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

What’s Inside the Mystery Box?!

Let’s make a mystery box!

It’s no mystery that families and children been spending more time at home than ever before. When we are constantly surrounded by the same scenery, including the same toys and games, it can be difficult to brainstorm ways to mix it up (without constantly rushing to the store or clicking ‘buy now’ on Amazon).

As a pediatric therapist, I am always seeking new ways to turn every day household items into fun, motivating, and enriching toys. I’ve found that some of the best toys are not ‘toys’ at all. One of my favorite non-traditional toys is a do-it-yourself mystery container/box!

This language-rich activity is appropriate for children at every developmental stage AND it only requires a few common household items. There are endless outcomes, variations, and possibilities with this activity!

Materials

  • An empty box or container (plastic flower pot, clean mini trashcan, big bowl, toy bin)
  • A short sleeve t-shirt
  • A rubber band to secure the t-shirt (optional)
  • Small items from around your home

Directions

  1. Collect the materials
  2. Pull the t-shirt over the top of the box/container, so that one of the sleeves lines up with the top or opening of the container.
  3. (Optional) Secure the t-shirt onto the box/container with a rubber band
  4. Place objects from around your home into the mystery box/container through the sleeve hole at the top. Choose objects that are safe to the touch- avoid sharp/pointed items.
  5. Take turns reaching inside of the mystery box. Encourage your child to use his or her hands (or even feet!) to feel the objects in the box/container. Ask your child to pull the objects out. *BONUS: Create a silly song to sing while you pull objects out! This song is to the tune of “Mary Had a Little Lamb”

What’s inside the mystery box?

Mystery box, mystery box

What’s inside the mystery box?

I wonder what we’ll find!

 

How to target speech, language, and social development during this activity:

  • Play ‘peek-a-boo’ with objects in the box! After modeling this phrase a few times, pause and wait for your child to fill-in-the-blank. Encourage your child fill-in-the-blank with the object label by modeling the phrase “It’s….a…”. Pause, look expectantly at your child, and wait for him/her to fill-in the blank.
  • Increase your child’s eye contact and joint attention by holding the box and objects by your face! Tickle your child with the objects or place box on your head to increase shared attention.
  • Encourage your child to follow 1-2 step directions (grab the bear, then put it in the box; pull a soft toy out of the box). If your child needs extra support, provide a model or use gestural cues to show your child how to follow the direction
  • Model grammatically correct phrases and sentences throughout the activity. Label and describe what you feel, see, and hear. Incorporate different word types into your models, including:
    • Exclamations (uh oh, wow, ooooh!)
    • Object names (box, bear, shoe, stick, spoon, playdoh)
    • Pronouns (my, your, his, hers)
    • Action words (shake, pull, feel, reach)
    • Location words (in, out, under, up, down)
    • Descriptive words (big, little, hard, soft, squishy, smooth, bumpy)
  • Practice turn-taking by taking turns reaching inside of the mystery box. Identify whose turn it is by pointing and/or using turn-taking language (It’s my turn! Now, it’s your turn!). Encourage your child to wait and watch while you take a turn.
  • If your child is working on specific speech sounds, place objects in your mystery box/container that contain the target speech sound in the object label. Each time your child pulls an object out, you can practice the target word 5x together! For example, if your child is working on the “b” sound at the beginning of words, you can include objects such as a ball, bird, balloon, bib, baby, bell, banana, etc.
  • Ask your child to guess what objects are inside based on what he/she feels! Once the objects are out of the box, compare and contrast how the objects feel and look. Make a list of similarities and differences between the objects.
  • Sort the objects into categories based on color, shape, size, or object function (things you eat, things you wear, animals, vehicles, etc.)

Not only is this activity great for building language, but it also targets many occupational therapy skills, such as the ability to discriminate and identify objects based on touch without the use of vision, increasing focus and attention on the hands and the sensory system, and increasing impulse control (as your child has to wait until he/she finds the right objects, via touch, before pulling it out of the box).

 

Questions or concerns?

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

Nicole Sherlock, MA, CCC-SLP
Speech-Language Pathologist
Photo Credit: Nicole Sherlock

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

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

Valentine’s Craft Ideas!

Valentine’s day is approaching, and love is in the air! Here are a few fun craft ideas for you to make with your littles while working on their language development!

Heart Man:

Supplies:

Red paper, white cardboard, black marker, googly eyes, scissors, glue

Instructions:

  1. Cut out one large heart and four small hearts from the red paper.
  2. Fold the white strips of paper like an accordion. Glue two strips for arms and two strips for legs.
  3. Create a face for your heart man! Glue two googly eyes and draw a mouth!

How to target language?

  1. Expressive language: Talk about body parts when making/gluing the eyes, mouth, legs, and arms.
  2. Receptive language: Following multi-step directions (e.g., “First, put on eyes, then draw mouth”).

Valentine Mailbox

Supplies:

Tissue box, wrapping paper, stickers, markers, candy and/or envelopes

Instructions:

  1. Cover the empty tissue box with wrapping paper.
  2. Decorate your tissue box with stickers, markers, pom poms, etc. Get creative!
  3. Deliver candy and/or Valentine’s cards to other mailboxes!

How to target language?

  1. Expressive language: practice “mail”-related vocabulary, such as card, send, mailman, mailbox, write, letter, and stamp
  2. Receptive language: understanding pronouns (e.g., “put the candy in her mailbox” or “put a card in theirmailbox”)
  3. Pragmatic language: role play social exchanges as you deliver letters to loved ones

Friendship Necklaces:

Supplies:

Craft foam, yarn, scissors, hole punch, beads

Instructions:

  1. Cut a small heart out of the craft foam.
  2. Punch a small hole into the top center of the heart.
  3. Thread a 2-3-foot piece of yarn through the hole.
  4. Add the beads of your choice and tie a knot on the top!

How to target language?

  1. Expressive language: using prepositions (e.g., “on the string,” “in the heart”)
  2. Receptive language: following directions to put different beads on the string

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

Bilingualism: Can a child with language delays learn two languages?

As a speech-language pathologist and Early Intervention provider, I frequently work with families who speak more than one language. While there is plenty of research on the benefits of bilingualism on children’s language development and cognitive skills, there is often confusion regarding the impact of two languages on delayed language learners. This blog aims to address frequently asked questions by bilingual families to guide language use inside and out of the home.

Question: My child has been exposed to two languages since birth. Has this caused his/her language delay?
Answer: Bilingualism itself will NOT cause a language delay. In fact, research shows that bilingualism may lead to long-term advantages, such as increasing vocabulary and problem solving skills. Birth-to-three years of age is the critical period for language acquisition, meaning that this is the easiest time in childhood for children to learn a second language.

Question: My child has a language delay. I’m afraid that a second language will confuse him/her. Should I stop speaking a second language to my child?
Answer: Definitely not! It is encouraged that bilingual families continue to speak both languages to their child and that this is carried over across settings (e.g., school, playgroups, etc.). Children with language delays can learn to speak two languages if given the appropriate supports and opportunities.

Question: My child is two years old and not yet speaking. He’s exposed to both English and our native language at home, so this is okay, right?
Answer: While children simultaneously exposed to two languages may say their first words a bit later than monolingual children, they are still expected to learn language at roughly the same rate. If your child is two years old and not yet producing words, he or she should be referred for a full speech and language evaluation.

Question: How can I support bilingual language acquisition in my child?
Answer: Some families choose to have one parent solely speak one language and have the other parent solely speak the other language. Some families decide to have parents speak both languages and use them interchangeably. Either way is fine, but it is important to consider what feels the most natural for you and your family!

What’s the takeaway?
There is NO scientific evidence that living in a bilingual household will negatively impact the language development of children. Furthermore, children with language delays CAN learn two languages with consistent, rich exposure to both languages.

Questions or concerns?
If you have questions or concerns about the impact of two languages on your child, please contact us at info@playworkschicago.com or 773-332-9439.

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

References:

Lowry, L., & Speech, H. C. (2012). Can children with language impairments learn two languages?. The Hanen Centre.

Photo Credit: 4dgraphic via unsplash.com

Language Milestones for Children with Down Syndrome (Birth to Five)

Birth to five years of age is a critical period for language development for all children. Each child progresses at his or her own rate, and each presents with his or her own strengths or weaknesses. The same applies to children with Down syndrome. However, children with Down syndrome tend to develop language skills at a slower rate than their typically developing peers. This blog will aim to answer questions regarding language development in children with Down syndrome by comparing language milestones to those of their typically developing peers.

While the milestones above are based on general trends, it is important to note that language development will vary for both typically developing children and children with Down syndrome. Speech therapy is recommended for children with Down syndrome, starting younger than one year of age to target feeding and oral-motor skills and after 15- to 18-months of age to target speech and language skills. Common early speech and language targets for children with Down syndrome include verbal turn taking, vocabulary acquisition, use of simple signs and gestures, following simple routines-based directions, use of age-appropriate speech sounds, and more.

Questions or concerns?

If you have questions about language development in children with Down syndrome, please contact us at info@playworkschicago.com or 773-332-9439.

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

Reference: Layton, T. (2004). Developmental Scale for Children with Down Syndrome.

Photo Credit: yulia84 via pixabay.com

Let’s Play! The Stepping Stones to Verbal Communicators

If you are a parent of a toddler receiving speech and language therapy, you may have noticed your child’s therapist playing games such as peak-a-boo, and wondered to yourself, “What do these games have to do with learning to talk?” While learning to talk is of course the ultimate goal in speech and language therapy, there are actually many skills a child needs to develop before they are ready to start talking. Some of these skills include joint attention, turn-taking, and responding to people and their environment, among others. One of the best ways to support acquisition of these pre-linguistic skills is to engage in social games with your child.

What are social games and why are the important?

Social games are people-based in that they are interactive games between you and your child rather than the use of toys. Examples include peek-a-boo, songs with corresponding actions, hide and seek, tickles, etc. Engaging in social games with your child will help to develop their interaction, communication, and social skills. Through social games, children learn to pay attention to others, anticipate what will happen next, and imitate actions. Additionally, through these games children learn important skills such as how to take turns and connect with others. These pre-linguistic skills are the foundation of verbal language. For example, a child who has difficulty using joint attention, which is shared attention with another person, will not have as many opportunities to learn about their environment from the people around them. Additionally, a child who is not using turn-taking will have difficulty understanding the back and forth nature of conversation. Through acquisition of these pre-linguistic skills a child becomes ready for communication and verbal language use.

How to play and what to look for?

You will want to engage in social games repeatedly so that your child learns the routine. For example, if you play peak-a-boo with your child play it over and over again and look for your child learning the game. You may notice that they have learned the game once they start to smile or laugh in anticipation of you saying, “boo!” Over time, you might see your child’s initiation skills emerging when they cover their eyes with their hands or cover themselves up with a blanket to request playing a peek-a-boo game with you. Eventually, you can try to pause after “peak-a…” and see if your child can fill in the word, “boo!” Once your child has learned the routine they will be able to anticipate what is going to happen next.

When thinking about your child’s language development it is important to remember that there are many steps that come before talking and children must master pre-linguistic skills before they can be successful with verbal language. So, when think you are just “playing” remember that you are actually teaching your child foundational skills to become an active learner and communicator!

Questions or concerns?

If you have questions or concerns about the importance of social games and 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

Speech and Language Opportunities on the Road

Looking for some ways to work on your child’s speech and language while in the car?

Stuck in gridlocked traffic is not fun, but you can make it a little more interesting by working on your child’s speech and language skills while in the car! Below are some easy ways to work on your child’s speech and language development that do not require a phone, iPad, or any physical toy. Reduce the noise in the car and tune into your child during your next drive!

12 months to 24 months

-Sing songs! Some great songs to sing include Twinkle Twinkle Little Star, Row, Row, Row your Boat, Old McDonald, Five Little Monkeys Jumping on the Bed, Itsy Bitsy Spider, Wheels on the Bus, BINGO, Baby Bumblebee,If You’re Happy and You Know It, andBaby Shark.” As your child gets older you can leave out words at the end of phrases (“…Twinkle twinkle little _____”) to see if your child can fill them in!

-Model environmental sounds like “wee, woah, uh-oh, vroom, beep-beep” while driving. Make your sounds exaggerated and silly to capture your child’s attention!

-Name things you see during your car ride! Label objects you see as you pass them by.

-Phrase “Ready, set, ____ (go)!” when you start/stop at a red light

-Make silly sounds as you drive to see if your child can imitate you

24 months to 36 months

-Continue to name things you see during your car ride! If your child labels something they see as you are driving you can expand on what they say. For instance, if your child said “truck” you can model “red truck.”

-Model simple location phrases such as “in, on, under.” For instance, “doggie inwater” or “car onroad”

-Target basic concepts:

-Model the words “open/close” and “in/out” as you open and close doors and get into or out of the car

-Model a variety of action words as you drive such as “go, stop, drive, park, turn”

-Look for and identify objects that are “big” vs. “small”

-Work on quantity concepts as you drive, such as onecloud vs. manyclouds in the

-Talk about the colors of cars around you

-Talk about the types of cars you see (e.g., semi-trucks, cars, construction vehicles)

3 years to 4 years+

-Play “I spy” to work on labeling and naming things that you see and drive past

-Model more complex adjectives and more advanced location concepts as you drive.

-Ask your child a variety of wh-questions while driving such as “Where are we going?, What are we doing?, When did we leave?, What are we doing when we reach our destination?, What is mom/dad doing?, What are we making for dinner? Why are we going grocery shopping, etc.” If your child responds with a single word see if you can give them two choices or model a longer phrase. If they use vague and non-descript language such as “this, that, right here, etc.” provide them with two choices to see if you can promote your child’s use of more descriptive language.

-Play the Grocery Storegame: Have an adult start. “…I went to the grocery store and I bought _____ (apples). See if your child can repeat the item just said and add one to it. For instance, “I went to the grocery store and I bought apples and stickers.” You can provide hints if you don’t think your child can recall what was said last. When it’s too hard start again from the beginning!

-If your child is working on speech sounds you can practice their sounds in the car! Pick several words with the target sound and say it every time you stop at a red light or every time you see a certain object or item such as a tree.

-Tell your child that you’re thinking of an object that starts with a certain sound such as “b.” See if your child can think of things as you drive that start with that letter.

-Promote appropriate grammar and sentence structure. If you notice that your child made a grammatical error model their sentence with correct grammar and sentence structure.

-Talk about letters or numbers you see on license plates

-Talk about categories (e.g., types of transportation that you pass, types of weather, types animals you see, etc.)

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

Photo Credit:Sandy Millar via unsplash.com

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