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Brynn’s Story

Brynn’s Story

We first met Brynn one Saturday in late January. Our first impression was a nine year old beauty with long blonde hair and huge blue eyes. The only facial feature that detracted from her beauty was her tendency to sit with her lips apart and rest her tongue visibly low and forward between her front teeth.

Brynn had been in speech therapy at school with limited progress. The sound that Brynn couldn’t produce was “r”. It wouldn’t be so bad if “r” was just one sound in the English language, but that’s not the case. There are 26 different “r” sounds in English. You have to count initial “r” like in “rabbit” and “run” and “r” blends like in “bread” and “green” and “r” colored vowels like in “far, “ear” and “door”. With so many different “r” errors, Brynn’s speech was still somewhat difficult to understand. By third grade, childrens’ speech should be adult-like with no speech sound errors, so Brynn’s manner of speaking was drawing negative attention to her as well. Brynn’s challenge was compounded by the fact that her own name contains an “r” sound and both of her brothers’ names do as well.

Fortunately for Brynn, her school speech therapist, Marium Gorgas, is knowledgeable about the relationship between the tongue resting posture and speech sound production and identified Brynn’s speech disorder as a tongue thrust related condition. Since tongue thrust therapy is beyond the scope of school speech therapy, she referred Brynn and her family to us for treatment.

Our evaluation confirmed that Brynn was indeed a mouth breather and a tongue thruster. The distance between her lips was so wide at rest that we were concerned that the tissue may not be competent for proper lip closure. Her tongue rested in a lazy position between her upper and lower incisors. No wonder Brynn couldn’t produce the “r” sound; that requires a taut, toned tongue pulled way back to the soft palate! Not only that, Brynn’s tongue was pushing against her upper front teeth, pushing them into a “buck” position.

As part of the evaluation, we took Brynn’s history to find out how she had developed this condition. She had allergies to pollen and dust mites, so every time her allergies kicked in, her nose clogged up, and she was forced to breathe through her mouth. In fact, Brynn needed an inhaler as a preschooler to prevent her respiratory issues from turning into bronchitis and pneumonia. Her beloved cat, Mimi, was also sleeping in her bed; animal dander is another common allergy and was possibly contributing to her nasal congestion as well.

The plan was to clear up Brynn’s congestion and get her breathing through her nose. After multiple tests and trial & error, Brynn’s allergies responded best to a nasal spray that she began using continuously morning and night. That cleared up her congestion, but after a 9 year habit, her lips were only comfortable in the open position. Proper lip closure would only be possible if Brynn could stretch and strengthen her lips and learn the proper muscle memory for lip closure by holding a tiny rubber band between her lips while watching tv and dressing her Barbies. A disciplined ballet dancer, Brynn related stretching her lips to stretching her inner thigh muscles in preparation to do the splits. She nailed it!

The next challenge was toning Brynn’s tongue, so it could sit comfortably in her palate. She practiced tongue exercises comparable to doing calisthenics and lifting weights. Then Brynn had to practice smashing her tongue blade to her palate for initially 5 minutes and presently 3 hours a day. Piece of cake!

Another important component of treatment was teaching Brynn the correct swallow: bite the back teeth together, squeeze the tongue tip to the alveolar ridge and lift the middle and back of the tongue to the palate. We started with swallowing tiny squirts from a spray bottle and then taught Brynn to sip and gulp from a cup. Next she will learn to correctly chew and swallow solid foods and then start monitoring her saliva swallows as well.

Of course, the goal for Brynn is clearing up her “r” sounds. We initially practiced correct tongue positioning and experimented with the different “r” sounds. Out of all the “r” sounds, Brynn was only able to say the “ar” in “car”. No problem! That was a starting point.

Brynn took home a list of words and practiced words like “star”, “car” and “far” at least twice a day. The next week Brynn came in to therapy rattling off those words like a champ. She also showed off her new pronunciation of her name: she was “Brrrynn”, not “Bwynn” any longer. You can imagine how good that felt to all of us, especially Brynn. Transitioning from the “ar” sound to the “br” sound was beyond expectations at that point in the program, but Brynn was highly motivated!

This is June, and Brynn has come to therapy almost every week since the beginning of March. She is gradually becoming a nose breather; her lips are usually closed. She is also gradually learning to keep her tongue suctioned up on her palate instead of hanging between her upper and lower teeth. We know this is true because Brynn wears a vibrating watch that goes off every 20 minutes. When her watch vibrates, Brynn checks the position of her lips and tongue; she has reported correct positioning about 75% of the time. The watch vibration is also Brynn’s signal to tell herself she is a “star” with a perfect “r”.

FYI...Brynn is allowed to release her tongue to participate in class discussions and converse with her family and friends; but she knows, when it’s her turn to listen, her tongue goes back into smash-up mode. And Brynn is highly motivated to talk; she is intelligent and articulate, and people can understand her now. She pronounces many “r” words correctly in conversation. At this rate of progress, she will be pronouncing all “r” words correctly by summer’s end.

Not only that, she will be consistently keeping her mouth in proper resting position; her lips will be closed and her tongue will be suctioned up on her palate where it belongs. This healthy position will guarantee excellent speech production for life. It will also contribute to her dental health....no more pushing on her upper front teeth and making them buck out. Breathing through her nose will also make her a healthier person; Brynn can tell you that nasal breathing cleans, warms and humidifies the air that we breathe and reduces the risk of asthma, allergies and airborne illnesses.

There are so many school-aged kids who share Brynn’s challenges. She would like other children to know that they don’t have to go through life with a speech problem......so she agreed to tell her story.

Kudos to you Brynn! You make us all proud!

If you would like more information about our services, call us at 858.509.1131. We still have times available for speech, language and tutoring during our summer program.

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Madi’s Story

We first met Madi when she was completing her first year of kindergarten. She was struggling with emergent reading and basic math concepts, and her handwriting was a mess! She was behaving herself in school, but all of the tension from failure after failure in the classroom was causing daily meltdowns at home. Her teacher and school administrators were encouraging Madi’s parents to enroll her in special education. If the pull-out program didn’t work and Madi fell two years behind, they could enroll her at the local special day class for children with moderate to severe learning disabilities. There would be fewer students in the classroom and the teacher would move at a pace slow enough to accommodate the most severely handicapped children. Even though this recommendation was a likely possibility, Madi’s parents had the sense to seek outside advice.

They took Madi to Kaiser for a full psycho-educational battery. Her psychologist, Stephanie Eischen-Lee, Ph.D., did a complete battery of tests and recommended outside intervention. She encouraged Madi’s parents to try intensive educational therapy and tutoring before making the drastic move to special education.

Following the advice of Dr. Eischen-Lee and Madi’s wise grandmother, Madi’s parents called for an appointment. Our assessment showed that Madi did indeed have severe learning problems. She had a lingering speech disorder causing her to mispronounce words, which made her speech difficult to understand. Like so many children, Madi’s speech disorder was related to poor phonological awareness. Madi couldn’t hear the difference between the “w” and “r” sounds, so she couldn’t pronounce “r” words correctly. Since Madi couldn’t hear the difference, it was practically impossible for her to learn the sounds for the letters, the skill necessary to begin reading. How was she going to learn that the letter “W” is pronounced “wu” and the letter “R’” is pronounced “ru”, when, to Madi, they sounded identical.

We dug deeper into Madi’s challenges and discovered that learning the sound-letter relationships was just the tip of the iceberg. Madi didn’t understand the basic concepts of “words”. To Madi, a long word was “train” and a short word was “caterpillar”. (e.g. Is “train” a long word or a long object?) If she didn’t grasp the idea of “words”, how was she EVER going to grasp the idea of “sounds”?

To make matters worse, Madi’s also had visual processing problems. She could see just fine...it was not a problem with visual acuity. But Madi was reversing many numbers and letters; she was even writing her name backwards..... “I” “d” “a” “M”.

Madi’s IQ tested high.....she was able to listen to a story and pick out the main ideas and supporting details. But her auditory and visual processing problems were making reading, writing and math practically impossible for her.

Her parents collaborated with us to determine the best course of action for Madi. Putting her in special education would make school less frustrating and challenging. The question was whether or not Madi, being in a slower paced setting, would keep up with her peers who were attending regular education. If she started first grade in special ed, would she EVER close the gap and keep up with California State Standards and graduate from high school and go on to college?

But it was a catch 22! If she didn’t move to a slower paced classroom, how were we going to get Madi ready for first grade? She didn’t have kindergarten readiness skills. How could we possibly prepare her for first grade, even if we tutored Madi 5 days a week?

Together with her parents, we decided to move Madi to a different school and have her repeat kindergarten. That was not a light-hearted decision. What if we were wrong? What if we lost a whole year of Madi’s life with another failing year of kindergarten? But, on the other hand, what if we were right? What if she could be ready for kindergarten this time and keep up with her peers? What if she could stay in regular education and have a better chance for a higher education? We decided to go with plan B....work intensively on readiness skills over the summer and get Madi ready for another year of kindergarten.

That summer we saw Madi three days a week. We hammered phonological awareness; Madi learned the concept that language is composed of words and words are composed of syllables and syllables are composed of sounds. Once she knew that “cat” is a word that represents that feline with a long tail, we could teach her that the word “cat” is composed of 3 sounds...“c” “a” “t”. Then we were able to teach her that the sound “c” is made with the letter C, and the sound “a” is made with the letter A and the sound “t” is made with the letter T. She started learning the sound-letter relationships.

To build her math skills, we also taught her to count up and down a number line. After she could count on a real plastic number line, she learned to make a number line in her head. Then Meghan, Madi’s tutor, taught her to add one digit to the number 1 and see where she ended up on her imaged number line. We celebrated the day when Madi realized that “1” + one more took her to the number “2” on the number line in her head.

Handwriting was another issue. We used the “Handwriting Without Tears” program and helped Madi write legible letters. She learned to write the letters for each of the sounds, and using many visual reminders, managed to get them going from left to right and facing the correct direction.

Madi has continued to receive thrice weekly tutoring throughout her second year in kindergarten. We have emailed her teacher to make sure we are meeting Madi’s needs and addressing her challenges. This is May, and by all reports, Madi is keeping pace with her class! She is reading basic kindergarten books and spelling simple words. She is counting up to 16 on her imaginary number line and adding facts up to 10. Her handwriting is neat and legible.

Reading and math are not easy for her yet, but she is succeeding in class! Her skills are comparable to most other kindergarteners. She will likely need support for another year or so to get her over the hump and onto the road to success.

Fortunately for Madi, once she cracks the decoding part of reading, comprehension will be a cinch. And that has nothing to do with us. Madi comes from a family of excellent comprehenders, great thinkers and AWESOME decision makers. Obviously, their wise decisions are paying off!

Whew!!!

Madi’s family understands that early intervention is key. The earlier we start remediation with our students, the less time it takes to close the gap and, thus, it reduces the chance of a poor self-concept and behavior problems.

Remember our motto; early to talk, early to read, ready to succeed!

If you would like more information about our services, call us at 858.509.1131. We still have times available for speech, language and tutoring during our summer program.

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Max’s Story

Max’s parents referred him to us when he was a high school freshman at Torrey Pines. He had a hearing loss and was highly distracted by background noise in any setting, but especially in the classroom, where background noise was rampant. He was excelling in art and math, but was struggling in literature, science, history and any class that involved reading novels and textbooks. Because of the discrepancy between Max’s high IQ and poor classroom performance along with his hearing loss, he qualified for special education; he was pulled out of the classroom for speech therapy, remedial reading and for 3 classes per week to prepare him for the CAHSEE (California High School Exit Exam).

Max’s parents were worried about his future. He was an intelligent kid who loved learning about history and current events. He was social and had strong relationships with his family and friends. Max wanted to go to college, but how was that ever going to happen?His grades were mediocre, at best. He could not write a legible essay with grammatically appropriate sentences and correct spelling, and he did not test well on exams like the SAT and the CAHSEE.

Completing a battery of tests, we pinpointed Max’s learning problems.

He was a freshman who was reading at the 5th grade level. He hadn’t mastered the rules for phonics or breaking words into syllables, so his fluency was very choppy. He put so much energy into sounding out the words that he couldn’t concentrate on comprehension. With his limited comprehension, he couldn’t take effective notes or make outlines and, therefore, he didn’t have the tools to prepare for tests.

Max’s writing was also a problem. He was an enthusiastic, creative writer who loved making up stories and writing about history. Unfortunately, he omitted words and word endings and confused the syntax. He forgot to include periods and capitals, so his writing was composed of run-on sentences. He spelled words without logical letters. Nobody could read Max’s writing including Max himself.

Another challenge for Max was language processing. His ability to listen to lectures and pick out the main ideas and supporting details tested at the 7 to 8 year old level. This was a boy who was already 13-1/2 and in 9th grade. No wonder he was struggling in class!

We enrolled Max in our tutoring program 4 hours a week. Our goal was to help Max catch up and GET AHEAD in school! He had the motivation and intelligence, and we had the expertise!

We started by teaching Max the rules for phonics and syllabication. We used the Wilson Reading System to drill those rules and practice fluency.

More importantly to Max, we dovetailed our instruction with his high school literature class. He and his tutor, Kathy, read John Steinbeck’s novel Of Mice and Men. Kathyfirst made sure Max could sound-out all the words. She choral read with Max and syllabicated the words for him and taught him instant recognition of those words (sight words) to build his fluency.

Then she asked Max to describe his visual imagery. He described the pictures in his head, explaining the colors of the rivers and trees and the expressions on the characters’ faces. Once Kathy knew that Max’s images were accurate, she asked him to think critically about the content; did Max think Steinbeck’s Lenny was going to hurt the puppy or would Lenny realize the danger of his physical strength and stop squeezing the puppy so hard?

To make sure Max remembered the key characters and events, Kathy helped Max write notes in the margins of the literature and "sequence boxes" at the bottom of each page. Those sequence boxes helped Max summarize the plots of each chapter and, finally, the entire book.

We needed to help Max write more effectively too. Kathy and Max practiced writing summaries of the chapters and then editing those summaries for clearly written sentences with rich vocabulary, appropriate grammar and logical (and oftentimes correct) spelling.

Max started to interact with the text, and he got into it! He and Kathy discussed the depth of the characters and their complicated relationships. Max began to relate to the characters and couldn’t wait to learn what would happen next. He started participating in class discussions and began to receive recognition from his teachers and classmates.

We had Max in tutoring for about a year. After that, he and his parents thought Max was ready for independence; he wanted to tackle the remaining years of high school without a tutor. What could we say? Max was ready!

We lost track of Max until earlier this year. We received an email from him at San Francisco State. He was writing to thank us and especially, Kathy, for our help. He mentioned that he would be graduating from college this spring and heading to law school in the fall.

“I used to be a student of Kathy, and I just wanted to say how grateful I was to be tutored by her at Jodie and Associates. I am currently atSan Francisco State, majoring in history, and I am planning on going tolaw school. Without the help of Kathy, I don’t think I would have appreciated reading as much as I do. She made me a more confident reader and writer.”

WOW! That email made our day!

These stories don’t occur every day, but they do happen frequently to kids who attend our program. If you would like more information about our tutoring and college prep programs, please call us at 858.509.1131

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Katelynn’s Story

Katelynn was born a premie with many problems associated with premature birth; she required oxygen and was hospitalized for several days. Her health began to stabilize, but her speech and language development continued to show significant delays. Unlike typically developing youngsters, who begin speaking their first words at age one, Katelynn didn’t begin speaking until age 2. Unlike typical toddlers, who are creating their first sentences at age 2, Katelynn didn’t combine words into sentences until age 4. When she did speak, Katelynn’s speech production was so riddled with errors that it was only understandable to her parents, and sometimes not even to them.

Since she was almost 8 years old and midway through second grade, her parents and pediatrician, Dr. Engfelt, were concerned about the persistent speech and language problems along with Katelynn’s failure to read.This prompted Dr. Engfelt to refer Katelynn to us for an assessment.

Our assessment revealed a severe delay in Katelynn’s language development. Her syntax was typical of a 2 to 3 year old; she spoke only in present tense verbs and omitted many articles, linking verbs and word endings. Her expressive vocabulary was similar to that of a kindergartener. Her language challenges interfered with her ability to retell personal experiences or even a simple sequence of events.

With all of these oral language challenges, it was no surprise that Katelynn’s reading and written language skills had failed to emerge. Our assessment revealed delays in her phonological awareness; Katelynn couldn’t listen to a word like “cat” and delete the “c” to make the word “at”. Consequently, she didn’t have a chance to learn the written phonics system when she couldn’t even perform the prerequisite oral language skill of changing around the sounds in words. And obviously, since Katelynn wasn’t sounding out words, her reading comprehension was suffering as well.

We conferenced with Katelynn’s parents and recommended a combined treatment program; 4 hours of Fast Track to School Success language-based tutoring and 2 hours of speech and language intervention every week for ten weeks. They decided to put their trust in us and give it a try.

Our language based tutoring program is in integrated approach that combines our expert knowledge of language development with renowned programs such as Wilson Reading System and Lindamood Bell. Unlike many other programs, however, we never put our students through a “canned” approach where it is one for all. Using our test results, we write a specific program for each individual child integrating phonological awareness, phonics acquisition, reading fluency, mental imagery, critical thinking, study skills and written language development, depending on the student’s needs.

Katelynn just finished her first quarter of treatment, and she WOWED us all!

She has developed phonological awareness; you can tell her to say the sounds in “slab” and she can tell you “s” “l” “a” “b”. You can tell her to delete the “s”, and she can tell you “lab”. She can even change the “l” to a “c” and produce the word “cab”. Now that she has developed phonological awareness(e.g. changing the oral word “slab” to “cab”) and is learning phonics (e.g. learning the letter “b” says “ba”), she is reading at the early first grade level. Our recent informal testing for Katelynn’s Fast Track report card showed about 6 months progress in 10 weeks time. Not only is she sounding out words at that level, Katelynn is also comprehending the literature, making accurate predictions and inferring character’s emotions and motivations. Her parents are delighted with Katelynn’s growing interest in reading; she can’t wait to read her books to her family and friends.

Along with her emergent reading, Katelynn’s speech and language development arecoming around as well.This quarter she learned to tell simple sequence stories with grammatically correct sentences. She also added dozens of new words to her expressive vocabulary. Imagine how much easier it was for Katelynn to write grammatically correct sentences and book summaries, once she could draw from a larger vocabulary, and she knew how to formulate sentences. And her speech language pathologist consulted regularly with her tutor to make sure Katelynn was demonstrating her new oral language skills in both settings. That was indeed the case!

With continued support, Katelynn will likely close the gap between her skills and those of her peers. With continued support, Katelynn will likely excel in school and go on to college.

We are thankful to Dr. Engfelt and Katelynn’s parents for giving us the opportunity tohelp Katelynn. She is a shining example of our hundreds of success stories, and these results are typical of students enrolled in our combined speech, language and tutoring program.

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Michael’s Story

Michael is a bright first grader at a local public school. He has qualified for classes for gifted children and is already reading and writing above grade level. He is popular on the playground and a model citizen in class. There was only one serious problem....Michael had a habit of sucking his pointer finger. To occupy himself when he was bored and to sooth himself to sleep at night, Michael would insert that finger between his upper and lower front teeth and suck vigorously. Michael’s pediatric dentist was concerned about the consequent damage to Michael’s teeth, so he referred Michael’s family to us for an evaluation.

His parents were ready to jump on this habit when they brought Michael in for his first visit. They had tried a variety of rewards and punishments to help Michael stop sucking, with little success. Michael was still on the fence about giving up his habit, but he agreed to attend the initial evaluation.

We took the evaluation slowly. We started by talking about a reward program for quitting his habit. It began with a chart on which Michael would hang a star for each morning, afternoon and evening he could refrain from sucking. His parents would follow-up with a daily grab-bag prize for each successful day. He would returnto our office after a week and receive a treasure chest prize for refraining from sucking for an entire week. The two most enticing rewards were the skateboard Michael would receive from his parents after his first 6 successful weeks and the Wii he would receive after passing his sleep test in 12 weeks.

We had Michael’s attention and the motivation necessary to begin the program! To help facilitate his success, we instructed his parents to give Michael their undivided attention during that first challenging weekend. For the daytime, we gave him a bag of tools to occupy his hands and mouth such as gum, lollipops, squishy balls and stretchy toys. We gave his parents the night-time instructions for helping Michael fall asleep and for wrapping his target finger.

Now that we had Michael’s trust, we proceeded with our evaluation to analyze his oral structures and related functions. That analysis showed that Michael’s finger was pushing his upper and lower front teeth apart into what is known in the dental world as an “open bite”. This opening was contributing to an unhealthy swallowing habit called a tongue thrust.This tongue thrust was causing a speech disorder called a frontal lisp whenever Michael would pronounce a word containing an ‘s’ or a ‘z’. We also noticed that Michael’s target finger had already developed a crook that was causing it to bend to one side. As a team, Michael, his parents and us, decided to eliminate the sucking habit and then correct the tongue thrust and the frontal lisp.

Jodie Schuller, Michael’s therapist, called him every evening before bedtime for that first week to give him a pep talk and glory in his success. He reported that he hadn’t sucked his finger during that first difficult day or night, and 6 months later, he hasn’t sucked it yet. Through a series of fun exercises using straws, cheerios and candy, he also learned to rest with his lips together, to ingest liquids using a healthy vertical swallow and to correctly pronounce words containing ‘s’ and ‘z’.

At his last visit in January, Michael was talking about the fun he was having on his skateboard and playing with his Wii. We took another picture of his teeth and saw a noticeable reduction in his open bite.

This is a huge relief for Michael, his family and his dentist, because Michael’s teeth will likely erupt and stay in proper alignment, and the family doesn’t have to worry about the disease and speech problems that go along with digit sucking, open mouth breathing and tongue thrusts.

We are so proud of Michael’s success that we asked the family for permission to share his story with you. It was Michael’s decision, and he agreed to do it in order to help other children. If you know someone who could benefit from this program, please contact us at 858.509.1131.

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Andy’s Story

Andy is a second grader at the Old Mission Montessori School in Oceanside. He is also enrolled in our Fast Track to School Success Tutoring Program.

Andy’s difficulties first became apparent when he was a toddler; he often retreated into his own world and threw temper tantrums when he couldn’t control his environment. The next challenges his parents noticed were his poor eye contact and his reluctance to engage in conversation and to play with others. Andy would also have melt-downs when there were changes in his routine. His parents eventually had him tested at Children’s Hospital and then by Oceanside School District. The results indicated that Andy was on the Autism Spectrum.

His parents tried many interventions when Andy was between ages 4 and 7, with little success. They even tried repeating kindergarten, because Andy was having great difficulty with reading acquisition and his parents were gravely concerned about the possibility of dyslexia. When they tried to help him with school homework, Andy would get extremely frustrated and throw daily temper tantrums. Andy’s family knew a preschool director whose son had attended our tutoring program, so they called here for advice.

When Andy first started with us 2 months ago, he was reading about 10 – 20 words. His scores on the standardized reading test put him below the 1st grade level. We enrolled him in our language-based tutoring program for 4 hours a week. To increase Andy’s reading fluency, we use an integrative approach which combines methodologies from Lindamood Bell, Reading Recovery, Slingerland and the Wilson Reading Program. Equal emphasis is given to Andy’s comprehension; after reading each paragraph, his tutor probes his imagery and tests his critical thinking to be certain Andy is making accurate predictions, drawing astute conclusions, making appropriate inferences and connecting to the text.

Andy has been enrolled in Fast Track to School Success since November. He is now reading books at the late 1st grade level. He is reading them fluently, and he is accurately predicting what will happen next. He is retelling the stories and, with his tutor’s help, he is writing book summaries. Andy has improved his reading by one whole grade level in two month’s time. This is not unusual for students enrolled in our tutoring program, but it is unique for a child like Andy, who was once diagnosed with Autism.

We are so proud of Andy’s achievement that we decided to feature him in our January newsletter. We are confident, with more academic and parental support, that Andy will soon be reading and writing at grade level.

Call us at 858.509.1131 if you would like more information about our unique tutoring program. We can help children from kindergarten through college who need help with any skill from readiness and emergent reading to note taking, study skills and essay writing. We will soon kick off our SAT training program, starting with early test-taking preparation for kids in late elementary and middle school.

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Jodie Schuller and Associates Have Recently Teamed Up With Local Orthodontic and Dental Workshops

Jodie Schuller and Associates have recently teamed up with local orthodontic and pediatric dental offices to increase public awareness. Together these practices are seeking to provide the highest quality of services for excellent speech production, optimum oral hygiene and permanent orthodontic results.

To accomplish this goal, Jodie Schuller and Associates have been invited to speak with dentists and their staff members regarding referring appropriate individuals for tongue thrust therapy. Participants of these sessions learn the typical causes of unhealthy tongue resting postures, the most common being sucking habits such as sucking on fingers, sippy cups and pacifiers. Other patients at risk for unhealthy resting postures are those who have high narrow palates, large tonsils and those who breathe with an open mouth.

Participants of these workshops also learn some treatment techniques to correct incorrect swallows and tongue resting postures. The most popular experiment is having the dentists and staff members suction pudding through a straw. Participants frequently comment on the difficulty of this task and learn how doing this action repeatedly can strengthen the lips and tongue to correct swallowing habits and develop a healthy resting posture where the tongue sits on the palate behind the upper front teeth.

These sessions also include a discussion about the risks of installing a crib on the palate rather than doing muscle retraining to keep the tongue away from the teeth.

Everyone understands how the crib keeps the tongue away from the teeth while it is in place; the problem is the danger of orthodontic relapse if the tongue does not learn the muscle memory for the correct swallow and resting posture and returns to its original resting position pushing against the teeth once the crib is removed.

Participants typically want to know the symptoms that they can look for to identify good candidates for tongue thrust therapy. The top 7 symptoms are these:

Overall, these sessions have been a great success. Jodie Schuller and Associates are hoping to reach more orthodontic and pediatric dental offices in the near future. To schedule a workshop or for more information, contact Jodie Schuller at j_schuller@att.net or call 858.509.1131.

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Social Skills are the Key to Success

We all know someone who is socially gifted. That person knows how to start a conversation with casual acquaintances and good friends, to balance talking with listening and to support conversational partners with their facial expressions and reassuring comments. These are the popular people with whom everyone wants to be friends.

Knowing the importance of social skills, therapists, Jodie Schuller and Rebecca Tomaszewski attended Michelle Garcia Winner’s Advanced Social Thinking Workshop earlier this month. Jodie and Rebecca were inspired with Winner’s curriculum and acquired many new ideas and materials to use in therapy.

Good social thinking is the ability to think about your own and other’s thoughts, emotions and intentions even when you are not physically interacting with them. Not only does social thinking influence peer relationships, it influences our ability to comprehend what we read, to listen in class, and to write organized and meaningful papers as well.

As toddlers and preschoolers, children learn that being part of a group has certain expectations. They learn that they are expected to follow certain social rules (taking turns and waiting in line). If they follow the expected behaviors, they will make others feel good, which in turn, will make them feel good. If they think only of themselves and engage in unexpected behaviors like becoming overly pushy or competitive, they will make others feel uncomfortable and react negatively to them, which, consequently, will also elicit a negative emotion in them. In other words, children learn that they will feel good if do what is expected and make others feel good. Those who don’t understand that concept are likely to be labeled as behavior problems.

By 4th grade, kids are masters of figurative language. This enables them to understand jokes and sarcasm. These skills separate the sophisticated children who lead the social groups from the gullible ones who are often bullied by their peers.

This mastery of inference and figurative language also enables kids to understand what they read. Imagine trying to understand a story if you are not able to understand the characters’ intentions and motives for behaving in a certain way. Imagine trying to write an essay without knowing how to get inside your reader’s minds and explain stories and ideas in a way that others can understand.

The ultimate challenge for kids with poor social skills is engaging in conversation.

Kids who don’t think about others don’t know the core conversational skills like keeping mental files on the key people in their lives, asking questions about them, making supporting comments and adding related thoughts to continue the conversation. They don’t know how long to talk and how to change topics and avoid interrupting.

Jodie and Rebecca will be incorporating Winner’s techniques into their therapy sessions in the clinic. Call 858.509.1131 if you would like more information about this treatment. We will eventually have social thinking groups for kids of all ages.

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What is a Tongue Thrust?

Toddlers and preschoolers are expected to mispronounce many words. Yet, as these youngsters mature and their oral motor structures develop, they correct most of their speech sound errors by the age of 5.

Children who still have speech sound errors after age 5 usually have related tongue thrusts. The proper mouth resting position is lips closed and tongue suctioned up on the palate behind the upper front teeth. Tongue thrusters rest with their tongues against their teeth and swallow by pushing their tongues between them. Additionally, these children often breathe with their lips apart, which can increase their risk for air-borne illnesses, allergies and asthma and make the tongue thrust more enduring and pronounced. Improper resting positions can interfere with jaw growth and development and damage orthodontic treatment as well.

We have developed a program to eliminate tongue thrusts in children as young as 5. We do this with a tactile program which uses fun exercises such as blowing bubbles and drinking through straws. Children with weak lips can develop those muscles by blowing bubbles and blowing through a hierarchy of horns. Those with weak tongues can strengthen and tone those muscles by drinking liquids through a hierarchy of straws which vary in length, diameter and curvature and then by learning to suction semi-solids like applesauce and pudding through straws. For older children and adults, we also have a direct cognitive approach combined with strengthening and toning exercises to eliminate their tongue thrusts in as little as 3 months.

By correcting these tongue thrusts, we can correct persistent speech sound distortions at the same time. Children do not have to go through life mispronouncing their “r” sounds, which can interfere with listener understanding, or at the very least, call attention to their speech and distract the listener from the message. Children who have slushy speech related to lisps can strengthen their tongues and clean up their “s” and “z ” sounds after a few months of treatment.

Our kids follow through with the exercises, because they are fun! And parents love the program, because it works!

If you have any additional questions or concerns, please contact Jodie Schuller and Associates Speech, Language and Educational Services (858.509.1131).

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Children’s Speech Sound Production — What is Normal and What is Not?

It is normal for toddlers who are first learning to talk to mispronounce many words. At age 2, we expect to understand about 60–70% (more than half) of their speech. They should be using consonants consistently at the beginnings of their words. By the time they turn 3, we should understand 75% –80% (three-quarters) of their speech, and both beginning and ending consonants should be in place as well as many consonant blends.

Speech production is the most common reason that children are referred to a speech pathologist. If these problems are identified and treated early, they are one of the easiest communication problems to correct. There are many reasons why some children have pronunciation problems. Some problems are developmental, which means that children will likely outgrow them as they develop and mature. Other problems are serious issues that should be treated as early as possible.

To determine which is which, the child’s speech should be evaluated by a speech pathologist who specializes in pediatric articulation development. Most speech production problems can be categorized into the basic areas of apraxia, phonological deficits, and articulation disorders. Apraxia (otherwise known as Childhood Apraxia of Speech - CAS) is a motor planning deficit that interferes with speech clarity. The child attempts to communicate but is unable to coordinate the complex movements required for the mouth to form each sound as well as the movements between sounds to produce words, sentences, and phrases. In a severe case of apraxia, a child might only produce a consonant as an approximation for a word (e.g., “p” for “please” or “t” for “want”). This child’s speech would be very difficult to understand.

Phonological deficits are characterized as errors inpatternsof sounds. A child’s sound errors can include patterns such as consonant cluster reduction (e.g., deleting the “s” from “star”), substitutions (e.g., pronouncing “cup” as “tup”), and syllable deletions (e.g., pronouncing “bubble” as “buh”). A child with a phonological deficit generally attempts to communicate; however, his/her speech can also be difficult to understand. In some cases, these children are not even aware that they are making any speech errors.

Articulation disorders are milder and are characterized by intelligible speech overall; though, occasional speech sounds are distorted or substituted (e.g., “wabbit” for “rabbit,” “fum” for “thumb,” or lisps). These are the errors that preschoolers typically make, which they may outgrow without intervention. These errors should be treated early in elementary school; however, as they can result in social difficulties caused by teasing and academic difficulties with phonics and/or spelling.

Research has demonstrated that a comprehensive approach tends to be the most efficient and effective method for treating speech sound deficits, incorporating elements of oral motor therapy, tactile-kinesthetic cueing, and cycling through individual speech sounds. For children with severe speech production problems, it is important to encourage functional communication through verbalizations and alternative forms of communication, which can include signs, gestures, word approximations, and augmentative alternative communication modalities such as aPicture Exchange Communication System (PECS)or speech generating devices.

Regardless of the cause of your children’s speech production problems, have them evaluated by a pediatric speech-language pathologist — the earlier the better. Treating a speech production problem at the preschool level will reduce your children’s risk for having trouble with the next sound-related task required of them: learning the sound-symbol relationships that are necessary for mastering phonics and learning to read. After completing speech therapy, many children will even have heightened awareness of the sound components of words and be one step ahead of their peers for learning phonics.

If you have any additional questions or concerns, please contact Jodie Schuller and Associates Speech, Language and Educational Services (858.509.1131).

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Speech Problems can Interfere with Early Reading

— Jodie K. Schuller, MA, CCC-SLP

Why do some children start reading in preschool while others are still struggling with phonics in second and third grade? Many times the answer has to do with phonemic (aka phonological) awareness.

In order to acquire phonics, children must be aware of the sounds in spoken words. To sound-out written  words, children must first have the understanding that spoken words are made up of sounds. The spoken word “fast”, for example, consists of sounds which, when produced separately, go like this; ‘f’-‘a’-‘s’-‘t’.

Children who understand that concept will understand the relationships between the spoken word and the written word and the spoken sound and the  written letter. This knowledge will enable them to learn the sound-letter relationships, which will lead to sounding out their first words. Then they will learn that they can change the ‘a’ in “fast” to an ‘i’ and make the word “fist”. They will also learn to substitute an ‘l’ for the ‘f’ and make the word “list” and to delete the ‘s’ from “fist” and make the word “fit”. This is possible because these children have phonemic awareness. Children’s decoding skills then quickly escalate until they can sound out most words, including those with multiple syllables.

While the majority of children acquire this concept in Kindergarten or 1st grade, there are some children who just don’t get it. These are the children who, as preschoolers, haven’t grasped the concept that the written word is not the same as the object it represents. If you ask these children to name a really long word, they may say “train”. Is “train” a really long word or a really long object? Having no concept of a “word”, it is not surprising that these children cannot understand “sounds”.

The children who have the greatest risk for this difficulty are those with a family history of learning problems and those with a history of ear infections and speech challenges. The good news is that these children can learn “phonemic awareness”. Like any delay, it is best to identify and treat this difficulty with phonemic awareness early before it can cause a reading delay and/or emotional trauma. As a precaution, parents of preschoolers can check to see if their children can rhyme words and make nonsense words out of real words. Also, watch children who are still mispronouncing words (e.g. “pasgetti” for “spaghetti” or “hangaber” for “hamburger”) in Kindergarten and 1st grade.

If a child in the middle of first grade is still struggling with phonics acquisition, it is best to have this problem evaluated by a speech pathologist who specializes in reading and written language. The earlier the problem is identified and intervention begins, the less time it takes to treat the problem and catch up with peers. Keep in mind that prevention is quicker, easier and less expensive than correction.

For more information, contact Jodie Schuller at Jodie Schuller and Associates, Language, Speech and Educational Services (858.509.1131).

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Treat Feeding Problems Early to Prevent Later Speech Problems

As a speech-language pathologist, I frequently work with children who have a variety of feeding and speech sound disorders in the toddler/preschool years. Often these problems are due in part to oral motor deficits. These can be detected even before children begin speaking their first words by looking at their feeding abilities. Around 6-9 months, infants should begin to munch on easy to dissolve solids (e.g., cereal puffs) and should be finger-feeding with these items as well as pureed solids. By 9-12 months, infants should begin to attempt cup drinking and eating more lumpy/mashed textures. The motions required to manage these changes in solid textures as well as control liquid from a cup are closely related to the motions required for speech clarity. For example, if a child is unable to control the liquid coming out of a cup with his/her lips, then he/she probably also has difficulty producing sounds that require lip rounding such as /w/ and /b/.

Another big feeding milestone is straw drinking. Children should be able to drink from a straw by around 14-16 months without biting on the straw or putting more than ¼-½ inch of the straw in their mouths at a time. If they are unable to wean from the bottle and/or “sippy” cup to achieve this level of straw drinking, this is an indicator of possible problems separating control of their tongues from control of their jaws, otherwise known as tongue-jaw dissociation. When children cannot separate control of their tongues from their jaws, then they are also at risk for speech production problems including difficulty producing /k/ and /g/ sounds (which require use of the back of the tongue), /r/ and /l/ sounds (which require a complex series of fine approximations of the tongue to the roof of the mouth) and/or possible lisps.

Good tips for mealtimes:

If you have any additional questions or concerns, please contact Jodie Schuller and Associates Speech, Language and Educational Services (858.509.1131).

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