From Birth to Babble: Prelinguistic Skills to Master Before Words Emerge

 

You have been told to expect your child to use “one word by one year.” Great! Does this happen magically? Are there skills you should be looking for? What strategies can you implement throughout your child’s first year to facilitate their language development? We often expect that children will just “catch on” and begin speaking. For some children, this strategy works; but for many children, they need more support. Sometimes this means seeking a full speech and language evaluation; but other times, you as caregivers can implement simple strategies to help your child gain new skills.

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Increasing Communication Opportunities for Language Learners

We’ve all been there. Your language learner is indicating they want something. They might be crying, vocalizing, reaching for, or gazing at the item of their desire. As caretakers, we often anticipate their needs and are readily available to help. In this space between their indication and your response, however, is a great language learning opportunity. Our goal is to increase language use by: capitalizing on these organic moments, purposefully creating opportunities for communication, and providing models of language. Here are some helpful tips and tricks used in speech therapy sessions that can be used in the home and out in the community: 

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Echolalia, Echolalia… What Do You Mean?

 

Like most things, the views on echolalia lie on a continuum. They range from considering its use non-functional, to tolerating it, to really accepting and celebrating it. We, as parents, caregivers, clinicians, and professionals, can facilitate further acceptance by understanding language learning differences, embracing echolalia, and educating others! 

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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.

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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.

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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.

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Green Screen Teletherapy

I spy, dinosaur hunts, and apple picking, oh my! As pediatric therapists, we have been faced with the challenge of engaging children of varying ages and diagnoses over teletherapy. Children, families, and even therapists are still getting used to this virtual format. I want to walk through some ways I have utilized green screen technology for speech therapy during my time as a graduate student clinician at PlayWorks Therapy, Inc. I have found that using the green screen technology creates a fun and engaging way to target goals, while keeping our clients’ attentions for longer periods during our virtual telehealth sessions.

How do you use green screen technology?

Green screen technology is easily utilized over Zoom (PlayWorks’ medium of delivering teletherapy).

To set up the green screen: You need a green screen, or another brightly colored background. Mine is a plastic green tablecloth hung with command hooks. Next, log into zoom. Click the up arrow in the “stop video” button on the lower left corner of the zoom window and click “choose virtual background…”. Now, in your camera view, there is a small circle in the bottom right that has a color. Click that circle, then click your mouse on your background in the camera view. This tells Zoom what color to detect as your background, so it can transfer your given image to your green screen.

To transfer activities to Zoom backgrounds: Download/export your activity in a “.jpg” format to your computer. Follow the above directions to get to the virtual backgrounds settings. Then, click the plus sign (+) to upload the background images.

What goals can be targeted in green screen teletherapy?

I have targeted my clients’ speech and language goals using elements of the green screen. I have even used the same green screen activity for clients of varying ages and goals by modifying the way I use the activity, my language level, and my prompts. Using green screen activities is a great way to create a “theme” for each week. Being fall, my clients have enjoyed a variety of fall-themed activities from apple picking to exploring a spooky mansion for Halloween.

Articulation

Articulation is easily targeted using these curated, story-like green screen activities. For example, for the apple picking activity, courtesy of “GoGo Speech”, I will have the client say their given target word 5 times, put the word in the sentence, and then we pick the apple together. You pick all the apples this way, but watch out for the worm who just might eat all our precious apples!

Language

Language goals can be targeted as well, including expanding language to age-appropriate utterance lengths, spatial concepts, pronouns, wh- questions, and more. I have used “I Spy” to practice expanding a child’s phrase length. I have used “GoGo Speech” materials for spatial concepts, where the clients must tell me where they see the chipmunk during our picnic: “is it behind me? Is it on top of the rock? In the tree?” I have used a “fall hunt” activity, modeled off of the classic “we’re going on a bear hunt” story, to target wh- questions and expressive language. The opportunities are endless!

What are some go-to resources?

My go-to resources come from a private Facebook group, entitled “Green Screen Speech Therapy”. Speech-Language Pathologists post many resources that can be downloaded, personalized to meet your client’s speech and language goals, and then added to Zoom for use during a speech therapy session. This Facebook group also has an incredibly useful video explaining how to set up a green screen and how to use it. My other go-to has been “GoGo Speech”. If you subscribe to their services, they send activities for free (and videos on how to use them) to your email inbox.

Is green screen technology only useful for speech therapy?

Other disciplines can use green screen technology to keep their client engaged and target goals simultaneously, too! This means that physical therapists, occupational therapists, social workers, and developmental therapists can use green screen resources as well.

Do I have to have a green screen to use these resources?

No, you do not. You can download the resources in a PowerPoint format. Then, share your screen during your sessions to take advantage of the same resources without having a green screen.

 

Gwen Berglind, B.S.

Speech-Language Pathology Graduate Student Clinician

 

Credits: “GoGo Speech”, “Green Screen Speech Therapy” Facebook Group

Teletherapy 101: What to Expect and Common Questions

PlayWorks Therapy Inc. is committed to ensuring your child receives quality services during this time of uncertainty and have transitioned to all online teletherapy sessions. We are looking forward to this virtual experience with you!

What is Teletherapy?

Teletherapy, also referred to as telehealth, is a type of therapy provided by your child’s therapist online through video chat, much like FaceTime, Skype, or Gchat. Although teletherapy is a new offering at PlayWorks Therapy, it is a model of therapy that has been used and researched in the field for several years. PlayWorks Therapy is remaining current with best practice and continuing to provide evidence-based therapy through this mode of therapy.

What can I expect from a Teletherapy appointment?

Depending on the type of therapy your child receives, the structure of the therapy session may differ slightly than the in-person appointments. The session itself may consist of the therapist reviewing goals and techniques with caregivers as well as assisting in choosing appropriate toys, games, and materials to target those goals. The therapist would then provide recommendations for how to use each material, including specific prompts to use throughout the activities. We realize that your child may not be as engaged or motivated to sit in front of a video so we require a parent or caregiver to be present or nearby for the majority of the session.

Will this really be a productive mode of therapy for my child?

Many providers have been using teletherapy as their primary mode of therapy over several years with success. Because the structure may look different than usual the in-person appointments, our expectation of what makes a “productive” or “successful” session may also change. Your child’s goals may shift slightly in this period but just know that every and any interaction your child has with their therapist informs their continued work. With a strong partnership, both the therapist and caregivers can use techniques with the child to reach targeted goals.

Won’t it be awkward that my child and the therapist are in different rooms?

At first, some children do find it slightly awkward or uncomfortable to work with therapists virtually. Below are strategies we recommend trying to increase your child’s comfort level with this new type of appointment:

  • Find a space that works for you and your child. This does not need to be the quietest or cleanest room in your home; however, be mindful of the visual distractions (e.g. toys, games) in the room as this may affect your child’s attention. We recommend that you choose a favorite place or comfortable space you usually spend time in as this may help your child with the transition.
  • Help your child settle in by allowing them to have a favorite toy or other comforting object with them.
  • With supervision, allow your child understand the technology by gently touching the screen and exploring the different functions, provided by the therapist.
  • Check in with others in your home to see if they want to be present or out of view for the session and ultimately let your child know who will be with them.

I’m not great with technology. Will this be challenging to set up?

In most cases, your teletherapy appointment will take place on a website or app platform. Your therapist will communicate with you about your child’s specific platform, and whether or not to download an app, based on what type of therapy they receive. Your therapist will then send you a confirmation email with the link and any other information you will need to access the appointment. It will be as simple as opening your email and selecting the link! You will then be directly connected to your therapist’s video chat.

I am in the appointment, but now I am experiencing a problem with the connection.

Below are technology tips to help you get the most of your therapy sessions:

  • Be sure to switch on audio and video settings at the start of the session.
  • Confirm a plan with your therapist in case the connection is abruptly ended.
  • Check the use of additional devices. Streaming or heavy use on another device at the same time as your session may slow your connection and video quality.
  • Having multiple tabs open on your device may also impact video quality.
  • If possible, try not to sit in front of a bright window or light.
  • Let your therapist know if you cannot see or hear them clearly – we want you to get the most of your session!

Questions or concerns?

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

Amanda Deligiannis, MSW, LSW
Licensed Social Worker

Photo Credit: GSCSNJ via photopin.com

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