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

 

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

 

Make ‘Bath Time’ ‘Language Therapy’ Time!

When life gets busy it can be hard to find time to work on your child’s early language skills BUT you can enhance your child’s communication during everyday activities that you’re already doing!  Here are some tips on how to facilitate communication during bath time.

• Being face to face with your child is important and bath time is an easy way to ensure you’re in this position when playing and talking
• Follow your child’s lead – talk about objects they are already interested in or are already playing with instead of trying to introduce a new toy or game
• Wait and pause to give your child a chance to communicate
• Use lots of single words or two word combinations (ex. Boat! Woo. Big boat!) This will help your child identify words and repeat them.
• Use a slower rate of speech and fun intonation to catch their attention
• Imitate the words, sounds, and actions your child makes
• This can be a great way to teach new words:
  • Objects – hold bath toys up as you label them (ex. duck, boat, ball)
  • Action words –  say the word as you make the action (ex. make a toy SWIM, make a toy JUMP into the bath)
  •  Location words – example: the man goes IN the boat, the man goes OVER the boat, the man goes UNDER the boat
  • Sing songs and rhymes! These provide a lot of repetition and make it easier for your child to predict familiar words and to join in. After they know the song you can pause and give them a chance to participate. Example: row, row, row your _____. Your child may respond with an expectant look, a sound, an action, a word…all are ways of communicating with you. Song ideas: row your boat, Patty-cake, this little piggy etc.
  • Similarly to the songs – use simple repetitive routine games to give them a chance to participate. Example: bring a toy up while saying ‘up, up, up’ and drop it into the water as you say DOWN! Once they are used to this routine pause before you say down to give them a chance to respond and join in.
  •  Expand on your child’s utterances. For example: if they say “duck” you can say “yellow duck”!
  • Give choices – do you want the boat or the bucket? Do you want the pink towel or the yellow towel?

Have fun and enjoy your time together! Bath time is a great time to bond with your child and teach them many important language and play skills! Happy bath time!

Written by:  Carla Montgomery, speech-language pathologist, The Speech Therapy Centres of Canada

www.SpeechTherapyCentres.com

Play-based learning: How to create your own language-rich environment this summer

There has been a lot of talk lately about the Ontario government’s move towards providing full-day kindergarten and incorporating a play-based curriculum.  A play-based curriculum means that children learn through play.  The idea behind this is that when children are given the opportunity to explore an exciting and stimulating environment, they will learn without even realising they are learning. 

You can create your own stimulating environment for your child at home.  Try this activity to create a language-rich environment while doing a simple, inexpensive craft:

Play-dough

Play dough Ingredients:

• ½ cup salt
• ½ cup water
• 1 cup flour
• food colouring (optional)

Language ingredients:

• Action words (verbs): Talk about how you are pouring the ingredients, mixing them together, stirring with a spoon, squishing, rolling, patting, poking, and cutting the play-dough.
• Description words (adjectives): Discuss how the play-dough feels sticky or squishy. Roll a ball and make it smooth.  Touch the water and talk about how it is wet, and contrast that to the dry flour.
• Location words (prepositions): Maybe the flour is beside the salt, on the table.  The ingredients go in the bowl.  Make a tree out of your play-dough and a person to go under the tree.
• People, places or things (nouns): This can be almost anything!  Names of the ingredients, the tools you are using, the objects you are building, the names of those participating, names of shapes, numbers etc…..      

Instructions:

• Mix all ingredients together in a bowl.
• Choose a word or two to focus on from each type listed above.
• Use those words 5 or more times during the activity.
• Encourage your child to actively participate, by doing, asking, feeling, and commenting.

 For more information on Ontario’s play-based curriculum visit: http://www.edu.gov.on.ca/kindergarten/whatwillmychildlearnanddo.html

Written by: Jana Zalmanowitz, Speech-Language Pathologist, The Speech Therapy Centres of Canada. (www.speechtherapycentres.com)

Developing pre-literacy skills at home during the preschool years

The environment and daily routines in your home can be one of the best teaching tools to help children develop pre-reading skills. A print-rich environment helps foster skills needed for reading.  By surrounding your children with print in your home and talking to them about what it means, they will learn more every day.

They will begin to discover cues and understand that the words they see in print and the words they speak and hear are related. They will begin to learn that print can carry a meaning, and that therear many different ways to communicate.

A print-rich environment also ignites an interest in writing. Kids want to model what they see around them and communicate in written form. If they also see you modeling reading and writing during your daily activities, they will want to try to communicate this way too!

Ordinary household routines and activities can be used as learning experiences for kids. Below are some simple and fun ways to make your home a print-rich environment, and incorporate print into daily routines:

• Post signs and label items in your home, such as “Kelly’s room” on your daughter’s door, or “coats” by the hooks by the back door. Draw your child’s attention to these signs as you read them.
• Make labels together. For example, when you pack away the winter clothes, have your child put labels on each container (e.g. hats, mitts, sweaters, pants).  If your child is young, you can write the word for them and they can try to write it underneath.
• Write a grocery list together. Have your child help you decide what you need, and then write the words down. Look at the list together in the grocery store and have your child help you cross off items as you shop.
• Surround your child with lots of books-storybooks, non-fiction books about things like dinosaurs and insects, as well as poetry and nursery rhymes, newspapers and magazines. Create a “reading corner” in their bedroom or in the family room.
• Point out print to your child during daily activities. For example, when you are cooking, direct your child’s attention to the recipe and read it aloud as you follow each step. You child will begin to learn that print carries meaning. You can also point out print when you are out of the home. For example, point to the stop sign and tell your child that every time you see those words on that sign you need to stop. Have them help you watch for stop signs.
• Make growth charts together. Measure your child’s height and have him help you record the numbers. Talk about how the numbers are getting bigger as they are getting taller. You can display this chart in their bedroom where they can see it.
• You can turn a walk into a learning activity by playing games such as pointing out all of the “S” words that you see on signs or store names, etc. You can also use a sand box for letter recognition. Writing out letters in the sand and erasing it is a great game that kids will enjoy and it’s easy to do.

When kids are in an environment that has labels, signs and charts, they will be exposed to letters, words and numbers early and make connections between the letters and the functions they serve, thus developing their pre-literacy skills. Try these suggestions in your home, and have fun!

Written by Emily Begley, Speech-Language Pathologist, The Speech Therapy Centres of Canada

It’s Allergy Season: How Recurrent Ear Infections Can Affect Speech and Language Development

Allergy season is here in full force and with it comes sneezing, watery eyes and often itching throat.  Aside from these apparent symptoms, allergies can also lead to ear infections in children due to irritation in the Eustachian tube. There are very close ties associated with recurrent ear infections and delays in speech and language development.  Children who have suffered from several ear infections may have mild hearing loss making it difficult for them to hear low intensity grammatical markers such as past tense /–ed/ and third person plural /-s/, and high frequency consonant sounds such as /s/. Children learn these grammatical markers, and sound production, first by imitation which is made very difficult if they are having trouble hearing these specific sounds and markers.  It is very important to be aware of the status of your child’s hearing, even in the spring and summer, as it could be effecting their speech and language development.

Written by:  Stephanie Mathias, Speech-Language Pathologist, The Speech Therapy Centres of Canada

Early vocabulary – what should I be teaching my toddler?

Often when parents think of what kind of words they would like their toddler to learn, these are some of the ones that come to mind: mama, dada, ball, bear, blanket, bottle, book, movie, car, home.

Now take a look at what types of words all of the above are.  Think way back to grade school when you learned about grammar and words classes.  How would you classify them?  They are all nouns – a person, place or thing. 

Children start saying words at around 1 year old.  Nouns are great for children at this stage of language use.  They can ask for the people and things that are most important to them. 

So what happens next?  Children begin combining words at around 2 years old.  In order to combine words, we need more than just nouns in our vocabulary.  Think about these common toddler phrases:

Mama up             (noun+preposition)

Go home             (verb+noun)

Want cookie      (verb+noun)

Bear sleeping    (noun+verb)

Baby hungry       (noun+adjective)

These all include nouns plus other kinds of words!  So when you think about teaching your toddler new words, consider some of these:

• Verbs or action words: Actions your child may encounter often are eat, sleep, wave, read, want, and go. 
• Prepositions or location words: in, on, up, down
• Adjectives or descriptor words: hungry, thirsty, big, small, fast, slow

Now you may be wondering how do you teach your child.   Try something speech-language pathologists call focused stimulation.  This involves you setting up a situation where you can use a target word many times so your child gets the input on how the word is used.

Using a pretend kitchen set, pretend food or even pots and pans, try the following:

To focus on “eat”:  Prepare and eat different pretend foods.  This helps children learn lots of different names for foods and can help you focus on the word “eat” as you eat bananas, eat cake or eat sandwiches.

 To focus on “on”: Once you are done preparing your pretend feast, set the table or a picnic blanket.  Put the cups on the blanket, the plates on the table, seat yourself on a chair etc…

To focus on “hungry”: Bring more people, dolls or animals into your pretend play.  Mom is hungry, dad is hungry, bear is hungry, bear is still hungry.

Playing is a way for children to expand their vocabulary, so be imaginative and have fun!

What is a Phonological Disorder?

When a youngster is learning to speak, he or she will often have difficulty producing certain sounds and will replace those sounds with another sound.

A common example of this is the “Elmer Fudd” way of speaking, where all the /r/ sounds are replaced by /w/ sounds. There are several typical phonological processes that children use as they learn speech and language. Usually, children are completely unaware that they have mispronounced a word and may even argue that they said it correctly. Typically, as children get older, they learn to produce those difficult sounds and usually correct those errors without even realizing it. As this happens, children’s speech productions become clearer, and they becomes more intelligible (i.e., easy to understand).

When phonological processes do not disappear by a certain age; and/or the child can easily produce the omitted sound but doesn’t use it in his or her speech, the child is said to have a phonological disorder. Phonological disorders can and do affect pre-literacy skills. As a result, children with these difficulties usually have difficulty learning to read and write.

As speech therapists, we can help children with phonological difficulties in the following ways:

• We can teach the child how to make the sounds that he/she is having difficulty producing

• We can help the child become aware of his/her difficulties

 • We can work with the child and caregivers to improve pre-literacy skills.

Written by:  Claudia Correia, Speech-Language Pathologist, The Speech Therapy Centres of Canada.