Lip-Reading In Children

Posted on March 23, 2012 by thespeechtherapyblog

A few weeks ago an article in the Globe and Mail caught my eye: “Babies Likely Lip-read When Learning to Talk”. This article had some interesting information about how babies learn to speak and reinforced some of the speech strategies that I often suggest as a speech-language pathologist.

This article reported that starting around 6 months of age babies shift their gaze to look at adult’s mouths when they are being spoken to. By their first birthday babies stop looking at the mouth and turn their attention to the person’s eyes unless they hear an unfamiliar sound, in which case they return their gaze to the mouth. So… what does this mean and why does it interest me as a speech-language pathologist?

As a parent, just being face to face while interacting with your child can support the development of their speech sounds. There are many great opportunities throughout the day for this to happen! For example: playing games when your child is in their highchair or bathtub makes it easy for you to be face to face and up close.  Singing songs with silly sounds or playing people games such as pat a cake will also work well. Making exaggerated facial expressions during play will help draw your child’s attention to your mouth.

This same principal applies to older children (3 years and up) as well. Research, in addition to clinical experience, tells us that children with speech delays benefit from watching an adults mouth when trying to learn a difficult sound. In fact, one of the first take-home strategies that SLP’s often provide is for parents to make sure they’re face to  face with their child during conversation so they can see what their mouth does  as they’re speaking. The fact that children’s attention returns to the mouth when hearing an unfamiliar sound further supports this idea.

Getting face to face and close to your child should be a natural and fun way to help enhance their speech development!

By: Carla Montgomery, MSc. SLP(C)

Posted in Helpful Tips for Parents at Home, Language Development, Pre-school, Speech and Language Milestones | Leave a comment

Study Tips

Posted on March 16, 2012 by thespeechtherapyblog

With exam time around the corner, many students, especially  those with learning disabilities and/or acquired brain injuries (ABI) are  starting to feel the pressure and stress that comes along with preparing for  finals. These times are stressful, but there are strategies for making study  time more effective and manageable.

Schedule and routine- create  a study schedule in advance. Allow yourself extra time for courses that you  find more difficult. Keep this schedule posted somewhere you will see it, e.g.,  at your desk, on the fridge, or beside your bed. Having this visual guide may  help you feel more at ease and prepared, knowing you have thought out studying  well in advance and know what day you will be working on what course.

Study Space- Set up and define your study space. This involves  choosing a room or location that has minimal distractions. For some people,  this is their bedroom, for others it’s a library or a nearby coffee shop.

Organization- Make sure your study space is organized, for example,  keep all notes together in one binder or folder. Knowing where your materials  are and having them organized and accessible makes study time more efficient.

Come prepared- predict what materials you will need to study. This may  include a highlighter, scrap paper for notes or a stop watch. Pack you bag  ahead of time if studying outside of the home to ensure you will have all the  materials you will need.

Reading- Many students find that when they are reading they get  distracted or zone out and after finishing a chapter they have not retained any  of the information. To help understand and retain the information you are  reading, try and use active reading strategies.  This includes:

Surveying the text ahead of time- is the chapter long? If so,  should I allot time for a break in my schedule? Will I need to modify my  environment to eliminate any  distractions? Asking yourself these questions  helps you become more aware of your energy and attention levels, and thus more  independent in managing your studying.

Predicting what will be covered in the chapter. This helps you  focus and hone in on the main idea and relevant information, looking for key  concepts you anticipate will be discussed.

Reading- while you are reading try and highlight or underline  important concepts or definitions. Write down key words in the margins of the  text. These strategies help you retain the information, but also helps to save  time when you go back to review the text closer to the exam (s).

Recite- after reading 1-2 pages, pause, look away from the text and  recite the information out loud. You can summarize the information to yourself  or a study partner. This strategy helps you check your comprehension of the material;  what you understand, what you do not yet understand and where the breakdown  occurred. This also helps with  memorization of the material.

Review- at the end of each chapter, review the highlighted text and  make sure you understand the main information. Make notes on the key concepts  you covered in the chapter.

These are only a few of many  study strategies and as very student is different, some may work better for you  than others. You can work with your Speech-Language Pathologist to help  determine you areas of strengths and weaknesses and create a study plan that  will work best for you! Best of luck!

Ashleigh Wishen, M.H.Sc. S-LP (C)

Speech-Language Pathologist, Reg.  CASLPO

 

 

Posted in Acquired Brain Injury, Adolescents, Uncategorized | Leave a comment

The Aging Swallow

Posted on March 2, 2012 by thespeechtherapyblog

As we age our ability to do many things changes. There are very clear changes that happen to our body as we move into older age which may include obvious signs such as not being able to run that marathon race and no longer being able to wear 5” heels all day. Some more subtle changes occur as well. One subtle but very significant change which occurs as we age is changes to our swallowing mechanism. Research has shown that our coordination between breathing (respiration) and swallowing changes as we move into our later years. The jury is still out on whether or not this change in coordination is a natural protective mechanism to slow down the process, or whether it is due to overall decreased muscle mobility. Either way, any changes to our swallow can put us at risk for
aspiration and potential pneumonia. Speech-language Pathologists are great resources to help you to ensure you are swallowing safely well into your golden years.

Some things to keep in mind as potential signs or symptoms of a possible swallowing problem include:

1) Having to swallow more multiple times to get the food down.

2) Pain during your swallow.

3) A significant increase in the amount of time it takes you to finish a meal.

4) A ‘wet’ sounding voice after eating or drinking.

5) Coughing while chewing, during your swallow or after your swallow.

These are just a small sample of some of the signs of a possible swallowing problem. When in doubt, contact your family doctor or Speech-language Pathologist if you have concerns about your swallow or about someone you love.

Ensuring we are swallowing safely can drastically help maintain quality of life at every age. Eat well!!

 

Stephanie Mathias, M.S-SLP

Speech-Language Pathologist, Reg. CASLPO

Posted in Uncategorized | Leave a comment

Language Games on the Go

Posted on February 16, 2012 by thespeechtherapyblog

When you are told that child needs a boost with expressive language development it might seem overwhelming to add yet another task to your endless to do list for the day. Here are two games that you can play anywhere/anytime. They will help add language to any daily routine, no matter how busy you are.

I spy: A classic game that can be played in the car, at the hockey rink while watching a sibling practice, or even in a Dr.’s waiting room (which can be ruthlessly boring!) The language objectives can be simple by asking your child to simply state what they spy (e.g. I spy a telephone), or make it more challenging by playing the traditional way using describing words (e.g. I spy something that is red). Additional language goals could be highlighting location words (e.g . in, on, beside etc. – I spy a chair beside the table), and talking about the ‘function’ of an object (e.g. pulls, spins, opens – I spy a door that opens). This game offers endless ways to incorporate your child’s speech goals into a fun game that requires no tools/objects and can be played anywhere and anytime during your busy day. Talk to your Speech-language Pathologist to discuss what specific language targets to focus on with your child.

Who, What, When, Where: This is a simple speech game routine that you can play after school together on the way home in the car, around the dinner table or even in the bath before bed. Sometimes having our kids respond to ‘what did you do today?’ will lead to a frustrated response of ‘nothing’. It can often feel like pulling teeth having your child fill you in on their day. If your child also has difficulties with speech and language, this task may be even more difficult. In this game, your child has to tell you about one thing that happened in their day. You can cue them to fill in the story with the ‘who’, ‘what’, ‘when’, ‘where’. For older kids challenge them with ‘why’ and ‘how’. You can model it for them by telling them something that happened in your day using the same template. For example, you could say and then expand to answer other WH- questions that go with that topic: “I saw Patty today. I saw her in the grocery store…”, or “I went to the park for lunch. I had a tuna sandwich”. After a couple of days repeating the routine together it will get easier for your child to share. Some language objectives that are targeted here include sequencing events and early story telling skills.

There are countless other ways to help incorporate language activities into your child’s daily activities. Talk to your Speech-language Pathologist for more suggestions and strategies. Have fun with the games and remember that you can work on language skills with your child anywhere.

Stephanie Mathias, M.S-SLP

Speech-Language Pathologist, Reg. CASLPO

Posted in Uncategorized | Leave a comment

What is the difference between SPEECH AND LANGUAGE?

Posted on February 9, 2012 by thespeechtherapyblog

People often wonder why we are called SPEECH-LANGUAGE pathologists. Why is there speech AND language in the title? Is there a difference between the two?
As ‘communication experts’ SLP’s work on both speech AND language. Some children/adults will have difficulty with both speech and language while others will only have difficulty with one or the other. Here’s a brief summary to explain the difference:

SPEECH
This refers to the ability to say the sounds that make up our words. Examples of a speech delay may include: a child who can’t say the “fff” sound, a child with a lisp, a child who says “dut” instead of duck, etc. Some people only have difficulty producing one sound while others struggle with a number of sounds. Regardless of which sound(s) are difficult, it can make it hard for others to understand what is being said. This makes it more challenging for that person to express themselves. Remember: for children, they develop different sounds as they get older. Your speech-language pathologist can tell you if the errors your child is making are age appropriate or if they are delayed in their speech development.

LANGUAGE
Language is broken up into:
Expressive Language -  This refers to the ability to speak or express oneself. It can include:

  • The early communication behaviors that young children use to express themselves such as pointing, making sounds to get your attention, or gestures (putting their arms up to let you know they would like to be picked up)
  • The words you know (vocabulary)
  • The ability to put words together (example: putting two words together such as ‘Mommy go’, or putting together multiple words to make a sentence)
  • The ability to use correct grammar

Receptive Language -  This refers to the ability to understand what others say/things you hear. This can include:

  • A child’s ability to understand single words such as ‘ball’ ‘milk’ ‘bath’ or understanding a sentence (e.g. I see a bird in the sky), or paragraphs.
  •  The ability to follow instructions (example: understanding “go to your room and get your bear”, understanding driving instructions to get to a friend’s place)
  • Understanding different kind of words such as prepositions (on, in, beside) or concepts (more/less, big/little, up/down etc.)
  • The ability to understand what the “wh questions” (what, where, who, why) are asking of them (example: ‘who’ questions refer to people, ‘what’ questions refer to objects)

Speech, expressive language, and receptive language all work together to enable us to communicate and interact! Check out our other blogs for more content on specific areas of speech-language therapy.

Carla Montgomery, M.H.Sc. SLP(C)
Speech-Language Pathologist, Reg. CASLPO

Posted in Acquired Brain Injury, Adult issues, Autism and Speech Therapy, Helpful Tips for Parents at Home, Language Development, Motor Speech Disorders, Phonological Awareness, Social Communication, Speech and Language Milestones, Stuttering, Uncategorized | Leave a comment

Word Finding

Posted on January 19, 2012 by thespeechtherapyblog

Since Joyce (name have been changed to maintain anonymity), a woman in her early 50’s, suffered a mild brain injury in a car accident a year ago, she often has trouble thinking of the right words in conversation. “It makes me feel stupid when I know what I mean but I just can’t find the words”, she says. She finds herself withdrawing from conversation and even avoiding social events because of this difficulty.

Although word finding problems are common in stroke, traumatic brain injury, and dementia, they also occur in ordinary aging. Word finding is a retrieval problem. The person knows the word, may be having the “tip of the tongue” experience but cannot recall the word. In other words, the library is intact but the librarian is on vacation. Word finding problems are one of the most common reasons that adults are referred to a speech-language pathologist.

Words are stored with multiple connections in the brain. For example, the word “cat” might be stored with words that begin with “c”, words that end in “at”, furry animals, pets, and boats (catamaran). To bring to mind a word that you have forgotten, you can go through the alphabet and think of what the word sounds like. You can also ask yourself questions about the word, such as “Is it abstract or concrete?”, “Where do I know it from?”, and “What other things are like it?” Consciously listing its attributes — how big, what colour — can help as well.
You can prepare for a social event or a meeting by priming the vocabulary that will be used in that situation. Take a little time beforehand and make a list of topics likely to be discussed and brainstorm the vocabulary that goes with those topics. The object is not to memorize the vocabulary or to think of every possible word you might need, which would be impossible. Rather, the aim is to warm up the part of the brain that stores the related words. It is especially helpful to review the more obscure terms as research has shown that learning more difficult vocabulary makes the more common words in a category easier to remember. However, reviewing the common words does not facilitate retrieval of the more obscure words. So, for example, if hockey is going to be a topic of discussion, reviewing the names of the minor players on a team will help you to remember the major players.

Joyce began preparing for social events by making lists of vocabulary for one or two topics. “I feel much more confident knowing that I have some things I’m ready to talk about”, she says, “but sometimes I still don’t think of the word I need until I’m halfway home again!”

Suzanne Bassett, M.A., M.H.Sc. S-LP(C)
Speech-Language Pathologist

The Speech Therapy Centres of Canada
www.speechtherapycentres.com

Posted in Acquired Brain Injury, Adult issues | Leave a comment

Can I change my accent?

Posted on January 17, 2012 by thespeechtherapyblog

Canada is a wonderful place because of the many different cultures that live here. With many of those cultures, come different languages and English accents. For people speaking English as a second language, their knowledge and understanding of English may be great, but their accent can be a barrier to being understood all of the time. Being better understood at work and in one’s personal life are major motivators for people wanting to modify their accents. Many speech language pathologists (SLP) see adult clients for “Accent Modification Therapy”. This is a process whereby a person works to modify his/her accent to make their English sound more like a native speaker, with the guidance and instruction of an SLP.

In order to learn about which sounds need to be modified, an SLP has to complete an assessment which will take into account your first language. It also involves analyzing how you produce specific consonant and vowel sounds, as well as the rhythm you use while speaking. This rhythm is often a very important part of the therapy. It includes aspects like how you stresses syllables within a word, stress words within a sentence, and link certain words together. Once an analysis is complete, your SLP will select goals and help you to work on them in a systematic manner.

One of the most important factors to success is at-home practice. Your SLP provides the goals and the exercises, but you must do them! If you set aside time to practice each day, you are more likely to experience success. Your practice must be consistent. Regular appointments with your SLP will increase your chances of continuing to practice and ensure you are moving on to new goals at the appropriate time. Most often the goal is not to “erase” an accent, but to ensure a speaker will be better understood in an English-speaking environment.

In short with hard work, consistency and guidance you can change your accent!

Jana Zalmanowitz M.Cl.Sc
Speech-Language Pathologist (C)

Posted in Uncategorized | Leave a comment

Modified Diets and Quality of Life

Posted on January 4, 2012 by thespeechtherapyblog

For most people, food is one of the most pleasurable aspects of life and many would agree that food increases our overall quality of life.  All great events in life include food.  So what happens to those adults, who have experienced this type of enjoyment and then have to shift their lives to one of a modified diet?  Modified diets are often needed for adults that have begun aspirating (choking) on foods they are eating which can happen for multiple reasons. The diets are prescribed by doctors or speech-language pathologists to reduce the chances of food or drink entering the lungs. This risk can be very serious and life threatening as it can cause pneumonia.

Modified diets, are stereotypically not as enticing as a regular diets since they may include soft-textured food, thickened liquids, inability to eat certain foods unless blended first etc.  The difficulty lies in balancing a modified diet with quality of life.  As SLP’s we consider quality of life when the client and their families are asking us questions about the modified diet recommendations.  We modify the diet as minimally as possible, to improve overall swallowing function, while trying to maintain pleasure of eating.  It is therefore important to let your practitioner or SLP know if there are any foods that you just can’t live without.

For example, my grandmother was put on a feeding tube, after being diagnosed with multiple mini strokes.  These strokes affected her overall functioning; she was wheelchair ridden, eating through a feeding tube and most of her day was spent on a respiratory machine.  The only joys in her life at that time were having her children, grandchildren and great-grandchildren visiting, but the family felt that wasn’t enough.  In our culture, food is everything, and what my grandmother loved was chocolate.  Although my grandmother was not supposed to be eating anything orally, her SLP said that if she couldn’t live without her chocolate, she could eat some chocolate pudding to improve her overall quality of life.  The role of the SLP was to provide our family with all of the information on swallowing risks. Since the family decided that chocolate was worth risking from time to time, and we were open and told this to our SLP, she was able to give us the information we needed to give my grandmother chocolate in the least risky format. This did not mean it was without risk, but it was a risk we were all fine with taking. At the same time, it allowed my grandmother to have one more pleasurable thing in her life, her love… of chocolate!

Melissa Oziel
M.Sc-SLP, Reg. CASLPO
Speech-Language Pathologist
 
The Speech Therapy Centres of Canada
www.speechtherapycentres.com
 
Posted in Uncategorized | Leave a comment

Ho, Ho, Ho Holiday Conversations

Posted on December 15, 2011 by thespeechtherapyblog

Holiday time is an exciting time for everyone: celebrations, food, and time with loved ones. With many families and friends coming together and reuniting, often after long periods of time, come many loud group conversations. These conversations can feel quite overwhelming to some people, especially those with acquired brain injuries (ABI). Many clients with ABI find it difficult to attend to the conversations, keep up and/or add meaningful information to the conversation, or remember what has been discussed.

Some tips for keeping up in group conversation:

  • Prepare. If you anticipate that it will be a long night, take a proper rest and cognitively prepare yourself. This could include deep, relaxation breathing or going for a brisk walk.
  • If you are nervous that people are going to be asking you about your injury, plan a script ahead of time and try to re-direct the conversation back to the speaker. This will help you feel more comfortable and confident, knowing that you have anticipated this exchange in advance. E.g., “It’s been a long year but things are moving along, thank you. And how is Johnny enjoying college?”
  • Try and eliminate background noise- if you are hosting the party, keep the noise to a minimum e.g., turn music low, turn off the television. If you are attending a party, ask the hostess if they do not mind to turn down the volume.
  • Seating is important. Try and sit close to the person you feel comfortable conversing with. Try and seat yourself away from distractions e.g., away from the kitchen, or washroom.
  • If you are finding it difficult to carry on a large conversation, try and create a smaller sub-group conversation. Smaller conversations are much easier to maintain and require less brain energy, than those larger, louder ones.
  • If you are having trouble concentrating, ask 1-2 people if you can go in the other room to talk. It may be easier to have a productive conversation when you have decreased the amount of distractions.
  • Repeat the question back to the listener. This helps you remember the information shared and also shows the listener that you are following the conversation. E.g., Q-“What do you plan on doing during the holidays?” A-“What do I plan on doing during the holidays? Well this week….”
  • Summarize the information back to the listener to confirm your understanding. E.g., “So you are leaving to Mexico next week and going with the family for 7 days. What a nice time!”
  • If you are stuck and are having trouble keeping the conversation going, transition to another topic. You can use the surrounding context if you are having difficulty choosing a new topic, such as commenting on the food, decorations, host or hostess, holiday plans.
  • Don’t be afraid to ask for repetition! Everyone needs clarification sometimes, and your participation matters.

 Use these strategies to help communication during the holiday season! The Speech Therapy Centres of Canada hopes to make your holiday conversations enjoyable and successful. Speak with your S-LP for more social communication strategies.

 Ashleigh Wishen, M.H.Sc. S-LP (C)
Speech-Language Pathologist, Reg. CASLPO
 
The Speech Therapy Centres of Canada Ltd.
www.speechtherapycentres.com
 
Posted in Acquired Brain Injury, Adolescents, Group Therapy, Group Therapy, Social Communication, Teenagers, Uncategorized | Leave a comment

Causes of speech and language disorders: Some answers to parent’s “why’s”

Posted on December 8, 2011 by thespeechtherapyblog

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.

Posted in Acquired Brain Injury, Autism and Speech Therapy, Helpful Tips for Parents at Home, Language Development, Motor Speech Disorders, Phonological Awareness, Pre-school, Social Communication, Speech and Language Milestones, Stuttering | Leave a comment