Tag Archives: speech language therapy

Speech and Language Evaluation: What to Expect

By: Jennifer Tripoli M.S.Speech Language Pathologist

You and your child may wonder what to expect when participating in a speech and language evaluation. Many children (and parents!) feel less anxious when they know ahead of time what they will be doing. Of course, the outline of a speech and language evaluation depends on the age of the child and the areas of need. Below is a general outline for a speech and language evaluation:

1. Parent Interview

Parents are the best reporters of their child’s development. They know their child and can paint a clear picture of their child before the speech pathologist begins the formal assessment. A formalized assessment does not always “pick up” everything that should be known about a child. A caregiver or parent’s role in a pediatric speech and language evaluation is crucial in helping the speech pathologist determine your child’s needs. During this interview, the therapist will usually ask you why you have come in for an evaluation, and ask about your concerns and goals for the evaluation.

2. Case History

A case history usually includes a medical history and developmental history. Typically, the speech pathologist is able to review provided information prior to the evaluation, but often there are additional questions that need to be answered.

A medical history includes any medical issues that your child has encountered since birth or before birth. Often this includes, but is not limited to pregnancy/birth history of the mother (e.g. complicated pregnancy, premature birth, complicated delivery), major surgeries, procedures or tests (e.g. tonsillectomy/adenoidectomy, ear surgeries, brain surgeries, hearing screenings/tests, MRI/CT, etc.), significant illnesses, infections or injuries (e.g. chronic ear infections, chronic congestion, respiratory illnesses) and/or hospitalizations.

It is also important for the speech pathologist to be aware of any specialty physicians your child has seen such as otolaryngologists, gastroenterologists, neurologists, etc. A developmental history is taken in order for the therapist to understand your child’s developmental progression. Developmental histories include all areas of development; not just speech and language milestones. They can include when your baby first sat unassisted, crawled, walked, babbled, etc.

3. Speech and Language Concerns

During this part of the evaluation, the therapist will ask more detailed/specific questions related to your child’s speech and language skills. The types of questions will depend on your child’s age and the type of evaluation. The therapist will ask you questions related to your child’s expressive language skills, receptive language skills, social/pragmatic language skills, oral motor skills, and speech sound production.

development2

4. Discussion of Previous Therapies

It is important that your therapist knows what services your child has participated in previously. Has your child received early intervention services? School based services? Other private therapies? You should be prepared to explain the other therapies your child has participated in including occupational therapy, developmental therapy, physical therapy, or behavioral therapy. Please be specific in the goals of each of the therapies if applicable.development

5. Formal Assessment

01_Lucas_VasquezThe point where the therapist begins the formalized assessment can vary significantly depending on the age and deficits of your child. For a young toddler, this part of the assessment may be play based. The clinician will likely be observing your child’s current communication skills in a play setting while administering a standardized or norm referenced test. The therapist may ask to observe you playing with your child.

For a preschool or school aged child, a standardized/norm referenced test would likely be administered depending on the abilities of your child. This would yield a score that will compare your child’s skills to other children his/her age. A standardized test will likely be your child looking/naming pictures in a book and answering questions.

The clinician will also interact with your child in a less structured way by engaging in conversation or asking questions related to his/her life. The therapist may also take a language sample, which will analyze your child’s expressive language skills and speech intelligibility (ability to be understood by others). Additionally, the therapist will likely complete an oral motor assessment if appropriate in order to examine your child’s oral structures. An oral motor assessment usually asks the child to do certain movements with his/her lips, tongue, jaw and face. The therapist may also have your child eat/drink something. Though this is not a feeding evaluation, it is often difficult to separate speech and feeding skills.

6. Discussion of Results and Recommendations

Toward the end of the evaluation, the therapist will discuss your child’s results and make recommendations for any further evaluations needed. If your child would benefit from therapy, a recommended frequency would be given (e.g. weekly therapy, twice weekly, monthly, etc.) At this time, you can ask questions regarding the evaluation or your child’s prognosis.

Think your child may need a speech and language evaluation? Learn more about speech and language services provided at Easter Seals DuPage and Fox Valley here.

 

Indulge! Language is sweet

By: Jennifer Tripoli M.S., CCC-SLP 

With the holidays around the corner, more than likely you will be baking some sweet treats this season! Believe it not, baking can be a great context to practice language skills. Here are a few speech and language skills you can work on while making your desserts this holiday season.

  1. Following directions- auditory comprehension of 1 and 2 step directions (e.g. Get out the eggs from the fridge and put them on the counter) and reading comprehension of written directions (e.g. following written recipe).
  2. Sequencing- doing steps in the correct order is key to baking! Have your child retell you the steps to making the dessert once it is completed.
  3. Inferring/Predicting- ask your child what he/she thinks you will need to complete your recipe. “We are making chocolate cupcakes, what do you think we may need.”
    • Inferring is a child’s ability to relate known information and apply it to a new context. This is an important skill not only for language, but also academic and social success!
    • Predicting– ask your child what he/she thinks will happen prior to each step in the recipe.
  4. Describing Skills- have your child describe what he/she is seeing, thinking, feeling, smelling, and tasting! Baking provides a rich sensory environment that allows for great practice with using different adjective/attributes (e.g. “this chocolate feels sticky and gooey, looks brown, and is smooth).baking cookies
  5. Improving vocabulary- baking is a great opportunity to introduce your child to new vocabulary words that they may not learn typically be exposed to such as utensils (e.g. whisk, spatula, etc.), appliances (e.g. oven, mixer, etc.), and unique verbs (e.g. beat, stir, bake, sift, etc.). You can also have your child name other desserts they know or like to eat!
  6. Problem solving/safety- all children should be baking with parent supervision, but this provides an opportunity to teach problem solving and safety skills. For example, you can ask your child questions such as “What should I do if I burn my hand?” or “What do I need to wear when I take the cupcakes out of the oven?”
  7. Planning/organization skills-have your child take part in the entire baking process from the beginning. Have he/she make a list of ingredients, go shopping with you, and pick out what is needed.
  8. Story retelling- have your child tell people who were not present during the baking session what you made! E.g. “Tell Aunt Kelly the chocolate brownie story.”

IMG_3398

Now that I have shared the different language skills you can work on while baking, I better give you some yummy recipes to try these out!

I follow a blog on Facebook called “Super Healthy Kids” and they post some amazing, healthy, kid friendly recipes (including desserts!). I highly recommend giving them a “like” so you can follow along too! Also, you can check out these best holiday baking recipes from food network! Also, there are some fun and useful tips for baking with children from Food Network.

Did I really have to convince you to go make something yummy? Life is short, eat dessert! HAPPY HOLIDAYS!

Are you looking for holiday gift ideas for kids? Our therapists have suggested toys and games they use in therapy that can be purchased for our Centers as a holiday gift. This Wish List also makes a great gift guide, as it is therapist recommended!

To learn more about Easter Seals DuPage & Fox Valley Speech & Language Therapy click here.

Why Treat the Rib Cage?

By, Laura Znajda, PT,  Manager of Community Based Therapy and Continuing Education

Photo by McKenzie Burbach
Photo by McKenzie Burbach

When I went to Physical Therapy school, the entire unit on respiration and the musculature that supports it consisted of a self-study chapter.  With so little importance placed on this subject in school, I was surprised to see what an impact treating the rib cage has on my pediatric clients.  Learning about the way the rib cage changes in structure and function through normal development, and then what happens when a baby is born prematurely or has poor trunk strength, was a big eye opener for me.  Delving into this topic, the most important thing I realized is how rib position could affect not just breathing, but so many other areas of development, including motor skills like sitting, dressing and talking.

If you have put off learning about the rib cage because you think it won’t have a productive impact on your clients’ outcomes, ponder these reasons to add rib cage treatment to your repertoire:

  • The ribs are connected to the spine and need to move properly in order for the spine to move in all directions—we all know spinal movement is needed for everything from sitting up straight to swinging a baseball bat.
  • The ribcage needs to move downward, usually between 8 and 24 months of age, in order to gain a more efficient breathing pattern.  (the newborn pattern uses the diaphragm only; this normally changes over time to include using muscles all around the trunk to expand the ribcage in 3 directions, which allows the lungs to expand fully.  When the lungs can expand fully, the child can take deeper breaths and move air in and out more effectively.)
  • The rib cage is connected to the shoulder via the collar bones and shoulder blades.  The ribs need to move downward after infancy in order to allow the shoulders to work properly for activities such as reaching overhead and dressing.
  • Normally, a baby or child can change his breathing pattern when the body needs more stability for difficult tasks or when he needs to breathe faster under stress.  If the ribs do not move normally or are not in the right position, the child will only have one breathing pattern and might learn to hold his breath to gain stability.

    Photo by Petra Ford
    Photo by Petra Ford
  • The lower ribs need to move inward when lower trunk musculature contracts to produce an effective cough, which clears secretions from the lungs and upper airway.  When mucous is not cleared from the lungs, it can become infected and cause a pneumonia.
  • When trunk musculature is working properly to contract the rib cage with control, airflow over the vocal folds is controlled in such a way that allows the ability to produce sounds properly for voicing.

Normal development of motor skills that typically occurs from birth until the age of 2 facilitates the muscle lengthening and strengthening that moves the ribcage into its mature position and provides effective breathing patterns for the child.  When motor skills develop atypically, muscle lengthening, strengthening, and rib mobility must be provided by a Physical Therapist, Occupational Therapist, or Speech-Language Pathologist trained in this type of therapy.  The therapist must also instruct parents in exercises to do at home for the very best result.

The therapy staff at Easter Seals DuPage & Fox Valley are invested in learning more about this frequently overlooked area of treatment and are hosting a continuing education course this month to expand our skill base. Click here to learn more from Rona Alexander, PhD, CCC-SLP, BCS-S, C/NDT.

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.