It takes two to tango!

  A child's speech and language development depends a lot on how natural and exhaustive the interaction of the adult (communication partner) and the child is. The more the adult communicates with the child, the easier it is for 'her' to pick up speech and language.

I have seen, that many kids who present with a delay in speech & language skills have a history of 'less talking' parents who fail to realise the importance of a stimulatory environment in the child's development. Mothers come and tell me that they didn't know that they have to talk to their babies to get them speaking. Merely switching on the TV and letting your child enjoy bollywood songs or cartoons isn't enough. You as a parent should make the child's environment very stimulating and richer by new experiences everyday.

- Speak to your baby even though she is tiny and you think she wont understand you. You will be surprised how in no time your child will start responding to your simple questions,gestures and facial expressions.

- Be it the time to feed, bathe, sleep, or play, you can talk about the relevant details of all these routines. e.g. while bathing your child, talk about how hot/cold the water is, how slippery the soap is, how tiny the baby's body is, how cosy the towel is.. so on..

- Play with your child. You can use colourful, squeaky toys and rattlers or music games to engage your little one. Click on the link below to find out more about the different toys for babies and toddlers.

http://babyproducts.about.com/od/toysgames/Toys_Games_Fun_Things_for_Babies_and_Toddlers.htm

- Give opportunities. Let your child assimilate what you speak and mean. Provide opportunities and chances for her to respond. She may start with just a smile initially, and soon babbling or word attempts will follow.

-Maintain Eye Contact. This is very essential. Even in my previous articles I have mentioned the importance of a good sustained eye contact while communicating/playing with your child.

It's always a give and take relationship..and communication especially is a two way process. Adult child interaction is essential throughout the child's development. Have a peep at the language pyramid beneath. Note that the skills of listening and attention are the basis of developing speech and language while issues of pronunciation and clarity follow much later.

Take home tip : If you want your child to speak nd communicate, you need to be an exceptional communication partner yourself. It always takes two to tango!

The magical world of Bubbles...

Bubbles are magic! Yes they truly are.. For kids and even for the little kid hiding inside an adult. Bubble fun is my favourite activity in speech therapy sessions. You can do so much with these little popping blobs.. Be it with infants, toddlers, preschoolers or even little older children, the floating, hopping, knocking bubbles work wonders.

I have found that--

• Bubbles are great to break the monotony of a therapy session with the kid. You can see the child's eyes glow at the sight of the bubble toy. So when you feel its getting boring doing the repeated activity with your little one, get the bubbles out!
• They are perfect tools to improve eye contact. Blow one at a time and in front of your face, this way the child tends to look more at you.
• They also help in developing visual tracking skills.
• You can encourage children to learn more words while playing with bubbles.. simple words like- up, down, more, pop, big, small, many, few, near, far, yes, no ...and so on can be focussed upon. You just need to consistenly repeat these words while playing with them.
• You can practice "blowing" skills (important oral motor skill for speech development) with bubbles.Children also learn rounding of lips during this fun activity.
• Popping the bubbles teaches cause and effect relationship.It also helps in fine motor control of finger pointing.
• This also instills the habit of turn taking. You blow and the child pops. Then you switch roles. Simple!
• Blowing bubbles in front of a big mirror helps in teaching imitation skills too.
• Simple instruction following can be another motive behind taking up this activity.. " pop the bubbles" , " pop the smallest one", etc.
• Bubbles can be used to teach "how to make a request". "Can I please have one more!"
• You can use them to make the child respond yes/no..
• The concepts of size, number, color etc all can be taught with the floating bubbles.
• Bubbles can be used to teach better breathing control hence you  indirectly work on improving the strength of abdominal muscles of speech.
• When the bubble hits the child on his body, you can also revise body parts.
• They work as super rewards for children of all ages.

I use different types of bubble tumblers. Children especially like flashy and  attractive ones. I have a variety of shapes with me...sunday ice cream,ice lolly, fish, butterflies etc. They all work beautifully!

Check out some intersting bubble activities cum recipes here!

Smell Box, a speech therapy tool?!

Vision, Hearing, Touch, Taste, Smell, Vestibular and Proprioception are the 7 horses of our sensory system that interact with each other to make us use our bodies effectively in the environment around us.It is indeed intriguing how these different senses integrate in our body to provide information. By such sensory integration, these sense organs indirectly help us to gather opportunities to communicate better!

Extrapolating this idea, I have tried using visual, auditory, tactile and olfactory kits during my therapy sessions to elicit speech.

On this page I will share about the 'Smell Box' that works wonders for kids who exhibit problems of insufficient expression of language.

The Smell Box can be made at home. It basically consists of 2 classes of odors. 1 pungent and strong and the other mild and sweet.

Pungent odors come from

• petrol,
• old scrappy food,
• mustard/horse raddish sauce,
• grated raddish,
• asafoetida(hing in Hindi),
• naphthalene balls,
• dettol/savlon,
• salmon omega & other strong tablets
• garlic etc.

Mild smelly items can be

• aromatic massage oils,
• mild perfumes,
• strawberry/apple jam,
• mild talcum powders,
• sugar,
• mithai,
• flower petals
• aromatic candles
• and most importantly your child's favourite food item, (chocolates, biscuits ) etc..

You can store all these items in similar looking little boxes, name/ tag each of them and store together in a bigger box.

The smell box can be used to elicit Yes/No response from your child. The pungent odors will lead to modelling out - No, while the mild sweeter odors lead to a Yes response.

I have observed  that children pick up 'No' response very quickly through this activity with the smell box. You can start by accepting gestures for yes/no and later graduate to verbal attempts.

You can also build your child's language by talking about the different smells in our environment.

Another game that you can play with the smell box is, identification of the source of the smell without looking at the box in which the stuff is stored. You can blindfold your child while playing this and even take turns. Great activity to build vocabulary, improve sentence formation, and teach turn taking.

So go try this tool now.I'm sure you yourself will have loads of fun doing this activity!

Eye contact and how to improve it!

Eye contact is the deepest way to form successful relationships and have better social interactions. Eye contact should be established not only when the child wants something from you, but also when she wishes to interact and connect! Always greet your child with a smile and a warm countenance when she makes eye contact with you.This way kids feel loved and cared for! The more your children look at you, the more they will learn, the more they will learn about the world of people, and how people communicate, about facial expressions, about the other subtleties of communication.

Children on the Autism spectrum have challenges looking at people. The more we encourage children to look the more likely they will have successful relationships with their peers.

To improve your little one's eye contact-

• Always position yourself in front of your child so that she can look at you.
• Be at eye level or a little below. Be at least 2 feet away from them.
• 
  
  
  While offering any object/toy.food/book etc to your child keep it in front of your face so that she can look at you.
• Reward your child when she looks at you. Use different tones of voice to celebrate the moment.. You can sing/whisper/ do a little dance or happily denote that the child looked at you!

You can-

• Play with stickers and bindis. Stick them on your face near your eyes. Choose different flashy ones, different sizes and colors. You can include your child's favorite sticker too!
• Incorporate different styles of hats, so that the child looks at your face. You can narrate stories to mimic different people wearing different hats. Use lots of tonal variations in your voice while doing this activity.
• You can cut out different head gears, that make your face look different..e.g. - different hair styles cut out in cardboard etc
• Use wigs! They work wonders..Pink, Orange, yellow, green..pull them all out!
• Candles have been my all time favorite.. They also encourage children to learn blowing ( very important oral motor skill for speech development) and also teach children cause and effect relationships.
• Peekaboo! yes get naughty and playful with your child.You can use curtains, pillows, dupattas or anything that helps you get your child look at you. You must talk to the kid while playing this old age game.
• Face/Eye masks also work well. You can get your child's favourite cartoon character mask and play!
• Bubbles - I personally have found this to be "the wonder tool " for kids who have poor eye to object contact. They get so fascinated by the floating, popping  bubbles..Blow one at a time.. and watch your child enjoy!

 Don't forget to respond back positively when your child makes eye contact with you.. She will surely do it again!

Blame the genes!

How often have you heard the phrase, "it runs in the family" ?  May be while talking about a good looking mother and daughter, or a brainy dad and son, or a family of obese parents & kids.. These hereditary blocks that pass traits from parents to offsprings and further down the ladder are called genes!

Scientific progress in the field of genetics has been an eye opener even for Speech Pathologists like me.We now know that many speech/language/hearing disorders are genetically linked. Difficulties like stammering, autism, ADHD(Attention Deficit Hyperactive Disorder), Specific Language Impairment, Reading disorders,Hearing loss etc have all been indicated to have a genetic preponderance.

 

A recent study indicated that a gene on Chromosome 6 – KIAA0319 – was associated with Specific Language Impairment (SLI) and reading disorder (dyslexia). Earlier it had been established that Chromosome 6 is among those that are linked to Speech Sounds Disorder (SSD) and Reading Disability/Dyslexia (RD ). This new finding has opened new doors of understanding the complexities of speech and language problems.It shows that all these difficulties of speech , language and reading etc may be  interlinked, hence hinting at the fact that a child with some speech disorder may also have reading /writing difficulties!

 

This newly discovered gene is surely a culprit! But keeping the genetic play in mind, we can always aim at earlier diagnosis, and early intervention of children facing such difficulties.

 

So be sure to get your child assessed thoroughly if she exhibits any speech difficulty or if you know anybody in your family who has one. Early identification and intervention are the best tools that you as a caregiver can exploit!

 

 

Speak with your hands!

I stumbled upon this "just beats" track by B.Ames while downloading some music for my iPod..and I was totally fascinated by the title.. Speak with your hands!! Something which all of us do..without even realising.. We all communicate using words and hand/body gestures. Ever noticed a dancer or an artist talk? They  incorporate a lot of hand and facial gestures to make their speech enthralling and attractive.

We all have also seen hard of hearing people who use sign language to communicate. Its amazing how hands can speak!

I myself use a lot of signs and hand gestures while teaching "talking" to my little kids. "Total communication" is the strategy I always employ. Hence gestures and signs are some strong speech therapy tools in my kitty.The younger a child, the easier its for me to introduce signs along with speech.Simple gestures for sleep, eat, drink, come, go, no, stop, sit, love, thanks etc come very handy!

These extra tools augment the speech and language development of all babies and toddlers. They especially work well with late talkers who start expressing their needs through pointing and gestures and then slowly graduate to attempting words.

One should always use plenty of gestures and facial expressions along with vocal intonations while singing rhymes and songs with children.The handed signs and gestures give added spatial cues which children pick up in a jiffy! For example, lets consider the rhyme Incy Wincy spider.. Using gestures for "climbing" of the spider, "falling" of the rain, rays of the "sunshine" , the kid is sure to participate with enthusiasm and will also learn the spatial features of simple verbs used in the rhyme and also grab concepts like the sun is up in the sky.

This reminds me of an autistic child who comes to me for therapy. He always utters "Incy Wincy" (misarticulation errors present) and signs a climbing spider, when he wishes to listen to this rhyme. So even though his speech is not clear, his expression is complete because of the accompanied gesture.Hence no frustration and only enjoyment follows!

In the USA, sign language for babies has become a frequently practiced approach. This helps foster speech and language skills in normal as well as special kids. I found the following article quite useful.

                                         Sign Language for children with special needs

Whether you choose to use these signs with your babies or not, it is worth remembering that expression of language can be through any form or modality.Research has proven that sign language is not just for deaf babies.It is said to promote expressive & receptive language and vocabulary skills of hearing toddlers too. I would like to amplify that gestures and or signs should be accompanied with clear and slow speech as what we are focusing on is - total communication.

So enjoy speaking with your hands! You might just explore how effective it can prove for your child's speech development.

Tips to enhance speech and language skills in your child

Children can communicate since their birth. Infact research shows that a foetus can communicate right from the 3rd trimester of pregnancy!

It is important that an infant learns to pick up speech and language early on. Here are a few tips that will help in promoting your child's speech and language development.

• Eye contact. It is essential for you to look at your child's face and eyes whenever talking or communicating with her. This way she will learn that it is imperative to look at people while communicating. Children get clues about shaping their mouth to pronounce words while looking at your face when you converse with them.

• Turn Taking. The art of turn taking is important to become a social communicator. You must talk to your child and then pause to give her some time to vocalise. This skill can also be worked upon while playing with your child.

• Give your child opportunities. As your child is communicating with you, and you know what they want, give them time before you jump upon fulfilling their needs. This will give them the opportunity to verbalise, point, or even come up with a word.

• Give choices. Giving choices to your child always helps them to become better communication partners. Choices provide your child with an opportunity to vocalise or attempt a word. The child feels confident by evincing her choices and hence is on the right path of further expansion of expressive language.

• Provide commands/instructions. You can begin with simple single step requests that only involve one element, such as 'look', 'smile' etc.Then increase to two elements when one element becomes easy for your child (i.e. "Sit down," or "Touch your ears," and so on).

• Instill the habit of reading books. You can read simple books to your child with one or two colourful pictures on each page. Then ask them questions that can be answered verbally or by pointing to the correct picture. Don't demand a lot initially. If your child fails to reply or respond after 15 seconds, answer the question yourself.

• Reward and Reinforce. If your child comes up with an utterance resembling a word, praise and reward her and then model the correct target word which you think she attempted.For example, if the child says "daw" for doll, say "You said doll. Yes, it is a doll!"

• Hunt for different occasions. Language can be learnt best from our surroundings. Hence its best to make your little one a part of different novel situations and occasion so that she can pick up more and more language. A simple trip to the mall can be a great chance to help your child imbibe new words.

• Clarity of your child's speech. Parents usually understand their kids' speech more than strangers do. It might be an idea to observe how much do others understand your child's speech.This will give you an idea as to how clearly your child is speaking. Children undergo a developmental phase while learning to talk.If you feel that your little one's speech is unintelligible till the age of 3, consult a Speech Language Pathologist/Therapist.

• Correct Modelling of words.Pronounce your words clearly when you speak with your child. Talk slowly and remember to look directly at your child's face.

Although speech and language development varies with every child, a little extra support from the communicative partners in a child's environment will ensure a smooth acquisition of speech .Always remember, parents are "Super heroes" for their kids. Children will emulate whatever their parents do and say. Implementing these aforementioned tips will  aid all parents and care givers in communicating better with the little angels!

The First words

...you and I belong to a species with a remarkable ability; we can shape events in each other's brains with exquisite precision...That ability is language.Simply by making noises with our mouths, we can reliably cause precise new combinations of ideas to arise in each other's minds.The ability comes so naturally that we are apt to forget what a miracle it is. (Pinker, 1994)

Most parents never really appreciate the marvelous process that takes place when infants learn to talk. They take great joy is seeing their little baby learn to crawl, sit and walk, but few of them have the sight to understand the much greater miracle when this little creeper actually turns into an adult like talking and communicating being.

Animals are capable of using sounds to communicate.  However, there is a colossal difference between the chirping of a bird or roar of a lion and a human who can express himself in the most complex combinations of speech sounds and words.

Speech is a rare gift! And it all starts with the reflexive utterances of the baby.Crying sounds, comfort sounds, babbling, socialised babbling, infected vocal play and then eventually arrives the first word of the infant.

The average age for the acquisition of the first words varies from 9 to 18 months. Words are acquired before they are used, and long before the first one pops out, the child shows by her behaviour that she understands the gestures, intonations and even some parts of her parent's speech.

The first words spoken by the child are usually single syllable (1 consonant + 1 vowel) words e.g - /ma/ or  two syllable reduplicate words e.g. - /mama/

Children then 'misuse' the first words learnt. They call everyone and everything using the same set of newly acquired words. But soon enough their vocabulary augments and multiplies and they start combining complex speech sounds to form sentences.

What is amazing is that children acquire speech not only due to their innate desire to communicate but also due to the stimulation from their environment. Nature and nurture both are equally responsible for the attainment of your child's speech. Hence a child born to a Hindi speaking couple learns Hindi words first as compared to a baby born to an English family whose 1st words are in English.

As participants of your baby's immediate environment, you must talk to her, include gestures in your conversation, use intonations in your voice,as she is constantly learning to understand your complex language.

My mom tells me that my first word was /papa/ and I acquired it before my 1st birthday. I would love to know what yours and your baby's was!

                            This cute baby's first word has been captured well in this video. Have a peep!

Red Flags for speech & language development

Humans are social beings and always display a craving to communicate.Be it an infant who lures you by his coos and goos or be it an adult who can speak out his complex thoughts, the desire to communicate is reflected at all ages.

However for some kids, speech and language development may not be as smooth and easy as it should be! It is important to identify and understand their difficulties as early as possible.

 

Never let a speech delay hold back your child 's normal development. You can use the following checklist to see if your child's speech is at par with his age.

 

Articulation (pronunciation of speech sounds)

You may have a concern about the clarity of your child’s speech. The acquisition of new sounds has a developmental pattern in children, but by the age of 6yrs-7yrs all children should have mastered all speech sounds.

 General guidelines for parents:

• 2-3 years: p, b, m, w, h and all vowels
• 4-5 years: d, t, n, g, k, f, y, ng
• 6-7 years: r, l, s, ch, sh, z, j, v, th, sh 

 

 Voice:

You may have a concern about your child's voice if your child manifests :

• Very high or low voice pitch
• Very high or low voice volume, which may cause hoarseness or breathiness
• Too much of nasal resonance

 

Fluency of speech

You may have a concern about your child's speech fluency if your child shows:

• hesitations or pauses which break up the natural rhythm of speech
• repetitions of sounds, syllables, words, or phrases
• prolongations of sounds or words 

Play Skills:

You may have a concern about your child's play skills if your child does not demonstrate the following skills at appropriate ages:

• 6 months - brings hands or toys to mouth
• 9 months - bangs objects together
• 12 months - takes things out of containers
• 15 months - stacks 2 blocks
• 18 months - pushes and pulls toys or objects while walking
• 2 years - enjoys watching and playing near other children, copies your actions (e.g.: clapping hands)
• 30 months - acts out daily routines with toys
• 3 years - plays alongside others comfortably
• 3 years - plays make-believe games with actions and words
• 4 years - takes turns and shares with other children in small groups
• 5 years - plays make-believe games with others
• 5 years - shares willingly with others
• 6 years - plays cooperatively with 2 to 3 other children for 20 minutes

Social Skills:

There may be a concern about your child's social skills if your child does not demonstrate the following skills at

appropriate ages:

• 4 months - laughs and smiles at you, brightens to sound, especially voices
• 6 months - smiles and babbles in response to adult attention
• 9 months - imitates facial expressions, has a special smile for familiar adults, fusses or cries if a familiar adult looks or acts differently
• 12 months - takes turns making sounds with you, shows emotions e.g.: anger, affection, joy, and fear, starts games with you e.g.: peek-a-boo, clapping
• 15 months - repeats an action that makes you laugh, looks at you to see how you react e.g.: after falling, or when a stranger enters the room
• 18 months - shows affection towards people, pets, or toys, points to show you something, looks at you when talking or playing together
• 2 years - says "no" and likes to do things without help
• 30 months - waits briefly for needs to be met e.g.: when placed in a highchair, recognizes self in the mirror
• 3 years - shares, some of the time, shows affection using words and actions, greets friends and familiar adults when reminded
• 4 years - takes turns and shares with other children in small groups, tries to comfort someone who is upset, looks for adult approval
• 5 years - separates easily from you, responds verbally to "hi" and "how are you?", shares willingly with others
• 6 years - apologizes for actions he/she didn't mean to do, listens while others are speaking, shows an understanding of right/wrong, helps others, explains rules of a game to others

Hearing:

Have your child's hearing checked as early as possible to ensure that hearing loss in not affecting your child's communication development.

 

Inspiration

Greetings everyone! I am Pratiksha,an SLPA and I have been seeing kids with speech problems for more than 9 years.I got inspired to become a speech therapist by my niece who had delayed speech due to congenital hearing loss. I remember how difficult it was for our family to come out of the shock and the shambles of denial.But life moves on, and always for the good. My niece is now 11 and has made all of us proud by her exceptional academic skills and a caring streak for all around her!
I started Hear n Speak - Your local Speech & Hearing clinic in August 2009 in Noida.It's not merely a work place for me, but a platform where I can help and educate families and kids in need.
I am thankful to all those parents who have showered trust onto my approach of dealing with their lovely kids. I get enthused and motivated by the positive aura of all the brave mothers I have come across in my profession.I love my special kids with all my heart..
I am starting this blog to share my experiences as a therapist and a counsellor for parents of children with communication difficulties.
I sincerely feel that we all learn and grow by sharing with each other. Hence I look forward to learning from you all and hearing what therapy material and tips you like best!
It's worth to keep in mind that the tips and techniques that I would be sharing in this blog are just little starters to give you a direction of moving ahead with your child's speech progress. As there are many factors that govern the speech and language development of a child, it's always better to seek professional help in all accounts.
I dedicate this blog to all the fantastic moments I'v had while working with my special children.Sweeties you inspire me!