Stuttering Update
Dennis Dryana, Ph.D., a director of the Stuttering Foundation and researcher for the National Institute on Deafness and Other Communication Disorders announced the discovery of three genes for stuttering today.
While this information could be helpful to one day find a cure, we still need to rely on speech therapy to prevent stuttering. This significant finding rules out stuttering is due to factors such as stress.
What is stuttering? The following information is condensed from Let's Talk, I think my child is stuttering. What should I do? American Speech-Language-Hearing Association, 2003.
It is considered normal for young children to have some dysfluent speech, especially when they are expressing complex ideas. It's also common for children ages 2 through 7 to repeat whole words or phrases and to use "uh" and "um" in their speech. Most children become more fluent as they get older and their language skills improve.
However, stuttering often begins during these early years. A speech therapist that specializes in treating stuttering / fluency disorders can help determine if the child is beginning to stutter or just has a normal dysfluency.
Characteristics of the child at risk for stuttering: - Repeats parts of words, prolongs a sound, or breaks up words
- Often repeats part of the word about 3 times
- During repetitions, the child substitutes an uh vowel (tuh-tuh-tuh-table)
- May use a broken rhythm during repetitions (b.b.....b..boy)
- Has 10 or more disfluencies every 100 words
- Opens mouth to speak but no sound comes out
- Has other family members who stutter
Select Characteristics of a child with normal disfluency: - Often repeats whole words or phrases
- Typically repeats part of the word no more than 1 or 2 times
- During repetitions, the vowel sound remains the same (ta,ta,table)
- Rhythmic repetitions
- 9 or fewer disfluencies every 100 words
- Starts speech easily; keeps speech going
Speech Pathologists that Specialize in Stuttering in Manhattan
Dr. Lesley Wolk
212.678.3895
Karin Wexler 212.678.3409
American Institute for Stuttering 27 West 20th Street Suite 1203 New York, NY 10011 212.633.6400
Phil Schneider 3333 Henry Hudson Parkway Suite 7 Riverdale, NY 10463 718.549.0433 phil@schneiderspeech.com
Attend a Stuttering Group For Kids Meets At Brooklyn College
Labels: Articulation, NYC, Speech, Speech Therapy, Stuttering
Fine Motor Activities
I often find that children with articulation issues have fine motor delays. At times, I feel a consultation with an occupational therapist (OT) is necessary. Other times it seems that a child may simply need to be exposed to the types of activities listed below to encourage development of the hand muscles.
Supervision is crucial for safety (many of these activities contain small parts) and to ensure that the fingers are used appropriately within each task. If the fingers are not used appropriately, your child is simply playing with the item and not developing their fingers / hand muscles.
Encourage the writing fingers (see picture above) to do the work during precise fine motor activities. While holding a marker or crayon, encourage a proper grip (see picture at right).
During writing and many other fine motor tasks, the writing fingers (thumb, pointer and middle fingers) are active, while the pinky and ring fingers stay tucked in, secure against the palm.
Proper use of the fingers lays the foundation for higher level fine motor skills like writing letters and tying shoes.
Some of these activities are great in the car or airplane.
Begin with these fine motor tasks: - Mr. Potato Head
- Crayons - try coloring with small, broken crayons to encourage a better grip.
- Pip-Squeaks Markers
- Stickers - peel off stickers with pincer grasp and place them on a vertical surface (piece of paper taped to the wall).
- Magnetic Sets
- Wikki Stix or Bendaroos
- String large beads or dried pasta - make a noodle necklace!
- Place coins in a bank - you can make a slit in a coffee cup top.
- Playdoh, Silly Putty - break off small pieces and roll them into balls between the pads of the thumb and pointer finger. Then, squish the small balls between the thumb and pointer finger. You can also roll and squish between the thumb and middle finger, thumb and ring finger and thumb and pinky. Place toothpicks or thin birthday candles into Playdoh and make a birthday cake!
- Glue dry macaroni - make a collage
- Scissor work - make sure the thumb stays facing upwards. Begin with My First Fiskars and promptly transition to a kids blunt tip.
- Magnadoodle
Later, try these activities: - Standard hole punchers or try challenging shape punchers
- Lacing cards (or make your own with a hole puncher)
- Clothes pins - pinch them onto the edge of a container or a dishcloth. Alternate fingers (first squeeze with thumb and pointer, then thumb and middle finger, then thumb and ring finger and finally thumb and pinky).
- Paper clips - connect colorful clips
- Practice fasteners (buttons, snaps, buckles, zippers)
- Eat with Farm or Fish sticks - or these tongs are easier.
- Tweezers - pick up small cotton balls and transfer them from one cup to another.
- Unifix cubes
- Zoobs
- Legos
- Lite Brite - you may like the travel size
- Small Pop Beads
- Pick Up Sticks
- Keychains like these are fun to connect. I recommend purchasing them from a hardware store where they will have more resistance than from a therapy toy catalogue.
- Theraputty - Choose a texture that will slightly challenge your child and then increase the resistance with a firmer texture. Hide pennies inside and encourage your child to find them.
Please remember, these activities are only helpful for fine motor skills if they are completed using an appropriate grasp as mentioned above. If you find the exercises are difficult for your child, a consultation with an occupational therapist may be appropriate.
My favorite Manhattan Occupational Therapist Lauren Stern has helped me compile these activities over the years. She can be contacted at laurendstern@gmail.com or 516.298.4084. Labels: Articulation, Fine Motor, Occupational Therapy, OT, Parent Friendly Activities, Speech
Ear Infections and Language Development
When a child consistently has ear infections, or has fluid in his ears, it makes it difficult to hear sounds and words accurately. If you plug your ears with your fingers, you can appreciate the muffled quality of speech your child is experiencing. Recurrent ear infections often occur before age 3 - when a child is learning to speak. These frequent ear infections may lead to speech and language difficulties.
- Speech (articulation) is the production of sounds that make up words and sentences.
- Language refers to the use of words and sentences to convey ideas and express our wants and needs.
You may realize your child is having difficulty hearing if he says "What?" often, has trouble following instructions and / or difficulty paying attention. He may wish for the music or television volume to be turned up as well.
Conversely, you may feel that your child is hearing just fine, despite fluid in the ear or a recent ear infection. However, he may have difficulty understanding words in conversational speech and hearing certain sounds, which could make it difficult for him to learn to produce these sounds accurately. Formal hearing tests with an audiologist and attending follow-up appointments with your Pediatric ENT are crucial. It is not possible for you to determine if your child can hear accurately without having a complete audiological examination.
Ear infections are generally treated with antibiotics, but there is no good medical treatment for ear fluid without infection. When a child has frequent ear infections or when fluid persists in the ears for an extended period of time, your ENT doctor may recommend tube placement. The tubes help ventilate the ear while your child's natural ear drainage system is maturing. Most tubes stay in place for 4 months to a year, and they generally fall out on their own. By that time, your child's anatomy will likely have changed, and it will be easier for them to clear the fluid or to avoid infections. In about 15% of cases, the tubes need to be replaced.
When your child has an ear infection:
- Talk and read to your child face to face
- Eliminate background noise
- Get your child's attention before you speak
- Use a normal loudness level
- Confirm that your child is understanding what you are saying
As a seasoned speech therapist and mother of two young children with a history of chronic ear infections, I would be happy to speak with you about questions you may have about your child's speech and language development.
I provide evaluations and therapy for children with speech (articulation), language, and oral-motor difficulties. Sessions are conducted in the comfort of your Manhattan home (Upper West Side (to 96th Street), Upper East Side (to 96th Street), Midtown, Village, Soho, Tribeca, and Gramercy).
Labels: Articulation, Hearing, Language, Oral Motor, Speech, Speech Therapy
Speech vs. Language
What is the difference between speech and language?
When a mom or dad calls me to set up an appointment for their child, we often discuss their concerns at length. Parents are often confused about the difference between speech and language.
Speech is the production of sounds that make up words and sentences. It involves the coordination of the jaw, lips, tongue, vocal folds (vocal cords), vocal tract and respiration. There are three divisions of speech:
1. Articulation - This is one of the most common reasons parents contact me, I typically hear things like "I am the only person that can understand my daughter." or "My son is having trouble pronouncing R." Treating articulation disorders is one of my specialties.
2. Voice - A consistent raspy or hoarse vocal quality or history of vocal nodules is a reason to seek out a speech therapist.
3. Fluency - The ease and flow with which words are connected in conversation. A disorder of fluency is stuttering. It is considered normal for young children to have some dysfluent speech. If the stuttering becomes more prevalent, it would then be appropriate to consult a speech pathologist that specializes in working with children who stutter.
Please contact me for recommendations of therapists that specialize in voice and fluency in New York City. For helpful information on stuttering, check out these resourceful websites: www.stutteringhelp.org
and www.nsastutter.org
Language refers to the use of words and sentences to convey ideas and express our wants and needs. Speaking, gesture use, writing, understanding verbal conversation and understanding what one reads are all language related.
Parents with children with language delay / disorders often report to me "My daughter is 18 months old and she only babbles, she doesn't have any words." or "My son is 2 and he has trouble putting words together to make sentences."
I am a pediatric speech and language pathologist (AKA speech therapist) specializing in improving articulation (speech) and language skills. Many of the parents I work with are often craving ideas about how to help their child's speech and language skills thrive. I enjoy sharing ideas with them that are appropriate for their particular child. I evaluate and treat children in their Manhattan homes and encourage parents to learn how to ask good questions, model language in an optimal way and follow their child's lead to create an effective playtime. Exercises to improve the muscles of the jaw, lips and tongue are often incorporated into these sessions.
Maximizing your child's speech and language skills will help build relationships with siblings, family, peers, teachers and most importantly, you.
If you live in Manhattan, and have speech and / or language concerns for your child, please contact me for an appointment:
Stephanie Sigal M.A. CCC-SLP 646.295.4473 email: sayandplay@yahoo.com website: www.sayandplayfamily.com |
Labels: Articulation, Language, Speech
Hearing and Speech - Language Development
Should I have my child's hearing tested? If you are concerned about your child's speech and language skills, you should have his or her hearing tested in a sound proof booth with a licensed audiologist before pursuing speech therapy. In my phone interview, I always ask parents: 'Have you had your child's hearing tested in a sound proof booth?' I always get one of three responses: 1. 'He had his hearing tested at birth and he passed.' This is a misconception because that was a hearing screening (not a test) and it only screened your child's hearing at THAT time. 2. 'The pediatrician tested his hearing and he's fine.' Again, this was a screening, not a complete test in a sound proof booth with a licensed audiologist. 3. 'He can hear everything, I'm not concerned.' I'm sure he can hear, but he may have difficulty, for example, hearing high frequency sounds such as S and F, which could make it difficult for him to produce these sounds accurately, or understand certain words in rapid conversational speech, especially in a classroom setting. It is not possible for a parent to determine if their child can hear accurately without having a complete audiological exam. Please feel free to contact me for a referral in Manhattan. Labels: Articulation, Hearing, Language, Speech
Treating Articulation Delays
It is difficult for people who don't know my child to understand what she says. What is your approach for improving articulation problems in children? Along with traditional speech therapy techniques, I use a muscle-based (oral motor) approach to improve the muscles of the jaw, lips and tongue, which support each other in this order. When completing a muscle-based assessment, I begin at the level of the jaw, administering child appropriate exercises that a parent or caregiver may carryover for homework. Exercises for the lips or tongue may be incorporated as well, depending on your child's skill level. These exercises may include blowing horns and bubbles using specific, hierarchical, adult directed methods that target the necessary movements for effective speech production. Exercises to be completed at mealtime may also be incorporated. For example, when a child drinks from an open cup, we only want them to use their lips to take a sip, we do not want them using their teeth (jaw) on the cup. It is best to see dissociation - the jaw, lips and tongue working independently. The same is true for removing pureed food from a spoon. We want children to remove the food with their lips only. I teach children and instruct their parents / caregivers how to do this most effectively to improve muscle movements used for standard speech.
We also want to eliminate the use of pacifiers, bottles, sippy cups, etc. as the suckling action that occurs will work against all our efforts. Nutrition should never be compromised; the bottle or sippy cup should be removed when the child can drink effectively from an open cup or straw.
The recommended exercises are thoroughly discussed with parents during or at the end of each therapeutic session, and a written program plan along with detailed instructions is consistently provided. Parents are encouraged to call or email with questions about the homework in-between sessions to maximize skills.
The specific sounds your child is having difficulty producing are analyzed using a standardized test. It is then determined which, if any sounds would be appropriate to address, depending on the muscle-based results.
I have found that using a muscle based approach, along with traditional articulation therapy (targeting individual speech sounds) increases children's speech clarity in conversation, rather than simply at the word level.
Labels: Articulation, Oral Motor, Speech
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