Tag

speech and language pathologist

The Importance of Play in Speech-Language Therapy

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP
NESCA Speech-Language Pathologist

As a speech-language pathologist, I immediately think about toys and games when planning my therapy sessions. Parents may wonder why speech-language therapy often looks like “just playing.” Children learn about their world through play. It facilitates their cognitive, emotional, physical, and social development. As young children develop, they begin understanding, learning how to communicate, and socializing within the context of play.

As I discussed in my last blog post, Five Ways to Facilitate Language Growth at Home, motivation and interest are key in language development, and play is highly motivating and interesting for children. When children learn in the context of play, these new concepts, sounds, and words became relevant and meaningful to the child. This promotes retention and generalization, which both increase learning.

Symbolic play is especially important in the development of language. Symbolic play is the use of objects to represent other objects (e.g., using a block as a phone). Language itself is symbolic since signs, gestures, and words represent ideas, objects, or relationships. Early symbolic play helps children understand that objects can be used to represent another object. Development of symbolic play often correlates with development of language: children often start to use single words when they begin using one object to represent another, and they may begin combining words when they combine two symbolic play actions.

Speech-language pathologists may even use play within assessment. Play in evaluations “is a nonthreatening way to gather information about general symbolic skills, linguistic skills, behaviors skills (i.e., attention and organization), and task persistence in a child-friendly setting” (Fewell & Rich, 1987; Short et al., 2011). I also use play to take language samples, which allows me to look at language understanding and use in a naturalistic environment.

For my older elementary- or middle school-aged clients, play often looks like playing games in therapy. The turn taking of games mimics the social reciprocity that we see in conversation and social communication. This facilitates older children’s understanding of taking the lead when it is their turn and waiting, listening, and watching when it is the other person’s turn. I also find more willingness to participate in therapy when it is fun and centered around specific interests.

In my opinion, we are never too old to play! I’ve found that most people learn and retain information better within the context of fun and enjoyable activities, which is why play is such an important aspect of speech-language therapy.

References:

Jarrold C, Boucher J, Smith P. Symbolic play in autism: a review. J Autism Dev Disord. 1993 Jun;23(2):281-307. doi: 10.1007/BF01046221. PMID: 7687245.

Short EJ, Schindler RC, Obeid R, Noeder MM, Hlavaty LE, Gross SI, Lewis B, Russ S, Manos MM. Examining the Role of Language in Play Among Children With and Without Developmental Disabilities. Lang Speech Hear Serv Sch. 2020 Jul 15;51(3):795-806. doi: 10.1044/2020_LSHSS-19-00084. Epub 2020 May 13. PMID: 32402229.

Terrell, B. Y., Schwartz, R. G., Prelock, P. A., & Messick, C. K. (1984). Symbolic play in normal and language-impaired children. Journal of Speech & Hearing Research, 27(3), 424–429. https://doi.org/10.1044/jshr.2703.424

 

About the Author

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.

 

To book an appointment with or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Facilitating Language Growth at Home

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP
NESCA Speech-Language Pathologist

I recently got to spend time with my 18-month-old nephew, after not having seen him in a year and a half due to the pandemic. It got me thinking about practical ways to help facilitate language throughout the day without feeling like you’re doing anything extra. Play and routines are great times to build language, and you can often find opportunities that are motivating for your child. Motivation and interest are key, because children are much more likely to participate and communicate. Below, I discuss tips to incorporate into your daily routine at home.

Five ways to facilitate language growth at home:

  1. Play!
    • Play the way your child is playing and imitate what they’re doing.
    • Even if you had a plan, don’t be afraid to change it to focus on their interests (i.e., follow their lead, as explained below).
    • Use fun sounds, words and gestures to go with what you’re doing (e.g., “beep beep” when playing with cars, “pop” when popping bubbles, “yummy/mmm” and rubbing your stomach when pretending to eat play food).
  2. Follow your child’s lead
    • Observe what they’re interested in, wait until they initiate or continue interaction, and listen to their words and sounds.
    • Get on their level so they know you are joining in.
    • If they are doing something unsafe, explain why it’s unsafe in simple terms and redirect them to a safe activity.
  3. Get silly
    • Repeat actions they think are funny.
    • Switch up routines in a silly way (e.g., “forget” their favorite bath toy, give them a fork with their yogurt). This encourages language when your child notices and wants to tell you something is different or missing.
    • Change song lyrics or words in stories to be about your child, their interests and/or what is happening around you in the moment.
  4. Pause
    • Slowly sing familiar nursery rhymes and songs and then pause at key words to encourage them to fill in a word or gesture.
    • Pause a familiar activity, such as pushing the swing, and wait for them to ask you to continue using words or gestures (e.g., “more,” “again,” “go”).
    • When looking for a response, stop talking, lean forward and look at them expectantly. You can count slowly to 10 silently, which gives your child time to respond.
  5. Expand
    • When your child uses one to two words, turn it into a short sentence. For example, if they say “up” wanting you to pick them up, you could say, “Ok, I’ll pick you up.”
    • Be sure to use correct grammar when expanding their message, even if your child is still using immature grammar.
    • Use a variety of words (e.g., describing words, action words, words for feelings, location words, etc.). Start with words your child would want to say to talk about the things they are interested in.

Many of these ideas are things you may already be doing throughout the day, but it is good to think about how doing so helps your child learn to understand and use language. If you feel that your child may be behind in their language understanding or production, it is helpful to schedule an evaluation with a speech-language pathologist. If therapy is warranted, your speech-language pathologist can make recommendations specific to your child and family and show you how to best encourage language growth in the home environment.

References:
Weitzman, E. (2017). It takes two to talk: A practical guide for parents of children with language delays (5th ed.). Toronto: Hanen Centre.

 

About the Author

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.

 

To book an appointment with or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Literacy-based Speech Therapy: Winter Edition

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP

NESCA Speech-Language Pathologist

Books are a great speech-language therapy tool. They can be used to target many different goals for a variety of ages and profiles. With books, children are given context for learning vocabulary, concepts and important story elements. Literacy-based therapy is not only more fun, but research also supports its use in teaching children with speech and language disorders:

  • Teaching story elements has been shown to improve oral language production and reading comprehension.
  • Teaching within a narrative context can make language learning less demanding, more meaningful and more authentic.
  • Students’ comprehension and story retelling/generation skills improved more with contextualized (literacy-based) intervention than decontextualized intervention.

Books can easily be incorporated into life at home, if they are not already a part of the daily routine. Just grab your or your child’s favorite book, or find a YouTube read aloud of it, and have your child help you read it! Be sure to pause throughout the book to talk about the pictures, make inferences about why events are happening and ask a few questions. Don’t be afraid to change the words to match your child’s level of understanding or interests.

My top three favorite winter books to use in speech-language therapy are:

  1. Sneezy the Snowman by Maureen Wright

A story about a cold and sneezy snowman who melts several times while trying to get warm. His human friends help him by rebuilding him and sharing their winter clothes.

Amazon: https://www.amazon.com/Sneezy-Snowman-Maureen-Wright/dp/1477810544

YouTube Read Aloud: https://youtu.be/iUsHnKSyDH0

Skills that I target and can be incorporated into shared book reading at home:

  • Producing subject-verb-object or complex sentences to talk about what is happening.
  • Predicting what will happen before and throughout reading (e.g., “Sneezy is drinking hot chocolate, what do you think will happen?”).
  • Answering detail (what, where, who, when) and inferential (why) questions.
  • Discussing story parts (e.g., characters, setting, problem, solution) and retelling the story.
  • Writing using different prompts, such as “My snowman melted because…” or “When I’m cold, I…”.
  1. The Mitten by Jan Brett

A traditional story about a boy whose grandmother knits him new mittens. He loses one mitten when he is outside playing, and many different animals climb inside to stay warm.

Amazon: https://www.amazon.com/Mitten-Jan-Brett/dp/0399231099

YouTube Read Aloud: https://youtu.be/duhj0Op_slo

Skills that I target and can be incorporated into shared book reading at home:

  • Sequencing events by talking about the order of animals that climbed into the mitten.
  • Creating a craft by printing a mitten and animals, coloring the animals and putting them inside the mitten as you retell the story.
  • Watching a different rendition of The Mitten on Vooks.com and comparing and contrasting the two stories using a Venn diagram.
  • Producing past tense verbs to describe what happened.
  • Making inferences about characters’ emotions and motivations.
  1. The Snowy Day by Ezra Jack Keats

A Caldecott Medal-winning book about a boy’s adventures in the snow when he puts on his snowsuit and goes outside to play.

Amazon: https://www.amazon.com/Snowy-Day-Board-Book/dp/0670867330

YouTube Read Aloud: https://youtu.be/FmZCQfeWjeQ

Skills that I target and can be incorporated into shared book reading at home:

  • Telling an original story together by covering up the words on the pages.
  • Finding words that contain the child’s target speech sound (i.e., if your child is working on producing the “R” sound, find all the words that contain “R” and practice those).
  • Describing character traits of Peter, the main character.
  • Discussing cause and effect (e.g., cause: Peter smacked a snow-covered tree, effect: snow fell on Peter’s head).
  • Writing using different prompts, such as “On a snowy day, I like to…” or “I can save a snowball by…”.

 

References:

Davies, P., Shanks, B., & Davies, K. (2004). Improving narrative skills in young children with delayed language development. Educational Review, 56, 271 – 286.

Gillam, S. L., Gillam, R. B., & Reece, K. (2012). Language outcomes of contextualized and decontextualized language intervention: results of an early efficacy study. Language, speech, and hearing services in schools43(3), 276–291. https://doi.org/10.1044/0161-1461(2011/11-0022)

Tomasello, M. (2003). Constructing a language. A usage-based theory of language acquisition. Cambridge, MA: Harvard University Press

 

About the Author

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.

 

 

 

To book an appointment or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson or call 617-658-9800.

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Is My Child a Picky Eater or Problem Feeder?

By | NESCA Notes 2020

Co-authored by: Abigael Gray, MS, CCC-SLP, NESCA Speech-Language Pathologist; Feeding Specialist, and Lauren Zeitler, MSOT, OTR/L, NESCA Occupational Therapist; Feeding Specialist

Do you have a child who presents as a picky eater? Have you ever wondered if their difficulties are more than just “picky eating”? Are mealtimes stressful for your family? There is someone out there who can help you!

Many children may be perceived as “picky eaters” while they are figuring out their food preferences. The important thing to understand is when your child would no longer be considered a “picky eater,” but instead a “problem feeder,” and therefore may benefit from feeding therapy. The chart below describes the general differences between the two. Every situation and child is different. If you have concerns, we always recommend reaching out.

There are other concerns that indicate a child may benefit from feeding therapy beyond the variety of food they accept, as described above. These concerns include:

  • Gagging, vomiting or choking when eating or drinking or shortly after
  • Poor posture while sitting at the table for meals
  • Difficulty using utensils within age-appropriate timeline
  • Issues with food control involving the mouth (e.g., chewing, closing lips around spoon or straw, drooling, pocketing food in cheeks, etc.)
  • Eating small volumes of food or taking more than 30 minutes to eat
  • Only eating certain textures of food (e.g., purees, crunchy solids, fluids)
  • Difficulty weaning from a bottle to solid foods
  • Transitioning from tube to oral feeding

Feeding therapy involves:

  1. Intake: you will be asked questions about your concerns to match you with a feeding therapist.
  2. Evaluation: before the evaluation, you will fill out a questionnaire about your concerns and goals for therapy as well as your child’s medical/developmental history. To obtain information about skills and behaviors, the feeding therapist will observe your child eating a variety of foods/textures and gain input from parents/caregivers. This will help the therapist determine whether your child presents with a feeding disorder and would benefit from feeding therapy. Recommendations will be made in a written report.
  3. Therapy: ongoing weekly therapy will be child-driven, and goals will incorporate your family’s priorities. Therapy will be individualized to address your child’s specific needs and goals.

For more in-depth information on this topic, register for the upcoming free webinar, “Is My Child a Picky Eater or Problem Feeder?” on November 18, 2020 from 10:30 – 11:30 AM Eastern Time. Register in advance for this webinar here.

If you have any concerns about your child’s feeding or questions about feeding therapy, please complete our online intake form, or email NESCA’s Director of Clinical Services Julie Robinson at jrobinson@nesca-newton.com.

 

About the Co-authors:

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.

 

 

 

 

 

Lauren Zeitler is a licensed Occupational Therapist in Massachusetts, specializing in pediatric occupational and feeding therapy. Ms. Zeitler joined NESCA full-time in the fall of 2020 to offer occupational therapy assessment and treatment for children of all ages, as well as to work in conjunction with Abigael Gray, MS, CCC-SLP, on the feeding team.

 

 

 

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.