Ask an Expert: Why Do I Need Speech Therapy If I Can Talk Fine?

Question: Why do I need speech therapy if I can talk fine?

Answer: Though our title of Speech-Language Pathologist suggests we focus on speech only, our scope of practice is much broader!

In addition to speech and language, SLPs assess and treat swallowing disorders and cognitive-linguistic impairments. Swallowing treatment addresses difficulty chewing and swallowing, and can include instruction in exercise, diet texture analysis, and training for compensatory techniques. Cognitive-linguistic treatment addresses changes in cognitive function and may include training in techniques to enhance memory, orientation, problem solving, and executive function skills.

Lisa Pinnell, CCC-SLP

Rehabilitation for Stroke Survivors: Speech and Motor Recovery

May is National Better Speech & Hearing Awareness Month, and we thank all Tx:Team Speech-Language Pathologists for their continued dedication to their patient, their community, and to Tx:Team. During this month, we want to raise awareness about hearing and speech problems, and to encourage people to think about their own speech and hearing and seek assistance through a Speech-Language Pathologist.

You may wonder, what does a Speech-Language Pathologist do?

A Speech-Language Pathologist provides skilled therapy services to stroke survivors in the areas of dysphagia, communication and/or cognitive impairments. As we know, seeking medical services immediately while experiencing signs/symptoms of stroke is critical because, “Time lost is brain lost. Every minute counts.”

Therapy services should be implemented as soon as the patient is able to participate, as early intensive therapy may lead to better outcomes. Depending on the location and severity of the stroke as well as impact on functioning, a patient may participate in skilled services while in the hospital and subacute rehab with home health or in the outpatient setting.

Impairments treated by a Speech-Language Pathologist are varied secondary to location of the stroke and may include the following:

A swallowing disorder known as Dysphagia may demonstrate impairments in oropharyngeal functioning. A patient may have an objective swallow study completed such as a Modified Barium Swallow Study (MBSS) or a Fiberoptic Endoscopic Evaluation of Swallowing (FEES) to assess oropharyngeal functioning, rule out risk of aspiration, and recommend an appropriate diet texture/liquid consistency that may need to be modified. The objective swallow study will also drive the Speech Therapy plan of care to provide appropriate swallow rehabilitation including recommendations, exercises, and strategies to facilitate safe intake of least restrictive diet to maintain nutrition/hydration orally.

Communication impairments include motor speech (Dysarthria or Apraxia) with deficits in articulation, respiration, and resonance via reduced coordination and strength as well as motor planning. Receptive and/or expressive language deficits (Aphasia) to understand communication (verbal and written) as well as being able to express wants, needs, thoughts, etc. to familiar and unfamiliar communication partners. A stroke survivor may also experience Dysphonia, which is a voice disorder with deficits affecting vocal quality and vocal functioning. A Speech-Language Pathologist will provide rehabilitation services as well as educating and developing appropriate compensatory strategies to enhance a patient’s ability to communicate independently without fear, frustration, or embarrassment.

Cognitive impairments may include deficits in memory and attention skills, which can directly impact their ability to communicate in addition to impaired safety awareness impacting a patient’s ability to maintain a level of independence.

It is important to recognize that a Speech-Language Pathologist will be a part of a Stroke Survivor’s multidisciplinary team. Research indicates, “Screening for dysphagia (within 24 hours) and communication impairment (within 48 hours) is critical in working toward optimal outcomes for stroke survivors,” indicating the need for immediate medical attention if someone demonstrates the signs or symptoms of a stroke.

 

Johanna Ebbs, MS, CCC-SLP is an outpatient Speech-Language Pathologist who specializes in a wide variety of speech-language & cognitive abilities. She has extensive experience treating the adult neuro population and is LSVT LOUD® Certified. Johanna also treats patients undergoing/following treatment for head and neck cancer.

 

References:  

1. CDC. (2022, November 2). About Stroke | cdc.gov. Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/about.htm#print 

2. Dilworth, C. (2008). The role of the speech language pathologist in acute stroke. Annals of Indian Academy of Neurology, 11(Suppl 1), S108–S118. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204112/ 

 

Debunking Speech-Language Pathology Myths

In honor of National Speech-Language-Hearing Month, we’re dispelling some misconceptions to highlight the vital role of speech therapy.

Myth #1: Speech therapy is only for those with lisps or stutters.

While addressing lisps and stutters is indeed a common aspect of speech therapy, it encompasses a far broader spectrum of issues, including problems with expression, sound production, comprehension, speech clarity, hearing, cognition, swallowing, and memory.

Myth #2: Speech therapy is only for children.

Contrary to popular belief, the benefits of speech therapy extend across the entire lifespan. From the earliest stages of development to the golden years of adulthood, individuals of all ages can reap its rewards. Speech-Language Pathology focuses on motor speech function, cognitive-language abilities, voice, and swallowing to help each patient reach their highest level of function and independence. Even in adulthood, tailored speech therapy programs are available to address the needs of those affected by disease, traumatic injury, or disorders of the nervous system, aiming to enhance functionality and elevate overall quality of life.

Myth #3: Speech therapy is only for talking.

Beyond speech, therapy plays a crucial role in addressing various challenges beyond verbal expression. Through targeted exercises and techniques, speech therapists help patients enhance cognitive abilities, memory retention, and improve swallowing function, thereby enhancing overall communication and quality of life.

Speech therapy encompasses interventions for memory, cognition, and swallowing issues, commonly associated with conditions like stroke, brain injury, Parkinson’s Disease, Multiple Sclerosis, and Alzheimer’s Disease, among others. Furthermore, individuals affected by cancer in the mouth, throat, or esophagus, as well as those recovering from head and neck injuries or surgeries, may also benefit from speech therapy interventions.

By dispelling these misconceptions and highlighting the multifaceted nature of speech therapy, we hope to foster a deeper understanding and appreciation for the invaluable contributions of speech-language pathologists in enhancing communication and quality of life for individuals across diverse backgrounds and circumstances.

We thank our Tx:Team Speech-Language Pathologists for the invaluable work they do every single day in improving the lives of their patients.

Ask an Expert: My Speech is Fine, Why Do I Need to See a Speech-Language Pathologist?

My speech is fine, why do I need to see a Speech-Language Pathologist?

A Speech-Language Pathologist (SLP) works with individuals from birth to end of life while focusing on swallowing, voice, communication, and cognitive disorders as well as enhancing speech skills.

An individual may be referred to a SLP because:

  • Their voice is not as strong as it used to be and they are unable to communicate with loved ones at a family gathering.
  • They may begin to experience difficulty while chewing their favorite food and/or coughing while drinking a glass of water.
  • They may have difficulty recalling the birthdays of their family members.
  • They are unable to express their thoughts to participate in a meaningful conversation.

A Speech-Language Pathologist aims to enhance an individual’s quality of life to participate in daily activities that require more than just their speech.

 

Johanna Ebbs, MS, CCC-SLP, LOUD® Certified

Speech-Language Pathology…Because Communication is Important

May is National Better Hearing and Speech Month, which is an opportunity to raise awareness about not only communication disorders, but also the treatments available.

Millions suffer with brain fog, difficulty eating and drinking, and general speech and language problems – and these issues were only amplified in the years following COVID.  These problems can affect a person’s quality of life. Speech Language Pathologists treat a wide range of disorders in both adults and children. With early identification and intervention, clinicians can help to improve communication, increase confidence, and help patients return to the activities and daily life they enjoy.

Many people aren’t aware of how a speech-language pathologist can help.

Speech-Language Pathology, or what is commonly known as Speech Therapy, assesses and treats speech disorders and communication problems. It helps people develop skills like comprehension, clarity, voice, fluency, and sound production. Speech Language Pathologists, or Speech Therapists, can treat childhood speech disorders or adult speech impairments caused by stroke, brain injury or other conditions. Speech-Language Pathologists work with their patients to identify areas for improvement and work to develop each patient’s individual goals.

Speech therapy offers skilled treatment designed to assist and restore speech and language problems caused by illness or injury that may affect:

  • Cognition, comprehension, memory
  • Swallowing and other oral motor problems
  • Communication and hearing
  • Expression

Does Speech Therapy make a difference?

Adult patients can improve the quality of life with speech therapy after a stroke or traumatic injury as well as those patients diagnosed with Parkinson’s Disease or Alzheimer’s. For children, speech therapy is most successful when started early and practiced at home with a parent or caregiver.

Some of the speech improvements that patients experience are a louder and clearer voice, better speech intelligence, a more natural rate of speech, and more robust facial expressions.

If you or someone you know could benefit from Speech Therapy, find a Speech Language Pathologist in your area.  Why?  Because communication is important.

April is Parkinson’s Awareness Month – #Take6forPD

According to the Parkinson’s Foundation, every six minutes someone is diagnosed with Parkinson’s Disease in the United States.

April is Parkinson’s Disease (PD) Awareness Month and along with the PD Community, we are encouraging everyone to take six minutes in an effort to raise awareness, advance the research, and become knowledgeable of the available treatments for this disease. With someone being diagnosed every six minutes, that totals 90,00 people per year in the United States alone.  Let’s be advocates.

Beyond awareness comes treatment. At Tx:Team, we have Physical, Occupational, and Speech Therapists who are trained and certified in treating patients with PD. One treatment program which has been proven beneficial is the LSVT BIG® and LOUD® Program.

How do the LSVT programs benefit Parkinson’s patients?

Parkinson’s can impact function in everything a person does at home, at work, and in their community recreational pursuits. The LSVT programs help patients to maintain movement and voice for normal function in everyday life beyond medication and repetitive, non-direct task training exercises utilizing principles of neuroplasticity backed by years of research. It takes all 16 visits (four times per week for four weeks) to achieve carry over so that by the end of one month, patients know how to move BIGGER and be LOUDER all the time.   

A unique feature of LSVT BIG® and LOUD® is that it recognizes there is an internal cuing proprioceptive issue in individuals with Parkinson’s such as softer voice and smaller movements, in people that are unable to recognize their deficits the majority of the time.   

What is the focus of LSVT BIG®?

  • Faster speed  
  • Greater arm swing   
  • Longer steps  
  • Overcoming difficulty getting through the doorway  
  • Longer distance  
  • Faster clothing donning  
  • Grasping materials during meal preparation  
  • Legible handwriting  
  • Amplitude of movement when showering  

What is the focus of LSVT LOUD®?

  • Louder voice that is not hoarse  
  • Improved facial expression   
  • Reduction of monotone speech  
  • Improved emotion  
  • Using more words  

Who would benefit from BIG® and LOUD®?  

Patients who have a decline in the amplitude of their movement, voice, posture, and balance in addition to reduced speech intelligibility are motivated to participate in all required sessions.  

Why are these programs so important to this patient population?  

LSVT BIG® and LOUD® assists this patient population in maintaining, enhancing, and slowing progression of Parkinson’s Disease, which in return facilitates their ability to maintain a level of independence with the following skill sets essential for daily living:   

  • Changes in cognitive function. People with PD can still learn, but it might take longer and require more repetition of practice. As a patient progresses, the therapist will work on dual tasking so you can keep moving bigger and being louder while doing something else at the same time. For example, getting dressed and talking, walking while carrying something, or tapping your leg while reading.
  • Changes in movement amplitude. Commonly, people with PD have difficulty with activities they didn’t before. As a patient progresses, utilizing larger movements helps patients return to these activities without cues and assistance. 
  • Changes in communication. People who have PD have soft speech and feel that they are talking WNL while others “need a hearing aid.” However, people may begin to feel embarrassed with social isolation. As a patient progresses with continuous use of a loud voice, they are able to participate in conversations without feeling excluded while maintaining their dignity.
  • Changes in emotional regulation, pacing, attention, cardiovascular health, sleep, and confidence can also be seen!  

If you have any more questions about the LSVT program for BIG® or LOUD®, find a certified therapist in your area or visit this website.

 

Nidhi, Alita, and Johanna are all experienced therapists in the Outpatient Clinic setting in Frederick, MD.  They work collaboratively together to support and treat patients with a variety of neurological diagnoses. Nidhi, Alita, and Johanna enjoy the relationships they foster with their patients, and they love to help them achieve their functional goals.

Nidhi Talpade, PT, DPT, BIG® Certified
Alita Borkar, MA, OTRL, BIG® Certified
Johanna Ebbs, MS, CCC-SLP, LOUD® Certified.

Speech-Language Pathology for COVID-19 Long-Haul Symptoms

With an estimated 10 to 30% of COVID-19 survivors experiencing long-haul symptoms including brain fog and swallowing difficulties, speech-language pathologists can help in regaining their functioning and quality of life.

May is national Better Hearing and Speech Month, which is an opportunity to raise awareness about not only about communication disorders but also the treatments. One set of difficulties that people have for months after contracting COVID-19 include brain fog, difficulty eating and drinking, and speech and language problems. This can affect return to work, the ability to take care of one’s family, and overall recovery.

Many people aren’t aware of how a speech-language pathologist can help. SLPs individualize treatment based on the person’s challenges. SLPs can help with both short and long-term difficulties, including:

Cognition

Many COVID-19 “long-haulers” are reporting persistent brain fog as a debilitating symptom after their bout with the virus. This can prevent a return to work and impact their ability to tend to family responsibilities. SLPs can work with individuals to improve their memory, attention, organization and planning, problem solving, learning, and social communication—such as re-learning conversational rules or understanding the intent behind a message or behind nonverbal cues. The focus is on the person’s specific challenges as well as regaining the skills that are most important to their daily life and priorities.

Swallowing

People diagnosed with COVID-19 may experience swallowing problems that can put them at risk for choking or aspirating, which is when food goes into the lungs instead of the stomach. This may be the result of time spent on a ventilator, or it may be another side effect of the virus. SLPs use different types of tests to determine what happens when a person swallows and how the related muscles are working—helping a patient’s medical team, including the SLP, decide on the best course of action with the patient and their family. SLPs may recommend modified textures of food and drink for patients; therapy exercises to strengthen the tongue, lips, and muscles in the mouth and throat; and strategies to make eating and drinking safer, such as modifying the pace of chewing/eating, size of food, and more.

Communication

People diagnosed with COVID-19 are also experiencing speech and language difficulties. Some, such as those who spent a significant amount of time on a ventilator or experienced low oxygen to the brain, may have muscle weakness or reduced coordination in the muscles of the face, lips, tongue, and throat—making it difficult to talk. Others, particularly those who experienced a COVID-related stroke, may experience a language disorder called aphasia—which makes it hard for someone to understand, speak, read, or write. SLPs work with patients through targeted therapy to improve their communication and understanding.

If you or a loved one are experiencing any of these challenges, consider working with a speech-language pathologist to regain your quality of life!

Cabin Fever? Beat the Winter Doldrums

“I’m bored.”  In the middle of winter, this phrase can make any mom or dad break out in a sweat.  And a snowy winter day with children who cannot find anything to do may seem to last centuries.  A long day at home or a lengthy winter vacation is the perfect time for children to participate in fun activities that will build their skills, as well as put a stop to the classic complaints of boredom.  Coming up with creative ideas in a variety of skill areas, along with ideas for adaptations for children with special needs, can be a daunting task for parents as well.  Consider the child’s age and/or developmental level, safety, needs, and preferences to help you select appropriate activities to bust those cries of boredom!

 

Plan Ahead

To avoid being put on the spot in coming up with a fun activity when the famous “I’m bored…” complaint erupts, put together a “boredom box” with ideas from which the children can select.  Assist your child with coming up with his or her own ideas of what to include.  This can be a good strategy to use whenever your child has more ideas of things to do than time.  Include skill building activities that are developmentally appropriate and are “just the right challenge” with a fun twist so that the activity is not viewed as work.  To avoid having to scramble for materials for activities at the last minute, organize an additional “supply box” with basic craft supplies (e.g., construction paper, crayons or markers, cardboard tubes, paper plates and bags, glue, glitter or other decorations).   Consider including small craft sets with instructions, puzzles, and small travel games that are new or seldom-used.  Examine the skill categories below and adapt the following activities to your child’s skill level and safety needs.

 

Make Dressing and Self-Care Fun!

Winter break, snow days, and weekends afford plenty of opportunities for children to master the art of getting dressed, due to the extra time to get ready, and the extra seasonal clothing, such as snowsuits and boots.  If your child needs additional practice mastering fasteners, or resists getting dressed without assistance, incorporate fasteners and dressing into a game.  When multiple children are present, have a suitcase race where children don clothes (over their own clothing) as quickly as they can to win a prize—this can be done as a relay race for more than two children.  Institute a fashion show where the children can practice putting together their own outfits from old clothes (including parents’ clothing), or a doll or stuffed animal fashion show.

 

Visual and Fine Motor Skills

As visual and fine motor skills are an integral part of the school day from an early age, incorporating some of the fun activities below at home will help to boost skills

  • Make some homemade Valentines or birthday cards.
  • Write letters to family or friends on personalized letterhead.
  • Design scrapbook pages from a recent vacation or holiday to incorporate cutting, coloring, and handwriting.
  • Dust off the jigsaw puzzles, legos, lincoln logs, or travel editions of games (these have smaller parts).
  • Encourage building from a model made by a parent or older sibling, or if appropriate, building from instructions on the box. In addition to visual motor skills, word finds or crossword puzzles build vocabulary, and your child can design his or her own puzzle for someone else to solve.
  • For imaginary play, set up a pretend office with supplies such as paper clips, binder clips, old folders, or junk mail to practice manipulating common items. Get messy with squirt bottles (to spray a window or shower), hole punches, or clay tools and presses to strengthen fingers.
  • You can make handwriting fun by designing a secret code to write with fun squiggly pens, bathtub or window markers, or invisible ink markers.
  • Institute a “no-talking, only writing” time to communicate for fifteen minutes or so to encourage writing (this also might help to calm a noisy household).

 

Gross Motor Skills

After spending too much time indoors due to inclement weather, children will need to find a safe way to move around and expend some energy.

  • In a large, open area (basement, family room), provide your children with common household items, such as chairs, plastic juice bottles, a broom handle, hula hoops, or jump rope to design an obstacle course (with adult supervision for safety).
  • Hang up an over-the-door basketball hoop, or design one from a box with the top and bottom cut out to play rag basketball (from knotted up towels or t-shirts), or use a lightweight sponge ball.  Using these homemade toys or games can be more fun than purchased ones, and this will encourage their creative development.
  • If your child enjoys dance or aerobic exercise, consider renting or purchasing an inexpensive exercise or dance video for kids, use a dance pad video game, or have your own dance choreography contest.
  • Consider games from birthday parties or gym class, such as “Twister,” hopscotch (many toy stores offer foam mats), hula hoops, jump rope, “Simon Says,” or “charades” to encourage development of certain movement skills and physical activity.  By playing these games in a fun, friendly atmosphere, rather than being graded in gym class, or being concerned with winning a prize in sports, children who have difficulties with coordination may become more comfortable with motor planning.

 

Cognitive and Social Skills

We all continue to build our cognitive and social skills throughout life, establishing systems to do things and how we appear to other people; therefore, these are very important skills to practice.

  • If your child has difficulties interpreting emotions from facial expressions and body language, try body language charades (what is this person telling you?) or making an emotions collage of people from magazines with a designated facial expression or body language.
  • Practice teamwork by building something together or use an obstacle course as a relay race.
  • Work on sequencing via the oldie but goodie “follow directions game” by having children write down the directions to make a peanut butter and jelly sandwich, then have someone else make the sandwich following the directions exactly (use your *clean* hands if the directions don’t specify a knife)!

 

Sensory Skills

For children who have difficulties interpreting and processing sensory information, winter may be a difficult time to get used to seasonal changes in sensory input, and less access to outdoors (where many calming strategies might be located).

  • You can put clean snow in a dishpan or large plastic container for some table play inside to adjust to the sensation and temperature of snow prior to immersing the child in snow outside.
  • For a slightly easier to clean up sensory experience, place rice, beans, flax, or popcorn kernels into a bowl/bin/container with some of those summer sand toys!
  • Also, pull out the summer mini child’s pool, and fill with lightweight plastic balls (available at many toy stores) to create your own ball pit.
  • To create an indoor quiet area, your children may enjoy draping old sheets or blankets over two chairs to create a tent or use a large (appliance) box for a calming space with cushions or pillows for resting.
  • Children may enjoy spending a day inside making pretzels, kneading bread dough, rolling out cookie dough, or making “slime” as a tactile sensory experience.
  • Some household heavy work can be calming to children with “cabin fever,” such as pushing or pulling a vacuum, pushing a shopping cart, shoveling snow, pushing a wagon or wheelbarrow—all of these should be of appropriate size/weight (toy or regular), depending on the child’s size/abilities.

 

Seeking Expert Assistance

If your child has significant difficulties with dressing/fasteners, fine motor or handwriting skills, visual motor skills, motor planning, or sensitivity to tactile experiences, he or she may benefit from a physician’s referral for a pediatric therapy evaluation.  A pediatric therapist working in an outpatient center can determine if your child could benefit from skilled services and home exercise programs that build on these skills.

Baby-Led Weaning A Developmental Perspective

Baby-led weaning.  Every parent has experienced the scenario. Seated comfortably at dinner with their six-month old baby in his high chair, a mother and father look over to see the face of an infant who wants nothing to do with his puréed carrots. He wants only one thing: their grilled chicken and steamed green beans. So, what’s a parent to do? The infant is at an age when pediatricians say that parents can start to offer smooth, blended (puréed) foods as a way to introduce different flavors. Yet some parents feel that, if their infant shows interest in solid foods, he or she must be ready for those foods.

baby-led weaning

Does your baby show interest in a new food?

Baby-led weaning (BLW) is an infant-driven feeding approach in which the parent offers the infant any food in which he or she shows interest. This could include, but is certainly not limited to, raw apples, french fries, potato chips, fish sticks, pieces of grilled chicken, and carrot sticks. Many parents report success with BLW, though studies have demonstrated an increased risk of choking using this approach. But why?

 

Each parent has to decide what works best for their child. (Parenting seems to be an endless series of decisions, does it not?) As with all decisions in parenting – bottle vs. breast, pacifier vs. no pacifier, co-sleeping vs. separate crib, Baby- Led Weaning vs. progressive textures – it’s important to have the facts. Once we have the facts, we as parents can make educated decisions about what’s best for our family and our little ones.

When deciding if BLW is right for your infant, there are many points about normal development that are important to consider. A large number of developmental factors play a role in an infant’s feeding progression. These include: vision (the infant’s ability to see the food), sensory input (the infant’s ability to distinguish different colors, tastes, smells, and textures of various foods), trunk control (the infant’s ability to sit up and support himself, promoting a safe, upright position for eating solid foods), and fine motor skills (the infant’s ability to hold a piece of food in his hand and bring it to his mouth).

While  all of these are important, some of the most critical developmental milestones to be aware of when considering BLW are those associated with the progression of oral motor functions. In order to safely chew and swallow foods, a person’s oral motor skills must be refined about to be able to 1) keep the food in his mouth, 2) move the food forward and backward, as well as side to side using his tongue, 3) chew the foods in a rotary pattern (this is a circular chewing pattern, like a cow chewing cud, not just munching or smashing the foods against the roof of the mouth), and 4) be able to purposely move the food backward in the mouth using the tongue.

Below are the milestones related to oral motor development that are important for readiness for solid foods (not just liquids or purées):

  • 0-4 months: During this time, infants continue to develop reflexes that protect their airway and prevent choking. They are able to coordinate two to three sucks from a nipple or bottle prior to swallowing, and respond with consistency to stimulation provided around the mouth (for example, a pacifier or toys).
  • 4-6 months: Infants continue to develop the ability to move liquid and watery purees backward in the mouth with their tongues, though these textures continue to move backward primarily through pressure within the mouth when the lips are closed. The tongue begins to move items back and forth (but not yet from side to side, which is important for being able to effectively chew.) Around six months, a primitive “munching” pattern may begin to emerge. This marks the first step toward a rotary chewing pattern.
  • 6-9 months: This is when developmentally mature movement of a bite of food from side to side in the mouth occurs. Infants are able to transition slightly more textured foods forward and backward, side to side in the mouth, and demonstrate emerging ability to chew these foods. Infants continue to move food to the back of the throat to swallow primarily via pressure within the mouth, rather than coordinated tongue movement. The primitive munch continues to be refined.
  • 10-12 months: Infants develop the ability to lick food off their lips effectively. Biting becomes more isolated, which is important in development of rotary chewing. Rotary chewing begins to emerge toward the end of this timeframe, but continues to be refined from 12-24 months. By this age, infants demonstrate the ability to move foods from side to side in their mouths without difficulty.
  • 14-16 months: Infants are able to chew and move firmer and more textured bites of the food throughout the mouth. By this age, they are able to reliably keep a bite of food in the mouth (hooray for no more bibs!)

All of these abilities (containment of a bite in the mouth, moving a bite forward and backward, moving a bite side to side, rotary chewing, active rather than passive movement of a bite backward to swallow) should be present for chewing and swallowing of solid foods to be considered safe.

You know your baby best. You are also in the best position to make the safest choice based on his or her abilities and whether BLW is right for your infant. If you have any questions, consult with your trusted medical provider.

Lauren Most, CCC-SLP, is a speech-language pathologist for Tx:Team partnered with Frederick Regional Health System. She received her Bachelor’s degree in speech-language pathology from Loyola University in Maryland, and her Master’s degree from the University of Maryland, College Park. Her work includes providing services to infants and toddlers in the neonatal intensive care unit and the community who have difficulty with feeding and/or swallowing.

Playing with Purpose: A Pediatric Speech Therapist’s Perspective

With holidays and birthdays, come many toys that cycle in and out of your home. They come in many different brands and styles but all have the same underlying potential for developing your child’s communication skills. Here are just a few commonly found toys that I use as a Pediatric Speech Therapist with the children I work with in order to develop and expand their speech and language abilities.

 

toy farmToy Farm: This toy is loaded with opportunities for you to model early developing speech sounds to your child. Some of the first sounds acquired by infants and toddlers are made with their lips such as “b” “p” and “m”. When playing with this toy with your child, exaggerate these target sounds while modeling animal names and noises.  Some of the target words I use include: “baaa”, “moo”, “pig” with exaggerating the initial sound of each word. Try to have your child watch your mouth while you are saying these words. Allow wait time after saying a target word to give your child an opportunity for imitation.

Cause and Effect Toys: These toys come in many varieties but all have the same underlying theme.popup They are toys that allow a child to “cause” an event to occur. In the case of the pictured toy, when your child pushes a button, the window opens and an animal appears. Communication is founded in cause-effect. Even before a child learns to speak, they understand that when they cry, it results in an event. This event can be a diaper change, a feeding, or attention from their caregiver. When a child understands this relationship, the door for purposeful communication is opened.

Kitchen Set: Pretend play is a huge component of a child’s language development. It is their way of taking scenes from their environment and re-enacting them using language they hear daily. When you listen to your child play, you may hear some familiar phrases!

Kitchen play

This is a great toy for children of all ages. When playing with this toy, help your child to pretend. Model actions such as: stirring with a spoon, putting food in the oven, or turning the sink on and off. While performing these tasks, keep your language SIMPLE.  Phrases such as “too hot”, “all done”, “more please”, and “all gone” are simple beginning phrases that can be used in many situations throughout the day.

While these are just a few suggestions for your holiday and birthday gift list, there are many other options of toys and play that stimulate communication. Any toy that encourages an opportunity for interaction between you and your child is a learning opportunity!

When you go shopping, look for toys that encompass interaction. Although there are several toys on the market that light up or make noise, many of these toys only have a visual component, but do not allow your child to manipulate or physically engage in active play. Much of our early language consists of “active” words that rely on motion or position. Some of the best toys set the scene for using words such as “go”, “stop”, “up”, “down”, “in”, “out”, “on” and “off”.

Why is this type of play important? Young children understand much more than they can verbally express. Even before your child says their first word, they are acquiring and understanding of multiple vocabulary terms daily. By the age of 2, a typical child understands 200-300 vocabulary terms! This makes your task of modeling these early vocabulary terms during play that much more meaningful.

If you are concerned about your child’s speech and language development, below are a few warning signs that may warrant assessment by a Speech Language Pathologist:

  • reduced eye contact
  • disinterest for communication
  • does not respond to their name or sounds in their environment
  • frequent ear infections
  • limited babbling or verbal output
  • difficulty understanding simple commands
  • For toddlers who have speech that is very difficult to understand, resulting in frequent anger outbursts and temper tantrums

There is no “right” age for seeking help for your child’s speech and language. Speech and language development varies for every child. A child who is behind may catch up on their own without intervention, especially when developing their speech sounds. With that being said, do not ignore your parental instincts. It never hurts to seek assistance or an expert opinion.

Michelle Keenan, SLP-CCC is a Tx:Team Speech Language Pathologist treating the Pediatric population at FMH Rose Hill Outpatient Clinic. You may contact Michelle at 240-566-3132 or find out more about Speech Language Therapy go to www.fmh.org/Rehabilitation