Myth: A Speech Pathologist only treats a lisp!

When our son needed a little extra speech support, we asked around and were lucky to find a terrific therapist at CommuniKids on the Upper West Side of Manhattan. Jessica L. Falkin, MS,CCC-SLP is an ASHA (American Speech, Language, and Hearing Association) certified and New York State licensed Speech-Language Pathologist. Using a diverse palette of fun therapeutic techniques, she was able to make leaps and bounds in our son’s linguistic abilities. She took some time out of her busy schedule to share some of her techniques below.

Myth: A Speech Pathologist only treats a lisp! Fact: Not True. Often times, there is a misconception about what speech pathologists treat. There are three main areas that Speech-Language Pathologists address. The speech or articulation part looks at how sounds are made, voice, and fluency. We also look at the core and mouth muscles to see if they are strong enough to support sound production. The area that most people don’t realize that a Speech-Language Pathologist addresses is language. The language piece looks at comprehension, (what children understand), expression, (what children say and how they get their needs met), and pragmatic language (how children use their comprehension and expression to engage socially with their peers). The third area is feeding which encompasses swallowing, chewing, and tolerating a variety of foods.

How do I know if my child needs speech and/or language therapy? As a parent, you slowly learn that, in most cases, when your child is ill there is little that can be done other than wait for the illness to run its course. This is specifically true when a child has a viral infection. While this is true of illnesses, it is not necessarily true of slowly developing speech and language skills. What is true is that there is a wide range of normal and that even though a child might demonstrate development that lags behind siblings or peers this does not necessarily equate to it being pathological. There are, however, expected norms in all areas of speech, language, and feeding development. Should a child’s development be stagnating, the effects, while not emergent, can be significant academically, socially, emotionally, and in some cases medically. The biggest indicator as to whether an evaluation is warranted in any of these disciplines is if your child is displaying signs of avoidance or frustration in his or her ability to communicate. Here are a few “red flags” to watch for:

  • No words by 18 months
  • No phrases by two years
  • Family history of learning or hearing impairment
  • Chronic ear infections or congestion
  • Relies on familiar contexts, gestures, or always wants the same activity
  • Dependent upon gestures to follow directions
  • Requires frequent repetitions of directions
  • Is close to 3 years of age and produces few creative utterances that are three words or more in length
  • Does not ask “what’s that?”, or “why?” questions, which are prevalent for most children around 4-5
  • Difficulty with transitions
  • Underdeveloped social or play skills
  • Shows little interest in playing with peers or in combining toys and objects in imaginative or symbolic play
  • Poor intelligibility
  • Groping behaviors with oral structures
  • Short attention span

Will my child be in therapy forever? It is best practices for a child to have a comprehensive speech and/or language evaluation before initiating therapy. An evaluation provides a baseline of your child’s skills, then determines if therapy is warranted . If therapy is in fact warranted, a clear treatment plan is formulated and goals are derived. Through evidence-based therapy your child’s progress is closely monitored and statistically quantified. When all the goals are met, a child should be discharged from therapy. In regard to an exact length of time, there is no easy answer to that question. Every child is different as is every therapeutic situation. If you can practice given homework on a nightly basis with your child, the duration of therapy can be greatly reduced.

What are some of the therapeutic speech techniques you employ and how do they differ? When determining what type of therapy is best for your child or which therapist will work best with you child, the myriad of information can certainly be daunting. There are differing opinions that one therapeutic technique is the ONLY correct or most beneficial approach that works. It is my opinion as a clinician that it is important to look for a therapist that is well rounded in their knowledge and incorporates a variety of techniques into therapy. It is most important that a therapist tailor their therapy to what best suits the needs of your child and will best help your child meet their goals in the most effective and efficient way possible
Some common therapy techniques used to elicit speech production all of which are valuable therapeutic tools to employ when necessary, include but are not limited to:

  • Oral Placement Therapy: Oral placement therapy targets the muscles used for speech and feeding. If it is determined that there is weakness, targeted exercises are used to strengthen these muscles for feeding and sound production.
  • PROMPT Therapy: PROMPT stands for Prompts for Restructuring Oral Muscular Phonetic Targets and uses a tactile(touch) cue on the corresponding articulator (mouth, tongue) to stimulate speech production.
  • Sounds in Motion: Sounds in motion pairs gross motor movements with phoneme production to teach articulation and phonemic awareness.

What can I do to help stimulate my child’s speech and language development? Participate in activities that stimulate the senses. For example, making orange juice. See the real oranges, cut them, squeeze them, smell them, taste them, and feel if they are cold or hot. The more senses you use, the better! Talk to your child!

  • Use Parallel Talk. Describe what your child is seeing, hearing, or doing as they experience it. “You have a truck. You pushed it.”
  • Use Description. provide word labels for the objects the child is playing with, touching, or seeing . “It’s a plane, it’s a big plane”
  • Use Self-Talk (most beneficial for children 12-24 months). Talk about what you are doing while the child watches. Use short sentences to talk about what you’re doing. “I’m tying my shoe. Tying my shoe.” “tie the shoe. make it tight.” “tie the knot.”
  • Use Expansion. Expansion is adding more information to the words the CHILD uses to talk about objects or actions. If the child says “yellow”. you say: “Yes, the flower is yellow”
  • Use Labels. Name objects and actions in real life and in pictures. Your child can begin to make connections between the label and the object or action. “wa-wa’ ” yes, drink water”

Read, Read, Read!! Read to your child each day. Choose colorful books with large, simple pictures. How you read to a 2 year old is different than how you read to a 3 or 4 year old. It is not necessary to read what is written on the page. Turn pages at a fast rate when “reading” to very young children to hold their attention to the book and point to actions in pictures. Books with repetitive lines such as those written by Dr. Seuss are useful to foster pre-reading skills.

Do Not Anticipate. Do not anticipate your child’s needs before they make them known to you. If your child gets what they want without gesturing or speaking, there is no incentive to ask. For example: Give your child a cup and then act like you’re finished. Your child is likely to communicate by pointing to indicate that you forgot to put milk in the cup.

Reference: Eichten, P. (2000). Help Me Talk: A Parent’s Guide To Speech and Language Stimulation Techniques For Children 1-3 Years. PI Communication Materials, Inc.

Recommended Reading

  • Beyond Baby Talk: From Sounds to Sentences, A Parent’s Complete Guide to Language Development. By Julie Masterson and Kenn Apel
  • Does My Child Have a Speech Problem? By Katherine Martin
  • Language Processing Problems: A Guide for Parents and Teachers. By Cindy Gaulin
  • Look Who’s Talking. By Laura Dyer
  • Talking on the Go. By Dorothy Dougherty and Diane Paul
  • The Late Talker: What to Do If Your Child Isn’t Talking Yet. By Marilyn Agin
  • The New Language of Toys: Teaching Communication Skills to Children with Special Needs: A guide for parents and teachers. By Sue Schwartz
  • The Out of Sync Child Has Fun: Activities for Kids with Sensory Integration Dysfunction By Carol Stock Kranowitz

Websites

  • communikidsny.com The official online home of CommuniKids
  • asha.org American Speech-Language Hearing Association. The professional association for speech-language pathologists and audiologists providing information for teachers/parents regarding communication disorders
  • nysslha.org New York Speech-Language Hearing Association. The professional association for speech-language pathologists and audiologist in the state of New York
  • schools.nyc.gov/offices/ISC/SpecialEducationservices New York Department of Education. To get speech and language services provided through the board of education search CPSE (Committee on preschool special education) for 3-5 year olds; and CSE (Committee on special education) for school aged children
  • health.state.ny.us/community/infants_children/early_intervention Early Intervention. To get services for children (birth to 3) with a developmental delay in one or more area (physical, cognitive, communication, social-emotional and/or adaptive)

Jessica L. Falkin

Bio: Jessica L. Falkin, MS,CCC-SLP is an ASHA (American Speech, Language, and Hearing Association) certified and New York State licensed Speech-Language Pathologist, attended the University of Massachusetts where she received her Bachelor’s degree in Communication Disorders. She then attended Seton Hall University and earned her Masters of Science in Speech-Language Pathology. Jessica is currently in her fifth year working with CommuniKids, a private practice providing speech, language, and occupational therapy services on the Upper West Side of Manhattan as well as in Summit, NJ.

Wow! That was a lot of great information. Let’s take a break and listen to some fun music. “Teacher Teacher” seems like an appropriate song for the occasion. You might also enjoy our debut music video “Mac & Cheese” (lots of cute animal shots!). Until next time, here’s to the power of language! xo Amelia & Harold