Starting with AAC? Here are Some Tips!

Now that some Augmentative and Alternative Communication (AAC) myths have been busted (see the previous blog post), it’s time to introduce, support, and use AAC with your child! Your speech-language pathologist and therapy team can help determine which systems and modalities are most appropriate to trial. Once you have these trial systems in place, here are some considerations, strategies, and tips to think about when supporting your child on his or her AAC journey.

Familiarize yourself with the system

Begin by familiarizing yourself with the AAC system. Borrow it during your child’s nap time, take an approved parent course on the system, observe a therapy session where the system is being used, or train directly with your child’s speech-language pathologist. The more you know, the more comfortable you will be using the system and therefore, the more likely you will be to model on the system!

 

 

 

 

 

Model, model, model

Children learn through experiences and observation, s

o it’s incredibly important to provide enriching models. We cannot expect a child to know how to use an AAC system without showing them how to use the system first.

Have fun! Then, model some more

When introducing AAC, start by introducing the system during play with motivating games, activities, and toys! Cause-and-effect games and routine based activities are great, as these activities use repetitive language and provide plenty of natural pauses in play where the child can fill-in-the-blank or request.

For the first few minutes of play, simply demonstrate how to use the system by naturally modeling during play (e.g., selecting “up” on the speech device when placing a car on the top of a race track, pointing to a picture card of an apple when pretending to eat the apple). Then, after the play routine is familiar and the “target” words are established, simply point toward the target word on the AAC system without directly selecting the word. Wait for up to 10 seconds to see if your child will imitate or select the word. After 10 seconds, model it one time then wait again. Do not be discouraged if your child doesn’t imitate right away- it takes time to learn a new system and it takes time to learn language. Keep modeling, keep having fun, and keep positive thoughts!

Focus on all functions of communication

It’s easy to default to “labeling” when modeling new words on AAC systems. However, it’s important to teach children to communicate for other functions, such as to request help, exclaim (Oh no!! Yay!!), protest (No!), ask and answer questions, greet (Hello!), and to indicate wants and needs. 

Incorporate different types of words on the AAC systems

Similar to how adults do not just ‘label’ when communicating, we do not speak using just one type of word. Read the following sentence that only consists of nouns (objects/people/places):

“Child food PlayWorks”

Now, read the sentence when other types of words (adjectives, articles, verbs, pronouns, prepositions, etc.) are added:

“The happy child enjoyed playing with her food at PlayWorks”

See the difference? When using AAC, it’s easy to get stuck on wanting to just use nouns (objects/people/places) and for great reason, objects and people that are relevant to a child are HIGHLY motivating and should be included. However, in order to appropriately model and to help the child functionally use language, we must include other types of words on the AAC systems.

Encourage use of AAC in a variety of settings

In order for AAC skills to be generalized, these skills need to be practiced in a variety of settings. This means that AAC should be accessible, available, and functional in all daily routines.

For AAC users, their systems are their voice, so we should try not take these systems away. In situations where ‘talking’ or using the AAC system is discouraged (e.g., in a quiet movie theater, while teachers are speaking, during fire drills, etc.), we should simply work with the child to teach them that expectation, rather than physically removing his or her device.

Provide meaning with what the child selects

In order to teach word meaning, always respond to what the child selects on the AAC system, even if it’s seemingly irrelevant or inappropriate at the moment. For example, if the child selects “apple”, you can say “we eat apples for breakfast!”. You can also go look for an apple in the kitchen, you can pretend to eat a fake apple, or you can ask “do you want a snack?”. If your child selects “all done”, then immediately stop what you’re doing, even if this is not what you *think* your child intended. One of the ways that children learn language is through this type of reinforcement

A great way to practice pairing meaning with your child’s selection is by providing choices to your child  (e.g., “Would you like to run or walk?”). Model these words on the system and wait for your child to make the selection! Then, immediately reinforce by doing the action or providing the choice.

Honor all communication attempts

One of the primary goals of AAC usage is to help individuals develop functional communication skills, no matter the method of communication. Therefore, it’s important to honor every communication method made by your child. For example, if your child speaks instead of using his or her AAC device, honor that communication attempt by responding to what they say. If your child selects “all done” on the AAC system but does not sign “all done” or say “all done”, honor his or her request to be “all done”! It’s important to encourage your child to communicate and we can only do this by responding to their communication attempts- no matter the system.

Be comfortable with making mistakes

Learning AAC can feel overwhelming, daunting, and generally unknown. If it feels this way to you, it likely feels this way to a new AAC user. Show your child that it’s okay to make mistakes, and even talk about your mistakes when using the system. This teaches your child that it’s okay to make mistakes, too! Trial and error is part of the process.

Note: This article is written from the perspective of a pediatric speech-language pathologist, and therefore, references ‘children’ throughout the entirety of the article. However, this information can be applied to all age-groups and populations.

Questions or concerns?

If you have questions or concerns about your child’s communication skills, please contact us at info@playworkschicago.com or (773) 332-9493. The Speech-Language Pathology team and the Assistive Technology team are available to provide individualized AAC recommendations based on your child’s needs.

 

Nicole Sherlock, MA, CCC-SLP

Speech-language Pathologist

Assistive Technology Co-Coordinator

 

Photo by PRC-Saltillo retrieved at:

https://store.prc-saltillo.com/image/catalog/ViaPro/Via-Pro-all-three-colors.jpg

Photo by AbleNet Inc., retrieved at: https://www.ablenetinc.com/quicktalker-ft-7/

Photo by Talk to Me Technologies, retrieved at: https://www.talktometechnologies.com/products/zuvo-12

Photo by Alexander Dummer on Unsplash

Photos by Tobii Dynavox, retrieved at: https://us.tobiidynavox.com/collections/low-tech-aac/products/picture-communication-symbols-pcs

Photos by Assitive Ware, retrieved at: https://www.assistiveware.com/learn-aac/planning-communication-when-aac-is-not-available

https://www.assistiveware.com/learn-aac/get-the-team-on-board

Photo by Pyramid Educational Consultants, retrieved at: https://pecsusa.com/shop/schedule-board-kit/#tab-description

AAC Myth Busting

Augmentative and Alternative Communication, or AAC, is instrumental for effective, efficient, and successful communication, especially for those with communication and speech disorders. Myths surrounding AAC can prevent families, individuals, and even some therapists from supporting AAC usage. Here are some of the top myths about AAC and why these myths are indeed, just myths.

Myth: Use of AAC discourages or hinders verbal speech production

Perpetrators of this myth believe that AAC will cause individuals to lose interest in talking or that they will only want to use AAC to communicate. Research studies show that AAC does not have a negative impact on verbal language (Millar et. al, 2006). Rather, AAC can actually support and encourage verbal language development. AAC is also beneficial for all-around development, as it supports expressive language skills, receptive language skills, literacy skills, play skills, social and pragmatic skills, behavioral skills, and frustration tolerance (Light et al., 2003; Millar et al., 2006).

Myth: AAC is only for pre-verbal or non-verbal individuals

Although AAC is extremely beneficial for those who do not speak, it is not exclusively reserved for these individuals. The term “augmentative” (the first “A” in AAC) refers to the use of communication systems to supplement speech. If an individual has limited verbal speech or demonstrates decreased understandability, AAC can help them effectively communicate. For example, people with motor-speech disorders often demonstrate decreased understandability due to muscle weakness, muscle incoordination, and/or planning/sequencing difficulties of the muscles involved in speech production. Even though these individuals have the ability to speak, they benefit from AAC to supplement their message when they cannot be understood or when they do not have the capability to produce the desired message. “Alternative” (the second “A” in AAC) refers to the use of systems by individuals with no-verbal communication.

Even individuals with intact verbal communication skills use AAC on a daily basis, as AAC emcompasses all of the ways that we communicate outside of talking. Use of facial expressions, body language, texting, emailing, gestures (e.g, waving, holding a finger up to the lips to indicate “shhh”), holding up objects, pointing to pictures, and writing are just a few examples of everyday AAC systems.

 

 

Myth: Children must reach a certain age or have certain prerequisite skills to use AAC

There is no evidence to suggest that children must be a certain chronological age to use AAC. Rather, introducing AAC during infancy and toddlerhood can have a positive impact on a child’s brain development. The National Scientific Council on the Developing Child (2007) reported that enriching experiences during infancy and toddlerhood (such as using AAC) establishes foundations for later brain development, which helps improve a way a child thinks and regulates emotions.

There is also no evidence that children need certain prerequisite skills to use AAC. In the past, children with cognitive or sensorimotor impairments were often excluded from AAC usage due to absent foundational skills. However, children with cognitive and sensimotor impairments have been shown to effectively implement and use AAC, provided individualized support. Further, implementing AAC with children with cognitive or sensorimotor deficits can have a positive impact on their global development (Ganz et al., 2011; Ganz & Simpson, 2018; Kasari et al., 2014; O’Neill, Light, & Pope, 2018; Romski et al., 2010; Walker & Snell, 2013). AAC can also enable children to demonstrate their cognitive abilities, especially in those who do not yet speak or have a reliable way to communicate. 

In short, no matter a child’s age or ability level, AAC promotes brain development and provides a way for a child to improve in a variety of developmental areas.

 

 

Myth: You must have good motor skills to use a speech-generating AAC device.

As stated above, there are no prerequisites for using AAC. Just as there are many different types of AAC systems, there are also a variety of ways to activate these systems. For individuals with significant motor impairments, eye gaze technology (using equipment to track eye movements) and switch scanning (activating a switch using a specific body part) are two of the most widely used access options. One of the most famous scientists of the 21st century, Dr. Stephen Hawking, lost voluntary muscle control throughout the majority of his body due to ALS. He activated his AAC speech-generating device using his thumb, then a switch mounted to his glasses, which picked up on small movements in his cheeks and face (DO-IT, 2021). Recently, researchers have helped completely paralyzed individuals activate AAC systems using just their breath and have even successfully found a way to activate devices using just the brain (Elsahar et. al., 2018; Moses et. al., 2021)

Individuals with vision, hearing, and other physical impairments are also able to access and use AAC systems, provided appropriate equipment and support. A team of professionals (occupational therapist, physical therapist, audiologist, vision specialists, etc.) should collaborate to help determine the best activation method for AAC based on an individual’s strengths and needs.

 

Myth: Children should start with low-tech AAC before moving on to high-tech AAC

Children do not have to demonstrate competence with a low-tech AAC system before moving toward a high-tech AAC system. (Don’t know the difference between low-tech and high-tech? Check out the previous blog post for more information!)

Since every child has different needs, strengths, skills, environments, and support systems, AAC should be selected based on those criteria, rather than a one-size-fits-all approach or progression. Further, since communication is most effective when it is multimodal, a combination of unaided systems, as well as aided low-tech and high-tech systems can be used in conjunction with one another to help provide the best functional communication outcomes.

A speech-language pathologist, as well as other healthcare professionals, can assist in the assessment, recommendation, and trialing of a variety of systems and modalities to determine the best fit for an individual. Even if a system is successful, modifications to the system or a replacement of the system may be necessary based on progress, changes, personal preferences, and other developmental factors. Flexibility, collaboration, and consistency is necessary for effective AAC interventions.

 

Questions or concerns?

If you have questions or concerns about your child’s communication skills, please contact us at info@playworkschicago.com or (773) 332-9493. The Speech-Language Pathology team and the Assistive Technology team are available to provide individualized AAC recommendations based on your child’s needs.

 

Nicole Sherlock, MA, CCC-SLP

Speech-language pathologist

Assistive Technology Co-Coordinator

 

Common myths about AAC (augmentative & alternative communication). Common myths about AAC (Augmentative & Alternative Communication) – Tobii Dynavox. (n.d.). https://www.tobiidynavox.com/learn/what-is-aac/common-questions/. 

Elsahar, Y., Bouazza-Marouf, K., Kerr, D., Gaur, A., Kaushik, V., & Hu, S. (2018). Breathing Pattern Interpretation as an Alternative and Effective Voice Communication Solution. Biosensors, 8(2), 48. https://doi.org/10.3390/bios8020048

Ganz, J.B., Earles-Vollrath, T.L., Mason, R.A., Rispoli, M.J., Heath, A.K., & Parker, R.I. (2011). An aggregate study of single-case research involving aided AAC: Participant characteristics of individuals with autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 1500–1509. doi:10.1016/j.rasd.2011.02.011

Ganz, J., & Simpson, R. (2018). Interventions for individuals with autism spectrum disorder and complex communication needs. Baltimore, MD: Paul H. Brookes.

Kasari, C., Kaiser, A., Goods, K., Nietfeld, J., Mathy, P., Landa, R., … Almirall, D. (2014). Communication interventions for minimally verbal children with autism: A sequential multiple assignment randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 635–646. doi:10.1016/j.jaac.2014.01.019

Light, J. C., Beukelman, D. R., & Reichle, J. (2003). Communicative competence for individuals who use AAC: From research to effective practice. Brookes Publishing.

Millar, D.C., Light, J.C., & Schlosser, R.W. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: A research review. Journal of Speech, Language, and Hearing Research, 49(2), 248–264.

Neuroprosthesis for Decoding Speech in a Paralyzed Person with Anarthria. Moses DA, Metzger SL, Liu JR, Anumanchipalli GK, Makin JG, Sun PF, Chartier J, Dougherty ME, Liu PM, Abrams GM, Tu-Chan A, Ganguly K, Chang EF. N Engl J Med. 2021 Jul 15;385(3):217-227. doi: 10.1056/NEJMoa2027540. PMID: 34260835.

National Scientific Council on the Developing Child (2007). The Timing and Quality of Early Experiences Combine to Shape Brain Architecture: Working Paper #5. http://www.developingchild.net

O’Neill, T., Light, J., & Pope, L. (2018). Effects of interventions that include aided AAC input on the communication of individuals with complex communication needs: A meta-analysis. Journal of Speech Language and Hearing Research, 61, 1743–1765. doi:10.1044/2018_jslhr-l-17- 0132

Romski, M., & Sevcik, R. (2005). Augmentative Communication and Early Intervention. Infants & Young Children, 18(3), 174–185. https://doi.org/https://depts.washington.edu/isei/iyc/romski_18_3.pdf 

Romski, M., Sevcik, R., Adamson, L., Cheslock, M., Smith, A., Barker, R., & Bakeman, R. (2010). Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. Journal of Speech, Language, and Hearing Research, 53, 350–364. doi:10.1044/1092-4388(2009/08-0156)

University of Washington. (2021, April 9). Dr. Stephen Hawking: A Case Study on Using Technology to Communicate with the World | DO-IT. DO-IT: Disabilities, Opportunities, Internetworking, and Technology. https://www.washington.edu/doit/dr-stephen-hawking-case-study-using-technology-communicate-world

Myth: Young Children Must Wait Until They Can Use AAC. Tobii Dynavox (n.d.).

http://tdvox.web-downloads.s3.amazonaws.com/MyTobiiDynavox/Pathways_SCF_Myth-Young%20Children%20Must%20Wait%20Until%20They%20Can%20Use%20AAC_v1-0_en-US_WEB.pdf

Photo by Volodymyr Hryshchenko on Unsplash

Photo by Stephen Andrews on Unsplash

Photo by Palle Knudsen on Unsplash

Let’s “talk” about AAC!

What does smiling at a neighbor, sending a text, and ordering food by pointing to menu pictures have in common? They are all examples of AAC. By writing this blog, I am utilizing AAC to convey this message to you. So, the question is…

 

What is AAC?

Augmentative or Alternative Communication (AAC) refers to all the ways that we convey our thoughts and feelings without talking. Our world is full of AAC and for good reason- AAC is essential for well-rounded and effective communication across all stages of life. 

Individuals with speech, language, or voice disorders especially benefit from use of AAC to help increase their functional communication skills (Drager et al., 2010). Research has shown that use of AAC can increase expressive language skills, increase language comprehension, increase positive behaviors, increase social competence, and even support verbal language skills (Light et al., 2003; Millar et al., 2006).

People with communication disorders may benefit from additional support to incorporate AAC into their daily lives. Speech-language pathologists are trained to assess, recommend, and implement AAC with clients, based on their strengths and needs. At PlayWorks, we empower clients by using various types of AAC throughout therapy, as well as encourage AAC in home carryover activities.

 

What are the types of AAC? 

There are two general categories of AAC: unaided and aided systems.

Unaided AAC refers to the use of the body to communicate. Examples of unaided AAC include:

  • facial expressions
  • gestures
  • body language
  • sign language
  • non-word vocalizations (i.e., laughing, crying, cooing)

Aided AAC refers to communication supported by supplemental tools or equipment. These tools can be categorized as either low-tech AAC and high-tech AAC. Low-tech AAC includes tools that do not involve electronics or use of batteries. Examples include:

  • Writing
  • Objects
  • Pictures and symbols
  • Picture Exchange Communication System (PECS)
  • Communication boards or books

High-tech AAC refers to tools that use electricity, electronics, or batteries to operate. Some examples include:

  • Speech-generating devices
  • Recorded or digitized buttons/devices (such as the Staples “easy” button)
  • Computers (e-mail, texts, etc.)
  • AAC software on tablets, computers, phones, and other devices

Many dedicated high-tech AAC systems have supplemental equipment available that makes communication access and transportation easier. For example, certain devices have external speakers to help others better hear the speech-generated message. Cameras may be attached to track eye movements for those people who use eye gaze to create their messages. Devices may have special stands or carrying cases to make them more accessible for those in wheelchairs.

At PlayWorks, we support the use of low-tech and high-tech AAC by creating custom communication boards, using props or objects, and utilizing AAC applications on speech-generating devices.

 

Determining AAC needs

Communication is most effective when it’s multi-modal, or occurs in a variety of ways. Therefore, in order to best support individuals with communication delays and disorders, it’s important to implement and teach both unaided and aided AAC. Research shows that no prerequisite skills are required before starting AAC (Light & McNaughton, 2012; Snell et. al, 2010). However, it is important to consider a variety of personal factors when starting, including:

  • Current profile (physical/motor, language, cognitive, sensory, etc.)
  • Strengths and areas of need
  • Available communication partners
  • Setting or contexts in which the person will need to communicate
  • Resources available to both the individual and the communication partners
  • Individual preferences

Your therapy team will then use this information to determine which AAC tools and strategies will be most appropriate to trial, implement, and possibly purchase!

No matter a person’s age or ability level, AAC is a fundamental part of increasing functional communication. In my upcoming AAC blog posts, I will address common misconceptions surrounding use of AAC and expand upon ways to support an individual in their AAC journey. 

 

Questions or Concerns?

If you have questions or concerns about your child’s development, please contact us at info@playworkschicago.com or 773-332-9493. The Speech-Language Pathology team and the Assistive Technology team are available to provide individualized AAC recommendations based on your child’s needs.

Nicole Sherlock, MA, CCC-SLP

Assistive Technology Co-Coordinator

 

Citations & References:

American Speech-Language-Hearing Association. (n.d.). Augmentative and Alternative Communication (AAC). https://www.asha.org/public/speech/disorders/aac/. 

American Speech-Language-Hearing Association. (n.d.). Augmentative and Alternative Communication (AAC). https://www.asha.org/practice-portal/professional-issues/augmentative-and-alternative-communication/#collapse_1

Crowe B, Machalicek W, Wei Q, Drew C, Ganz J. Augmentative and Alternative Communication for Children with Intellectual and Developmental Disability: A Mega-Review of the Literature. J Dev Phys Disabil. 2021 Mar 31:1-42. doi: 10.1007/s10882-021-09790-0. Epub ahead of print. PMID: 33814873; PMCID: PMC8009928.

Drager, K., Light, J., & McNaughton, D. Effects of AAC interventions on communication and language for young children with complex communication needs. Journal of Pediatric Rehabilitation Medicine. 2010;3(4):303–310. doi: 10.3233/PRM-2010-0141.

Phonological Processes: What are they and is my child using them?

Do you find yourself asking your child to repeat what they said, utilizing your detective skills to figure it out, or perhaps acting as your child’s commentator for people that are less familiar with their speech? We know that children can sometimes be difficult to understand when they are learning to speak. It can be tricky to know if this is part of typical development or if your child would benefit from support. In this post, we will help you understand phonological processes and their potential impact on your child’s overall speech intelligibility.

What is typical for intelligibility?

Intelligibility refers to the amount of speech that is readily understood by a listener. A good standard for how well children can be understood by their parents is as follows:

  • By 18 months, a child’s speech is typically 25% intelligible
  • By 24 months, a child’s speech is typically 50-75% intelligible
  • By 36 months, a child’s speech is typically 75-100% intelligible

What are phonological processes?

Phonological processes are predictable developmental patterns that children use to simplify their speech as they are learning to talk. Your child might use these patterns if they are not developmentally ready to coordinate all of the precise movements required for production of certain sounds or syllable shapes that are more complex. For example, your child might refer to a cookie as “tootie” or a banana as a “nana.” Depending on your child’s age and stage of development, the use of these processes can be considered typical or can indicate a need for further evaluation. The chart below (from Mommy Speech Therapy) outlines the different phonological processes, their definitions, examples of each, and the approximate age at which these processes are typically eliminated as part of development, beginning around age three.

http://mommyspeechtherapy.com/

When should I seek support?

If your child uses these processes in their speech for longer than expected, uses many different processes, and/or uses processes that are less typically seen in development, their overall intelligibility can be impacted, leading to difficulties being understood by adults, peers, and other communication partners. In this case, your child could benefit from evidenced-based, individualized support to facilitate acquisition of age-appropriate phonological skills.

What else can I do?

Your child’s speech-language pathologist can help to determine which phonological processes your child is currently using and whether or not therapeutic intervention is indicated. If so, your child’s therapist will develop individualized goals and implement an evidenced-based treatment approach. Your child’s therapist will work with you to establish a home practice program in order to facilitate generalization of skills learned in therapy across environments and communication partners. If your child does not yet have a speech-language pathologist and you are concerned about their overall intelligibility or use of phonological processes, please contact our office to schedule a screening or a full evaluation with one of our experienced clinicians.

 

Questions or concerns?

If you have questions or concerns about your child’s overall intelligibility or use of phonological processes, please contact us at info@playworkschicago.com or 773-332-9439.

 

Ana Thrall Burgoon, MS, CCC-SLP

Speech-Language Pathologist

 

References: Bowen, C. (2011). Table 1: Intelligibility. From Speech-Language-Therapy.com. Retrieved March 15, 2021.

Phonological Processes. From Mommy Speech Therapy. Retrieved from http://mommyspeechtherapy.com/wp-content/downloads/forms/phonological_processes.pdf. Retrieved March 15, 2021.

 

Photo Credit: Photo by Kindred Hues Photography on Unsplash

Make a Silly Face! Oral Motor Imitation: What Is It and Why Should You Target It?

Do you remember the first time your child made that cute little “raspberry” sound? What about the first time he or she blew a kiss of stuck out his or her tongue?  Did you know that these seemingly small (yet adorable) moments are actually important building blocks towards your child’s speech, language, and feeding development?

What are oral motor movements?

Just as we develop gross motor movements (e.g., walking) and fine motor movements (e.g., grasping), we also develop oral motor movements that impact our ability to speak and eat. While any movement made by your lips, tongue, or oral structures are considered an oral motor movement, the following are some specific movements that are beneficial for development as well as highly visual, thus increasing your child’s ability to imitate.

  • Opening mouth: The basis of speech, opening the jaw is imperative for both articulation (speech sounds) and feeding.
  • Lip pucker: “Kissy face.” Lip pucker strengthens lips, which helps with producing bilabial sounds (i.e., /p, b/) as well as controlling food and saliva.
  • Tongue protrusion: Sticking the tongue out helps with a variety of speech sounds (specifically lingual sounds).
  • Tongue lateralization: Moving the tongue from side-to-side helps with a variety of speech sounds, as well as chewing and swallowing food.

How does imitation of these movements impact development?

Imitation of movements, including oral motor movements, is a skill that toddlers master before words emerge. Some children are able to produce specific oral motor movements independently, but have difficulty imitating them on command. While oral motor imitation varies among children, once a child is able to consistently produce the movement independently, we would expect them to imitate it fairly consistently. Continuing to provide repetitive models of the movement you’re eliciting will go a long way in encouraging your child to imitate. If your child consistently has difficulty imitating movements that he or she can produce spontaneously and demonstrates difficulty with speech and language skills, an evaluation could be warranted to determine if he or she is demonstrating some difficulties with motor planning.

How can I target oral motor imitation?

It can actually be quite simple to practice oral motor imitation! The only two things you really need are you and your child; however, there are some tips and tricks to eliciting imitation. If your child is very young, simply engaging with your child by making silly faces is perfect! You can also add oral motor movements to books (e.g., pucker face when reading about a duck, etc.). If your child is an older baby, toddler, or school-aged, the mirror can be a wonderful teaching tool. While I typically prefer low-tech modes of practice, taking silly “selfies” or using apps with photo filters can also be a motivating tool!

Questions or concerns?

If you have questions or concerns about your child’s ability to imitate oral motor movements, reduced oral motor movement, or concerns regarding speech, language, or feeding development, please contact us at info@playworkschicago.com or 773-332-9439.

Sarah Lydon, MA, CCC-SLP
Speech-Language Pathologist

Photo Credit: Chayene Rafaela on Unsplash

Employee Spotlight: Ana Burgoon

What do you love most about working for PlayWorks Therapy?

PlayWorks places such an emphasis on caring for the whole child, not just teaching a particular skill, which I have found to be critical in the field of speech and language therapy. Also, you can’t beat working with a team of competent, supportive, and compassionate individuals, such as the team here at PlayWorks.

What is your favorite children’s book?

Miss Spider’s Tea Party, by David Kirk.

What do you enjoy most about living in Chicago?
My favorite thing about Chicago is living close to Lake Michigan. I also love the big buildings, being able to walk so many places, and never running out of things to do.

What is your favorite childhood memory?

I have many favorite memories related to spending time with my grandma and grandpa. One that came to mind involved attempting ballet to the sounds of a wind-up music box in my grandma’s living room. I now have the music box on my dresser and think of those memories affectionately and often. My grandpa did a series of stretches every morning and when he came to visit, I would always do them by his side.

Would you rather a mountain or beach vacation?

I do sincerely enjoy hiking, but I have to go with beach overall. I recently enjoyed a trip to California, where I was lucky enough to do both!

A proud “therapy moment”:

On my third session with a child with autism, they spontaneously gave me the biggest hug! I believe it was because they felt supported and understood that I was going to help them communicate.

What is your hometown?

Grand Rapids, Michigan!

What do you like to do in your free time?
I love exploring Chicago with my husband, heading up to Michigan to spend time with my family, taking pictures, and anything related to being outside (when it is warm enough).

What is your favorite therapy toy?
I always enjoy doing crafts with the kids – glitter pens, stickers, markers. The possibilities are endless. You can scaffold the activities to target a variety of skill levels and treatment objectives.

A fun fact about me:

I am a certified small boat sailor!

 

Ana Thrall Burgoon, M.S., CCC – SLP 

Speech-Language Pathologist

Language Milestones: School-Age Children

As your child grows, their understanding of language, use of language, and ability to use language to interact socially with family and friends will continue to expand and become more complex. It can often be difficult to know what language skills you should be looking and when you should expect them to be developed. The chart below outlines general milestones for language development in regards to receptive-language, expressive-language, and pragmatic-language.  If you have any concerns regarding your child’s language skills, please contact your speech-language pathologist.

Questions or concerns?

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

Claire Hacker MS, CCC-SLP
Speech Language Pathologist

Photo Credit: from Pixabay

A Set Routine + Family Meals = First Steps to Mealtime Success

 

 

 

 

 

 

 

Mealtime can be stressful, often with your child challenging your attempts to have them try new foods. Some days, your child may not go to the table or sit in their chair long enough to even offer new foods! However, establishing a set routine and regular meals may be the first steps to mealtime success.

What can a mealtime routine look like?

Why is mealtime so challenging for my child? And why is a routine and family meals so important?

Eating is one of the most challenging sensory activities for children. When we eat, all eight senses are working and integrating eight new pieces of information. The properties of the food change as we eat, for instance, as part of our five senses, the taste and smell changes as we chew. Additionally, our sense for self-movement and body position is working to use different amounts of jaw pressure. Our sense for balance and spatial orientation is working to re-adjust our balance as we chew. Lastly, our sense of the internal state of the body is being put to the test by requiring that we track the changes to our stretch receptors (on the stomach) to the changes to our appetite. Processing each of those sensory changes can be and is difficult for many children. Furthermore, eating is a multisensory experience; therefore, we need to help children’s sensory systems to be regulated before, during, and after meals to increase their feeding skills and sensory tolerance for new foods.

What can I do?

If your child is demonstrating some behaviors before or during mealtime and/or is a picky eater/problem feeder, consider contacting one of our speech-language pathologist or occupational therapists, who can provide your family with helpful tips and tricks to make mealtime less stressful and more fun!

Questions or concerns?

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

Jaclyn Donahue MS, CCC-SLP
Speech-Language Pathologist

Reference: Toomey, Kay A.. 2008/2010. Family Meals.

Kay A. Toomey, Ph.D. & Lindsay Beckerman, OTR/L., 2016. Explanation of The Role of Sensory Therapy In Advancing Feeding Goas.

Photo Credit: Jennifer Murray and amsw photography via pexels.com

Employee Spotlight: Kelsey Martin, CCC-SLP

What do you love most about working for PlayWorks Therapy?

My favorite part about working for PlayWorks Therapy is being surrounded by such an amazing support system. I truly view all of my coworkers at PlayWorks not only as colleagues, but friends as well! I have grown so much as a therapist due to the collaborative environment that this company creates, and I especially love how easy it is to bounce ideas off of one another to provide our clients with the best therapy possible.

What is your favorite children’s book?

My favorite children’s book would have to be “If You Give a Mouse a Cookie.” I adored this book as a child and appreciate it now as a therapist because the illustrations and plot allow for tons of language opportunities!

What do you enjoy most about living in Chicago?

My favorite part about living in Chicago is having so many family and friends nearby. I grew up in a suburb outside of the city and earned both of my degrees in the Midwest, so many of the people that I love most happen to be here too! I also love the fact that there is always something to do in Chicago, whether it be a sporting event, concert, outdoor activity by the lake, or a street festival to check out!

What is your favorite childhood memory?

It’s hard to pick just one, but I hold my memories of Christmas Eve at my grandparents’ house are very close to my heart. My entire extended family is OBSESSED with the holidays and spreading Christmas cheer, so I vividly remember how excited I always was to spend time with my grandparents, aunts and uncles, cousins, and sisters singing Christmas songs, wearing matching pajamas, and of course, eating lots of cookies. It’s been pretty amazing to see how our traditions have continued over the years as new family members have been welcomed, too!

Mountain or beach vacation?

I think I’d have to say both… I would probably pick the beach in the summer and mountains in the winter, as I love soaking up the sun and being by the water, but also am a huge fan of skiing!

Share a proud “therapy moment” with one of your clients.

One of my absolute favorite parts about working with children is that every accomplishment, no matter how big or small, is celebrated and cherished. One moment that I remember specifically was when one of my clients on the autism spectrum looked me directly in the eye and said, “bye-bye Kelsey!” Not only had he never said my name before, but I was so unbelievably proud to see this little guy initiate such an awesome social interaction!

What is your hometown?

Prospect Heights, Illinois.

What do you like to do in your free time?

In my free time, I love to spend time with my friends and family, run along the lake or attend a yoga class, cross restaurants off my extensive bucket list of places to try, and support all of my favorite Chicago sports teams! I also love to sing and play guitar, as well as sing karaoke with friends on the weekend!

Fun fact about yourself?

Speaking of singing, I once sang the National Anthem to open a Bret Michaels concert in 2013! I got to hang out with Bret for a little after the show and take some pictures, too!

Favorite therapy toy?

My favorite therapy toy, without a doubt, is my sock monkey ball popper. Not only do kids of all ages find it extremely entertaining, but it’s an amazing facilitator for language, such as asking for help and more, working on directions (up vs. down), working on body parts, and more!

Kelsey Martin, MS, CCC-SLP
Speech-Language Pathologist

Is My Child Stuttering? How to Identify Typical Disfluencies Versus Red Flags for Stuttering

As a pediatric speech and language pathologist, I often find myself listening as a child tells me, “my mom – my mom – my mom – my mom – likes green!” You may find yourself in a similar situation, waiting for your child’s response, as they repeat sounds, parts of words, whole words, or even phrases. Now, how much of that is typical? The information below will help you determine whether your child’s fluency is characteristic of their age and stage of development, or if there are red flags for stuttering present.

What is Disfluency

A disfluency is anything that interrupts the forward flow of speech. Within every person’s speech, children and adults alike, there are disfluencies present. As adults, we become acutely aware of these disfluencies during times of increased pressure, such as during an oral presentation or an interview. Even something as simple as taking a big breath, sneezing, or coughing can impact our fluency. Some types of disfluencies are typical, while some may be indicative of something more significant, such as a fluency disorder (i.e. stuttering).

So, what is typical disfluency?  

Typical disfluencies include repetitions of whole words (my – my dog is small) or phrases (can I – can I – can I go outside?). They also include interjections (um, like) and revisions (I went to the – I saw a chicken at the farm). With typical disfluency, the speaker does not demonstrate physical characteristics of difficulty, such as increased tension in their face or body.

Developmental Disfluency

Children may have periods of increased disfluency from two to five years of age, as these are years of significant expressive language development. Between these years, children often transition from using single words and two-word phrases to engaging in adult-like conversations. This is sometimes referred to as “preschool stuttering” and consists largely of the typical disfluencies outlined above. If your child is using mostly typical disfluencies in their speech, does not have negative feelings about their fluency, and does not appear to be physically struggling to complete their sentences, then it is likely typical and not cause for concern at this time.

Stuttering

If a fluency disorder or “stuttering” is present, it can lead to breakdowns in communication, which can impact your child’s participation across settings.

What are the red flags for stuttering?

  1. A family history of stuttering is present
  2. Your child is a male
  3. Your child is repeating sounds (b-b-b-ball) or syllables (break-break-fast) in addition or instead of words and phrases
  4. Your child is prolonging sounds (sssssoup)
  5. Your child has periods of time when they are trying to speak, but no words are coming out
  6. Your child appears to be tense or struggling while talking
  7. There are observable secondary behaviors present (i.e. blinking eyes, changing pitch or volume, grimacing)
  8. Your child has negative feelings regarding their speech
  9. Your child is avoiding speaking in general or speaking in certain situations
  10. Your child has been stuttering for over six months
  11. Your child has other speech and language related concerns
  12. Your child began presenting with significant disfluency after three and a half years of age

What can I do?

If your child is demonstrating some of the behaviors above, consider contacting a speech and language therapist who can provide your family with helpful tips and tricks to encourage fluency, or recommend therapeutic intervention as necessary. In the meantime, visit The Stuttering Foundation’s website for tips for talking with your child.

Questions or concerns?

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

Ana Thrall Burgoon, M.S., CCC – SLP 
Speech-Language Pathologist

Reference:

Coleman, Craig. “How Can You Tell if Childhood Stuttering is the Real Deal?” LeaderLive, ASHA, 26 Sept. 2013.

Photo Credit:Limor Zellermayer via Unsplash