ctober is Disability Awareness Month. According to Easter Seal, one million children go undiagnosed and untreated for a disability each year. Easter Seals has a questionnaire that is available online that can help determine if your child may have a disability. This Developmental Milestones Screener will help you to assess if your child is developing skills at the appropriate time and pace. It is important to remember that each child develops skills at their own pace. But by keeping track of your child's development, especially in the first five years, it will be possible to diagnose developmental delays that can be helped by developmental specialists, including speech, physical, and occupational therapists.
Preschool children can receive a free screening through the local intermediate unit. In the Troy Area School District, services for preschool children with disabilities are provide through BLaST, Intermediate Unit # 17. If you have a concern about your child's development, you can call the Canton office of BLaST at 570-673-6001 to inquire about the procedure for obtaining a free screening for your child. BLaST also has a Facebook Page that includes information on support for families of children with disabilities.
Parents can also find support resources at the Parent-to-Parent website. Parents who have questions about their child's development may contact the CONNECT Helpline at 1-800-692-7288.
How Common Are Speech and Language Problems in School-Age Children?
Posted by Donna Williams at 9/8/2012
Statistics from the American Speech-Language-Hearing Association (ASHA) from 2008 reveals that communication disorders are among the most common disabilities in the United States. In school age children, learning disabilities are the most common disabilities. Often many children with learning disabilities also have communication problems in the area of reading, writing, listening, and speaking.
Speech and language skills are essential to academic success and learning. Language is the basis of communication. Reading, writing, gesturing, listening, and speaking are all forms of language. Learning takes place through the process of communication. The ability to communicate with peers and adults in the educational setting is essential for a student to succeed in school.
Children may experience one or more of the following disorders:
Language disorders - (difficulty understanding what they hear as well as expressing themselves with words)
Cognitive-communication disorders - (difficulty with thinking skills including perception, memory, awareness, reasoning, judgment, intellect and imagination)
Stuttering (fluency) disorders - (interruption of the flow of speech that may include hesitations, repetitions, prolongations of sounds or words)
Voice disorders - (quality of voice that may include hoarseness, nasality, volume (too loud or soft)
Information reported from 2003 reveals that 24.1% of children aged 3-21 received speech and language services in the schools. Sometimes, communication disorders are secondary to another type of disability, such as cerebral palsy, autism, hearing impairment, or learning disabilities, just to name a few. This number (24.1%) does not include children who had speech and language therapy due to another cause, such as those mentioned above. These are often differentiated in schools as "speech only" or "speech as a related service" (when the child has an iep for another purpose, such as a learning disability or intellectual disability).
Language disorders and speech sound disorders are the most common problems seen in school age children. Stuttering and voice disorders are known as "low-incidence" communication disorders, but can have the potential to affect the child's performance in school. Children with specific learning disabilities or intellectual disabilities often have communication disorders that affect their communication in the classroom, as well as their acquisition of reading and writing skills.
Children with communication disorders frequently do not perform at grade level. They may struggle with reading, have difficulty understanding and expressing language, misunderstand social cues, avoid attending school, show poor judgment, and have difficulty with tests.
Difficulty in learning to listen, speak, read, or write can result from problems in language development. Problems can occur in the production, comprehension, and awareness of language sounds, syllables, words, sentences, and conversation. Individuals with reading and writing problems also may have trouble using language to communicate, think, and learn.
Sometimes, it is not apparent why a child is recommended for speech therapy in the schools. When thinking of speech therapy, most people automatically think of the child who has trouble pronouncing words. This is only one reason why a child might go for speech therapy. There are many other areas of communication that are considered when determining the child's need for speech therapy.
1. Articulation: Some children have difficulty saying specific sounds, groups of sounds, or long and/or complex words. Children may have simple substitutions of one sound for another, such as saying "w" for "l" or "r". Other children may make errors on classes of sounds. The sounds "s, sh, z" all have the characteristic of being "continuant sounds", because they are produced with a steady stream of air. In some cases, children can produce the same subsitution, such as the "t" sound for all continuant sounds, including s, sh and z. This is referred to as "stopping" which is a phonological processes disorder. Other children may have difficulty with the muscles used for speech, and have a speech disorder known as dysarthria, which is caused by muscle weaknesses. Still another articulation disorder is known as apraxia of speech, in which children have normal muscle control, but have difficulty with "motor planning", which is producing sounds in a sequence, or in combination with other sounds. Typically, students with apraxia, dysarthria and phonological disorders are more difficult to understand than children with simple articulation substitutions.
2. Fluency: Fluency includes speaking without hesitations, prolongations, or repetitions of sounds and/or words. Often the disorder is referred to as "stuttering". It is common for young children to have normal dysflencies when learning to speak. Preschoolers often display dysfluent speech as a normal part of learning to speak. It usually runs it's course without intervention. Sometimes, children will develop what are referred to as "secondary behaviors", which include facial grimaces or distortions, such as eye blinking, or nasal flaring. These behaviors often accompany actual "stuttering", as opposed to normal dysfluency. Fluency also includes the rate of speaking, and the rhythm of the words. Halting speech or rapid speech, in which parts of words are omitted (a disorder known as "cluttering") are different types of fluency problems.
3. Voice: Voice problems can be the result of children who yell or scream a lot. They might develop "vocal nodules", which are growths on the vocal cords that are caused by stress put on their vocal cords from misuse of voice. Vocal nodules affect the quality of the voice, making a child sound hoarse, or even causing the loss of voice. Allergies and colds can cause disturbances with voice production, but these effects are usually temporary. Children may also have resonance problems, in which they sound very nasal, or may sound as if they have a stuffed up nose, in the absence of a cold. If a child has a cleft palate, they often display resonance problems in their speech. A child with a suspected voice disorder should have an examination by an ear-nose-throat doctor (ENT).
These disorders complete the reasons a child may be referred to speech for speech production problems. Other areas in which a child might receive speech therapy include language disorders or hearing problems. A more complex problem might be found in a child who does not speak, or even communicate at all. These language, hearing and communication problems will be addressed in upcoming blog posts.
In order to produce sound when you speak, four components are needed:
A.Breath, that functions as a force of power
The secret of speech/voice projection is to use your breath to support your voice as you speak. The more efficiently you breathe, the more air you will have to sustain your voice and project it to all your listeners.
B.Vocal cords, that make sound when vibrated
When you make sound, your breath passes through the vocal cords in your voice box and causes them to vibrate. To achieve free vibration of the vocal cords, you need a relaxed throat: a tensed throat can cause your vocal cords to tighten and force the pitch of your voice to go up. When you are ill, depressed and/or low in vitality, you do not have the energy to breathe properly; the voice then lacks power, has a limited range, and sounds low.
C.Resonators (e.g. neck/head cavities), that amplify the resulting sound
The cavities of your head and neck act as resonators that determine the tone/quality of your voice. The aim is to have a balanced used of all resonators. If there is too much resonance in the throat, you can sound gruff/harsh/strangled and you may find it difficult to project your voice. If there is too much resonance in the mouth, your voice may sound as if it lacks foundation. To produce a good, resonant voice, you should:
- have a good alignment of the head, neck and spine so that all channels are open;
- keep up the pressure of breath from below;
- aim to fill all cavities with sound on its way out; and
- project the channel of sound through the mask/front of your face and forwards towards the listener.
D. Oral cavity, that moulds sound to form words
You can change the size and shape of your oral cavity by moving your lips, tongue, lower jaw and soft palate. Such actions change the relative position of your teeth, tongue, soft palate and hard palate accordingly and shape sound into speech/words. To speak clearly, you should have a relaxed jaw. For good articulation, you should also exercise your lips and tongue regularly to improve the agility of these two sets of muscles.
The month of March is designated as Brain Injury Awareness Month. Brain injuries can affect people of any age, and can be responsible for a wide range of physical and congnitive disabilities in people.
The most common cause of brain injury is due to falls, followed by car accidents, physical abuse, and assaults. Recently, traumatic brain injury due to explosions has become the leading cause of injuries of military personnel in war zones. Other causes of brain injury include drug abuse, airway obstruction, heart attack/stroke, and near drowning.
The groups that are most prone to brain injury are children from 0 to 4 years old and young adults from 15 to 19 years old. Males are more likely than females to suffer a brain injury. African-Americans are more likely to die as a result of brain injury. 1.4 million people annually acquire brain injuries.
Brain injury can affect the way a person thinks, feels, acts, and moves. Body function and sensory perceptions can also be affected.
Even mild brain injuries can cause long term consequences that are often not recognized as being the result of a brain injury. Short and long term memory problems, persistant headaches, and sleeping problems can often be traced back to a mild brain injury.
Recent research has suggested that the effects of repeated concussions and bumps on the head are cumulative, and can lead to long term disabilities over time. Children involved in sports should be closely monitored for bumps and injuries that could cause brain injury. Immediate medical care and attention can help decrease long term effects from what is often considered a mild injury.
Language is the code we use to form what we say. It includes the symbols we use to communicate, and the rules we use to form what we say. The symbols that are used to communicate include: letters/sounds, words, pictures, and gestures. All of these communicate a message, whether it is verbal or visual, and have a meaning attached to them. The rules that govern how we communicate include how we put sounds together, how words are arranged in sentences, and the social rules we use to communicate with different people. Language is generally classified as oral (expressive) language and listening (receptive) language.
Language includes five major areas: Phonology, Semantics, Syntax, Morphology, and Pragmatics.
Phonology is the rule system for sounds. It includes phonemic awareness and phonics.
Phonemic awareness is the understanding of how sounds are combined to produce words. Phonemes are the smallest units making up spoken language. English consists of about 41 phonemes. Phonemes combine to form syllables and words. For example, the word stop has four phonemes (s-t-o-p), while shop has three phonemes (sh-o-p). Phonemic awareness refers to the ability to identify and manipulate these phonemes in spoken words. It is also the understanding that the sounds of spoken language work together to make words.
Phonics is the understanding that there is a predictable relationship between phonemes (the sounds of spoken language) and graphemes (the letters and spellings that represent those sounds in written language). Readers use these relationships to recognize familiar words and to decode unfamiliar ones.
Morphology is the smallest unit of speech that has meaning attached to it. Morphology includes words, and prefixes and suffixes. It is how word meaning is changed when other parts are added to it, such as happy, happier, unhappy, happiest.
Syntax includes how words are combined together into sentences. The rules for syntax include word order, the relationship words have with each other, and the grammatical parts of the sentence. The message meaning can change, depending on the relationship of the words. For example, "Go, get him doctors!" has a different meaning than "Go get him, doctors!". Syntax includes parts of speech such as pronouns, verb tenses, and conjunctions like "and" or "but".
Semantics is the acquisition and the understanding of the meaning of words. It includes vocabulary, and is vital for speaking, listening, reading, and writing. Vocabulary includes the building blocks for learning. Vocabulary development refers to the knowledge of stored information about the meanings and pronunciations of words necessary for communication. It also includes multiple meaning words, figurative language, and idioms. Reading comprehension is highly dependent upon well developed semantic language skills.
Pragmatics is generally referred to as the social use of language. It includes rules for politeness, gaining information, holding conversations, and giving explanations. There are many rules that dictate how a student might talk with a peer, as opposed to a teacher or parent. It is a skill that is needed to successfully communicate with a wide variety of people in many different settings.
Communication development is dependent on each of the five components of language. Children in school can have difficulty with one or all of the five components, which can affect their learning and acquisition of literacy skills. The five components all overlap, and help give meaning to our speech and communication.
Children need to learn how to listen and follow directions. They also need to learn how to express themselves. Try to use the following suggestions during everyday activities to encourage your child’s language development:
1.When you talk to your child, make sure you have his/her attention. Call his/her name before you say anything or touch him/her gently on the arm.
2.Make sure child is listening when you talk to him/her. To ensure you have his/her full attention, get down to your child’s level and make eye contact with him/her.
3.Try to eliminate any distractions, turn off the television or clean up toys. These can distract his attention away from listening to you.
4.Pair gestures and facial expression with directions. This will help them to understand what you are telling them to do.
5.Speak clearly and not too quickly so that they have time to take in what your are telling them. Kids are more likely to listen to slower speech that is broken into segments: Take your coat off. (pause) Go wash your hands please.
6.Repeat information where necessary. Repetition will really help them to learn.
7.Encourage your child’s attempts to communicate with you. If a child uses a word incorrectly repeat the word back correctly and emphasize the word or sound they are having difficulty with as often as you can. Do not try to get the child to repeat the word back to you because they may repeat it incorrectly again which may discourage them from trying again and/or emphasis the incorrect use rather than the correct use. It’s not necessary to correct your child’s pronunciation or grammar. Instead repeat what s/he said in the correct way without insisting that s/he copies you. It is better to provide them with lots of chances to hear the word or sound used correctly.
8.Emphasize key word and sounds you want your child to learn. Remembering all the groups of words we use to form sentences: names, locations, action words, describing words, and socially useful words.
9.Repeat main ideas and new information frequently in as many different ways as possible.
10.Give your child enough time to respond. Your child may take a long time to organize his thoughts and feelings and put them into words. Avoid the tendency to interrupt your child or finish their sentences. Most children take 3 to 5 seconds to respond. It may take 5 to 11 second for a child with a speech and language delay to respond. We usually give our children .5 or 1 second to respond.
11.Be aware of the words, sounds and sentence patterns or grammar that your child needs to learn and model them often for your child.
12.Talk out loud about what you and your child are doing in simple sentences. It is also a good idea to talk about how you and other people might be feeling.
13.Expand on what your child says by adding new words and new ideas to their remarks.
14.Reading to your child is one of the best ways to develop their listening and talking skills.
Speech is the mechanical production of words. There are several physiological processes that take place in order for speech to occur. Speech involves respiration (breathing), phonation (sound produced with the vocal cords), and articulation (mouth movements that produce individual sounds).
Speech also includes fluency, which is the ability to speak in a rhythm, without stuttering or pausing. Voice production is another process that is part of speech production.
Producing speech sounds
Producing a good strong voice
Voice problems can make a child's voice sound weak, rough, hoarse, breathy, or nasal.
Fluency problems can affect a child who stutters or speaks at too fast or too slow of a rate.
Articulation problems affect how a child makes speech sounds. Simple errors in articulation usually do not affect intelligibility, and the child can be understood most of the time. More severe articulation problems can severely affect how well a child can be understood.
When a speech therapist evaluates a child for a speech and language problem, he or she assesses each of the areas of speech production. The voice quality and fluency are noted through a conversation sample, and standardized testing if required.
Articulation skills are evaluated through a conversation sample, standardized testing, and informal assessment. Results of standardized testing are compared to norms that have been established for children at different ages. Informal assessments are used to determine if the child is easy or difficult to understand, and to acquire the particular sounds the child might have difficulty with.
The most common type of speech disorder that is seen in the school setting include articulation disorders. These children will often substitute one sound for another, omit sounds in words, or make a distortion of a particular sound.
Speech and language support is a program that is available to children who have delays or disorders in speech and language development. There are a variety of problems that children can have with their communication skills that require direct teaching, modeling, providing feedback and structured practice from a speech and language therapist.
Articulation (speech sound) and language (vocabulary, sentence structure, and verbal expression) delays are the most common types of speech problems that are seen in schools. Children might also have problems with stuttering, voice production, and hearing and listening.
Speech and language therapists are trained to determine if speech and language problems are developmental, and related to the child's age and point in development. In these cases, it is often recommended that time, maturity, and exposure to regular school activities will help the child develop the appropriate communication skills.
In other cases, the child might have difficulties that he or she will not outgrow, and specially designed instruction is necessary to help the child gain the appropriate skills. The indicators that a child may need speech and language intervention include factors such as:
difficulty with a skill that is typically acquired at a younger age
the child's communication skills make it difficult to easily understand him or her
academic skill weaknesses that reflect poor language skill development
the child exhibits significant frustration due to poor communication skills
Speech and language support is provided to children with delays in speech and language skills to help address weaknesses and provide strategies for the child to use to improve communication skills. Support can be provided individually, in a small group, in a classroom situation, or through consultation with the classroom teacher. The goal of the speech and language program is to make the child an effective communicator in the school environment.