Causes of speech and language disorders: Some answers to parent’s “why’s”

When parents walk through our door, they often want to know ‘WHY’ their child is not understanding and talking like other children; ‘WHY’ they aren’t pronouncing sounds like others; or ‘WHY’ they’re stuttering. Listed below are some factors that are known to predispose or precipitate speech and language disorders.

Neurological factors: Specific areas in the brain control our speech and language functions. Understanding what others say to us, expressing our thoughts and needs, remembering details of what was said, reading, and writing are all controlled by regions in the brain. There is evidence in the literature to suggest that children with language disorders may have a neurological involvement contributing to their speech and language difficulties. This means that there may be obvious or subtle differences in the brain which makes the child susceptible to a language disorder. No one pattern of brain architecture has been consistently shown in all individuals with language impairments, which makes this all still a bit of a mystery.

Motor and Sensory factors: Our senses serve as channels for us to perceive the external environment. Be it our sense of vision, hearing, touch, taste, and smell; they offer us with different ways to perceive things from the external environment. If any of these senses are not functioning optimally, it would limit the essential information that we receive from our environment. For example, children with vision or hearing problems will not be able to use those senses to see by reading, or hear someone speaking in their environment, making them more susceptible to a speech or language disorder. Having adequate motor skills is also essential to speech and language development. Early on, children move around and explore their environment. This exploration fosters early language and cognitive development as they are exposed to new ideas and vocabulary. Children who have limited motor abilities may be at a disadvantage because of not being able to actively explore their environment. Adequate motor abilities are also required for the movement of the voice and oral structures (lips, teeth, tongue etc.) required for speech. Thus, any difficulty with speaking movements may impact a child’s speech and language development.

Cognitive: Intact cognition (the ability to think, know, perceive, judge, reason etc.) is an important foundation on which we build our speech and language skills. Vice versa, developing our speech and language skills helps us improve our cognitive abilities. Hence, children with cognitive challenges may be at risk for developing speech and language disorders. These children may have trouble associating different words with their meanings, remembering words, recognizing patterns and sorting words into different categories, and learning new concepts in general.

Genetic factors: Speech and language disorders tend to run in families, suggesting a possible genetic involvement in causing these disorders. However, it is also true that many people with speech/language disorders’ children do not have any difficulties, and that children with speech/language disorders have no family history of it in the past.

Environmental factors: Environmental information is key in fostering speech and language development. Providing a language rich environment with an adequate amount of stimulation is necessary to support children in developing age-appropriate speech and language skills. Children who have a less language rich environment and stimulation may be at risk for developing speech and language disorders.

Acquired factors: Some individuals may acquire speech and language skills as per typical milestones and then lose some of these skills due to an acquired injury or illness. Some examples of these include a traumatic brain injury, infections such as meningitis, tumors, strokes, etc.

It is important to note that this list is not exhaustive, but is an overview of some of the reasons we may see speech-language disorders.

If you are concerned about  your child’s speech and language development, see a Speech-Language Pathologist to address your concerns.

Nisha Balakrishnan M.A. SLP, Reg. CASLPO

Speech-Language Pathologist

 

The Speech Therapy Centres of Canada

www.speechtherapycentres.com

 

Reference: Paul, R. (2007). Language Disorders from Infancy through Adolescence- Assessment and Intervention. (3rd ed.). St. Louis, Missouri: Mosby Inc.

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Social Communication – What does it Really Mean?

Think back to a recent cocktail party you attended with distant relatives or unfamiliar co-workers in a new job setting…did you dread getting ready for the event? Did you feel awkward trying to start a conversation with your distant Aunt? Did you feel your heart pounding faster and harder as your new boss approached? Welcome to the world of many adolescents and adults, especially those on the Autism Spectrum or with an Acquired Brain Injury (ABI). Similar to those cocktail parties, social settings that require conversing, initiating  and keeping conversations going can lead to feelings of anxiety, anger, confusion and even depression.

At the center of all our interactions lies the foundation of communication: to flourish academically, to build successful friendships, to develop professional relationships, and to create intimate bonds with our partners. However, the fundamental requirements of successful social communication are far from basic.  One must have: the motivation to interact, be aware of their surroundings and how to modify them appropriately (eliminate distractions), recognize their own intentions, have the flexibility to shift perspectives, understand the “hidden”
social conventions appropriate to different contexts, and formulate their  response in an organized manner.

A Speech-Language Pathologist works with individuals who have difficulties with social communication using a one-on-one direct model, or through group programs. You start increasing your or your child’s communicative competence by:

• Anticipating topics and/or vocabulary that will come up during the social interaction. Predicting conversational topics allows you to prepare ahead of time and thus increase your social confidence. E.g., if you or your child is going to a sports event;
  research about the teams, rules, scores, and players or if you will be attending a work conference; read about the lectures ahead of time and familiarize yourself with the content of the day.
• Using ice breakers that you find helpful in starting conversations, such as “it’s a beautiful day today” or “how is your day going?”
• Practicing the tricky skill of making small talk. You can do this in the car on the way to an appointment, in a coffee shop or even at the dinner table.
• Using surrounding context to guide the conversation, especially when stuck on what to say next to keep the interaction going. For example, if you or your child are at a baseball game, comment on their favourite player, the uniforms, a great pitch. If you are at a wedding, comment on the bride and groom, the food, their opinion of the band.
• Shifting the conversation back to the speaker. Many clients with ABI dread answering questions about their accident or the details of their recovery. Instead of going into detail, briefly state how you are doing and then divert the conversation back to the partner, for example, “I am doing well, thank you. I heard you started a new job, and how is that going?”

These are a few tips that can help build communicative competence. If you are concerned about someone’s social communication skills, speak with a Speech-Language Pathologist for additional suggestions, recommendations and/or strategies.

Ashleigh Wishen,
M.H.Sc. S-LP (C)
Speech-Language Pathologist, Reg. CASLPO

The Speech Therapy Centres of Canada

www.speechtherapycentres.com

 

Back in School

With the start of a new school year already upon us, here are some activity ideas to help you and your kids as they get back into the grind.

By incorporating activities for listening, language expression, reading and writing into your daily routine, and creating a language-literacy rich environment, you can help ensure smoother transitions at school.

Simon Says: This is a great game to sharpen your child’s listening skills. This game can help to improve verbal attention, following directions, language processing skills, and self-regulation. You can increase the difficulty level of the game based on your child’s skill level.  You can also incorporate multi-step directions (e.g., ‘Simon says take your back pack, put on your shoes, and wait in your seat’); opposites (e.g., ‘Simon says do the opposite of walk’); negatives (e.g., ‘Simon says don’t clap’); rhyming (e.g., ‘Simon says tell me a word that rhymes with bat’); segmenting words into syllables (e.g., Simon asks you to clap for the word potato’)…The possibilities are endless!

Shared book reading: Set aside some time for shared book reading. Look through the book with your child and encourage them to tell you the story. Encourage your child to read the words if the book is at their reading level. Encourage them to use the pictures in the book to support their story narration. Ask them to predict what will happen next in the story. Retell the story to your child including important details. Ask your child to recall the main ideas, main characters, and the plot of the story. Ask your child to make inferences about the feelings of the characters and other events in the story (e.g., How do you think she feels? Why does she feel this way? What would make her feel better?)

 Name-Place-Animal-Thing: Here’s a fun group word game that stimulates
vocabulary and targets literacy skills. Ask one person in the group to call out
a letter of the alphabet. All the members of the group then take a couple of
minutes to write down a ‘name’, a ‘place’, an ‘animal’, and a ‘thing’ that
starts with that letter. When all members in the group have finished writing
down all four fields, each one calls out their list. Participants will get full
credit for any responses that don’t overlap and half credit for any overlapping
answers. You can build on to this game, and have your child identify the
‘category’ the ‘thing’ belongs to. Have them add on one more member to that
category. Give them an opportunity to describe how the members of that category are related. You can further expand this game to include adjectives and verbs as well. Encourage your child to think of synonyms (words with similar
meanings-e.g., scold, yell, shout) and antonyms (opposites-e.g., angry vs.
happy).

Young writers in the making! What did your child do this summer? Travel to a new and exciting place? Watched a movie that they’ve been waiting for forever! Encourage your child to write about it. If they travelled to a new place, enrolled in a summer camp, visited some exciting local attractions, ask your child to write about it in a descriptive paragraph. Start with brain storming ideas together. Support your child’s writing with a topic and conclusion sentence (e.g., Topic sentence- ‘This summer, I had a lot of fun’. Conclusion sentence- ‘I can’t wait for another fun-filled summer next year). Watch them as they write. If you see them struggling with their spelling, encourage them to sound out the sounds in the words and to come up with ‘possible’ spellings (e.g., conclusion,
conclution, conclushan). Discuss what is an ‘accepted’ spelling (e.g., conclusion). Once they have finished writing, encourage them to check their work. Provide them with guidelines for checking: Punctuation (i.e., periods, commas, question marks), Capitalization, Spelling, and Articles (and, the, an).

 Nisha Balakrishnan M.A. SLP
Speech-Language Pathologist, Reg. CASLPO

 

The Speech Therapy Centres of Canada

www.speechtherapycentres.com

 

How to Help People With Communication Disorders in the Community

Last week I was in Tim Horton’s when I saw a man trying to order a coffee but he was struggling because of a communication disorder. He was having a difficult time being understood by the Tim Horton’s employee and needed help getting his money out of his wallet because of physical difficulties. Although the people around him – both the employee and bystanders – all seemed to want to help the man they were all hesitant and did not seem to know what to do or how to help this man.

One of our jobs as speech-language pathologists is to advocate for those with
communication disorders.  As part of that we try to increase awareness and knowledge on how to interact with people in the community who have various communication disorders. This may include people with disabilities (cerebral palsy, developmental disorders), people who have had a stroke or head injury, people with dementia (such as Alzheimer’s), people who communicate with assistive technology/computers, or people with speech that is difficult to understand. Here are some communication tips that you can use with almost any kind of communication difficulty:

First and foremost – always be respectful and ask the person if they would like your assistance! Remember: a communication disorder does not mean they are unintelligent!!

To help the person understand you:

• Keep your messages short and to the point (for example: say “Do you want help?” not “I noticed you’re trying to order and I thought that I could help by…)
• Wait! They may need more time to process the information
• Keep your message short but grammatically correct so they do not feel that you are insulting them (for example: do not say you….help….get….coffee??”)
• Repeat if necessary or try to say your message in a different way
• If they are still having difficulty understanding you, use gestures (pointing to objects or locations) or use objects around you (if they don’t understand “what size coffee do you want?” show them the different sized cups)
• If open ended questions are difficult (“what do you want?) give choices (“do you want a drink or something to eat?” “do you want coffee or tea?”)

To help the person express themself:

• Give them specific feedback on what you did not understand. Instead of just saying what?” try saying  “you want a coffee, what do you want in it?”
• As explained above – if they are still struggling have them gesture, use objects around the room, or give them choices
• If they are using assistive technology – wait for them to finish creating their message. Avoid reading their message over their shoulder or guessing what they might be saying.
• Most importantly – be patient, give them time, and don’t give up!

Carla Montgomery, M.H.Sc. SLP(C)
Speech-Language Pathologist, Reg. CASLPO

 

The Speech Therapy Centres of Canada

www.speechtherapycentres.com

Bullying

When I was a kid I had a pet hamster, that I adoringly named Grover. Unfortunately, I was not able to produce my /R/ sound, so Grover shortly became known as “Gwova.” By being teased and imitated at school, I quickly learned what other people heard when I spoke… and I was very embarrassed about my speech. Looking back years later, I consider myself to be incredibly fortunate that this teasing did not lead to bullying, but sadly not the case for most children.

It has been a goal of mine, since becoming a speech-language pathologist, to not only work on the communication difficulty itself, but to target self-esteem. Speech-language pathologists often find themselves faced with the bullying epidemic. They may work in schools, where most bullying typically occurs, or they may work outside of schools, but with students that are frequently susceptible to bullying, for example, children with communication, developmental, and/or social difficulties.

A professor from Pennsylvania State University, Gordon Blood, has done extensive research on bullying and feels that speech-language pathologists have a role in managing and reducing social bullying. Examples of social bullying are: a child not being allowed to join a game, to participate in conversation with peers, or becoming the subject of teasing or negative gossip, in turn causing children to experience emotional and/or academic difficulties. Blood says, “In all bullying, there’s intent to do harm, and a perceived power imbalance.” Speech-language pathologists are in a position where they can often have a strong role in restoring the balance of power that is disrupted in bullying. Instead of encouraging a child to ignore the problem, or pretend not to be bothered, it is recommended that professionals, such as speech-language pathologists, teachers, and parents do the following: 1) Listen to the child. Give them non-interrupted time to speak. 2) Praise the child for discussing the bullying – it can be incredibly hard for children to talk about. 3) Encourage the child to build his or her social network – one or two friends is all most children need to stick up to a bully.

Remember that the common goal for children that experience bullying is to develop their confidence enough to overcome bullying before it has negative effects on their learning and health.

Information obtained from Speech-language pathologists positioned to help victims of bullying, January 7, 2011, written by Gordon Blood, Ingrid Blood, Michael Boyle, and Gina Nalesnik from Pennsylvania State University.

Written by:

Michelle Cameron, M.H.Sc. S-LP(C)

Speech-Language Pathologist, Reg. CASLPO

 

The Speech Therapy Centres of Canada

www.speechtherapycentres.com

 

Speech-Language Therapy in the Movies

As speech-language pathologists (SLPs), my coworkers and I were all excited to see an SLP hold a prominent role in a movie when “The King’s Speech” hit theatres last winter. All of the sudden other people had an interest in a movie we wanted to see!  Little does everyone know we have a few other favourites that circulate around our water cooler conversations, not because they deal specifically with our profession, but because they feature the people we work with.

One of my personal favourites is “Autism: the Musical”.  This is a documentary which follows five children with Autism who take part in a project to write and perform their own full length musical.  Under the guidance of one mother’s vision and many parents determination, the musical allows these special kids to explore their creativity and show off their talents.  As an SLP I loved watching it to get some perspective on thinking outside the box to help children with autism realize their potential and showcase accomplishments.

Another movie I recently stumbled across is called “Wretches and Jabberers.”  It’s the story of two grown men with autism, Larry and Tracy, who embark on a world tour to advocate for people with disabilities.   Larry and Tracy communicate by typing to augment their speech. On their journey they meet
others who use similar forms of communicating. In the SLP world this is called AAC (Augmentative and Alternative Communication) and the movie is a great example of how AAC can be used to open up a world of communicating.  Larry and Tracy’s views are profound and often poetic. I highly recommend it.

Jana Zalmanowitz, M.Cl.Sc.

Speech-Language Pathologist (C)

 

The Speech Therapy Centres of Canada

www.speechtherapycentres.com

Social communication and bullying

Social communication is the way that we relate, understand someone else’s perspective, make connections and develop meaningful relationships. Being able to communicate effectively is vital to being a part of the world around us and
feeling included. For many children delays in social communication, even the
slightest and most subtle delays, can wreak havoc on their ability to
participate in peer games and interactions on the school yard.  For many children being included is much more important than their grade on the last math test. Feeling lost in a social environment can leave children feeling alone and can have negative impact on their self-esteem putting them at risk for bullying. Speech-Language Pathologists can offer strategies to help students develop social communication skills. Depending on the child’s age, focus may be on conversational skills such as starting a conversation and turn taking, or non-verbal skills such as understanding facial expressions and emotions. Understanding someone else’s perspective, learning how to deal with negative communication in a constructive way and discovering the nuances of peer interactions can help give your child the right strategies to join in.  Having
strong social communication skills leads to increased confidence in social
settings making interaction with peers easier and more enjoyable for your
child. Social communication may be the link your child needs to make those
connections on the playground.

Stephanie Mathias

Speech Language Pathologist

The Speech Therapy Centres of Canada

http://www.speechtherapycentres.com/

Just Give Him the Toy!

 

Many children with Autism Spectrum Disorders (ASD) have what the medical model calls “repetitive or restricted interests.” Although these interests, fascinations, or rituals may seem “strange” to us, they offer the child sensory stimulation and relief. Allowing your child to engage with his or her special interest, whether that is magazines or bottle tops, provides them with a sense of calmness.  For example, sitting in solitude is their oxygen, it helps block out negative thoughts, eases their anxiety from the day and provides a sense of predictability that they need.

Often parents believe that by giving their child this special interest (book, stamps, train) they are “giving in” to them and losing control. Instead, we should shift our mindset to thinking that this interest gives us something to work with- a motivator.

The following are some ideas for incorporating special interests into day to day activities (using the example of trains):

• Take out all the trains  you have at home and make it a counting activity,
• Have your child sort through a pile or trains, finding the ones that are the same or different,
• Draw pictures of trains, commenting on what you see (E.g. “I spy…”),
• Make a mystery bag of trains where your child has to reach in the bag and describe what he/she feels and when he/she takes it out describes what he/she sees,
• Use the trains to work on goals such as prepositions. Hide the trains between, on top, beside, inside and under  furniture and walk around the house together giving clues where the trains are hidden (E.g., under the desk, between the books),
• Create a schedule to outline what he/she will be doing that day and cut and paste trains on the schedule to make it more visually appealing, and
• Read a book together with characters that are trains or other modes of transportation he/she enjoys.

These are only a few ideas using trains; however these examples could be applied to many different interests. Be creative and have fun! Use your child’s strengths to motivate, facilitate and engage them in activities!

 This blog was inspired from a lecture given by Temple Grandin at the Geneva Conference for Autism, November 2010.

Written by: Ashleigh Wishen, Speech-Language Pathologist, The Speech Therapy Centres of Canada Ltd.

WHY GROUP THERAPY?

For years we have been hearing about the benefits of private one-on-one therapy and need for individual support, however recently there has been a lot of talk about group therapy. Why choose group therapy for your child? How will your child get the attention they need if there are other children around?

Group therapy is a functional way of helping your child learn new things and practice their goals in a realistic setting. For example, if you are training to become a professional swimmer you can weight train and go for daily runs but the true test is when you get in the water and race alongside your competitors. Group therapy takes on a similar path. It is important to get the one-on-one support you need to gear up for the real world but mastering and transferring your goals to the real world takes place when you practice what you have learned outside of one-on-one settings. We all know therapy rooms with two people, free of distractions are quite different from our childrens’ classrooms, play groups and birthday parties.

What group therapy offers:

• Modelling and support and from a registered Speech-Language Pathologist to help your child reach their goals

• Support from peers and building of confidence through newfound friendships

• Peer communication within a realistic social settings

• Practice in a setting that mimics a real world environment (a classroom, play date with friends)

• The ability for your child to teach and learn from others

• Cost efficiency

Whether group therapy is targeting social communication (turn taking, staying on topic, initiating conversations) or building language skills, it is an exciting way to help children reach their full potential. Group therapy offers a supportive network and trusting environment where children can grow with and from each other.

Written by: Ashleigh Wishen, Speech-Language Pathologist, The Speech Therapy Centres of Canada Ltd.

WHAT ABOUT ME?

Sibling rivalry and jealousy is common in all families. But when it comes to dealing with siblings of children with Autism Spectrum Disorder (ASD), stresses can be far more complex.

Many siblings, especially those of children with ASD, feel that the focus is always on their brother or sister. Even the idea of a sibling coming for therapy may make the sibling not in therapy feel as if their brother or sister is more “special” than they are. After all, they get to go to appointments and play with toys!

Below are a few tips to help the jealous sibling be more understanding:

1. Give your child(ren) insight into their sibling’s world. Explain why their brother or sister acts differently than them, remembering to highlight all the things that they also have in common.

2. Create activities where the sibling(s) can “lead” to make them feel important. Encourage their brother/sister to join in or sit with them and read them a book.

3. Designate 5-10 minutes of every day to spend exclusively with each child. Talk about their day, and provide examples of how they have helped or guided their sibling.

Children that have siblings with ASD are exposed to many complicated issues that most people have never come into contact with, and as a result may have many difficult questions they want to ask. Assist them through the journey. Let them know that their sibling looks up to them, regardless of the age difference, and allow them take an active role in their sibling’s development.

Recommended books:

“All About My Brother” by Sarah Peralta

“Sometimes my Brother: Helping Kids Understand Autism Through A Sibling’s Eyes” by Angie Healy

Written by: Ashleigh Wishen, Speech-Language Pathologist, The Speech Therapy Centres of Canada Ltd.