Tag Archives: speech

Beyond the Sippy Cup

By: Jennifer Tripoli, M.S., CCC-SLP

I often get asked the question “Should my child use a sippy cup?” It’s a difficult question to answer. Sippy cups were initially invented in the 1980s by a mechanical engineer who was sick and tired of cleaning up his son’s juice mess around the house. He uniquely devised a prototype for the no spill mechanism and just like that problem solved! He eventually sold his patent to Playtex ® and the rest is history as this became the go to type of cup for babies learning to transfer from bottle to cup.

I am sure you probably see tons and tons of children walking around the mall, playing at the park, and in the car with their sippy cups. This is the era of “to go” cups. Everyone, including adults bring their drinks (coffee, tea, water) to their next destination. I understand the convenience of sippy cups for parents and quite frankly I get it, but hopefully I can convince you to try out some other convenient cups that will support your child’s oral motor and speech development.

So why are they really SO bad?

  • Promote immature tongue movement pattern or suckle
    • Sippy cups promote an anterior-posterior tongue movement pattern, similar to the way an infant extracts liquid from a bottle or breast (suckle pattern). We want to begin to promote a more upward and backward swallow pattern for infants and toddlers by way of an open cup or straw cup. Sippy cups promote a suckle pattern especially with continued use.
  • Promote inappropriate tongue position for swallowing
    • The spout on the sippy cup can anchor the tongue tip down during swallowing. The only way for the tongue to move is forward. During a mature swallow pattern the tongue tip elevates to the area behind the upper teeth (alveolar ridge) as the tongue moves upward and backward.
  • Promote speech sound errors
    • Continued and overuse of sippy cups (and pacifiers!) promote the tongue to rest forward in the mouth. This inappropriate resting tongue position can directly impact your child’s ability to produce certain sounds. For example, a child may produce the ‘th’ sound (a frontal produced sound) in for an ‘s’ sound (‘tho’ for ‘so’). It is important to note that not all children who use sippy cups will have speech sound errors. My thought is though let’s set our children up for success by using developmentally appropriate cups!
  • Poor dental development and Dental Caries
    • Sippy cups can cause cavities and tooth decay. If your child is sipping on fruit drinks, milk, or any other sugary drinks, sugar can be left on their teeth which will cause the enamel to erode away. Sippy cups (and pacifiers!) can also cause misshaped oral cavities and affect resting tongue position.
  • Risk of Injury
    • In my research on sippy cups, I came across a study proving sippy cups can be dangerous?! Who would have thought?! A study conducted in 2012 by Dr. Sarah Keim at Nationwide’s Children Hospital in Columbus, Ohio stated every 4 hours a child in the U.S. is rushed to the hospital due to an injury from a sippy cup, bottle, or pacifier. Dr. Keim stated this likely occurs due to the child learning to walk. As they are learning to walk, they trip and fall often. If they have a bottle, pacifier, or sippy cup in their mouth they can injure themselves.

So what’s the alternative?

  • Open cups
    • Many parents think I am crazy when I suggest an open cup for a young child. Yes, it may seem a bit ambitious, but an important step in the development of good oral motor and feeding skills! When children drink from an open cup they are developing a more mature swallow pattern. A smaller open cup (with a smaller rim) will allow your child to have better motor control of the liquid. You can first try giving your child an open cup to practice without liquid (place a preferred pureed on the rim of the cup) or you can use thickened liquid in the cup for a slower flow.
  • Straw Cups
    • It may take your child some time to learn how to extract liquid from a straw, but be patient and the skill should develop! When choosing a straw cup choose a straw that is thin versus thick. Also make sure the straw is not too long. It is possible for young children to drink from a straw cup with a suckle pattern. Some children are able to extract liquid from the straw by placing the straw under their tongue. To avoid this, you can slowly cut the straw ¼ inch at a time until the straw is short enough that the child cannot place his/her tongue underneath it.

Here are a few of my favorite open cups and straw cups!

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To learn more about development milestones and speech-language therapy services, visit eastersealsdfvr.org.

 

 

 

 

 

 

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Communicative Temptation: Arranging Your Environment Can Get Your Child Talking!

By: Jennifer Tripoli, M.S., CCC-SLP

Communicative temptation is a speech therapy technique I use consistently during my sessions with children who are late to talk. It is an easy strategy that can be implemented across environments, not just in therapy! Communicative temptation was coined in 1989 by Wetherby and Prizant in order to use a creatively engineered environment to facilitate communication in young children.

In short, communicative temptations are what they sound like. You are going to tempt or entice your child to communicate by setting up your environment in a specific way. Sometimes we do not give late talkers a chance or an opportunity to learn/use communication. Not because we do not want them to talk, but more so because we anticipate their needs way too frequently.

Is your child ever struggling to open a container full of a preferred food and you jump in and open it for them? Do you ever anticipate the type of snack your child would like without allowing them to tell you? Are all of your child’s preferred toys in reach? Here are a few examples of ways you can tempt your child to communicate! 

  • Placing a highly preferred toy or food item out of reach for the child. Key is in sight but out of reach!
  • Placing highly preferred objects inside a clear plastic container that the child cannot open on their own
  • Placing a lock on a cabinet door where a preferred object is located
  • Eat a desired object in front of the child but don’t offer it to them
  • Take the batteries out of a preferred toy and wait for the child to communicate the toy is not working properly
  • Initiate a reciprocal interaction game such as “peekaboo”, then stop and wait
  • Blow bubbles with the child a few times then place the bubbles out of reach or hand the child the bubbles container without the wand
  • Push the child on the swing a few times and then stop
  • Block the entrance of the slide they want to go down
  • Change a familiar routine

Hopefully these examples, will allow you to think of other creative ways to engineer your home, daycare, toy room, etc. to allow for more communicative opportunities! The outcome is not always “talking”, it can be ANY type of communication! A gesture (e.g.

Nicholas_T
Photo by: Christine Carroll

pointing or reaching), a facial expression, a word, a phrase, etc.! The key here is WAITING. Often times, we do not give children who are learning language enough time to communicate. We jump in quickly and eliminate that opportunity to communicate independently.

Depending on your child’s language level you may need to model what is expected first (a gesture, a word, etc.). For example, if a child is attempting to open a locked cabinet you may first need to model the word “open” and then slowly fade this model. You eventually hope that the child will independently use the word after they are “tempted.”

Take a quick look at your home today. How can you make a few small changes to facilitate communication in your environment? How you can change how you interact with your child to increase communicative opportunity?

For more information about our speech services and other programs at Easter Seals DuPage & Fox Valley, click here.

7 Tips for Learning and Loving it!

By: Jessica Drake-Simmons M.S. CCC-SLP

Does helping your child with their homework ever feel like a laborious task?  These learning strategies will help you teach your child in a way that increases their understanding and retention.  Above all, these tips are meant to make the learning journey an enjoyable experience for all of those involved!

  1. Relate new information to known information.  Our brains are pattern-seeking devices.  They are always searching for associations between information being received and information already stored.  Linking new information with familiar information creates a connection that your brain will hold on to.blog
  1. Multi-Sensory involvement: the more varied experiences a child has with a new concept, the more neural pathways will be developed.  Whenever possible, teach the concept in a way that the child can experience.  If your child is learning about volcanoes, you can have them:

Role play being a volcano OR create a visual Venn Diagram comparing it to something they already know about.
volcan

  1. Active learning-the more a child is involved with the information, the more efficiently he will consolidate and recall it.  When a child passively receives information, he will understand and remember less.  Passively receiving informcloudation would be listening to a lecture or passing your eyes over the print from beginning to end in a chapter. Active learning would involve making predictions about the chapter, taking notes and discussing what was read or learned.
  1. Rhythm and Music: Rhythm and music stimulates both sides of the brain.  It activates our attention system and multiple neural pathways which facilitates memory and retrieval.   Create a song, set to a familiar tune that reviews key concepts in a curricular area.  Memorizing the 50 states, days of the week, or spelling words can all be easier when taught within a song or chant.
  2. Movement: Adding movement to an activity provides extra-sensory input and enhances attention.  Movement helps increase cognitive function while also helping children get rid of “the wiggles”.

It is also beneficial for children to have downtime for movement built into their days. Many studies have found that students who exercise do better in school.   Exercise triggers the release of a substance that enhances cognition by boosting the ability of neurons to communicate with each other. Below are some ideas to incorporate movement into learning:

  • Air writing letters
  • Playing charades to act out a history lesson
  • If the answer is correct, make a sign like a referee
  •  Jumping on the trampoline while doing math facts
  • Playing catch while reviewing information
  1. Humor– Humor wakes up the brain cells!  It also encourages attention and relieves stress.  Humor keeps learning an enjoyable experience for teachers, parents and children.  Using humor lets students have an increased feeling of safety in making an error or getting an answer wrong.  Make time for laugh breaks to keep your child alert and attentive while learning
  2. ReflectionDowntime is important to help the brain process new information and strengthen neural connections.  Have your child learn and study in small chunks of time.  Implement breaks for movement, listening to music, doodling or having a snack.

For more information on strategies for learning and about Easter Seals DuPage & Fox Valley, visit: eastersealsdfvr.org.

Childhood Apraxia of Speech: Signs and Symptoms

By: Jennifer Tripoli M.S, CCC-SLP

You may have heard the term “apraxia” before but wondered, what exactly does this mean? According to the American Speech Language Hearing Association (ASHA),

“Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.”

Childhood Apraxia of Speech (CAS) is not a black and white diagnosis and can be difficult for speech language pathologists to diagnose especially in very young children (under the age of 2). Children with CAS may have coexisting conditions such as Down Syndrome, Cerebral Palsy, or some other neurological disease. Some children with CAS though do not have any other known neurological deficit.

Children with CAS may present the following key characteristics:

  • Limited vowels produced, lack of differentiation between vowels, and/or vowel distortions
  • Inconsistency or variability in productions
  • Groping of oral structures or physical struggle to produce sounds
  • More difficulty with multisyllabic words or more complex productions (longer phrases/sentences)
  • Difficulty with imitation, better productions observed with spontaneous, learned, or automatic productions
  • Choppy or monotone speech (equal stress patterns on multisyllabic words)
  • Slow rate of speech
  • Difficulty with non-speech oral movements such as sticking tongue out, pursing lips, etc. (oral apraxia)

Listed below are other common signs present in children with CAS, though are not exclusive to CAS:Baby nico on swing

  • Decreased babbling or vocal play as an infant
  • Lack of imitation skills in infancy
  • Delayed speech production or expressive language skills
  • Poor speech intelligibility (ability to be understood)
  • Decreased sound inventory for his/her age
  • Words used once and never used again

Children with CAS may not present with all of the above characteristics. There is currently no “rule” regarding how many characteristics a child must have to qualify for a CAS diagnosis.  If your child presents any of the above key characteristics, an evaluation by a speech language pathologist who specializes in CAS is recommended in order to differentially diagnosis your child.  Children with the above characteristics may present CAS or another speech sound disorder.

Visit Easter Seals DuPage & Fox Valley at EasterSealsDFVR.org to learn more about speech-language services and evaluation. And to learn more about CAS and access parent friendly resources, visit Apraxia Kids.

5 Reasons To Enroll Your Child in Private Therapy

By: Jennifer Tripoli, M.S., CCC-SLP

A question I am often asked is about working at a private, non-profit pediatric therapy center. What makes us different?! Well some unique qualities that compliment other services! Below are the top five reasons to enroll a child in private therapy (primarily from a speech-language perspective!).

  1. Enhancing School Services

Many children have significant issues that require more frequent, intense services in order to progress. Unfortunately, the public school districts are limited by the hours in the school day. Participating in outside therapy services allows for a child to work on similar goals or additional goals.

For some children, the repetition of school goals helps them progress faster and allows them more time to understand concepts. For other children, the school therapist may be working on one area of need where the private therapist is targeting another area of need. We are happy to collaborate with school therapists. I find that this is the best recipe for success!

  1. Your child did not qualify for Early Intervention Services (EI)

Currently, the Early Intervention Program for the state of Illinois requires a child (0-3 years of age) to have a 30% or more delay in 1 area of development in order to qualify for services, have a qualifying underling medical diagnosis (e.g. Down Syndrome), or have 3 or more risk factors for delayed development. In many cases, children do not meet the criteria as listed above for services through the Early Intervention system, but still present with developmental delays.

For example, a child may be evaluated for speech and language delay

Frank in therapy
Photo by: Nancy Kerner

through the early intervention system and only found to have a 20% delay in expressive language. In most cases, a child with a 20% delay would not receive services through EI, but may benefit from private therapy in order to improve their expressive language skills to a more age appropriate level. Just because your child has not qualified for EI does not mean they will catch up to their peers without assistance. A private speech and language evaluation may be warranted to determine if your child would benefit from speech therapy services.

  1. Your child has feeding or oral motor issues

Often, feeding and oral motor skills are not addressed in the school system as these skills may not be considered as educationally relevant as other skills. It can also be difficult to find a Speech Pathologist who has experience in working with children with oral motor and feeding deficits. Private speech therapy services can address your child’s feeding and oral motor deficits as these skills are extremely important. Here at Easter Seals DuPage & Fox Valley our speech pathologists have an extensive knowledge of oral motor and feeding deficits in pediatrics.

  1. Your child can participate in co-treat Sessions

When appropriate, co-treat sessions may be of benefit for your child. A co-treat session is when 2 therapies are rendered simultaneously. Often children may be receiving speech therapy along with occupational therapy or occasionally physical therapy. This allows both therapists to work together in order to improve different skills.

For example, the occupational therapist can assist with improving sensory regulation so the child is better able to attend and understand speech and language concepts. The physical therapist can assist the speech pathologist with body positioning/posture to achieve the best speech/voice possible for a child with motor deficits. This is a strength at Easter Seals DuPage & Fox Valley. We often have multiple disciplines work together to get a holistic picture of a child’s needs. Voice Box Photo

  1. Your child has minor speech/language deficits that are not addressed by the school

Some children may present mild articulation issues that may impact their ability to communicate, but are not severe enough for a child to qualify for school therapy. Private speech therapy can address these issues if found developmentally inappropriate through a private speech and language evaluation.

If you feel your child would benefit from private speech and language intervention, please visit our website here. Let me know in the comments if you have additional questions!

10 Ideas for Practicing Speech

By: Jessica Drake-Simmons, M.S. CCC-SLP

I recently had a shoulder injury and was prescribed a long list of exercises to do multiple times a day.  True confession: I was not the best patient.  The exercises were time consuming and pretty boring.  Being in the shoes of the uncooperative, slowly progressing patient made me reflect on what I could do as the practitioner who may be guilty of occasionally recommending time consuming and boring home practice.  My best advice for working on speech is:  incorporate it into a routine as part of your day and Make it FUN!

When working with kids with articulation disorders, phonological disorders or apraxia of speech, I like to balance repetitive, structured practice with functional, meaningful words.  Here are 10 fun and easy ideas for practicing speech at home:

  1. Beat the timer: This is one of my favorite games for getting A LOT of repetitions quickly!  I like to use a visual timer which can come in the form of an app like Time Timer Time Timer or a sand timer from an old board game.   The visual timer lets the child see time passing and acts as a great motivator.  If you don’t have a visual timer—any timer will do!  Set a goal of how many words the child will say correctly before the time runs out.  I like to set this as an almost unobtainable goal so that it is a fun challenge and perhaps something that has to be attempted 2 or 3 times before we succeed.

smart timer timer

  1. Story time: Have the child find his targeted sound in a story. He can repeat the word or fill-in-the-blank of your sentence as you read to practice his targeted sound.
  2. Driving in the car: Practicing speech words in the car can be a great way to use this time more purposely. You can leave a sheet of pictures or flash cards in the car.  If your child were to produce their target words each time they got in the car they could get SO MANY repetitions throughout the day!
  3. Playing a sport: There are many different ways that you could incorporate speech practice while playing a sport but here are a few of my favorites:
  • Basketball- Set up different places to shoot with a targeted word attached to each place. Have your child say the word a given number of times before they can shoot.  You can play this game like HORSE to create a fun element of competition.
  • Soccer- each time a goal is scored against your child he has to say a set number of words.
  • Playing catch- have your child say a targeted word every time they throw a ball.
  1. Meaningful Words: Create a list of your child’s favorite foods, activities, toys and important people. Identify which of these words contain your child’s targeted sound.  You can have your child practice these words in drill or in meaningful opportunities.  These words are a good bridge for generalizing correct production of a sound into natural, spontaneous speech.
  2. Board games– When playing board games, I like to make a list a list of the words we are saying related to the board game that contains the targeted sounds. As the game progresses, I focus on having the child accurately (or to the best of his ability) produce the meaningful, targeted words.  I also make the child produce a given number of words before they take their turn.
  3. Silly stories– This is one of my recent favorites! I will give a child a sheet of pictures that contain his targeted speech sound.  The first person selects a picture and starts a story using the target Speech-Language Therapy - Cara Pagelsword.  The next person repeats the first sentence and then builds onto the story by selecting a different picture and creating a sentence.  I cannot even begin to tell you the funny and crazy stories that some of my little munchkins have come up with! Not only is this a fun activity to target speech production but it also develops language skills, sharing an imagination, memory and sequencing.
  4. Talking Activity-For a child who is at the level of generalizing his speech sounds into conversation, any talking activity can be a great time to work on speech! When a child is at the level of generalization, I don’t like to correct all of the time because I don’t want the child to get the message that how they are saying something is more important than what they have to say.  I recommend designating specific times or activities to monitor speech production. These could be activities like: telling you about his day, reading a book, playing I Spy, describing pictures, or playing a game.
  5. Brushing teeth– This is a routine activity that children do 2 times a day and can be a perfect time to spend a few minutes targeting speech goals. Being in front of the mirror and having the child watch their mouth movements can be very beneficial!
  6. Follow your child’s lead: So many of the kids I work with have brains that are far superior to mine in terms or creativity.  Kids can come up with the greatest games using the simplest of materials.  So try giving your child the opportunity to develop their own creative ideas and games while working on their speech.

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

Finding Our Voice With New Speech Technology: Part 2

By: Jennifer Tripoli M.S., CCC-SLP

In my previous blog post, I introduced the Voice Box, a motor speech lab that houses equipment related to voice, resonance, and articulation. The first post was primarily centered around the Smart Palate technology by Complete Speech. Now I am here to tell you more about the other stars of the Voice Box, the Nasometer and the Visipitch.

Nasometer by KayPENTAX

speech tech 2 speech tech 1

Above pictures include computer with headset (worn by client) that takes nasalance measurement.

So what is the Nasometer? 

  • The Nasometer is an evaluation and treatment device that is able to objectively measure nasality (resonance) in a client’s speech.
  • Prior to this piece of equipment, clinicians were using their own perception or ear to determine if a client had a nasality problem. This takes the guess work out!

    Voice Box 2 Photo Credit Rich Howe
                        Photo by Rich Howe
  • Provides a nasalance score that objectively measures nasality.
  • Helps clinicians determine if further evaluation is needed to assess the velopharyngeal port by ENT or craniofacial clinic.
  • Allows clinicians to objectively measure progress in therapy for children with resonance disorders by improvements in nasalance scores.

Who would benefit from this technology?

  • Children with suspected nasality problems or resonance issues
  • Children with a:
    • Cleft palate
    • Deficiencies in the velopharyngeal port
    • Neuromotor/motor speech deficits
    • Hearing impairment
  • How is it used in treatment?
    • The Nasometer has biofeedback games that can be used in treatment and allow the child to practice appropriate resonance in real time speech.
    • The child is able to make adjustments based on feedback they are receiving in fun, highly motivating computer game.

Visipitch by KayPENTAX

The Visipitch can be used for a variety of skills and has various programs targeting different aspects of speech.

What does it do?

  • The visipitch is an all-encompassing instrumentation that gives real time displays for visual feedback of critical speech/voice parameters.
  • Contains 8 modules all used for different/various speech skills.

How do we use this technology at Easter Seals DuPage and Fox Valley?

We mainly use the Multi-Dimensional Voice Program (MDVP) to evaluate voice disorders contained in Visipitch software and Voice Games.

  • Gives clinician’s objective quantitative measures for voice analysis which can be compared to normal levels
  • Clinicians can measure progress in therapy based on improvements in quantitative measures provided by MDVP.

Who would benefit from this piece of equipment?

  • Children/adults with voice disorders
  • Children with vocal nodules or other vocal fold pathology
  • Children with hoarse, breathy , or harsh vocal quality
  • Children with motor speech disorders including apraxia and dysarthria

How is it used in treatment?

  • Visipitch contains a variety of highly motivating voice games to be used in treatment
  • Voice games are very visual and rewarding for children demonstrating good speech and voice behaviors
  • Voice games work on sustained phonation, frequency/pitch of voice, amplitude/loudness of voice, voice onset, etc.

The frog game (below) . Child is asked to sustain phonation or hold out voice to expand frog’s throat. If child holds out voice until frog’s throat expands, they are awarded with a visual reinforcement on the screen.

speech tech 3speech tech 4

Dragon/Fire game (below). Child is asked to use low to loud vocal volume to pop all the balloons with the dragon’s fire. This game works on vocal loudness and ability to control vocal loudness.

Voice Box 1 Photo Credit Rich Howe
Photo by Rich Howe.

speech tech 5

Of course, these pieces of equipment are never used solely in treatment. All equipment is used in addition to traditional speech treatment!

If you have questions or are interested in having your child evaluated for use of the Voice Box, please contact our intake coordinator at 630.282.2022.

The Voice Box has been a wonderful addition to the Speech and Language Department at Easter Seals DuPage & Fox Valley! We are forever grateful to the generous donors who made this possible! Thank you again!

Myths and Realities of Augmentative Communication

By:  Amanda Nagle, MA, CCC-SLP/L

Frank in therapy
Two-year-old Frank vocalizes the word “duck” while playing with a computer laptop and recorder. Frank attends weekly speech pathology sessions at Easter Seals DuPage & Fox Valley to help with issues that stemmed from food allergies and delayed truck core strength. After a year of therapy, Frank is now quite a talkative young boy!
Photo by: Nancy Kerner

Parents understandably worry when they hear the words “speech generating device”, “AAC” and  “augmentative communication”. Concerns are voiced such as:

  • The Speech Language Pathologist (SLP) doesn’t think she will talk and is giving up on her speech
  • My son talks, why is the SLP recommending a speech generating device? My son doesn’t fit this profile!
  • Won’t that device stop her talking and make her too lazy to talk?

That is just not the case. The American Speech Language Hearing Association (ASHA) defines augmentative and alternative communication (AAC) as “all forms of communication (other than oral speech) that are used to express thoughts, needs, wants and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write.”

There are many myths around the use of augmentative and alternative communication (AAC) in individuals of all ages but these myths are particularly prevalent with our young children. Below are the most common concerns (myths) that I continue to hear from families and professionals, especially those working with young children.  I want to dispel the myths with the realities surrounding the concerns.

MYTH:  The AAC system will become a crutch for my child.  Parents are frequently concerned that their child will use the device instead of learning to communicate verbally.

REALITY:  Many children’s verbalizations increase when they begin using a voice output AAC device.  Research and clinical practice continue to indicate that AAC does not interfere with verbal speech and actually encourages spoken language.   We frequently see increased imitation and spontaneous verbalizations when children use augmentative communication systems.  Children will communicate with the easiest and most flexible means available to them.  It is easier to use verbal speech when possible than it is to create a message on a communication device.

MYTH:  The term ‘augmentative communication’ refers only to devices with voice output.

REALITY:  There are many different types of augmentative communication with and without voice output.  Some types include using objects, photographs, picture symbols such as Boardmaker or SymbolStix, gestures and manual signs.  Other types are low tech battery operated single message voice output devices with as few as one message.  Mid tech devices are available with multiple message selections.  High tech devices are also available with robust language organization that can be modified for various stages in a child’s receptive and expressive language development. Boardmaker Software

Tablet systems such as iPads have a variety of communication apps from single messages to full robust language organizations.  Frequently, children’s full communication systems include a combination of no tech, low-tech and high-tech AAC, in addition to their unaided communication including verbalizations.

MYTH:  Individuals must progress through a specific hierarchy of skills before they are ready to use augmentative communication or before moving to the ‘next level’ of augmentative communication.

REALITY:  There are no prerequisites for communication.  A child does not need to understand cause-effect before he/she can use AAC.  A child may actually learn cause-effect skills through the use of augmentative communication while she is learning new forms of communication.  A child does not need to know that a picture represents an object.  When a picture is attached to a voice output device or to a low tech surface, the child will begin to associate meaning between the picture and the object she receives when she selects the symbol.

For example, if you attach a picture symbol of ‘bubbles’ to a single message device, your child touches the picture and hears the message ‘bubbles’, then you blow bubbles for her, in time she will begin to associate the picture of bubbles with the actual bubbles.

MYTH:  AAC is a last resort and we are giving up on my child’s speech.

REALITY:  A child’s use of AAC can enhance speech, language and communication development while reducing frustration at the same time. Ideally, augmentative communication strategies should be introduced and implemented prior to communication failure in order to prevent communication failure.  When AAC is introduced early, before increased frustration and communication failure occur, a child may naturally incorporate the system into their typical communication repertoire.  Receptive and expressive language skills can be modeled using an AAC system.  It is never too early to begin to incorporate AAC strategies into a child’s communication development.  When introduced early, AAC can provide a strong foundation for a child’s receptive and expressive speech and language development.

MYTH:  My child speaks and AAC is only for people who are completely nonverbal.

REALITY:  AAC systems and strategies may be used as primary communication systems or as supplemental/augmentative systems for individuals.  Many children are verbal and have trouble being understood by unfamiliar listeners or become frustrated when a familiar listener doesn’t understand a spoken message when the context is not known.

The following are some, but not all of the additional ways that AAC can be used with children who are verbal but may be difficult to understand:

  • repair communication breakdowns
  • set topics
  • word retrieval
  • receptive language development
  • expressive language development
  • expansion

It is important to remember that individuals with complex communication needs should have the opportunity to use augmentative communication strategies if they are not able to say what they want or need, share an idea or story, offer their thoughts, ask questions, tell you that they are afraid and what they are afraid of, and tell you if they are in pain.  Augmentative communication can provide a means for them to share these types of messages to more people in more places more often.It is never too early to introduce AAC into communication intervention.  There are no prerequisites for communication.

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

Finding Our Voice with New Speech Technology: Part 1

By: Jennifer Tripoli M.S., CCC-SLP

A few years ago, the Speech Language Department at Easter Seals DuPage & Fox Valley had a vision to create a speech lab that would house cutting edge equipment related to articulation, voice and resonance disorders. A few therapists made a wish list of equipment that speech pathologists in an outpatient pediatric clinic could only dream of having. We knew this equipment would benefit our clients and hoped our vision would become a reality. Fortunately for us, our idea was chosen as one of the paddle raise items at the 2013 Easter Seals DuPage and Fox Valley Benefit Gala.

Due to the donations of several individuals, we were able to transform a therapy room into a beautiful speech lab and purchase three very high tech pieces of equipment. This room was given the name “The Voice Box” and we were ready to put our new equipment to use! A huge thank you to each and every one of you who were so generous in donating to this lab and to everyone who has supported the idea from the beginning!

Since openings the doors of the Voice Box, we have had many questions about the technology and how it could help a child.  In my next few blog posts, I am hoping to help you better understand the Voice Box and all of its possibilities!

The first piece of high tech equipment inside the Voice Box is the “Smart Palate” by Complete Speech. This device is used primarily for children with articulation disorders or children who have difficulty making specific sounds. Sometimes traditional articulation approaches are not enough for children to learn to produce a specific sound.

The system is designed to:

  • Use biofeedback to help a client see exactly what their tongue is doing inside their mouth
  • “It takes the guessing out of speech therapy by showing students exactly where their tongue is supposed to touch their palate to produce different speech sounds,” says Complete Speech.

Who can the Smart Palate help?

  • Children with Down Syndrome
  • Children with Dysarthria or Apraxia
  • Children with Articulation Disorders
  • Children with repaired Cleft Palates
  • Children with a hearing impairment

How does it work?

First, an acrylic mouth piece or palate is custom made for each client by Complete Speech (*fee involved for purchase of palate). The Client’s dentist or orthodontist makes impression of a client’s palate which is then sent to Complete Speech for palate construction.

Once completed, we receive the palate and connect to our computer software. It looks similar to a retainer with sensors.

palate collage
The smart palate connected to the computer via USB port.

Below are pictures of the Smart Palate in action.

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The palate with sensors that show tongue to palate contact on computer screen.
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The client’s tongue resting on their palate (sensors light up blue).
palate3
The “blue” sensors represent accurate tongue placement for sound /r/.
palate4
Only “blue” sensors are lit which indicate accurate production of sound /r/.
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The “orange” sensors show inaccurate tongue placement for sound /r/.  This indicates activation of sensors outside of accurate /r/ tongue placement.
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Side by side display of the clinician’s palate and client’s palate.

What are the Smart Palate requirements?

  • Client must have adequate attention to computer screen
  • Client must have cognitive ability to understand what they see on the computer screen is what they feel inside their mouth
  • Client must be able to tolerate acrylic retainer in mouth
  • Be at minimum 4 years or older

Click here to watch videos on the Complete Speech website.

To learn more about the Smart Palate please visit the Complete Speech Website here

Important note: Here at Easter Seals DuPage & Fox Valley we are using the Smart Palate in therapy to augment our current, traditional articulation approaches. We are not solely using the Smart Palate to address speech sound disorders. The Smart Palate is not appropriate for every child who has a speech sound disorder. An evaluating Speech Pathologist who has experience in working with children with the Smart Palate will determine appropriateness for each individual client.

If interested in the Smart Palate, please contact our Villa Park intake coordinator at 630.282.2022 for questions or to schedule an appointment. For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.

My Favorite Speech and Language Apps: Part 2

By: Jennifer Tripoli M.S., CCC-SLP

Photo by: John Smith
Photo by: John Smith

As promised, here is the next installment of my favorite speech and language apps! My February blog post listed a few of my go to speech and language apps that I use during many of my therapy sessions. Here’s a few more great apps that I hope you will LOVE too!

  1. Panda Games by Dr. Panda ltd.

Price: Apps range from free to $3.99

I recently came across Dr. Panda games app and I fell in love with the adorable characters and interface! Being the therapist I am, I tried to think about how I could use these apps in my therapy sessions. Let me tell you, it was EASY! The company’s mission is to “help kids understand life and the world around them”. There are a slew of Dr. Panda apps, with one being better than the next! Each app has a different theme with countless speech, language and play benefits.dr.panda

Panda’s SuperMarket is my favorite of the Dr. Panda’s apps!

With this app you can work on pretend play scheme for a grocery store, introduce grocery store vocabulary (e.g. shopping cart, checkout, cashier, produce section, etc.), sequencing (First get a cart, then go shopping, checkout, and put groceries in car), following a shopping list, math/numbers during checkout, and categorizing (fruit, veggies, dairy products, bakery, etc.).

  1. Conversation Builder by Mobile Education Store

Price: $19.99 for iPad

This is an app geared towards elementary aged children who need help with conversational skills! This app is essentially a conversation simulator that works on children’s conversational reciprocity with multiple exchanges (back and forth practice).

  1. Bag Game by all4mychild whatsinthebag

Price: $0.99

  • You hide a photo in the bag and your game partner has to try to guess the object you hid by asking questions about it in a process of elimination type way.
  • This app is a spin-off of the game “20 questions”. I use this app to address a variety of different language skills

I have also used this without using questions, but having the child (the object hider) use different language concepts to describe what is in the bag! (the child needs to be careful not to say what the item is in the description!) I will go back and forth with the child where they are describer and I am the guesser and I am the describer and they are the guesser. Not only does this work on descriptor skills when they are describing the items, but also word finding skills when they are the guesser!

You can also go a step further and make it like the game “Taboo” where you give the kids words they cannot use in their description (this is very tough).

whatsinthebag2

  • At the end of it, all the kids LOVE opening the bag and seeing what is inside!
  • It’s a great game for using descriptor words, working on word finding skills, asking questions, and answering yes/no questions as well!

If you are interested in learning about other apps and app resources, please see my February blog post here!

For other speech and language ideas, please visit the Easter Seals DuPage & Fox Valley speech and language department’s pinterest page here!

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