2018 Holiday Shopping Guide -Toys to Promote Language Development

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“What should I get them???”
As therapists we hear this all the time.
You know what else we hear often?
“My kids don’t really play with toys.”

Here’s our 2 cents on this as professionals who believe in the power of play. We all play. All mammals. No matter how old. We were designed for play. It’s the best form of stress release. It recharges creative pathways. And most importantly, it brings JOY.

Sometimes as parents the hardest part is finding the right toy for the right kid (or adult). But we believe Santa has the perfect one for everyone .
So here’s what we’ve done this week.
We’ve made our lists and we’ve checked them twice.

We added toys we have in our homes. Toys we’ve learned about in patient’s homes. Toys recommended by therapists around the globe. And toys that span a large range of interests and prices.   Remember that toys and interest vary by age, so something on another list may really interest a child even if it is not included on the list for your child’s particular age.

We’ve given suggestions by age but here we are sharing some of our favorite LANGUAGE toys! However with toys to support language development it is MOST important to remember the magic is not in the toy but in the interaction you have with your child and the language  you model for your child while playing with the toy.  It is best to pick toys that do not light up, make sounds or talk for the child.  Often children are drawn to those types of toys (that require batteries to work) because of the flashing lights and sounds, however it takes the work out of the play and lessens your interaction with your child because the toy does that for you.  But YOU are and ALWAYS will be the best “toy” for your child to learn from!  These toys range from infant through preschool age.  We’ve picked toys that support join attention, offer opportunities for repetitive modeling of words, singing, early pretend play and vocabulary building.  But most importantly these toys are FUN and TIMELESS!   PLAY ON and Merry Christmas!!









DIY Adaptive Summer Seating

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Equipment for individuals with special healthcare needs have come a long way. The field is always evolving to higher levels of performance and patient friendly options, but the problem generally still exists that many items are bulky, heavy, and expensive.

A family I work with in early intervention is well equipped with equipment to ensure that their daily activities as a family are as easy as possible, including adaptive seating and mobility options for community outings, playtime, and daily routines like bathing and eating.

With spring finally deciding to show up around here, this family (like many) is busy planning more ways to enjoy time together outside. One area they identified as a challenge was helping their son to sit on their deck and at the park or beach. Yes, they are fortunate to have specialized strollers, but the reality is that for a quick trip, something light or something that doesn’t take up the whole trunk was desired.

Today during our session, for under $10, his mother and I created something that filled the need for his family. If you or someone you know could benefit from something similar, we are happy to share what we did and what we learned.

Supplies:

1 simple plastic chair ($5):

TIPS:

Fit to size for your child.

We preferred one with the bottom lower than the knee area (to prevent sliding).

Highly recommend a chair with slits to help with attaching supports.

2 Pool Noodles ($1 each).

Scissors to cut noodles.

Two bags of large zip ties ($1.87 each).

Plastic or wire cutters to trim zip ties once attached.

 

Assembly:

  1. We chose to start with the child in the chair and observe his posture. Where did he struggle to maintain neutral and upright positioning?
  2. With him in the seat, cut noodles to accommodate his size and weaker areas. For him this included: back of head, on each side of the trunk under arm pits to base of hips (vertically), on sides of lap from knees to hips (horizontally), a smaller piece on top of these horizontal pieces to support the elbows as needed (these were added after the photo shown above), and a small piece in between the legs as a pummel to prevent sliding.
  3. Attached noodles with zip ties by lacing through chair slits (note: we realized after the fact, but it would be recommended to have the fastener part of the tie on the backside of the chair to prevent rubbing/irritating the skin). 
  4. We attached a loose scarf of moms through slits and around his upper trunk, not as a firm support, but a light reminder for him to avoid slouching.

We were thrilled with the results and so was he! With an adaptive tray he could easily access his I-pad (used for vision work and communication) in his new “desk!” His mom and I were quickly able to identify many potential uses – kicking in the baby pool, outdoor movies, on the sidelines at siblings games, at grandma’s house!

We believe play keeps us all happy, healthy, and smart! When I can help adapt something simple to make joyful activities easier for families, it’s just a really good day.

 

 

 

Share Your Story With Stones

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Stones. Rocks. Pebbles. Boulders.

I love them. I don’t know why but I do. And I always have.

I love to see kids proudly tuck them in pockets. It reminds me of my “lucky hopscotch rock” I kept for months in my pocket.

I love to create and craft with them. I especially love to paint on them (a favorite I used to do with my mom and later with my kids).

But one of my favorite’s is to create story stones.

Using (free) rocks and a simple black marker, you can create a variety of children’s favorite objects or people and let them line them up and then create a story based on the order they created.

I recently did this with my cousin’s son. He is just 3 years old but is creative, articulate, and thoughtful and was pretty fascinated by the “game.” He made me tell about 10 different stories based on the various arrangements of rocks he laid down. When I asked him to take a turn, he wasn’t quite ready, but a short while later, I found him creating his own story with his special rocks for his Papap (who just woke up and wasn’t sure what was going on!).

I love story stones because they are simple, cheap, build vocabulary, help focus attention to task, and are fun! As a child gets older or understands the process of the “game,” stones can easily be added to develop more complex plots and details. And you can search for the perfect stones on walks and hikes! This is a great activity to introduce around 15 months but may be especially meaningful as a child’s vocabulary increases rapidly between 2-3 years old.

 

This story went something like…..

Once Thomas the Train had a best friend, a little boy named Gabriel. Gabriel loved trucks and cars. He lived in a house with his mom and dad and baby brother and their dog named Ethan (he filled in this detail!).  One sunny day Gabriel and Ethan went on a walk and chased birds at the park.

Simple. Easy. Fun. and a purposeful way to play.

Try exploring new mileSTONES today with story stones — and send us your pictures. We’d love to hear from your little authors!

For more ideas of pairing milestones with with purposeful play, grab your copy of 1-2-3 Just Play With Me today! (As always FREE Shipping in the US).

 

OUR GIFT to #ASHA15 Customers!

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We are packing our bags and headed to DENVER!  This year’s National ASHA Conference is the biggest conference we have attended and we are thrilled and honored to be among 12,000 Speech Therapists as speakers and as vendors! We hope if you are attending, you will come see us at BOOTH #358 where we will be sharing all we have to offer, including:

1-2-3 Just Play With Me (print and digital) – Print copy at a discounted conference rate!

PLAY BUILDS BRAINS coffee mugs

Customized Developmental Checklists

To celebrate this MILESTONE event for our company, we are sharing our joy in several ways, including:

A FREE TOY OF THE DAY TREAT to use in your work as an SLP (while supplies last!)

An INCREDIBLE daily and grand prize drawing for therapists purchasing 1-2-3 Just Play With Me — you could go home with an inspiring and beautiful bracelet, new stylish totes for your therapy gear, and resources (books, toys, games – including resources from Scanlon Speech Therapy) to fill those totes, PLUS a KINDLE FIRE with the ebook version of 1-2-3 Just Play With Me on it!

See flyer below for pictures of all these great goodies!

ADDITIONALLY – if you purchase 1-2-3 Just Play With Me at ASHA ’15 (which will will ship for FREE to your home or office  – no need  to fill your carry on with our beautiful box!), you will receive a FREE set of useful handouts to use with parents and teachers/staff.  We’ve created detailed handout like the one below on our TOP 10 TOPICS (aka the things we repeat OVER and OVER as therapists!) So let us help you reinforce your message with having your own copies of these on your computer to reuse as many times as you like!

Topics incude:

  1. BYE BYE BINKIE (Risks of prolonged sucking and strategies for weaning)
  2. READ ALL ABOUT IT (Benefits and tips for daily literacy)
  3. TUMMY TIME TIPS (Benefits & tips for tummy time)
  4. ALL ABOUT PLAY (Information for parents of staying focused on play based activities)
  5. THE WONDERS OF BLOCK PLAY (A beautiful picture graphic on the many uses of blocks)
  6. IS TV SAFE FOR BABY? (Guidelines and education on screens and the young child)
  7. WHAT DOES READY FOR KINDERGARTEN MEAN ANYWAY? (Education & tips on pre-K play based readiness)
  8. PICTURE THIS (Education & tips for picture based communication) 
  9. LEARNING TO SPEAK (Articulation Development)
  10. TOY TIPS (Support on choosing toys with a developmental purpose and setting up a play space). 

 

We are proud to be with you at ASHA ’15 as your #1 PLAY advocates! So come have fun with us. BOOTH #358 is the place to be for FUN, useful education, & practical resources! Follow the butterfly & come PLAY with us in Denver!

Milestone or Modern Convenience Part II: What to do when the convenience becomes a hard habit to break

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Lacy recently wrote a blog for Virginia’s Early Intervention Program – specifically geared for therapists that work for that program, but the information is important for clinicians AND parents and caregivers. We have reposted it here but you can find the original HERE.

 

Written by: Lacy Morise, M.S. CCC/SLP

 
If you haven’t read it yet, be sure to check out the first blog post in this 2-part series, Milestone or Modern Convenience? – Part I: Overuse of the Sippy Cup and Pacifier, to learn important information about an infant’s need for sucking and the risks involved with overuse of the pacifier and sippy, cup!

 
Now that you are familiar with the pluses and minuses of pacifier and sippy cup use, what about when the parents are ready to help baby “give up” the sucking habit? Again, as the resource for all things infant and toddler, we can suggest the following tried and true strategies.

 
Cut back – When ready to begin weaning, cut back on the time that the pacifier and/or sippy cup is available to the child. If the pacifier has been available to the child all day, every day suggest cutting back its availability to only nap and bedtime. As for the sippy cup, cut back its use to only when the family is out and about. When at home suggest offering the child a straw or open cup in its place.

 
Go cold turkey…if the child is ready – If going cold turkey is the method of choice pass along this wisdom: if the child is not ready, he may find something else to suck on, like a thumb or fingers. However, if ready, this method may work just fine. Suggest that, if going cold turkey, it is a good idea to rid the house (or at least baby’s line of sight) of all pacifiers and/or sippy cups. If they remain in the cabinet or drawer, baby will know and will want them!

 
Provide additional comfort – In preparation of weaning a baby from the pacifier and/or sippy cup, provide him with an additional comfort item. If the child’s only “lovey” is the pacifier or sippy cup, having a back up “lovey” will still allow the child a comfort when his first choice is gone.
Understand that routines may change – Warn your families that routines may change when weaning baby from the pacifier and/or sippy cup, especially if it is used as the child’s primary comfort item. When the pacifier/sippy cup is gone, the child may need assistance with calming, temporarily; swaddling, rocking, singing and some extra cuddles may be necessary until baby learns how to calm himself without the help of his pacifier or sippy cup.

 
Give the pacifier or sippy away to a new baby – Sometimes parents can convince the child to give up these items with some incentive. However, it is suggested that the new baby receiving the child’s old pacifiers/sippy cups not live in the same house. It will be more difficult for the child not to suck on a pacifier if there is one nearby. Some parents are also able to negotiate a trade with their child: “If you leave your pacifier under the Christmas tree, Santa will take it with him and leave you a present!” If the child is ready, this trick is a gem!

 
Some tips to warn parents to not try are:
Never, ever cut the pacifier nipple and give it to the child – Yes, if there is no nipple for the child to latch onto they will be less interested in sucking the pacifier. However, the risk of choking is too great to ever recommend this as a means of pacifier weaning. Pacifiers have to pass what is called a “pull test” during manufacturing. A cut nipple would not pass this pull test and would be deemed as unsafe for a child to have.

 
Do not shame the child for wanting to suck on his pacifier or sippy cup – Toddlers and preschoolers typically do not respond to being shamed into giving up the pacifier or sippy cup. Telling the child that in order to be a “big kid” he must give up his most prized possession may just make him want it more. And who can blame him, who really wants to “grow up” anyway?!

 
Do not recommend putting something that tastes bad on the nipple of the pacifier and/or sippy cup – I have known families to dip the nipple in chili powder to convince their toddler to stop sucking on his pacifier. One sweet little guy I knew still wanted his pacifier so badly that he licked the chili powder off, little by little, chased it with water and eventually got his paci back. Again, this is a case of the parent wanting the child to make the decision to give up the comfort item. Not gonna happen! Sometimes the parent has to be just that and take control.

 
So we wish you good luck as you head into the magical world of the paci and sippy cup. It holds a strong spell on many little ones, but with the right guidance and when our families are ready, we can help them help their children kick the habit!

 
Do you have any suggested weaning methods to add to this list? What would you say to encourage your families to follow through with weaning their child?
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Lacy Morise, M.S. CCC/SLP educates families on the risks involved with over-use of the pacifier and sippy as an early intervention speech-language pathologist in the West Virginia Birth to Three Program. She guiltily confesses to allowing all of her children to abuse the use of the pacifier! She owns Milestones & Miracles, LLC a company devoted to educating families about child development and the importance of PLAY! Check out her website and blog and follow her on Facebook, Pinterest, Twitter and YouTube.

Milestone or Modern Convenience? Part 1: OverUse of the Sippy Cup or Pacifier

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Lacy recently wrote a blog for Virginia’s Early Intervention Program – specifically geared for therapists that work for that program, but the information is important for clinicians AND parents and caregivers. We have reposted it here but you can find the original HERE.

 

Written by: Lacy Morise, M.S. CCC/SLP

Although shocking to many, the sippy cup is NOT a developmental milestone. Nor is sucking on a pacifier, for that matter. But why do we (therapists,??????????????????????????????? parents and caregivers) celebrate these acquired “skills” as developmentally appropriate achievements? Why do we allow these “skills” to happen for much longer than they should? Is it just easier to always have a pacifier (aka mute button) in the baby/toddler’s mouth? Sippy cups are so easy to take along with us everywhere, how can it be harmful if a preschooler continues to exclusively drink from one?
The pacifier is a great thing for infants. It meets a physiological need to suck and allows baby a way to comfort himself. It may reduce the risk of SIDS as it appears to allow baby’s airway to remain more open and prevent baby from falling into a deeper sleep. Not to mention the other fringe benefits like quieting rowdy babes, helping them sleep longer and making outings and car rides more enjoyable for all. It certainly has a “place” in an infant’s world! And the sippy cup is an awesome convenience must-have. Drinks can be toted everywhere with baby/toddler and a sippy’s use means less spills to stain the carpet! Beautiful!
But aside from these benefits, there are risks associated with the over-use of both. Pediatricians and family physicians recommend weaning or stopping pacifier use in the second six months of life. Shocking I know considering how many toddlers we see with pacifiers in their mouths! The sippy cup can be skipped all together if natural development is occurring with no issue. Created for convenience, the sippy cup now has an entire market (and aisle in most stores) devoted to it! However a baby can transition to a straw (as early as 9 months) or open cup just as easily and drinking from both of these IS developmentally appropriate.

 

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As trusted resources on development, it is our job as early interventionists to inform families of both the positives and negatives of (prolonged) sucking. Some points to keep in mind as you discuss these “milestones” with parents and caregivers:
Prolonged sucking on a pacifier puts children at (a higher) risk for misaligned teeth. As those tiny white pearls are erupting, the pressure of the nipple of the pacifier can cause teeth to move around and shift. Also, the pressure can cause their hard palate, the roof of their mouth directly behind the front teeth, to change. It can push the palate forward, again changing the position of the teeth. In his research, J. Poyak concludes, “The greater the longevity and duration of pacifier use, the greater the potential for harmful results.”
A sippy often allows access to drinks all day long for a toddler. Not necessarily a bad thing, depending on what is in the sippy. If it is a sugary drink, the sugar increases the risk of developing cavities. The Medline Plus article titled, “Tooth decay – early childhood” states, “When children sleep or walk around with a bottle or sippy cup in their mouth, sugar coats their teeth for longer periods of time, causing teeth to decay more quickly.” Also, if a sippy is the only way a child gets liquids the developmentally appropriate skills of drinking through a straw and open cup are inhibited.
If children are allowed to have a drink (in a sippy or other cup) all the time, they may fill up on liquids and not eat meals as well, negatively impacting their nutrition. 

 

Although inconsistent, research suggests a relationship between prolonged sucking and speech delays. Barbosa et al. (2009) concluded in their research of 128 Patagonian preschoolers that, “The results suggest extended use of sucking outside of breastfeeding may have detrimental effects on speech development in young children.” When speech sound development is negatively impacted, so is the child’s intelligibility of speech making it difficult for others to understand them.
Sucking on a pacifier increases a child’s risk of developing otitis media (ear infection). The AAP (American Academy of Pediatrics) and AAFP (American Academy of Family Physicians) advocate for limited to no use of the pacifier in the second six months of the child’s life to decrease this risk.
A pacifier or sippy cup that is always in the mouth of a child, even when the child is walking around, puts him/her at a higher risk for mouth injuries. A 2012 study by Dr. Sarah Keim of Nationwide Children’s Hospital in Columbus, found that “a young child is rushed to a hospital every four hours in the U.S. due to an injury from a bottle, sippy cup or pacifier.” When little ones are just learning to walk, doing two things at once requires a bit more coordination than they are capable of!
Besides the physical risks, beyond the age of 1 a stronger emotional attachment to the pacifier (or sippy cup) makes it increasingly difficult for the child to detach. The pacifier/sippy goes from meeting a physiological need during infancy to providing emotional comfort to the toddler when scared, upset or sleepy.
However, it is our job to know and respect the individuality of each child. Therefore it is best practice to reassure parents that we recognize they know their child best. We all want our children to be happy and if using a pacifier and/or sippy is what’s best for them and their family, that is okay. Our job is to inform the families we serve the best we can. Equipping them with knowledge on why prolonged sucking may be detrimental to their child allows the family to make the final call. Education and Support, that’s what we are there for.
Have you ever had the “prolonged sucking” discussion with any of the families you serve? How might you begin this conversation with a family?
Today’s blog is Part I of a two-part series on prolonged sucking and what we can do to educate families about it. Stay tuned for “Part II – What to do When the Convenience Becomes a Hard to Break Habit” next week featuring ideas you can share with families who are ready to wean their child off of the pacifier or sippy!
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References
Barbosa, Clarita, Sandra Vasquez, Mary Parada, Juan Carlos Velez Gonzalez, Chanaye Jackson, N David Yanez, Bizu Gelaye, and Annette Fitzpatrick. “The Relationship of Bottle Feeding and Other Sucking Behaviors with Speech Disorder in Patagonian Preschoolers.” BMC Pediatrics. N.p., n.d. Web. 20 Mar. 2015. http://www.biomedcentral.com/1471-2431/9/66
EG, Gois, HC Rubeiro-Junior, MP Vale, SM Paiva, JM Serra-Negra, ML Ramos-Jorge, and IA Pordeus. “Influence of Nonnutritive Sucking Habits, Breathing Pattern and Adenoid Size on the Development of Malocclusion.” Angle Orthod.4 (2008): 647-54. Print. http://www.ncbi.nlm.nih.gov/pubmed/18302463
Guideline on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents (n.d.): n. pag. Web. 18 Mar. 2015. http://www.aapd.org/media/Policies_Guidelines/G_Periodicity.pdf
Hauck, Fern R., MD, MS, Olanrewaju O. Omojokun, MD, and Mir S. Siadaty, MD, MS. “Do Pacifiers Reduce the Risk of Sudden Infant Death Syndrome? A Meta-analysis.” PEDIATRICS5 (2005): E716-723. Do Pacifiers Reduce the Risk of Sudden Infant Death Syndrome? A Meta-analysis. PEDIATRICS. Web. 17 Mar. 2015. http://pediatrics.aappublications.org/content/116/5/e716
Keim, Sarah A., MA, MS, Erica N. Fletcher, MPH, Megan R.W. Tepoel, MS, and Lara B. McKenzie, PhD, MA. “Injuries Associated With Bottles, Pacifiers, and Sippy Cups in the United States, 1991-2010.” N.p., n.d. Web. 19 Mar. 2015. http://pediatrics.aappublications.org/content/129/6/1104.long
Natale, Ruby, PhD, PsyD. “Risks and Benefits of Pacifiers.” American Family Physician79 (2009): 681-85. – American Family Physician. Web. 18 Mar. 2015. http://www.aafp.org/afp/2009/0415/p681.html
Poyak, J. “Effects of Pacifiers on Early Oral Development.” Int J Orthod Milwaukee4 (2006): 13-6. Print. http://www.ncbi.nlm.nih.gov/pubmed/17256438
Regulatory Summary for Pacifier (n.d.): n. pag. U.S. Consumer Product Safety Commission. Web. 18 Mar. 2015. http://www.cpsc.gov//PageFiles/120645/regsumpacifier.pdf
“Tooth Decay – Early Childhood: MedlinePlus Medical Encyclopedia.” S National Library of Medicine. U.S. National Library of Medicine, n.d. Web. 17 Mar. 2015. http://www.nlm.nih.gov/medlineplus/ency/article/002061.htm
Zardetto, CG, CR Rodrigues, and FM Stefani. “Effects of Different Pacifiers on the Primary Dentition and Oral Myofunction Structures of Preschool Children.” Pediatric Dentistry6 (2002): 552-60. Print. http://www.ncbi.nlm.nih.gov/pubmed/12528948
____________________________________________________________________
Lacy Morise, M.S. CCC/SLP educates families on the risks involved with over-use of the pacifier and sippy as an early intervention speech-language pathologist in the West Virginia Birth to Three Program. She guiltily confesses to allowing all of her children to abuse the use of the pacifier! She owns Milestones & Miracles, LLC a company devoted to educating families about child development and the importance of PLAY! Check out her website and blog and follow her on Facebook, Pinterest, Twitter and YouTube.
Website: www.milestonesandmiracles.com
Blog: www.milestonesandmiraces.com/blog/
Facebook: https://www.facebook.com/milestonesandmiracles
Pinterest: https://www.pinterest.com/milestonesm/
Twitter: https://twitter.com/MilestonesM
YouTube: https://www.youtube.com/watch?v=HmuWPFDcqZ4

COMMUNICATION FOR ALL – How AAC Helps Children Find Their Voice

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This post was originally written for Child Guide Magazine. Check out the many resources Child Guide offers as well as this article and others HERE.

 

clairechase

What comes to your mind when you hear the word “communication”? Do you think of talking? That is what most people consider to be communication. But what if you don’t have a voice to talk? Or if when you talk no one can understand what you are saying? How do you communicate then?

 

Speech-language pathologists help those without an audible voice find their “voice” by introducing them to AAC. What is AAC? Augmentative and Alternative Communication (AAC) is just that; other ways, using high or low technology, to communicate. AAC includes something as simple as a head nod to something as high tech as a speech generating device.

 

The American Speech-Language and Hearing Association defines AAC as all forms of communications, other than oral speech, used to express thoughts, needs, wants and ideas. AAC can be aided or unaided. Unaided AAC is using body language, gestures and/or sign language to communicate. Aided AAC is when tools and/or equipment are used, such as pictures and speech devices.

 

Communication is a right of all people and it is the job of a Speech-Language Pathologist to help children access that right in the absence of the ability to speak. But how does one decide which AAC approach is best for the child? There are recommended criteria that typically have to be met for the child to be considered as an AAC candidate.

 

  1. Does the child understand cause and effect? Cause and effect is the foundation of communication; I do something and get something in return. Sometimes cause and effect can be taught using an AAC device.

 

  1. Manual dexterity and fine motor skills. To be able to access sign language as a means of communication the child must have the fine motor skills to perform two-handed signs. Also, to be able to push a button to activate a speech device, the child must be able to control the motor movement of the arm and hand. Tilt switches (a simple head tilt) and eye gaze systems exist to allow children with minimal controlled movement to access AAC.

 

  1. Motivation! The child has to be motivated to communicate to be successful with any type of communication option. A highly desirable reward just might motivate any child to use their AAC!

 

So what does AAC look like for real kids? How does their voice sound? Meet Claire and Ethan, two AAC user success stories!

 

Claire

Claire Elias, daughter of Mark and Melanie Elias of Frederick, Maryland, is an adorably sweet 4-year-old girl. Claire loves the color pink and hugging her stuffed animals. She loves to watch Minnie Mouse and Sophia the First and her best friend is her twin brother, Chase. Claire has an incredibly happy disposition and a smile that lights up a room. Claire uses AAC to express herself. At the age of 2 she began using an iPad with a communication app to request toys and answer yes/no questions. The fine motor movements necessary to operate the iPad proved to be a difficult for Claire. Now she uses a PODD (Pragmatic Organization Dynamic Display ) book to communicate. A PODD book is a picture system that allows Claire to use visual gaze to make requests, ask questions, comment, etc. Claire will be 5 in June and will attend Kindergarten next fall. Her PODD book goes with her everywhere, just like her voice.

 

 

Ethan

Ethan Judd, son of Christy and Jeff Judd of Inwood, WV, is a 6-year-old kindergartener at Bunker Hill Elementary. Ethan has an awesome sense of humor and a determined mindset. His favorite colors are green and orange and he loves, and often wins, playing UNO. Because of his tracheostomy, Ethan was unable to access his voice during his infant, toddler and preschool years. During this time Ethan used a combination of sign language and an iPad with a communication app. Since then Ethan has gained respiratory strength and now mostly relies on his voice to communicate. Sometimes he accompanies his speech with sign language to increase his intelligibility (the clarity of how he is understood). Ethan’s story is an example of how AAC bridged the gap for him until he was strong enough to vocalize. AAC gave Ethan a voice when his wasn’t available to him.

 

Claire and Ethan’s stories are just 2 of many, many AAC success stories. If you know a child who has yet to “find” their voice, contact an SLP close to you to help. Communication is a right of all individuals, no one should be denied!

 

Lacy Morise, M.S. CC/SLP, better known as Miss Lacy, is a Speech-Language Pathologist with the WVBTT and Loudoun County Schools. She is co-owner of Milestones & Miracles, LLC (www.milestonesandmiracles.com), a company dedicated to educating families about the importance of PLAY. She loves to use verbal and nonverbal language approaches to help kids access their right to communicate!

Why Moo, Baa and La La La Matter (and crash, boom and bam too!)

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I commonly ask the following question when I enter a home for a new evaluation: “What animal sounds does Johnny make?” Or I might ask, “Does he make any car noises or crashing sounds?” Although I know why I ask those types of questions I recently put myself in the parents’ shoes. The parent who most likely doesn’t have a background in speech and language development and might wonder why on earth it matters if Johnny can say “moo” or “vroom”. After all, our goal is real words here, so what purpose does moo or baa (or la la la) have to do with his ability to talk?

 

Environmental sounds, as they are called in the child development world, matter. They are the first sounds that most children produce, long before true words. They are easier to say and offer children the opportunity for practice in producing sounds and combining them into syllables. Environmental sounds (animal sounds, car noises, crashing noises, etc.) are also how little ones let us know early on that they understand associations between objects/animals and the sounds they make. Also, environmental sounds are repetitive which make them easier for little ones to say. “Moo moo”, “neigh neigh”, “baa baa” are all single syllable, repetitive sounds.  Environmental sounds can be learned and practiced through PLAY; you model the sound for the child and they imitate it. Environmental sounds can also be learned and practiced through books.

 

Sometimes I work with kids who make no or very few environmental sounds. Because production of environmental sounds typically precludes word production I make the following suggestions to the family to encourage development of this skill:

 

  1. Work on the skill of imitation. Your child may not be quite ready for verbal imitation so work on imitating gestures instead. For example, if your child doesn’t imiate the “yuck” sound, stick out your tongue while you say it and they may stick their tongue out too. These gestures associated with sounds will bring about the verbal production sooner!
  2. Expose your child to a new experience related to environmental sounds. When a child can visit the cow on the farm or the lion at the zoo it allows them to make the connection between sound and animal more real and the boost in their receptive language results in more verbal expression. Or visit the construction site to hear the loud trucks and diggers, or take a walk outside and listen to the birds.
  3. Read books that have sounds in them that the child can imitate. When you read be silly, exaggerate the sounds, vary your pitch and volume to grab the child’s attention and make them feel more comfortable in attempting to imitate you.
  4. Reward your child’s attempts of saying any and all sounds. Praise, celebrate and recognize their attempts to make car, animal, and all environmental sounds. When they know they were heard and understood, kids feel more empowered to attempt more communication.

 

As I mentioned before, PLAY affords a child the best opportunity to learn what sounds animals, cars and other toys make. But books can also be an important tool in learning early communication skills. Here are some of my favorites for teaching imitative sounds:

 

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So now you know why those silly sounds are SO important.  Fun to say, even more fun to imitate, environmental sounds play a part in your child’s communication development!  Now that you know, you must feel empowered,  so go “moo, baa and la la la” with confidence! 🙂

 

 

 

BIG INSPIRATION IN A tiny PACKAGE- how a little girl with CAS taught me to believe and persevere.

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I received the phone call after recently rejoining the workforce from  maternity leave with my second child.  I remember exactly where I was when the service coordinator called to ask if I would consider joining the team of a  2 year old diagnosed with Childhood Apraxia of Speech (CAS) whose parents are both special educators.  Whoa!  Talk about pressure!  The family was requesting me because of a recommendation they had received from another family I worked with whose son had CAS.  I had recently developed an interest in the speech disorder after serving two other children with suspected CAS.  I took a couple of courses and settled on a therapy kit to address CAS but like they say, “experience is the best teacher” and I wanted some of that.  So I agreed to be Camryn’s speech therapist, anxious to learn more about CAS through my treatment of her.  Although I didn’t know it at the time, Camryn would end up being  MUCH more to me than just experience.

I first met Camryn one Spring evening at her home.  She was a pint-sized toddler full of spunk and cheer.  Our first interactions let me know it was going to be a long road for her.  I explained to her parents that her speech therapy would be more like a marathon than a sprint.  They asked me questions like, “Will she ever talk ‘normal’?“ and “Will this be something she will struggle with for the rest of her life?”.  All valid, good ‘concerned parent’ questions, all of which I could not answer.  And so began my journey with Camryn, me teaching her-her inspiring me!

ASHA (American Speech-Language and Hearing Association) defines Childhood Apraxia of Speech (CAS) as a motor speech disorder where children have difficulty saying sounds, syllables and words in the absence of muscle weakness or paralysis.  The brain has difficulty planning the movements required of the tongue, jaw, lips, etc. needed for speech production.  The child knows what they want to say but are unable to get their mouth to move in a way to produce the words.  These children require frequent, intensive speech therapy to improve and sometimes CAS co-occurs with feeding difficulties and/or cognitive delays/learning difficulties.  There is little data available reporting the prevelance and incidence of CAS however, some sources suggest that 1-10 in 1000 children have the disorder.

When I started with Camryn she could say /s/ and /ah /.  That was it.  Because of her sweet, laid back personality she wasn’t yet experiencing much frustration.  Plus her mom had been very proactive in teaching her sign language, which gave Camryn a way to express her immediate desires.  We started with 2 sessions per week and continued on with this schedule for a few years.  Her improvement was slow and steady with some bursts of progress here and there.  While me being there was important to guide her therapy along, the biggest job was left in the hands of her family.  I stressed to them that her progress would be hugely dependent upon them practicing with her EVERY single day.  Their dedication was obvious when I would come week to week and witness her saying new sounds and syllables with less effort.  Each sound, syllable and word Camryn said was earned.  Repetition, practice, dedication, perseverance and determination were required for her to do something the rest of us take for granted.  Camryn’s challenges were huge.  What I was asking her to do week to week in therapy was extremely difficult but she didn’t give up.  When I think of the challenges Camryn has faced over the years I am ashamed to think how quick I am to give up on much less challenging tasks.  She has never backed down, only risen up.  And her progress and successes are proof of that!

 

It’s been 5 years since I had the pleasure of meeting Camryn and her family. Today she is an aspiring gymnast who attends kindergarten, speaks in 5 word sentences, ask questions and carries on lengthy conversations.  She has inspired me and challenged me beyond my expectations.  She is my success story; my proof that hard work and a positive attitude can only lead to awesome achievements!  Camryn will go far in this world inspiring others to rise up to whatever challenge they may be facing.  I am proud of her, and her family!  And Camryn will forever remain one of the strongest, bravest, FIERCEST girls I know!

 

If you are concerned that your child, or a child you know, may have CAS, contact a speech-language pathologist to request an evaluation.  For more information on the disorder visit:  www.asha.org and www.apraxia-kids.org.