Speech-Language Pathology Archives - Page 3 of 3

Transitioning from Bottle to Cup

Posted on February 15, 2022October 4, 2023

When should my child transition from their bottle to a regular cup?

It’s time to transition off the bottle! The American Academy of Pediatrics recommends transitioning from a bottle to a cup when your baby is about 15 months old. You might think it is time for those adorable sippy cups! BUT, current research is clear, and many therapists are recommending skipping the sippy cup altogether and moving straight to an open cup or a straw cup.

Many parents decide to use a sippy cup because they think that’s what they are supposed to do. Sippy cups were not designed as a tool for proper oral motor and feeding development, but instead were created to keep the carpets clean! The occasional use of a sippy cup is nothing to worry about, as it can be great for those long car rides and times where cleanliness matters. It is important to note that if your child has a medical reason to use a sippy cup, follow your pediatricians recommendations (i.e. some children require a valved sippy cup for safety). Despite the convenience of a sippy cup, parents should be aware that it is easy to become dependent on anything that makes life less messy, so when it’s possible to bring out the regular cup or straw, do it!

Why should I skip the sippy cup?

At only 12 months of age, your baby is developing a more mature adult-like swallow pattern! As opposed to the anterior-posterior suckle pattern infants use with a bottle, at only a year old, the tongue begins to stay in place or even move backward and rise while pressing on the alveolar ridge (the hard, ridged spot just behind the front teeth). The tongue will rise, push, and propel the food backwards! When your little one drinks from a bottle or a sippy cup, the spout prevents their tongue tip from elevating, often forcing the tongue down or requiring them to stick their tongue out in order to drink. If the tongue doesn’t rise to the alveolar ridge at rest and when swallowing, the brain creates a habit to keep the tongue on the floor of the mouth. This can contribute to oral motor weakness, and an impaired oral phase of the swallow.

According to the American Speech-Language and Hearing Association, when the tongue sits low in the mouth it often forces the mouth to rest in an open position, which leads to mouth-breathing instead of your little one breathing through their nose. Long-term use of a bottle or sippy cup may also lead to dental concerns. The immature pattern of an anterior tongue thrust during the swallow increases the risk of pushing their teeth forward and creating a dental malocclusion. The tongue, lips, cheeks, and jaw all play important roles in both articulation of speech sounds and eating, and little ones with weaker oral motor skills may be at increased risk for a speech sound delay.

What are the benefits of using a regular cup or straw?

Open cups and straw cups help build normal movements in oral musculature.
Using a straw helps your child develop lip, cheek and tongue strength.
Open cups provide practice using the mature pattern of swallowing that will allow your child to safely drink and eat.
Straw drinking supports a child’s early articulation of speech sounds.
Regular cups and straws encourage proper breathing patterns and prevent mouth breathing.

What’s the best way to make the transition from the bottle to a cup?

When beginning to make the transition from a bottle to a straw cup or regular cup, it’s important to start small! This process can take time and it’s important to know it won’t happen overnight.

Start by introducing an open cup at mealtimes. You can hold the cup for your child to sip from the side of the rim to get them comfortable.
A great straw sipping cup is the Talk tools Honey Bear Straw Cup, which allows your child to squeeze the bottle so they can get comfortable with using a straw to start out with.
Offer both straw cups and open cups to allow for comfort with various drinking cups.
Use a weighted straw cup, which is spill-proof and allows a child to drink from any angle!

How can Carolina Therapy Connection help?

Your child may need speech therapy if they have difficulty with speech/articulation (pronouncing sounds or words) or using words to communicate. Because the muscles and structures used for speech (such as lips, tongue, teeth, palate and throat) are also used in drinking and eating, a speech and language pathologist may also help with feeding, drinking and swallowing difficulties, also known as dysphagia.

While using a sippy cup does not necessarily mean your child will need speech therapy, it’s considered best to encourage oral motor development by using open cups or straw cups at home! Ditch those sippy cups, and check out the spill-proof options for open cups and straw cups they make these days! Spill-proof….now that’s a concept we can ALL get behind!

As always, if you have any questions about your child development, call our clinic at 252-341-9944 to speak with one of our speech-language pathologists!

Written by: Ashley R. Holloway, 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

Now Offering Free Screenings!

Posted on June 1, 2021October 4, 2023

What is a Screening?

A screening for occupational therapy, speech-language therapy and/or physical therapy is a quick 10-15 minute discussion or observation of your child for potential areas of developmental concern. A screening may be over the phone, zoom or in person. A screening is used to determine whether your child may or may not need a formal evaluation.

What is a Formal Evaluation?

There are a variety of evaluation methods and standardized tests that are designed to assess different areas of functioning including visual-motor, visual-perception, gross motor, fine motor, sensory integration and many others. A child’s performance on each of these tests is compared with the average performance of other children in his or her age group. In addition to these tests, clinical observations are made based on discussion between the parent and the therapist. These formal evaluations allow the therapist to see your child’s current level of function, determine if services are needed, and develop client-centered goals and planning for therapy outcomes.

Everything You Need to Know About a Screenings

One of our amazing Occupational Therapist, Kelly Burton, explains everything you need to know about the screening process in the video below. If you have any questions or concerns about your child’s development or would like to set up a screening, call our clinic at 252-341-9944!

Apraxia and PROMPT

Posted on May 16, 2021October 4, 2023

May is Apraxia Awareness Month

According to Apraxia Kids, for the first time, the entire month of May has been designated Apraxia Awareness Month and corresponds with May is Better Hearing and Speech Month, sponsored by the American Speech-Language-Hearing Association (ASHA). Childhood Apraxia of Speech is a motor speech disorder in which a child knows what they would like to say but has difficulty sending the message from their brain to their mouth. It is a significant problem with motor planning and coordination of the lips, tongue, jaw and palate to produce intelligible speech. Parents of children with childhood apraxia of speech commonly say things like, “No one can understand my son,” “It looks like he is trying to say the word, but can’t get it out,” and “He said that word one time, and then I never heard it again.” Our goal this month, is to educate families about apraxia, spread awareness, and provide resources that may be helpful for children struggling with apraxia.

A quote from Apraxia Kids: “The more people that know and understand Apraxia, the more support children and families will have. Early intervention is crucial. A team supporting a child with Apraxia is crucial. I’ve learned along the way, we don’t know what we don’t know. Let’s help people know about Apraxia!”

What are the signs of apraxia?

According to the American Speech-Language-Hearing Association (ASHA, 2007), the three most common features in children with apraxia of speech are:

Inconsistent errors on consonants and vowels in repeated productions of syllables or words (for example, a child says the same word differently each time he tries to produce it).
Difficulty producing longer, more complex words and phrases.
Inappropriate intonation and stress in word/phrase production (for example, difficulty with the timing, rhythm and flow of speech).

Apraxia and PROMPT

PROMPT (Prompting for Restructuring Oral Muscular Phonetic Targets) is a multifaceted approach used to treat a variety of speech production disorders such as expressive language, stuttering, motor planning, articulation/phonology, and auditory processing as well as cognitive or global delays. PROMPT is a highly successful treatment method for children with motor speech disorders such as apraxia. During PROMPT, a speech-language pathologist manually guides a patient’s jaw, lips, vocal folds, and tongue by targeting certain words, phrases, or sentences. They use touch cues to shape and support the proper movements. In doing so, the therapist helps the patient produce phonemes, or the smallest units of sound that distinguish one word from another. Together, the therapist and child progress through different sounds at a steady pace, moving to new sounds only when the patient is ready. The child learns through assistance and repetition to plan, organize, and create steadily more advanced vocal sounds. For more information about PROMPT, watch this quick video.

Carolina Therapy Connection is now using PROMPT

To be certified in the PROMPT method, a speech-language pathologist attends PROMPT training courses and meets a number of certification requirements established by the PROMPT Institute. One of our amazing Speech-Language Pathologists at Carolina Therapy Connection, Lindsey Grant, is now certified in PROMPT! Lindsay graduated Summa Cum Laude in 2012 from East Carolina University with her Bachelor of Science degree in Communication Sciences and Disorders and a minor in Hispanic Studies. She then continued at East Carolina University, receiving her Master of Science degree in Communication Sciences and Disorder in 2014. While completing her Master’s degree, she completed a research project on the relationship between dyslexia and language. Lindsay has experience working with children of all ages in a variety of settings including school, home, daycare, and clinic. She is a member of the American Speech-Language-Hearing Association, where she received her Certificate of Clinical Competence. She is also a Certified Autism Specialist through the International Board of Credentialing and Continuing Education Standards. Lindsay has a passion of helping children with apraxia of speech make significant improvements to their speech and communication skills.

If you have any questions about your child’s speech development, apraxia or PROMPT, call our clinic at 252-341-9944!