Aphasia

Aphasia is a language disorder that is caused by an injury to the brain, typically the left side of the brain. Impairments occur in four primary areas. These areas include; spoken language expression, spoken language comprehension, written expression and reading comprehension. There are different subcategories of aphasia. These include fluent and non-fluent. A person with fluent aphasia is able to produce connected speech, however their speech may not have much meaning. This is also known as Wernicke’s Aphasia due to the area of the brain that has damage. People with non-fluent aphasia have effortful speech; grammar is impaired however their speech frequently has meaning. This is also known as Broca’s Aphasia.

Some causes of Aphasia include, traumatic brain injury, brain tumors, brain surgery, progressive neurological diseases such as dementia and stroke. There are two types of strokes. These include ischemic and hemorrhagic. Ischemic strokes are caused by a blockage that interrupts the blood flow to an area of the brain. A hemorrhagic stroke is caused by a blood vessel that ruptures and causes damage to the brain tissue surrounding that blood vessel. The most common cause of Aphasia is stroke.

Symptoms vary based on severity and location of the damage. A person with aphasia often has difficulty with both expressive and receptive language. Anomia is another symptom often associated with aphasia. Anomia is difficulty with naming and word finding.

Treatment will vary based on the extent of damage and the individual needs of the patient. Treatment can either be restorative or compensatory. Restorative treatment aims at restoring functions that the person previously had, but are now impaired. The goal of compensatory treatment is to compensate for functions that were lost and cannot be regained. Two useful treatment strategies for patients with non-fluent aphasia include; Melodic Intonation Therapy (MIT) and Script Training. MIT is a technique that utilizes the musical elements of speech to improve language production. This technique is based of off the idea that music is processed in the right side of the brain, which is undamaged. Patient’s begin by singing short phrases and then slowly increase sentences lengths and eventually decrease their reliance on music to speak. Script Training is a technique that relies on the repeated practice of a script that has been created by the therapist and patient. The script should be something that is highly relevant to the patient’s everyday life. The goal is for the scripted speech to become automatic and less effortful.

Michelle Weiman MA CF-SLP

Reference:

https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934663&section=Treatment

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Feeding and Sensory Deficits

Children who present with sensory difficulties can have nutritional deficiencies. It is important to ensure your child is getting the proper nutrients necessary to stay healthy. There are two types of eaters, picky eaters and problem eaters. A child is considered a picky eater when he/she eats more than 30 different foods. They generally eat a variety of fruits, vegetables, lean meats etc. They’re selectivity regarding foods is usually behavioral rather than a sensory issue. A problem eater is a child who eats less than 20 foods. These children usually have either hyper-sensitivity or hypo-sensitivity. Children who are hyper-sensitive often gravitate towards bland foods, such as breads and pastas where as children with hyper-sensitivity tend to prefer foods that are stimulatory such as spicy or hot food.

If your child is a problem eater, the following techniques may help introduce new foods into your child’s repertoire:

  1. Use a food processor, to make soft foods such as creamy chicken.
  2. Let your child pick their own condiments, this will give the child some control as well as pair a preferred food with a new food.
  3. For those children who are color sensitive regarding food, try hiding nutrient filled food into their preferred color food. For example blending vegetables into brownies.

It is best not to pressure your child into trying new foods but encourage them to explore new foods at his/her own pace.

 

Reference:

https://www.brainbalancecenters.com/blog/2014/07/sensory-friendly-foods-child-will-love/

ARFID

Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by failure to meet nutritional needs. This can lead to the following, significant weight loss, significant nutritional deficiency, dependence on taking nutritional supplements, or the placement of a feeding tube and an interference with psychosocial functioning. Along with the aforementioned the following are listed in the Diagnostic and Statistical Manual of Mental Disorder-Fifth Edition (DSM-5) as diagnostic criteria; the eating disturbance is not due to a lack of food in the child’s environment, the eating disturbance is not due to body image and the eating disturbance cannot be attributed to a co-occurring medical condition. A child with ARFID may experience anxiety around certain food items or texture, which can result in avoidance of those foods. These kids also can have illogical thoughts regarding food, for example “If I eat that I will choke”.

There are several types of treatments that can help a child with ARFID. Cognitive behavioral therapy paired with feeding therapy is a common course of treatment. Cognitive behavior therapy will address the underlying thought processes leading to the eating disturbance. Feeding/exposure therapy can help patients learn to tolerate the anxiety provoking foods.

Michelle Weiman MA CF-SLP

References:

https://www.eatingrecoverycenter.com/conditions/arfid

https://www.waldeneatingdisorders.com/understanding-arfid-a-case-study/

http://emedicine.staging.medscape.com/article/2500040-treatment

https://eatingdisorder.org/eating-disorder-information/avoidantrestrictive-food-intake-disorder-arfid/

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

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