The terms stammering, stuttering and dysfluency are interchangeably used to mean the same thing, disruption in fluent speech. While there are many theories about stammering the cause and nature is not well understood. Therapist are instead more focused on the therapy approaches that can support a child who stammers. The Lidcombe Program is an effective therapy program for children under the age of 6 years. The Lidcombe Program it is a direct treatment program, meaning that therapy involves direct remediation of the stammer. Indirect therapy approaches may involve making changes to the child’s environment e.g. reducing talking demand etc.

Developing your child’s expressive language in the early years

Sometimes as adults we forgot that children’s language is not fully developed, in fact is our language ever fully developed? Most adults are hearing and learning new words all the time. We can often forget that learning a language is difficult, think back to your high school French class! Now imagine that that the teacher spoke to you like a native French speaker, at times this is how children will feel when adults speak to them! In this post we will think about how we can help our child best develop their expressive language skills.

Having a speech and language assessment can be a daunting decision for a parent. It can be difficult to decide whether it is the right time to schedule an assessment or whether you should hold off.  Sometimes having an assessment completed by a professional can give you peace of mind and also provides you with an opportunity to clear up questions you have.

You may decide to have your child assessed for a number of reasons. Perhaps a nursery teacher/ school teacher has highlighted some concerns and advised you to get a second opinion? Maybe your child is not speaking and using their language the same way their brother and sister did/ the same way a friend or family member’s child is?

From a therapist point of view we want your experience to be as smooth and hassle free as possible. We understand that you may be feeling stressed and anxious about the assessment. The following is some information to help you prepare.

How can I use books to develop my child’s language skills?

This week we had a competition for a book voucher at our clinic. In therapy sessions I love to use books to model language when interacting with a child. There are so many different types of books to choose from nowadays to suit everyone’s age and interest! Reading books with your child can be a very effective way to build on their language skills. Here are some tips on how you can use books to build on language skills.

1. To start with you can encourage your child to request a book by giving them a choice of two books. Encourage them to request for one by pointing or using a sound or word to ask for their preferred story book.
2. If your child is labelling items or starting to label pictures and objects you can use some of the more tactile books to keep their interest and encourage them to use their language. Books with flaps and different textures create expectation around what is coming next. We want to find out what’s going to be ‘under the flap’ or coming on the next page. Books like ‘Where’s Spot?’ or ‘Dear Zoo’ are great for keeping children engaged in in this  way.
   
   
   
   
3. If your child is communicating using mostly ‘one word’ utterances you can use picture story books to scaffold longer phrases e.g. if your child says ‘dog’ you can model ‘dog barks’ or ‘dog is running’. Encourage your child to imitate the model you have given them and give them lots of praise if they follow!
4. Following instructions- books can be used to develop your child’s ability to listen to language and follow instructions e.g. ‘turn the page’, ‘point to cat’, ‘point to the house’. As your child’s language skills improve you can add another key word to the phrase e.g. ‘point to the black dog’, ‘point to the red car’.
5. Building routines- reading stories regularly can help build up your child’s understanding of sequences. In a story a sequence of ideas happens in an orderly way e.g. first Jack bought the beans from the seller at the market, next he planted the seeds in his garden, next a big beanstalk started growing in his back garden.
   
   
   
   
6. Reading stories with repetitive phrases supports a child’s ability to finish sentences. This builds the foundation for answering more complex questions in the future e.g. ‘run run as fast as you can, you can’t catch me I’m the gingerbread man!’ As your child becomes more familiar with completing the phrases you can hold back from answering and encourage them to finish the sentence independently. Some examples of other books that use repetition effectively include ‘We’re going on a Bear Hunt’ and ‘Brown bear, brown bear what do you see?’
7. With longer stories we can encourage children to answer a range of different questions related to the story e.g. ‘what happened?’ ‘who?’ ‘where?’, ‘why?’ and ‘how?’ Questions can be introduced depending on your child’s comprehension skills. Generally it is best to start off with ‘what?’ ‘where?’ and ‘who?’ questions before asking ‘why?’ and ‘how?’ questions.Understanding sequence and order: as your child’s language skills develop you can ask them questions related to sequence and time e.g. what happened first? What happened in the end? What happened before the giant chased Jack out of the castle?

8. Story reading encourages creativity and imaginative thinking. Children can be asked ‘what will happen next?’ and allowed time to think of a good ending to the story!
9. Retelling stories helps develop your child’s spoken language skills. Putting the story in the correct order using grammatically correct sentences is a great way for your child to expand their language and sentence structure. It gives you an opportunity to model corrected examples of any mistakes your child makes. It also allows you to praise your child for how well they are using their language!
10. Reading stories is a nice way to spend time together. It is a shared special time with your child where you are giving them your undivided attention. It also creates a positive experience with reading that can help with motivation in classroom activities further along in your child’s school experience.

I regularly see articles and studies being published that show the negative impact iPads can have on the development of children’s speech and language skills. Some of the research states that children are using iPads independent of their parents. As a result parents are often recommended to put a limit on the amount of screen time their children have on a daily basis.

Leaving a child to independently ‘use’ or ‘play’ on an iPad for an extended amount of time will limit the number of communication opportunities a child has with another person. As the iPad can’t respond to them in the same way a person does the two way interaction of communication is lost. Some children can become fixated on iPads. I think we can all identify with how lost we are when we don’t have our phones!

Speech and Language therapy can only have long term impact if the therapy plan created by the therapist gets implemented in the classroom and at home. Goal setting is key. When I work with a child in a therapy session we work through a speech and language therapy plan that I have set for them. This happens following an assessment of their skills. When a speech and language therapy plan is set it will often include goals related to the child’s understanding of language (receptive language), how they use signs, gestures, sounds, words and sentences to get their message across to another person (expressive language) and how language is used to interact with another person (social language) goals.

5% of children will stutter under the age of five years. Of this number 25% will go on to have a stutter after age five. Stuttering or dysfluency can take a number of forms but generally it is the repetition of sounds and words. Your child may sound like they are ‘getting stuck’ on a word or part of a word e.g. ‘I I I I want a juice’. Generally children go through a normal period of stuttering/ dysfluency between the ages of one and a half to five years. These periods can last from a few weeks up to a few months. Your child may stutter for a period of time, it will disappear and then reappear at another time. When should you consider getting some more support for a child that stutters?

It’s estimated that approximately 25% of individuals with autism are non verbal. Of the 75% who use verbal/ vocal communication many struggle with using language spontaneously and to initiate communication in social interaction. Communication devices are types of equipment (often in tablet form) that assist an individual to interact with others. They often have an interface with buttons/ icons that a student presses and the device speaks out a word or sentence when pressed.

Advances in technology have made communication devices more easily available and accessible to parents and families. Previously a communication device may have cost in the region of 10,000 USD. Nowadays communication apps can be purchased and used on iPads. They have become cheaper and more accessible for parents and families.

This month is Assistive Augmentative Communication (AAC) awareness month. AAC is an umbrella term that covers any additional communicative means (rather than speech) a person uses to get their message across. It can include gesture, sign, picture exchange (exchanging pictures as a means of communication) and devices that support communication e.g. hand-held devices or devices activated by other means e.g. eye tracking. To give some more insight I spoke to Veerle Oben, a Senior Speech and Language Therapist based in Dubai, who specialises in the field of AAC.