The following newsletters are included:
Treat Feeding Problems Early to Prevent Later Speech Problems
— Kim Stone, MA, CCC-SLP
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:
- Introduce a variety of tastes and textures from an early age.
- Provide a low-stress environment where feeding is fun.
- Encourage weaning from the bottle around 12 months.
- Allow your child to independently feed him/herself as much as possible.
- Encourage straw drinking as early as possible rather than relying on a “sippy” cup.
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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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Children’s Speech Sound Production — What is Normal and What is Not?
— Kim Stone, MA, CCC-SLP
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 in patterns of 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 a Picture 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.
For more information, contact Kim Stone at Jodie Schuller and Associates, Language, Speech and Educational Services (858-509-1131).