FREEBIE Friday: Vocal Abuse Behavior Checklist

I have several different vocal abuse behaviors checklists and they all have different behaviors listed.  However, I wanted a checklist that was fairly comprehensive including all of these behaviors in one, so I took matters in my own hands, made one myself the way I wanted it to look, added my own rating system and a re-assessment column and voila'.  

Here's my Vocal Abuse Behaviors Checklist.  Check it out below and download it via Google documents here!

P.S.  I like to save a few trees by printing front to back and my files are much thinner that way! :)

Enjoy!

Vocal Abuse Checklist

Tip Tuesday! Let's Talk About Voice Disorders!

The "terrible twos" and what I like to call "horrendous threes" seem to be that time when our children are trying to determine their role as an individual in our families.  Temper tantrums are part of everyday life.  So it is not unusual for us to hear crying, screaming and yelling in our homes at any given moment.  However, we must remember that prolonged use of such vocally abusive behaviors can cause our children to have voice disorders.

We as parents are so used to hearing our children screech out in excitement or cry out in frustration that we tend to forget that this type of vocal abuse can cause our children to have voice disorders. 

  
What is a Voice Disorder?
     A voice disorder is defined as an abnormality in at least one of the following:  vocal quality (resonance, e.g. nasal or hyponasal), vocal pitch, and vocal intensity (volume level).

What causes a voice disorder?
     A voice disorder can be caused by a number of things:

• Vocal abuse over a period of time which caused growths on one's vocal cords (known as vocal nodules or polyps).
• Vocal cord (also called vocal fold) movement difficulties due to
• vocal fold paralysis,
• spasmodic dysphonia (when vocal cord movement is tight, jerky, and there are vocal cord spasms with periods of aphonia-lack of voicing),
• paradoxical vocal fold movement (when vocal cords close when they should be open).
• Most child voice disorders are caused by vocal abuse so let's explore that further.

Vocal Abuse can be caused by numerous behaviors.  Here are some more common causes:

• Excessive Screaming
• Excessive Yelling/Shouting
• Excessive Crying
• Cheering (at sports events)
• Singing
• Chronic use of a higher pitch than typical
• Chronic use of louder volume than typical
• Chronic coughing due to colds
• Chronic post-nasal drip due to allergies
• Chronic medical illnesses that affect the throat area (ex. laryngitis, strep throat, etc.)
• Inadequate breath support (not using diaphragmatic breathing)

What are the signs and symptoms of a voice disorder?

• rough/hoarse voice
• breathy voice
• scratchy voice
• harshness in vocal quality
• decreased pitch and volume range
• difficulty sustaining voice and difficulty singing
• moments of aphonia (i.e. unable to achieve voice)

What should I do if I see these symptoms in my child?

• Discuss your concerns with your pediatrician and contact an ENT (Ear, Nose and Throat doctor) or Otolaryngologist to determine if there is a medical reason for your child's vocal disturbances (structural damage vs. vocal cord movement problems)
• Then contact a Speech-Language Pathologist so your child can participate in voice therapy.  **Keep in mind speech therapy will be MOST effective when the SLP knows the underlying cause (i.e. structural damage or other medical issues) and how your child's vocal cords are moving.  This can only be determined by the ENT/Otolaryngologist evaluation.**

What is voice therapy?
     Voice therapy consists of teaching your child the optimal ways of using their vocal quality (resonance), pitch and intensity (volume).  It focuses on reducing abusive behaviors, while improving healthy vocal cord behaviors (e.g. proper hydration, use of proper breath support, etc.).  Voice therapy has been found to be very effective in reducing voice disorders and improving vocal quality.

For further information on Voice Disorders go to American-Speech-Hearing and Language Association website.


If you are concerned about your child's voice, don't hesitate to contact a local Speech-Language Pathologist for a consultation.

Happy Talking!

Let's go on a Speech Corn Maze!

This material has been removed.  Sorry for the inconvenience.

 It's the fall and corn mazes are one of the fun things to do with family and friends.  Why not bottle some of that fun when practicing speech goals?

I made this quick little fun reinforcer activity you can do at home, school or maybe even out at the park...all while working on your speech goals.

Always remember to ask your SLP for guidance on how to use materials found on communicationstationspeechtx.blogspot.com for your child's particular goals.


Corn Maze Reinforcer Activity includes:

• one page of corn maze pictures with points
• two pages of corn pictures with various directions

How can you use this activity at home?

• You can create your own "corn maze" at home. 
• Taking turns practicing your child's speech goals/homework with him/her and then your child then "follow the maze" in order to find points cards to keep score. 
• If you make two copies of points cards (put them on different colored backgrounds) and mix them up, your child can play with you or other siblings.  The one with the most points wins!

You have another idea for this activity?  Comment below!!!!


Enjoy your maze and Happy Talking!!!

Grandparents Day Craft/Card: A simple language activity!

 

Making a craft together with your child is a GREAT way to facilitate language.  Your child learns the function of craft objects as well as several simple vocabulary words ("stickers, construction paper, scissors, glue, markers, paint, painbrushes, etc"  as well as color names)!  In addition, you can practice following simple one-step directions, multi-step directions, and/or directions using location concepts (using prepositions such as "on, next to, above/over, below/under" etc.).  

If you are working on correct speech production, fluent speech, social skills, or correct use of voice (volume, pitch, etc.) ANY language can be used to target those goals. Ask your SLP for guidance or comment below and I will try to help you modify a craft activity accordingly.

For a simple craft my son and I decided to make a grandparents day card (grandparents day is September 9th of this year).  So I searched the site of all sites one goes to for ideas...Pinterest.  I saw this cute card where you use a cupcake liner, as a flower bloom and put your child's face in the middle.  I, of course, didn't have any cupcake liners in my house today...so I tweeked this idea a bit and well...here it is!

First I got out all the materials and laid them out on the table.  However, I made a ROOKIE MISTAKE and I didn't make an example of what we where going to make.  For a two year old...the more visuals the better.  So please please remember NOT to make my mistakes at home...make your child an example first!

We started by "cutting" stems for the flowers.  We talked about what scissors are used for as well as the dangers of using them without adult supervision.  Quite a bit of language for one little task but you'd be amazed how much your children will understand and learn just by hearing you talk.  With LOTS of help and hand over  hand modeling (which is hard as I am a lefty and my son is a righty) we successfully cut our strips of paper!!!  If your child is NOT ready for cutting...you can show him/her and talk about these things or just focus on two words "open, close/shut" every time you open an close the scissors to cut.  Rhymic repetition is a nice way to practice and model new words.

 

Next it was time to glue the stems onto the paper.  More learning...we talked about glue, how it "sticks" things together, and what other things can we use to keep things together (tape, rubber bands, paperclips, etc.).  During this time you can see the concentration on his face as he tries to coordinate both hands (one to glue and the other to hold the paper).  Look at the next picture...

 

See how his tongue is out!  So cute!  It is not uncommon for children who are concentrating on something difficult to make some sort of face as they are "working".  Many children I have worked with will actually open and close their mouths when they first practice cutting (yes, my son does the same thing) because they are concentrating on that "open, close" movement of their hands.

 

On to the next step, gluing the "flower" onto the TOP of the stem.  Great direction following here.  He had to remember to turn the flower over, put glue on the back, turn it back over, place it at the top of the stem and hold down.  Gluing is a GREAT problem solving activity because of the number of steps a child needs to take to actually get that glued object to stick to the paper!

 

Last step, glue his picture in the CENTER of the flower.  It was a new word I used for him.  I usually say middle, but I thought I'd extend his vocabulary by using a synonym.  Synonms are a GREAT way to quickly expand your child's vocabulary.  Just remember to tell them what it means the first time they hear it!

 

And here is the finished product!  Well before we signed our "I love Yous" to it!

Because we had to make several cards, it took some time and we made each card in the same sequence.  After the first card, I began to ask him "what do we do next" to see if he remembered or could problem solve by looking at the first card he did.  You'll be surprised how much you child remembers with a simple visual cue.

Remember, its not the complexity of the craft...its the kind of language you are using when making the craft.  I like to pick crafts that are NOT too complex when I am focusing on language because I want my son to listen to my words more often than trying to figure out how to make a craft!

Do you and your children have a favorite craft you like to do at home?  How do you incorporate language into it?  Please share your ideas by commenting below!

Happy Talking!!!

Ten Ways to Facilitate Communication Skills Through Music!

Using music as a means to improve communication skills is not a new concept.  If you walk into any preschool classroom across the country you will learn that singing children’s songs is a daily occurrence and for good reason. In addition to other numerous benefits, listening to and signing children’s songs encourages development in auditory processing skills, auditory memory, working memory, attention skills, fluency, expressive language, articulation skills, as well as volume, speech rate, intonation, prosody and rhythm control.

Here are ten different ways you can incorporate music in your child’s daily environment to facilitate growth in communication skills:

1.       Sing, sing a song!:  Simply spending time singing children’s songs encourages language development by improving expressive vocabulary, learning pre-academic skills (counting, colors, etc.), improving auditory comprehension skills as well as memory.

2.      Smooth sailing!:  Singing familiar songs slowly facilitates smooth speech for children who are struggling with fluency (stuttering).  Repetition and slow tempo is the key!

3.  Sing out loud, sing out strong!:  Singing familiar songs while changing the volume (whisper, quiet, loud voices) helps your child practice volume control in a fun, stress-free way.  This is the first step to understanding appropriate volume control in various communication situations.  Once a child can control his/her volume, vocal abuse can be consciously reduced for those with voice disorders.

4.      Speedometer!:  Changing the tempo of familiar songs aids in helping children understand they can control their rate of speech.  For those with fluency disorders (stuttering), it also helps to illustrate how using a slower rate of speech (or singing) improves fluency.  You can begin at the typical song tempo and sing faster and slower throughout verses in order to demonstrate these skills.

5.      Speed bump!:  Stopping and resuming songs in the middle of verses actually encourages child participating in singing as well as increases a child’s anticipation of what is coming next.   You need to use your working memory (recalling where you stopped and where to start up again) for this task as well.

6.      Feel the beat!:  Begin by imitating your child's "beats" and then have them try to imitate yours.  As they grow, practice clapping your hands or using musical instruments (play, real, or homemade) to tap out the rhythm of songs.  Children will to listen to rhythm and beat of songs and will realize the faster the song, the faster the beat.  They will begin to understand how speech rate can change from fast to slow as well as improve understanding of prosody and rhythm.  Ats also a great auditory processing task as you can use multiple instruments to make different "beats".



7.      Name that tune!:  You remember this game…hum a familiar tune to your child and have them guess what song it is or, if they are too young to remember song titles, they can sing along with your tune.  This is a great auditory processing task requiring your child to listen carefully to the intonation and prosody patterns of songs and use their memory to recall the song name or words.



8.      The Song Bee!:   (Just like the show on the CMT channel)  Have your child finish the verse to a familiar song you started to sing.  Work on correct syntax (organization of words), grammar (speech term-morphology), vocabulary (speech term-semantics), articulation (correct sound production), and auditory memory skills.

9.      Finger plays!: are a fun easy way to add visual cues to songs.  This give a child gross and fine motor movement while reciting songs.  You can use props, finger puppets, just your hands or grand gross motor gestures to make it really fun!

10.   Name that instrument!:  This is one of my favorit games to play!  You can use previously recorded music or child friendly instruments for this game.  I like to use my “band in a box” which you see above.  Have your child watch/listen at you label and play each musical instrument so they can attach visual and auditory input to that instrument.  Then they can turn around or blindfold them and have them guess which instrument you are playing.  This is a fun activity for vocabulary development, category development, auditory discrimination and memory!

4 yr old Female with Misarticulations and Loud Volume

4 yr old female with Misarticulations and Loud Volume

Q:  "My daughter will be four in less than a month. She was a preemie, but has caught up in most areas. She still uses "h" a lot instead of s, f, t ....ex: hog instead of frog, hurt instead of shirt, hee instead of tree. At what age should I be worried that she needs help? 2nd question ... She talks soooo loud all the time. First her ent said it was bc of hearing loss and it would get better after her tubes were put in. It didn't get any better. :( Anything we can do to help her talk more quietly?? Thank you!!!"

Great questions!  I will address each question separately! 

Q Part 1: My daughter will be four in less than a month. She was a preemie, but has caught up in most areas. She still uses "h" a lot instead of s, f, t ....ex: hog instead of frog, hurt instead of shirt, hee instead of tree. At what age should I be worried that she needs help? 

A:  Let me address the age question first.  The following sounds should be mastered by the following ages:  /t/-4yrs, /f, v/-5yrs, /sh, ch, soft g/-6yrs, /s, z/-7yrs (according to Goldman, Smit, Sander, Templin, Prather).  I do caution parents NOT to look at these ages and say “Ok than my child is fine”.  There are several indicators that would make me question whether an articulation deficit exists.  The first concern I have is that the TYPE of substitution for these sounds (/h/) is considered atypical or non-developmental in nature.  And I wonder how this substitution affects your daughter’s overall intelligibility (i.e. understandability) with people who are not familiar with her speech pattern.  So what can you do?

Step 1: Make sure hearing is within normal limits. 

For parents out there that see similar things and your child has NOT received a hearing screening this may be indicative of a hearing deficits IF there is a systematic deletion of sounds (i.e. your child cannot produce this sound in isolation, or in any syllable or word positions) that have similar frequencies (higher frequencies such as the fricative sounds /s, z, f, v/ and affricates /sh, ch, soft g/).  If your child has not had a proper hearing screening, I would make sure he/she can actually HEAR the sounds before we expect him/her to say them.  With that said, you mentioned she is a preemie and is currently being followed by an ENT so I will assume at this point that you know her hearing acuity is within the normal range.  What’s next?

Step 2:  Make sure your child is “marking” the sounds in question. 

Does your child actually know this particular sound exists by producing it in contexts (e.g. in isolation-if you here her making /sh/ for “quiet” or “spraying hose” sound, or making the sound in other parts of words-maybe she can make a /f, sh/ at the ends of word-maybe she puts the /f, sh/ on the end of familiar words)?  If the answer is YES, than your child marks that sound!  GREAT!  I would recommend you model the sound in the words she does not use it in and describing the sound is a great way to do this.  “Oh, honey remember that “frog” has that “bite your lip sound” in the beginning” or “You know “shirt” has that “quiet sound” in the beginning.  Watch mommy say it.”  Begin with modeling with no expectation of her self-correcting (less pressure and really you are just wanting her to become aware of when to say those sounds).  Many times children will attempt to self-correct just from your model and will begin to try to say it in other instances.  And of course you can do lots of modeling/practice (there are TONS of ideas on the internet but some of my favorites I will add here):  singing familiar songs, playing games that have those sounds… “I spy with my little eye” or Rhyming games, etc.  I usually recommend to parents to just take 5 minutes a day looking at books or in play and model, model, model, those sounds (technical term-bombarding the child’s Auditory System with this sound).  If there are no additional difficulties, a typically developing child will likely pick up on these models and begin to use them.  It doesn’t happen overnight, but if you are seeing improvements, no matter how small they may seem, than you know its working.

Step 3:  If your child is NOT marking the sound (meaning she does not say the sound in any context we may be looking at a more significant articulation deficit), see if your child can make the sound in any context (usually isolation is the easiest context but not always). 

If she can achieve the sounds, than she is NOT AWARE that she is not making the sound itself and it’s a matter of improving awareness while working on these sounds from the simplest to most complex sound contexts (isolationàsyllable level (CV, VC)àsingle syllable words (CVC)àmultisyllabic words or multiple single syllable sentencesàreading or for young children repetition of familiar finger plays, rhymes, books etc.àconversational speechàgeneralization).  Heidi Hanks, M.S. CCC-SLP has a WONDERFUL blog out there called Mommy Speech Therapy (http://mommyspeechtherapy.com/) that explains how this process works.  Type in the search box “The process of Articulation” and you will find a simple and concise explanation of how this process works and what you can do to help your child.  Again there are a TON of free speech therapy activities on the internet that you can find to aid in this practice.

If your child CANNOT elicit this sound isolation after models and practice than we must move to….

Step 4:  Consult a Speech-Language Pathologist near you!  There may be a more significant articulation disorder that requires outside therapy!

_________________________________________________________________________

Q Part 2:  “She [my daughter] talks soooo loud all the time. First her ENT said it was bc (because) of hearing loss and it would get better after her tubes were put in. It didn't get any better. :( Anything we can do to help her talk more quietly?

A:  Thank you for this question!  It really is an important one for several reasons.  Using a higher vocal intensity (technical term for “volume level”) is a form of vocal abuse and over time can result in a voice disorder!  It can also prevent others from wanting to communicate with your child if they feel your child is too loud.  So thank you, thank you for this question! Often times volume is overlooked and is a very important part of communication.

Again, assuming that hearing acuity is within normal limits, this should be a much easier fix.  Many children are not aware of the volume they typically use.  It is not uncommon for children with various medical diagnoses to use a higher volume level (or even an inappropriate pitch-hoarse voice, high pitch, etc.) than would be appropriate for conversation.  However, the good news is that volume level can be practiced and improved upon!

Step 1:  Make your child aware that there are different volume levels for various situations.  Explain that we use a “whisper voice” when we want are at the movies, church, telling secrets, etc. (however you want to describe it).  An “inside voice” is the voice we use to talk to mommy and daddy and our friends when they are next to us.  An “outside voice” is a voice we use when we are playing on the playground. 

Step 2:  Practice makes perfect!  Now you play games and practice using all 3 kinds of voices.  You can make up any game you want to practice these skills. A simple example would be when playing with stuffed animals/dolls, have the dolls use “whisper voices” to tell secrets to each other, an “inside voice” to talk in the doll house when playing, and an “outside voice” (with the dolls far apart to show more distance needs higher volume) when the dolls are outside of the house playing!   

Step 3:  Make a visual to demonstrate volume level and encourage carryover!  Some people use a rating system with numbers or colors showing various levels of volumes.  For PK kiddos I have used a “stop light” with pictures next to it.  Red-“outside voice”-with a picture of kids on the playground.  Yellow-“inside voice”-picture of a family inside, maybe playing or at the kitchen table.  Green-“whisper voice”-picture of someone whispering into another person’s ear.  You can create any visual you think your child will understand.

Step 4:  Post this visual where you are most often in your house and even make one to take with you on errands etc.

When your child is doing a GREAT job, give her lots of praise, and show her at which volume level she is speaking.  If your child is struggling, show her at what level she is currently speaking and at what level she should be speaking to encourage her volume to decrease or increase as needed.  If volume is not increasing/decreasing with visual and verbal encouragement go back to Step 3.  We need more practice!

Great Questions!  Good luck and let me know how this works out for you!