We’re off to a speechie – finding a brilliant one

Be it speech or language or many other issues such as stuttering, feeding or autism, you might be in search of a speech pathologist for your child.  Where do you start? How do you find a good one?

Here is a list of things to consider:

  • First of all, we are supposed to be ‘communication experts’, so expect extremely good communication with your speech pathologist!
  • Like any professional, there are the good ones and the ‘not-so-good’ ones.  Always keep that in mind
  • Before forking out, consider government services, generally through a community health centre or maybe a hospital.  These are free but might have a long waiting list so don’t delay.  The government provides funding for professional development and good conditions, so it does not mean that you are getting less of a service because it is free!  I prefer to work in a government service than privately because of the conditions!
  • But! Many very passionate speech pathologists choose to work in private practice to do it their own way (and avoid government issues!), so you can certainly find some fantastic ones there too
  • If looking into a private speech pathologist, have you looked into an Enhanced Primary Care (EPC) plan? (this entitles you to a maximum of five rebated sessions – you’ll surely have some gap fee, per calendar year).  Ask your GP about this or the speech pathologist that you have chosen
  • If you sign up to a private speech pathologist, do you know roughly how long you’ll need to be going for?  I used to have families thinking they would solve their child’s speech delays using their five EPC sessions when in fact, it would probably take years of therapy
  • If a speech pathologist has the letters CPSP after their name, this means ‘certified practicing speech pathologist’ and they have chosen to sign up to seeking out professional development each year
  • Consider the difference between those that offer 30 minute sessions versus 45 minute (or even 1 hour sessions).  Sometimes short and regular sessions are good, but other times the child will only just get into the 30 minute session right when it is finishing
  • Another thing to think about (if you get a choice), is to do ‘chunks’ of therapy.  You might go for a term, then have a term off.  Sometimes kids do have ‘spontaneous recovery’, so at least you can assess this while you have a break.  Regular, ongoing therapy can also be draining and monotonous for some kids (even though we do make it pretty fun!) and also the parents/siblings.
  • Ask around for recommendations.  Every second person know someone who has needed speech therapy before.

And once you have started seeing a speech pathologist:

  • Do they encourage you to sit in on the sessions? (this allows you to see if your child is truly progressing and to take ideas for home) – I don’t feel there is any good reason for a parent to be asked to sit outside of the session.  This just makes it easier for a speech pathologist to be a bit ‘lazy’
  • Do they listen to you?  Do they encourage you to make goals with them?  If not, do they tell you of their goals?  Do they explain what and exactly why they are doing it? Are they well-prepared?
  • Do they give you ideas for home?  A take-home scrapbook might be fine for a school-aged child, but generally ‘real life’ situations are better practice for pre-school children which will encourage more generalisation
  • Remember to constantly assess if you are making progress and if not, move onto a different speech pathologist.  I am constantly surprised to talk with families who have been seeing other speech pathologists that can barely tell me what they are working on and when questioned they sit back and realise their child has made NO progress after continued therapy.  Of course there are the good stories too though! 🙂
  • Always ask questions if you are unsure of anything.

When in doubt, please ask a question through this blog.  🙂 Heidi

Getting the sounds out

Learning to talk has so many aspects, including a very tricky one…  Getting the brain to coordinate the ‘articulators’ (tongue, lips, teeth) along with voice and the jaw and even cheeks to make a sound.  Let alone stringing a few sounds together to make a word!

Babbling

It all begins with babbling, getting the jaw and lips/tongue moving.  It might be /bababa/ or /mamama/ or /dadada/ or /papapa/.  These might sound like what we say, but they are actually ‘immature’ versions of the sounds we produce later as adults.  For example, a baby moves their jaw and if their tongue happens to go with it, it might come out as a ‘dada’, but they cannot actually hold their jaw still and move their tongue to produce a ‘d’ by itself.  And even a ‘b’ or ‘m’ actually happens more by the fact that their lips happen to be closed before they open their jaw, rather than actually choosing to press their lips together, as we would.

Babbling is a great sign that your baby is practicing to talk!

First sounds

Children can make many different speech ‘errors’ as they learn to talk clearly.  Their brain has a lot of work in organising a string of sounds to make a word… and then sentences.  By two (anything goes before that!), the first sounds your child should be able to physically make are: p, b, m, d, n, t, h, w.  For all the other sounds, your little one may either use a different sound or leave it out altogether.

At two years of age, can other people understand half of what your child says?  A parent will always understand more, so get someone like a family member or a daycare leader to judge.

At three years of age, can others understand most of what your child is saying?  Then your child is probably going along okay!

Between 12 months and 3 years of age, your child will gain literally hundreds and thousands of words and have a lot of time to practice talking.  If your child is an early talker, their speech will tend to be clearer before the later talkers, just through more practice!

By three years of age, your child should also be able to use these sounds in words: k, g, f, ng.

By four years of age, your child should be using all sounds accurately except the following: s, v, r, th and consonant clusters (eg. green, pink).  Your child may still have a ‘lisp‘ when starting school (eg. ‘thilly’ for ‘silly’), which may need attention from a speech pathologist to correct.  They may also have difficulty with ‘r’, ‘v’ and ‘th’ up until 8 years of age.  This is the grey area where it is good to keep an eye on your child up until these ages (or think about speech pathologist waiting lists) but not necessarily be too concerned before this as it could certainly resolve itself.

If your child uses a dummy or sucks their thumb, keep in mind the longer they do it, the more possibility they could experience difficulty with a lisp and incorrect mouth position.   This is more likely for children who suck a dummy or thumb well past three years of age.

If your child is having difficulty making certain sounds, here are a few pointers:

  • don’t make fun of your child’s speech! For the young ones, it is likely they aren’t aware they are making errors
  • emphasise the correct way to pronounce the sound in the word (eg. ‘ohh the carrot’ for a child saying ‘tarrot’) but don’t make a big deal of it 
  • try not to exaggerate the sound too much or you risk your child learning to say the word with the sound exaggerated
  • be wary of children who may become upset with a lot of attention drawn to their speech errors (particularly the older children).  It is probably better to look into a speech pathologist if this becomes a problem before they really get put off focussing on changing speech errors
  • notice if your child changes the speech error over time – your child might start by saying ‘crown’ as ‘wown’, but then they might start calling it a ‘fwown’ which is getting closer as they are now putting a sound (‘f’) in place of the ‘c’ instead of no sound.  This is a sign your child is developing their speech skills and might resolve the speech errors on their own!

Remember!  The more you reinforce your child’s shortened versions of words, such as ‘nana/narny’ for ‘banana’, ‘bik bik’ for ‘biscuit’ or ‘puter’ for ‘computer’, the less of a model they get to eventually say the word correctly.  Model how to say words for your child!

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Related post – ‘We’re off to a speechie – finding a brilliant one’.

It’s not all lisps and stuttering!!!!

So what does a paediatric Speech Pathologist actually do?

Well, definitely more than just speech!  Having worked in a bar whilst I was at uni, I got my fair share of people pretending to have a ‘speech impediment’ or just thinking that I’d help them to ‘talk better’ (picture ridiculous lisps and the like!).  I think that’s how my uni friends and I started pretending to do anything other than Speech Pathology whilst we were out with drunken ones!

Anyway!  Sometimes we are called Speech Language Pathologists, as we also work with language difficulties.  A coming post on the actual difference between speech and language.  But we do much more than that….!

We can help children with delayed pretend play skills, those with attention difficulties, help teach cognitive skills, or help students who are struggling with literacy skills at school.  We teach social skills to children from pre-school to high school.  We can also help children with voice difficulties such as vocal nodules.  We work in hospitals with little newborns who have difficulties breastfeeding and those who have been born with a disability right through to supporting teachers at school.  We also work in community health centres.  Other Speech Pathologists work in private practice and cover some or all of the issues above.  We educate parents and other people involved with the child such as daycare leaders, teachers and even siblings.

Speaking for myself, I work with children with disabilities from birth to six years old.  We see children with autism, Down syndrome, many other syndromes, hearing impairments, intellectual impairments, Cerebral Palsy, medical complications, brain injuries and children with no diagnosis but whom are globally delayed.  Not only do I teach the children language skills, clearer speech, preliteracy skills, play and social skills but I also educate their parents so that they can continue ‘therapy’ for the rest of the time they are not with me.  Working closely beside physiotherapists, occupational therapists and psychologists, I also gain many skills off them which I can also pass onto the kids and families.  This job is where I draw my inspiration from in being an enthusiastic parent with my own children!

Speech pathology is now becoming quite a popular course at university as it is a rewarding career and is being sought out more.

Did you know Paul Jennings, author of some great books and the old TV series ‘Round the Twist’ is a speech pathologist?

So now you know a bit more about us Speech Pathologists!

Oh and of course we do lisps and stuttering!! 🙂

The Jolly Postman – book review

[3 years +] The Jolly Postman – by Janet and Allan Ahlberg

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Like Each Peach Pear Plum, Janet and Allan Ahlberg again have fun with well-known fairy tale characters.  They use rhymes to introduce the characters the Jolly Postman comes across and real envelopes with letters, cards and postcards to open on each page.  It is very fun for the kids!

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There is a lot for the older children as well to get from this book.  They can read the front of the envelopes and work out who they are to (eg. Mr V Bigg = the giant) or work out the puns in the witches’ catalogue.  You really have to know your fairy tales to ‘get’ the whole book 🙂

Each Peach Pear Plum – book review

Each Peach Pear Plum By Janet and Allan Ahlberg

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Clever, fun and catering to many ages, this book is a MUST-HAVE!

It features a repetitive rhyme that brings in all of your favourite nursery rhyme characters.  AND you get to play ‘eye spy’ on each page, looking for one of them.

So get it out for:

– the under ones for some good exposure to rhyming words (great for later preliteracy skills) and interesting pictures to look at

– the 1 year olds, again for some good rhyme exposure and vocabulary building – you can just point out all the common items on each page

– the 2 and 3 year olds for some ‘eye spying’, or even finishing the rhyme for you (‘I spy the…’).  You can talk about which nursery rhymes the characters come from or ask many questions such as ‘I wonder if Jack and Jill liked the Wicked Witch?’ or you can predict what you will be looking for on the next page by the mini picture above the writing (eg. the 3 bears’ porridge bowls…find the three bears)

Here are a few sample pages!

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can you see the three bears..?

can you see the three bears..?

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can you find the wicked witch?

can you find the wicked witch?

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Parsley Rabbit’s Book about Books – book review

[3 years +] Parsley Rabbit’s Book about Books by Frances Watts and David Legge

**winner of the Children’s Book Council of Australia Book of the Year award 2008**

Yes, this was a great find at the library!  Particularly in time for Book Week.

As the title suggests, this book is all about books!  It teaches your child about every aspect of a book.. Just take a look.

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Parsley Rabbit introduces all the book terms you can think of, from ‘author’ to ‘end pages’ and all in an exciting book, complete with flaps, a dinosaur head which had Master 3 intrigued (you’ll have to see it to see what I mean!) and clever ways to engage a child about something as dry as specifics about books!

Seek this out at your library today!

Play School Nursery Rhyme Favourites – book review

so loved!

so loved!

Play School Nursery Rhyme Favourites and Play School More Nursery Rhyme Favourites

Well these two books are the most used books in our house BY FAR.  Held together with sticky tape and a rubber band, we’ve had these since the birth of Master 3 and they are still going strong for the two boys now!  Three-and-a-half years of nursery rhyming!

And they aren’t just any nursery rhyme books.. Here are some of the features:

  • The Play School characters show up in each nursery rhyme which adds more interest if your child already knows the Play School characters OR subtly introduces them to the characters so that by the time they are ready for Play School (as was the case for my two boys), they held them at ROCK STAR level that they might be seen ON TV!!!!
  • The lovely clear pictures all made out of recycled ‘stuff’.
  • The many parts to each nursery rhyme are illustrated so you can point it all out and keep your child’s attention for longer.  For example, in Baa Baa Black Sheep, the 3 bags of wool are there; the Master, Dame and little boy are there; and even the lane.  Whereas in other nursery rhymes books, I find you might just see only a couple of these as the nursery rhyme gets boring when you’ve got nothing to point to (do you point to the pictures as you read books?).
  • Between the two books, pretty much all the classics are covered.. no boring ones!
  • The books are made of VERY thick pages so they are durable – that’s how much we’ve used ours.
  • They are inexpensive.  I’ve seen them at the Play School concert (most expensive), ALDI and eBay.
  • Great for travel as they are light but have hours of entertainment.
  • You can sing the songs, practice your signing with little ones and the everyday objects/actions you see in the books, get the musical instruments out with them, leave them for the little ones to discover, let your older child ‘read’ the book themself, act out the nursery rhymes with props, the list goes on!

If you are up for some nursery rhymes (and I’ll get onto the benefits of those in another post) or want to have a revamp of your old nursery rhymes books (they get straight to the classics), then please give these a go!  Or buy them as a present for someone 🙂 Heidi

🙂 It is Book Week in Australia this week – come and see us at our facebook page – I raise my kids, to see what is happening this week.  🙂

List of books for children aged 4-7!!

Here is a compilation of books that are great for children aged between 4-7. Younger readers will love them as well and of course older ones love them too.

This is a great starting place for birthday presents 🙂

 

Books for Children Ages 4-7 (the following titles are suitable to be read to younger readers or can be read by beginning readers)

 

‘A.B. Paterson’s Mulga Bill’s Bicycle’ by Kilmeny & Deborah Niland

Alexander and the Terrible, Horrible, No Good, Very Bad Day by Judith Viorst

Amazing Grace by Mary Hoffman

Amelia Bedelia by Peggy Parish

Animalia by Graeme Base

Aranea: A Story About a Spider by Jenny Wagner

Are You My Mother? by Philip D. Eastman

‘Arthur’ series by Marc Tolon Brown

Basil of Baker Street by Eve Titus

Caps for Sale by Esphyr Slobodkina

Chicka Chicka Boom Boom by John Archambault

Clifford, the Big Red Dog by Norman Bridwell

Complete Adventures of Blinky Bill by Dorothy Wall

Counting on Frank by Rod Clement

Cowardly Clyde by Bill Peet

Curious George by Hans Augusto Rey

Fancy Nancy by Jane O’Conner

Fantastic Mr Fox, by Roald Dahl

Fox in Socks by Dr Seuss

Granpa by John Burningham

Green Eggs and Ham by Dr. Seuss

Horton Hatches the Egg by Dr. Seuss

How the Grinch Stole Christmas by Dr Seuss

Hubert’s Hair-raising Adventure by Bill Peet

If You Give a Mouse a Cookie by Laura Joffe Numeroff

In My Back Yard by Nette Hilton & Anne Spudvilas

Irving the Magician by Tohby Riddle

John Brown, Rose and the Midnight Cat by Jenny Wagner

Jumanji by Chris Van Allsburg

Lester and Clyde by James Reece

Lilly’s Purple Plastic Purse by Kevin Henkes

Love You Forever by Robert N. Munsch

Make Way for Ducklings by Robert McCloskey

‘My Hiroshima’ by Junko Morimoto

No Kiss for Mother by Tomi Ungerer

‘Oh, The Places You’ll Go’ by Dr. Seuss

Petunia by Roger Duvoisin

Red Sings from Treetops: A Year of Colors, by Joyce Sidman

Snugglepot and Cuddlepie by May Gibbs

Stellaluna by Janell Cannon

Strega Nona by Tomie De Paola

Sunshine by Jan Ormerod

Sylvester and the Magic Pebble by William Steig

Tale of Despereaux by Kate DiCamillo

The Art Lesson by Tomie De Paola

The Banana Bird and the Snake Men by Percy Trezise and Dick Roughsey

The Bears’ ABC Book by Robin & Jocelyn Wild

The Cat in the Hat by Dr. Seuss

The Complete Adventures of Peter Rabbit by Beatrix Potter

‘The Complete Tales of Winnie the Pooh’ by A. A. Milne

The Digging-est Dog by Al Perkins

The Eleventh Hour by Graeme Base

The Enchanted Wood by Enid Blyton

The Fisherman and the Theefyspray by Jane Tanner

The Giving Tree by Shel Silverstein

The Jolly Postman or Other People’s Letters by Janet & Allen Ahlberg

The Lighthouse Keeper’s Lunch by Ronda & David Armitage

The Little Engine That Could by Watty Piper

The Little House by Virginia Lee Burton

The Lorax by Dr. Seuss

The Magic Pudding by Norman Lindsay

The Napping House by Audrey Wood

The Paper Bag Princess by Robert N. Munsch

The Polar Express by Chris Van Allsburg

The Rainbow Serpent by Dick Roughsey

The Story of Ferdinand by Munro Leaf

The Tale of Peter Rabbit by Beatrix Potter

‘The True Story of the Three Little Pigs’ by Jon Scieszka

‘The Story of Shy the Platypus’ by Leslie Rees

The Velveteen Rabbit by Margery Williams

Tough Boris by Mem Fox

What Made Tiddalik Laugh by Joanna Troughton

Wheel on the Chimney by Margaret Wise Brown

Where’s Julius by John Burningham

Where the Forest Meets the Sea by Jeannie Baker

‘Where the Sidewalk Ends: the Poems and Drawing of Shel Silverstein’ by Shel Silverstein

Where the Wild Things Are by Maurice Sendak

Whistle Up the Chimney by Nan Hunt

Wilfrid Gordon McDonald Partridge by Mem Fox

 

Saying it with a pen – coping with disappointment

Coping with disappointment is related to ‘difficulty adapting to change’, when a change happens that the child wasn’t expecting!  Spirited children find it even harder to cope with change and disappointment as they go into almost a flight/fight/freeze reaction where they cannot think logically or clearly.

Master 3 had been watching Playschool, one of his favourite dinosaur episodes and always loved to dance to the dinosaur songs with his dino tail on.  Unfortunately, if the tail isn’t on as the song begins, a meltdown occurs.  It is easy to say ‘calm down’, ‘you’ve missed TWO seconds of the song, don’t worry’, but Master 3 has ‘flipped his lid‘ (as The Whole Brain Child calls it) and he cannot think clearly or logically from then on.  No matter what we do!

So!  One day, having had enough of it, I announced we were doing a drawing to set Master 3 up for success the next time.  This time was lost, but at least I could prepare his brain better for next time, before he had another ‘dino meltdown’!

If you haven’t already, you can also refer to When in doubt, say it with a pen! for a run-down on the benefits of drawing with your child 🙂  This is how this drawing went…

First

the meltdown

the meltdown

Square 1. Master 3 watching Playschool

2.  I asked how Master 3 felt in this scenario – he responded ‘sad’ so I prompted ‘but what made you sad’ to get him talking more – ‘no tail’.

3. I drew Mummy running to get the tail but Master 3 still crying.

4. I asked Master 3 how he felt after Mummy went to get his tail – he responded ‘sad, I didn’t like missing out on the song (without the tail on)’

5. So I drew Mummy trying to give him the tail so we could go back to that part to talk about it more, as Master 3 just couldn’t calm down even though he had the tail and the song was still going.  He responded ‘too sad to dance to some of the song’.  His words.

6. We finished the drawing with how the scenario ended, Master 3 still upset.

Second

take 2 - the fairytale version

take 2 – the fairytale version

Square 1.  I started the drawing with ‘Master 3 is happy his dino song is on!!’ and drew a happy face to start the drawing.  This had Master 3 laughing just thinking about it, almost relieved he didn’t have to get upset.  I asked him what he needed to say – he came up with ‘mummy get my tail please!’. Nice.

2. I wrote what Master 3 might say ‘put it on quick, I’ll dance to some of it, with my tail’.

3.  Master 3 again, so happy to see himself happy and dancing at the end of this story.  We compared with the ending of story 1.

Third

the what if version

the what if version

The most important part – thinking about what variations of the fairy tale version might happen, so we don’t get another surprise next time!  Mental practice for the not-so-planned times is SO helpful for children who don’t cope with change and disappointment well.  Knowing that Master 3 was primed for me to put his tail straight on, we talked about what happened if the tail wasn’t right there in the room.

Square 1. ‘Mummy get my tail please’

2. Mummy running for the tail – the key point here – Master 3 still SMILING!

3.  I asked Master 3 what he would do in the meantime – ‘I might dance until my tail comes’.  He’s getting it!

4.  Mummy putting the tail on – Master 3 still happy (‘not like that first story!!’)

5.  Hooray, Master 3 is STILL happy.

 The other day, we had success!  Master 3 stayed calm and said to Master 1 ‘You just dance and mummy will get a tail for you’.

problem solved!!!!

problem solved!!!!

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The future of a little sucker

dummy, pacifier, soother, comforter

dummy, pacifier, soother, comforter

Let’s look at the dummy from a Speech Pathologist’s viewpoint.

Did you know sucking (well any stimulation to that joint where your jaw hinges from, the temporo-mandibular joint, which often includes chewing gum or biting nails as an adult) promotes calmness and body awareness?  It’s no wonder many babies are ‘sucky’ babies!  And besides calming your baby, maybe promoting body awareness is also a positive out of sucking.

I’m in no place to comment as to the thumb/finger sucking vs dummy debate.  Here is a good link to the Raising Children Network about the pros/cons about dummies.  http://raisingchildren.net.au/articles/should_you_use_a_dummy.html

But yes, sometimes dummy sucking can be difficult to stop (as can thumb sucking).  http://raisingchildren.net.au/ditching_the_dummy.html

When should you get rid of the dummy?

Basically, the sooner the better but there is obviously a ‘safe’ time as far as speech and dental development.  Some say it should be gone by six months, to avoid a habit forming, but I’m fairly sure you’ll still face difficulties getting rid of it then!  The next thing to consider is when and how often is your baby using the dummy?  The more they use it, the less chance for babbling and speech development.  I have seen toddlers who manage to talk with a dummy in their mouth or those that are choosing not to say anything because they are quite comfortable sucking…and I have to restrain myself from taking it out of their mouths!

How does it affect speech development?

First, you’ll need to experience the sucking for yourself.  So go and grab a dummy or just stick a thumb in your mouth and suck!  Feel where your tongue is and how your jaw feels.  Now take it out and let your mouth go back to a resting position with your lips together.  Feel the difference!  Try a suck again and you’ll notice how your jaw sits forward, along with your tongue.  The longer your child’s jaw and tongue sit in this position, the more the brain gets used to this feeling as ‘normal’.  It is certainly not a ‘normal’ resting position to achieve normal speech development.

And looking into the future, this abnormal resting position with the tongue and jaw sitting forward can promote a lisp.  Have a go at saying any sentence with your jaw resting forward, even just slightly forward, and you can see how some people end up with speech errors.  I have no data to say exactly when dummy sucking equates to a lisp but this is the time to use common sense.  Aim for dummy sucking only at ‘non speech times‘ such as in the cot, car or pram but not in social scenarios or times you have noted your baby babbling or attempting words.  It is good to think this through very early when you introduce a dummy – will you only allow it in the cot/make them put it into a cup at the end of sleep time or will you just plan to cut it off altogether by around 12 months?  Soon after 12 months, your baby learns to communicate more, say ‘no’ and tries to take more control of their life (!!), so you will certainly have a harder time telling them when/where they can use it if firm rules have not been set up since before they can remember!

A little bit more on speech development

Babbling starts on average at six months of age and words come around 12 months, so this is about the time you will need to think about where the dummy fits into your baby’s life.  Of course you can’t take a thumb away either, but I have noticed babies tend to automatically take a thumb out when they have something to say, but maybe it is harder with a dummy as they know they will then have to hold onto it..

What many people don’t know is that a certain percentage of lisps are not just a speech error but caused by a ‘tongue thrust’ or ‘reverse swallow‘.  This relates to the child retaining that early swallow pattern (with the tongue pushing forward to swallow), which can certainly come about from excess sucking on a dummy or thumb as a baby.  A tongue thrust involves the tongue pushing forward against the front teeth in order to be able to swallow, instead of pushing against the roof of our mouth and backwards.  This constant pushing of the tongue against the teeth can cause dental issues and ‘interdentalized’ sounds (/s/, /t/, /d/, /n/), where the tongue sits in between the teeth to produce them, instead of behind.  Braces and speech therapy will not be able to repair the dental or speech issues until this swallow pattern has been corrected.  A speech pathologist can help with this.

So by all means, give the dummy a go, but be prepared and advocate for your baby’s speech development – they certainly don’t know to!

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