What does a speech-language pathologist do?
Welcome to Chatter-boxes Speech Pathology Services Did you know that 1 in 7 Australians has a communication difficulty? Chatter-boxes Speech Pathology was established here on the Sunshine Coast in 2002 and has provided what does a speech-language pathologist do? quality, evidence based care for children and their families, community screening, kindy talks and mentoring in that time. We have become the first port of call for many parents, medical professionals and educators looking for child-development and family support services.
Our office has EFTPOS and HICAPS facilities. We are registered with most Private Health Funds, have Helping Children with Autism Funding, Better Start Funding, Helping Indigenous Children Funding and Enhanced Primary Care Plans. For more information on these programs please call our office. Frequently Asked Questions Question: How long will my child need speech therapy for? Answer: As each child is an individual, it is hard to answer this question until the assessment has been completed. Most children require a minimum of six sessions.
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However depending on the disorder, its severity, the amount of homework you do and your child’s motivation to learn, the number of sessions will vary. Question: What does speech pathology involve? Answer: The first thing that needs to be done is an assessment. An assessment specific to your child’s needs will be chosen and administered during the first session. From there your therapist will discuss therapy goals with you and develop an individualized program for your child. Question: Sometimes my child is shy and won’t talk to new people. Answer: We have a wide range of interesting and irresistible toys we use in our sessions.
While it may take some children 5 or 10minutes to “warm-up” we are usually able to entice them to talk and build a relationship with them by the end of the first session. Most kids don’t want to go home. Developmental guidelines: Sometimes it’s hard to tell whether your child’s speech and language skills are developing appropriately. Chatter-Boxes is part of the Sunshine Coast Children’s Development Centre incorporatating Speech Pathology, Occupational Therapy, Family Dietitian, Psychology and food School.
I have received many questions about therapy techniques for toddlers with apraxia. Before I give you ideas that are specific to treating children with apraxia, I want to first outline what I believe to be the best treatment approach for all children who are experiencing difficulties learning language. These strategies can also be used at home by parents, who I believe are a child’s first and best teachers. Before I talk about my treatment philosophies, let me send out a disclaimer for all of you who are working with SLPs or other early interventionists who may be taking a different approach with your child. I believe that establishing communication and improving both receptive and expressive language skills are the primary focus for treatment. FUN part of therapy, and are absolutely necessary for kids with apraxia.
By non-communicative, I mean children who lack interaction skills. These kids do not come to you to get the things they need. They do not point or use other gestures to make you understand what they want. He or she does not initiate social games with you. They focus on their specific likes to the exclusion of more meaningful interaction.
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Children who are social responders, but not social initiators, can be taught to do this. I might use another adult or older sibling to help model these kinds of things. I model pointing constantly with a child who can’t do this yet. Point to pictures in books, choices in play, clothing items, body parts, everything.
I make it a big gesture. I work on pointing by making sure kids reach for things. If he’s not reaching, I hold toys he wants just in front of him to make him lean in. Sometimes I ask Mom to help him reach with hand-over-hand assistance. A toddler with apraxia can still have issues with social communication, interacting, and even gesturing.
More importantly, if he’s not following directions or doing other kinds of things to indicate that he understands language, direct lots of your efforts to improving language comprehension. For those of you who can’t help yourself, work on the other issues in at least the same amount of time that you spend working on saying words. Children do not get to veg out in their own worlds, or direct all the play. If this sounds like your child, please carefully read the next paragraph.
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This kind of language stimulation approach is generally not successful for children with apraxia. I also use Floortime techniques for at least part of the session to be sure we’re working on engaging at whatever level they can achieve. I require the child to respond. But they absolutely, positively MUST communicate. I don’t give any kid who can initiate or respond a turn with any toy, a piece of any snack, or let them do anything else, until he at least tries to ask for it using the highest level of communication he can.
I play for most of my therapy sessions. For most toddlers I see over 15 months old or so, play means using toys. I like to use a combination of things we sit down to do and alternate them with movement activities. Strategies for Toddlers with Apraxia For example, we might start the session with a favorite toy that I know a kid likes. Initially most children are generally pretty eager to attend and play when I first arrive. I try to make this as upbeat and as fun as possible. Act like you are having the time of your life!
Begin your own play sessions with toys you know that he or she likes. Then move on to new things or things that are difficult. Lavish your child with affection and attention during this special play time. Let her know how crazy you are about her by how totally focused you can be during play. Don’t constantly look over her head to watch TV.
Model what he should imitate if he’s not using spontaneous words or signs yet. Say the word or demonstrate the sign and wait. As I’ve stated before on this site, I always give choices. Do you want trains or cars? Wait for him to pick one, either with a word or sign. If he can talk or sign, model the choice 3 to 5 times before giving in and playing. If he resists or becomes too upset, go ahead and play with what you think he wants.
I think it’s too mean to hold out beyond this point. I want to keep the toddler engaged and wanting to play with me. I believe that it is counterproductive to have a toddler throw tantrum after tantrum in a session because he’s so upset. It should be the same during playtime with mom and dad too.
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When kids are this upset, they don’t learn. Or the lessons he is learning are ones I don’t like. This woman is so horrible to me that I don’t ever want to play with her again. This tantrum thing is working for me. All I have to do is scream and pitch a fit to get my way.
When a toddler begins to exhibit these kinds of patterns, I do not use withholding or sabotage as my primary approaches. I still choose the activities so that I can make them fun and target language, but I do lots of modeling in an animated way with occasional withholding when he’s happy and can tolerate it. By praise I don’t mean a 5 minute lecture with language that’s over his head before I give him what he wants. I always insist that kids help me clean up an activity.
I am not a therapist who lets a kid drag out 7 or 8 different toys at a time. How in the world can a busy toddler stay focused on what we’re doing in that kind of clutter? Several parents of children on my caseload save certain toys to use only when they play together with their child. They put them in bags or baskets and put them away in the closet until Mommy or Daddy can play too. The novelty alone will make your child want to interact. Think of the reaction you’ll get when you bring out the special bag!
When my own children were toddlers, there were many kinds of activities that I never let them do alone. If you have a child that continues to mouth toys, you may choose to introduce ones during this time that you’d never let him play with on his own while your attention is solely focused on him. This cleaning up process does so much to help with transitions. It also prevents them from moving on to something else before you’re ready and keeps them engaged with what you’re doing. Barney so much, they ought to charge me, but it works. Have your child try to sing this with you. If you have a child that hates cleaning up, you could pick up 3 or 4 pieces to his 1 piece.
The point isn’t to be a tyrant or a neat freak. The point is that activities have a beginning, a middle, and an end. Children, especially those with short attention spans or transition issues such as wanting to play with a few preferred things exclusively and who freak out when an adult tries to move on, need practice with this concept. Additional Tips for Toddlers with Apraxia Other tips to make the clean up process work are using giant zip-lock bags for most of your toys. 5 gallon size since almost anything can fit in there.
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At home try baskets or bins. These terms are borrowed from occupational therapy. Kids who have systems like this usually display sensory integration differences. For more on this, search this term on this site or the Kidpower site. Many children have plastic slides or swings in their homes, and I never neglect an opportunity to use those kinds of things. For older 2’s, I might use games with movement such as bowling with plastic pins or Elefun, a game with an elephant that blows butterflies out of his trunk that we catch with nets.
I routinely use puzzles and turn this into a running game or obstacle course. Put the pieces at one end of the room and the board at the other. I might also use other movement activities a child’s OT or PT recommend such as swinging in a blanket or Lycra with help from Mom or bouncing on a therapy ball if Mom mentions that these help a child to regulate. During the movement tasks, I require them to talk or sign to request more turns to continue. Once I think we’ve moved enough or read a toddler’s signals that he is ready, I go back to a sit-down play task. For many toddlers and even preschoolers, these movement breaks are absolutely essential.
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A Word about Books with Toddlers with Apraxia I only use cards and even books when it’s one of a toddler’s preferred activities. Otherwise, I don’t use them at all. You will NEVER catch me with a worksheet. Therapy is not as efficient as if I used cards or books, but what good is it anyway if a kid hates it? I do not see the value in this. It takes much more creativity on my part, and I may only get 5 productions of a word or sound vs. I rarely work on sounds without having a functional target.
The way I work sound practice in is by seeing what sounds they do have and then getting them in words as quickly as possible. I practice new sounds vowels or consonants alone in isolation ONLY in the context of play. I use lots of phonemic cues when we start to pay more attention to specific sounds. I work in oral motor practice, or for children with apraxia, oral sequencing practice, into play activities. I exaggerate facial expressions constantly in play and encourage children to imitate me. I do this with WORDS ONLY.
We’re beginning that word with a relatively closed mouth and opening up to a huge vowel sound. As I stated before, as soon as I hear a new sound in isolation or alone, I try to get it in a word as quickly as possible. When a child is good at imitating a word, I set up situations for him to use the word spontaneously, or on his own. We keep it at the single word level until he’s ready for phrases. One thing I emphasize with all children I see, and especially those with apraxia, is to set up play when I have to get multiple repetitions of the same word.
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Repetition is how children establish the motor planning necessary for and make the brain connections that result in intelligible and consistent speech. Don’t settle for one production of a word. For vocabulary selection, I try to teach words that toddlers can use and ones that represent things they love. This is not how typically developing children expand to phrases. For most of the children I see for early intervention, this doesn’t happen before they are discharged to school-based or private services at age 3.
Teaching Your Toddler Words to Change His World. I don’t focus on how they say words, with specific sounds, unless they are really, really, really unintelligible and no one, including mom, dad, regular babysitter, or me, can understand them. Nothing is more humiliating to a new talker than a parent who overcorrects first word attempts. I can see this in their little faces. My mom never thinks it’s good enough. What you can do is restate the word they intended to say correctly.
Please, for the sake of your little one’s self-esteem, avoid the temptation to overcorrect. This places too much pressure on your child. They are only allowed to model and shower their children with praise. Most of the time a couple of week break is all everyone needs to restore balance and order again.