Speech-Language Pathology Scope of Service

By: Anne O’Dowd, Pediatric Speech-Language Pathologist, CF-SLP

What does Speech Therapy Include?

Perhaps your child or another child you know is referred to see a speech-language pathologist from their doctor. When you think about the areas a speech-language pathologist treats, it is easy to assume we work only in the areas of speech and language, as our title implies. This is a common misconception.

In fact, our field is much larger than our title offers it to be. To provide a better view of the areas we treat, below is an extensive list of our scope or service delivery areas. A speech pathologist can help a child in nine key development needs. Please note that this list is not exhaustive, not all service delivery areas are offered at Easterseals DuPage & Fox Valley, and individual speech-language pathologists can specialize in one or several areas. Areas in which we practice vary in development, some continuing to evolve (e.g., literacy) and others emerging.

Learn more about our speech services here.

Speech

Speech refers to the production of speech sounds, individually and in words. Children produce several typical speech errors that decrease over the first few years of life, resulting in adult-like speech. Intelligibility, how well an outside listener without context can understand an individual’s speech, is one quick tool we can use to measure speech development. Below are some examples of the service delivery areas we treat regarding speech:

• Articulation: errors in individual speech sounds
• Phonological: errors that follow rule-based, predictable patterns (e.g., phonological processes of stopping, final consonant deletion, or weak syllable deletion)
• Motor planning and execution: developmental or acquired disorders at a motor/neurological level characterized by difficulty producing consistent, predictable speech patterns

Language

Photo by Keira Burton on Pexels.com

Language refers to expressing and comprehending words through multiple modalities, including speech, writing, reading, speech-generating devices, picture symbols, and gestures. We use language for various intents, including sharing ideas and ensuring our needs are met. Below are some examples of the service delivery areas we treat regarding language:

• Phonology: system of speech sounds and how we combine them to make meaningful words
• Morphology: use of word forms to create new words
• Syntax: combining words to create grammatically correct sentence structures
• Semantics: appropriate use and identification of word meanings
• Pragmatics: social aspects of communication and language use
• Literacy: spelling, reading, writing
• Prelinguistic communication: (e.g., intentionality, communicative signaling, joint attention)
• Paralinguistic communication: (e.g., body language, signs, gestures)

Fluency

Fluency refers to the rhythm of our speech. Typical speech is characterized by occasional disfluent moments (e.g., pauses and repetitions), although a higher frequency of these may be a cause for concern. Below are some examples of the service delivery areas we treat regarding fluency:

• Stuttering: disfluencies in speech, including repetitions, blocks, and prolongations
• Cluttering: abnormally fast and/or irregular rate of speech

Voice

Photo by Stan Kedziorski-Carr

Voice refers to the quality, pitch, and volume of an individual’s voice. A voice disorder is present when one or more of these voice qualities are perceived as different or inappropriate for an individual’s gender, age, culture, and geographic location. Causes for variation in voice can be organic (e.g., structural changes due to aging, vocal fold paralysis) or functional (e.g., vocal fatigue). Below are some examples of the service delivery areas we treat regarding voice:

• Pitch: how “high” or “low” one’s voice is
• Loudness: the volume of one’s voice
• Alaryngeal speech: speech production utilizing a substitute for the vocal folds in the larynx

Resonance

Resonance in speech refers to the production of a filtered sound, beginning at the vocal folds. The sound travels through the pharynx and oral and nasal cavity. As it passes through, it is filtered and enhanced based on the shape and/or size of an individual’s vocal tract. Below are some examples of the service delivery areas we treat regarding resonance:

• Hypo- and hypernasality: not enough or too much sound energy in the nasal cavity
• Cul-de-sac resonance: when sound energy is “trapped” in the oral, nasal, or pharyngeal cavity due to an obstruction

Auditory Habilitation

Photo by Christine Carroll

Typically, when discussing the pediatric population, Auditory Habilitation instead of rehabilitation is used as rehabilitation refers to restoring a skill that was lost. Often, a young child who presents with hearing loss or is Deaf has not yet developed age-appropriate auditory skills and therefore is not restoring the skill. Below are some examples of the service delivery areas we treat regarding aural habilitation/rehabilitation:

• Auditory processing: comprehension and interpretation of auditory information
• Speech, language, communication, and listening skills: as affected by deafness, hearing loss

Learn more about our audiology services here.

Cognitive-Communication Disorders

Speech-language pathologists also provide services for individuals with Cognitive-Communication Disorders.  In the pediatric population, the most common etiologies for cognitive-communication disorders are autism spectrum disorder, cerebral palsy, developmental delay, and traumatic brain injury. Below are some examples of the service delivery areas we treat regarding cognitive communication:

• Executive functioning: includes working memory, inhibitory control, and cognitive flexibility
• Attention: ability to attend to someone or something
• Memory: includes episodic, semantic, procedural, short-term and working, sensory, and prospective memory
• Problem–solving: obtaining, processing, and collaborating the information needed to find a solution to a simple or complex issue

Feeding and Swallowing

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Feeding and swallowing refer to how individuals transport food and drink from their environment into their bodies. Speech-language pathologists are involved in the parts of this process that involve the mouth, pharynx, and esophagus. We collaborate with other specialists, such as nutritionists, occupational therapists, and gastroenterologists, to meet each child’s individual feeding and swallowing needs. Below are some examples of the service delivery areas we treat regarding feeding and swallowing:

• Oral, pharyngeal, and esophageal phase of swallow: components of the swallow that occur in the mouth, pharynx, and esophagus; abnormal swallow can occur in one or multiple phases
• Atypical eating: (e.g., food refusal, food sensitivity, negative physiological response)

Learn more about our feeding clinic here.

Augmentative and Assistive Technology

Photo by Michael Vanko

Augmentative and Assistive Communication (AAC) includes all forms of communication that are used to supplement or replace oral speech to express thoughts, needs, wants and ideas. AAC allows children to communicate more easily and, in doing so, reduces frustrations for the individual and his or her family. There are several forms of AAC ranging from light tech to high tech. Below are some examples of the service delivery areas we provide in AT services:

• Diagnostic Therapy – working with a child to explore access methods that are consistent and least restrictive to a robust communication system
• Assistive Tech/ Speech Therapy – building language skills and learning how to operate the communication system to be able to express wants and needs
• Customization of systems – setting up, maintaining, or generalizing communication systems to all environments
• Consultations – may work with other providers/school team members to ensure consistency of aided language partners
• Parent training – provide parents the tools to implement operations of communication systems and to be a language model

Learn more about our Assistive Technology (AT) and Augmentative and Alternative Communication (AAC) services here.

Speech-Language Therapy at Easterseals DuPage & Fox Valley

If you are concerned about your child’s language or other development, take our free online developmental screening tool for children birth to age five. The Ages and Stages Questionnaire (ASQ) will showcase your child’s developmental milestones while uncovering any potential delays. Learn more at askeasterseals.com. 

To learn more about Speech Language services at Easterseals DuPage & Fox Valley, click here or call us at 630.282.2022.

Books to Improve Mental Health

By: Dr. Citlaly Gonzalez, Clinical Psychologist

Winter weather and a week off of school, what better time to cozy up with a nice pile of books? There is something magical about the world that is waiting inside a book and the places and times you can travel to, the feelings they evoke, and the things we can learn.  

As a psychologist, the opportunity to blend my appreciation for each person’s story and my love of reading has been an incredible thing.  In my work in our Autism Diagnostic Clinic, my job is to include a recommendation to support each child’s development. I find that including a list of book recommendations with each report has been a fun way for parents to support their child’s needs.  

When presented with the opportunity to write a blog about books I would recommend from a mental health lens, I jumped at the chance, but where to start? Books about feelings? Books on tough topics? My favorite children’s books? One blog post can’t cover them all (but maybe a part II or part III can try), so we’ll focus on the magic of reading with your child and what it can do to support connection, increase understanding of feelings and tough situations, and support the child’s sense of self.  

Books on Feelings 

There are so many books about feelings out there! It’s a beautiful thing. It’s best to start with feelings books at your child’s level. This could include introducing basic feelings concepts or stories with more complex social situations. Here are some of my go-to books!  

• For the youngest readers and those whose attention is best supported by simple books try the Feelings Book and Glad Monster, Sad Monster, both of which introduce feelings paired with bright illustrations. Lots of Feelings on the other hand uses photographs for children who might benefit from more realistic representations.  
• In the Boy with Big, Big Feelings, a little boy wonders why he has a “big, giant heart in a world that’s so heavy and kind, where all of the feelings under the sun feel as if they were made to be mine.” He learns that it’s okay to have big feelings and that it can even help us understand and connect with others!   
• A Whole Bunch of Feelings has been a favorite in our house. Each page has a brief introduction to a different feeling paired with an activity or question for discussion. We read a page at breakfast and made it part of our normal routine showing that any time is a good time to talk about our feelings.
• We usually followed up with one page from Breathe like a Bear for a quiet moment of meditation before we get our day started. See the theme, little moments, scheduled regularly, make for some big impact!  
• Think of who and what your child responds to, like their favorite characters. If you have a dinosaur lover, the “How do Dinosaurs” series might be a great place to start. Superhero lovers might be most interested in a book with their favorite characters, Super Heroes Have Feelings Too (DC Super Heroes).

Books on Tough Topics 

Our therapy team is often asked for book recommendations to talk about tough topics. We welcome opportunities to connect families with books that can help them navigate hard discussions. If you are going through a challenging moment, feel free to reach out to your therapist or our mental health team for book recommendations. Your local library may also provide a wealth of resources!  

Photo: Topics to Talk About display at the Berwyn Public Library 

• Books on Making mistakes: For the kids who can’t stand to make a mistake try The Girl Who Never Made Mistakes. Pair it with a conversation about the times you’ve made a mistake and how you recovered. Social-emotional learning happens when children are provided opportunities and models. 
• A Garbage Can Day–  talks about the feelings and choices that come with a rough day. Written by a local therapist and a teacher, this book is paired with a board game for reading and play.  
• When Sadness is at your Door personifies the feeling of sadness, making it easier for younger children to talk about what it feels like for them. It doesn’t look to resolve the problem or make the feeling go away, but to provide language to discuss it, ideas to cope, and reassurance that it is okay to feel deeply.  

• We are often asked for books on grief, change, and loss:  A Memory Box looks at grief from a child’s perspective and suggests an activity to do to keep the person present. The Invisible String uses a more subtle approach and looks at separation, both temporary and permanent, providing language to use when children really miss someone and wished they could be closer. The Fall of Freddie the Leaf is a more abstract book that discusses change through the framework of fear moving toward acceptance. It’s a classic book and good for all ages.  
• It’s not just “therapy books” that can be useful! Sometimes just regular books can open the door to conversation. Alexander and the Terrible, Horrible, No Good, Very Bad Day was a favorite in my home growing up. When one of us was having a bad day, my mom would ask if we were feeling a bit like Alexander. It allowed us to externalize the feeling and provided a touch of humor.   

Books to celebrate your child  

There are tough moments and there are beautiful moments and all of them deserve space and attention. At Easterseals we are dedicated to celebrating each child and their many skills, talents, and unique way of being. The following are some of my favorite books to celebrate children from a strengths-based frame.  (Bonus: These are some of my favorite gifts for my children’s classrooms as a gentle reminder that there are so many ways kids share their gifts!) 

• All the Ways to Be Smart: this beautiful book celebrates the many ways children share their gifts. It’s an important reminder that every child has strengths, and it is our job and joy to find and honor them.  
• All Kids are Good Kids: this simple board book was inspired by a child I saw in our clinic. Her frequent and unexpected behavior led to her belief that she was “bad.” Children (and adults!) don’t always make the best choice, but no child is ever bad, this book reminds us that all kids are good kids. Try these books from the same series too: All Kinds of Kindness, Love Makes a Family 
• I Know a Lot: Another great book to remind kids (and the grown-ups around them) that there are so many important things our kids know, things that matter, things they learn by playing and exploring the world around them. (These books are from the same series too: I am So Brave).  

Books to Support Connection 

• The Rabbit Listened: This is one of my very favorite books for parents to read to their children. Read more about why in this powerful blog written by Natalie Donald, an Easterseals social worker. At its core, the Rabbit Listened gently reminds us that in order to help, we need to first listen. I like to invite parents to identify which animal they think they’re being (Unsurprisingly, I am a chicken. I want to talk talk talk about it all).  Read it with your child and try to see which one you are, and lean in to listen to which one your child best responds to, knowing it can change across situations, moods, and needs.  
• Mama do you love me: This simple board book tells the story of a little girl with a big imagination who wonders what would happen if she did all the things she knew she wasn’t supposed to do. Each time, her mama assures her that some things might make her angry, surprised, or scared, but that no matter what she would still love her, because of who she is.  

The Book You Write Together 

The most important book you read might be the one you write together. How you write it, is up to you and your child.  

• Not all of us can keep up with baby books but we can all keep up with a quick note. I’d like to introduce you to the “My Child Can” journal. Whether it’s in a beautiful notebook, the margins of your planner, or the not-quite-a-book notes app on your phone, the “My Child Can” is a running list of all the milestones and little moments that make you smile. It might be “my child told me they have a best friend” or “My child learned to spell his name.” In this work, we spend a lot of time asking about the things children can’t do (yet), but this journal can be an important reminder of all the things your child can do. You may also choose to work with your child to teach them to do the same and focus on all the beautiful things they can do using an affirmation book. 
• Shared art journal (Draw with Mom): For kids who have started writing and drawing, I love a shared art journal (Draw with Dad). Keep the pressure low and the journal accessible and watch the communication blossom. Some days may be just a scribble or a funny picture while other days might include a more meaningful note, all of it helps support an open line of communication  

Reading is Wellness

Simply reading with your child is the best, no matter what book your reading, the connection between parent/guardian and child, language exposure, and of course the introduction to new themes all have the potential for so many benefits for wellness.

Our Mental Health team often receives requests for books on various themes which we happily oblige. We have recommendations for books on learning about feelings, grief, potty training, divorce, sharing a diagnosis, and more. We have another blog post with recommendations on best children books on disability. We have those recommendations and lots more! But here is my biggest tip, read these books before you think you need them. Have them accessible. Read about all abilities, cultures, and a wide range of challenges and situations. Normalize talking to your child about life challenges, feelings, and tough topics. This way, when a situation of their own comes up, they know it’s okay to talk about it. They will be less resistant to reading about it. They will be more prepared to handle it.  

An added reminder for the parents of children who haven’t yet discovered the magic of books –kids don’t always start out loving books. There was a long stretch of time with my own children when it looked like I was reading to myself or the dog, but I knew that even while running around the room, they were listening. Hearing the stories, exposing them to language, and even the rhythmic reading of toddler books are way to support both connection and reading.

As a bonus recommendation for the kids who are still learning to appreciate books, I love to recommend the Indestructible series and any book with interactive components or buttons. Kids are always taking in pieces from the world around them, whether it’s the words you are reading or the fact that you are sitting, present with them.  

So, if you are looking for a final gift to complete “the something you want, something you need, something you wear and something you read” I hope this list helps you find a new book to add under the tree, a book to quietly add to your library for “just in case” or even a simple surprise for an any day moment to have with your child. 

About Easterseals DuPage & Fox Valley

For additional information on services for children with disabilities, visit: https://www.easterseals.com/dfv/programs-and-services/. The Easterseals’ Mental Health & Family Support team strives to provide children and families with the mental health support they need to help thrive and empower one another. Our work helps caregivers and children experience more joyful interactions through attunement and connection. For more information on our services, contact us at socialservices@eastersealsdfvr.org.

Common Questions About Bilingualism

By: Joanna Nasiadka, M.S., CCC-SLP

Speech-Language Therapy strengthens children’s communication and feeding skills so they can participate fully in daily activities and achieve success. Easterseals DuPage & Fox Valley therapists have numerous years of experience in typical and atypical speech and language development and offer a fun and engaging environment for children to learn and develop their skills. We also have a number of therapists fluent in several language such as Polish (myself), Korean and Tagalog. There are often questions shared about raising a bilingual child and I wanted to discuss the many benefits and what to look for if you suspect a speech delay below.

Q1: Does bilingualism mean my child is equally proficient in two languages?

Being bilingual does not mean that the child has equal proficiency in both languages. It is common for children to have a dominant language. Children can also have a dominant language for specific contexts. For example, a child might speak English at school and communicate most effectively in English when the context is academics but might prefer to talk in their family’s native language while talking about a sport, religion, or while talking to their family members. The dominance of language fluctuates depending on the amount and nature of exposure. There are two types of bilingualism:

Simultaneous Bilingualism:

This type of bilingualism is the acquisition of 2 languages at the same time, typically before age 3.​ Early language milestones are met in typical time and manner in both languages.​

Sequential Bilingualism:

This type of bilingualism occurs when the second language is introduced AFTER 3 years old.

Photo by Stan Kedziorski-Carr

Q2: Will my child be confused if we use two languages at home?

Many studies on bilingualism have shown that using two languages does not confuse a child, even when they are young and learning two languages simultaneously.

Q3: What if my child has a language delay or disorder?

There is no evidence that using two languages confuses a typically developing child OR a child with a disability. Bilingualism can actually be beneficial for children who have disabilities, and it allows them to be active participants in their daily activities. It also allows them to have full social-emotional growth since it will enable them to communicate with family members and friends who have a shared language and culture.

Q4: Will bilingualism cause my child to have a language delay or academic difficulties? Will he or she be behind other kids?

Bilingualism does not cause language delay or disorders in children. It also does not exacerbate delays or disorders that are already present. If a child presents a disorder in one language, they will have the disorder in the second language as well. If the difficulties only arise in one language, this could be a sign of limited language proficiency.

Bilingual children develop language similarly to their monolingual peers. However, bilingual children may have lower proficiency in one of the languages until they catch up to fluent speakers.

• Average time to achieve social proficiency (conversations, social interactions): 2-3 years
• Average time to reach academic proficiency:  5-7 years

Photo by August de Richelieu on Pexels.com

Q5: What are some pros and cons of raising a bilingual speaker?

Q6: What is the best way to support two languages? Should I wait for my child to be proficient in one language before introducing a second one?

Photo by Alex Green on Pexels.com

The best time for a child to learn two languages to be proficient is before 3. Younger children are more likely to develop a natural accent, more likely to become proficient and achieve higher syntax levels in the long run. Therefore, there is no need to wait for your child to learn one language before introducing a new one.

Many families have found success in speaking both languages at home. Other families prefer to speak both languages and spend time reading, writing, or doing activities in each language. A very effective way to help a child learn both languages is to have one caregiver speak one language and a second caregiver speaks the other language. This choice depends on the family dynamic and your preferences.

Q7: My child started to mix the two languages together in the same sentences. Is this normal?

Using both languages or alternating between languages in the same utterance or conversation is very common for bilingual speakers and is called code-switching. Competent bilingual speakers often code-switch for many reasons, including using a word that is not present in the other language, quoting ideas, emphasizing, excluding others from conversation, showing status, or adding authority. Code-switching can happen more in certain cultures and contexts.

Code-switching does require rules to be done appropriately:

1. Must follow the grammatical structure of both languages
2. The word order has to make sense

Photo by Julie Hermes

Q8: How will a speech-language pathologist evaluate and treat my bilingual child with a language disorder or delay?

A speech-language therapist can help determine a speech-language disorder from a limited language proficiency by considering the sound and language rules of both languages that your child speaks. Your therapist will administer evidence-based methods of testing that are adjusted for your child’s needs as a bilingual speaker. These tests include speech-language samples, writing samples, play-based observations and assessments, standardized measures (if appropriate and adjusted), and assessments of ability to learn new skills. If your child benefits from services, treatment will focus on improving speech and language skills while supporting both languages.

Take our Free Developmental Screening

If you are concerned about your child’s language or other development, take our free online developmental screening tool for children birth to age five. The Ages and Stages Questionnaire (ASQ) will showcase your child’s developmental milestones while uncovering any potential delays. Learn more at askeasterseals.com. 

To learn more about Speech Language services at Easterseals DuPage & Fox Valley, call us at 630.282.2022.

Short Stories to Explain the Coronavirus to Children

By: Yvonne D. Anderson, LCSW, CADC, CODP II, Bilingual Licensed Clinical Social Worker

The current pandemic of the novel coronavirus (COVID-19) is a difficult time for everyone and leaves a lot of unanswered questions, especially for children. The following short stories are great resources to bring some clarity and comfort to young children while their normal routines are disrupted. The stories below vary in length and detail ranging from very short to slightly more detailed. I hope you find a story or two that will be helpful for your specific child’s needs!

Caroline Conquers her Corona Fears

By: Kellie Camelford, Krystal Vaughn, & Erin Dugan

This short story answers some of the many questions young children may be having about Covid-19 and why their normal routines are so different. A simple breakdown of social distancing and safety procedures are talked about to help young children understand why certain actions are in place. Overall the story is informative, positive, easy to read, and is a great resource to calm uncertainty and confusion for children. When printed out, the book doubles as a coloring book and includes a page for parent’s and children to write out a simple schedule.

Story Link: https://alliedhealth.lsuhsc.edu/clinics/docs/CarolineConquersherCoronoaFears31820.pdf

Coronavirus: A book for children

By: Elizabeth Jenner, Kate Wilson & Nia Roberts

What is the coronavirus, and why is everyone talking about it?

Engagingly illustrated by Axel Scheffler, this approachable and timely book helps answer these questions and many more, providing children aged 5-10 and their parents with clear and accessible explanations about COVID-19 and its effects – both from a health perspective and the impact it has on a family’s day-to-day life.

With input from expert consultant Professor Graham Medley of the London School of Hygiene & Tropical Medicine, as well as advice from teachers and child psychologists, this is a practical and informative resource to help explain the changes we are currently all experiencing.

Story Link: https://nosycrow.com/wp-content/uploads/2020/04/Coronavirus-A-Book-for-Children.pdf

Dave the Dog is Worried About Coronavirus

By: Nurse Dotty

A book for children about coronavirus that aims to give information without fear.

With everything that is going on at the moment; big changes to children’s routines and lots of stories on the news it can be a really scary time for children.

This book opens up the conversation about coronavirus and some of the things they might be hearing about it and provide truthful information in a reassuring and child friendly manner.

Story Link: https://nursedottybooks.files.wordpress.com/2020/03/dave-the-dog-coronavirus-1-1.pdf

Hello! My name is Corona Virus

By: Manuela Molina

Summary from the author: I have created this short book to support and reassure our children, under the age of 7, regarding COVID-19. This book is an invitation for families to discuss the full range of emotions arising from the current situation. It is important to point out that this resource does not seek to be a source of scientific information, but rather a tool based on fantasy. My recommendation is to print this material so children can draw on it. Remember that emotions are processed through repetitive play and stories read multiple times. Share COVIBOOK and help ease kiddo’s anxiety all over the world. 

Story Link: https://660919d3-b85b-43c3-a3ad-3de6a9d37099.filesusr.com/ugd/64c685_0a595408de2e4bfcbf1539dcf6ba4b89.pdf

I’d rather go out!

By: Deborah Woods

This short illustrated story highlights the use of imagination as a means of dealing with stressful times.

Story Link: https://www.magneticmoms.com/userfiles/481350/file/I%20would%20rather%20go%20out%20story%20(2).pdf

My Hero is You

This book was a project developed by the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support in Emergency Settings (IASC MHPSS RG). The project was supported by global, regional and country based experts from Member Agencies of the IASC MHPSS RG, in addition to parents, caregivers, teach-ers and children in 104 countries. A global survey was distributed in Arabic, English, Italian, French and Spanish to assess children’s mental health and psychosocial needs during the COVID-19 outbreak. A framework of topics to be addressed through the story was developed using the survey results. The book was shared through storytelling to children in several countries affected by COVID-19. Feedback from children, parents and caregivers was then used to review and update the story.

Over 1,700 children, parents, caregivers and teachers from around the world took the time to share how they were coping with the COVID-19 pandemic. A big thank you to these children, their parents, caregivers and teachers for completing the surveys and influencing this story. This is a story developed for and by children around the world.

Story Link: https://interagencystandingcommittee.org/system/files/2020-04/My%20Hero%20is%20You%2C%20Storybook%20for%20Children%20on%20COVID-19.pdf

Also, please don’t hesitate to reach out to anyone in our Social Services department if you and/ or your family need support, resources, etc. We are happy to help. Our staff completes comprehensive assessments to pinpoint what a child and family need to be able to succeed. Working with the entire family, our staff can identify each child’s unique strengths and challenges and then tailor a treatment plan to meet those needs.

Our Social Work and Counseling services can help children and their families learn to grow together. Contact us at socialservices@eastersealsdfvr.org or 630.620.4433.

March is Cerebral Palsy Awareness Month

By: Jack McGraw, Easterseals DuPage & Fox Valley client

While many wear green on St. Patrick’s Day, you can wear green all month long to honor Cerebral Palsy Awareness Month. Why green? The color was chosen to reflect youthfulness and new growth, as well as hope for advancements in treatment and acceptance.

Cerebral Palsy is a disability that is caused by damage to the brain before or at birth. It mostly affects movement and fine motor skills but can have a large range of severity for children. Some children with cerebral palsy can walk or talk, while some may use a wheelchair or assistive technology device to speak like me.

Honestly, living life with a disability can be very challenging but I don’t let it stop me from having an awesome life! I have a lot of friends, a great family and have been a successful student. I graduated from St. Charles North High School in 2017 and am now a proud honors student at Elgin Community College. My communication device uses eye gaze technology and helps me type up essays and lecture notes.

I also love sports. I really, really love sports. While my disability has kept me from participating on teams with my friends, it hasn’t stopped me from being a huge fan. I had the privilege  of being a team manager for football, basketball and volleyball while in school and those were very special experiences. I really felt like a part of the team and got close to some of my teammates.

I have been going to Easterseals since I was a little boy. I have done Physical, Occupational and Speech therapies. Easter Seals has helped me to be as independent as I can be and my therapists have always listened to me and asked me what I want to be working towards in therapy. They have been a great support to me and an asset in my life.

People with disabilities aren’t really very different from people that don’t have disabilities. We enjoy a lot of the same things and want to be treated fairly like everyone else! Having a disability is hard, but I haven’t let it stop me yet! Life is good!

Editor’s Note: Easterseals DuPage & Fox Valley offers many resources for children with spastic and non-spastic cerebral palsy and their families including physical therapy, occupation therapy, speech-language therapy, assistive technology, inclusive day care and parent-to-parent support.

Treatments and therapies can benefit a child with cerebral palsy by helping him or her gain the strength and mobility needed to take first steps, speak first words and maximize their independence.

For more information on cerebral palsy and therapy service at Easterseals DuPage & Fox Valley, visit http://www.easterseals.com/dfv/our-programs/cerebralpalsy.html.

What is an Augmentative and Alternative Communication Evaluation?

By: Laura Van Zandt, MS, OTR/L

Did you know October was National Augmentative and Alternative Communication (AAC) month? AAC is a specialized area of clinical services. Here at Easterseals DuPage & Fox Valley, we are very lucky to have several therapists who specialize in helping individuals find their voice through AAC. We have both Occupational Therapists (OT)  and Speech-Language Pathologists (SLPs) involved in a multidisciplinary team evaluation to determine the best strategies and/or communication systems to help a child learn to communicate.

As an OT, I first became interested in AAC when I was working with a little boy with autism who received a high tech speech output device. It was amazing to see how having his new voice provided so many new opportunities for him. It helped with his overall regulation as he now had a system to share his wants, desires, and needs.

AAC looks different from person to person and varies from low tech options, light/mid tech and high tech systems. If you think your child might benefit from AAC, our team evaluative approach may be helpful. Below is more information on what each team member does to best help your child.

1. Many parents often have questions about whether or not a device will hinder their children’s ability to speak. This is absolutely not the case. Research demonstrates that AAC does not keep children from learning to speak.  In fact, users will make gains in language AND speech because AAC helps a child connect with others, produce successful communication, and provides consistent speech models. The child I described above, went on to learn a ton of new words after he got his device! When we begin to use AAC with toddlers, it doesn’t mean we believe they are never going to talk; instead, it often means, we believe they need a way to have a meaningful connection to others through a common language which helps serve as a bridge to spoken language.
2.  Do try and introduce forms of AAC early. Using AAC can be very helpful for a toddler who is beginning to make gestures, eye contact or sounds to communicate messages, but isn’t yet using spoken language. Often these toddlers are frustrated they can’t communicate certain thoughts and messages. Once they start to see and learn the power of communication through signs, pictures, or more formal AAC apps/devices, they begin to feel a little less frustrated.

3. Model, model, model. When using any type of AAC, we can never model enough. This means that everyone in a child’s life should use AAC too! As with all language learning, AAC is learned because those around the child speak the same language. If you think about it, early communication development (between birth – 12 months) is only modeling – caregivers communicating without any expectation while being connected with their baby using a common language. I love it when my clients bring their devices to therapy. If your child is already receiving therapy services, ask the therapist to use your child’s communication system during sessions to connect and engage with your child. When using AAC, continue to use verbal speech to model and help children understand the pictorial representation of language and develop the words.

4. When you schedule an evaluation, you will see both an occupational therapist and a speech therapist trained in AAC. Both therapists are knowledgeable in a variety of access methods such as hand access, switch scanning, and eye gaze technology. The occupational therapist will specifically look at:

• the child’s overall posture and strength to allow for upper extremity (or any other extremity) use while accessing the communication system
• determine optimal positioning of both the child and the device to ensure the most efficient method of access
• the child’s vision, auditory, and sensory processing needs
• the child’s visual and/or auditory scanning ability
• the child’s visual/auditory tolerance
• any adaptations to engage different sensory systems, as well as monitor for sensory overload and/or assist in sensory regulation for device access.

The speech therapist is extremely knowledgeable in the vast array of AAC communication systems and AAC strategies available. They will help determine the communication system and language page best suited to bridge the gap between the child’s receptive and expressive communication skills. The evaluations are done in a play based manner to help the child feel comfortable. And play is how children learn!

Here at Easterseals we offer a team approach for evaluating children for AAC needs. For children that could additionally benefit from AAC, we will see them for co-treats to help expand their language within play based therapy sessions.

When the child’s specific goal is to assist in overall regulation and play to support device access, then a co-treat can be extremely valuable between Occupational Therapy and Speech Therapy. OTs are trained in setting up sensory rich environments to support regulation and drive play. These activities can be very motivating for your child’s communication. There are endless opportunities to model language depending on your child’s unique development.

To learn more about Assistive Technology at Easterseals DuPage & Fox Valley, click here. 

 

Additional resources: www.speechscience.org

How Speech-Language and Occupational Therapies Work Together

By: Danielle Maglinte, MAT, MS, CCC-SLP

Young children go through many developmental stages before they begin talking. One of the first stages of development is shared attention. In a baby, shared attention looks like the baby turning her head toward mom when she hears mom’s voice or a baby looking into dad’s eyes when dad talks to the baby. As children get a little older, shared attention looks like mom holding up a toy, the child looking at the toy, then looking back at mom and smiling. The next step in developing shared attention is dad looking at or pointing to a toy, the child looks where dad looks or points, then he looks back to dad. These steps towards developing shared attention typically happen within the first 12 months of a child’s life.

When a young child reaches a stage of shared attention where they can follow a caregiver’s point and they can shift their gaze between the caregiver and the object, they start to develop back-and-forth communication. At first, this looks like a child reaching for an object to tell the caregiver “I want that.”

As back-and-forth communication with gestures continues to develop, the child starts to vocalize. In the beginning, these vocalizations are mostly babbling. As parents talk back when the child babbles, these vocalizations turn into jargon where a child sounds like they are speaking in sentences but not actually saying words. Some parents comment that it sounds like the child is speaking in another language. Over time, the child’s vocalizations are shaped into short, simple words, such as mama, dada, and baba for bottle. Children with speech delays often demonstrate limited shared attention. Working to develop strong shared attention will help a child learning to communicate.

One challenge for some children with speech delays is that they need to maintain a calm, regulated state so that they are available for interactions and can share attention with another person. Read more about self-regulation from OT Maureen here.

If a child is focused on seeking sensory input, they may not have the ability to focus on social interactions, developing shared attention and speech with caregivers. Occupational therapy can help figure out activities and ways we can include these activities in everyday life so that a child can remain in a calm, regulated state so that she is available for social interactions. This may look like a child with limited eye contact running away and looking back to see if you are chasing him or a child who is quiet asking for “more” when you stop pushing the swing.

When a child stays regulated for longer periods of time, she will be available for interactions so that she can continue to develop strong shared attention, and move on to using gestures and speech to communicate. By working together, speech-language therapists and occupational therapists can help a family find activities, such as climbing, playing chase, swinging, and swimming  or others that help a child with speech delays stay regulated and available to develop shared attention and communication skills.

To learn more about speech-language and multi-discipline therapy at Easterseals DuPage & Fox Valley visit: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/speech-language-therapy.html. 

Comparing School & Clinic Speech Services

By: Valerie Heneghan, M.A. CCC-SLP/L
Speech Department Manager

 As a speech-language pathologist who has worked both in school-based and clinical settings, I am often asked questions about the difference between these two settings. Overall, they work together! I’ll explain more.

School-based setting

Qualifications

Photo by Pixabay on Pexels.com

Schools have entrance and exit criteria for qualifying children for speech services derived by their district or state. Using formal assessment protocols, children may need to demonstrate a deficit of a pre-set standard deviation before they are eligible for services.  There is usually a wide range of differences from district to district, so it is difficult to predict qualification criteria prior to the evaluation.

Services:

School services can treat children with language, articulation, pragmatic (i.e., social), and voice/fluency disorders to make educational progress. These services may be delivered in a variety of ways including one-on-one, group setting, or push-in to the classroom.

A Clinic-based setting (like at Easterseals DuPage & Fox Valley)

Qualifications

Clinics typically do not have pre-set qualification criteria as they are not regulated by state or governing bodies.  Clinicians will qualify children for services based on clinical judgement using both formal and informal assessment procedures. Coverage for these services however may be dependent on the child’s insurance and/or may be an out of pocket expense.

Services

Clinics may be able to provide more specialized, intensive, or varied skilled services based on functional and/or medical necessity. Often these services are delivered on a one-on-one setting in the clinic, however additional options may be available.

Easterseals

At Easterseals DuPage & Fox Valley , we offer a variety of service delivery models including: one-on-one therapy, community base therapy (groups), co-treatment with multiple services, tele-therapy services in addition to providing services in our clinic, homes, and through our daycare setting.

We deliver a wide range of speech-language services cultivated by upholding ongoing continued education/ certifications, state of the art equipment, and collaboration with multidisciplinary teams.  Our speech-language services work to strengthen children’s communication and feeding skills so that they can participate fully in daily activities and achieve success.

Our speech-language therapy services address functional communication, language expression/comprehension, pragmatics, speech-sound production, voice, fluency, oral motor, and feeding skills. Areas of specialization include but are not limited to the following:

1. The Voice Box: A Motor Speech Lab, focuses on improving articulation, voice and resonance skills through cutting edge and innovative technology.
2. Oralfacial Myology addresses disorders of the muscles and functions of the mouth and face. These may address tongue thrust, dental malocclusions, breathing, speech, swallowing, and chewing.
3. Feeding services seek to ensure safety and adequate consumption of a varied diet. Treatment may address feeding issues related towards chronic diseases or syndromes, disorders of oral motor structure or development, growth disorders, failure to thrive or obesity, tube feedings, food allergies and sensitivities, gastrointestinal disorders, neurological conditions, constipation, diarrhea, sensory-related or Autism Spectrum Disorder-related feeding difficulties.

Our services continue to expand to meet the needs of the current populations that we serve.  Additional initiatives that we have been growing this year include: tongue/lip ties, auditory processing, and Spell-Links for improving spelling and reading comprehension.

I see value in both school and clinical settings!  I often encourage families that I work with, to consider both options based on the needs of the child.  Our therapists work with other disciplines like our Occupational Therapy, Physical Therapy, Audiology or Nutrition teams. We make sure to consult and involve all medical professionals and school therapists that work with a child, to  review goals and achieve maximal outcomes. To learn more about Speech-Language services at Easterseals DuPage & Fox Valley visit http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/speech-language-therapy.html.

5 Tips for Keeping Hearing Aids on Babies/Toddlers

By: Beth Rosales, Au.D, CCC-A.

As both an audiologist and a mother of 2 young children who wear hearing aids, I definitely understand that keeping hearing aids on your child can be a very difficult task. Young children and babies seem to love to get their hands on those hearing aids and pull them right out of their ears! I often hear from parents of babies and toddlers that they have tried to keep the hearing aids on their child, but it seems impossible. As a result the child doesn’t wear the hearing aids regularly, which means he or she is not hearing very well most of the time, and this will likely delay oral speech and language development.

When 2 of my boys ended up needing hearing aids, I knew I had to do everything I could to keep their hearing aids on their ears when they were awake. Well, I can say from personal experience that the struggle is very real when it comes to keeping hearing aids on young babies and children, but utilizing some helpful tools and tips can make it a lot easier.

Tip #1 – Pilot hats

This is best for babies up to 18 months old or so. I fell in love with pilot hats and here’s why you should too. Not only are they cute, but they will make your life so much easier!! For my boys, pilot hats worked better than anything else when they were very young. The pilot hats should be lightweight and ideally have mesh sides or very thin material that will not block the sound from entering the microphones of the hearing aids. It’s important to get a pilot hat that fits well. If it is too loose, then it will be too easy for your little one to get his hands under the hat.

Here are some great places to get pilot hats that work well with hearing aids:

• LilNells: https://www.etsy.com/shop/LilNells  My personal favorite shop! The hats fit my sons very well, and she makes them with snap closures, as well as ties. I love the snap closure because they are harder for toddlers to undo (tie up closures can work too, but tie closures are easier for kids to play with and untie). The shop owner also has options with mesh sides available and unlined (thin) hats, both of which are good for hearing aids. She is great at making custom orders, so if you see a hat you like that doesn’t have mesh sides, send her a message to see if she can make it with mesh sides, or if you have an idea or color you’d like, just send her a message to see if it is possible. Hats cost about $15 – $18.
• Anchor Your Hearing shop: etsy.com/shop/AnchorYourHearing. These hats come with mesh sides which are very breathable so there won’t be too much material covering the microphones of the hearing aids. You can email the owner of the shop through etsy with any questions about orders, sizes, etc. Hats cost about $15-$18.
• Emmifaye shop: etsy.com/shop/emmifaye. Another etsy shop that sells pilot hats for hearing aids with mesh sides. Cost per hat is about $12.
• Hanna Anderson hannaandersson.com. These hats are also an option ($14 for the Pilot Cap – not the “winter” pilot caps which are lined, but rather the regular pilot caps which are thinner, not lined, and less expensive than the winter hats).
• Silkawear silkawear.com. Cost is about $28 per hat.

Tip #2 – Crochet type of Headbands

If pilot hats don’t work, but your child tolerates wearing headbands well, then consider trying crochet type of headbands (worn over the ear, somewhat like the mesh pilot hats). Some patients have found that tight fitting, crochet type of headbands are useful to hold the hearing aids on and these can sometimes be found at stores like Target or Walmart. They can also be found online at stores or on etsy.com.

Tip #3 – Toupee Tape

Hooray for toupee tape! Some children benefit from using toupee tape on the behind-the-ear part of the hearing aid. I use this on my 4-year-old son’s hearing aids when he has gymnastics class! It helps stop his hearing aids from flopping off his ears. This is basically like 2-sided tape that you can use on skin. You can cut the tape into a small square or rectangle to fit onto the hearing aid. Place the tape on the behind-the-ear hearing aid, and then tape it to the child’s head since it is meant for skin contact. Some people have found this helpful to use along with the hats or headbands. My 4-year-old no longer needs a pilot hat, so this is a nice solution for when he is doing sports activities. You likely need to replace the toupee tape daily or whenever you take the hearing aids off your child and then put them back on him. Toupee tape can be purchased at places like Sally’s Beauty Supply (local stores carry this). www.sallybeauty.com.

Tip #4 – Otoclips

I love otoclips! Otoclips are helpful in preventing the loss of hearing aids when a child pulls them off. An otoclip is attached to the hearing aid and it has a cord and clip that is attached the child’s clothing so that if the child pulls the hearing aid off, it will be hanging from the cord attached to the clothing.

Here are some websites that sell otoclips:

• Westone: www.westone.com. Search for “otoclip” and if your child wears one hearing aid, he will need “monaural” and if your child has 2 hearing aids, he will need “binaural”.
• ADCO Hearing: http://www.adcohearing.com/. Website offers a very large variety of tools for hearing aids and hearing loss, including otoclips (under “hearing aid supplies”, “clips and loss protection”).
• The Bebop Shop (etsy.com): https://www.etsy.com/shop/thebebopshop. Very cute otoclip options, as well as some matching hair clips.

For additional tips and resources, visit Hearinglikeme.com. 

Tip #5 – Positive attitude

Have a positive attitude about your child’s hearing aids! Young children pick up on how their parents feel about things. Remember, hearing aids are a very good thing. Hearing aids will help your child hear speech and other sounds that they otherwise would not detect. This will help your child develop oral speech and language skills. So if oral communication is what you want for your child, then hearing aids will help them move toward reaching this goal. Hearing aids are wonderful things!

For more information on hearing services for children or adults, visit eastersealsdfvr.org/hearing.

Communication Breakdown

By: Courtney Leonard, MS, CCC-SLP/L

Editor’s Note: Please welcome, Speech-Language Pathologist, Courtney, to the blog. She is a big fan of music and has sprinkled references to a number of songs below. See if you can spot them all!

The road to verbal communication is a long and winding road. This road is often met with many roadblocks (i.e., mismatches in communication) or “communication breakdowns” as well as many repairs which can then “lead you to the door” of effective and efficient verbal communication. Each breakdown affords us another opportunity to broaden and engage in a wider variety of communication opportunities.

Communication is happening all around you every minute of the day. From a baby cooing in response to a loved one’s verbalizations, a toddler pointing and grunting to his favorite snack, a teenager expressing frustration with the boys her age, to adults imparting wisdom on the next generation- communication is something we do day in and day out. We communicate for a wide variety of purposes including expressing wants, needs, thoughts and emotions. We communicate to build relationships, repair relationships, and grow relationships. We communicate to advocate for ourselves, to forgive, and to make promises. Communication often, becomes such a natural part of our day that we often forget just how complex communication is.

Communication comes in a variety of forms both verbal and non-verbal. The term “communication” often brings pictures of spoken words and conversation to mind; however, communication is so much more.

Before we reach our destination of verbal communication, we have to learn how to be effective non-verbal communicators. We begin growing our non-verbal skills as infants and young babies by learning to regulate our bodies with loved ones, learning to attend to faces, maintain attention to faces, and responding to faces to which we are attending (e.g., smiling when smiled at, frowning when frowned at, cooing when talked to, etc.). As we continue our road to verbal communication, we learn to initiate engagement with our caregivers using our voices and smiles and learn to continue engagement with our caregivers by continually responding or initiating to maintain attention. As these circles become more frequent, natural, and smooth, purposeful non-verbal communication begins starting with gaze shifting (i.e., moving eyes toward preferred activity/toy), and joint attention (i.e., making eye contact with caregiver, shifting gaze to preferred toy/thing to comment on, and shifting gaze back to caregiver). I like to refer to “joint attention” as the skill we acquire so we can say “Did you see that cute guy!?” to a friend without having to use words. As gaze shifting and joint attention strengthen reaching, pointing, and gesturing begin to emerge. Once these skills are strongly in place, then we begin to see first words.

The crazy thing is all of this development happens within the first year of life! These skills often develop without much thought or ado and as parents, therapists, and caregivers, we are hardwired to receive and foster these very sophisticated communication opportunities just as children are hardwired to develop them.

There are times, however, that these skills don’t appear to have developed in children. This may happen for a variety of reasons including: physical limitations, sensory difficulties, early trauma, neuro difficulties, etc. Whatever the reason for the delay in developing these early communication skills, there are a few things you can do in order to begin working on developing these skills.

1. Find times when your child is calm and regulated before interacting. This may be while you are swinging them in your arms, during diaper changes, bath times, laying on the floor or on the couch, or any other time your child is calm. Having calm and regulated bodies provides the foundation for meaningful interactions.
2. Be silly! Use big facial expressions and lots of intonation in your voice to catch your child’s eye. You can sing songs, blow raspberries, play peek-a-boo, or just talk with your child. When you notice they are attending to you, stick with the thing you are doing. Your child may need a break from the interaction at some point (i.e., they may look away or walk away) but you can use the same intonation and facial expressions to try and woo them back into the interaction. This takes a lot of practice and attempts to find what will work. Don’t give up, keep trying new things until you find what works best for you and your child.
3. Move slower. Many times I find that kids need a slower pace in order to engage and maintain interactions. You can still use fun, giant intonation and facial expressions but use them more slowly and more exaggerated. This will give the child a chance to keep up with you and an opportunity to maintain engagement for longer periods.

Many things can impact a child’s development of his non-verbal and verbal skills. At times, it may be appropriate for a child to receive an occupational therapy or physical therapy evaluation and start a treatment plan to work on their sensory systems and/or strengthening of their bodies in conjunction with working on increasing their language skills.

Take our free screening tool, the Ages & Stages Questionnaire , to help measure and keep track of your child’s growth and development.

By detecting developmental delays early, you have the power to change lives and educational outcomes for children! If delays are identified, Easter Seals DuPage & Fox Valley can offer the support needed to be school-ready and build a foundation for a lifetime of learning. Learn more at eastersealsdfvr.org.