation delays and disorders often require a lot of drill and practice to make improvements.  This kind of practice isn't the most fun activity in the world, but there are ways to make it enjoyable for your kids.  Practicing articulation skills can keep a little routine in your summer, and keep your child in the habit of doing homework, without all the pressure of school.  Again, this is where a program or some intervention from a speech pathologist can be invaluable.

The goal for summer shouldn't be maintaining (or not losing many) skills.  The goal of summer should be starting your child's next year ahead of where they ended the last year.  Special needs do not just go away over the summer.  Our children, especially our special needs kids, still need help and guidance when school is not in session. Some creativity, and a little help from an SLP, can make your child's summer fun AND beneficial for them all at the same time.

REFERENCES:
Bennett, C.W. & Runyan, C.M. (1982). Educators’ perceptions of the effects of communication disorders upon educational performance. Language, Speech and Hearing Services in Schools, 13, 260-263

BROPHY, J. E., & GOOD, T. L (1970). Teacher’s communication of differential expectations for children’s classroom performance: Some behavioral data Journal of Educational Psychology, 61, 365-374.

BRAUN, C (1976) Teacher expectation: Soclopsychological dynamics Review of Educational Research, 46, 158-213.

GOOD, T. L. (1970). Which students do teachers call on2 Elementary School Journal. 70, 190-198.

MARRS, Isa.  (2013). Summer and Speech Delays.  Retrieved from http://www.speechlanguagefeeding.com.

RIPICH, D. N. (1989) Building classroom communication competence: A case for a multi-perspective approach Seminars in Speech and Language, 10, 231-240.