“Encouraging a child means that one or more of the following critical life messages are coming through, either by word or by action: I believe in you, I trust you, I know you can handle this, You are listened to, You are cared for, You are very important to me.”
– Barbara Coloroso
Pediatric Speech Language Pathology at The Therapy Tree
Working with children from birth to 21 years of age, speech language pathologists, focus on improving both spoken and nonverbal language, hearing abilities, learning difficulties, and feeding and swallowing problems. Because of the complexity of many disorders that are associated with treatment by speech language pathology, there is often collaboration with our other specialties including physical or occupational therapy, and counseling services. Total mind and body wellness, restoring confidence, and building life skills is always our goal in providing optimal growth and health of the children we treat.
How do I know if my child needs help with speech and language?
Speech and language difficulties are one of the most common of all developmental delays. Children develop at different rates, however, there are certain skills that are expected by certain stages in a child’s development. At wellness check-ups, your child’s pediatrician may notice problematic areas of communication and write a prescription referring your child to speech language pathology.
Conditions Treated by Pediatric Speech Language Pathology
There are many reasons children are referred for speech therapy. Our Pediatric Speech Language Pathology Team helps children with an incredible range of needs. The areas of child development that are treated include developmental delays/disorders, auditory processing, medical conditions that cause oral-motor, feeding, or communication difficulties, language-based learning disabilities, and developmental delays. Below is a list of the more common conditions that pediatric speech language pathologists treat.
Articulation & Phonological Disorders
Articulation & Phonological Disorders
Children with speech sound disorders have difficulty producing sounds, words or phrases clearly and fluently. This can be due to immature development, neurological impairment or a structural/anatomical difference.
Speech Sound disorders include:
- Articulation disorders: An articulation disorder is the inability to say certain speech sounds correctly beyond the age when the sound is typically learned. Speech sounds may be dropped, added, distorted or substituted. Keep in mind that some sound changes may be part of an accent or dialect, and may not be true speech errors.
- Phonological process disorders: A phonological process disorder occurs when a child makes predictable and typical patterns of speech sound errors. The mistakes may be common in young children learning speech skills, but when they continue past a certain age, it may be a disorder.
- Disorders that involve a combination of both articulation and phonological process disorders.
Signs of an articulation disorder can include:
- Leaving off sounds from words, such as saying “coo” instead of “school”
- Adding sounds to words, such as saying “puhlay” instead of “play”
- Distorting sounds in words, such as saying “thith” instead of “this”
- Substituting sounds in words, such as saying “wadio” instead of “radio”
Signs of a phonological process disorder can include:
- Saying only one syllable in a word, such as saying “bay” instead of “baby”
- Simplifying a word by repeating two syllables, such as saying “baba” instead of “bottle”
- Leaving out a consonant sound, such as saying “at” or “ba” instead of “bat” or saying “tar” instead of “star”
- Changing certain consonant sounds, such as “tat” instead of “cat”
https://www.chop.edu/conditions-diseases/speech-sound-disorders-children
Attention Deficit (Hyperactivity) Disorder (ADD/ADHD)
Attention Deficit (Hyperactivity) Disorder (ADD/ADHD)
ADHD is a neurodevelopmental disorder. In other words, it is brain-based, and it begins in childhood. Similar to what we see with autism, ADHD traits can vary widely from person to person. However, the disorder nearly always impacts executive functioning, including working memory, task initiation and completion, and complex problem solving. https://www.thedigitalslp.com/what-slps-need-to-know-about-adhd/
A person with ADHD may show some of the following signs:
Inattention
- Has trouble concentrating
- Starts thinking about other things
- Has problems staying focused on tasks
- Does not seem to listen
- Does better on some tasks than others
- Has problems planning, organizing, and finishing tasks on time
- Has problems learning new things
Hyperactivity
- Seems unable to sit still
- Is restless and fidgety
- May bounce from one activity to the next
- Often tries to do more than one thing at once
Impulsivity
- May act before thinking
- Has problems waiting their turn, such as when playing a game
Each child with ADHD has different needs. Your doctor may prescribe medicine to help your child pay attention. You will learn about possible side effects.
Some children with ADHD also have learning disabilities. Others need help with social skills. An SLP can work with your child on speech, language, and social problems. The SLP can help your child learn how to plan and organize to get tasks done. Your child may need to learn how to take turns and pay attention when talking to others. https://www.asha.org/public/speech/disorders/adhd/
Auditory Processing Difficulties or Disorder
Auditory Processing Difficulties or Disorder
Auditory skills development includes these areas: awareness, discrimination, identification, comprehension and reasoning. Difficulty in any of these areas can be addressed by Speech Language Pathologists.
Auditory Processing Disorder (APD) is a disorder of the auditory (hearing) system that causes a disruption in the way that an individual’s brain understands what they are hearing. It is not a form of hearing loss, despite showing difficulty with hearing-related tasks.
Signs and symptoms of Auditory Processing Disorder vary from person to person. Many of these symptoms can often be associated with other commonly known disorders, such as ADD/ADHD, Autism Spectrum Disorder and speech and/or language disorders. A child with APD often appears to have a combination of many symptoms.
Some of the most frequently reported symptoms of APD include:
- Significant difficulty understanding speech, especially in the presence of background noise
- Difficulty following multi-step directions that are presented verbally, without visual cues
- Easily distracted by loud or spontaneous (sudden) sounds
- Difficulty attending to long lectures or other long periods of listening
- Difficulty remembering and/or effectively summarizing information presented verbally
- Difficulty reading, spelling, and/or writing when compared to their peers (performs consistently below grade level)
- Trouble following abstract thoughts or ideas
- Delayed or misunderstanding of jokes, idioms, and figurative language
Autism Spectrum Disorders (ASD)
Autism Spectrum Disorders (ASD)
Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain. Some people with ASD have a known difference, such as a genetic condition. Other causes are not yet known. Scientists believe there are multiple causes of ASD that act together to change the most common ways people develop. We still have much to learn about these causes and how they impact people with ASD.
People with ASD may behave, communicate, interact, and learn in ways that are different from most other people. There is often nothing about how they look that sets them apart from other people. The abilities of people with ASD can vary significantly. For example, some people with ASD may have advanced conversation skills whereas others may be nonverbal. Some people with ASD need a lot of help in their daily lives; others can work and live with little to no support.
ASD begins before the age of 3 years and can last throughout a person’s life, although symptoms may improve over time. Some children show ASD symptoms within the first 12 months of life. In others, symptoms may not show up until 24 months of age or later. Some children with ASD gain new skills and meet developmental milestones until around 18 to 24 months of age, and then they stop gaining new skills or lose the skills they once had.
As children with ASD become adolescents and young adults, they may have difficulties developing and maintaining friendships, communicating with peers and adults, or understanding what behaviors are expected in school or on the job. They may come to the attention of healthcare providers because they also have conditions such as anxiety, depression, or attention-deficit/hyperactivity disorder, which occur more often in people with ASD than in people without ASD.
People with ASD often have problems with social communication and interaction, and restricted or repetitive behaviors or interests. People with ASD may also have different ways of learning, moving, or paying attention. These characteristics can make life very challenging. It is important to note that some people without ASD might also have some of these symptoms. https://www.cdc.gov/ncbddd/autism/facts.html
There are five major types of autism which include Asperger’s syndrome, Rett syndrome, childhood disintegrative disorder, Kanner’s syndrome, and pervasive developmental disorder – not otherwise specified. https://www.integrityinc.org/what-are-the-5-types-of-autism/
Central Auditory Processing Disorder
Central Auditory Processing Disorder
Central auditory processing disorder is a rare, poorly understood condition that affects the central auditory nervous system. Patients are classically young children presenting with hearing difficulties but may have other learning disorders, such as attention deficit hyperactivity disorder.
Clinically, CAPD presents in young children as behavioral characteristics. These include:
- Difficulty in localizing sound
- Difficulty in understanding language in noisy backgrounds or when words are presented rapidly
- Longer response times in oral communication
- Inappropriate or inconsistent responding
- Poor attention span and easy distraction
- Reading, spelling, and learning difficulties
- Inability to follow complex commands or directions
Childhood Apraxia of Speech
Apraxia (Childhood Apraxia of Speech) affects the ability to plan, execute and sequence the motor movements for producing speech sounds, syllables, and words. Characteristics of apraxia include:
- Difficulty moving smoothly from one sound, syllable or word to another
- Groping movements with the jaw, lips or tongue to make the correct movement for speech sounds
- Vowel distortions, such as attempting to use the correct vowel, but saying it incorrectly
- Using the wrong stress in a word, such as pronouncing “banana” as “BUH-nan-uh” instead of “buh-NAN-uh”
- Using equal emphasis on all syllables, such as saying “BUH-NAN-UH”
- Separation of syllables, such as putting a pause or gap between syllables
- Inconsistency, such as making different errors when trying to say the same word a second time
- Difficulty imitating simple words
- Inconsistent voicing errors, such as saying “down” instead of “town”
Childhood Speech & Language Delay/Disorders
Childhood Speech & Language Delay/Disorders
Children who have a language disorder have trouble understanding language and communicating. There are 2 kinds of language disorders: receptive and expressive. Children often have both at the same time. Receptive language disorder is characterized by trouble understanding spoken or written words, phrases or sentence. Expressive language disorder is characterized by trouble speaking with others and expressing thoughts and feelings.
A child with receptive language disorder may have trouble:
- Understanding what people say
- Understanding gestures
- Understanding concepts and ideas
- Understanding what he or she reads
- Learning new words
- Answering questions
- Following directions
- Identifying objects
A child with expressive language disorder may have trouble:
- Using words correctly
- Expressing thoughts and ideas
- Telling stories
- Using gestures
- Asking questions
- Singing songs or reciting poems
- Naming objects
https://www.stanfordchildrens.org/en/topic/default?id=language-disorders-in-children-160-238
Cleft Lip and Palate
Cleft Lip and Palate
Cleft lip and cleft palate are openings or splits in the upper lip, the roof of the mouth (palate) or both. Cleft lip and cleft palate result when facial structures that are developing in an unborn baby don’t close completely.
Cleft lip and cleft palate are among the most common birth defects. They most commonly occur as isolated birth defects but are also associated with many inherited genetic conditions or syndromes.
Submucous cleft is less common, and occurs only in the muscles of the soft palate, which are at the back of the mouth and covered by the mouth’s lining. This type of cleft often goes unnoticed at birth and may not be diagnosed until later when signs develop. Signs and symptoms of submucous cleft palate may include:
- Difficulty with feedings
- Difficulty swallowing, with potential for liquids or foods to come out the nose
- Nasal speaking voice
- Chronic ear infections
Children with cleft lip with or without cleft palate face a variety of challenges, depending on the type and severity of the cleft.
- Difficulty feeding.One of the most immediate concerns after birth is feeding. While most babies with cleft lip can breast-feed, a cleft palate may make sucking difficult.
- Ear infections and hearing loss.Babies with cleft palate are especially at risk of developing middle ear fluid and hearing loss.
- Dental problems.If the cleft extends through the upper gum, tooth development may be affected.
- Speech difficulties.Because the palate is used in forming sounds, the development of normal speech can be affected by a cleft palate. Speech may sound too nasal.
- Challenges of coping with a medical condition.Children with clefts may face social, emotional and behavioral problems due to differences in appearance and the stress of intensive medical care.
https://www.mayoclinic.org/diseases-conditions/cleft-palate/symptoms-causes/syc-20370985
Deafness and Hearing Loss
Deafness and Hearing Loss
There is often confusion over the terms “hearing impaired,” “hard of hearing,” “deaf,” and “deafened,” both in definition and appropriateness of use.
The term “hearing impaired” is often used to describe people with any degree of hearing loss, from mild to profound, including those who are deaf and those who are hard of hearing. Many individuals who are deaf or hard of hearing prefer the terms “deaf” and “hard of hearing,” because they consider them to be more positive than the term “hearing impaired,” which implies a deficit or that something is wrong that makes a person less than whole.
“Deaf” usually refers to a hearing loss so severe that there is very little or no functional hearing. “Hard of hearing” refers to a hearing loss where there may be enough residual hearing that an auditory device, such as a hearing aid or FM system, provides adequate assistance to process speech.
Individuals may experience hearing loss and deafness during different stages of life for the following reasons:
Prenatal period
- genetic factors including hereditary and non-hereditary hearing loss
- intrauterine infections – such as rubella and cytomegalovirus infection.
Perinatal period
- birth asphyxia (a lack of oxygen at the time of birth
- hyperbilirubinemia (severe jaundice in the neonatal period)
- low-birth weight
- other perinatal morbidities and their management.
Childhood and adolescence
- chronic ear infections (chronic suppurative otitis media)
- collection of fluid in the ear (chronic nonsuppurative otitis media)
- meningitis and other infections.
Factors across the life span
- cerumen impaction (impacted ear wax)
- trauma to the ear or head
- loud noise/loud sounds
- ototoxic medicines
- work related ototoxic chemicals
- nutritional deficiencies
- viral infections and other ear conditions
- delayed onset or progressive genetic hearing loss.
https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss
Dyslexia
Dyslexia
Dyslexia is a condition of neurodevelopmental origin that mainly affects the ease with which a person reads, writes, and spells typically recognized as a specific learning disorder in children.
Signs of dyslexia in childhood include:
- Difficulty learning nursery rhymes
- Difficulty paying attention, sitting still, listening to stories
- Difficulty learning to sing or recite the alphabet
- A history of slow speech development
- Muddles words e.g. cubumber, flutterby
- Difficulty keeping simple rhythm
- Finds it hard to carry out two or more instructions at one time, (e.g. put the toys in the box, then put it on the shelf) but is fine if tasks are presented in smaller units
- Forgets names of friends, teacher, colors etc.
- Poor auditory discrimination
- Confusion between directional words e.g. up/down
- Family history of dyslexia/reading difficulties
- Difficulty with sequencing e.g. coloured beads, classroom routines
- Substitutes words e.g. “lampshade” for “lamppost”
- Appears not to be listening or paying attention
- Speed of processing: slow spoken and/or written language
- Poor concentration
- Difficulty following instructions
- Forgetting words
- Poor standard of written work compared with oral ability
- Produces messy work with many crossings out and words tried several times, e.g. wippe, wype, wiep, wipe
- Confused by letters which look similar, particularly b/d, p/g, p/q, n/u, m/w
- Poor handwriting with many ‘reversals’ and badly formed letters
- Spells a word several different ways in one piece of writing
- Makes anagrams of words, e.g. tired for tried, bread for beard
- Produces badly set-out written work, doesn’t stay close to the margin
- Poor pencil grip
- Slow reading progress
- Finds it difficult to blend letters together
- Has difficulty in establishing syllable division or knowing the beginnings and endings of words
- Unusual pronunciation of words
- No expression in reading, and poor comprehension
- Hesitant and laboured reading, especially when reading aloud
- Misses out words when reading, or adds extra words
- Fails to recognise familiar words
- Loses the point of a story being read or written
- Has difficulty in picking out the most important points from a passage
- Confusion with place value e.g. units, tens, hundreds
- Confused by symbols such as + and x signs
- Difficulty remembering anything in a sequential order, e.g. tables, days of the week, the alphabet
- Has difficulty learning to tell the time
- Poor time keeping
- Poor personal organization
- Difficulty remembering what day of the week it is, their birth date, seasons of the year, months of the year
- Difficulty with concepts – yesterday, today, tomorrow
- Poor motor skills, leading to weaknesses in speed, control and accuracy of the pencil
- Memory difficulties e.g. for daily routines, self-organization, rote learning
- Confused by the difference between left and right, up and down, east and west
- Indeterminate hand preference
- Performs unevenly from day to day
- Uses work avoidance tactics, such as sharpening pencils and looking for books
- Seems ‘dreamy’, does not seem to listen
- Easily distracted
- Is the class clown or is disruptive or with-drawn
- Is excessively tired due to amount of concentration and effort required
A cluster of these indicators alongside areas of ability may suggest dyslexia and further investigation may be required.
https://www.bdadyslexia.org.uk/advice/children/is-my-child-dyslexic
Executive Function Difficulties
Executive Function Difficulties
The phrase “executive function” refers to a set of skills. These skills underlie the capacity to plan ahead and meet goals, display self-control, follow multiple-step directions even when interrupted, and stay focused despite distractions, among others.
The twelve executive functioning skills are self-restraint, working memory, emotion control, focus, task initiation, planning/prioritization, organization, time management, defining/planning and achieving goals, cognitive flexibility, observation/self-monitoring and stress tolerance.
The SLP focuses on all these areas of executive function skill development looking at skills needed in different developmental stages and life skills. The SLP focuses on helping develop executive functions needed to navigate daily routines including Emotional Control, Task Initiation, Task Completion, Working Memory, Planning, Prioritizing, Processing Speed, Organization, Attention, Self-Monitoring, Impulse Control, Cognitive Flexibility, Foresight, Hindsight, Self-Talk, Problem Solving, Persistence, Shift
https://www.theottoolbox.com/executive-functioning-skills/
The following illustrates examples of the executive function skills that are expected at different stages of development/life:
0-24 Months
- Attract caregiver’s attention when not feeling well
- Look for hidden toys and objects
- Focus on objects and start grabbing them
- Begin matching skills
- Play with cause and effect toys
- Plays hide and seek and peek-a-boo (Life Skills Advocate, 2020).
2-4 Years
- Follow simple instructions
- Cleans up toys with adult help
- Names simple emotions
- Responds to adult reminders to pay attention
- Can start and complete tasks that take up to 10 minutes (Life Skills Advocate, 2020).
5-12 Years
- Follows a visual schedule
- Starts identify solutions to problems
- Can follow simple checklists
- Plays in team sports
- Follows most safety rules
- Checks own work for simple mistakes (Life Skills Advocate, 2020).
13-18 Years
- Start cooking a meal
- Efficiently manage homework and finish them on time
- Plans ahead for desired goals (e.g. save money to buy something)
- Can estimate how long it takes to complete tasks and adjust speed accordingly (Life Skills Advocate, 2020).
Executive Function Skills By Age: What To Look For | Life Skills Advocate. (2021). Retrieved 24 December 2021, from HTTPS://LIFESKILLSADVOCATE.COM/BLOG/EXECUTIVE-FUNCTION-SKILLS-BY-AGE/#EXECUTIVE-FUNCTIONING-SKILLS-BY-AGE
Expressive Language Delays and Disorders
Expressive Language Delays and Disorders
Children with expressive language disorder have trouble talking and making other people understand them. These are some of the more obvious symptoms:
- trouble finding the right word, and using placeholders like “uh.”
- uses the incorrect verb tense
- uses the wrong pronouns (such as him/he, her/she, them/they)
- omits pronouns or verbs
- stumbles over words
- difficulty asking and answering questions
- repeats words back when asked a question
- struggles learning songs or rhymes
- difficulty expressing thoughts and ideas
- uses noticeably fewer words and sentences than children of a similar age
- uses shorter, simpler sentence construction than children of a similar age
- has a limited and more basic vocabulary than children of a similar age
- uses the wrong words, wrong word order in sentences or confuses meaning in sentences
- relies on standard phrases and limited content in speech
- hesitates when attempting to converse
- talks “in circles”
- fails to observe general rules of communicating with others, difficulty with social skills
- has difficulty with oral and written school assignments
- uses vague words, like “thing” or “stuff”
- uses vocabulary incorrectly
- speaks quietly and/or with little voice inflection
- exhibits selective mutism
- demonstrates incorrect usage of grammar
- struggles to use more complex language features such as descriptors, metaphors, similes, idioms, multiple-meaning words, etc.
https://presencelearning.com/insights/signs-your-child-has-expressive-language-disorder/
Genetic Disorders and Rare Diseases
Speech Language Pathologists frequently provide services for conditions that coexist or result from genetic disorders including but not limited to:
Angelman Syndrome
Angelman Syndrome is a genetic disorder resulting in global developmental delays. Receptive language abilities are typically more advanced than their expressive language abilities, resulting in a limited expressive vocabulary.
DiGeorge Syndrome
Down Syndrome
Down Syndrome is a chromosomal abnormality, with a diagnosis typically made at the time of birth due to the physical characteristics such as flat facial features, poor muscle tone, heart problems, and an enlarged tongue. Speech and language may be delayed.
Fragile X Syndrome
Fragile X Syndrome is a genetic disorder which is more common in boys than girls. Physical features of Fragile X Syndrome include: long face, large prominent ears, and hyperextensible joints. Speech and language delays are present.
Joubert Syndrome and other related disorders
Landau-Kleffner Syndrome (LKS)
LKS is diagnosed through sleep EEG due to frequent nighttime seizure activity. LKS is characterized by a progressive loss in the ability to understand and use spoken language.
Prader-Willi Syndrome (PWS)
PWS is a chromosomal disorder, affecting the #15 chromosome. Signs of PWS include the following: hypotonia (lack of muscle tone), global developmental delay, feeding problems, narrow face, almond-shaped eyes, small mouth, hypopigmentation (loss of skin color), motor planning problems, behavioral problems, sleep disturbances, and compulsive eating problems.
Williams Syndrome
Williams Syndrome is a genetic disorder which is present at birth, affecting the #7 chromosome. The following physical features are typically present in Williams Syndrome: elfin-like facial features, heart and blood vessel problems, elevated blood calcium levels, slow weight gain, feeding problems, colic, dental problems, kidney problems, hernias, and hypotonia (low muscle tone). Children with Williams Syndrome may be extremely social, have attention deficits, learning disabilities, and a developmental delay.
Wolf-Hirschhorn Syndrome (WHS)
Wolf-Hirschhorn affects many parts of the body, both physical and mental. The most common symptoms are abnormalities of the face, delayed development, intellectual disabilities, and seizures. Children with this syndrome often experience delayed/disordered speech and language skills, and often have feeding difficulties, and may have cleft lip and/or palate.
Language-Based Learning Disabilities
Language-Based Learning Disabilities
Language-based learning disability (LBLD) refers to a spectrum of difficulties related to the understanding and use of spoken and written language. LBLD is a common cause of students’ academic struggles because weak language skills impede comprehension and communication, which are the basis for most school activity.
The development of fluent language skills is rooted in complex cognitive processes that include attention, auditory and visual perception and processing, memory, and executive function. Students who have difficulty in any of these areas may also have difficulty acquiring the facility with language that school requires. To understand a reading selection, for example, students must be able to pay attention to the task of reading, decode the words, retrieve vocabulary and related knowledge from memory, and recognize the syntax and structure of discourse.
LBLD can manifest as a wide variety of language difficulties with different levels of severity including. Students with LBLD commonly experience difficulties with listening, speaking, reading, writing, spelling, mathematics, organization, attention, memory, social skills, perseverance, self-regulation. One student may have difficulty sounding out words for reading or spelling, but no difficulty with oral expression or listening comprehension. Another may struggle with all three. The spectrum of LBLD ranges from students who experience minor interferences that may be addressed in class to students who need specialized, individualized attention throughout the school day in order to develop fluent language skills.
Ultimately, children with LBLD struggle with aspects of Executive Function skills and achieving academic proficiency. Executive function enables students to maintain focus, progress, and motivation; make connections with existing knowledge; recognize when comprehension falters; and apply strategies to modulate frustration and resolve lapses in understanding.
Academic proficiency in encompassed in three general areas: language and literacy, study skills, and self-efficacy. Language and literacy skills include listening, speaking, reading and writing. Study skills include flexible and appropriate use of strategies for managing materials, time, and language. Self-efficacy (the belief that one’s actions are related to outcomes) includes skills in self-awareness, self-assessment, and self-advocacy. All of these skills are coordinated by executive function, which is the brain’s super-manager that empowers students to set goals, marshal the various internal and external resources needed to meet them, and to make adjustments to ensure accomplishment.
Neurogenic Disorders or Injuries
Neurogenic Disorders or Injuries
Some more commonly experienced neurogenic disorders and injuries include aphasia, apraxia, cerebral palsy, cognitive-communication impairments dysarthria, muscular dystrophy, stroke, or traumatic brain injury.
A Neuromotor Speech Disorders is present when a child struggles to produce speech because of problems with motor planning or muscle tone needed to speak. The two major types of neuromotor speech disorders dysarthria and apraxia.
Dysarthria affects the muscles needed for speech production. The lips, tongue, vocal folds, and/or diaphragm may have impaired movements, resulting in unintelligible speech. The following speech characteristics may be present in a child with dysarthria: slurred speech, slow rate of speech, rapid rate of speech, limited movement of the mouth, abnormal rhythm while speaking, and abnormal vocal quality.
Apraxia (Childhood Apraxia of Speech) affects the ability to plan, execute and sequence the motor movements for producing speech sounds, syllables, and words. Characteristics of apraxia include:
- Difficulty moving smoothly from one sound, syllable or word to another
- Groping movements with the jaw, lips or tongue to make the correct movement for speech sounds
- Vowel distortions, such as attempting to use the correct vowel, but saying it incorrectly
- Using the wrong stress in a word, such as pronouncing “banana” as “BUH-nan-uh” instead of “buh-NAN-uh”
- Using equal emphasis on all syllables, such as saying “BUH-NAN-UH”
- Separation of syllables, such as putting a pause or gap between syllables
- Inconsistency, such as making different errors when trying to say the same word a second time
- Difficulty imitating simple words
- Inconsistent voicing errors, such as saying “down” instead of “town”
Oral Motor, Feeding and Swallowing Difficulties
Oral-Motor Disorders
Oral-motor disorders are caused by incorrect motor programming of the muscles of the mouth; which may lead to difficulty with eating and speaking. Oral motor exercises are used to strengthen, improve coordination, and improve range of motion of the articulators (e.g., jaw, lips, and tongue). Activities may include blowing bubbles, using straws, and blowing horns to name a few.
Swallowing/Feeding Disorders
wallowing and feeding disorders include problems with gathering food and getting ready to suck, chew, or swallow it. Swallowing disorders are also called dysphagia. Dysphagia may occur in one or all of the following phases: oral phase (sucking, chewing, and moving food/liquid to the throat), pharyngeal phase (starting swallow, squeezing the food down the throat, and closing off the airway), and the esophageal phase (relaxing and tightening the openings at the top and bottom of the esophagus and getting the food into the stomach).
Pediatric Feeding Disorders
Feeding disorders are characterized by extreme food selectivity (beyond pickiness) by type, (exclude more than one food group from the child’s diet); by texture (only eat smooth or crunchy foods); or by brand, shape or color. Some children develop feeding problems due to a medical condition such as reflux or a severe illness. Some have poor oral motor skills and have difficulty chewing and swallowing and this restricts their diet. What separates feeding disorders from picky children is that children with feeding disorders tend to not eat in other situations outside of their home due to their extreme selectivity.
https://www.nationwidechildrens.org/conditions/feeding-disorders
Pediatric feeding disorders often lead to problems including weight loss, nutritional deficiency, need for nutritional supplements, or problems with daily functioning. These disorders often limit a child’s ability to participate in normal social activities such as eating with others, and disrupt family functioning. Conditions and disorders in which feeding difficulties are often present include Attention Deficit Disorders, Autism Spectrum Disorders, Pervasive Developmental Disorders, Sensory Processing Disorders, PANDAS, ARFID, Failure to Thrive.
For most children, there is not just one thing that causes a feeding disorder. Most often, it is a combination of factors. Things that can contribute to the development of a feeding disorder include:
- Child temperament (slow to adapt, easily over-stimulated)
- Pain or discomfort with feeding (from things like reflux and allergy)
- Negative experiences with feeding (pain, coughing, vomiting or gagging during feeding)
- Negative experiences related to the mouth (history of NG tubes, oral procedures, being on a ventilator, surgeries)
- Slow emptying of the stomach
- Poor oral motor skills (dysphagia)
- Low muscle tone or high muscle tone
- Developmental delays
- Certain developmental disabilities, such as autism spectrum disorder
- Anxiety
- ADHD
- Sensory differences (hypersensitivity to taste, smell, texture)
- Chronic health problems (ear infections, frequent respiratory infections, dental problems, seizures)
- Parent-child conflict, parental anxiety
Occupational Therapy and Counseling are often an integral component of a comprehensive approach to treating feeding problems. Counselors provide specialized intervention related to mental health and behavioral concerns around eating such as anxiety, avoidance, fight/flight behaviors, control issues, body image and self-esteem issues. Occupational therapists provide specialized intervention related to sensory regulation and integration with may impact feeding and other areas of development, and other activities of daily living that include feeding skills and behavior. Additional medical consult with pediatric specialists and therapies such as GI, and ENT can also be an integral part of a comprehensive therapy plan to gain the best changes and progress in feeding difficulties and disorders.
Orofacial Myofunctional Disorders (OMD)
Orofacial Myofunctional Disorders (OMD)
An orofacial myofunctional disorder (OMD) is when there is an abnormal lip, jaw, or tongue position during rest, swallowing or speech. You may also see this when there are prolonged oral habits, like thumb or finger sucking.
Some signs of an OMD may include the following:
- Someone who always breathes through the mouth or has difficulty breathing through the nose.
- Limited tongue movement.
- Eating may be messy or difficult. Keep in mind that it is normal for babies to stick their tongue out and push food out of their mouth. Over time, they do this less.
- An overbite, underbite, and/or other dental problems.
- The tongue pushing past the teeth, even when a person is not talking or using the tongue.
- Difficulty saying some sounds, like “s” in “sun,” “sh” in “ship,” or “j” in “jump.”
- Drooling, especially beyond age 2.
- Difficulty closing the lips to swallow.
Causes of Orofacial Myofunctional Disorders
There is not a known, single cause of OMDs. OMDs may be caused by several factors:
- Blocked nasal passages because of tonsil size or allergies. When the nasal passages are blocked, people may need to breathe through their mouth instead.
- Anything that causes the tongue to be misplaced at rest or makes it difficult to keep the lips together at rest.
- Sucking and chewing habits past the age of 3 years.
Pragmatic (Social) Language Disorder
Pragmatic (Social) Language Disorder
Pragmatic language disorder is a condition in which someone has difficulty communicating both verbally and nonverbally in social situations.
Language pragmatics is the use of appropriate communication methods in social settings. This includes things like knowing what to say, how to say it, and when to say it.
Pragmatic language is made up of three major skills:
- Using language for a specific purpose, like to say hello or goodbye or to make a request or statement
- Changing your language depending on the person you’re talking to or the situation you’re in, like speaking differently to a teacher than to a baby or in a classroom than on the playground
- Following social rules for conversations, like taking turns talking, staying on topic, respecting personal space, and using and understanding body language
Difficulties with language pragmatics and social communication are often associated with other specific conditions such as Aphasia, Attention-Deficit/Hyperactivity Disorder (ADHD), Autism spectrum disorder (ASD), Cerebral palsy, Dementia, Down syndrome, Fetal alcohol syndrome, Spoken language disorders, Traumatic brain injuries, and Written language disorders.
https://www.webmd.com/children/what-is-pragmatic-language-disorder
Receptive Language Delays and Disorders
Receptive Language Delays and Disorders
Receptive language disorder is characterized by trouble understanding spoken or written words, phrases or sentences.
A child with receptive language disorder may have trouble:
- Understanding what people say
- Understanding gestures
- Understanding concepts and ideas
- Understanding what he or she reads
- Learning new words
- Answering questions
- Following directions
- Identifying objects
Selective Mutism
Selective Mutism
Some children are uncomfortable speaking in unfamiliar situations or with people they don’t know. They usually start talking when they feel more comfortable. Children with selective mutism have repeated difficulty speaking, or seem afraid to communicate, at certain times or in certain places. Selective mutism might continue into the teenage years and adulthood.
If your child has selective mutism, you may notice the following things:
- They will not speak in certain places or situations, such as in class or in front of certain people. This will happen every time they are in that situation. Your child will talk at other times and in other places.
- Not speaking gets in the way of school, work, friendships, or relationships.
- This difficulty talking lasts for at least 1 month. This time period does not include the first month of school because children may be shy and may not talk right away.
- Your child can understand and speak the language used in this specific situation but is still not talking. Sometimes children don’t speak when people are using a language they are less familiar with but do speak when people are using a language they know. This is not selective mutism.
- Your child’s mutism cannot be explained by conditions such as autism, stuttering, or mental health disorders.
https://www.asha.org/public/speech/disorders/selective-mutism/
Speech Sound Disorders
Speech Sound Disorder
Children with speech sound disorders have difficulty producing sounds, words or phrases clearly and fluently. This can be due to immature development, neurological impairment or a structural/anatomical difference.
Speech Sound disorders include:
- Articulation disorders: An articulation disorder is the inability to say certain speech sounds correctly beyond the age when the sound is typically learned. Speech sounds may be dropped, added, distorted or substituted. Keep in mind that some sound changes may be part of an accent or dialect, and may not be true speech errors.
- Phonological process disorders: A phonological process disorder occurs when a child makes predictable and typical patterns of speech sound errors. The mistakes may be common in young children learning speech skills, but when they continue past a certain age, it may be a disorder.
- Disorders that involve a combination of both articulation and phonological process disorders.
(see Articulation and Phonological Disorders)
https://www.chop.edu/conditions-diseases/speech-sound-disorders-children
Stuttering or other Fluency Disorders
Fluency
Fluency refers to continuity, smoothness, rate, and effort in speech production. All speakers are disfluent at times. They may hesitate when speaking, use fillers (“like” or “uh”), or repeat a word or phrase. These are called typical disfluencies or nonfluencies.
A fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm, and disfluencies (e.g., repetitions of sounds, syllables, words, and phrases; sound prolongations; and blocks), which may also be accompanied by excessive tension, speaking avoidance, struggle behaviors, and secondary mannerisms (American Speech-Language-Hearing Association [ASHA], 1993). People with fluency disorders also frequently experience psychological, emotional, social, and functional impacts as a result of their communication disorder (Tichenor & Yaruss, 2019a).
Stuttering
Stuttering, the most common fluency disorder, is an interruption in the flow of speaking characterized by specific types of disfluencies, including
- repetitions of sounds, syllables, and monosyllabic words (e.g., “Look at the b-b-baby,” “Let’s go out-out-out”);
- prolongations of consonants when it isn’t for emphasis (e.g., “Ssssssssometimes we stay home”); and
- blocks (i.e., inaudible or silent fixation or inability to initiate sounds).
These disfluencies can affect the rate and rhythm of speech and may be accompanied by
- negative reactions to speaking;
- avoidance behaviors (i.e., avoidance of sounds, words, people, or situations that involve speaking);
- escape behaviors, such as secondary mannerisms (e.g., eye blinking and head nodding or other movements of the extremities, body, or face); and
- physical tension.
Children and adults who stutter also frequently experience psychological, emotional, social, and functional consequences from their stuttering, including social anxiety, a sense of loss of control, and negative thoughts or feelings about themselves or about communication (Boyle, 2015; Craig & Tran, 2014; Iverach et al., 2016; Iverach & Rapee, 2014).
Stuttering typically has its origins in childhood. Approximately 95% of children who stutter start to do so before the age of 4 years, and the average age of onset is approximately 33 months. Onset may be progressive or sudden. Some children go through a disfluent period of speaking. It is also not unusual for disfluencies to be apparent and then seem to go away for a period of weeks or months only to return again. Approximately 88%–91% of these children will recover spontaneously with or without intervention (Yairi & Ambrose, 2013).
Stuttering can co-occur with other disorders (Briley & Ellis, 2018), such as
- attention-deficit/hyperactivity disorder (Donaher & Richels, 2012; Lee et al., 2017),
- autism spectrum disorder (Briley & Ellis, 2018),
- intellectual disability (Healey et al., 2005),
- language or learning disability (Ntourou et al., 2011),
- seizure disorders (Briley & Ellis, 2018),
- social anxiety disorder (Brundage et al., 2017; Craig & Tran, 2014; Iverach et al., 2018),
- speech sound disorders (St. Louis & Hinzman, 1988; Wolk et al., 1993), and
- other developmental disorders (Briley & Ellis, 2018).
Cluttering
Cluttering, another fluency disorder, is characterized by a perceived rapid and/or irregular speech rate, atypical pauses, maze behaviors, pragmatic issues, decreased awareness of fluency problems or moments of disfluency, excessive disfluencies, collapsing or omitting syllables, and language formulation issues, which result in breakdowns in speech clarity and/or fluency (St. Louis & Schulte, 2011; van Zaalen-Opt Hof & Reichel, 2014). Individuals may exhibit pure cluttering or cluttering with stuttering (van Zaalen-Op’t Hof et al., 2009).
Breakdowns in fluency and clarity can result from
- atypical pauses within sentences that are not expected syntactically (e.g., “I will go to the / store and buy apples”; St. Louis & Schulte, 2011),
- deletion and/or collapsing of syllables (e.g., “I wanwatevision”),
- excessive levels of typical disfluencies (e.g., revisions, interjections),
- maze behaviors or frequent topic shifting (e.g., “I need to go to…I mean I’m out of cheese. I ran out of cheese and bread the other day while making sandwiches and now I’m out so I need to go to the store”), and/or
- omission of word endings (e.g., “Turn the televisoff”).
Cluttering may have an effect on pragmatic communication skills and awareness of moments of disruption (Teigland, 1996). For example, individuals who clutter may not be aware of communication breakdowns and, therefore, do not attempt to repair them. This results in less effective social interactions.
There are limited data on the age of onset of cluttering; however, the age of onset of cluttering appears to be similar to that of stuttering (Howell & Davis, 2011). Individuals typically aren’t diagnosed or do not start treatment until 8 years of age or into adolescence/adulthood (Ward & Scaler Scott, 2011).
Cluttering can co-occur with other disorders, including
- learning disabilities (Wiig & Semel, 1984),
- auditory processing disorders (Molt, 1996),
- Tourette’s syndrome (see Van Borsel, 2011, for a review),
- autism (see Scaler Scott, 2011, for a review),
- word-finding/language organization difficulties (Myers, 1992), and
- attention-deficit/hyperactivity disorder (Alm, 2011).
Speech clarity and fluency may temporarily improve when the person is asked to slow down or pay attention to their speech. These should be considered during differential diagnosis but should not be the sole therapeutic strategies.
https://www.asha.org/practice-portal/clinical-topics/fluency-disorders/
Voice Disorders
Voice Disorder
A voice disorder is characterized by abnormalities in the volume, quality, pitch, and prosody of the voice. Some common types of voice disorder include: vocal cord nodules, vocal cord polyps, vocal cord paralysis, paradoxical vocal fold movement, and spasmodic dysphonia.
Vocal Cord Nodules
Vocal Cord Nodules are noncancerous growths on the vocal cords that are caused by vocal abuse (yelling, excessive amounts of caffeine, constant throat clearing). As vocal abuse continues, the growths become larger and harder; making the vocal quality hoarse, breathy, harsh, or scratchy.
Vocal Cord Polyps
A vocal polyp is a blister-like growth and is usually larger than a nodule. Polyps may also be caused by vocal abuse (yelling, excessive amounts of caffeine, constant throat clearing). Polyps may make the vocal quality hoarse, breathy, harsh, or scratchy.
Vocal Cord Paralysis
Vocal cord paralysis occurs when one or both of the vocal cords are unable to move. Bilateral vocal cord paralysis occurs when both vocal cords are unable to move and are stuck halfway between open and closed. Unilateral vocal cord paralysis occurs when one vocal cord is stuck halfway between open and closed or has limited movement. Symptoms may include: hoarseness, breathy voice, limited variation in volume, and choking and/or coughing while eating.
Paradoxical Vocal Fold Movement
Paradoxical vocal fold movement occurs when the vocal cords intermittently close when they should open, and open when they should close. Paradoxical vocal fold movement may be mistaken for asthma because it often leads to wheezing and difficulty breathing.
Spasmodic Dysphonia
Spasmodic dysphonia is a chronic voice disorder, resulting in a strained vocal quality with periods of aphonia (no sound), and periods of normal voice.
Developmental Milestones & Red Flags
Below are both standard developmental language and communication skills milestones and signs you can look for to determine if your child might need speech and language therapy. Children develop at different rates, which is why these are general milestones and the overall health and well-being of a child should always be taken into consideration.
Birth to 3 Months
Developmental Milestones
- Coos, makes gurgling noises
- Turns head towards sounds
Screening Signs
- Doesn’t respond to loud noises
4 to 6 Months
Developmental Milestones
- Responds to sounds by making sounds
- Strings vowels together when babbling (“ah,” “eh,” “oh”)
- Likes making sounds back and forth with parents
- Recognizes own name
- Makes sounds to show joy and displeasure
- Begins to make consonant sounds like “m” or “b”
Screening Signs
- Does not respond to sounds around him/her
- Doesn’t make vowel sounds like “ah,” “eh,” “oh”
- Doesn’t laugh or make squealing sounds
- Has lost skills previously obtained
7 to 9 Months
Developmental Milestones
- Understands “no”
- Makes a lot of different sounds like “mamama,” “bababa”
- Copies sounds and gestures of others
- Uses fingers to point at things
Screening Signs
- Doesn’t babble
- Doesn’t respond to own name
- Has lost skills previously obtained
10 to 12 Months
Developmental Milestones
- Responds to simple spoken requests
- Uses simple gestures like shaking head “no” or waving “bye-bye”
- Makes sounds with changes in tone (sounds more like speech)
- Says “mama,” “dada,” and exclamations like “uh-oh”
- Tries to say words you say
Screening Signs
- Doesn’t say single words like “mama”
- Does not point to things
- Does not imitate gestures like waving hand or shaking head
- Has lost skills previously obtained
13 to 18 Months
Developmental Milestones
- Says several single words
- Says and shakes head “no”
- Points to show someone what he wants
Screening Signs
- Doesn’t point to show others things
- Doesn’t gain new words
- Doesn’t have at least 6 words
- Has lost skills previously obtained
19 to 24 Months
Developmental Milestones
- Points to things or pictures when they are named
- Knows names of familiar people and body parts
- Says sentences with 2-4 words
- Follows simple instructions
- Repeats words overheard in conversation
- Points to things in a book
Screening Signs
- Doesn’t use 2-word phrases “drink milk”
- Doesn’t copy actions and words
- Doesn’t follow simple instructions
- Has lost skills previously obtained
2 to 3 Years
Developmental Milestones
- Follows instructions with 2-3 steps
- Can name most familiar things
- Understands words like “in” “on” “under”
- Says name, age, and sex
- Names a friend
- Says words like “I” “me” “we” “you”
- Says some plural words “cars” “birds” “dogs”
- Talks well enough for most strangers to understand most of the time
- Carries on conversations using 2 to 3 sentences
Screening Signs
- Drools or has very unclear speech
- Doesn’t speak in sentences
- Can’t follow simple instructions
- Has lost skills previously obtained
3 to 4 Years
Developmental Milestones
Between or at ages 3 and 4, your child should be able to:
- Say their name and age
- Speak 250 to 500 words
- Answer simple questions
- Speak in sentences of five to six words, and speak in complete sentences by age 4
- Speak clearly, although they may not be fully comprehensible until age 4
- Tell stories
- Correctly name familiar colors
- Understand the idea of same and different, start comparing sizes
- Follow three-part commands
- Remember parts of a story
- Count, and understand the concept of counting
- Recognize and identify common objects and pictures
https://www.webmd.com/parenting/3-to-4-year-old-milestones#1-1
Screening Signs
- Unable to use a sentence with more than three words and uses “me” and “you” inappropriately
- Persistent drooling and trouble speaking
- Continues to experience extreme separation anxiety
- Lacks interest in interactive games and doesn’t engage in fantasy play
- Does not play with other children and doesn’t respond to non-family members
- Self-control isn’t improving when angry or upset
- Does not understand simple commands, or repeats the commands
- Avoids making eye contact
- Can’t retell a favorite story
- Doesn’t follow 3-step directions
- Doesn’t use “you” or “me” properly
- Speaks unclearly
- Has lost skills previously obtained
4 to 5 Years
Developmental Milestones
Most children at this age enjoy singing, rhyming, and making up words. They are energetic, silly, and, at times, rowdy and obnoxious. Other language and cognitive milestones your child may achieve in the coming year include being able to:
- Speak clearly using more complex sentences
- Count 10 or more objects
- Correctly name at least four colors and three shapes
- Recognize some letters and possibly write their name
- Better understand the concept of time and the order of daily activities, like breakfast in the morning, lunch in the afternoon, and dinner at night
- Use future tense, such as, “We will go to the park soon.”
- Have a greater attention span
- Follow two- to three-part commands. For example, “Put your book away, brush your teeth, and then get in bed.”
- Recognize familiar word signs, such as “STOP”
- Know their address and phone number, if taught
- Understand everyday things like food and money
https://www.webmd.com/parenting/4-to-5-year-old-milestones
Screening Signs
Possible signs of developmental delay in 4- to 5-year-old children include:
- Being extremely afraid, shy, or aggressive
- Being extremely anxious when separated from a parent
- Being easily distracted and unable to focus on one task for more than five minutes
- Not wanting to play with other children
- Having a limited amount of interests
- Not making eye contact or responding to other people
- Being unable to say their full name
- Rarely pretending or fantasizing
- Often seeming sad and unhappy and not expressing a wide range of emotions
- Can’t give first and last name
- Doesn’t use plurals or past tense properly
- Doesn’t talk about daily activities or experiences
- Has lost skills previously obtained
6-12 years
Social and emotional milestones
Middle school is a time of major social and emotional growth. Kids may struggle to fit in even while looking for ways to be an individual. And they may not ask for advice as often as before. It’s not uncommon for middle-schoolers to do these things:
- Bow to peer pressure to be like others
- Have experiences with bullying or cyberbullying
- Be sensitive to other people’s opinions and reactions, and think the whole world is watching them
- Develop a sense of pride in accomplishments and awareness of their challenges
- Keep secrets (often just having a secret is more important than the secret they’re keeping)
- Have a better awareness of what’s appropriate to say in conversation
- Are introspective and moody, and need more privacy
- May test out new clothing styles and try on “personalities” while figuring out where they fit in
Keep in mind that middle-schoolers develop at different rates. But when a child this age isn’t meeting a number of these milestones or is struggling, it’s a good idea for parents and teachers to talk. Parents and caregivers may also want to talk with their child’s health care provider.
https://www.understood.org/en/articles/developmental-milestones-for-typical-middle-schoolers
13-17 years
Social and emotional milestones
There are huge changes in social and emotional skills between ages 14 and 17. The emotional maturity of a high school freshman is very different from that of a graduating senior. Here’s what you might see at different ages.
14-year-olds
- Can recognize personal strengths and challenges
- Are embarrassed by family and parents
- Strive to be independent
- Are eager to be accepted by peers and to have friends
- May seem self-centered, impulsive, or moody
15-year-olds
- Don’t want to talk as much; are argumentative
- May appreciate siblings more than parents
- Narrow down to a few close friends and may start dating
- Analyze their own feelings and try to find the cause of them
16- to 17-year-olds
- Start relating to family better; begin to see parents as real people
- Develop a better sense of who they are and what positive things they can contribute to friendships and other relationships
- Spend a lot of time with friends
- Are able to voice emotions (both negative and positive) and try to find solutions to conflicts
From learning to drive to starting to think about the future, high school is a time of big change and growth. High-schoolers hone their reasoning skills and learn to find solutions to problems. By the end of high school, teens typically can appreciate the positive things about themselves. Older teens can usually voice their emotions, whether negative and positive.
https://www.understood.org/articles/developmental-milestones-for-typical-high-schoolers
18-young adult
During adolescence, young people will negotiate puberty and the completion of growth, take on sexually dimorphic body shape, develop new cognitive skills (including abstract thinking capacities), develop a clearer sense of personal and sexual identity, and develop a degree of emotional, personal, and financial independence from their parents.
Growth and development while transitioning to young adults includes achieving autonomy: trying to establish oneself as an independent person with a life of one’s own; establishing identity: more firmly establishing likes, dislikes, preferences, and philosophies; and developing emotional stability: becoming more stable emotionally which is considered a sign of maturing.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC548185/
Life skills are abilities that allow individuals to effectively navigate and manage different aspects of their daily lives. They are essential for personal development and well-being, and can be taught and developed at any stage of life. Some common life skills for young adults, teens and adults include:
- Time management: The ability to prioritize tasks, set goals, and manage time effectively is essential for success in both personal and professional life.
- Communication: The ability to express oneself clearly and effectively, both verbally and in writing, is crucial for building and maintaining relationships.
- Problem-solving: The ability to identify and analyze problems and come up with effective solutions is essential for success in any area of life.
- Decision-making: The ability to make informed, rational decisions is crucial for personal and professional success.
- Emotional intelligence: The ability to understand and manage one’s own emotions, as well as the emotions of others, is essential for effective communication and relationships.
- Financial literacy: The ability to understand and manage financial resources, budgeting, and planning for the future.
- Interpersonal skills: The ability to build and maintain positive relationships with others, including the ability to resolve conflicts, is essential for personal and professional success.
- Self-care: The ability to take care of one’s physical, emotional and mental well-being, is crucial for maintaining a healthy balance in life.
https://www.quora.com/What-life-skills-are-for-young-and-adults-or-teensw.quora.com
Top 10 management skills for young adults:
1. Managing Time
Possibly the most important skill for young adults to master as they become increasingly independent is time management. When parenting children and teens, it’s natural to fall into the habit of creating a calendar for them and enforcing appropriate times for school, sleep, appointments, and recreation. But this also means that time management is a set of skills that needs to be consciously taught to most young adults in order to become truly independent.
2. Managing Money
Money can be a difficult topic for many people to talk about, but it’s critical that young adults develop the ability to handle money independently. A basic understanding of savings and checking accounts, how to read a pay stub and a balance sheet, and how to create a simple budget are essential.
Knowledge of credit and interest is important to avoid getting pulled into scams, payday loans, and high-interest credit card debt. Whether using an envelope method or fancy computer-based systems, all adults need to be able to make appropriate purchases within their financial means.
3. Getting From Here to There
Transportation has a huge impact on how all of us live our lives. For those young adults who have both the desire and the ability to drive, basic car maintenance is a must-have. The knowledge of how to change a tire, how to use jumper cables, and when to schedule professional maintenance are often-neglected lessons that take some young adults by surprise.
For those who don’t drive (or who can drive but don’t have access to a vehicle), working knowledge of public transportation systems is indispensable. Luckily, GPS systems have made navigation as simple as typing in a destination, and some (such as Google Maps) include bus, train, bicycle, and walking directions as well as those intended for drivers. Regardless of the method used, all adults need to know how to get where they want to go and arrive on time.
4. Communicating With Others
While everyone has their own communication style, not every kind of communication comes naturally. Solid phone skills, for example, are necessary in order to make a doctor’s appointment, call a plumber, or even make a reservation at a restaurant.
The ability to explain one’s work and skill set is the foundation of a successful job interview.
5. Maintaining Their Environment
Keeping a living space livable is a surprisingly complex process. From laundry (How much detergent do I use? What counts as “delicate”?) to waste (When should I take out the trash? What can I put in a garbage disposal?) to dealing with incoming mail, the work of maintaining a home environment is never done.
And even for young people with strong habits in this area, adulthood still produces new situations to be addressed. Where should I keep a spare house key? What’s an appropriate refrigerator temperature? What do I do if I discover weather damage, mold, or pests? It can be overwhelming at times, but solid coaching can ease the transition to independent adult.
6. Healthcare and Self-Care
While young adults might sometimes think they’re invincible, taking care of your physical well-being is a major part of independent adulthood. This means making and keeping key medical and dental appointments, but also skills like planning and preparing healthy meals, tracking and taking necessary medications, and finding a type of exercise that is engaging enough to want to do it regularly. Self-care also means knowing how to seek out assistance when their health seems to be slipping, whether physical, mental, or social.
7. Stress Management
Americans are more stressed than ever, and learning to navigate that reality is an important skill for all young adults moving towards independence. While money, work, relationships, and prospects for the future can all cause anxiety, learning one’s own triggers and how to cope with them is a highly individualized process.
Some people may respond well to breathing exercises or meditation, while others take refuge in journaling. Exercise, music, and spending time in nature can all be helpful, as can therapy or medication. Regardless of the particular solution, learning to address and cope with stress in a healthy way is a critical skill for both new and experienced adults.
8. Building Personal Relationships
Strong social bonds have been found to be closely linked to longevity, but newly independent adults can find it challenging to make and maintain friendships once they are no longer in school with their peers. Learning to seek out like-minded people—such as by joining a book club, volunteer organization, faith community, or other special interest group—isn’t something that teens need to think about consciously, and can come as a surprise to many people as they enter adulthood.
In an age of digital communication, developing real-world friendships can be extra challenging, which is all the more reason to think about making friends as a skill to be developed, rather than a “natural” side effect of just being in the world.
9. Setting Healthy Boundaries
Closely related to relationship building is the skill of setting appropriate boundaries. Knowing how and when to say “no” in an appropriate but firm way to people ranging from a boss to a friend to a romantic partner can be challenging to newly-minted adults who are used to seeing anyone older as an authority figure, but it’s important in establishing both good relationships and a healthy balance between needs, desires, and obligations.
10. Citizenship
Adulthood comes with a lot of new freedoms. It also comes with a lot of new responsibilities. Adults need to know how to educate themselves about local, state, and national issues, how to register and vote, what jury duty is and how to respond to the call to serve. Adults also need to know how to advocate for themselves, their communities, and for issues they care about.
https://ndfya.com/2018/01/23/top-10-life-management-skills-young-adults-need-for-independence/
Our speech therapists provide evaluation and direct therapy services for ages birth to young adult. We provide Free Developmental Screening for children ages birth to five years of age. If you are interested in a screening or evaluation for your child, email us at info@thetherapytree.org, or call The Therapy Tree at (847)265-7300.
What happens after the screening?
Once we complete the developmental screening, our therapists will provide you with a Screening Summary Sheet. If the therapists who performed the screening feel that a full evaluation is needed, they will request in writing, that your pediatrician prescribe a speech language pathology evaluation on the Screening Summary.
What happens if a full evaluation is suggested?
Your child will be evaluated to determine if speech language pathology would be of benefit and what areas of development need improvement. We strive to provide you with the most comfort, knowledge, and confidence in understanding what pediatric speech language pathology will accomplish. After the evaluation, if it is determined that therapy is necessary, we will address in-depth, specific obstacles that are occurring with your child’s speech and language development and work to develop an individualized treatment plan along with teaching tools for parent/caregiver to continue skill-building in the home, to improve or eliminate these problem areas. The use of different techniques, both traditional and complimentary, along with collaboration across multiple specialties available at The Therapy Tree, provide children the best possible outcome for increasing communication, independence, confidence, and overall life skills.
The type of therapeutic methods used and length of services are dependent on varying issues such as what problems are being addressed, who willing participants are and what their desired goals are, and also influenced by the strength and help of their support systems, and level of needs to be met. Sometimes sessions are set on a weekly basis, taking learning step by step and at a steady pace. Other times sessions can be more or less frequent based on the client’s particular needs at the time.
Techniques Used in Pediatric SLP
The Therapy Tree is blessed with highly trained therapists in multiple disciplines. Our Pediatric Speech and Language Therapists are leading the way in extensive training in complimentary or alternative techniques.
The use of different techniques, both traditional and complimentary, along with collaboration across multiple specialties including physical therapy, occupational therapy, or counseling services available at The Therapy Tree, provides children the best possible outcome for increasing mobility, independence, confidence, and overall life skills.
Emotion SPOT® series
Emotion SPOT® series
Developed by Diane Alber, the SPOT® series is used by therapists as a tool in individual and group therapy to build understanding of emotions, build social-emotional intelligence and promote learning and discussion about managing and navigating emotions in daily living situations.
Greenspan Floortime Approach
Greenspan Floortime Approach
The Greenspan Floortime Approach is a system developed by the late Dr. Stanley Greenspan. Greenspan Floortime “has proven highly effective for children on the autism spectrum and those with other developmental delays. With it, you can help your child improve self-regulation and build relationships, while strengthening communication and thinking…Floortime meets children where they are and builds upon their strengths and abilities through creating a warm relationship and interacting. It challenges them to go further and to develop who they are rather than what their diagnosis says.” – https://stanleygreenspan.com/
Infant Massage Instruction
Infant Massage Instruction
Infant massage encourages bonding through eye-to-eye contact, smiling, soothing vocal sounds, loving touch, caressing and mutual interaction. Studies show that bonding increases a parent’s feeling of attachment as well as their desire to nurture and care for their infant.
Massage can also enhance oxygen and nutrient flow to cells and improve breathing patterns and lung health (respiration). It can enhance the release of hormones, including growth hormones to help with weight gain, and can spark neurons in the brain to grow and branch out to improve mental processing/skills (cognition).
Massage has many other physical and emotional benefits for your baby. These benefits include:
- Promoting social, emotional and cognitive development
- Helping a baby relax and release tensions of daily stimuli
- Decreasing irritability and excessive crying
- Reducing gas, colic and intestinal difficulties
- Regulating behavioral states and promoting sleep
- Strengthening and regulating primary systems (i.e., respiratory, circulatory, nervous, musculature, digestive and endocrine)
There are also benefits for parents and the development of parenting skills. The act of massaging an infant helps:
- Promote better understanding of infant cues
- Enhance communication and emotional ties
- Increase confidence and handling skills
- Provide quality one-on-one interaction
- Encourage parents to unwind, relax, and listen to their baby
Early development is influenced by touch and infant massage can support development in these five areas:
- Communication skills – promotes emerging speech, direct eye gaze, listening and turn taking
- Motor skills – improves muscle tone and coordination, increases body awareness
- Social skills – encourages infant and caregiver to engage one another
- Self-help skills – stimulates oral motor musculature awareness, lip closure, and relaxation of tension needed for swallowing
- Cognition – enhances overall awareness of self and body boundaries, cause and effect, and increase in attention span
Interactive Metronome®
Interactive Metronome®
Interactive Metronome® (IM) is an assessment and treatment tool used by therapists and other professionals who work with pediatric and adult patients with neurological conditions that affect cognitive and motor functioning. Therapists use IM because it engages their patients’ attention and builds concentration, sensory processing, language, balance, and motor skills. IM’s entertaining, game-like interface and easy-to-understand feedback motivates patients to achieve higher scores after each exercise and reach for new levels and rewards. Design of the program ensures that patients recognize progress as it is occurring, increasing their motivation toward therapy.
IM is used to improve: attention, coordination, language processing, reading and math fluency, executive function, working memory, processing speed, speech fluency, Self-monitoring and impulse control, motor planning and sequencing, balance and bilateral coordination, endurance, gait symmetry, and fall risk reduction. IM training helps clients overcome difficulties associated with: ADHD, Auditory Processing and Central Auditory Processing Disorders, developmental delays and disorders, stuttering, dyslexia/dysgraphia, Autism, Sensory Processing Disorder, and brain injury just to list a few.
IM is believed to improve the resolution and efficiency of an individual’s internal brain clock(s) and temporal processing. IM facilitates more efficient brain connectivity, communication, and synchronization via increased integrity of the brains white matter tract communication system, producing more efficient communication between critical brain networks. Research and theory suggest that IM training increases the efficacy of the parietal-frontal brain network, the brain network most associated with general intellectual functioning, working memory, controlled attention and executive functions. Source: www.interactivemetronome.com
The Kaufman Speech to Language Protocol
The Kaufman Speech to Language Protocol
The Kaufman treatment method explains in a systematic way how to simplify word pronunciation patterns, making it easier for children to communicate. This unique program helps the clinician determine why a word is difficult for a child to produce and how to change the stimulus to meet the motoric needs of the child.
The Kaufman Speech to Language Protocol (K-SLP) is an evidenced-based evaluation and treatment method for childhood apraxia of speech (CAS), other speech-sound disorders, and expressive language development. It was created by Nancy R. Kaufman, MA, CCC-SLP, and has been evolving since 1979. www.talktool.com
Lindamood-Bell® Seeing Stars
Lindamood-Bell® Seeing Stars
A cause of struggling in establishing sight words and contextual fluency is difficulty in visualizing letters in words. This is called weak symbol imagery.
A significant number of students—even those who have well-developed phonemic awareness—have difficulty with rapidly perceiving sounds in words and are slow to self-correct their reading errors.
Individuals of all ages can experience the symptoms of weak symbol imagery.
This causes weakness in:
- Memorizing sight words
- Sounding out words
- Orthographic awareness
- Phonemic awareness
- Contextual reading fluency
- Orthographic spelling
The Seeing Stars® program develops symbol imagery – the ability to visualize sounds and letters in words – as a basis for orthographic awareness, phonemic awareness, word attack, word recognition, spelling, and contextual reading fluency.
Lindamood-Bell® Visualizing & Verbalizing®
Lindamood-Bell® Visualizing & Verbalizing®
A primary cause of language comprehension problems is difficulty creating an imagined gestalt. This is called weak concept imagery. This weakness causes individuals to get only “parts” of information they read or hear, but not the whole. Individuals of all ages may experience the symptoms of a weakness in concept imagery.
This causes weakness in:
- Reading comprehension
- Listening comprehension
- Critical thinking and problem solving
- Following directions
- Memory
- Oral language expression
- Written language expression
- Grasping humor
- Interpreting social situations
- Understanding cause and effect
The Visualizing and Verbalizing® (V/V®) program develops concept imagery—the ability to create an imagined or imaged gestalt from language—as a basis for comprehension and higher order thinking. The development of concept imagery improves reading and listening comprehension, memory, oral vocabulary, critical thinking, and writing.
https://lindamoodbell.com/program/visualizing-and-verbalizing-program
Myofascial Release Therapy
Myofascial Release Therapy
Myofascial release therapy is a gentle method used to locate trigger points and help loosen muscles that have limited motion and cause pain in other areas of the body.
Myofascial tissues are strong tissues that surround, connect, and support muscles throughout the body. They have the ability to shorten and relax similar to the muscles they support, and play a large role in stability and range of motion of joints. A physical therapist with specialized training in myofascial release treatment, locates points of muscle tightness and pain and uses gentle pressure to help improve range muscle strength and relaxation, increase range of motion, and decrease pain over time.
Myofascial release therapy is also often used by occupational therapists, chiropractors, speech language pathologists, massage therapists, and osteopathic physicians as well. It is especially helpful for those who suffer from migraines, back, hip, jaw, or shoulder pain, and any conditions that cause ongoing pain, or decreased movement or flexibility.
Neurodevelopmental Therapy
Neurodevelopmental Therapy
Neurodevelopmental Therapy (NDT) is a holistic and interdisciplinary clinical practice model informed by current and evolving research that emphasizes individualized therapeutic handling based on movement analysis for habilitation and rehabilitation of individuals with neurological pathophysiology. The therapist applies a problem-solving approach to assess activity and participation to identify and prioritize relevant integrities and impairments as a basis for the establishment of achievable outcomes with clients and caregivers. An in-depth understanding of typical and atypical development, and expertise in analysis of postural control, movement, activity, and participation throughout the lifespan, form the basis for examination, evaluation, and intervention. Therapeutic handling, used during evaluation and intervention, consists of a dynamic reciprocal interaction between the client and therapist for activation of optimal sensorimotor processing, task performance, and skill acquisition for achievement of participation in meaningful activities.
Source: Cayo C, Diamond M, Bovre T, et al. The NDT/Bobath (Neuro-Developmental Treatment/Bobath) Approach. NDTA Network. 2015;22(2):1
Pediatric Massage Therapy
Pediatric Massage Therapy
Children need physical contact for healthy growth and development. Nurturing touch promotes physiological, neurological and psychological development and function. Healthy children receive the benefits of touch from many sources, but just as with adults, the symptoms of physical and emotional stress can often be alleviated by massage therapy from a trained professional. Massage can help in physical and emotional conditions induced by strenuous athletics or exercise, physical pain from injury or medical treatment, family difficulties including death, divorce, or moving, difficulties in school either academic or social, natural disasters or other traumatizing events. Children also may benefit from massage when experiencing stressful situations such as hospitalization, medical conditions, have a condition that makes untrained touch dangerous or difficult to tolerate, neglect or abuse.
Children are more than just small adults. Physically, mentally, emotionally, (and yes, legally), they have unique needs, wants and limitations. In addition, there is far more variation in childhood than in adulthood. Imagine if we went through as many physical changes between the ages of 30 and 40 as we did between two and twelve! Having a basic understanding of child development is important, but even more essential is the willingness and flexibility to meet each child at his or her own level of development, wherever that might be. Several facets of this flexibility that must be apparent when providing massage therapy for children can be expressed as the Five Ps: permission, pace, pressure, positioning, and parents.
Pediatric Massage is recommended for many specific conditions including autism, cancer, cerebral palsy, underserved populations, health children.
http://mtf.amtamassage.org/wp-content/uploads/mtf-pediatric-ebook.pdf
PROMPT
PROMPT
PROMPT stands for PROMPTs for Restructuring Oral Muscular Phonetic Targets. The technique is a tactile-kinesthetic approach that uses touch cues to a patient’s articulators (jaw, tongue, lips) to manually guide them through a targeted word, phrase or sentence. The technique develops motor control and the development of proper oral muscular movements, while eliminating unnecessary muscle movements, such as jaw sliding and inadequate lip rounding.
PROMPT is most known for being a tactile-kinesthetic (touch and feel) approach where an SLP places his/her hands on the client’s face to guide his/her jaw, lips, and tongue to move correctly to form words.
Sensory Processing Therapy
Sensory Processing Therapy
Sensory Processing Therapy (SPT) (Formerly known as Sensory Integration Therapy)
Speech Language Pathologists trained in use of SPT techniques use this approach as part of comprehensive treatment when children display difficulty with sensory processing and regulation. Therapists help children who are either oversensitive or under responsive to sensory input learn to accept information through the sensory channels, and process and integrate that information so they can respond in a more adaptive fashion within their daily routines and a variety of situations.
The sensory channels within our central nervous system include tactile (touch), vestibular (awareness of body in space), proprioception (perception of feeling/pressure through joints), olfactory (smell), visual (sight), auditory (hearing), gustatory (taste, oral sensations). A well organized and integrated sensory system is the crucial foundation for development of sensory motor skills, perceptual motor skills, gross and fine motor skills, speech and language skills, cognition, intellect and social emotional skills.
Social Thinking and The Zones of Regulation
Social Thinking and The Zones of Regulation
Social Thinking and The Zones of Regulation is a popular social emotional curriculum which fosters regulation across ages 4 to 18+ years. “The Zones of Regulation” is a framework and easy-to-use curriculum for teaching regulation strategies for managing feelings and sensory needs to children, students, and clients ages 4+. Rooted in cognitive behavioral therapy, the framework uses four colors to help individuals identify how they are feeling in the moment given their energy, feelings, and level of alertness. By understanding how to read their bodies, detect triggers, think about the social context, and consider their reactions, individuals learn a system for how to increase their ability to regulate their feelings, manage their sensory needs, and become more self-aware and skillful problem solvers.” – www.socialthinking.com/zones-of-regulation
Socialization Groups
Socialization Groups
Therapists may combine with other therapists and children in sessions to provide guided, therapeutic socialization activities tailored to each child’s needs. More formally structured therapist facilitated socialization groups may also be available depending on needs of clients and availability for scheduling.
SOS Approach to Feeding Therapy
SOS Approach to Feeding Therapy
In the SOS Approach, the feeding problem is conceptualized as the tip of an iceberg. The child’s difficulties with eating and gaining weight is what everybody sees, but similar to an iceberg, it is what is under the water that crashes the boat. The SOS Approach to Feeding stands for Sequential-Oral-Sensory because these are the major components of the program. However, SOS also stands for Save Our Ship! In the SOS Approach to Feeding, we assess and address all of the underlying (“under the water”) causes of the feeding difficulties. SOS uses a transdisciplinary team (Pediatric Psychologists, Pediatricians, Occupational Therapists, Registered Dietitians, and Speech Pathologists/Therapists) to evaluate and treat the “whole child” including:
- Organ systems
- Muscles (including oral motor)
- Sensory processing
- Learning, behavior, and cognition
- Development
- Nutrition
- Environment
Based on and grounded philosophically in the “normal” developmental steps, stages and skills of feeding found in typically developing children, the SOS Approach focuses on increasing a child’s comfort level by exploring and learning about the different properties of food. The program allows a child to interact with food in a playful, non-stressful way, beginning with the ability to tolerate the food in the room and in front of him/her, then moving on to managing the smell of the foods, learning about how foods feel on the body and in their mouth, and then enjoying tasting and eating new foods following the Steps to Eating.
TalkTools© Oral Placement Therapy™
TalkTools© Oral Placement Therapy™
Oral Placement Therapy™ (OPT) is a speech therapy technique which utilizes a combination of auditory stimulation, visual stimulation and tactile stimulation to the mouth to improve speech clarity.
OPT is an important addition to traditional speech treatment methods for clients with placement and movement deficits.
It is a tactile-proprioceptive teaching technique which accompanies traditional therapy. Traditional therapy is primarily auditory and visual.
Clients with motor and/or sensory impairments benefit from tactile and proprioceptive components because speech is a tactile-proprioceptive act.
OPT is used to improve articulator awareness, placement (dissociation, grading, and direction of movement), stability, and muscle memory; all of these are necessary for the development of speech clarity.
TalkTools© Feeding Therapy: A Sensory-Motor Approach™
TalkTools© Feeding Therapy: A Sensory-Motor Approach™
This approach encompasses sensory processing and oral-motor skill development needed for safe, effective, nutritive feeding for all ages and ability levels.
Webber HearBuilder® Program
Webber HearBuilder® Program
Many young learners lack the listening and comprehension skills necessary to succeed.
HearBuilder® is focused on teaching students, especially developmentally delayed and/or struggling PreK-5 students, the necessary listening skills and ability to comprehend and retain information.
HearBuilder® includes basic directions up to very complex objectives within each training module, and focuses on all levels of a students’ listening, comprehension, and especially memory skills.
The Background Noise feature is very unique to HearBuilder®. This could be especially beneficial to students diagnosed with Auditory Processing Disorder.
Our Pediatric Speech & Language Therapy Team
Our therapists provide therapy with compassion and enthusiasm, while focusing on improving the lives of families as a whole. Just as much as we teach and help our pediatric patients, they become some of our greatest challenges, joy, and teachers.
For more information on the therapeutic services we offer adults, families, and others, including massage therapy, yoga, and other wellness classes, please visit our Adult Services and our Wellness Center pages.
THE THERAPY TREE
89 Cedar Avenue
P.O. Box 764
Lake Villa, IL 60046
(847) 265-7300
(847) 265-7301
Growing Together in Mind and Body
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Hours
Monday – Friday: 8:30am – 8:00pm
Saturday: By Appointment
Sunday: Closed
Additional appointments upon request
