BY NANCY R. KAUFMAN, MA, CCC-SLP
KCC Owner & Director / Speech-Language Pathologist

May is Better Speech and Hearing Month, and the 14th is Childhood Apraxia of Speech Awareness Day! In the spirit of helping children who struggle to speak, here are some best practices that parents should look for in children’s speech and language therapy.

MOTIVATION

Favorite toys and activities should be used in therapy and changed up often to keep children attentive, engaged and willing to perform structured tasks. In addition to some drills, there should also be time for play while working on target words and phrases. Therapy should be fun!

TARGET WORDS & PHRASES

Words chosen for therapy should be within the child’s capability: they should be able to produce most of the vowels and consonants within the words. The words should help them gain syllable shapes they haven’t yet mastered and to help them request and comment in their environment. SLPs should determine what the child’s best approximations would be for specific target words and continue to assist them toward perfection of these targets.

CUES

Multisensory cues (hand signals, oral postures, gestures, first consonants/syllables, etc.) should be used to support the child’s initial efforts until the cues can be faded. Imitation with full cues should then be used to help the child produce the target word as independently as possible.

MASS PRACTICE

Gaining as many repetitions as possible on the chosen target syllables, words, or phrases is important. Using the child’s favorites for reinforcement and avoiding wasted time will help keep motivation high.

AVOID OVERGENERALIZATION

SLPs should vary their goals within sessions. If final consonant inclusion was the only goal (for example), the child may believe that every word should have a final consonant.

COACHING THROUGH PLAY

Coaching parents and caregivers to gain the child’s goals within their natural environment is important for success. It is our task as SLPs to help parents and caregivers to practice at home and through so that homework is fun and practical!

BY KERRY PETERSON, MA, CCC-SLP, BCBA
Speech-Language Pathologist
Board-Certified Behavior Analyst

The type of cup your young child drinks from can have a big impact on the development and function of their lips, teeth, tongue, and jaw — and ultimately their speech.

Speech-language pathologists often see children with developmental delays who are drinking from bottles or sippy cups instead of open cups way beyond an age that is recommended. This may be because the parents or the child have difficulty with change. It may seem silly to change something that seems to be working.

Transitioning from bottle to cup (and especially the right cup) is an important developmental step for feeding and for supporting the development of speech. Continuing to drink from a bottle or a sippy cup can have a long-term negative impact on a child’s speech development and the health of their teeth.

The American Academy of Pediatrics recommends that children transition from a bottle to a cup by 12 months and completely eliminate bottle drinking by 18 months of age. This is to ensure they transition from an immature to mature swallow pattern.

Without getting too technical, a more mature swallow pattern is important for having the tongue stabilize and rest in the best position in the mouth and allows the tip of the tongue to move and lift easily to contact the bumpy ridge on the roof of the mouth behind the teeth. The tongue needs to be fully inside the mouth at rest and for all speech sounds. Tongue tip elevation requires the mid-tongue be stable within the mouth in order move independently for letter sounds such as t, d and n.

The longer a child continues an immature sucking/swallowing pattern the more likely they may develop speech sound errors.

SOME ADDITIONAL TIPS:

• The best cups are those with straws or recessed lids, or with open tops. Balance straw cups with open-topped cups as often as possible.
• The worst cups for speech development are those with bottle-like nipples for kids past 12 months, or those with hard, firm spouts.
• It is important that children only use their lips to draw up the liquid and not their tongues. If your child’s tongue is under the straw and thrusting forward with a suckling-like movement, cut the straw to a shorter length or eliminate straw drinking completely.
• Don’t be surprised if you get a little resistance when changing up your child’s cup. Be patient, set clear expectations, and know your child will benefit in the long run by transitioning to better drinking options.
• Don’t hesitate to contact a speech-language pathologist for guidance.

By JENNIFER HILL, MA, CCC-SLP
KCC Speech-Language Pathologist

Those of us who are parents are all too familiar with this scenario: Upon picking up your child from school or camp you ask excitedly, "What did you do today?" Your child responds with an unenthusiastic, "I don't know."

It may not be that your child does not want to share or did not have a good day, but that he does not know how to share. The problem is with that open-ended question: it is not specific enough and has too many possible answers.

To get more information and fewer shoulder shrugs, try this proven strategy.

1. Ask your child's teacher or counselor about the day's planned activities and other students your child spends time with. Pick 1-3 activities or people to ask your child about.
2. At drop-off time, prepare or "pre-teach" your child by telling them the questions you will be asking when you pick them up at the end of the day.
3. Be sure to have gotten the answers to your questions from the teacher/counselor prior to asking your child. It is difficult to determine the accuracy of your child's responses if, for example, you do not know the name of a friend or the type of activity you plan to ask about. Also, the teacher/counselor can act as a facilitator in recalling and retaining information, by reminding your child about another student's name or about the sequence of events throughout the day.
4. As soon as you have your child in the car, away from the distraction of others and while the information is fresh in their mind, ask your questions:
   "What is your new friend's name?"
   "Who was your partner during reading today?"
   "What did you eat at snack time?

Try asking the same questions every day for the next several days. Eventually, you can ask different questions or fade away the pre-teaching step at the beginning of the day.

As time goes on, your child will begin to anticipate these questions at pick-up time. You may find that it becomes easier for your child to share the details of the day, given less reminders and facilitation for recall.

You may also discover that your child begins to offer up information that was not predetermined or rehearsed. At the very least, it will help to add a little more chatter to your ride-home routine.