Tag Archives: speech and language development

Is Articulation Therapy Appropriate for My Toddler?

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My toddler’s speech isn’t 100% clear, and his preschool teachers say that they have a hard time understanding him. Should I be concerned?
Let’s set the scene: Your child walks up to you and says “mohmik peas,” and at first you don’t have a clue what they are trying to tell you! But by using the clues in your environment and by observing their gestures, you eventually figure out that they requested “more milk please.” You were able to meet your child’s needs (getting them more milk) even though they did not produce all of the correct sounds in each word. So are their speech sound (i.e. articulation) skills something to be concerned about?

As your child produces new words and phrases you might be noticing that their speech is not 100% clear. Your child’s speech clarity, also referred to as intelligibility, is your child’s current production of sounds which impacts how others can understand them. Intelligibility for a two year old should be approximately 50% to an unfamiliar person. By three-years of age your child should be approximately 75% intelligible, meaning that you should understand at least seven out of every ten sentences that they produce. It is important to remember that as your child is learning how to talk they may not sound exactly like an adult would, and that’s typical! In general, your child should be using a variety of consonants and vowels at two- to three-years of age but there is variability speech sound development.

Speech sound development: What should I expect?
Not all speech sounds are alike! Some speech sounds are considered early developing sounds, while others might develop when your child is older due to the complexity of oral movements required to make that sound. Early developing sounds include: “p, b, m, n, w, t, d, h.” Later developing sounds include: “sh, s, z, l, r, th.” Later developing sounds may be substituted with a different sound at two- to three-years of age due to their motoric complexity.

“So you’re saying that not all speech sounds need to be mastered by three-years of age?” That’s right! At three-years of age it is possible that your child may be substituting different sounds in real words, such as “wed” for “red,” and this is age-appropriate! At the age of three, a “w” for “r” substitution would be considered a developmental error, or an error that does not require direct therapeutic intervention. The majority of developmental errors will correct themselves as your child’s language and articulation skills develop.

What are phonological processes?
Phonological processes are patterns children use to simplify their speech as they are learning how to speak. For instance, your child may be saying “back” for “black.” Each phonological process is considered age-appropriate until it persists past a set age of elimination (the age in which the majority of children no longer present with that specific error pattern). The majority of children will correct their own speech and no longer use phonological process substitutions as their language and speech sounds develop. (Please see resources listed below to view an age-appropriate phonological processes chart.)

Is your child ready for articulation therapy?
Articulation therapy uses a hierarchical approach to master target speech sounds. For instance, you may first practice the sound “f” in isolation, or by itself, and then progress to practicing “f” with a vowel such as “fee” or “foe.” Articulation therapy requires your child to have the ability to follow directions given by the therapist, tolerate a variety of cues to help support appropriate production of their target speech sound, pay attention to the therapist, and imitate what the therapist is saying. At two years of age, your child’s attention span is shorter than a three- or four-year-old’s attention span, and they may become frustrated by some of the direct cueing provided during traditional articulation therapy. One critical component of articulation therapy is avoiding negative practice, or practicing your child’s target speech sound the incorrect way. Your child’s therapist wants to avoid negative practice because they want to support and encourage the accurate production of the speech sound and not have your child continue to practice incorrectly. A child who is not ready for articulation therapy is a child who is unable to follow directions provided by a therapist, unable to pay attention to a therapist’s face, or is unable to imitate what a therapist is saying.

Should my two-year old be receiving articulation therapy?
If you feel like you understand your child approximately 50% of the time, but notice that there are some sounds that are not the same as an adult’s production they may be using age-appropriate substitutions and/or phonological processes. For instance, if your child is deleting the end of words (final consonant deletion) at two years of age this is considered an age-appropriate phonological process that is typically eliminated around three years of age. In addition, at two years of age children are still learning how to use language and are increasing their phrase length and vocabulary, which are both age-appropriate skills to promote and target with a two-year old. If at two years of age you feel like your child is not using a variety of vowels or consonants, or you feel like producing speech sounds is effortful, your child may be a candidate for a speech and language evaluation.

So what can you do to help support your two-year-old’s speech intelligibility? Your mouth is a great cue for your child! Several early developing speech sounds can be seen on the lips and this visual cue makes it easier for your child to imitate you. For instance, “p” and “b” both require your lips to come together before making sound. Children learn a lot by what they see, so hold objects and toys near your face to encourage them to look at how your mouth is making sounds. You can also talk slowly and prolong different sounds to help your child imitate new sounds they may not be using such as “mmmma-mmmma” for ‘mama.’

Should my three-year old be receiving articulation therapy?
If your child is three years old or older and you feel like their intelligibility is less than 75%, have difficulty producing early developing speech sounds, have a limited variety of vowels, or are using phonological processes that are no longer considered typical for their age, your child may be a candidate for speech and language therapy. If you have concerns regarding your child’s articulation skills, talk to your speech-language pathologist or schedule an appointment for an evaluation.

Some things you can try at home include:

  • Encourage your child to look at your mouth! Your mouth is a great cue for your child to look at as you model a new sound.
  • Model the word with the correct sound for your child to hear the difference. For instance, if your child says “bid” for “big,” you can model the correct word “big” after your child’s attempt.
  • Tap or clap out syllables to promote the inclusion of all syllables in a word. Tapping or clapping can help your child know the exact number of syllables in the word, which can facilitate inclusion of all syllables within a target word. A word is much easier to understand when all of the syllables are produced clearly and do not run into the next word in a sentence!
  • Give your child two verbal choices to choose from if you’re having a difficult time understanding your child. By providing your child with two verbal choices for them to imitate you know what they are trying to say, even if their sounds don’t come out just right!. Also, it may be easier for your child to imitate one of the two choices you give rather than produce the word on their own.
  • If you notice that their speech sounds are ok in single words, but are incorrect when they try to produce a full sentence, try to decrease the number of words in your child’s sentence and have the imitate it back to you. For instance, your child attempts to produce a four-word phrase such as “puppy drink more water,” however, there are multiple words that are challenging to understand. You can model a shorter, three-word phrase such as “drink more water” to aid with increased intelligibility.

Resources:
Visit Mommy Speech Therapy to download the phonological processes chart!

Questions or concerns?
If you have questions or concerns about your child’s speech and language development, please contact us at info@playworkschicago.com or 773-332-9439.

Samantha Labus, MS, CCC-SLP
Speech-Language Pathologist

Reference:

Fabiano-Smith, L., & Goldstein, B. A. (2010). Early-, Middle-, and Late-Developing Sounds in Monolingual and Bilingual Children: An Exploratory Investigation. American Journal of Speech-Language Pathology,19(1), 66-77. doi:10.1044/1058-0360(2009/08-0036)

Sander, E. K. (1972). When are Speech Sounds Learned? Journal of Speech and Hearing Disorders,37(1), 55-63. doi:10.1044/jshd.3701.55

Photo Credit:Ryan Fields via unsplash.com

More Than Words: Building Social Communication Skills

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Does your child have difficulty playing with other children? Do they prefer to play alone or demonstrate challenges in making friends? This blog will discuss what pragmatic (social) communication is, review the signs of a pragmatic language delay or disorder, and provide strategies for encouraging pragmatic language development in your child.

What is pragmatic language and why is it important?

Pragmatic language or social communication refers to the appropriate use of language in social situations. It is not only what we say, but also how we say it. This includes being able to understand and use nonverbal cues such as body language and facial expressions. Pragmatic language is comprised of various important skills for successful communication, including eye contact, turn-taking, initiating and maintaining conversation, and understanding and using humor, among others. Children may have difficulty with one or more of these skills. It is important to support the development of your child’s pragmatic language skills so that they can learn to express themselves, understand others, and build relationships with family and peers.

Signs of a pragmatic language delay or disorder:

  • Preferring to play alone for an extended period of time
  • Limited eye contact while talking and/or playing
  • Difficulty taking turns
  • Limited initiation of conversation or play
  • Difficulty maintaining a topic of conversation
  • Difficulty participating in pretend play activities
  • Difficulty understanding or expressing emotions
  • Difficulty understanding another’s point of view
  • Difficulty interpreting tone of voice or body language
  • Difficulty making inferences
  • Difficulty using appropriate greetings
  • Difficulty adapting language to different listeners (i.e. talking to a friend the same way as to an adult)
  • Difficulty adapting language based on environment (i.e. talking the same way on the playground as in the classroom)
  • Not providing background information when appropriate

Strategies for building pragmatic language skills:

  • Pretend play:Engage in pretend play activities with your child, such as playing house, pretending to bake cookies, or pretending to be a veterinarian. Pretend play facilitates growth in cooperative back and forth play, ability to act out social situations, and ability to understand another’s perspective.
  • Turn-taking games:Turn-taking is a fundamental skill of communication as it teaches the basic back-and-forth exchange of a conversation. Through turn-taking games children learn to wait when it is someone else’s turn and they learn how to identify when it is their turn. Turn-taking games could be as simple as rolling a ball back and forth or taking turns blowing bubbles. You could also play simple turn-taking board games with your child to support development of this skill.
  • Story time:When reading a book with your child, try to make it interactive. Based on their age and language skills you could ask them to describe the pictures and what they see. For older children you can ask questions such as, “How do you think he feels?” or “What do you think she will do?” Prompting your child to answer these types of questions will help your child to make inferences, learn to understand another person’s perspective, and have a better understanding of emotions.
  • Be a good role model: You are your child’s best teacher. Model appropriate social communication skills such as making appropriate eye contact, using appropriate greetings, asking on-topic follow up questions, etc. Help your child to use these social communication skills when talking to family, teachers, and peers.
  • Facilitating peer interactions:Children need practice in order to learn to share, take turns, and play cooperatively with others. Setting up play-dates that you can be present for is a great way to facilitate peer interactions and relationships. You can encourage your child to communicate with their peer by prompting them to initiate conversation and play ideas. In addition you can encourage them to maintain play and communication with their peer by prompting them to ask on topic questions and make on topic comments.

Questions or concerns?

If you have questions or concerns about your child’s pragmatic language skills, please contact us at info@playworkschicago.com or 773-332-9439.

Claire Kakenmaster, MS, CCC-SLP
Speech Language Pathologist

Photo Credit: Image by HaiRobe on Pixabay

Picture Exchange Communication System: Is PECS appropriate for my child?

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When people think of communication, they often think of verbal communication. However, communication is not limited to one modality. In fact, communication can occur through a variety of modalities: verbal exchanges, written exchanges, facial expressions, gestures, sign language, etc. Picture exchange is another modality through which people can communicate. To capitalize upon this modality, Picture Exchange Communication System, or PECS, was created as a leading therapeutic technique for children who cannot yet verbally communicate.

As a pediatric speech-language pathologist, I often come across the question from parents, “Is PECS appropriate for my child?” Let’s dive into what PECS is, how it works, and for whom it may be appropriate.

What is PECS?

Picture Exchange Communication System (PECS) is a form of augmentative and alternative communication (AAC) that allows people to communicate using pictures. Although PECS contains a formal protocol that systematically moves through six phases of communicative exchanges, the method of picture exchange can be modified to meet the needs and skill level of the child.

How does PECS work?

  • Children using PECS are first taught a cause-effect relationship between pictures and communication. In other words, they learn that when you give a picture, you receive something in exchange.
  • Children are then taught to use pictures to communicate with different people across a variety of environments.
  • After the basic communicative exchange is established, the child learns to discriminate between multiple pictures in order to request specific objects or activities.
  • Pictures can then be combined to communicate phrases and sentences of increasing complexity, such as “I want ___.”

Who benefits from PECS?

PECS is often recommended for children who do not yet have a means of verbal communication. For PECS to be effective, however, the child must be motivated to communicate, as PECS relies upon the child initiating communication exchanges by giving pictures to another person. PECS also requires that child must have the cognitive skills to understand the cause-effect relationship between giving a picture and getting something in return. Therefore, a child who does not yet understand the cause-effect nature of a basic communicative exchange would be an inappropriate candidate for PECS until this skill emerges.

Myths Debunked

  • PECS is only for people who won’t learn to talk: The use of PECS does not imply that the child will never learn to use verbal language. In fact, the use of PECS can facilitate verbal communication by providing children with an outlet to reduce frustration and establish early communication skills.
  • PECS is only for people with Autism: PECS is frequently recommended for children with Autism Spectrum Disorder due to deficits in expressive language and social communication. However, recommendations of PECS should be child-specific and may or may not be appropriate for any child who does not have a means of verbal communication.
  • PECS only targets requesting: As a child moves through the PECS hierarchy, they can learn to use pictures for different functions, including requesting, answering questions, and ultimately, commenting independently. PECS involves high priority vocabulary to teach children that they can expand their expressive vocabulary to meet their wants and needs.

Questions or concerns?

If you have questions or concerns about whether PECS is appropriate for your child, please contact us at info@playworkschicago.com or 773-332-9439.

Jill Teitelbaum, MS, CF-SLP
Speech-Language Pathologist

References:

Bondy, A. (2001). PECS: Potential benefits and risks. The Behavior Analyst Today, 2(2), 127.

Vicker, B. (2002). What is the Picture Exchange communication System or PECS?.

Photo Credit: sitemaker.umich.edu

The Function of Echolalia

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Echolalia is the repetition or “echoing” of sounds, spoken words, phrases, or sentences. Echolalia is a typical function of early language development seen in young children as they begin to learn spoken language. Echolalia can also be a symptom of various disorders including aphasia, dementia, traumatic brain injury, schizophrenia, or Tourette’s Syndrome; however, it is most often associated with autism spectrum disorder (ASD). It may be difficult to discern typical versus atypical echolalia and whether or not it is a functional part of your child’s language skills, but there are specific qualities to look out for in order to differentiate the underlying causes.

Types of echolalia:

There are two types of echolalia: immediate and delayed. Immediate echolalia is when a child repeats what they just heard. For example, if a parent asks a question, “Do you want a cookie?” and the child responds with, “You want a cookie?” rather than responding to the question. Delayed echolalia is when a child repeats something they heard hours, days, months, or even years prior. For example, the child may repeat a line from a video they saw earlier that day or a phrase heard at the park the week before.

Functional versus non-functional echolalia:

For some children, echolalia is just a meaningless imitation of sounds or words strung together. These children may imitate things they’ve heard recently or in the past with no communicative intent. For other children, echolalia serves a purpose to express wants and needs when they are unable to produce novel statements of their own.  When a child “scripts” (i.e. recites exact lines) from shows or movies, it may appear that they are producing long, meaningful utterances, when in fact they have no comprehension of what they are actually saying. In these instances, they may be using the familiar and memorized words and cadence as a calming strategy, but not to convey a specific message. Functional echolalia, however, is the use of learned words or phrases to make requests and otherwise express wants and needs. Some children will use exact words and intonation in order to get their needs met in a functional way even though they may not yet be able to produce their own novel word combinations. For example, they may say “Are you hungry?” to request food, as opposed to simply stating they are hungry or requesting specific food items. It is significant to note, the child who is “scripting” lines from a movie, may also be using those words as a way to request that movie at that time.

When is echolalia considered typical?

Echolalia is seen in typically developing children during early language development between one and two years of age. While we will continue to see some repetition of overheard language between two and three years of age, we also expect to see a consistent increase in novel words and phrases as well. By three years of age, echolalia should be observed minimally in a child’s spontaneous language, and by four and five, a child is expected to engage in conversations using completely novel language. Children with a language delay or autism spectrum disorder may demonstrate these echolalic characteristics beyond three years of age depending on the severity of the delay or disorder.

While first instinct may be to try to stop the echolalia altogether, it is important to recognize it as either a functional communication tool your child has developed, or as a stepping stone into functional expressive communication skills that can be further developed with the help of a speech therapist. If your child’s echolalia has continued past an age considered part of typical language development or appears “non-functional,” it may be helpful to consult a speech and language pathologist. They can help identify the underlying causes and use these emerging verbal skills to target and build functional communication.

Questions or concerns?

If you have questions or concerns about your child’s echolalic language, please contact us at info@playworkschicago.com or 773-332-9439.

Therese Brown, MS, CCC-SLP
Speech-Language Pathologist
Photo Credit: Echolalia Autism (repetitive speech)-Causes, Symptoms, and Treatment via hearingsol.com

The Importance of Promoting Early Literacy Skills

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Literacy skills develop from language skills and language skills begin to develop as soon as your child is born. Your baby begins communicating through eye contact, smiling, crying, facial expressions, and gestures and relies on your response with words and attention to lay the foundation for language and literacy development. Your child’s brain develops the most during those early years, and frequent exposure to language and reading will help build your child’s vocabulary, comprehension, story-telling, reading, and writing skills.

Why is Early Literacy Development Important?
Research shows that babies and toddlers who participate in literacy activities with their caregivers are more likely to develop a sustained interest in reading and writing. Developing an interest in reading and writing early on will have a positive impact on your child’s academic readiness.

Literacy, which is the ability to read and write, is comprised of a variety of skills including letter recognition, phonemic awareness, use and understanding of vocabulary, and story comprehension. These skills begin to develop within the first year of life. For example, when your child is six to twelve months old they may begin to grasp books or pat pictures they are interested in. At twelve to twenty-four months your child may begin to turn board book pages, give a book to you to read to them, and point to and name objects in pictures. Between the ages of two and three your child may start to scribble, request the same story over and over, and begin to complete sentences or rhymes in stories that are familiar. As a parent or caregiver, you can provide your child with positive early literacy experiences, which will lay the foundation for language, reading, and writing skills to develop.

Tips For Promoting Early Literacy Skills:
1. Have fun while reading! If your child is engaged and enjoying themselves, they are learning. You can use silly voices and actions while reading your child a story. This will promote positive feelings towards reading for your child.
2. Talk about the pictures. Rather than reading the words on each page, try talking about the pictures. Point to the objects and actions in the pictures as you describe them so that your child will begin to make connections between the words you are saying and what they see. Eventually you can ask them to describe the pictures themselves.
3. Let your child interact with books. Let your child hold the book and turn the pages even if you need to help them do this. Remember that it is okay to skip pages and to talk about pictures rather than read all of the words.
4. Make books and stories a part of your daily routine. Have books in your car, sing songs and nursery rhymes during mealtimes or play, and make time to look at books before naps and bedtime. Provide your child with frequent opportunities to engage with books and story time.

Early Literacy Skills Are Developed Through Early Experiences:
Remember that early language and literacy skills are learned through every day experiences with you and your child. Through playing, talking, singing, and reading together, your child is developing early language and literacy skills. While your baby or toddler may not be ready to read or write yet, exposing your child to frequent opportunities to interact with books and tell stories will help to develop your child’s vocabulary, comprehension, story-telling, reading, and writing skills. Remember, it is never too early instill a love for learning and reading in your child!

Questions or concerns?
If you have questions or concerns about your child’s early literacy skills, please contact us at info@playworkschicago.com or 773-332-9439.

Claire Kakenmaster, MS, CCC-SLP
Speech Language Pathologist

Photo Credit: Child, Fun, Family, Love via Pixabay.com

How to Expand Your Child’s Play!

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Play is highly correlated to your child’s cognitive and speech and language development and is a great way to bond with your little one! Many parents are challenged by how to play with their little one and get involved in their world. Not only is learning to play important, but equally important is the expansion of your little one’s play.

Some toddlers get “stuck” in wanting to play with a toy in only one or two ways. Toddlers who play with a toy in a limited number of ways are showing us that they do not quite understand the function or multiple functions of a toy. Take for example a child who only moves a car back and forth on a table. This little one is showing us they understand that the car can move, but they are not yet aware of all the other things we can do with that same car. We can drive the car up the couch, it can crash or fall, the car can get gas or a car wash, pick up pretend toys and animals, or take us to different places like the grocery store or to see friends and family.

Why Do We Want to Expand Play?

Expanded play shows us your little one’s expanded understanding of the world. Play allows adults to label and model actions that your child is completing, in turn, helping your child’s speech and language skills develop.

The higher levels of play your little one demonstrates, the more they understand their world and the more language they have. If a child is playing with an object in just one way, there is a limited amount of words we can use to talk about that play interaction. For example: Your little one hands you a ball. You could say: “Ball!” “Look, ball.” “Red ball.” “Big ball.” If your child throws a ball to you, you can add “Throw ball.” “Bounce!” “Go ball!” “My turn!” “Your turn” and so much more. By expanding from showing to playing, there are SO MANY more words we can use to support your little one’s vocabulary development!

Tips for Expanding Play:

  1. Get on your child’s level:Sit on the floor or at the table together so you are physically at the same level as your child. Being on the same level also increases your eye contact and is easier to share attention with your child.
  2. Follow their lead:If your kiddo is playing with a car, you play with a car too! Try finding another of the same toy so you each have a toy and you don’t have to take turns.
  3. Add ONE play idea at a time:Sometimes we get a little over-zealous showing our kids 50 different ways to do something—it can be overwhelming. Remember expanding play is a gradual process and each child learns at their own pace. Your little one might need you to show something once or they might need some more help to copy your play—that is okay. Start by adding ONE step. Your child shows you a ball. You roll the ball back to them. Once your child is imitating one action, show them something new (try bouncing the ball)!
  4. Keep your language simple: We want to say one word above what our child is saying. If your little one says, “Ball” add an action word to describe how you are playing: “Ball go!” “Bounce ball.” etc. If your little one isn’t saying anything yet, just label the object or the action, or even just make a silly sound (slurping if you’re playing with a pretend cup)!
  5. Don’t force it:If your little one is getting frustrated that you are changing their play, show them one more time and move on. We want to keep play fun, exciting, and enjoyable for both of you! If your little one abandons an activity, move with them or take a short break and join them later to play again.

For more info on play and play milestones, check out some of PlayWorks’ previous blog posts:

Play in speech and language therapy: http://playworkschi.wpengine.com/toddlers-speech-therapist-playing-child/

Toy guide for babies through toddlers: http://playworkschi.wpengine.com/toy-guide-babies-toddlers/

Jessie Delos Reyes, MA, CCC-SLP
Speech-Language Pathologist

Image: https://www.sheffield.ac.uk/news/nr/want-to-boost-your-toddlers-development-put-a-toy-chicken-on-your-head-1.485117

Skill Building and Repetition

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“It feels like we’re doing the same things over and over, why hasn’t my child learned this by now?”
“We’ve tried that and it didn’t work.”
“My child said that once, but hasn’t said it again since.”

CareyHope/Getty Images

Toddlers with language delays often learn along the same developmental path as “typically” developing children, they may just require more time to learn skills, more repetition of models, more cueing or help, more practice with each new concept, word, or skill, etc. Often times, children with language delays don’t just pick up words overheard in adult conversation and they don’t repeat things they have heard within full sentences. They require more direct teaching of each word or concept, which often includes a lot of exposure to each target, keeping things simple and concise, and a lot of repetition and practice before it truly becomes part of their repertoire. Some children may process a new word after five repetitions, some may require 20, some may require 50 or more, it all depends on the complexity of the concept or word, their interest level in said concept or word, what cues or aids they have when being exposed to this concept or word (e.g. pictures, physical objects, models of actions, etc.) and a variety of other factors. Just as we as adults often need practice or multiple exposures to be good at something new, children’s brains, oral motor mechanisms, and bodies need a lot of repetitions to efficiently learn and use new skills.

At times it may feel like our toddlers are not listening or intentionally refusing to do or say something we’ve seen or heard in the past, but it’s important to be aware that just because we’ve heard something or seen it done once, twice, or even a handful of times, does not necessarily mean it’s been mastered; therefore, we cannot necessarily always expect it done. Until each new skill is used consistently, children need continued repetition and practice. Oftentimes, we will hear some children in the initial phases of learning to talk repeating words to themselves for seemingly no apparent reason, but they are practicing when there is no pressure to perform!

Once we’ve seen a new skill or heard a new word, resist the urge to move on to the next new thing. Elicit this over and over to help your toddler practice! Make it a game to perform the action or repeat the word again and again. Make it functional so the child has more motivation to keep trying or participating. For example, saying “Say ___. Say it again. ____. Say ___,” is not a functional use of this new word. While it seems to be the quickest, easiest way to get high repetitions of the word in a short period of time, they will quickly lose interest, in addition to not necessarily equating this new word with it’s true meaning. Instead, with each target word, give a little at a time so the child is motivated to use to the word again in order to receive the desired output. For example, give one piece of the snack until your child uses the word again to request more of it, give one piece of a desired toy until they use the word again to get another one, or perform one silly action and pause until they use the word to request another performance. It may feel redundant, but modeling or eliciting a new concept, skill, or word with high repetition is key to your toddler’s acquisition of it. Once children find something they like, they will attempt to get it over and over again anyways, so you might as well use it as an opportunity for repetitive exposure and practice!

Therese Schmidt, MS, CCC-SLP
Speech-Language Pathologist

When to Skip the Sippy Cup

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Many parents love sippy cups- they are great for “on-the-go” days and avoiding spills and messes! However, the problem with sippy cups is that prolonged and frequent use can impact a child’s development of speech and feeding skills. Below are three reasons why you may consider skipping the sippy cup:

  1. Tooth decay: Constantly sipping on anything that is not water can lead to tooth decay because the child does not have the opportunity to rinse away the sugars from the juice or milk with their own saliva. The acid from the drink may break down the tooth enamel leading to tooth decay. If you are going to use sippy cups for anything besides water, it is best to limit to only meal times and to take breaks with water to rinse your child’s teeth.
  2. Oral-motor delays: At around 12-months, a baby’s swallowing pattern matures from a front to back swallowing pattern to a more advanced swallowing pattern where the tongue raises to the top of the mouth and starts a wave-like motion for swallowing. It is important for babies to move to this new swallowing pattern as it allows them to transition from soft solids and liquids to more advanced foods and textures. When using a hard-spouted sippy cup, the sprout rests on the front of the tongue impeding the ability of the tongue to elevate to the top of the mouth. When a child uses a hard-sprouted sippy cup for a prolonged period of time, it can impact their ability to develop a mature swallowing pattern necessary for chewing and swallowing age-appropriate foods.
  3. Speech and language delays: Prolonged use of a sippy cup can impact a child’s ability to develop a mature swallowing pattern which means that their oral-motor skills may not be well-developed. Decreased oral-motor skills may lead to a greater likelihood that the child has difficulty saying and imitating certain sounds.

Other options? A great alternative to the sippy cup is a straw cup. There are some great options for spill-proof straw cups at most stores. Straw cups can offer the same “on-the-go” convenience of a sippy cup while still promoting appropriate oral-motor development!

Claire Kakenmaster, MS, CCC-SLP
Speech Language Pathologist

Can Prolonged Pacifier Use Affect My Child’s Speech and Language Development?

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Sucking is a postnatal reflex and is a natural part of your child’s development. So it is no wonder that a large majority of infants and toddlers use pacifiers to help them self-soothe throughout their daytime and nighttime routines. Pacifiers may be helpful for comforting your child in stressful situations, distinguishing between a fussy and hungry infant, and also as a sleep aid. But how old is too old for pacifier use? And are there any negative affects from prolonged use of pacifiers?

Pediatricians recommend that babies be weaned from pacifiers around four- to six-months of age. Pacifier use is no longer needed as a calming strategy after six months, primarily because the sucking, or “rooting,” reflex has disappeared. Prolonged use may result in the pacifier becoming a habit and therefore more difficult to wean.

Speech-language pathologists also recommend discontinued pacifier use by 12 months of age for many reasons. First, your child’s oral development is changing rapidly during the first few years of life. Prolonged sucking may in fact create a raised or indented palate, resulting in an oral cavity that is too large for typical articulation. This may manifest as a speech disorder around four to five years of age, often requiring therapy to remediate. Additionally, sucking on a pacifier encourages an immature suck-swallow pattern, resulting in possible feeding difficulties and articulation concerns.

Pediatric dentists recommend that pacifier use be discontinued by 24 months of age at the latest. The constant sucking on a foreign object beyond 24 months may cause the palate, gums, and teeth to develop atypically. This is primarily seen in the atypical eruption of permanent teeth, leading to crowding and/or gaps in the teeth.

If you are ready to tackle the job of weaning your child from his/her pacifier, there are a few strategies that can ease the transition. It is not recommended to go ‘cold turkey’ at first; rather, tell your child that the pacifier is for sleeping only and keep it out of sight during the day. Once you have established this routine, remove the pacifier from nap times and eventually from bedtime. It is helpful to offer a brand new comfort item (such as a new blanket or stuffed animal) that your child can use as a replacement for self-soothing. The most important thing to remember for weaning your child from a pacifier is to remain consistent with the rules you set in place!

While there is variability in the recommended age for weaning your child from a pacifier, general consensus is that pacifiers should not be used at any time (day or night) after 24 months of age. Consult your speech-language pathologist or dentist if you have any questions about your child’s pacifier use, as well as for recommendations and support for weaning your child from the pacifier.

Autumn Smith, MS, CCC-SLP
Director of Speech-Language Services

Taking the Pressure off Talking!

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If you are a parent who has tried implementing some of the language strategies your speech therapist has taught you with your little one- only to end in your child running off or having a meltdown- this blog is for you! Often the reason for these meltdowns is due to pressure. Not only the pressure put on your child but also the pressure you put on yourself. Below are three strategies for ways to encourage language development while avoiding a meltdown.

  1. Finding your child’s limit- Knowing how much you can push a child can be tricky. We want to encourage and challenge our little ones, but not to the point that we see a meltdown. Try starting with something that is easy for them and make slow, gradual changes to increase the difficulty. The moment you notice your child is at their limit pull back. It’s important to keep in mind that your child’s limit can change daily or even by activity and we may need to adjust accordingly.
  2. Play- The best way to encourage language development in our little ones is to play! Rather than planning a specific activity, think about what toys or activities your child loves and how you can incorporate language into that. If it something that they like then they will be more interested and engaged and you will be more likely to avoid a meltdown. If your child loves trucks- play with trucks. You can practice the sounds that they make or talk about their size and color. If you’re having fun then your child will too!
  3. Get moving- Sitting for extended periods of time can be hard for toddlers., so incorporate movement into your activities. This is a great way to engage your child and keep their attention while avoiding a tantrum. If you’re doing a puzzle you can put the pieces on the other side of the room so your child has to run to go get each piece or you could make an obstacle course out of pillows and blankets and work on following directions.

By taking the pressure off talking you will see your child become more engaged and eager to participate. I hope these strategies are helpful and as always if you have any questions or concerns, please feel free to contact us!

Claire Kakenmaster, MS, CCC-SLP
Speech Language Pathologist