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Common Misconceptions About Picture Exchange Communication System

What is a Picture Exchange Communication System (PECS)? PECS is a form of Augmentative and Alternative Communication (AAC) which uses a picture/symbol system to teach initiation ofBlog-Picture Exchange Communication System-Main-Landscape
functional communication. PECS was developed by Lori Frost and Andy Bondy in 1985 to be used with preschool children on the autism spectrum who demonstrated little to no socially-related communication. Examples include: children who avoided interactions with others, did not approach others to communicate, and/or only communicated when prompted to do so.

Myth #1: The Picture Exchange Communication System is strictly used for nonverbal children or children on the autism spectrum.

A common misconception about the Picture Exchange Communication System (PECS) is that it is strictly used with nonverbal children. While PECS and other forms of AAC have proven very useful and successful with nonverbal children, the system services many other populations with the purpose of eliciting and initiating functional communication.

To fully understand the meaning of functional communication, a distinction must be made between actions directed to the environment vs. actions directed toward a person. A child may climb on a step stool to reach a toy car on a shelf. From this action, we could infer that the child wants to play with the car. However, this is not communicative. If this same child looks from the car to his mother, or leads his mother over to the car, this is considered communication. Neither interaction involved speaking, however the distinction is that communication occurs when an action is directed towards someone else to achieve a certain outcome.

Therefore, Picture Exchange Communication System is appropriate, not just with children or adults that are not verbally communicating, but with those who are verbal, yet lack person-directed communication.

Other populations where PECS might be appropriate (to name a few):

-late-talking children (research is showing benefits for the introduction of AAC as early as 12 months)

-adults with aphasia

-Childhood Apraxia of Speech (CAS)

-children with reduced speech intelligibility

-verbal children with reduced social language and initiating

Myth #2: Using PECS will deter my child from communicating verbally

For some children, verbal communication can be a challenge; speech and language are not developing as quickly as would be anticipated and, accordingly, result in accompanying frustration and associated behaviors. Introduction of an augmentative and alternative communication system like PECS can help bridge the gap for children who are not yet verbally communicating but need an accessible means of communication as speech and language develop. Without an effective means of communication, these children are at risk for social, emotional, and behavior problems, including feelings of frustration and isolation.

Often, parents are concerned that using an augmentative or alternative form of communication will replace or deter verbal communication. In fact, research has shown just the opposite:

“Research over the past 25 years has shown not only that use of augmentative communication systems (aided or unaided) does not inhibit speech development but that use of these systems enhances the likelihood of the development or improvement of speech.” (Bondy & Frost, 2004)

The PECS program mirrors the acquisition of typical language development; children are taught one-word labels for frequently requested items before transitioning to formulation of two-word utterances. Verbally requesting and labeling can be targeted in conjunction with the program. The PECS program also details modality transitioning (i.e., transitioning from PECS to verbal communication), if and when it is appropriate.

If your child is using PECS now, this does not mean that you are “giving up on speech”. It is a system that is being utilized to give your child a means of communicating and interacting with others while speech is developing.

Myth #3: PECS cannot be used with children who have visual impairments, fine motor, or gross motor difficulties.

PECS can be used with a wide range of age-groups and disabilities. Accommodations can be made for children and adults with visual impairments, fine motor, or gross motor difficulties, to name a few.

Pictures can be made in various sizes to accommodate visual impairments. Additionally, you or your child’s speech language pathologist can select and modify pictures to suit your child’s needs; photographs can be used instead of clipart or Boardmaker pictures, and images can be modified to create more contrast.

Pictures can also be put on objects (e.g., bottle tops) to make them easier to grasp and pick up from a table or book for children with fine motor difficulties.

Step 2 of PECS involves ‘distance and persistence’, meaning a child is taught to move across a room, multiple rooms, etc. to select a picture from his book and persist when giving it to his communication partner. Students that are non-ambulatory can use a voice switch or a button to request his communication partner in order to perform the exchange.

If you have questions about PECS and if it would be appropriate for your child, please consult with a licensed speech language pathologist.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Lauren Kastan

Lauren Kastan

Lauren Kastan (M.S., CCC-SLP), a licensed speech-language pathologist, received a Master of Science degree in Speech, Language and Learning from Northwestern University and a Bachelor’s degree from the University of Michigan in Ann Arbor. Upon receiving her Bachelor’s degree, Lauren spent a year teaching English at an elementary school in Tel Aviv, Israel, which further fueled her love of language and passion for working with children. At Northwestern University, Lauren gained extensive experience diagnosing and treating an array of speech and language disorders in both children and adults. She gained clinician experience working with inpatients in acute care at Northwestern Memorial Hospital, as well as with children in the Chicago Public Schools. Lauren is trained in the Orton-Gillingham reading program and holds a Professional Educator’s License through the state of Illinois. Lauren is passionate about helping children communicate to their full potential.

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5 Best Apps to Work on Speech and Language at Home

  1. My PlayHome by PlayHome Software LtdBlog-Speech-Apps-Main-Landscape
    • A digital doll house that lets your child use everything inside. You can fry an egg, feed the family pizza, pour drinks, feed the pets, and more! This app does not specifically target speech
      and language skills; however, there are many ways it can be used to work on speech/language at home. While playing with the doll house, you can work with your child on pronouns, identifying actions (e.g., cooking, sitting), present progressive –ing (e.g., drinking), plurals (e.g., two apples), vocabulary (around the house), formulating complete sentences, etc. I also like to use this app as a motivating activity for children working on speech sounds. For example, I will say, “Tell me what the doll is doing with your good ‘r’ sounds.” There is also My PlayHome Hospital, My PlayHome School, and My PlayHome Stores.
  2. Articulation Station by Little Bee Speech
    • This app is fantastic for children working on speech production skills. The whole app is pricey, but beneficial for a child working on more than one speech sound. It is also possible to download individual speech sounds to target a specific sound at home. This app is motivating and excellent for home practice!
  3. Following Directions by Speecharoo Apps
    • Excellent app for working on following directions. Choose from simple 1-step directions, 2-step directions, or more advanced 3-step directions. These funny directions will have your child laughing and wanting to practice more.
  4. Peek-A-Boo Barn by Night & Day Studios, Inc.
    • My favorite app for toddlers working on expressive language skills. First, the barn shakes and an animal makes a noise. Have your child say “open” or “open door” before pressing on the door. You can also have your child guess which animal it is or imitate the animal noises. When the animal appears, have your child imitate the name of the animal.
  5. Open-Ended Articulation by Erik X. Raj
    • This app contains over 500 open-ended questions to use with a child having difficulty producing the following speech sounds: s, z, r, l, s/r/l blends, “sh”, “ch”, and “th”. It is great for working on speech sounds in conversation. Have your child read aloud the question and take turns answering. The open-ended questions are about silly scenarios that will facilitate interesting conversations.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Andrea Levy

Andrea Levy, Speech-Language Pathologist, earned her Masters of Science in Speech, Language, and Learning from Northwestern University. During graduate school, she provided treatment for children ranging from 1 to 14 years of age presenting with childhood apraxia of speech, articulation and phonological disorders, receptive-expressive language disorders, pragmatic disorders, and fluency disorders. Andrea gained valuable experience at a medical externship at Shriners Hospitals for Children in Chicago where she provided treatment for children with cleft lip and cleft palate presenting with articulation and receptive-expressive language disorders. Prior to graduate school, she had numerous experiences working with children as a teacher’s assistant in a public school special education program and as a daycare substitute teacher. Andrea completed a student externship at North Shore Pediatric Therapy in 2015 where she enjoyed working with the pediatric population and collaborating with other therapists. She was excited to return to North Shore Pediatric Therapy after graduation. Andrea is a dedicated therapist that enjoys working with children and their families to find the approach that best supports the individual child.

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What Can a Child with Autism Expect in Speech Therapy?

If you are a parent or a professional who has had experience with a child diagnosed with autism, you know that they are all as different as the colors under the sun. Speech therapy services areBlog-Autism-and-Speech Therapy-Main-Landscape typically recommended and necessary for kids diagnosed with autism, as they may have difficulty communicating effectively. These services will be tailored to the individual to ensure the child is making progress and achieving developmental milestones. No two speech therapy sessions are the same, as will be the case for your child. However, there are overarching goals that you can expect your child to be working towards.

Here are factors you should expect to be consistent for a child diagnosed with autism that is receiving speech therapy services:

  1. Speech therapy will be individualized.

The speech language pathologist will complete an evaluation of the child’s current speech and language skills. Based on the results of the evaluation and any observations made, goals will be formulated to target areas to improve.

  1. Speech therapy will target functional communication.

This may mean different things depending on the level of the child. Whether the child is verbal or nonverbal, therapy will address making sure the child is effectively communicating their needs and wants. If the child is nonverbal or has significant difficulty utilizing verbal language, Augmentative and Alternative Communication (e.g., pictures, sign language, iPad, etc.) may be implemented. Therapy may also target talking about events, telling stories, answering questions, asking questions, commenting, expressing opinions, and participating in conversations.

  1. Speech therapy will target social language.

Social language is also known as pragmatic language and includes using language for a variety of purposes (i.e., greetings, informing, demanding, etc.), changing language according to the needs of the listener or situation, and following rules for conversation and storytelling. In order to warrant a diagnosis of autism, the child has already been determined to have a deficit in social communication and interaction. Treatment goals may include maintaining eye contact, initiating and terminating conversations, maintaining topics of conversation, identifying emotions, and utilizing appropriate body language.

The above goals are targeted in a variety of ways, again dependent on your child. Sometimes direct education is provided prior to practicing skills in activities, role-play scenarios, or structured real-life situations. Other times, skills are targeted during play and motivating activities for the child. No matter the skill level of your child with autism, speech therapy is an integral piece to their progress and successful functioning.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Katie Hesch

Katie Hesch

Katie Hesch, MS CCC-SLP, is a certified speech-language pathologist with experience and love for working with the pediatric population. She earned her Bachelor of Science degree from Purdue University in Speech, Language, and Hearing Science and her Master of Science degree from Indiana State University in Communication Disorders. Katie worked with pediatric clients during her graduate studies at Indiana State University and during her hospital externship with Lakeland Healthcare in Niles and St. Joseph, MI. She also completed a placement in the school setting at the elementary and high school levels. Her experience includes work with autism, language, feeding, articulation, reading, and phonological disorders. Katie is trained in the Orton-Gillingham Method of Reading Instruction and holds a Professional Educator’s License through the state of Illinois. One of her speech pathology loves is language therapy. She enjoys incorporating and targeting language in functional ways through the use of daily routines and family-specific activities.

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Tips and Tricks to Boost Your Toddler’s Speech and Language

When your child enters into this world, he is immediately exposed to his new environment. Speech and language development begins right away, as your child begins to explore the environment around him. The early years of your child’s life is a crucial period for speech and language development. Blog-Toddler Speech and Language Main-Portrait

As you interact with your child, there are various ways that you can help to boost his speech and language:

  • While you are playing with your child, talk about the actions that he is doing and what you are doing. For example, if your child is throwing a ball, say “throw the ball” as he throws it. This will help him match spoken words to actions.
  • Label objects for your child. As you are engaging with your child, tell him what it is that he is holding, looking at, etc. For example, if your child is holding a ball, say “you have a ball” This will help to increase his ability to identify and name various objects.
  • Expand on your child’s utterances. As your child is acquiring language skills, he will start to speak using short utterances before he can use full sentences. When your child produces one word or short multiword utterances, take his utterance and use it in a full contextual sentence. For example, if your child points to a ball and says “ball,” you can respond with “yes, I see the red ball!”
  • Use natural sounding speech with appropriate intonation when talking to your child. As your child is being exposed to language, not only is he listening to the words, but he is also listening to your tone of voice and looking at your face. Therefore, to help him understand what you are saying, it is important to match your tone and facial expression to your spoken words. For example, if your child is throwing toys inappropriately, tell him “no throwing” with a more stern tone of voice. If you say “no throwing” with a “happy” tone of voice and a big smile, your child may have a difficult time understanding the concept of “no” since the tone of voice and facial expression did not match the meaning of “no.”
  • Sing familiar songs with your child. Engaging in song is a fun way to encourage language development. At first, you will be doing most of the singing while your child closely watches and listens. While you sing, you can use gestures to match words in the song. As your child gets multiple exposures to you singing the song, encourage him to engage in the song by gesturing along with you. For example, when singing “head, shoulders, knees, and toes,” start by singing the song while you touch each body part matching the words in the song. Then to engage your child more, you can sing the song while you help him move his hands to touch the body parts from the song. Another tip you can do with songs is pausing at certain words for your child to say. For instance, you can pause before “toes” each time it occurs in the song to allow your child to say it. Not only can this help to increase language production, but it can also help your child identify and name objects, items, or in this example, body parts.

NSPT offers services in Bucktown, Evanston, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Julie Behm

Julie Behm

Julie Behm is a certified speech-language pathologist (CCC-SLP) with experience and passion for working with the pediatric population. She earned her Bachelor of Arts degree from Indiana University with a double major in Speech and Hearing Sciences and Spanish. She earned her Master of Science degree from Western Illinois University in Communication Sciences and Disorders. Julie has worked with children in clinic and school settings where she evaluated and treated children with articulation and phonological impairments, receptive and expressive language disorders, fluency disorders, feeding disorders, autism spectrum disorder, Down syndrome, and behavioral problems. She also has experience working with adults at a hospital and skilled nursing facility, as well as providing voice therapy for a transgender client. Julie is proficient in Spanish and is CPR certified. Additionally, she is accredited by the American Speech-Language-Hearing Association (ASHA).

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How to Use Visual Supports at Home for Language Development

For children with receptive and expressive language disorders, visual supports can be powerful tools when communicating. Visual supports are beneficial to aid in not only the comprehension of language, but also to improve expression of language. These visuals can provide a child with information they are missing when comprehending language or speaking. Visual supports are so universal and easily to utilize that they can be implemented seamlessly in the home environment.

How to use visual supports to improve language comprehension:

For children that experience deficits in language comprehension, visual aids are a great way to improve their ability to comprehend instructioVisual Supportsns, rules of an activity, and expectations. Here are some examples of ways to create visual aids for receptive language tasks.

  • Visual schedules can be pictorial, written or both. It is important to tailor the schedule to the child’s abilities. For children with receptive language deficits, hearing their schedule for the day can be confusing and maybe, even a little scary. By presenting a visual schedule, paired with a verbal description, a child will receive the information via two avenues of communication, which will likely improve comprehension of what to expect.
  • A Listening Chart, as shown below, visually depicts the components to being a good listener. When expectations or rules are presented only verbally, information is often forgotten. By using a visual to depict expectations, the child will be more successful and can easily remind him or herself of what actions need to be completed.
  • Presenting choices visually can be a powerful tool for children who have receptive language deficits. For example, if there are two choices for snack (e.g., pretzels or grapes), you can present two pictures of these food items when asking the child what he or she would like to eat.

How to use visual supports to improve language production:

The use of visual aids for language production is slightly more diverse than those utilized for language comprehension. Visual aids for language expression are often used to help a child initiate communication, participate appropriately in a conversation, and to expand utterances. Here are some examples of visual aids used to improve expressive language skills.Smash Mats

  • Smash mats are a great tool to use to expand a child utterance length (e.g., from two word to three words). As shown here, a smash mat can be as simple as three dots on a page. When modeling a sentence, you can touch a dot as you say each word (e.g., Girl is swinging or I want goldfish). You can make smash mats even more enticing by adding a playdoh ball to each dot. Smash mats are also great, because as your child continues to progress in their expressive language skills, you can continue to increase the length of their utterance by adding additional dots to your mat.
  • A Topic Tree is one of many visual aids that can be used during conversations. The topic tree is specifically for topic maintenance (i.e., staying on the same topic of conversation with your
    communication partner). For example, if you are talking about Christmas with your child, each time that you make a comment, ask a question or appropriately respond on the topic of Christmas, you put a leaf on the tree. This is an easy DIY visual aid you can make at home!
  • A Yes/No Board is a great visual aid for an emerging communicator. It is a simple visual depiction of the concepts of “yes” and “no.” Yes/No boards can be visually Y-N Boards2displayed in a variety of ways as shown below. When asking a child a Y/N question, by presenting the child with this visual, you are not only cueing the child that you are asking a question, but also providing the child with the appropriate response choices.Y-N Board

All of these visual aids will not only increase a child’s engagement in a daily activity, but also aid in making transitions smoother. Visual aids can be implemented at any age and in any environment.

NSPT offers services in Bucktown, Evanston, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Katie Devore, MA, CCC-SLP

Katie Devore, MA, CCC-SLP

Katie Devore, MA, CCC-SLP is a pediatric speech-language pathologist with experience providing clinical services to children and young adults in an outpatient clinical setting. Katie earned her Masters of Arts in Speech, Language and Hearing Sciences from the University of Iowa. Previously, Katie attended Augustana College receiving an undergraduate degree in Communication Sciences and Disorders. While completing her graduate program, Katie’s education and clinical work had an emphasis on child language and speech disorders, specifically autism spectrum disorder. Contributing to her education was her experience working in Dr. Karla McGregor’s Word Learning Lab. Her clinical externships involved providing speech-language therapy to both adults and children in an outpatient setting. Katie feels passionate about working with children and watching them succeed.

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How to Get Your Baby Talking

A baby typically starts babbling, using speech-like sounds, between four to six months of age. Usually, the sounds p, b, and m are the first to develop. Additionally, in this age range, a baby is more Blog-Baby-Talking-Main-Landscapeinteractive with the parent or caregiver, laughing and vocalizing displeasure or excitement. Between seven months to a year of age, communication will expand and most babies are producing repetitive consonant-vowel combinations such as baba or dada, using gestures for communication, using vocalization to gain and maintain attention, and by one year of age a baby typically has one or two words or word approximations.

A parent or caregiver can support their baby’s language development or “talking” by encouraging all communication, interacting on their baby’s level, and making communication opportunities.

  • Match your child’s communications and interaction attempts, including repeating his/her vocalizations and gestures. By matching your baby’s vocalizations, you are communicating on a level that allows them to maintain communication turn-taking. Additionally target speech games and songs such as itsy-bitsy spider, peek-a-boo, and gestures such as clapping, blowing kisses, and waving hi/bye.
  • Talk through daily routines such as bath time, bedtime, get dressed, and feedings. You are providing your baby with the associated language during these daily routines. Talk through the plan for the day, what will you be doing, where you are going, who are they seeing, etc.
  • Teach your child gestures and signs to support language development.
  • Teach your child animal sounds (e.g., moo, baa) and environmental sounds (e.g., vroom, beep).
  • Spend time reading to your child and labeling pictures in books.
  • Reinforce your baby’s communication attempts by giving them eye contact and interacting with him or her.
  • Simplify your language during communication interactions with your baby.
  • Make communication opportunities within routines and daily activities.
  • Limit your baby’s exposure to television and/or videos. A 1:1 interaction between a parent and child is preferable to support turn-taking communication.

Remember there is a range of typical development. Not all babies will have their first words around one year of age!

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Julie Paskar

Julie Paskar

Julie Paskar, M.A., CCC-SLP is a speech-language pathologist, and the Branch Director at the Lincolnwood clinic. She joined North Shore Pediatric Therapy in August of 2012. Julie obtained both her Bachelor of Arts in speech and hearing sciences and her Master of Arts in speech-language pathology at Indiana University in Bloomington, Indiana. She has lived and worked in the Chicago area for the past eleven years. During that time, Julie worked for a pediatric clinic providing Early Intervention services as well as speech-language therapy services to children ages 3-12. She has her Early Intervention credential in speech pathology as both a provider and an evaluator. Julie’s areas of interest include: phonological disorders, motor speech disorders: specifically childhood apraxia of speech, feeding disorders, and expressive language disorders/delays. Julie is a Hanen certified therapist, has also attended both the Introduction to PROMPT and Bridging PROMPT trainings, has attended Picture Exchange Communication System (PECS) Level 1 and Level 2 trainings as well as the Kaufman Speech to Language training. She has been trained in the Orton-Gillingham program which is a treatment program for dyslexia. Julie is a member of the American Speech-Language Hearing Association and is licensed to practice in the state of Illinois. Julie is dedicated to working with children and their families to make communication both fun and functional.

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What is a Tongue Thrust?

A tongue thrust is the most commonly known type of Orofacial Myofunctional Disorder. According to the American Speech-Language Hearing Association, this is when “the tongue moves forwardblog-tongue-thrust-main-landscape in an exaggerated way during speech and/or swallowing. The tongue may lie too far forward during rest or may protrude between the upper and lower teeth during speech and swallowing and at rest.”

A tongue thrust or an Orofacial Myofunctional Disorder may impact speech, chewing and swallowing as well as create changes in the dental pattern. An improper tongue resting pattern may develop as a result of enlarged tonsils or adenoids, allergies, extended thumb, finger, or pacifier sucking. It may also be related to restrictions in tongue movement, lip movement or the shape and size of the mouth.

Who Can Help With A Tongue Thrust?

This issue may be identified by a pediatric dentist or orthodontist due to the bite pattern seen in the child. An open bite (where the front teeth do not meet creating an open space) may indicate that there is a tongue thrust or an abnormal tongue resting position. A Speech-Language Pathologist trained in the area of orofacial myology or a Certified Orofacial Myologist (who may be a speech-language pathologist or a dental professional) are among the professionals who can diagnose an OMD.

To screen for the possibility of an OMD, it is beneficial to look at all the underlying factors including:

Habits – Thumb sucking, finger sucking, tongue sucking, extended bottle use and overuse of a “sippy cup.”

Airway – Open mouth breathing, enlarged adenoids and/or tonsils, allergies.

Lips – Do the lips rest apart or together habitually? Are there structural restrictions that don’t allow comfortable lip closure?

Tongue – Any difficulty moving the tongue to the roof of the mouth? Does the tongue appear to move forward during speech? Any structural restrictions impacting the movement? Sometimes the “lingual frenum” which is the attachment under the tongue is too short or tight and creates issues with tongue movement.

Teeth – What does the bite pattern look like? Is there an “anterior open bite” (the upper and lower incisors don’t meet when the teeth are together)? The “anterior open bite” is a very common pattern seen with tongue thrusts and other OMDs.

Speech – Speech may sound distorted especially the sounds “s,” “z,” “sh” and “j.”

Chewing and Swallowing – May show up as eating too quickly, too slowly, messy eater, as the swallow pattern is altered. This is sometimes referred to as a “reverse swallow.”

How is tongue thrust treated?

The approach to treatment involves first the proper diagnosis and designing a tailored approach to the particular OMD and how it is presenting in the individual patient. The therapist works closely with the rest of the OMD team, which may include the physician, ENT, gastroenterologist, oral surgeon, dentist and orthodontist. Any habits, structural issues, allergies or airway restrictions are addressed by the appropriate professionals.

Using tailored exercises, the treating therapist addresses forming correct placement of the lips, tongue and jaw at rest and the habituation of this over time. Addressing correct swallow patterns and the carryover into the ability to do this on an everyday basis with all foods is also addressed. Also addressed by the speech-language pathologist are any speech articulation issues with increased emphasis of the correct placement of the tongue and the appropriate tongue pattern.

Successful treatment involves ongoing treatment in weekly therapy, daily exercises done in the home and a collaborative approach with the family and the other professionals on the team.

Resources:

The American Speech-Language Hearing Association’s website information page: http://www.asha.org/public/speech/disorders/OMD/

International Association of Orofacial Myology information page: http://www.iaom.com/OMDisorders.html

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Stephanie McCabe

Stephanie McCabe

Stephanie has been a speech-language pathologist for 22 years. She received both her BA (in English and Communication) and MS (in Communicative Disorders) from the University of Louisville in Kentucky. Stephanie’s diverse background includes direct treatment as well as owning and managing pediatric therapy practices. She has also developed mentoring, training programs, and curriculum. She has received specialized training in many assessment and treatment approaches including DIR/Floortime®, Talk Tools® Beckman Oral-Motor, Scientific Learning/Fast ForWord, Diane German's Word Finding Intervention Program, Joan Sedita's Key Three Routine Comprehension Strategy Instruction. She completed her certification in Orofacial Myology through the IAOM (International Association of Orofacial Myology) in 2007. Previously, she served as the Chairperson of the IAOM’s mentoring committee for members pursuing certification in the area of Orofacial Myology. She was appointed to the IAOM Board of Examiners in 2013. She is the author of the HALTTS Orofacial Myofunctional Disorder screening form (2010).

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Age Appropriate Toys for Speech and Language Development

With the holidays fast approaching, here are some tips for choosing gifts that also support your child’s development.  The best toys to support your child’s speech and language development are blog-speech-and-language-main-landscapetraditional toys that do not make noises or talk for your child.  Taking batteries out of toys is an option as well. Choosing toys that relate to everyday activities (e.g., kitchen set, baby doll) are great for facilitating language that can be applied to real life situations.

Additionally, toys that are open-ended and can be used in a variety of ways are best.  For example, a basic farm set has more language opportunities than a toy with buttons that makes animal noises.  With a basic farm set, the child can imitate animal noises, label the animal names, practice location concepts (e.g., on, in, under, next to, etc.), answer wh-questions (e.g., “Where is the pig?”), and much more!

Here is a list of basic, traditional toys that are great for expanding your child’s speech and language skills:

  • Wooden blocks
  • Cars/trains
  • Baby doll
  • Potato Head
  • Doll House
  • Bubbles
  • Kitchen set and play food
  • Tea set
  • Farm set
  • Dress-up clothes
  • Stacking toys
  • Puzzles
  • Doctor set
  • Play-doh
  • Wind-up toys

Traditional toys are excellent for supporting speech and language development, but it is also fun to discover new toys/games as well!

Here is a list of new toys/games I have been using in speech and language therapy:

  • Seek-a-Boo Game
    • Great for working on vocabulary, turn-taking, and memory skills!
  • Melissa & Doug Reusable Sticker Pads
    • All of these reusable sticker pads are AWESOME for working on speech and language skills! I particularly like the “play house” one. These are great for answering wh-questions (i.e., who, what, where, when, why, how), labeling actions (e.g., swimming, playing), formulating complete sentences (e.g., “She is playing), and more!
  • Frankie’s Food Truck Fiasco Game
    • Excellent for working on shape identification and turn-taking! Find foods that are in the shape of a triangle, square, circle, heart, and rectangle.
  • Zingo
    • This one is always a favorite with the kids. Great for vocabulary, turn-taking, and asking questions. Play with the family and have your child ask if you need a piece, such as, “Do you need a hat or a bird?”
  • Melissa & Doug “Stamp Sort” Mailbox
    • Great for little ones to practice phrases, such as, “go in,” “put in mail,” “close the door,” “open door,” “put in key,” etc. Put stamps on the letters and ask your child, “Who are we mailing it to?”
  • Sneaky, Snacky Squirrel Game
    • Work on color identification, matching skills, and turn-taking with this fun game. Ask your child, “Whose turn is it?” to practice pronouns in “my turn” and “your turn.”

There are many great toys/games out there, but these are favorites among speech-language pathologists.  Ditch the batteries and get talking!

Happy Holidays!

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Andrea Levy

Andrea Levy, Speech-Language Pathologist, earned her Masters of Science in Speech, Language, and Learning from Northwestern University. During graduate school, she provided treatment for children ranging from 1 to 14 years of age presenting with childhood apraxia of speech, articulation and phonological disorders, receptive-expressive language disorders, pragmatic disorders, and fluency disorders. Andrea gained valuable experience at a medical externship at Shriners Hospitals for Children in Chicago where she provided treatment for children with cleft lip and cleft palate presenting with articulation and receptive-expressive language disorders. Prior to graduate school, she had numerous experiences working with children as a teacher’s assistant in a public school special education program and as a daycare substitute teacher. Andrea completed a student externship at North Shore Pediatric Therapy in 2015 where she enjoyed working with the pediatric population and collaborating with other therapists. She was excited to return to North Shore Pediatric Therapy after graduation. Andrea is a dedicated therapist that enjoys working with children and their families to find the approach that best supports the individual child.

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Holiday Speech and Language Activities

Here are some examples of how a holiday tradition can be turned into a speech and language activity: blog-holiday-speech-main-landscape

Looking at Holiday Lights

  • For a younger child: Play a silly sentence game. Make a sentence about the light display but put in a nonsense word. See if your child can fix the silly mistake. For example, “The snowman is under the grass.” or “There is an elephant on the roof.” Then see if your child can make a silly sentence for you to correct.
  • For an older child: Create complex sentences. Challenge your child to use the conjunctions and or but to talk about the lights. For example, “The window has a wreath and the garage has a bow.” or “This house has only white lights, but that house has all different colored lights.”
  • For a child working on speech sounds: See if the child can find decorations containing their sounds. For example, if a child is working on /l/, they can practice saying blue lights, yellow lights, snow globe, soldier, and igloo.

Singing Holiday Songs

  • For a younger child: Work on rhyming by starting a well-known carol then substituting a non-rhyming word in place of a rhyming word. For example, “Dashing through the snow, in a one horse open sleigh. O’er the fields we go, laughing all the go.”
  • For an older child: Make inferences about song lyrics by asking your child why For example, “Why do you think Santa asked Rudolph to guide his sleigh?”
  • For a child working on speech sounds: Listen to a familiar song and have your child write down every word with their sound. Then go back and practice saying the words they wrote. For example, a child working on final /l/ can listen to “Chanukah, Oh Chanukah” and practice saying the words we’ll, all, while, and table.

Decorating the Christmas Tree

  • For a younger child: Teach directional concepts. Ask your child, “Should I put this ornament above the tinsel or below the tinsel?” or “Should I put the star on the top or on the bottom?” while showing them what each directional word means.
  • For the older child: Practice describing ornaments by word features. Have the child say the shape, size, color, material it’s made of, and parts. You can play a guessing game where the child describes clues about the ornament and you guess which one they are describing.
  • For a child working on speech sounds: Pick a word that has a child’s sound in it and have your child repeat the word while decorating the tree. For example, a child working on “ng” can say “hang” every time someone hangs an ornament. A child working on /r/ can say “wrap” a number of times while wrapping lights around the tree.

Making Holiday Crafts

  • For the younger child: Practice requesting. Provide your child with all necessary materials but leave one item out. Encourage them to make sure they have all the items they need and have them ask questions if they do not have everything.
  • For the older child: Work on narrative skills. Have the child pretend they are leading a how-to TV show. Have them use the words first, next, then, and last to give at least four steps. Build the craft yourself and see if the directions are clear enough to be followed and encourage your child to clarify communication breakdowns if needed.
  • For a child working on speech sounds: Create a phrase that the child must use for each part of the craft. For example, a child working on ch can say,” I chose the ____.” A child working on /g/ can say, “I got a ____.”

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Lindsay Valentino

Lindsay Valentino

Lindsay Valentino enjoys the art of combining data with client and family values in order to develop and refine treatment plans. She holds a Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association and is licensed by the state of Illinois to practice speech-language pathology. Lindsay earned her Bachelor of Science degree in Human Communication Sciences from Northwestern University and her Master of Science degree in Speech-Language Pathology from Rush University. Lindsay has experience with a variety of communication disorders, including expressive and receptive language disorders, articulation and phonological disorders, and social (pragmatic) communication disorders. She completed her Clinical Fellowship in a junior high school, where she gained experience in working with individualized education programs (IEPs). She believes communication between clients, parents, physicians, teachers, and related service providers is essential for continuity of care and improved outcomes. Lindsay is especially interested in diagnostics, intervention for late talkers, emergent literacy, and using technology to improve communication. She has formal training in the Picture Exchange Communication System (PECS) and the Kaufman Speech to Language Protocol.

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Why Your Child is Making Progress in Speech Therapy, But Not at Home

An articulation disorder occurs when a child produces a distorted sound, such as a lisp (i.e., incorrect tongue placement during /s, z/ sounds) or an /r/ sound with a “flat” or vowelized quality blog-speech-main-landscape(“spiduh” for “spider”). It is worth noting that an “articulation disorder” has become a generalized label used to also describe patterns of errors in speech, for instance, “tat” for “cat” or “wion” for “lion,” which is a substitution rather than sound distortion. Many therapists will address substitution errors using a “sound-by-sound” approach if there are only a few errors. Nevertheless, it is important to understand that speech altogether is a learned movement pattern, just like walking, for example. A motor pathway of nerves in the brain is developed, established, and practiced, at a very early age.

The “give ‘em some time!” myth

Pediatricians and therapists often advise parents to “give it some time” before they seek out the help of a professional, leaving parents wondering why. Professionally, I am a supporter of the “wait and see” approach if the child demonstrates correct productions in some words, but not all, during their conversational speech. A child’s awareness of their speech increases as their gross and fine motor skills also develop and mature. As a result, common speech distortions may resolve with postural maturity, improved fine oral motor control, or exposure to same-aged peers which increases a child’s awareness. However, at the age of 4-years old, a child should be understood by familiar and unfamiliar listeners 90% of the time. Similarly, children who are typically developing demonstrate rapid growth of speech articulation skills in 6-month increments.

I advise parents to ask themselves the following:

  1. Has my child’s speech become easier to understand or made improvements at any time over a 6-month period?
  2. Can my child make the sound correctly at any time in spontaneous speech?
  3. Can my child make the sound correctly after I make the sound?
  4. Can acquaintances understand my child’s speech?

If any of the above answers are “no,” it may be time to consult with a speech-language pathologist regarding a full speech-language evaluation, especially if your child is approaching kindergarten. During the evaluation, the therapist will determine oral-structural abnormalities, evaluate for substitutions and omissions of sounds, and trial therapy techniques to determine the prognosis. The therapist may also hear the impact of reduced speech-articulation on language skills.  In my experience, children typically respond well to treatment unless structural differences (e.g., tongue tie, high palate, cleft palate) exist that impact their ability to produce the sound physically. In that case, a referral to an orthodontist, otolaryngologist, craniofacial specialist, may be warranted.

So, what does articulation therapy look like? Speech therapy for an articulation disorder is focused on creating a new movement pathway in the brain, “weakening,” or just simply not using the distortion pathway. Therefore, intervention should be repetitive and intensive in nature once the correct sound placement is achieved.

The process of articulation therapy includes producing the sound at specific levels of speech:

  • Establishing awareness of incorrect productions
  • Isolation
  • Syllables
  • Words
  • Phrases
  • Sentences
  • Reading
  • Story re-tell
  • Conversational speech

Many parents ask how long it takes to re-mediate an articulation disorder. Progress depends on consistency regarding the child’s attendance, treatment frequency and productivity/number of repetitions during speech sessions and completion of home practice assignments on a daily basis. I often set a goal to help the child achieve the sound hundreds of times per session. Once a child has established a sound by itself consistently, the therapist will challenge the child to produce it in words, phrases, sentences, etc. Many children will use their sound perfectly while practicing their articulation cards but become completely unaware of errors made as they speak spontaneously. Awareness and self-monitoring spontaneous speech is the most challenging part of articulation therapy. I explain this to kiddos I see to remind them that un-doing the speech distortion takes time! We ultimately want the child to use the new motor pathway without the need to actively self-monitor. Therefore, treatment is most effective when the child makes hundreds of productions per session and engages in daily home practice as directed by the SLP.

This is what you can do to work on speech:

  • Pick a daily routine to coincide with repetitive practice: before brushing teeth at night, during breakfast in the morning, on the way to school, etc.
  • Require your child to use correct speech while talking in the car, during dinner time, or while speaking on the phone.
  • Encourage your child to sing their favorite songs or nursery rhymes using their correct sound. For a challenge, make them start over if you catch an error!
  • Play games like “Guess Who?,” “Connect Four,” or “Sorry” and use a target word or phrase with their sound in it each time they take a turn.
  • Combine homework assignments and speech practice into one activity! Encourage your child to read the directions with correct speech, identify/practice vocabulary words that have the sound, or read stories aloud.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Stephanie Sorrentino

Stephanie Sorrentino

Stephanie Sorrentino is a certified speech-language pathologist (CCC-SLP) who recently joined North Shore Pediatric Therapy in September of 2015. Stephanie is accredited by the American Speech-Language Hearing Association (ASHA), with Illinois Licensure, and has a Professional Educator License, which allows her to work in the school setting. She obtained her Bachelor of Arts degree in Interpersonal Communication, Bachelor of Science degree in Communication Disorders, and her Master of Science degree in Speech-Language Pathology, at Eastern Illinois University in Charleston, Illinois. She completed her Clinical Fellowship year with EBS Healthcare, through Beach Park Middle School and Our Lady of Humility Parish in Beach Park, Illinois, in addition to a hospital fellowship (with both children and adults) at Northwestern Medicine’s Lake Forest Hospital in the Department of Rehabilitation services. Stephanie continues to work at Lake Forest Hospital in both the inpatient and outpatient speech therapy services on a monthly basis. She is Lee Silverman Voice Treatment (LSVT) Certified, a program that is primarily used for adult patients with voice disorders as a result of Parkinson’s disease, but also used for pediatric patients with cerebral palsy. Stephanie’s extensive training and experience allows her to treat a variety of needs/disorders including (but not limited to): Autism spectrum disorder, cerebral palsy, pediatric dysphagia/feeding difficulties, apraxia of speech, articulation/phonology, fluency (stuttering), craniofacial abnormalities/syndromes, central auditory processing disorder, language processing disorder, word-finding, and pediatric traumatic brain injury. Stephanie enjoys working with the little ones who are still learning to talk or the older children that can’t seem to stop! Regardless, she certainly is committed to helping all children discover their confidence despite their challenges with communication. She is extremely passionate about caregiver/family education in regard to treatment and is a strong advocate for the children and their loved ones that she serves.

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