Ask a Speech Therapist!

Ask a Speech Therapist!

This page is for parents and educators who have questions about communication skills and/or your child's development as it regards to his or her communication skills.  Feel free to ask your questions in the comment section below and I will attempt to answer them as best I can.


My website has moved to: communicationstationspeech.com  
Althought I continue my blog through this webpage, I am no longer accepting questions on this page.  I apologize for the inconvenience!

20 comments:

  1. My 5yo son has a rather odd speech pattern. He will repeat a word over and over until the next word comes to mind and he can continue his narrative. It isn't a syllable or a sound but a full word and it is random. It is almost always present but certainly more evident when he is making up a story or excited to tell me something. Should I worry and is there anything I should do? Thank you

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    1. d amato,
      I have attempted to answer your question with as much detail and additional resources as I can. Because your question is one many parents have, and it is one that does not have a simple answer I have replied to you on my blog. Go to the link below to read my answer. Feel free to ask additional ?s if you feel I have misunderstood or didn't fully answer your question. I hope this helps! http://communicationstationspeechtx.blogspot.com/2012/09/my-5-yr-old-son-repeats-full-words.html

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  2. I am wondering if you might have any activities or games on your site that would help me work on vowel controlled "R's" with my son. Great site! Thanks in advance.

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    1. Thanks for your inquiry and thanks for visiting my site! I have something in the works right now for articulation however, it is not complete and I am currently visiting family on the east coast for another week or so. I will definitely let you know when I publish those materials. Until then, you still need some materials to work on with your son. There are a number of FREE articulation activities and resources out there for children. Here are some of my personal favorites:

      1) Busy Bee Speech Therapy has a super cute activity called Hungry Hippo Artic at http://busybeespeech.blogspot.com/2012/10/hungry-hippo-artic-freebie.html?spref=fb Here she shows you how to play the game and then you can get the game for FREE at her Tpt store (you need to register with Teachers Pay Teachers...its free to register) at: http://www.teacherspayteachers.com/Product/Hungry-Hippos-Artic

      2) Adventures in Speech Pathology has some great articulation cards and game boards (scroll down the pages to R sounds)at: http://adventuresinspeechpathology.wordpress.com/free-resources/articulation-cards/ and http://adventuresinspeechpathology.wordpress.com/free-resources/articulation-board-games/

      3) Mommy Speech Therapy has some great articulation pictures BUT also has some great resources for sounds in sentence level as well. Check out her articulation worksheets at: http://mommyspeechtherapy.com/?page_id=55

      4) Crazy Speech World has a cute activity "Caramel Covered R Words" at her TpT store at: http://www.teacherspayteachers.com/Product/Caramel-Covered-R-Words (it FREE and directions are included in packet)

      5)Crazy Speech World also has this Eskimo Articulation Packet Freebie at: http://www.teacherspayteachers.com/Product/Eskimo-Articulation-Adventures-for-Speech-Therapy-r-s-l

      These are some really good resources and should get you started! Let me know how it goes! Good luck!

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  3. Replies
    1. Hey I just wanted to let you know in case you didn't see it yet, I've made a Valentine's themed R packet game for initial and vocalic /r/. You can download if for free here: http://communicationstationspeechtx.blogspot.com/2013/01/i-heart-therapy-r-game.html
      Hope your practice is going well with your son :)

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  4. I am a childcare provider and have five chidren of my own. One of the children in my daycare is 3 years, 5 months and 70%+ of what she says is intelligible. Her mother recently told me she did not get rid of her pacifier until she was over 3 (I've only had her for 2 months). Once she told me that, it hit me. The little girl does not move her mouth when she talks. She talks like she is trying to keep her pacifier in her mouth still. If you require her to say something like she's sorry, she'll often cover her mouth shake her head, and have a pained expression on her face as if it is a struggle to talk, but she has and understands words. She just can't articulate enough for anyone, including the other kids, to understand her consistently. She often makes sounds like, "Woah" and "uh-oh" and high pitch squeals while she's playing, but she prefers not to talk. It's not uncommon for her to go several hours without uttering a word. I spoke with mom about potentially putting her in a public school preschool program for children who have special needs, but mom says the doc says this will just work itself out. I've been around A LOT of kids over the years and this is not normal. Should I continue to gently enourage mom to have the little girl assessed, or is the doc correct? Is this okay at almost 3 and a half?

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    1. Kendra, great question! Firstly let me say I'm not overtly worried about her intelligibility level as children at the age of 3 are expected to be ~75% intelligible to unfamiliar listeners. However, with that said, I am a bit concerned with her minimal mouth movements, limited verbal output when she can indeed talk and understand, and her refusal/noncompliance with imitating. There could be several reasons behind these behaviors and I don't want to speculate or shout out diagnoses as I've never seen the child, but I think you are right to be concerned. I would recommend the parent follow up either with the school district who can do an screening and determine if an evaluation if necessary (all of this should be free of charge for the parents if they go through the school), or contact a private/outpatient speech therapist and have a phone consultation discussing concerns in order to determine if further evaluation is needed (private/outpatient will NOT be free but may accept insurance). I always tell parents...doctors are NOT speech pathologists. They really don't know what is typical or atypical and the wait and see method has really hurt so many children in the past. I won't do their job if they don't do mine! I ALWAYS error on the side of caution b/c it never hurts to have a child evaluated and a disorder ruled out if there is no problem. So that would be my recommendation, get an evaluation and if there is an issue than treatment and/or a possible setting change (i.e. classroom) can be discussed after that.

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  5. I am the proud mommy of two beautiful boys. One, almost 4 years of age, the other 18 months of age. My husband is English and I come from an Afrikaans family. We decided to raise our boys using both languages at home. I learnt that children actually have the greatest capacity to learn language in the first 5 years of their lives. I speak Afrikaans to them almost exclusively and so does my hubby with English, although there is the odd word that we refer to in either language for a particular activity or place. It's probably also worth mentioning that my husband and I communicate with one another in English. We have chosen not to have television in our home especially while the children are young so as to encourage physical, object, imaginative and creative play. We also live a very social lifestyle, so even though the children aren't at a play-school/ crèche, they do get to play with other children regularly. Now that I have coloured in a bit of our background, I can state my concern with my 3 yr 10-month old son who is struggling with expressing himself well. He is and always has been physically very advanced and is easily able to keep up with 4-5 year old friends in physical activities, but if I have to compare his speech development , I would say it is delayed with about a year. His vocabulary is extensive. He is able to identify objects (often in both English&Afrikaans), but seems to struggle with pronouncing certain sounds as well as stringing words together to form comprehensive sentences. He only really started putting sentences together at age 3.3months and started doing what I notice most 2 year olds (even my 18 month old) does in repeating sentences after me. I remember when he was younger, he would mumble sounds and then say outside. In other words, he knew that a sentence was usually used to indicate what he wants to do, ie. I want to go play outside, however the word "outside" would indicate enough for mom to understand and meet his need. My parent tend to think that I might have confused him by introducing two languages at such a young age and am encouraging me to switch over into communicating with him in English only. What do you think? It is perhaps worth mentioning that he prefers to communicate in English 80% of the time. My other concern is that because I spend so much time with him and therefore am easily able to interpret what he is saying that it might not be all that great for him to stay at home going forward and that it might be necessary for him to go to school next year (Grade RR). I love the idea of home schooling my children, but would do so in English because of the curriculum and resources I would follow. Would that further confuse him? As it is I do read his story books to him in English. On the odd occasion I will "read" (ie translate) it to him in Afrikaans. So I wonder if my inconsistency of languages, especially lately ( last 3 months) and his already seemingly slower development in speech and language is something I should be concerned about?

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    1. Darryl,
      What a great question! I'm so glad you found my website and decided to ask this question b/c I hope it helps many parents out there who are asking themselves the same thing. Let me first give you KUDOS for doing everything in your power to help your boys develop through natural exploration and play! I LOVE IT!!!!

      Although I don't know your son, you did give me some wonderful description and background that I feel I can share some of my thoughts with you so as to hopefully help you out. Firstly, the old adage that speaking two languages (or more) results in delayed language development has been debunked many many times over the last few decades. So the answer is "NO exposing children to more than one language during their early developmental years does NOT CAUSE language delay"! Whew! Feel better? I hope so, b/c there are many more ADVANTAGES to being multilingual than there are disadvantages. Granted it is not surprising your son prefers English 80% of the time as you and dad speak English together and books are read in English, but just because he speaks English 80% of the time doesn't mean he isn't getting very rich vocabulary development from the Afrikaans you are speaking to him. The truth of the matter is there are some children that are predisposed to having language delays which seem to be unrelated to hearing development, parental modeling and language exposure. We don't know why it happens. Sometimes there is a genetic link but many times there isn't. So regardless of whether you spoke one or five languages if a child is predisposed to having a language delay, they will indeed have a language delay. The difference for the monolingual child is their vocabulary is significantly more reduced as compared to language delayed children who are multilingual.

      B/c this response is too long for this blog, I have to respond in 2 parts. So here goes part 1!

      It definitely sounds like you do have some legitimate concerns about your older son's language development. I would recommend a few things in this case:

      1.) contact a licensed Speech-Language Pathologist in your area and get a comprehensive speech and language assessment. I'm not sure where you live, but if you are in the US, and you contact the public school system in your area, they will have to respond to your concerns (most likely by screening your child to determine if further assessment is needed and if so, they can perform the assessment free of charge), however the process can take several months. Your other options would be to contact a speech language pathologist who is a private practitioner or an outpatient clinic/hospital and set up an appointment for your child to have his speech and language skills assessed. ALL of the above information is crucial for an SLP to know prior to the evaluation so please don't hesitate to share it with them. Keep in mind private or outpatient clinics may or may not accept your insurance so you may have to pay out of pocket for those services. I would recommend you choose whichever path works for you and your family but an evaluation is essential to determining or ruling out the existence of a speech and language disorder.

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    2. Part 2!

      2.) The second thing I would do is try a few tried and true language elicitation techniques at home such as:
      a. Self-Talk: When we talk about what we are doing, seeing, hearing, feeling, tasting, etc. we model language for our kids in a way they will not usually hear it. You are teaching your child how he/she can talk about the things he/she is doing. Your child doesn't need to be paying attention every time you do this, but if he/she is in hearing distance than he/she will still be able to benefit from your use of self-talk. Example: your child is playing in the living room and you are in the kitchen washing dishes you can say things like: "Hot water. Add soap. Scrub, scrub, scrub. Wash the cup." Or you are at the grocery store and your child is in the cart: "Look for apples. Here they are. Red. Round. Apples in bag. Apples in cart." DO NOT EXPECT YOUR CHILD TO REPEAT AFTER YOU...THIS IS JUST FOR HIS "LISTENING PLEASURE"!
      • b. Parallel-Talk: When we talk about what our child is doing, it teaches him/her that he/she can talk about what others are doing as well. Again, your child doesn't have to be paying attention and NO REPETITION IS REQUIRED OR EXPECTED! Example: Your daughter is putting her stuffed animals in her bed. You say "Teddy bear, bed. Monkey, bed. Ann puts you in bed. Animal friends, get in bed!" or your son is playing with cars "Car goes fast. Down the street. Johnny drives the car. Drive too fast! Crash!" REMEMBER TO ONLY NARRATE WHAT YOUR CHILD IS ACTUALLY DOING. DON'T TRY TO GIVE DIRECTIONS OR SUGGESTIONS FOR PLAY.
      • c. Echo then Expand: Echoing what your child says then expanding upon those utterances teaches your child how to combine more words to create new and different multi-word combinations. You can use this technique at various stages of communication not just at the single word level. REMEMBER YOUR CHILD IS NOT EXPECTED TO REPEAT YOUR EXPANSIONS. Example: You child says "Up" and you say "want up", your child says "daddy" and you say "daddy work", your child says "more milk" and you way "want more milk", your child says "baby cry fall" you say "The baby fell and is crying".
      (This exert is copied directly from my blog post on ways parents can facilitate language found at: http://communicationstationspeechtx.blogspot.com/2012/07/parents-what-you-can-right-now-to.html) Feel free to read the rest of the blog for other ideas if you haven't already. Keep in mind your modeling will be above the level your child is talking at right now. So if your child is using 3 word sentences you are modeling 5+ word sentences, and so on.

      What is important during the time you are trialing these techniques is to see if after a week or two of using each (and depending on your child, you may want to trial one technique at a time to determine which works for your child) your child is responding to you differently or using more language (regardless of whether it's English or Afrikaans). IF your child is showing improvement with these techniques that will not only be wonderful but will also be very important information to share with the speech pathologist at the evaluation.

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    3. Part 3!

      3.) The third thing I would do, is continue to provide such a wonderful language-rich environment for your children. Both of your children are benefiting greatly from the exposure to two languages.

      4.) The lasting thing I would have you consider is that regardless of whether your child requires speech therapy or not (determined by the evaluation), continue to consider your dream of homeschooling. Your child can always get speech therapy services on an outpatient basis (even in the schools although you may have to provide the transportation), and working closely with your child and your child's speech language pathologist will help you find the best ways to teach your son. If you are as dedicated to your child's development as it sounds like you are, I encourage you to explore ALL options for your son and choose what works best for him. If it's homeschooling than do it and don't let anyone else tell you otherwise!

      Best of luck to you!

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  6. Hello,
    My question is about my four year old. I am a stay at home mom and she and I are never apart and I wonder if she has a speech delay or maybe other developmental issues. She is good with colors, numbers, and repeating things she is taught but she cannot tell me anything about herself. From her favorite color, to what she wants to eat, if she needs help with something she can't find, or how her day has gone. I have finally gotten her to tell me she is hungry but she won't tell me what she wants, and she will burst into tears if there are multiple choices. When I tried to get her evaluated through our school district the people more or less hinted that they believed it to be autism, my daughters father wanted to hear nothing of it an feel she is simply delayed in speech. I try flash cards, videos, and ask open ended question but she will only repeat what I say. I'm sad for her when we are in public and people ask her things and she simply repeats them, or covers her ears and hums. My husband thinks I'm trying to label her, but I know that this can't be normal seeing as she turned 4 in may and I have been doing flash cards, talking with her, videos, crafts and the works to get her to speak since she was 2 and I realized she lacked in communication. If she is asked too many questions she will start to bawl, my husband thinks she is being stubborn, but I no longer want to hinder her because of her fathers fears. Does this sound like something you've heard of or seen? She repeat what is asked of her, if she remembers a phrase that worked for something else she'll use it if thinks she's in trouble. For instance, if in one situation I ask "Don't do that again do you understand, say yes mommy", she'll respond, "Say yes mommy". If in another situation I'm like why did you do that, you could hurt yourself?" she'll reply "Say yes mommy" because that response worked previously. I don't know what to do.

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    1. Cookie,
      First let me say, yes from what you are describing you have a right to be concerned! I have seen children with immediate echolalia (immediately repeating all or parts of a phrase, sentence or question after hearing it), and delayed echolalia (repeating a familiar phrase, sentence for a communicative purpose however the repeated phrase may not quite make sense). These are a sign of a language delay (receptive and expressive it sounds like in this instance). Is it autism? I cannot tell you that as I do not know your child and as an SLP, I alone cannot diagnose autism. But these are concerning signs. I recommend you contact your local school district immediately and have your daughter evaluated. So much learning occurs between birth-5 years of age, it is so important to provide children with delays appropriate services prior to kindergarten if possible. I understand your husband may be struggling with accepting the possibility that your daughter may be delayed but I recommend getting her evaluated first. If there is a delay, allow her to receive the services she needs as quickly as possible. Your husband sounds like many parents I have met. It's so hard to even think there might be something wrong with our own children. But please don't let his fear stop you from getting your child the best help you can. Take care. I hope it all works out for you!
      Maria

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  7. Do you think there is a correlation between delayed speech and a young child not feeding him/her self? Is it possible that the lack of oral stimulation could cause an unawareness of the child's own mouth and delay their progress?

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    1. I apologize for the late response. I am no longer updating this blog as I have moved to a new website communicationstationspeech.com and do not check this page often. However, to answer your question in a nutshell, there can be a correlation between poor oral motor coordination (that may be evident in poor oral management of food) and poor speech production. There are a few underlying causes to these behaviors such as oral motor weakness, motor planning problems, poor oral sensitivity, inability to control articulators, etc. A thorough evaluation by an licensed speech-language pathologist could provide differential diagnosis needed to determine the underlying cause and possible therapy solutions. I would recommend you contact you local school district or private SLP if you suspect a speech or language delay and/or note your child has difficulties managing food orally. Best of luck to you! Again so sorry for the delayed response!

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  8. Hello,
    My son is five years old and he'll be turning six in January. For a couple years now, ever since his dad and I split up, he has developed this tick with saying the word "hey" before everything he says. For example: "Hey, hey, hey, hey, can we go the park?" He'll say it anywhere between 2 to 6 times. Or Hey mom hey mom hey mom. Hey is the word he uses almost 85% of the time. Sometimes he'll repeat other words or phrases. He also sometimes gets stuck with a word in the middle of a sentence. For example: "Hey, hey ,hey, hey mom why is that paaaaaaaarrot green?" He goes through stages of when it's really bad and then not so bad, but it never goes away completely. He also talks very fast and has been diagnosed with ADHD. His kindergarten teacher hasn't said anything to me, but I don't know if that means anything. I thought it was just something he was going through with the stress of his dad and I separating and figured he would grow out of it. But he hasn't. Should I take him to see someone? And who should that someone be? Should I be really worried? Have I waited too long? I just didn't want him to feel he was talking "wrong" or something. His dad always gets on him about saying "hey" so maybe that has something to do with it?
    Jessica

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  9. Hello,
    My son is five years old and he'll be turning six in January. For a couple years now, ever since his dad and I split up, he has developed this tick with saying the word "hey" before everything he says. For example: "Hey, hey, hey, hey, can we go the park?" He'll say it anywhere between 2 to 6 times. Or Hey mom hey mom hey mom. Hey is the word he uses almost 85% of the time. Sometimes he'll repeat other words or phrases. He also sometimes gets stuck with a word in the middle of a sentence. For example: "Hey, hey ,hey, hey mom why is that paaaaaaaarrot green?" He goes through stages of when it's really bad and then not so bad, but it never goes away completely. He also talks very fast and has been diagnosed with ADHD. His kindergarten teacher hasn't said anything to me, but I don't know if that means anything. I thought it was just something he was going through with the stress of his dad and I separating and figured he would grow out of it. But he hasn't. Should I take him to see someone? And who should that someone be? Should I be really worried? Have I waited too long? I just didn't want him to feel he was talking "wrong" or something. His dad always gets on him about saying "hey" so maybe that has something to do with it?
    Jessica

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  10. Jessica, from what you describe, it does sound like there is a possibility that your child is exhibiting some deficits in fluency. However, only a complete evaluation by a licensed speech-language pathologist can determine if there is a true disorder that requires therapy or if there are techniques you can trial at home. I would recommend you contact your local school district or a local private speech-language pathologist for further evaluation and guidance. Don't worry about waiting too long. If you feel there is a problem, tackle it now and see what the SLP says! Take care!

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