Many times, the patients we see struggle to communicate verbally. They easily become frustrated and may demonstrate behaviors because they cannot communicate their basic wants and needs. Some of these patients may be candidates for Augmentative and Alternative Communication (AAC) devices. An AAC device gives a person a way to communicate via a machine that they control. Parents are often skeptical about implementing these devices because they believe it will deter any verbal language development. A study performed at the University of Tennessee found that using an AAC device (specifically Proloquo2Go) can enhance a child’s verbal speech skills. The children throughout this study showed improvements with manding, verbal completion, and tacting tasks during ABA therapy when using the Proloquo2Go software. The following are some things to consider when beginning to implement an AAC device:
- Consider the activities of daily living your patient participates in. It is important to personalize the AAC device so the patient can participate in all social and academic activities.
- It may be helpful to begin with manding tasks when an AAC deivce is first presented. Manding tasks will allow the patient to understand that the device acts as their own voice and can be used to answer, comment, and express.
- Encourage parents and patients to carry the AAC device with them at all times. This device is the voice for the child and they need to be able to communicate their wants and needs easily.
- Utilize other related service providers when implementing an AAC device. For example, some children who are presented with an AAC device may struggle with fine motor skills. Making proper referrals to an occupational therapist may help to alleviate some of these struggles
Johanna Sullivan MA, CF-SLP
As speech language pathologists, we often encourage parents to read to their children and engage them in joint book reading activities. Many parents may not understand the direct correlation between language and literacy. Children who have difficulties acquiring language are more likely to struggle academically, specifically with reading and writing. Books offer an opportunity for parents to engage children in conversation, ask questions, and learn new vocabulary. Even if children cannot read yet, exposing them to books will reinforce the importance of literacy skills, a basis for all academic success. According to ASHA, reading can foster the growth of spoken language. Parents can begin reading to their children at a young age and developing joint book reading skills. During joint book reading, parents should encourage children to turn the pages of a book and point to the words as they read, this will help young children become familiar with how books work. The following are books that can help foster language and are useful during speech-language therapy.
- Repetitive books (Brown Bear/Five Little Monkeys Jumping on the Bed)- these stories are easy for children to follow and have certain phrases that are repeated throughout the entire book. This allows for children to learn the story and understand a sequence of events.
- Animal books (Touch and Feel Farm/Dear Zoo)- these books can be used to when introducing animals and animal noises. Pairing the book with a toy farm and animals is often a good technique during therapy and allows children to have a tangible object to reference.
- Song books (The Wheels on the Bus)- any books that incorporate songs are typically engaging for children and allow for them to participate with you. Singing lines from a book allows for children to learn new vocabulary in a fun and memorable way.
Johanna Sullivan MA, CF-SLP
The holidays are a time that many people look forward to each year but for a child with Autism Spectrum Disorder (ASD), they can be challenging and scary. Many times, holidays involve going to family member’s houses and interacting with people you may not see on a daily basis. Holidays may involve being exposed to new foods, which are not part of a child’s typical dietary repertoire. Many of these new experiences can cause a child with ASD to become anxious. As speech therapists, we can do different activities during therapy to help ease the anxiety of the holidays and make this special time something a child looks forward to.
- Holiday themed books: Choosing a holiday themed book can help a child understand what the purpose of the holiday is and the activities that usually take place on that day. Therapists can easily incorporate these books into sessions if a child has goals involving Wh- questions, object labeling or following directions etc.
- Talk to parents: Bring parents into your sessions and discuss the traditions that the family has and what their plans for the holidays are. This can help therapists personalize therapy sessions and role play situations that could happen on the holiday.
- Holiday foods: Encourage parents to bring in foods that are present on their holiday tables. This will allow therapists to use the SOS feeding hierarchy on a food that the child may be interacting with during the holiday season.
- Discuss behaviors: Encourage parents to talk to their children and practice behaviors that are expected when you are around family members or in someone else’s house. Therapists can role play these situations and target greetings that may be required over the holidays.
When children on the Autism Spectrum are young, their parents, teachers, and related service providers are often the ones who advocate for them. Although it is crucial that these children have a support system, it is equally as important that these children learn to become self-advocates as they age. As SLPs, we can incorporate activities into our sessions to help children with ASD transition and become independent adults. The following are some therapy suggestions to help teach independence when working with young adults with ASD:
- Incorporate a calendar/planner into sessions and have your patient write down any homework that may be given. This will make homework your patient’s responsibility to remember and not his or her parents.
- When assigning homework, make all activities functional. For example, suggest that your patient help with chores around the house (ie., doing dishes). This gives your patient a responsibility and something that can be checked off in a planner.
- Encourage your patients to help with preparing meals. Learning to cook is another step to becoming independent. Learning to cook involves following the steps of a recipe and using sequencing skills, many things worked on in therapy.
- Technology is at the center of our world, children with ASD should be encouraged to use technology to further their independence. For example, suggest using an alarm to wake up in the morning so there is less reliance on caregivers to get up and get ready for the day.
- Talk to your patients about their hopes for the future. It is important to remember that everyone has dreams. If it is your patient’s aspiration to work in retail one day incorporate this into sessions. Do some role-playing activities that involve scripts using the language required for a retail setting.
- Practice interviewing skills during therapy sessions. As an SLP you want your patients to feel prepared for everything. Practicing interview questions and the conversational flow of an interview will make the process less daunting.
Johanna Sullivan MA, CF-SLP
When treating children with voice disorders, one of the key components of treatment is encouraging hydration. Although clinicians can encourage patients and parents to increase daily water intake, children are often not as enticed to drink water as they are to drink many sugar-based beverages. According to Franca and Simpson (2009), both jitter and shimmer were directly affected by a person’s hydration status. People who drank more water were noted to have lower shimmer and jitter numbers than those who were not properly hydrated. Higher Jitter and shimmer numbers are often reflected during a voice evaluation and correlate with atypical vocal fold vibration. According to ASHA, drinking water is not only important for vocal hygiene but can also help improve gastrointestinal health and overall wellness.
It is also important to introduce water so children do not become reliant on milk products. Milk intake drops significantly after the first year of life as children begin to add new foods to their dietary repertoire. If children continue to rely on milk they may not be willing to try other foods as they are getting daily nutrients through their milk intake. Encouraging children to drink water can ultimately encourage them to broaden their dietary repertoire.
ASHA offers some fun ideas to help encourage children to choose water as a beverage:
1. Honey Bears are a fun (reusable) way for kids to remember to drink water throughout the day.
2. Infused Water: Have kids experiment by adding their favorite fruits to water. This is a fun way to add flavor to water without the added calories/sugar that soda, juice, and energy drinks offer.
3. Parent involvement: It is important for parents/clinicians to practice healthy habits in front of children. Parents can keep a chart in the house of everyone’s water consumption for some friendly competition. Clinicians should also drink water throughout sessions with voice patients to set an example.
Johanna Sullivan MA CF-SLP