Let’s Talk Articulation!

Posted on March 15, 2024March 18, 2024

When Do I Bring My Child for a Speech Sound Evaluation?

As our children grow and develop speech, they don’t learn to use all the speech sounds in their native language simultaneously. That’s why my little one tells me that “it’s dart outside” when he looks out the window after dinner these days! But how do you know when to seek out a speech therapist for your child?

Check out the chart below, which is available as a downloadable PDF on the SLP now website at https://blog.slpnow.com/the-slps-guide-to-speech-sound-disorders-articulation-phonological-development/; when looking at the chart, understand that some children start to develop sounds before the ages listed. The ages listed represent the age at which 90% of children have mastered each sound. For many speech sounds, there is a wide range of ages at which a child may start to produce the sound or approximations inconsistently before they truly master the sound. However, it is a quick rule of thumb that if a child cannot produce one of the sounds listed under their age, speech therapy may be indicated.

What Can I Do at Home to Help My Child with Their Speech Sounds?

So, what can a parent do to help their child develop speech sounds correctly at home? The first strategy I recommend is to make sure your child is looking at your face when you’re producing words or sounds that they had difficulty with. Draw attention to your mouth by pointing. Children learn a lot about how a sound is produced by observing you.

Another strategy that you can use is called recasting. Recasting is when you repeat what your child says precisely, including the errors, in a questioning voice. For example, if your child says, “Look at the tar” when they mean “Look at the car,” you might respond by saying, “Tar? Is that what you meant?” When the child attempts to correct himself or herself, if he or she cannot do so, I suggest using the first strategy we discussed. Your child may not produce the sound at that moment, but that’s okay because they are still learning from what they see and hear from you.

I also recommend reading with your child regularly. Even if a child cannot read independently, draw their attention to some of the letters in the book, especially if the book has large decorative letters at the beginning of paragraphs. Talk about the sound the letters make, and again, ensure your child is watching your face.

For emerging readers, phonics activities are an excellent time to work on articulation at home. While doing phonics homework with your child, could you talk about how each sound is made? For example, the “T sound is made with our tongue on the roof of her mouth.” If you’re unsure how to describe how sounds are made, PeechieSpeechie.com has an excellent video library with tutorials for each sound.

If your child is receiving speech therapy services, their SLP will be able to provide you with additional, personalized resources.

How Can Carolina Therapy Connection Help?

If you are still unsure or feel that your child’s speech is difficult to understand compared to others his/her age, Carolina Therapy Connection has licensed Speech Language Pathologists at the clinics in Greenville, Goldsboro, and New Bern that are highly qualified to evaluate and diagnose speech sound disorders. You can schedule a speech sound evaluation at whichever clinic is most convenient for your family at 252-341-9944. Our professionals can also provide personalized resources for your child’s needs.

By Michelle Berghold

Stuttering: Developmental or Disordered?

Posted on February 1, 2024January 31, 2024

Stuttering in children is a speech disorder characterized by disruptions in the natural flow of speech. Developmental stuttering is a common experience, typically emerging between the ages of 2 and 5 when children are first learning to speak fluently and developing a large repertoire of words, phrases, and sentences. While many kids experience a phase of disfluency in their normal speech development and may outgrow it, some might continue to stutter as they grow older. In this case, speech therapy may be recommended.

Causes of Stuttering in Children

The exact cause remains unclear, but it’s believed to arise from a combination of genetic, neurophysiological, and environmental factors. Children with a family history of stuttering are more likely to develop it. Some kids experience stuttering due to differences in brain structure or function related to speech production. Emotional factors like stress, pressure to communicate quickly, or a hurried environment can also increase stuttering. Stuttering occurs at the initiation of voice, which is why we typically hear disfluencies at the beginning of words and phrases.

According to Johns Hopkins Hospital, A child is more likely to stutter if he or she has:

A family history of stuttering
Stuttered for 6+ months
Other speech or language disorders
Strong emotions about stuttering or family members with fears or concerns

Types of Disfluencies

Stuttering manifests in various ways, such as repetitions (repeating sounds, syllables, or words), prolongations (elongating sounds), and blocks (inability to produce sounds). These disruptions can lead to tension and anxiety, causing the child to avoid certain words or situations where they might feel pressured to speak.

Speech Therapy for Stuttering:

Speech therapists play a crucial role in assessing, diagnosing, and treating stuttering. Here are some primary approaches utilized in speech therapy:

Speech Modification Techniques: Therapists teach children to use gentle starts to sentences, and employ smooth, relaxed breathing patterns. This helps in reducing the frequency and severity of stuttering moments. Continuous phonation, for example, is a technique where speakers learn to keep their voice on and vocal folds vibrating throughout speech.

Fluency Shaping: This technique focuses on reshaping the child’s speech patterns by teaching smoother speech movements. It involves controlled breathing, gentle voicing, and gradually increasing sentence length to enhance fluency.

Stuttering Modification: This approach concentrates on changing the child’s emotional and cognitive reactions to stuttering. It involves desensitizing the child to the fear and anxiety associated with stuttering and teaching strategies to manage and accept disfluency.

Parental Involvement: Educating parents about stuttering and how to support their child’s speech development is key to increasing the child’s success. Therapists often teach parents techniques to practice at home, creating a supportive environment for the child’s progress.

Communication Skills Training: This includes enhancing overall communication skills, like turn-taking and using pauses effectively. It helps in building the child’s confidence and reducing the pressure associated with speaking.

Long-Term Outlook

Many young children outgrow developmental stuttering; however, some might continue to stutter into adolescence and adulthood. In such cases, ongoing therapy, support groups, and strategies for managing stuttering in social and professional settings become vital.

How can Carolina Therapy Connection help?

Children who sutter often benefit from therapy from skilled Speech-Language Pathologists. Stuttering in children is a complex speech disorder that necessitates early intervention and specialized therapy. Speech therapists employ a variety of techniques focusing on speech modification, emotional support, and overall communication enhancement to help children manage and, in many cases, overcome stuttering. Family involvement and a supportive environment are fundamental in the child’s journey towards improved fluency and confidence in communication. At Carolina Therapy Connection, our treatment is highly individualized to your child’s needs. A standardized assessment will be administered to detect any disfluencies, and our therapists will work with you and your child to develop a plan for enhancing skills to build confidence across all social environments (home, school, social groups, etc). If you have any concerns or questions regarding your child’s development, call our clinic at (252) 341-9944.

By Ashley Holloway, MS, CCC-SLP, CAS

Winter Activities for All Ages!

Posted on January 15, 2024January 12, 2024

What are Some Winter Activities When the Weather is too Cold Outside?

Ever wonder what you can do to keep your Kiddo occupied and safe while providing the necessary sensory input when it’s too cold to play outside? It is recommended to take indoor breaks every 20-30 minutes when the temperature outside is between 13-30 degrees; however, some kiddos tolerate cold weather better than others. Here are some tips for activities that can be done indoors when it’s just too cold to go outside this winter!

A Fun Winter Activity: Play Board Games

This is dependent on your child’s age and skill set. If you have some board games tucked in the closet, break them out and have family fun! This will work on building your child’s reciprocal play skills, following multistep direction skills, coping skills, and emotional regulation. Check out our Amazon storefront for some of our recommended board games!

Build a Pillow/Blanket Fort

Who didn’t love making a fort under the kitchen table as a kid? Build a fort in the kitchen and living room, then place some of their favorite books, toys, and stuffed animals inside. This can be a fun way to get your kids into critical thinking mode and build their visual perceptual and motor skills!

Scavenger Hunt

Another fun winter activity is to hide some items in your house and have your kiddos find them! This can be graded according to skill level and age. For example, for a younger kiddo, have them locate items they would typically use. For older kiddos, give hints to the item they are looking for. “Find two things mom uses to stir within the kitchen (utensils)” or “Find something round and blue in your bedroom (ball).” This will work on their figure ground skills and get their body moving!

Bake/Cook

Have your kiddos help you bake/cook your favorite snack or dessert in the kitchen. Have your kiddos follow the directions given or help with the messy tasks. This can be great for our sensory-seeking kiddos and those resistant to messy play!

Dance Off!

GET MOVING with a fun dance-off! Put off some of your favorite music and have a contest to see who dances best to the song! This is a great way to work on gross motor skills, coordination, and auditory processing, and it’s just plain fun!

Watch your Favorite Movie and Act Out the Scenes.

Many kids like to watch movies; however, do you ever notice that they get bored halfway through and are on to the next thing? Get them involved with the movie. Have that pause button ready and have them act out a scene to see if they can recall what happened!

Indoor “Snowball” Fight

Do you have some extra tissue paper lying around after wrapping those Christmas presents? Make snowballs and toss them at each other! This is a great way to get kiddos moving without fear of knocking things off tables/counters and breaking things!

Keepie-uppie with Balloons

Everyone knows this one! Can we keep the balloon off of the ground? Try it! It is so much fun, works on your kiddo’s hand-eye coordination, and has less risk of damaging something in your home!

How can Carolina Therapy Help?

With winter in full swing, ask your therapist about tips/tricks to have fun indoors with adaptations specifically for your child’s sensory-related needs. A therapist at Carolina Therapy Connection can help adapt the activities listed above and give more ideas for your specific child! Also, check out our link for Amazon storefront to find fun toys/activities to make the indoors fun! Many great toy ideas and sensory-related tools can be used when your child needs to get some energy out!

I hope these tips have helped build some fun ideas for you and your family for this winter season! Stay happy, healthy, and warm!

By: Shelby Godwin, COTA/L, AC

What is AAC?

Posted on November 7, 2023November 7, 2023

AAC stands for Augmentative and Alternative Communication. It encompasses all of the ways in which an individual may communicate outside of speaking verbally. Augmentative communication means to add to someone’s existing speech skills, and alternative means to be used in place of verbal speech. There are many different kinds of AAC including, but not limited to: gestures, facial expressions, writing, pictures symbols (e.g., picture exchange communication system/ PECS), drawing, sign language, high-tech speech generating devices, communication boards, etc. Some people may use one of these modalities, and some may use multiple modalities depending on the way in which they can most quickly and clearly communicate the topic.

Who Needs AAC?

Many different people use AAC throughout their lifetime. It can be used across the lifespan by any age, at any time, and for a variety of different reasons. Some people use AAC for their entire life, and some use it for only a short period of time. AAC can help any person who has difficulty fully or partially meeting their daily communication needs such as expressing wants and needs, socializing, asking questions, and a variety of other functions.

How can AAC help your child?

AAC may be able to help your child if they have difficulty being understood by others, have a limited vocabulary, demonstrate limited spontaneous speech, are non-speaking, and a variety of other different reasons. There are no prerequisite skills to your child beginning to use AAC. One common misconception is that AAC will hinder language development or cause your child to become dependent on it for communication. While some children may have minimal to no verbal speech throughout their lifetime, there is research to show that AAC can actually help children to develop language. Using AAC can also help to reduce frustration surrounding communication attempts, and help your child to communicate their needs more clearly, quickly, and effectively.

Parent’s Role in AAC

When introducing AAC to your child, it is important for family members/ caregivers to make the commitment to help the child succeed with the chosen AAC device. Your input is crucial in helping to choose and develop an appropriate AAC system, and using the device at home and in the community is a vital step to help both you and the child continue to learn the system. According to Jane Korsten, SLP, the average 18-month-old has been exposed to 4,380 hours of oral language at a rate of 8 hours/ day from birth. A child who has a communication system (AAC) and receives speech/language therapy 2 times/week for 20-30 minutes will reach the same amount of language exposure (in their AAC language) in 84 years. It is our role as professionals and caregivers to help minimize the communication gap between oral language users and AAC users.

Modeling: Modeling is an awesome way to both learn your child’s AAC system, and teach them an example of how they can use it. The best way to model is to speak and use the system at the same time, although you do not always have to select an icon for every word you say. For example, you may verbally say “time to go to school” while modeling “go” and “school” on the AAC system. A general rule of thumb is to model the number of icons your child is currently using, plus one. If your child uses 1 icon at a time, you may choose to model 1-2 icons at this time. It is important to model without expectation, meaning that you use the AAC system without expecting or requiring the child to respond, withholding items or activities, or “testing” their skills. The goal is to provide an example to the AAC learner, which they will then learn by watching and listening to what you do/say.

How can CTC help you and your child?

Whether your child is already receiving speech/language therapy services at our clinic or not, CTC is ready to help support both parents and children through their own individual journey with Augmentative and Alternative Communication. If you believe that your child may benefit from the use of AAC, talk to one of our many incredible speech-language pathologists to begin the process of figuring out what type of system (no tech, low-tech, mid-tech, high-tech) will work best. This process can take time, but with your support and the support of your SLP, it is possible to find the right system for your child!

Your Baby’s Communication: Prelinguistic Vocalization

Posted on November 3, 2022October 4, 2023

What can I expect before my baby begins talking?

Your baby’s first form of communication will be nonverbal and happens soon after birth. Your may baby grimace, cry, or squirm to express a range of emotions and physical needs, from fear and hunger to frustration and sensory overload. Oftentimes, parents learn to listen and interpret their baby’s different cries, coos and babbles. Many parents wonder when their baby will begin using words, imitate them, laugh and form a variety of other communication methods to express how they are feeling. A very important part of language development is the prelinguistic stage, which is the stage that is characterized by vocalizations before language begins. So for starters, what is language? How does it develop during a baby’s first year of life?

Language is when we use and organize sounds and words to convey meaning. Language development is considered a continuum, and there is not an abrupt shift from babbling to talking. There is an overlap between all stages of language development. Every child is different in the way they learn and grow; however there are many exciting milestones to watch for as your baby explores their environment in the first few months of life. Continue reading to learn more about the prelinguistic stage, how you can interact with your child during this stage, and how Carolina Therapy Connection can help your child reach their full potential!

What can I expect from my baby during the prelinguistic vocalizations stage?

1: Reflexive and Vegetative

Occurs birth – 2 months
Reflexive sounds (crying, coughs, burps)
Cries that mean different things (hunger, pain, etc.)

2: Cooing and Laughter

Occurs 2 – 4 months
Vowel like sounds
Squeals

3: Vocal Play

Occurs 4 – 6 months
Longer vowel like sounds
Some consonant sounds
Changes in pitch and loudness

4: Canonical Babbling

This stage is when babies may start to imitate what they hear! This is a fun time to sit and play with your babies and babble to them and see if they imitate!

Occurs around 6 months – until first words
Reduplicated or strings of identical syllables: “mamamama” “babababa”
Variegated or strings of varying consonants and vowels: “madagama”

5: Jargon

During this stage, it will seem like your baby is trying to tell you a story. They may look at you and make facial expressions and use hand movements. This is a fun time to encourage them and engage with them in conversation. Check out this awesome resource from Reading Rockets for Tips and Activities to Encourage Speech & Language Development!

Occurs around 10 months or older
This stage overlaps with first words
Strings of babbling
Paired with eye contact, gestures, and adult like intonation

Why does the prelinguistic stage matter?

Research indicates that babbling correlates to later language development. Greater babbling complexity and a variety of sounds used positively indicate greater language growth. Delayed babbling may be an indicator for speech/language delays. If you notice that your child is not babbling by 10 months of age, it may be beneficial to consult with a Speech Language Pathologist. While this is not the only factor, it can be helpful when looking at your child’s overall development.

How can Carolina Therapy Connection help?

There is so much new information and research these days that can be overwhelming for a parent. At Carolina Therapy Connection, our team of pediatric speech therapists are licensed professionals who are trained to help children with any communication difficulties. We know that developing strong communication skills is one of the most important elements to socializing and creating relationships.

Our knowledgable and experienced team of SLP’s provide screenings, assessments, consultations, and treatment to children birth through 21 years old. If you have any questions about your child’s development or would like to set up a FREE screening with one of our speech language pathologists to determine the need for an evaluation, call our clinic at 252-341-9944 to speak with one of our staff members.

Meet the Author

Optimizing Therapy Progress

Posted on February 1, 2022October 4, 2023

Competence Brings Confidence

When we begin treatment with a new patient, or we begin working on a new skill at home as a parent, we often become so excited about the goal, or the end game, that we forget about all the small steps we should take to get there. Over the past 20 years working with children and families as an SLP and raising my own children I have learned that we need to celebrate the small steps in life and for therapy progress.

At some point I started telling parents of preschoolers and early elementary students, “Competence brings confidence!”

Your child might learn a very small step toward their goal in a therapy session. This small step should bring a lot of excitement, praise, and chances to “show it off” at home. These chances are growing your child’s confidence in their abilities. Those chances are giving neural connections a chance to form. Those chances are reinforcing new motor patterns. Being competent in a new skill, no matter how small, brings confidence! Confidence gives us the drive and the will to keep working hard and keep going. It keeps us excited in our pursuit to learn something new or difficult and optimizes therapy progress.

Focus on the Small Steps for Big Victories

Often parents and practitioners focus too much on the end goal. Young children do not even know what the end goal is. We need to celebrate each very small step along the way.

With the confidence your child has from practicing a seemingly small skill at home, they come to therapy ready to move on and add more new skills. They will have the skill they have become so good at in their tool belt, and add to it! They might have started making a speech sound with confidence in isolation. When they are confident with that skill because they have shown it off many times, they will be ready to move on to making that sound in words.

In the opposite scenario we might spend time working on the small skills, try to speed along, and forget to give praise and practice at each step. We are focused on the end goal, for example, clear speech. All along your child or patient might practice and never realize all the small gains because we forget to praise them with small steps or have them show off their small steps. In this scenario, opportunities to practice important building blocks are missed. Opportunities to build confidence are missed, and ultimately the pace of progress is slower.

In the end, learning the “end goal” should have felt like many moments of satisfaction and praise to finally reach where we wanted the child to be. It should not feel like many moments of trying and not {quite} getting there and being corrected over and over until we {finally} get good enough.

Incidentally, this works for grown ups too! If you are trying to learn something new, give yourself some grace. Focus on a small step you have mastered and practice it or show it off many times, and then move on. In the long run, you will be smarter and stronger for building competence in the small steps all along, and you will be more confident with your goal when you get there!

Optimizing Therapy Progress at Carolina Therapy Connection

The key to success is realizing that our large or end goals aren’t going to happen overnight, in the next week or maybe even the next year, but this is okay. We tend to take the present moment for granted – it seems insignificant, and we believe the little things we do in the moment are not changing us. At Carolina Therapy Connection, we believe in a culture that embraces the small victories for your family! Each time your child has milestone achievement, we will find a way to celebrate. We believe it is critical to make therapy as fun and motivating as possible by celebrating the small victories as well as major achievements. After all, when children enjoy what they are doing, who they are with and the environment they are in, anything is possible! If your family has concerns regarding your child’s development or goals you would like to achieve, call us at 252-341-9944. We would love to help you and make you a part of our CTC family and culture.

Written by: Susan Hill, MS, CCC-SLP

Phonological Patterns

Posted on January 14, 2022October 4, 2023

What are phonological patterns?

So your child’s speech-language pathologist says your child presents with phonological patterns…What does that mean? Phonological patterns are “patterns of sound errors that typically developing children use to simplify speech as they are learning to talk” (Hanks, 2013). Children often demonstrate difficulty coordinating their lips, tongue, teeth, palate, and jaw for intelligible speech. There are many different patterns that your child may demonstrate.

What is a phonological disorder?

A phonological disorder is when a pattern persists past what is considered “normal” for their age. For example, if your 4 year old still uses the phonological process of “reduplication” (saying, “wawa” for “water”) that would be considered delayed since most children stop using that process by the time they turn 3 (Hanks, 2013).

Typically, if your child is exhibiting several phonological patterns, their speech is difficult to understand or “unintelligible”. You, as a parent, may understand what they are saying because you are familiar with these speech sound patterns; however, other family members and peers demonstrate difficulty understanding your child.

As described above, a speech sound disorder is considered a phonological disorder when:

Phonological processes persist beyond the typical age of development.
Phonological processes are used that are not seen in typical development
A child is highly unintelligible due to the excessive use of phonological processes

What are common phonological patterns and what do they mean?

Assimilation: when one sound becomes the same or similar to other sounds in the same word

Age of Elimination: 3 years
Example: “I want a pip” when they meant to say “I want a sip” (the “s” becomes like the “p” at the end of the word)

Final Consonant Deletion: when a child drops off or doesn’t produce the last sound at the end of a word

Age of Elimination: 3 years
Example: “Look at the bow!” for “look at the boat!”

Devoicing: when a child produces a voiceless sound instead of the voiced sound

Age of Elimination: 3 years
Example: “Where is my back?” For “Where is my bag?”

Voicing: when a child produces a voiced sound for a voiceless sound

Age of Elimination: 3 years
Example: “I want more bees” for “I want more peas”

Stopping: when a child stops the airflow needed to produce a sound and substitutes it with another sound

Age of Elimination: 3-5 years
Example: “my two” for “my shoe”

Fronting: when a child substitutes sounds that they should be making in the back of the mouth with sounds towards the front of the mouth

Age of Elimination: 3.5 years
Example: “Daddy’s tea” for “Daddy’s key” (substituting “t” for “k”)

Cluster Reduction: when a child drops off or deletes one of the consonants in a “cluster”

Age of Elimination: 4 years
Example: “I see a nail” for “I see a snail”

Weak Syllable Deletion: when a child drops off or doesn’t say one of the syllables within a word

Age of Elimination: 4 years
Example: “I want a nana” for “I want a banana”

Deaffrication: when a child doesn’t produce the pressure sound in a combined sound

Age of Elimination: 4 years
Example: “I want ships” for “I want chips” (ch -> sh and j -> zh)

Gliding: when a child substitutes the “l” and “r” sounds for the “y” and “w” sounds

Age of Elimination: 5 years
Example: “The apple is wed” for “The apple is red”

*Examples and explanations are referenced from Adventures in Speech Pathology

How can Carolina Therapy Connection help?

This is a lot of information that can be overwhelming for a parent trying to help their child. We know that you want the best for your kiddo and we want to help! Our team of pediatric speech therapists provide screening, assessment, consultation, and treatment to help children overcome communication obstacles. Call Carolina Therapy Connection at 252-341-9944 to speak with one of our skilled and knowledgable speech-language pathologists. They can evaluate your child’s communication patterns, further explain phonological processes, and discuss the best treatment interventions for your family.

Written by: Brandi Ayscue, MS, CCC-SLP, CAS