Auditory Processing Disorder
Auditory Processing Disorder (APD) affects many school-aged children. These children have difficulties processing information they hear auditorily because their ears and brain don’t fully coordinate. Something adversely affects the way the brain recognizes and interprets sounds, particularly speech sounds. APD is an often misunderstood because many of the behaviors related can also appear in other conditions such as learning disabilities and attention deficit hyperactivity disorder (ADHD). Although APD is often confused with ADHD, it is possible to have both. It is also possible to have APD and specific language impairment or learning disabilities.
Symptoms of APD can range from mild to severe and can take many different forms. If you think your child might have a problem processing sounds, consider these questions:
- Is your child easily distracted or unusually bothered by loud or sudden noises?
- Are noisy environments upsetting to your child?
- Does your child’s behavior and performance improve in quieter settings?
- Does your child have difficulty following directions, whether simple or complicated?
- Does your child have reading, spelling, writing, or other speech-language difficulties?
- Is abstract information difficult for your child to comprehend?
- Are verbal (word) math problems difficult for your child?
- Is your child disorganized and forgetful?
- Are conversations hard for your child to follow?
Below are some strategies for auditory memory that are used in therapy to target goals related to APD:
- Write down important information or words
- Highlight the important information/words you want to remember
- Repeat to yourself
- Picture it in your head-VISUALIZE!
- Make an association-Think of something that reminds you of what you are trying to remember
Hope this was helpful!
Vocal Cord Dysfunction
Vocal cord dysfunction is a condition that is often misdiagnosed as exercise-induced asthma. Asthma medications are not effective for those individuals with vocal cord dysfunction. The vocal cords in your throat open when you breathe in and close as you breathe out, unless you suffer from vocal cord dysfunction. Then, your vocal cords close when they shouldn’t, which limits your ability to inhale air. A whining or high-pitched sound may be present when you inhale if you have vocal cord dysfunction. Breathing exercises are very beneficial and a common treatment option for individuals with vocal cord dysfunction. Below are some exercises to target breathing efficiency.
Lying Down Breathing Exercise
- Lie face up on the floor in a supine position (on back). Bend your knees and place your feet on the floor. Relax your neck, shoulder blades and throat, letting your body sink into the floor. Place your hand or a book on your stomach so you can observe the movement of your abdomen during the exercise. The book will be more difficult to lift so you may wish to work up to using a book.
- Inhale through your nose as if you were sniffing a flower. Breathe into your abdomen and watch the book or your hand move upward as you inhale. Do not breathe with your upper chest. Keep your chest and shoulders stationary.
- Purse your lips as if blowing out a candle, but do not pucker them away from your teeth. Exhale through your mouth and either making a soft hissing sound or whisper “ffff” or “shhh.” Observe the book or your hand lowering as you breathe out without any active contraction of your abdominal muscles.
- Continue inhaling and exhaling, making your preferred sounds for at least a few minutes. Alternate between taking quick breaths and long, slow breaths. Perform this exercise three times a day.
Seated Breathing Exercise
- Sit up straight with your shoulders pulled back and your chin level with the floor. Place your hands on the sides of your body with your elbows bent. Hold near the lower area of your rib cage so that you can feel your ribs expanding during the exercise and know you are doing it correctly.
- Inhale through your nose as if sniffing and draw the air into your abdomen. Your lower ribs should expand. Keep the rest of your upper body still and relaxed, especially your throat and upper chest.
- Exhale through pursed lips. Whisper a letter or sound such as “s,” “f'” or “sh” or hiss as you breathe out. Feel your lower ribs gently contract back to their original position. Do not force your ribs to move. Breathe for a few minutes sitting upright.
- Change your seated position so that you are leaning forward or completely bent over and continue to do this breathing exercise. Keep the upper body relaxed and your hands on your ribs even in these new positions. Perform this exercise three times daily.
*It is recommended that you start off lying face up first, and then progress to sitting or standing up and eventually practicing breathing exercises during aerobic activity. You may place your hand on your abdomen or use a mirror for feedback during exercises.*
I often have parents asking for apps for the iPad that would be beneficial for their child to use at home to assist in improving language skills. Here are a few applications and a brief description of each that are great for targeting language skills:
- Speech With Milo Interactive Storybook
This app is good for pre-school children in which they can listen to the story, interact with the pages, and record themselves retelling the events on the page.
- Rainbow Sentences
This is a great app for forming grammatically correct sentences and expanding utterances.
- Cookie Doodle
This application is great for following the directions of the recipe, sequence the steps, decorating, and describing a cookie. There are many things you can do with this app to elicit language.
- Let’s name things: Fun Deck
This app is designed for children and targets naming skills. It contains 52 flashcards with visiuals, a built-in audio, and the ability to track data.
- Toca Kitchen Monsters
The series “Toca Boca” apps are great for pretend play. On the Toca Kitchen Monsters app, children get to feed a monster. The children can interact with the monster by selecting different types of food. This is great for pretend play and building vocabulary.
An additional website for applications for a variety of speech/language deficits:
Sometimes I Just Stutter
By: Eelco de Geus
This book is a great way for children to learn and become aware of stuttering in a positive way. It explains that the harder they try not to stutter, the more they may do so. This book consists of letters to brothers and sisters, grandparents, teachers, and others to assist children in educating people in their environment. These personal letters are written by other children who stutter, which helps to normalize stuttering and let readers know that they are not alone.
This book is written for children typically between the ages of 7-12 who stutter. It discusses:
– What makes you stutter
– Why sometimes you stutter and sometimes you don’t
– Why some people don’t understand why you stutter
– What others should know about stuttering
– That they are not alone and a lot of other kids stutter too
– What to do if you are teased about stuttering
“…counseling children to accept their stuttering is a means of working directly on stuttered speech. Because if a child is encouraged to go ahead and stutter, they then can change it. But if a child is encouraged to not stutter, this perpetuates the negative reaction.” Barry Guitar, Ph.D.
Below is a link that provides a full copy of this 40 page book:
Speech Sound Development
Speech sounds begin to develop from the time a baby vocalizes their first babble (which is when an infant appears to be experimenting with sounds) to about 8 years of age (middle of elementary school). When sounds are developing, children may demonstrate omissions, substitutions, or inconsistent productions. Typically these errors should disappear by a certain age. Below shows the range of ages at which most children are able to make consonant (non-vowel) sounds.
Early Developing Sounds
Between ages 1-3
/m/ as in “mama”
/b/ as in “baby”
/p/ as in “pop”
“y” as in “you”
/n/ as in “no”
/w/ as in “we”
/h/ as in “hi”
/k/ as in “cup”
/g/ as in “go”
/d/ as in “daddy”
/t/ as in “two”
Middle Developing Sounds
Between ages 3-6 ½
“ng” as in “running”
/f/ as in “fish”
/v/ as in “van”
“ch” as in “chew”
“j” as in “jump”
Late Developing Sounds
Between ages 5 -7 ½
“sh” as in “sheep”
/s/ as in “see”
“th” as in “think”
“th” as in “that”
/r/ as in “red”
/z/ as in “zoo”
/l/ as in “like”
“zh” as in “measure”
Each speech sound has a range of when they should be developed. There is a wide range of when your child will master the production of the different sounds. It is difficult to decide what age a child should master a sound with 100% accuracy. These sets of norms can be helpful when deciding if a child is typically developing sounds or may need speech therapy to assist in correcting the production of a sound.
I often have parents inquiring by what age their child should produce certain sounds.
I hope this is helpful! 🙂
How to stimulate more speech from your toddlers
Most often children just need a little more incentive to get them talking. There are many ways of “tempting” your child to speak. Here are a few ways to elicit expressive language.
- Eat something your child loves in their presence without offering them any. When your child indicates that they would like some, model a more advanced way for them to make the request, whether it is using a sign, a word or a simple phrase. For example, if your child points and grunts to the candy, model the sign for candy then wait and see if your child will imitate the sign candy. If your child simply keeps pointing and grunting take his/her hand and help him make the sign for candy then reward him/her with the candy.
- Play with something your child loves. but don’t offer to share. For instance if your child loves playing with play dough and wants to participate in the fun, you could model the /p/ sound for “please” or “play,” or you could model the signs for please or play. If your child can already say one word model a two word phrase for him/her to imitate like, “play please.”
- At meal time and snack time give your child bite size portions, rather than dishing up a whole serving for them, then wait for them to request more. If no attempt is made model the sign “more,” help them make the sign, or model the /m/ sound for them to imitate.
- Limit your child’s access to things like the T.V., toys, and food. Set it up so they have to make a request or ask for help to access these things. You may accomplish this by putting their favorite things up high or locked up.
- Play turn-taking games such as rolling the ball back and forth, or pushing a car back and forth. Once your child expects another turn hold the car or ball and wait. Look at him/her expectantly if no sign or verbal request is made, model an appropriate request such as the sign for “ball,” the /b/ sound, the word “ball” or “ball please”…
- Use tight containers to store things in. When your child indicates he/she wants a cookie you might hand him/her the cookie jar (tightly sealed of course), when he/she can’t open it and hands it back to you make him/her sign open or help.
- Use wind-up toys or other toys that are difficult for kids to operate on their own. Wind up a wind-up toy your child enjoys then hand it to them when they want a turn, wait for them to request help by using the sign or the word to operate the toy
- Blow bubbles then screw the lid on tightly and hand it back to your child for their turn. Wait for them to request help with a sign or a word. Model the sign or word if necessary.