Tuesday, May 29, 2012

ASDs and Social Skills Groups

One of the defining characteristics of Autism Spectrum Disorders is difficulty with social interactions.  This difficulty with social interactions can become even more challenging when speech and language disorders are also present.

Social interaction challenges associated with autism:
  • Fleeting/lack of eye contact
  • Lack of Theory of Mind, or the ability to attribute mental states (beliefs, intents, desires, pretending, knowledge, etc.) to oneself and others and to understand that others have beliefs, desires and intentions that are different from one's own.  In other words, the ability to put yourself in someone else's shoes.
  •  Literal interpretation (does not understand sarcasm, humor, figurative language, etc.).  For example, the figurative language used in the previous bullet: "to put yourself in someone else's shoes" would be interpreted as literally wearing someone else's shoes.
  • Reading nonverbal cues of communication partners (e.g., interpreting facial expressions, body language, tone of voice)
  • Staying on topic when the topic is uninteresting to them

These social interaction difficulties associated with autism can lead to hurting other's feelings, isolating themselves from peers even more, an inability to appropriately manage conflicts, and even increased difficulty with obtaining and holding down a job.  Without specific training in appropriate social skills, the social challenges of individuals with autism can negatively impact their lives and may lead to hostility, teasing, bullying and social isolation.

Social Skills Groups
Social skills therapy provides people on the autism spectrum with the ability to converse, share, play and work with typical peers.  Social skills groups are designed to teach subtle social skills very specifically and directly with many opportunities for practice.

Bright Beginnings will be starting a new social group for school-aged children starting the week of June 4th.  If you are interesting in finding out more information about our groups, please contact us at 615-898-7461 or info@brightbeginningsptc.com.


Thursday, May 17, 2012

How much speech and language therapy is too much?

Lately, we have had several parents call and ask questions like:
  • Do other children receive school-based speech and language services, as well as, private therapy? 
  • Do multiple therapies (i.e., school-based and private) contradict each other? 
  •   My child will not receive speech and language therapy during the summer. Can we do private therapy during summer break?

At Bright Beginnings, we have many families that pursue both school-based and private therapy.  Our speech-language pathologists are glad to collaborate with other professionals (ie., teacher and/or school speech-language pathologist) to ensure consistency of goals and monitor carryover of skills to all of the child’s environments. We offer both individual and group summer services for those children who wish to continue speech and language therapy during the summer and then transition back into school-based therapy in August. If you would like to discuss additional therapy services for your child, feel free to contact us at 615-898-7461. 


Wednesday, May 16, 2012

So, what is the difference between language and speech? Part 2: Speech

Speech relates meaning with sounds; it is the verbal means of communicating.  Speech includes 3 areas:

  1. Articulation
    • Refers to how speech sounds are made.  Speech-language pathologists (SLPs) may work on specific sounds or patterns of sounds.  For example:  An SLP may help a child correct his prevocalic /r/ sound, so instead of wabbit, he can say rabbit.  
  2. Voice
    • Refers to using the vocal cords and breath to produce sounds.  SLPs may work on decreasing vocal abuse which can lead to hoarseness, vocal fold nodules, etc.  Hypernasality (too much air through the nose) and hyponasality (not enough air through the nose on nasal sounds) may also fall under this heading.
  3. Fluency
    • Refers to the rhythm and smoothness of speech.  If fluency is disrupted, a person may stutter or hesitate when communicating.
Speech disorders and language disorders can present together or independently of one another and severity can range from a mild issue to a severe one.  If you have any concerns or questions regarding your child's speech and/or language development, please do not hesitate to contact us at 615-898-7461 or info@brightbeginningsptc.com.


Tuesday, May 15, 2012

So, what is the difference between language and speech? Part 1: Language

In our experience, many parents, healthcare professionals, and daycare workers do not know that there is a difference between language skills and speech skills or what that difference looks like.

Language is made up of socially shared rules which communicate a message.  Language involves:

  1. Knowing the meaning of words
    • Example:  Someone asks a child, "Where do you go to school?" and the child begins naming students in her class.  The child knows that they are supposed to respond, but they answer the question incorrectly.
  2. Using/combining words to communicate a message effectively and clearly
    • Example:  A toddler points to an out of reach item and requests "want," but the parent is unsure of what the toddler is requesting exactly because the child does not have the vocabulary to label the object.
    • Example:   Labeling all four-legged animals with a tail a "dog."
  3. Understanding the social rules (i.e., pragmatics) of language.
    • Example:  A child is talking to another classmate about his favorite subject, dinosaurs.  The classmate is not interested in talking about dinosaurs, but the child does not pick up on social cues (i.e., classmate glances around the room, attempts to engage the child in another topic are unsuccessful, sighs, rolls his eyes).
The examples listed above are just a small pieces of language.  Language can be broken down into many areas including semantics (meaning/vocabulary), syntax (sentence structure), morphology (word structure/ word endings), phonology (the sounds within a language), and pragmatics (social rules of language).  A child may have a deficit in one language area or deficits across several areas.

Language can be both verbal and nonverbal.  For example: a child can request a cookie by pointing and saying the label "cookie."  The child's pointing is nonverbal communication and the child's word is verbal communication.  If you remove either part of the communication, you would most likely still understand the child's request.  

Below is a chart from the Children's Hospital of Pittsburgh.  It contains both speech and language milestones.  If you have any questions about your child's speech or language, do not hesitate to contact Bright Beginnings at 615-898-7461 or info@brightbeginningsptc.com.

Age-Appropriate Speech and Language Milestones

Age-Appropriate Speech and Language Milestones

The ability to hear is essential for proper speech and language development. Hearing problems may be suspected in children who are not responding to sounds or who are not developing their language skills appropriately. The following are some age-related guidelines that may help to decide if your child is experiencing hearing problems.
It is important to remember that not every child is the same, and children reach milestones at different ages. Consult your child's physician if you are suspicious that your child is not developing speech and language skills correctly. The National Institute on Deafness and Other Communication Disorders (NIDCD) and other experts list the following age-appropriate speech and language milestones for babies and young children.

Milestones related to speech and language:

Birth to 5 months
  • coos
  • vocalizes pleasure and displeasure sounds (laughs, giggles, cries, or fusses)
  • makes noise when talked to
6 to 11 months
  • understands "no-no"
  • babbles (says "ba-ba-ba")
  • says ma-ma or da-da without meaning
  • tries to communicate by actions or gestures
  • tries to repeat your sounds
  • says first word
12 to 17 months
  • answers simple questions nonverbally
  • says two to three words to label a person or object (pronunciation may not be clear)
  • tries to imitate simple words
  • vocabulary of four to six words
18 to 23 months
  • correctly pronounces most vowels and nmph, especially in the beginning of syllables and short words - also begins to use other speech sounds
  • vocabulary of 50 words, pronunciation is often unclear
  • asks for common foods by name
  • makes animal sounds such as "moo"
  • starting to combine words such as "more milk"
  • begins to use pronouns such as "mine"
  • uses two word phrases
2 to 3 years
  • knows some spatial concepts such as "in," "on"
  • knows pronouns such as "you," "me," "her"
  • knows descriptive words such as "big," "happy"
  • vocabulary of 250 to 900 words
  • uses three word sentences
  • speech is becoming more accurate but may still leave off ending sounds - strangers may not be able to understand much of what is said
  • answers simple questions
  • begins to use more pronouns such as "you," "I"
  • uses question inflection to ask for something such as "my ball?"
  • begins to use plurals such as "shoes" or "socks" and regular past tense verbs such as "jumped"
3 to 4 years
  • groups objects such as foods, clothes, etc.
  • identifies colors
  • uses most speech sounds but may distort some of the more difficult sounds such as l, r, s, sh, ch, y, v, z, th - these sounds may not be fully mastered until age 7 or 8
  • uses consonants in the beginning, middle, and ends of words - some of the more difficult consonants may be distorted, but attempts to say them
  • strangers are able to understand much of what is said
  • able to describe the use of objects such as "fork," "car," etc.
  • has fun with language - enjoys poems and recognizes language absurdities such as, "is that an elephant on your head?"
  • expresses ideas and feelings rather than just talking about the world around him/ her
  • uses verbs that end in "ing," such as "walking" and "talking"
  • answers simple questions such as "What do you do when you are hungry?"
  • repeats sentences
4 to 5 years
  • understands spatial concepts such as "behind," "next to"
  • understands complex questions
  • speech is understandable but makes mistakes pronouncing long, difficult, or complex words such as "hippopotamus"
  • vocabulary of about 1500 words
  • uses some irregular past tense verbs such as "ran," "fell"
  • describes how to do things such as painting a picture
  • defines words
  • lists items that belong in a category such as animals, vehicles, etc.
  • answers "why" questions
5 years
  • understands more than 2,000 words
  • understands time sequences (what happened first, second, third, etc.)
  • carries out a series of three directions
  • understands rhyming
  • engages in conversation
  • sentences can be eight or more words in length
  • uses compound and complex sentences
  • describes objects
  • uses imagination to create stories

From Children's Hospital of Pittsburgh http://www.chp.edu/CHP/P02170

Monday, May 14, 2012

Happy Mother's Day


We hope all of the wonderful mothers out there  had a great Mother's Day! For all of the mothers of children with special needs, here is a link that celebrates what you do.


Thursday, May 10, 2012

How much of my child’s speech should I understand?

Frequently, we get calls from parents asking, “How much of my child’s speech should I understand?” or “How much of my child’s speech should others understand?” Often, parents understand their children better than others. If their child exhibits articulation errors, parents often become the translator between their child and their communicative partner.

Speech intelligibility refers to the percentage of conversational speech clearly understood by unfamiliar listeners. When children have decreased speech intelligibility due to articulation errors, they can become frustrated when others do not understand them, act out (e.g., hit, bite, etc.), or just give up on the conversation.

Listed below are age expectancies for speech intelligibility in conversational speech: 
  •  19-24 months       25%-50% intelligible to unfamiliar listeners 
  •  2-3 years              50%-75% intelligible to unfamiliar listeners
  • 4-5 years              75%-90% intelligible to unfamiliar listeners
  • 5+ years               90%-100% intelligible to unfamiliar listeners
If you have concerns with your child’s speech sound production or speech intelligibility in conversational speech, feel free to contact Bright Beginnings to speak to a speech language pathologist or schedule a free speech-language screening.