TalkAboutSpeech.com

Here is an interesting way to work on social skills for kids with autism.

Countless approaches, techniques and medications - not to mention alternative therapies, special diets and vitamin injections - are available. Few have been subjected to rigorous studies of effectiveness.

In Legoff’s opinion, too many popular strategies involve “skillstreaming” - systematically explaining, modeling, and role-playing acceptable social skills to children.

“I found that approach to be, first, boring and painful to go through for the kids. And second, it didn’t seem to work,” said the psychologist, who has treated children with neurological disabilities for 20 years. “I needed to find something that they could practice but that they would enjoy and be motivated to do.”

Finding an activity or topic of interest is always a good idea to make learning fun.

My colleague Charlene Westman has put together a great blog about speech therapy. My favorite post so far is the one about using YouTube as a therapy tool. I love out-of-the-box thinking like this and I cringe when I see SLPs who only know how to use a workbook or a set of cards. Don’t get me wrong, I love a good deck of artic cards, but I like to use them in any way that promotes learning, not just in the ways listed in the instruction. And as a homeschooler, my family is often looking around for ways to learn from what is around us.

One reminder though–kids on the ‘net need supervision. Charlene’s activity is definitely meant to be interactive.

Now I’m itching to blog about all those things I’ve been meaning to get to so we can get a conversation started.

Just a brief note today about autism spectrum disorders.

Years ago, I read a great book, The Boy Who Would Be a Helicopter. That work has influenced me greatly as a speech pathologist. It taught me, more than a textbook ever could, that we don’t have to label everyone. I’m not against getting an accurate diagnosis, and especially in the education world it helps to have one, but we have to remember to see the kid first, the label second (or third or…..). In doing that, we design a curriculum that is specific to a child’s specific needs. Seems simple, huh?

In other news…..the American Academy of Pediatrics is calling for all children to be screened for autism between the ages of 18 and 24 months of age, whether or not their are any red flags. The press release identifies these red flags:

“Red Flags” that are absolute indications for immediate evaluation include: no babbling or pointing or other gesture by 12 months; no single words by 16 months; no two-word spontaneous phrases by 24 months; and loss of language or social skills at any age. Early intervention can make a huge difference in the child’s prognosis. “Autism doesn’t go away, but therapy can help the child cope in regular environments,” said Chris Plauche Johnson, MD, MEd, FAAP, and co-author of the reports. “It helps children want to learn and communicate.”

Play is the work of a child, and every day is a learning experience. A child can whip up a science experiment using tools she finds at hand. Sure, to you it looks like she smeared an entire jar of Vaseline all over the couch, but what your child learned is that petroleum jelly is sticky and gooey, and it doesn’t come off of her fingers very easily, even if she wipes them on something like the couch. No, the rug isn’t much better at getting it off. Yes, the dog may lick some of it off, but he is not really interested. Sure, it still tastes the same after the dog licked it. Still doesn’t come off when you wipe it on the couch though.

Learning is a rapid, ongoing process for a child, not confined to the times of day that we set aside to teach. There are many ways you can use your child’s play to encourage their language growth and build their vocabulary.

In most cases, a child will produce her first word around the time of her first birthday, but the foundation for communication comes much earlier.  By about 8 months of age, a child has developed the concept of object permanence, the ability to understand that an object exists even if she can no longer see it.  If you hide her toy under a blanket at this point, she will look for it.  At this stage, games such as peek-a-boo reinforce this concept as well as demonstrating the turn-taking aspect of conversation. 

First words tend to be nouns—people or things that are familiar.  As children develop improved oral motor skills, pronunciation will become more precise.  In the early stages of speaking, it is important to pay attention to the intent as much as to the production. 

Routines provide comfort through predictability in a world that is just beginning to make sense. When you do the same thing the same way time after time, your child learns what to expect in a given situation. If you always kiss your baby’s toes when changing her diaper, she’ll begin to put her feet up for a kiss at diaper changing time. This is an early form of expressive communication. She is inviting you to play the game. When you play along and kiss her toes, you have reinforced her communication and shown her that you understand what she has asked. In this way, you have laid a foundation for conversational give and take in the future.

Getting on the child’s level is an important step. Play, and the communication that goes along with it, is enhanced when you partner with your child. That means side by side on the floor or at a kiddie table or anywhere that puts you eye to eye.

When planning for play, let your child take the lead. Look at her interests and introduce a play scenario that you know she will find interesting. Expect that she may deviate from the plan and follow her lead as she explores new ways of interaction.  Remember that a child’s attention span will lengthen as she grows.

Encourage her attempts at communication by talking about your play. Give her time to respond. Talk back to her in a conversational style. Include appropriate hand motions, animal noises, actions and facial expressions to help her understand what you are saying as well as to give her an alternate means to communicate back to you the same information.

For many children, the combination of having a lot to say and an inability to get a clear message across leads to what is known as developmental stuttering. 

Developmental stuttering often sounds like a child is repeating a whole word.  For example if a child wants to say “We go store,” it might start out “We, we, we, we go store.”  Children at this age and stage seem unaware of disfluency.  Developmental stuttering usually appears and disappears before age 3. 

Stuttering becomes cause for concern when there is a familial history of stuttering, when the child has other speech and language difficulties, and when the child is showing signs of frustration in his attempts to speak.  Facial grimacing, tension around the mouth, and rapid body movements which are unrelated to speaking are known as secondary characteristics.  The presence of secondary characteristics should prompt an immediate referral to a speech-language pathologist.

 Modeling  good communication techniques is a good idea for any developing child.  Your speech should be slow and deliberate, but not stilted, especially when talking with your child.  Listening with eye contact is extremely important in making a child feel secure enough to develop better communication skills. Take time each day to listen without distraction and without rushing your child.  If your child expresses frustration with communication, reassure her that everyone has trouble talking sometimes.

Contact your pediatrician and ask for a referral for a speech and language evaluation.  

Consult a professional. 

Speech-language pathologists evaluate and treat children with speech, language and swallowing difficulties. Audiologists diagnose and manage hearing and balance disorders. 

Look for a speech-language pathologist who holds the Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association. 

To find a professional in your area, visit www.asha.org or www.aappspa.org.  

By federal law, free or low-cost early intervention services are available to children age 0-3 who have a demonstrated language delay.

Private insurance plans may cover certain language disorders as well.  

University programs which have a program in speech-language pathology and audiology have clinics where evaluation and treatment are provided by supervised graduate students.  Services are often low-cost or free.

Public schools provide assessment and therapy services to children who qualify.

It can be difficult to respond to a child’s first attempts at communication when it sounds as if she is speaking an unknown language. How do you turn your child’s first attempts at communication into recognizable words?

Listen for sounds that are repeated in a given context. For example, if your child says “mmmmmm” whenever she holds up a cow, consider that a “moo” and respond to it as such. Simply repeat what it was you think she was telling you and acknowledge it or comment on it. “Oh, yes, the cow says ‘moo’.” The key is to treat it as conversation, not insist that she say each sound in each word correctly.

As children learn to express themselves, they incorporate combinations of pointing, grunting and jabbering to tell you what they are asking for. When these attempts at conversation are encouraged and responded to, the child learns that communication has value.  Words can manipulate her world.

A child takes life as it comes. There are no deadlines, no bills, no strict schedules. Any experience can be play.  Imitating our work can be a joy to a child.  When your child follows you around dusting, sweeping or trying to clean the mirror, it is play to the child.  Your words and actions will enforce that concept

and encourage her.  Take a moment from your chores to demonstrate what you are doing and talk about it, keeping your vocabulary at her level.  Praise your child for her contribution.

Childhood is a wondrous time, a time of exploration, learning, and delight.  Each day, look for ways to see the world through your child’s eyes. Take a moment with your child to talk about what she sees, how it feels, how it smells, what it does.  Explore.  Encourage. Play. Listen. Learn.