My Child Stutters

Tips at home to help my child who stutters

Stuttering —or childhood-onset fluency disorder — is a speech disorder that involves frequent and significant problems with typical fluency and flow of speech.

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Tips in conjunction with receiving speech therapy:

Create an environment that facilitates fluency!

Speak at a slow rate at home – modeling a slow rate of speech for your child at home

Allow them to take their time speaking to you, as opposed to rushing their thoughts out

Try not to finish their sentences, as it can be discouraging

Avoid critical comments or corrections when they are experiencing disfluencies

Avoid interrupting them when speaking

If the child is very young, demonstrate simple vocabulary and slow pace when speaking

Increase positive feedback

Something that is extremely important to keep in mind when your child is experiencing disfluent speech is to be mindful of their overall emotions, attitudes and confidence. It is extremely important to stay encouraging, especially at home!

A helpful read for teens who stutter: “Stuttering is Cool- A Guide to Stuttering in a Fast-Talking World” by Daniele Rossi

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Other forms of support:

Support groups for parents

Children’s support groups

Gradually accept treatment as opposed to dismissing

 

 

 

 

 

 

Dominique Micheletti MA CF SLP

Recourses: Dr. Dorothy Leone Presentation, Iona College 2017.

Dr. Michelle Veyvoda Presentation, Iona College 2017

Roseberry-McKibbin, C., & Hegde, M. (2016). An Advanced Review of Speech-Language Pathology. Austin, TX: Pro-ed.

ASHA.org

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Auditory Processing at Home!

Some carry-over task at home to target Auditory Processing Skills

In its very broadest sense, Auditory Processing Disorder  (APD) refers to how the central nervous system (CNS) uses auditory information. However, the CNS is vast and also is responsible for functions such as memory, attention, and language, among others. To avoid confusing APD with other disorders that can affect a person’s ability to attend, understand, and remember, it is important to emphasize that APD is an auditory deficit that is not the result of other higher-order cognitive, language, or related disorder.

(ASHA, 2017)

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Activity 1:

3 word recall – verbally express three irrelevant words with absolutely NO correlation to one another at random, instruct your child to repeat back the same exact words you have expressed in the same chronological order. Working on these during the car ride to school, before bed, at the pool, etc. is a great way to continue carry over for APD skills with your child!

 

 

Here are some to get you started!

Mom, bear, pool

Man, fair, farm

Call, waffle, puppy

Sand, lamp, frog

 

To increase difficulty, begin using three words with similar sounds and rhymes!

Foam, comb, Rome

Lock, Land, Leak

Mom, Man, Mop

 

Activity 2:

Read a short story aloud to your child, at the end, ask the child basic WH questions to exercise recall skills, for example:

Who was the boy in the story?

Where did he go?

When did he go?

Why was he happy?

 

 

 

Dominique MIcheletti MA CF SLP

 

Recourses: Dr. Dorothy Leone Presentation, Iona College 2017.
Dr. Michelle Veyvoda Presentation, Iona College 2017
Roseberry-McKibbin, C., & Hegde, M. (2016). An Advanced Review of Speech-Language Pathology. Austin, TX: Pro-ed.
ASHA.org

Social Stories

WHAT ARE SOCIAL STORIES? HOW CAN THEY HELP MY CHILD?

  • Developed by Carol Gray in 1990
  • THE GOAL – to share information, gentle coaching or description
  • “The goal of a social story is to share information using content, format, and a voice that is descriptive, meaningful, and physically, socially, and emotionally safe for the intended audience” (Gray, 2015)

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This is a great exercise to use with a child who has difficulty with executive functioning and behavior issues. For example, a child with autism spectrum disorder may suffer from adapting to new situations, completing tasks, executive functioning of daily living etc., therefore, demonstrating emotional distress and frustration is often the result. Therefore, a social story is a perfect way to get help the child in a simplistic and friendly way!

 

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This can also improve overall pragmatic language skills!

Using language for different purposes, such as

  • greeting (e.g., hello, goodbye)
  • informing (e.g., I’m going to get a cookie)
  • demanding (e.g., Give me a cookie)
  • promising (e.g., I’m going to get you a cookie)
  • requesting (e.g., I would like a cookie, please)

Changing language according to the needs of a listener or situation, such as

  • talking differently to a baby than to an adult
  • giving background information to an unfamiliar listener
  • speaking differently in a classroom than on a playground

Following rules for conversations and storytelling, such as

  • taking turns in conversation
  • introducing topics of conversation
  • staying on topic
  • rephrasing when misunderstood
  • how to use verbal and nonverbal signals
  • how close to stand to someone when speaking
  • how to use facial expressions and eye contact

(ASHA, 2017)

 

 

Here’s what to know:

STRUCTURE and CLARITY is crucial, keep as positive as possible!

Getting Dressed:

My name is Shelly.

When I get up in the morning, I have to get dressed.

I can dress myself.

When I get dressed, it makes mom and dad happy.

First, I can put on my socks, then my pants, then my shirt, then my shoes.

When I dress myself, I feel very happy.

I can show my mom and dad I dressed myself and they will be happy too!

 

 

 

Dominique MIcheletti MA CF SLP

 

Recourses: Dr. Dorothy Leone Presentation, Iona College 2017.

Dr. Michelle Veyvoda Presentation, Iona College 2017

Roseberry-McKibbin, C., & Hegde, M. (2016). An Advanced Review of Speech-Language Pathology. Austin, TX: Pro-ed.

ASHA.org

Back to school language activity

An AT HOME language activity to get your child ready for school!

Language is made up of socially shared rules that include the following:
• What words mean (e.g., “star” can refer to a bright object in the night sky or a celebrity)
• How to make new words (e.g., friend, friendly, unfriendly)
• How to put words together (e.g., “Peg walked to the new store” rather than “Peg walk store new”)
• What word combinations are best in what situations (“Would you mind moving your foot?” could quickly change to “Get off my foot, please!” if the first request did not produce results)
When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder.bottle
Get your child ready for going back to school with a fun game to get them excited for the upcoming year and to recap on the summer you spent together!

Materials: BEACH THEME – message in a bottle! Crumble each “WH” question (who, what, when, where, why) provided and dump into the bottle! Take turns taking questions from the bottle with your child to target their expressive and receptive language skills as well as recall skills from your past experiences this summer!
WH Questions:
Who will be your teacher?
When will you start school?
What will be your favorite subject?
Who are you excited to see?
What will you bring your first day?
How will you get there?
Why are you going to school?
Who else will go to school?
When will you come home?
Where will you eat your lunch?
What will you be excited to do?
What will you miss about summer?
What was your favorite thing you did this summer?
Who did you spend the most time with this summer?
Why are you excited to go back to school?
What will you wear the first day?
What do you need to write with at school?
Why do you need notebooks?
Why do you have desks?

 

 

Dominique Micheletti MA CF SLP

Practical Carryover Assignments

Turning everyday activities into speech and language opportunities is both functional and effective.

Activities of daily living present the most natural setting to learn/practice speech and language goals that will generalize outside the confines of a therapy room.

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IN THE CAR

  • Practice speech sounds by taking turns thinking of as many words as you can that begin with target sounds.
  • Practice language by labeling items within certain categories.
  • Play 20 questions; have your kids guess an object based on clues.
  • Play “I Spy” with items outside the car that include target sounds.
  • Involve siblings/friends to encourage carryover during play/social situations.

DRY ERASE MARKERS/CHALK

Kid’s love making a mess! Let them use dry erase markers on mirrors or chalk on the driveway to practice their speech sounds and/or language goals. Turn simple arts and crafts supplies into an interactive and exciting way to practice.


BOARD GAMES

  • Board games help with social communication via turn-taking, eye-contact, and non-literal language.
  • Game pieces may be labeled with words and sounds (i.e., Jenga).
  • Rules may be added to games (i.e., name x amount of words with target sound based on what number is rolled on the dice)
  • Some board games even double as speech-language activities: Scattergories (language/categories/phoneme awareness), UNO (counting and colors), Chutes and Ladders (/sh/ sound), etc.

SCAVENGER HUNT

  • This is as easy as turning off the lights and heading around the house with flashlights to discover as many words as possible with a target sound, or items that fit a certain criteria (may be modified to fit goals).
  • Photo/Speech/Vocab Flashcards may be printed and hid within a certain room or space; encourage kids to collect as many as possible.
    Make a map (following multi-step directions) and have kids work together to complete a puzzle with clues.
  • Play hide and seek with multi-syllabic word cards that are taped around the house.

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PLAY DOUGH

Play Dough is an interactive sensory activity. It can be used to describe slow stretchy speech for children with fluency disorders. Children learn best through multiple modalities, especially hands on!


PLAYGROUND/BEACH

  • These two environments offer the opportunity to learn about spatial concepts, verbs, and adjectives! New places, people, and things can help expand your child’s lexical repertoire. Target words such as “under”, “above”, “big”, “small”, “fast”, “slow”, “push”, “swing”, “swim.”
  • Bury laminated objects or picture cards in the sand and/or dirt for kids to find. When they find the objects or speech cards have them say the word as they put it in their bucket.

READING

Choose books that are interesting to your kids, as well as those full of target speech sounds and vocabulary! (See previous blog post about the importance of reading!)


ON THE GO

  • When in doubt, grab your iPad, phone, or tablet and have fun practicing words, sentences, stories, category games, memory, etc.
  • There are endless options for enriching “therapy” apps on smart devices.
  • They range in price and difficulty level.
  • Some of my favorites include:
    • Articulation Station
    • My Play Home
    • Super Duper Publications Apps
    • Hear Builder Phonological Awareness/Auditory Memory

This is always fun for kids and perfect no matter where you are!

Ashley DiGregorio M.A. CF SLP TSSLD

Sensory Processing Disorders

A person with a sensory processing disorder may be unable to respond “appropriately” to ordinary experiences. This disorder makes it difficult to integrate information from the five senses (sight, hearing, touch, smell, and taste), in addition to the sense of movement (vestibular system), and/or the awareness of the body’s position in space (proprioception).

Sensory processing is the procedure in which we take in messages from our bodies and our surroundings.

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When sensory processing is typical, we interpret these messages and organize purposeful responses. Individuals with a sensory processing disorder have difficulty interpreting these sensory messages.

Individuals with a sensory processing disorder may sense information normally, but the information is perceived abnormally and may cause discomfort, pain, or confusion.

A person with a sensory processing disorder finds it difficult to process and act upon information received through the senses, which creates challenges in performing activities of daily living.

An individual with a sensory processing disorder may exhibit the following characteristics:

  • Hypersensitivity
  • Hyposensitivity
  • Difficulty self-regulating (experience an activity level that is unusually high or unusually low)
  • Decreased proprioceptive awareness (difficulty knowing where one’s body is in space)
  • Easily distracted
  • Physical clumsiness
  • Apparent carelessness
  • Impulsivity
  • Difficulty making transitions from one situation to another
  • Poor self concept
  • Lacking in self-control
  • Social and/or emotional problems
  • Inability to self-soothe
  • Delays in speech, language, motor skills, and/or academic achievement

What causes sensory processing disorders?

There is no known direct cause of sensory processing disorders; however, a discrepancy in the sensory integration process is the root of this disorder. The mid-brain and brainstem regions of the central nervous system are early centers in the processing pathway for sensory integration.

Prenatal/birth complications and environmental factors, as well as other disorders, such as autism spectrum disorder, may increase the risk of a sensory processing deficit/disorder.

Sensory Processing and Speech

Individuals with sensory processing disorders often have speech and language impairments.

Speech and language development requires several foundational processes including the integration of auditory and visual stimuli, motor planning, and proprioceptive knowledge of the body in space.

Difficulties in these and other areas of sensory processing can negatively affect speech and language development.

Treatment for Sensory Processing Disorders

Sensory processing disorders may be assessed and diagnosed by occupational therapists, neurologists, and/or developmental pediatricians.

Treatment for sensory processing disorders is usually provided by occupational therapists. Treatment focuses on integrating a variety of senses including sight, sound, smell, touch (tactile sense), proprioceptive sense, and vestibular senses.

Goals for sensory integration therapy are unique to each child and vary greatly depending on the child’s specific difficulties and challenges.

Areas of treatment may address:

  • Gross motor skills
  • Fine motor skills
  • Motor planning
  • Postural control
  • Coordination
  • Balance
  • Strength

Ashley DiGregorio MA CF SLP TSSLD

Dealing with Defiance

When working with children who exhibit defiant behaviors, it can be hard to sustain an environment conducive for learning. Some children exhibit defiance to seek attention and express frustration towards the level of work that is expected of them, while others may be experiencing a behavioral disorder.

The first step in managing negative behaviors in therapy may be to shift gears. Many behaviors demonstrated by children (i.e., self-stimulatory, attention-seeking, aggression) are triggered by stimuli in their surrounding environment.

The treating SLP must consider the framework of each session and the goals being targeted. Some children with oppositional traits benefit from a patient-centered approach, in which the patient guides the structure of the session (maintaining a sense of control) while goals are integrated into productive, yet achievable tasks.

Other children may exhibit success with visual schedules, positive reinforcement (verbal/tangible), and work-to-earn systems. It is important to tailor incentive to each individual in order to yield the most success.


Tips for Dealing with Defiance in Therapy:

  • Respond without anger.
  • Speak calmly and matter-of-factly to a defiant child. Defiant children will not respond well to sarcasm, lectures, or complex directions.
  • Avoid open-ended questions (unless you are willing to accept any answer).
  • Avoid a power struggle; children with defiance often seek power and control. Offering limited choices let’s the child feel in control and allows them to hold onto their sense of significance and dignity but teaches them expectations.
  • Avoid negotiating in the moment; decide on a consequence and remain firm in this decision. Negotiation gives the child more control and gives them the message that they can avoid redirection by resisting.
  • Be strong in your follow through; defiant children will work to “wear adults down and win.”
  • Do not take a child’s behavior personally.
  • Be as neutral and objective as possible (in both verbal and non verbal expression).
  • Keep setting limits with children and follow through by giving them consequences/holding them accountable for their actions.
  • Defiant children need to feel that despite difficulties, you will still care about them, recognize their successes, and actively include them in the learning environment.
  • All children, including those who frustrate you, have positive attributes. Make a point to learn about their interests and channel their talents in ways that foster their sense of significance.
  • All children, especially those who struggle with defiance, need to hear when they are doing well and where they are improving.
  • Make a point of noticing a child’s successes, such as following directions, transitioning smoothly, or doing anything ordinary that might invite resistance.
  • Avoid suggesting that pleasing you is what’s most important; steer clear of phrases such as “I like..”, “I want…”, or “I appreciate” when reinforcing positive behavior.

A child who is sensitive to being told what to do may feel manipulated by “I” statements.

  • Teach defiant children how to disagree respectfully; when teaching children appropriate ways to disagree make it clear that in the moment they still need to follow directions and rules. Let them know that later they can discuss what they feel was unfair and what should be changed. Teaching phrases such as “I feel that…”, and “I suggest…” can go a long way.
  • When a child is being defiant make sure they are (1) safe and (2) give them time to cool down.
  • Avoid doing things that may heighten a child’s level of stress and trigger more resistance.
  • Do not try to reason or make en emotional appeal to “win” the child over.
  • Slow down; waiting a few seconds before you say/do anything lets the child regain their ability to cooperate and also lets you assess the situation calmly and objectively.
  • After an episode of defiance, reflect on what preceded it. Eventually you will begin to recognize the situations that set off the child’s defiance, such as unexpected schedule changes or tasks that are too challenging.
  • Look for signs of frustration and discomfort such as opening and closing fists, body tension, and avoiding eye contact. Often times we may overlook red flags and consequently push children further into a defiant episode.
  • Intervene early; respond as soon as you can with respectful reminders or redirections. Following redirection do not expect immediate compliance. Children often need space literally and emotionally. Taking a step back will lessen the sense that you are controlling them.
  • A reward system can give children incentive to be compliant. Behavior contracts may also allow children to earn privileges through compliance (i.e., 15 extra minutes of iPad at home when session goes well).
  • Consistent discipline across settings is essential in reducing defiance.

Ward off attention-seeking negative behavior by giving children a daily dose of positive attention. A few minutes of positive attention can be enough for defiant children to feel satisfied.

Sometimes after cycling through teaching techniques and therapy approaches, children still exhibit reluctance to participate in sessions. This may be indicative of a clinical behavioral disorder.


What is Oppositional Defiance Disorder (ODD)?

Oppositional Defiance Disorder (ODD) is a childhood behavioral problem characterized by constant disobedience and hostility. The characteristics of ODD usually appear in school-aged children and include:

  • Child is easily annoyed or angered
  • Child has frequent temper tantrums
  • Child argues frequently with adults, particularly their parents
  • Child refuses to obey rules
  • Child appears to deliberately annoy or aggravate others
  • Child has low self-esteem
  • Child has a low frustration threshold
  • Child seeks to blame others for any misconduct

Some children with traits of ODD may experience:

  • Poor social interactions
  • Difficulties complying with rules and expectations
  • Anger/Frustration
  • Difficulty taking responsibility for their own actions

Management Strategies for School and Home:

  • Parent counseling by a licensed psychologist helps parents to better manage and interact with their child. This may include learning behavioral techniques that reinforce good behavior and discourage bad behavior.
  • Functional family therapy teaches family members how to problem solve and communicate more effectively with one another to decrease defiance and hostility in the home.
  • Consistency of care is essential. For effectiveness of intervention, all people involved in the care of the child need to be consistent in the way they behave and manage the child. This includes teachers, grandparents, parents, siblings, babysitters, etc.

Speech-Language Therapy to Support the Child with ODD:

  • A thorough speech and language assessment may help families understand how a child is processing, understanding, learning, and using language and communication.
  • Communication strategies may provide families with strategies and techniques to increase and enhance communication with their child.
  • Daily activities can be targeted to help children with ODD understand the environment, routines, and importance of language.
  • Developing language can help younger children to understand and use language more spontaneously and appropriately.
  • Working on conversation and pragmatic language skills can help children with social communication (i.e., turn-taking, appropriate use of language across settings). An SLP can help children learn when and how to use language.
  • Concept skills can enhance a child’s ability to develop abstract concepts, such as time (this can decrease frustration and confusion in regards to change and consistency in routine).
  • Visuals can be used to help children express their needs, wants, and thoughts, as well as organize and plan a routine for the day.
  • Speech goals may enhance verbal and non-verbal communication, including gestures/signs, speech, and written language.
  • Communicating with educators and family members to discuss the nature of the difficulties and ways to help the child will help ensure a cohesive plan for generalization of skills.

What does a diagnosis of Oppositional Defiance Disorder (ODD) really mean for a child?

A diagnosis can help to identify:

  • Other co-morbid disorders
  • Medication that might be appropriate
  • Therapies that might help the child
  • Course of intervention/projected outcome

According to the DSM-V, diagnoses are used to label a set of symptoms that are being experienced by a child. A licensed psychologist can provide a comprehensive evaluation to determine the nature and severity of a child’s deficits, as well as the presence of a behavioral disorder.

Ashley DiGregorio M.A. CF-SLP, TSSLD