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What is Dyslexia, Anyway?

boy reading book There is so much confusion and myth surrounding dyslexia. I decided to take this opportunity to answer the questions that keep popping up in my discussions with our parents and teachers. This information comes from a compilation of textbooks on dyslexia, especially Sally Shaywitz&rdsquo;s book, Overcoming Dyslexia, and my own 25 years of experience teaching dyslexic children and adults to read.

What is the Dictionary Definition?

If you look up dyslexia in the dictionary, it simply says dyslexia is difficulty learning to read, write and spell, despite intelligence, motivation, education and/or sensory damage. That means.... to have dyslexia, a person must be bright, motivated, educated and have normal hearing and visual skills and yet have problems with reading. Dyslexia is not a delay in reading achievement; it will not resolve itself over time.

How Many People are Affected by Dyslexia?

According to recent surveys, about 3-1/2 percent of all public school children are receiving special education for reading difficulties....that&rdsquo;s 3 or 4 out of 100. In 1998, the National Research Council&rdsquo;s Committee on Preventing Reading Difficulties in Young Children did a study. They gave hundreds of kids an intelligence test and a reading test. A whopping 20% of these children were reading below their grade or ability levels. That&rdsquo;s 20 out of hundred! Clearly the public schools are not picking up the majority of these children. That&rdsquo;s discouraging news knowing that dyslexic readers will NEVER catch up with their classmates without appropriate intervention.

What Causes Dyslexia?

Let&rdsquo;s start by clarifying a common myth. Children with dyslexia are NOT prone to seeing letters or words backwards. Children with dyslexia do not SEE “was” as “saw” or “saw” as “was”. They do not SEE “d” for “b” or “b” for “d”. Rather they can&rdsquo;t tell the difference; because those squiggly lines and curves we call letters have no meaning for them. Imagine yourself trying to remember the names of two Chinese “letters” you couldn&rdsquo;t understand. You&rdsquo;d get those characters mixed up too.

The deficit responsible for dyslexia resides in the language system of the brain. It is not an overall defect in language, but rather a localized weakness in the phonological system of the brain. That is the part of the brain where the sounds of language are put together to form words and where words are broken down into their component sounds. The word “cat”, for example, has 3 sounds....c-a-t. Before a toddler can understand the meaning of cat and learn to pronounce it, that toddler&rdsquo;s brain must break the word “cat” into phonemes (sounds). Children with dyslexia have difficulty doing that.... identifying the phonemes in words.

What are the Earliest Symptoms of Dyslexia?

Children at risk for dyslexia can be identified very early. The first factor for parents to consider is the family history. Dyslexia is a genetic disorder, so if any family member, including aunts, uncles, grandparents and cousins, were diagnosed with dyslexia, your child has a greater chance of suffering from dyslexia too.

The first physical symptom to look for is a delay in speech and language development. Babies should be speaking their first words by 12 months of age, 18 months at the latest. Toddlers should be combining words into phrases by age 2. Parents should be able to understand 50 - 60% of their one-year-old’s speech and at least 70% by the time a toddler is 2. Children who don&rdsquo;t meet these standards are warning us of a potential problem.

During the preschool years, 3-year-olds should be speaking in 4 - 5 word phrases and 4-year-olds should be speaking in complete sentences with occasional grammatical errors. Language should be almost adult-like by age 5. Parents should understand at least 80% of a 3-year-old&rdsquo;s language, 90% by age 4 and 98% by age 5.

Preschoolers at risk for dyslexia may also be identified by their malapropisms; they may make pronunciation errors like saying “hangaber” for “hamburger” and “puzghetti” for “spaghetti”. Other red flags are difficulties with rhyming and learning/remembering the letters in their own names.

What Symptoms are Most Common in Kindergarten and First Grade?

This is the age at which many children begin to struggle. These are the kids who have difficulty understanding that words can be pulled apart into sounds. Many of these kids have difficulty remembering the names for the letters of the alphabet and/or they may have difficulty learning the sounds that go with the letters... in other words, they may have difficulty with early phonics.

Kindergarten and first grade are the years when children learn to read. The way our schools are set up, kids better learn to read during those first years of elementary school, or they are at risk for reading failure.

Why do so Many Kids Slip Through the Cracks Until Second or Third Grade?

Just as kindergarten and first grade are the years when children learn to read, in third grade and on, children read to learn. Second grade is a transitional year when phonics acquisition is reinforced, and children learn to break long words into syllables and then develop fluency in their reading. If children don&rdsquo;t have the ability to “sound out” words by third grade, they are inevitably in trouble.

To complicate the issue, their assigned stories and novels are becoming increasingly complex with fewer pictures to help them. A second grade child who was relying on pictures to understand the plot of a story will fall apart in third grade when the pictures are reduced to one or two per chapter.

To identify dyslexic individuals in second grade and on, look for kids who are having difficulty pronouncing unfamiliar, complicated words like “aluminum” and “rhinoceros”. Look for problems with oral language like word finding problems and slow response times. Look for difficulty remembering isolated pieces of verbal information like phone numbers and birthdays. Also look for disfluent speech with many “ums” and “ahs” or imprecise language like “stuff” and “thing” for proper names of objects.

Another big red flag is a problem with word identification strategies during reading. These are the kids who have difficulty reading unknown words that must be sounded out...this problem is especially noticeable when they try to read lists of words like spelling words, class lists or phone books. These kids rely on contextual cues to read words, because they don&rdsquo;t have reliable word identification strategies.

Another common symptom is problems with writing, especially spelling. These kids often have disastrous spelling. They may do OK on spelling tests because of their excellent memories. But ask them to write a story using their spelling words and their spelling goes right out the window.

Can you Prevent Dyslexia?

Remember the motto... the best intervention is prevention. Very early intervention can prevent a potential problem with dyslexia. And even when prevention was not possible, early intervention can nip a problem in the bud and enable at-risk children to read. In fact, early intervention and treatment bring about more positive changes at a faster pace than intervention provided to older children.

Can you Overcome Dyslexia?

The answer is a resounding YES! Any child with normal cognitive skills can be taught to read. But you must start with the earliest possible diagnosis and then seek effective treatment. The keys to successful treatment are:


What can Parents do to Help?

Parents are their children&rdsquo;s advocates. Parents must do everything possible to get help early and then insist on proven reading programs with qualified teachers and optimal instructional settings.

Home is the place for reinforcement of new skills and for pleasure reading. Home is the place to build word and worldly knowledge. Parents can do this by reading to their child at her interest/intellectual level but above her reading level. This will enable her to gain new vocabulary words and new knowledge about the world that would otherwise be unavailable to her. Imaginef how much easier it is to read the word “Yosemite” and visualize the gushing waterfalls and towering rocks and lush meadows if you have heard about it, and better yet, if you&rdsquo;ve actually been there.

Parents&rdsquo; number one priority should be nourishing their child&rdsquo;s soul and preserving his self-esteem. That starts with helping him understand the nature of his reading problem... helping him understand that it has nothing to do with his intelligence, but rather, a very specific challenge in one little part of his brain. Point out other people who have suffered from dyslexia including relatives, Tom Cruise, John Irving and Charles Schwab. Help your child identify an interest or hobby in an area where he can have a positive experience... either through enjoyment or excellence.

Make sure that school is a positive experience and teach him to advocate for himself. That starts with speaking up and asking for more time on tests or sitting closer to the teacher. And that starts at home....by having parents who listen to their children and respond thoughtfully to their concerns.

What can Teachers and Schools do?

With the understanding that the best intervention is prevention, teachers can educate themselves about dyslexia and encourage parents to seek early identification and treatment. Schools can also provide early intervention programs, like our P.R.E.P. Preschool Reading Enrichment Program,in their preschools and kindergartens... programs that will build phonemic awareness and mental imagery....skills that will facilitate the acquisition of phonics and reading comprehension when formal instruction begins.

If you would like more information about our assessment and/or intervention programs, either at our clinic or on school site, please contact us at 858.509.1131. It is never too early or too late to begin.
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Riley’s Story

Riley The speech delay that we treat most often is a phonological disorder. It is very common in toddlers and preschoolers and, without early intervention, shows up in the primary grades as well.

Phonemes are the sounds that make up our words. So a phonological disorder pertains to a child's production of sounds. Unlike other speech production problems, phonological disorders are patterned. One of the most common patterns is producing ‘t’ for ‘k’ and ‘d’ for ‘g’, so “car” sounds like “tar” and “good” sounds like “dood”. Another common pattern is changing the ‘l’ and ‘r’ sounds to ‘w’, making “ring” sound like “wing” and “listen” sound like “wisten”. The third pattern that we see frequently is cluster reduction, where children will reduce consonant clusters that have 2 or 3 sounds; kids typically delete the ‘r’ from ‘br’ and the ‘l’ from ‘bl’ clusters, changing “bread” to “bed” and “black” to “back” and they delete the ‘s’ or the other consonant from ‘s’ clusters, so “school” is “cool” or “star” is “sar”.

Riley bounced into our office one day in August with her concerned parents. Picture an adorable 3 year old with big blue eyes and brunette curls wearing a whimsical little yellow sundress with matching sandals and a sparkly headband adorning her hair. Riley has great social skills, so after introductions in the waiting room, Riley took Tessa’s hand and went back to the therapy room with ease.

She sat down with Tessa and played with the farm. Before long, Tessa was able to engage Riley in conversation. Riley set up the farm. She wanted “da titty tat and da tows in da bawn. Da doats and wittle wams wuh seeping out in da yawd, and the dod was bawting at dem.” Riley made a “woad to da bawn so da fawma tould dwive da tata to da bawn and mit da tows.”
Did you get that? Actually we did! Because Riley was using patterns, we translated Riley’s speech to the following: “The kitty cat and the cows were in the barn. The goats and little lambs were sleeping out in the yard and the dog was barking at them”. Riley made “a road to the barn so the farmer could drive the tractor to the barn and milk the cows.”

We understood Riley about 70% of the time if we knew the context of the conversation (probably about 50% of the time without contextual cues). But her parents and peers were baffled. There were times when they couldn’t understand a word Riley was saying. Like many children with phonological disorders, Riley is a very bright little girl. She has a lot to say. She wants to be heard during circle time and while playing at recess with her peers. She was starting to get frustrated. And her parents were worried.

We assured Riley’s parents that we understand phonological disorders, and we know how to fix them. So Tessa and Riley got to work. Riley was able to make a ‘k’ when Tessa tapped her finger on the front of Riley’s neck to show her that ‘k’ is made with the back of the tongue; that was where they began. Riley learned to say “cow”, “king” and “key” with three perfect ‘k’ sounds. Tessa and Riley read books and sang songs that were doused with ‘k’ sounds like “Crazy Camel” and “Cat in the Hat”. They made cookies with playdough and cut out cat pictures to immerse Riley in activities that were loaded with ‘k’.

After working on the ‘k’ sound at the beginning of words, they switched to initial ‘g’, which is produced just like the ‘k’ sound except you turn on your larynx (voice box). Then they worked on ‘k’ and ‘g’ at the end of words. Riley was also reducing consonant clusters, so they worked on ‘sw’, ‘st’ and ‘sp’ as they played with the toy swing set, built a railroad track with stop signs and had a picnic they ate with spoons.

The other important sound for Riley to master was the initial ‘l’. This is a later developing sound for some children; some don’t develop ‘l’ until age 4. But there are a lot of ‘l’ sounds in English... think about it... there is the ‘l ’ like in “listen” and ‘bl’ like in “black” and the ‘sl’ like in “sleep”. Then there is the ‘gl’ like in “glide” and the ‘pl’ like in “place”. And that’s not all. There are so many ‘l’ sounds in English that not having them, especially for Riley, makes your speech a mess. So they worked on getting an ‘l’.

Riley was having difficulty getting her tongue up on her palate for ‘l’ placement, so Tessa taught Riley to do a “cheerio hold-up”. Riley put her tongue tip in the hole of a cheerio and held it to her palate for 30 seconds, and then Tessa told Riley to munch. At first, Riley said “This is twicky, Tessa.” But after a few attempts, she got it.

To further strengthen Riley’s tongue, Tessa taught Riley to drink properly from a straw. The tongue tip went up to the bumpy ridge behind the upper front teeth, and then Riley was told to suck. The water in the cup didn’t move. Riley didn’t get the concept of sucking, so they worked on that. Tessa brought in Lifesavers and they placed them in their cheeks and sucked and swallowed. The Lifesavers worked. Riley is now drinking efficiently through a straw.

Better yet, Riley is now able to make an ‘l’; not a ‘bl’ or an ‘sl’ yet, but she can do the ‘l’ in “lot”, so that is a place to start.

And the best news of all, Riley is starting to produce ‘k’ and ‘g’ correctly in conversation. Last week she shared her Halloween plans, “I am going twick or tweating in my costume and get candy”.

Riley’s ‘s’ clusters are also popping up in conversation. Tessa held up a picture and Riley described it, “Dat skunk is so smelly, Tessa.” Did you notice the ‘s’ cluster and ‘k’ sounds together in the word “skunk”? We sure did! Thumbs up to Riley and Tessa!

Having those two very important sound groups, the ‘k’ & ‘g’ group and the ‘s’ cluster group, Riley’s speech is now 90% clear to us and much better to her parents and peers. Her father even said, “When Riley talks to adults, I barely have to interpret anything anymore.”

Not only is Riley’s speech clearer, she is also in a better place for emergent literacy. Imagine trying to learn the names of the letters if the ‘k’ and ‘t’ seem identical to you. More difficult yet, imagine trying to learn that the letter ‘k’ says “ku” if, when you say it, the letter ‘k’ says “tu”, and that would be confusing if it seems identical to the sound the letter ‘t’ says... also “tu”.

As we mentioned at the beginning of Riley’s story, phonological disorders are problems with sounds. And sounds are parts of words...and sounds are linked to letters... and learning the sounds and related letters is one of the first skills children learn in kindergarten... it’s otherwise known as “phonics”. Kids with phonological disorders are telling us that their sound systems are out of order.

So these kids are very often at risk for dyslexia. Without intervention, these kids are almost certain to have problems with emergent reading.

But the good news is that phonological disorders, of all the speech and language problems, are so treatable! And treating them early, before kindergarten, is the best way to prepare children for school. Like Riley, bright kids who receive early speech therapy may actually have an advantage as they prepare to read; Riley knows how to listen to the sounds in her words and replace the ‘d’ in “doat” with a ‘g’ for “goat” to repair her communication breakdowns. She also already knows what sound the letter ‘k’ makes... “ku”. Bring on the phonics!!!

Riley comes into our office twice a week with a big smile on her face, and she truly makes our day. It is such a joy listening to her talk about her day and understanding practically everything she has to say!

If you know a child who is having difficulty pronouncing sounds, call our office at 858.509.1131 for more information. It is never too early or too late to begin.

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Raquel’s Story

Raquel Most of our clients are preschool and elementary school age; because, thankfully, most speech disorders are identified and remediated by third or fourth grade, before they become weights on a child’s shoulders. When a middle schooler, or worse yet, a high schooler has a noticeable speech disorder, it often exacerbates the feelings of insecurity and self-consciousness that afflict most of us during adolescence. Speech disorders can sometimes discourage teenagers from participating in extracurricular activities or even speaking up in class; so whenever possible, speech disorders are resolved by the intermediate grades.

That’s why it was such a surprise to get a call from Raquel’s mother. Her two teenage daughters, ages 14 and 15, had problems producing their /r/ sounds. They had been enrolled in speech therapy, off and on, at a local children’s hospital and, for many years, through their public schools. So far, nothing had helped. Their pediatrician, Dr. Snyder Block, referred the family to us as a last resort. Raquel’s mother was beside herself wondering if ANYTHING could be done to remediate this disturbing speech disorder that drew attention to her daughters and caused others to comment on the “way” they spoke rather than “what” they said. The matter was made worse by the fact that “Raquel” and “Rebecca”, both names beginning with the letter “r”, could not introduce themselves without revealing their embarrassing handicap.

After interviewing Raquel’s mother over the phone and questioning her about her daughters’ orthodontic histories, it sounded like her girls’ speech disorders were related to tongue thrusts. They had both worn braces, and their teeth were gradually shifting out of alignment. We assured Raquel’s mother that we had seen this type of disorder in scores of other kids, and we knew how to fix it.

Sure enough, when Raquel came in for her evaluation, her /r/ sounds were a mess and her tongue rested in a lazy, relaxed position against her teeth. When she swallowed, she pushed her tongue even harder against her teeth. The pressure caused by her tongue resting against her teeth was pushing her teeth apart, and she was perpetuating a relaxed, lazy tongue. The healthy tongue resting position is suctioned up on the palate behind the upper front teeth. By keeping our tongues in the proper position, we are toning them and enabling them to produce all of the speech sounds, especially the intricate muscles involved in producing the correct /r/. Raquel’s tongue didn’t have the muscle tone to make an /r/.

We started Raquel’s treatment by strengthening her tongue and increasing her awareness. She practiced suctioning her tongue to the roof of her mouth and then stretching her jaw open as widely as possible. She used her cell phone and computer to help her maintain a healthy resting position by checking her tongue position and making sure it was appropriately suctioned up to her palate every time she received /sent a text or an email. At age 15, the cell phone was the ticket! Raquel used her cell phone repeatedly throughout the day.

Raquel and her sister were model clients. They were motivated! They did their exercises like clockwork and came to speech therapy with their completed charts every week.

Eventually, Raquel became stimulable for her first /r/. It was the /r/ in “ar” like “car”. Once we could help her feel the musculature for that /r/ sound, success was right around the corner. She was able to transition that skill to other /r/ sounds like “ear” and “ire”. That opened the door to more and more /r/ sounds, which, in English, numbers to 21. You can imagine how we celebrated the day Raquel could say her name.

Once Raquel could say the /r/ sounds in words, she had to learn to say them correctly in sentences and then during oral reading and, eventually, while participating in conversations and class discussions. We gave her sentence drills, and she mastered them. Then we gave her reading exercises, and she nailed THEM!

By that time Raquel was ready to try her new /r/ sounds in public. THAT was scary! Everybody she knew was familiar with her way of speaking. She sounded like she was from Boston or someplace like that. Her peers had accepted that. How were they going to react when they heard her speaking correctly? What would they say? Would she get teased for that too?

We had to do some talking to get Raquel to try her new skills in public...this is the compromise we were able to make. “Try your new speech production with your family and work on making it natural”. That was acceptable Raquel and Rebecca. Then “Try your new speech production when you are out in public with someone who doesn’t know you....like when you are ordering at In-n-Out and shopping at Nordy’s, for example.” Raquel agreed to give it a go, and the reaction was positive! The saleslady knew what she wanted when she asked to “Try on a pair of True Religion Jeans” with four perfect /r/s. That reward was more effective than any amount of praise we could provide!

After that Raquel shared her secret with her best friends and tried her new speech on them. They were extremely supportive. Her confidence grew, and she began using her excellent speech production at school, in public, at work, everywhere. She conquered her 15 year nemesis!

Raquel has gone on to be one of the top students in her class. She earns straight A’s in school on top of being the president of her class and running the tutoring club. She has applied to college at brainiac schools like Stanford and UCLA. She is clearly one of America’s future leaders. We are so proud of Raquel! And we are pleased to announce that she is currently volunteering as an intern in our office one day a week. She is investigating future career opportunities and helping Pam organize the office.

Raquel was so moved by her success in speech therapy that she decided to make it the subject of her college entrance essay. We would like to share part of it with you:

Strength and perseverance can get you through just about anything. I got through speech therapy with a single idea: that I could do it. I didn’t start talking until I was four years old; something my parents thought was very strange. After taking me to many doctors and specialists, they assured my parents that I would grow out of it, and that it was nothing to worry about. As I began to grow up and start school, my parents realized they had a bigger problem than they had thought. I was diagnosed with a speech impediment and immediately placed in Special Education.

I started middle school in all honors classes and began to achieve the much desired success, against all the odds. The only thing holding me back was the bullies. All through elementary school I was considered to be different than the other kids. Kids bullied me because of the way I talked, mimicking the way I said certain words. And it is because of these bullies that I worked ten times harder. I stayed up later and studied longer, because I wanted to prove myself to all those bullies. I wanted to prove to them that I was smart even though I didn’t talk how they thought was “normal.”

Then, my freshman year of high school, I realized that I couldn’t put up with the bullying anymore. After a frustrating English class, where two boys decided to laugh at me while I was speaking in front of the entire class making a presentation I had worked on for hours, I came home and fell apart. I told my mom that I was willing to try anything and that I wanted to find a therapist who could actually help me.

That’s when I found Jodie K. Schuller & Associates. Walking into that office, I knew something was different. That day I was told that I had a tongue thrust and speech impediment, both causing my impaired speech. After an intense six months of therapy, I “graduated” and became “normal.”

To say that Jodie K. Schuller & Associates changed my life would be an understatement. I rid myself of my speech impediment, and became a positive individual, proud of myself and happy to be who I am today. I have more self confidence than I ever imagined I could have. I am proud to speak in front of a group of people and see the reactions of the kids who once made fun of me just a few years ago. From the look of surprise on their faces when I introduced myself in front of the class that first day of sophomore year, I knew that I wasn’t the person I was a year before. I wasn’t the little kid that couldn’t pronounce certain sounds. I was a strong individual, living every day to the fullest and proud to be the person that I had become.

– Raquel Z.

If you would like more information about our services, please contact us at 858.509.1131. It is never too early or too late to seek help.

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Erik’s Story

Erik We first met Erik last spring. In walked a handsome little boy with thick wavy brown hair and big brown eyes. He was a second grader at a local private school. His intelligence tested well above average...his vocabulary acquisition exceeded his years, and his memory for numbers was outstanding. He could also read any piece of literature you put in front of him, or rather...he could call out the words. Erik was hyperlexic. He had mastered the phonics system and could sound out words with ease. He could decode two- and three-syllable words more adeptly than the average second grader. But he was bored with reading. Reading was the last thing Erik would chose to do in his free time, and his reading group at school was stressful and challenging.

Erik struggled severely with reading comprehension. When Erik read a word, it did not generate a picture in his head. If he read the word “dog”, he didn’t see a furry animal with 4 legs and a long tail. Having difficulty at such a basic level, he struggled even more when he had to visualize phrases like, “The white dog raced down the beach for the ball.” And at the second grade level, the literature isn’t written in single words or phrases, it is written in paragraphs and pages and chapters. Erik was lost!

Visualizing the literature is the first step of the comprehension process, but that’s not enough. Once the reader has an accurate picture in his head, the reader must think critically about the literature. The reader must make inferences about the literature to figure out the conflict in the story and the characters’ motives and feelings. The reader must also make predictions about the literature and then keep on reading and drawing conclusions to see if his predictions were wrong or right. These critical thinking skills are the reader’s anchor to the text...they are the reason that readers enjoy literature and hunger for more. It was not happening for Erik.

It is not just reading comprehension that depends on accurate imagery and critical thinking, listening comprehension requires these skills as well. Imagine trying to attend to a discussion about the Children’s Pool in La Jolla, if you can’t visualize a seal basking in the sun at the shore. Imagine trying to follow directions such as “take out your paper, put your name in the upper right-hand corner and number from 1 – 25, if you can’t picture yourself doing each step. His teachers were concerned that Erik was not following directions. He was often breaking down in tears instead.

The other skill that is closely linked with listening/reading comprehension is “social thinking”. That means being able to think about others, even when they are not present. To succeed in social situations, children must be social detectives and figure out what other people are thinking. They must study body stance and eye gaze and figure out people’s feelings and motives and then decide to enter the situation or not. If their teacher is standing on a chair reaching up to get the globe, is that a good time to go up and ask for help with a math problem? If a peer group is tightly huddled in a circle, is that a good time to enter that group?

The children who are really popular with their peers are those who can remember information about others. We call it keeping files on your friends. You try to have a file on each friend just like you have a file of animals and clothes and food groups in your brain. You try to remember the people in your friends’ families and ask how they are doing from time to time. Your friends’ files include their favorite past-times, and you ask if they have played them lately. You try to remember your friends’ interests and ask if they have been to a Charger or a Padre game, for example, or seen any good movies lately. One thing social thinkers don’t do is think and talk only about themselves.

When asked about his school day, Erik said that recess was his worst time of the day. He didn’t know how to play with friends. He had his own interpretation of rules for games and took personal offense to anyone who violated his rules. He didn’t know how to begin conversations; it didn’t occur to him to ask about a friend’s interests. Erik only knew how to talk about himself.

After completing our assessment of Erik in March, his parents enrolled him in tutoring 4 hours a week. By summer his parents gave him the benefit of 6 hours a week of tutoring and 3 hours a week of language intervention.

Erik’s language intervention was a combination of individual and small group. In his individual intervention, he learned to make mental images as he listened to Tessa, his therapist, describe a scene from a picture story. He learned to describe a scene back to Tessa, focusing on the salient elements like the characters in the picture and their motives and corresponding actions. He learned to listen to a story and, after making accurate images, to think critically about the literature and make astute inferences and predictions and draw conclusions. He learned to organize the events into a logical sequence and retell a captivating story.

In his social thinking group, Erik learned the expected behaviors like keeping his body, brain and eyes in the group and always thinking about the other participants. He learned to read people’s plans and then say something that would make them feel better about themselves, which, in turn, would make them have “good thoughts” about Erik. He learned to make a brain file on his peers and then to start a conversation by asking a question that would interest them. He eventually learned to continue a conversation by adding a supportive comment like “cool” and then a follow-up question; ending with a same-topic comment about himself. Erik became at master at conversation!

Erik’s tutoring was a lot like language intervention, except that Nancy, his tutor, asked him to read. He read a sentence from his story and told Nancy what he pictured. When that was understood, Nancy asked him to make a prediction...was Toad going to give up on growing a garden or would he persevere? Sometimes Nancy asked Erik to make an inference...how did Toad feel about his challenges? And to help Erik relate to the literature and appreciate it, she asked him to make a connection...did Erik ever feel frustrated when, like Toad in the Garden, he was really trying to accomplish a project with little to no success?

In all the years we have been offering combined language intervention and tutoring, we have seldom seen a child progress as quickly as Erik. He began with poor language comprehension and little to no reading comprehension and progressed at least 2 grade levels up to the second grade. He has learned to read stories and retell the plot. He has even learned to write book summaries with a complete description of the plot.

The greatest accomplishment of all, though, is Erik’s social interaction. He is our shining star! He is popular with the other participants, because he keeps files on them and asks questions about their interests. He is a humble winner and a gracious loser when we play games. He turns on his social detective skills and tries to get inside their brains and make comments that make them feel good, because he knows that making them feel good will make him feel good about himself.

Erik is going to a new school next year and will have a fresh new start. We are hopeful that he will be able to use his improved comprehension skills to participate in classroom discussions and follow directions. Although he does not comprehend at the third grade level (yet), he is getting there and will likely have an easier time with grade level literature. We are optimistic that he will be able to take his new social skills and make a couple of friends. We are holding our breath that recess won’t be his worst time of the day.

Now that he’s had 6 months of intervention, it looks like Erik will have a pretty typical life. He’s not completely adept at reading or social interaction, but he is well on his way. If he keeps making the kind of progress he has made since March, he will close the gap between his skills and those of his peers.

Erik is a shining example of what can be done with appropriate early intervention.
For the speech-language therapists and tutors at Jodie Schuller & Associates, it doesn’t get any better than working with Erik. Helping him makes him feel good which makes us feel GREAT about ourselves!

If you know someone who could use help with comprehension or social thinking, please call us at 858.509.1131.

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Ava’s Story

Ava Ava had just turned 2. She was a darling blue-eyed toddler with a full head of blonde curls, which she adorned with various hats ranging from a floral bonnet to a fireman’s hat depending on her mood or the occasion.

Her motor skills were developing normally. She could walk and run from room to room with ease.

Her feeding history and oral motor development were also typical. She had been eating solid foods and feeding herself since she was 6 months. She appeared to have a healthy diet with her rosy cheeks and cute little body.

Ava came to our attention because she was not speaking. Her parents had wisely consulted their pediatrician, Dr. Chrystal DeFreitas, who suggested they watch Ava’s communication development closely until she turned 2. Ava turned 2 in November, and her initial speech and language evaluation took place later that month. That was one of their best decisions as Ava’s parents yet!

Ava was accompanied to our office by her mother. When her therapist greeted Ava in the waiting room, she ignored her. When her therapist brought out an array of stimulating toys, otherwise known as the tricks of our trade, Ava jumped from one activity to the next so rapidly that they had tried and tested each one of the therapist’s 20 toys with limited interest by the end of the first session.

Equally concerning, the race track, pop-up toys and puppets that usually elicit a “more” or a “pop” from our toddlers, evoked no communication from Ava. Ava was practically silent.

Since Ava wasn’t talking, we had to collect information and form our impressions based on Ava’s behaviors and her parents’ reports. They counted about 50 words in Ava’s vocabulary. Most children have at least 200 words, and they are combining words by the time they turn 2. Unlike her peers, Ava was not asking for help with her needs, imitating words in conversation, asking for “more” of a favorite food/ activity or naming objects upon request.

Another major concern was Ava’s apparent delay in her social interaction and ability to play. Most two year olds are making eye contact, producing greetings, asking for comfort and engaging in social routines (Pat-a-cake and finger plays). Most two year olds are engaging in parallel play; socializing with their peers as they play with similar toys side by side. Ava preferred to play alone and had a tendency to respond physically when she became upset. Ava did not have any same-aged friends.

During that initial evaluation, we also delved deeper into Ava’s history. Her birth had been traumatic; her mom had to undergo an emergency C-section because the umbilical cord had been wrapped around Ava’s neck. There was no history of ear infections, which is often the case when toddlers aren’t talking by age 2. Ava had passed her initial hearing test, so, fortunately, we could also cross hearing loss off of the list.

So why wasn’t this healthy two year old with toned articulators (e.g. lips, tongue and jaw) developing communication skills like other children her age? There was no logical explanation other than the fact that Ava’s parents were going through a divorce, so separation anxiety may have been a factor.

Ava’s parents weighed their options. They could wait to see if Ava would outgrow her communication challenges and hope for the best. They could wait until she turned three and have her assessed by the local school district. Or they could be aggressive about Ava’s challenges and pursue early, intensive intervention.

For some parents, this is a tough decision. Some children don’t start talking until they turn three. And in rare circumstances, some of these late talkers speak with perfect clarity and develop reading readiness skills by the time they start kindergarten. And in even rarer circumstances, these late talkers/late readers go through their entire academic careers without a glitch...not a year of tutoring or social language support needed!

This is usually not the case. Many late talkers are late readers. And many late talkers/late readers struggle forever. Some struggle with learning the sound-letter relationships (learning that the letter “b” makes the “bu” sound) that entail the first year of reading instruction, whereas others struggle later in school with reading comprehension. Other late talkers/late readers develop problems with the process of written expression...whether it be with spelling, writing correct sentence structures or producing book summaries and essays. There is another group of late talkers/late readers whose challenges emerge in the social arena. They don’t know how to think about other people to make and keep friends or to solve life’s many problems. One way or another, late talkers/late readers who don’t have the benefit of early intervention usually have challenges down the road.

This was not going to be the case for Ava!

Ava’s parents enrolled her in intervention two times a week starting within a month of her initial evaluation. They have been diligent about attending therapy, and the results have been AMAZING!

Ava is now producing two word combinations on her own such as “mommy sit”, “daddy car”, and “my banana.” She has even begun to combine three words at a time, which is appropriate for her age group at 2-1/2. Ava’s language has shown measurable growth with every therapy session, and her parents have noticed these developments at home as well.

Though once a silent withdrawn little girl, Ava now comes into therapy with a smile on her face and excitement to begin. Ava loves choosing her favorite toys and will often include her family members in role playing activities. Ava enjoys sharing these toys and taking turns with her clinician and is constantly requesting “more bubbles” or “more cars”, because she can’t get enough. Thankfully, Ava’s parents have also seen improvement in her peer interaction; she will play dolls, build with blocks and race cars alongside her friends at preschool.

We have been thrilled with Ava’s progress! And her parents will never regret their decision to get aggressive about Ava’s intervention. Her rapid progress has given us all reason to believe that she will catch up and be ready for reading, writing and social interaction by the time she begins school. Fortunately for Ava and her family, prevention is less expensive and more effective than remediation.

Stories like this are the reason that Tessa, Rebecca, Amber and Jodie choose to become speech-language pathologists. By providing appropriate, early intervention, we can change lives! Wow! What a feeling!

If you would like more information about our services, please contact us at 858.509.1131. It is never too early or too late to seek help.

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Brynn’s Story

Brynn 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, please contact us at 858.509.1131. It is never too early or too late to seek help.

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Madi’s Story

Madi

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, please contact us at 858.509.1131. It is never too early or too late to seek help.

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Max’s Story

Max 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 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 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 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 teaching at dental workshop 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

Student 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?

Student reading book and smiling 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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