Scope of Speech Language Pathology

When most people think of speech therapy, working on speech sounds is the first thing that usually comes to mind. We all either know of or experienced a "speech teacher" when we were in school ourselves; not knowing the "speech teacher" worked on a lot more than just speech! Speech-Language Pathologists (SLPs) can work in schools, hospitals, rehabilitation centers, skilled nursing facilities, private clinics, universities, and even provide home based services.

According to the American Speech Hearing Association, the practice of Speech Pathology "continually evolves" and contains several domains of service delivery. I hope this list below helps you have a better understanding of all the many different areas in which an SLP may work on improving.  This list does not include domains such as counseling, collaboration, education, research, or specific etiologies within the categories listed. Please refer to the ASHA updated scope of practice for a full and comprehensive list of what the profession of Speech Language Pathology entails.

Speech-Language Pathologists (SLPs) work on many different areas of communication and cognition, including but not limited to:

DIAGNOSTICS

Screenings and Evaluations: including but not limited to speech screenings, speech/language evaluations, and bedside swallowing evaluations (to determine a patient's safest diet level). SLPs who work in hospitals may also perform endoscopy, videofluoroscopy, fiber-optic evaluation of swallowing (voice, velopharyngeal function, swallowing) and other instrumentation to assess aspects of voice, resonance, and swallowing.

SPEECH

Articulation: working on error speech sounds, such as /th/, /r/ and /s/

Phonology: working with whole sound classes that are being produced incorrectly, for example, a child is stopping (shortening) all of their "long" sounds (t/s, ch/sh, d/z)

Apraxia: Apraxia is the inability to coordinate the muscle movements for speech. The differentiation of apraxia versus a severe speech or phonological delay/disorder is determined when the SLP performs the initial speech/language evaluation.  Speech sound errors, phonology errors, and apraxia are all different diagnoses, and all have a different plans of treatment that your SLP will choose to follow.

Oral Motor: working on improving any oral motor weakness or decreased range of motion that might interfere with speech sound production or the mechanics of eating (biting, chewing).

Augmentative Communication: Teaching children and /or adults how to communicate via a device, such as an Ipad which has a communication program app installed, Vanguard communication devices, or other.

Sign Language: Speech pathologists who work with deaf individuals  or who work at Schools for the Deaf are fluent in sign. Speech therapists may also choose to teach  ASL signs to hearing children prior to them being able to communicate verbally, in order to increase their current ability to communicate their needs and wants, and thereby decreasing their frustration while learning to communicate verbally.

Stuttering: When a client has speech blocks, or repeats sounds, words, or phrases, and this has been determined to not be due to normal childhood dysfluency and is more than 3% of their total speech production, then a therapist will work with the client to teach them smooth speech techniques. For children who stutter, it is important they receive therapy prior to the age of 8 to have the best chance for fluency.

LANGUAGE- Spoken and written language (listening, processing, speaking, reading, writing, pragmatics)

Prelinguistic: joint attention, intentionality, communicative signaling

Expressive language: Work to improve a client's ability to express their needs and wants via speech, sign, or AAC. SLP's also work with clients to improve their grammar, syntax, and semantics. Describing, story retell, and conversation skills are also worked on under expressive language.

Receptive language: SLPs work on this to help a client's ability to understand what is being said to them. They work on improving a client's ability to follow directions, answer questions, and understand main ideas in both written and spoken language.

Social/Pragmatic Langauge: SLP's work on a client's ability to understand the components of non verbal language (tone, body language, eye contact), in addition to turn taking (both in activities and in conversations), sportsmanship (being a good winner/loser), friendship skills (making and maintaining)  understanding sarcasm, and the ability to participate in and maintain "small talk". Therapists also work on helping clients understand and use figurative language (idioms, similes, metaphors, etc) appropriately.

FEEDING/DYSPHAGIA (In certain states, it is the Occupational Therapist who addresses these issues, and not the SLP).

Feeding: SLP's work with clients who have a limited food reportoire (picky eaters) to help them expand their food choices and tolerances, including helping them overcome any sensory issues that are contributing to their limitations.

Swallowing: Children who had feeding tubes early on and adults/children who have had strokes can demonstrate difficulty with the process of  forming a bolus (our food mixed with our saliva to form a cohesive "package" that we easily swallow), moving said bolus to the back of the oral cavity to trigger a swallow reflex, and swallowing appropriately (ability to protect our airway during swallowing so that the food goes down the esophagus and into the stomach and not down the trachea where it can end up in the lung and cause aspiration pneumonia.) The elderly and those who suffer from dementia, including Alzheimer's are also at risk for needing this type of skilled speech therapy intervention. SLPs who work in medical settings who work with dysphagia clients will also perform bedside swallowing evaluations to help determine a patient's safest diet and will work in conjunction with radiologists and doctors to assess modified barium swallow studies.

Cognition/Safety

Problem Solving : Therapists work with clients of all ages to help them effectively and safely problem solve (including being able to correctly gauge the size of a problem and determine danger within the environment)

Divergent/Convergent Thinking: The ability for the brain to be able to both list and categorize (organize) information

Sequencing: The ability to sequence steps of tasks, specifically life skills, in order to complete the skill and improve overall independence.

Other

Voice: Speech therapists work with both adults and children who are recovering from vocal surgery, rehab from vocal abuse (think little boys who yell all the time on the playground, then develop hoarseness due to vocal nodules), and people whose pitch is either too low (hyponasal) or too high (hypernasal).

Cleft Palate/Craniofacial: Clients who have had surgery to repair a cleft lip or palate often need speech therapy to help them make their speech sounds appropriately, specifically plosives (sounds where air is built up and then released, for example, /b/ and /p/)   and speech sounds where nasal air emissions were previously present due to the cleft (/s/, /z/) or both /ch/.

Auditory Habilitation/Rehabilitation: Speech, language, communication, and listening skills impacted by hearing loss, or deafness. Auditory processing skills are also addressed by the SLP.

Play skills: Play is considered the building block foundation of language skills. Children who have limited play skills or do not play with toys appropriately (for example, line up their cars instead of moving them with a car noise) require intervention to expand their play skills. Often an SLP will work in improving vocabulary and ability to understand and follow directions into play goals.

Life Skills: Because so many life skills require the ability to categorize, sequence, and be safe, SLPs will work on life skills with their clients. This could be a teenager with autism who needs to learn how to fill out a job application, answer interview questions, do their own laundry, or follow a recipe. For an adult who has had a stroke, this can mean relearning how to do these things. By working with an SLP, the client who has had a stroke or head injury can, through speech therapy, teach a different part of the brain to "take over" these tasks from the part of the brain that has been hurt by the stroke or injury.

As all encompassing and vast as this list seems, there are still other things that are within an SLPs scope of practice, for example, a speech pathologist may choose to specialize in  early intervention (working with clients age birth-3 yrs old), helping second language learners work on accent reduction, or specialize in children who need help getting rid of a tongue thrust. I hope this has given you a window into the world of being a Speech-Language Pathologist.

Katie Sullivan, M.S., SLP-CCC has been a pediatric Speech Language Pathologist for 23 years, and is a Therapy Supervisor with Theracare.  She is the mother to five children, ages 8-18,  including twin teenage sons with special needs. You can follow her at the My Sweet Homeschool blogfacebook, twitter, and instagram.

10 Ways to Work on Speech Language Skills During the Summer

Summer is almost here. School is out, and with that comes the halting of any school-based services until the fall. It also means vacations and other activities that can interrupt home based services. Here are 1o ways to romote your child's speech/language skills during the summer months.

  1. Reading. Reading is a great way to continue to improve both expressive and receptive language skills. Incorporating daily reading time into your schedule, even 10 minutes each day, can make a difference in your child's language skills. If your child is not reading, you can read to them or look at a book together while you point out and name the pictures, depending on their level of interest. If your child is a reader, help them make a summer reading list and have them read daily. Asking your child questions about what they are reading is a great way to further encourage expressive language skills, while reading in the summer helps continue to build literacy skills.
  2. Practice speech words. If your child has speech sound errors that they are working on correcting through speech therapy, a little bit of practice goes a long way. Ask your speech therapist for a weekly practice list to do with your child between therapy sessions. I always tell my parents that even just 2-3 minutes a day practice will add up to better speech habits, and help your child make progress faster than 30 minutes once a week. If your child has just started working on a sound, or has multiple sounds in error, a listening list is a great daily practice activity. A listening list (technically called "Auditory Bombardment") is a list of words that you read to your child while they do another quiet activity (sit at the table, play with legos, while they are in the bathtub, etc). The list contains their target sound and is read at a pace of one word per second. Your child does not repeat the words, just listens to you reading the words containing their target sound. When I give a "listening list" to my client's families, I recommend reading the list 1-2 times through, once in the morning and once in the afternoon or evening for a total of two times each day. This is a very quick and easy home activity that helps your child learn their speech sounds.
  3. Social Opportunities. It can be very difficult to find activities for a child with special needs where they can spend time with peers. The opportunities during summer for a child to have opportunities for social practice are lessened when they are not with their school peers five times a week. Social activities can help a child practice social/pragmatic skills from greetings to conversations to turn taking/sportsmanship. Adaptive recreation programs are offered through many communities Parks & Recreation Departments. In Gilbert, AZ, for example, the Adaptive Recreation department offers activities such as bowling, movie nights, and outings for children/adults of all abilities. Weekly outings in the community with a parent or provider can also fill the need for social language opportunities, as can play dates set up with classmates, neighbors, or family.
  4. Incorporate langauge apps into iPad time. We have all read that it is important to limit our children's screen times, and that too much TV/cell phone/ipad time can hinder a child's speech, language and social development. While this can be a challenge with any child during the summer months, it can be a particular challenge when your child has special needs. One way to give your child more opportunities to work on speech/langauge skills is to have some learning apps on their ipad. Learning apps are a great way to help a child, any child, practice a particular skill while the child is having fun. Some of my favorites are Food Frenzy (directions following), and Starfall (phonics/reading).
  5. Play Time. Play is the building block of speech language skills, so the more play time your child can participate in the better. For many children with special needs, however, play is a skill still being learned. Depending on your child's level of development in this area, they will require different levels of help. To help make play time more successful, try offering toys of various types of play including cause effect, manipulatives, representational, and creative play. Cause efffect toys are toys that your child manipulates in some way and the toy does something in response (plays music, etc). Cause effect toys are a great play activity for children who may be younger or just learning how to play. Manipulative toys include puzzles, legos, and building toys. Try puzzles with knob-handled pieces or large duplo blocks for younger children or children who have fine motor challenges. Representational toys include toy cars, dollhouse/people, and other sets where the toy represents the same real life items. Creative play can include dress up items, imagination games, and arts/crafts activities. For younger children, you can also rotate toys each week to help keep interest in play higher.
  6. Continue to Narrate and Ask Questions. Continue to talk about what you are doing while you are doing it when you are at home or on vacation. Talk about your day and ask your child about theirs. (Try to ask open ended questions instead of yes/no to get more language out of older kids). Describing tasks as we are doing them also helps a child who is listening continue to grow their language and vocabulary.
  7. Talk about the schedule. Summer can be difficult for children who thrive on schedule. Talking about the day's schedule each morning can help your child's understanding of time and schedule grow, and decrease anxiety about changes. Posting the schedule in a common place (refrigerator) or in a child's room can help as well.
  8. New experiences = New vocabulary. Summer is a time of new experiences. When visiting new places, whether local experiences or out of town vacations, name items to your child that may be unfamiliar to them. (You can have older children write about new experiences in a summer journal to help them practice writing skills).
  9. Play games. Games provide a great opportunity to learn and practice turn taking and good sportsmanship; both important life/social skills. Games also provide an opportunity for unscripted small talk and family fun. For children just learning to play games who have difficulty with losing, try a cooperative game where there is no "winner" but the goal is to work towards completing a goal. My favorite game to play with smaller children is Snails Pace Race by Ravensburger. In this game, there is not winner, instead each participant guesses which snail they think will win. It is fun to see who picks the right snail, and this game can be played very quickly, making it a good choice for kids who have short attention spans. For older children, you can incorporate specific speech/language practice into specific games. There are several speech therapy goals packets available on Teachers Pay Teachers and are available for anyone (including parents) to purchase. I like this yes/no questions pack that goes with the game Zingo by the Teachers Pay Teachers seller Mermaids for Speech and is a FREE download in her store. You can also find packs that go with traditional childhood games from Candyland to Jenga on this site.
  10. Involve your kids in kitchen activities. No matter how busy the summer schedule gets, everyone still has to eat. The kitchen provides many opportunities to learn and practice vocabulary, language, sequencing, and safety. Check out this post for 15 more ideas that help promote speech language skills for all ability levels, when in the kitchen together.

Summer is a wonderful break from academics, but that doesn't mean that learning and speech/language activities have to stop. Keep summer speech/language activities fun, and enjoy the extra time with your child that summer allows.

Katie Sullivan, M.S., SLP-CCC has been a pediatric Speech Language Pathologist for 22 years, and is a Therapy Supervisor with Theracare. She is the mother to five children, ages 7-17, including twin teenage sons with special needs. You can follow her at the My Sweet Homeschool blog, facebook, twitter, and instagram.

How can I tell if my child needs speech therapy services?

I often get asked questions from friends, family, (and sometimes even strangers once they learn what I do for a living) about if I think they should seek out speech therapy for their child. As parents, we want to do our best and make sure our children are getting everything they need, but that is hard to do if we aren't sure they need something to begin with.

Children who are school aged, will be referred for speech therapy services by their teacher, who then informs the school SLP, who then sends a notice home to parents. However, if your child is homeschooled, participates in online school, or in a private school that does not offer therapy, there is no outside teacher to refer. If your child is under school age, you may have concerns based on how that child is doing compared to an older (or younger sibling) or other same-aged children you know. When younger children are taken to their pediatric well check visits, a thorough pediatrician asks questions about their speech/language/social development which helps them determine if a referral for speech therapy is necessary. However, annual well checks are just that...annual, and a lot can happen (or not be happening) with a child's developmental and speech/language skills in that 12 month in between appointments. Here are a few tips to help you decide if seeking out a speech therapy consult or evaluation may be necessary.

Your child is not meeting speech/language milestones. There are many blog posts and lists that share what a child should be doing at each age. The one I prefer to refer parents to for children birth to age 5 is this one from the American Speech Hearing Association. Educating yourself on developmental norms can help you make an informed decision on if you feel a speech language consult or evaluation is needed or not needed.

Your child is verbal but is only understood by family or familiar listeners. The general guideline is your child's age divided by 4 and turned into a percentage is the amount of their speech that should be understandable by an unfamiliar listener: 1 yr old-25%, 2 yr old-50%, 3 yr old-75% and 4 yr old 100% (Coplan & Gleason, 1988; Flipsen, 2006). Speech sound errors in and of themselves are not always a sign that speech therapy is needed. For example, you may be concerned that your 4 yr old cannot say /R/ when their siblings all could at that age. However, 4 year olds are not expected to have this particular speech sound yet (although many do). You can refer to the ASHA checklists referred above which also tell which sounds are due at which ages. Most speech therapists will determine if speech therapy is needed for speech sound errors based on the Iowa Nebraska Articulation norms and to what degree your child's speech sound errors are negatively impacting their ability to effectively communicate.

Your child has limited interest in social interaction or avoids eye contact.

Your older child is interested in social interaction but has difficulty being socially appropriate (making/maintaining friendships, commenting appropriately, holding their side of a conversation, etc).

Your child does not play with toys appropriately. For example, lines up all of his cars instead of pushing them back and forth pretending they are a car.

Your child stutters or is exhibiting periods of stuttering. Stuttering is a time sensitive speech disorder. Children who begin therapy for stuttering prior to age 7-8, can with successful therapy, remediate their stuttering completely and have fluent speech going forward without conscious effort. Children who begin stuttering therapy past the age of 8, while they can also achieve fluency, may or may not have to actively incorporate the strategies they learn in therapy to stay fluent even as adults. While some children will go through what is considered "normal" periods of disfluency which is usually due to a fast and large increase in expressive language skills/vocabulary within a short time period, it is best to consult with a speech language pathologist to be sure.

Your child is an extremely picky eater, avoids certain food textures, or has difficulty swallowing. If you suspect your child has any concerns in this area, contact your child's primary care physician immediately for a referral. Depending on your state, you may be referred to an SLP or an OT to address your child's feeding/swallowing issues.

Your child falls into a higher risk group. Children who have had multiple ear infections, prolonged hospital stays, were preemies, or have other medical conditions are at higher risk for needing speech/language therapy services.

While this is not a comprehensive list (the area of speech/language pathology is vast and can include (but not limited to) the areas of speech, articulation (how sounds are produced) expressive language (what is said), receptive language (what is understood), swallowing disorders, oral motor weakness (when is excessive drool just excessive drool and when is it a problem needing therapy? An SLP will know), social skills, play skills (0-3 yrs), stuttering, social skills, reading concerns, written language, and more), I hope this post is helpful as you determine if speech therapy is something you want to seek out for your child.

Katie Sullivan, M.S., SLP-CCC has been a pediatric Speech Language Pathologist for 22 years, and is a Therapy Supervisor with Theracare. She is the mother to five children, ages 7-17, including twin teenage sons with special needs. You can follow her at the My Sweet Homeschool blog, facebook, twitter, and instagram.

10 Way to Help Your Child Improve Express Vocabulary

Expressive vocabulary is our ability to name/label items (and people) in our environment. While receptive vocabulary encompasses the words that we understand, expressive vocabulary refers to the words we produce. Children with special needs may or may not begin building an expressive vocabulary at the expected time developmentally, but this is a skill that you can help your child build, no matter where they are currently in their level of development. Expressive vocabulary can include any modality that your child uses to express himself, request, and label those things that are within their environment, be it words, word approximations, signs, or use of an AAC.

Here are 10 ways you can help promote expressive vocabulary building.

  1. Point to pictures in books and label the pictures for your child. This can be as simple as pointing to and labeling large pictures that are found in a board book, or naming pictures and talking about the story in a children's picture book. If your child uses an AAC device, you can also find the corresponding icons on their device in addition to naming the pictures for them.
  2. Every time you hand an item to your child, say the name of that item. By naming each item for your child you are helping them build a receptive (understanding) vocabulary in addition to promoting expressive (labeling) vocabulary.
  3. Play with your child. Play is the foundation of language skills. If your child is not playing with toys yet, try a simple cause/effect toy to elicit interest. If your child is playing with toys, narrate what the toys are doing or narrate what you are doing with them.
  4. Use songs and fingerplays. Singing helps to promote automatic speech in addition to speech prosody. When your child attempts to hum or sing along, this enables them to join in a verbal activity, which is a precursor to speech.
  5. For names of animals, start with the sound that animal makes; for example, "Moo" is much easier for most children to produce than "cow".
  6. Communicate face to face when possible. Get down to your child's level so that they can see your face when you are talking to them or showing them an item.
  7. Expand on vocabulary your child already knows. If your child sees a bus and says "bus", expand on this to "yellow bus", If they say "dog", expand on this and say "Yes, that is a big dog", etc. This helps children learn modifiers (describing words) and build their expressive vocabulary beyond just nouns.
  8. Build one level up from where your child's vocabulary is presently. If your child is using one word at a time, expand and model two word phrases. If your child is using two word phrases, also use two word phrases when playing with them, throwing in three word phrases during the play time.
  9. Read to your child. Books with brightly colored pictures help keep interest. If your child has a short attention span for listening to a story, you can shorten the text each page to accommodate your child's attention level.
  10. Utilize other modalities of expression. If your child is not verbal yet, teach basic ASL signs (or sign approximations) for items/actions that are most important (highest motivation) for your child; for example, Mom, Dad, milk, etc. If your child has an AAC device incorporate it into reading/labeling activities.

Katie Sullivan, M.S., SLP-CCC has been a pediatric Speech Language Pathologist for 22 years, and is a Therapy Supervisor with Theracare. She is the mother to five children, ages 7-17, including twin teenage sons with special needs. You can follow her at the My Sweet Homeschool blog, facebook, twitter, and instagram.

Home Program Kitchen Activities for Children of All Ages

There are so many "teaching moments" that can happen when you include your kids in the kitchen, whether they are typical or have special needs. Helping in the kitchen lends itself to learning vocabulary, sequencing, and life skills. With my own twin sons who have special needs, I have found it easier to work on home program activities when they coincided with activities that were already happening in my home. Here are some easy ideas to include your child in the kitchen that can help support speech, language, and other therapy and life skills goals.

Easy:

  1. Help you grease a pan. This can be a great sensory activity. Most recipes that call for this use shortening or butter. If it calls for butter and your child is on a casein free diet, you can use a vegan butter substitute.
  2. Give them a wooden spoon, a few bowls and plastic measuring cups to play with, ("cook with") while you are doing your own cooking. This encourages representational play skills.
  3. Hand over hand pouring in ingredients into the mixing bowl. Name the items as you pour them in to help vocabulary grow.
  4. Hand over hand stirring. You can add counting the "stirs" to help your child learn counting/number sequence.
  5. Lick the beaters! Licking the beaters (unattached, of course) is a great way to improve tongue strength and range of motion; a fun flavorful oral motor activity!

Moderate:

  1. Practice sequencing..."First we put in the milk, then we stir". Start with two steps then build from there!
  2. Is your child reading already? Then make flashcards of "Bake, Mix, Cook", and other cooking or kitchen themed words.
  3. Separating the muffin/cupcake liners and putting them in the muffin pan. This is a great fine motor activity.
  4. Help you fold and/or put away the small kitchen linens: dishcloths and dishtowels. The square shape and smaller size of dishcloths make them a great first laundry item to learn to fold.
  5. Help you pat down the dough when making homemade pizza. This is another great sensory activity. There are many gluten free options now!

Higher:

  1. Using a melon-baller or spoon to drop cookie dough onto the pan. This is a great way to bring in "smaller/bigger" or "more/less" as needed, and using the melon baller or an ice cream scoop for this activity helps build fine motor skills and hand strength.
  2. Make a simple drink mix. This usually involves only 3 steps and is a great first kitchen task to "make" something independently. Based on your child's age, you may want to hold the pitcher as the water goes in.
  3. Follow a simple 3-5 step no-cook recipe with your supervision. This is great for sequencing and learning to follow steps to complete a task. If your child is not reading, they can follow picture recipes. A favorite of my boys is to make a no-bake pie.
  4. Breaking the eggs. Have them break them into a separate dish; this way it is easy to get out any shells that fall in while they are learning.
  5. Review kitchen safety. (Explain why we use potholders. Explain that steam is hot and can burn you the same as fire. Explain your home's rules on when they can/can't use microwave/oven, or go over rule that they are never allowed to.

There are so many teachable moments that happen in the kitchen but the best part is the memories you make with your children when you take the time to include them. A lot of character can happen in the kitchen as well. One of my favorite books to read with my kids that are cooking and character related is Sugar Cookies: Sweet Little Lessons on Love by Amy Krouse Rosenthal. This is a favorite to read in my house when we are making cookies; especially at Christmastime and Valentine's Day. Another favorite book is How to Make an Apple Pie and See the World by Marjorie Priceman. You can also check out Teachers Pay Teachers for more great kitchen themed packets for children of all ability levels!

Katie Sullivan, M.S., SLP-CCC has been a pediatric Speech Language Pathologist for 22 years, and is a Therapy Supervisor with Theracare. She is the mother to five children, ages 7-17, including twin teenage sons with special needs. You can follow her at the My Sweet Homeschool blog, facebook, twitter, and instagram.

Five Tips to Happy Holiday Hosting if You Have a Child with Special Needs

With the holidays here, families are making plans to get together with loved ones. As a parent of special needs twins myself, it has always been easier for me to host than to take my twins to a new environment during an already very excitable time. Having visitors, especially if they are overnight visitors, is stimulating for typical children. When you have children with special needs, having company can be a bigger challenge. Here are some tips that will make your holiday visit go more smoothly.

FIVE TIPS TO HAPPY HOLIDAY HOSTING

  1. Prepare. Prepare your child for what visitors are coming. Showing your child pictures in a photo album if you have them, and talk about who is coming before they arrive.
  2. Educate. Your family and friends will be able to relate with your child easier and more appropriately for your child's level of understanding if you educate them on the best ways to do that prior to their arrival. If your child is nonverbal, teach your guests a few of their most used signs. If your child is sensitive to touch, hugs, perfumes, etc., let them know that ahead of time.
  3. Try to keep (at least some of) their schedule consistent. This is easier said than done this time of year, but can really help to minimize melt-downs. If the schedule is changing upside down one day, write out or use a picture schedule to allow your child to see what is planned instead of their "usual routine". We all like to know our day's schedule or what is "coming next", and children are no different.
  4. Allow for-- and schedule-- quiet times for your household as the visit allows so that your child does not get over stimulated or overwhelmed. This is good for typical children as well. The holidays sometime turn into a fever-pitch of activity. Be sure you allow all your child quiet times to calm and "reset".
  5. Enjoy! The holidays are first and foremost a celebration. Remember to have fun and enjoy your guests, and remember that most people visiting your home are there because they want to visit with you and your family and know up front your child has special challenges.

P.S. Holiday visitors and activities provide a perfect time to practice social skills, both in the house and during outings. Look for those teachable moments!

Katie Sullivan, M.S., SLP-CCC has been a pediatric Speech Language Pathologist for 22 years, and is a Therapy Supervisor with Theracare. She is the mother to five children, ages 7-17, including twin teenage sons with special needs. You can follow her at the My Sweet Homeschool blog, facebook, twitter, and instagram.

5 Ways to Help Your Child Practice Gratitude

I love this time of year. It is a wonderful time to remember and reflect on all the things we have to be grateful for. When we are grateful, those around us are on the receiving end of our positive energy, and more inclined to count their own blessings. Gratitude can be modeled and taught to our children just like any other life skill. But why should we make the effort?

Why practice gratitude?

Having a gratitude practice can be just as important to your health and well being as a regular gym schedule, getting a good night's sleep, or any other practice that promotes well being. And, gratitude has become the study of science. According to http://greatergood.berkeley.edu/, researchers who study gratitude are finding that people who practice gratitude consistently report a host of benefits, including:

  • Stronger immune systems and lower blood pressure
  • Higher levels of positive emotions
  • More joy, optimism, and happiness
  • Acting with more generosity and compassion
  • Feeling less lonely and isolated

These benefits are not limited to just adults. Children can reap benefits from a gratitude practice as well. In a UC Davis study, children who practiced gratitude showed more positive attitudes toward their school and families, were less likely to judge others, and were more likely to share and to want to help. Here are five easy ways you can incorporate more gratitude into your children's routine.

  1. Help them Keep a simple gratitude journal : This is not limited to those children who have the fine motor dexterity to write. For my boys with special needs, I ask them to come up with three things they are happy for and I write them down for them. (They are thankful for Thomas the Train on most of their sheets and that is okay!) When my boys have trouble coming up with three things, I give them suggestions. We use these fun gratitude journal sheets ($3 for 52 weeks) from Teachers pay Teachers, but you can list them on any paper you have at home. (You do not have to be a teacher or therapist to use Teachers Pay Teachers, and they have really fun speech/language materials on there for parents, homeschoolers, and more!)
  2. Books. Books are a great way to incorporate lessons of gratitude into daily reading time. Some of my favorites are: Richard Scarry's Please and Thank You Book, and Thank you Mr. Panda.
  3. Dinner time Turns. Before eating, go around the table and have every one name one thing they are thankful for. If your child isn't talking yet, you can include them by sharing for them something you know they like, or even signing.
  4. Gratitude jar. When something good happens to your child, write it down on a small sheet of paper, and place in a Mason jar or other container. At the end of the year, take out all the slips of paper and read them.
  5. Set the example. Our children watch and listen to everything we do. When they see us be thankful or try to find the "bright side" in a situation, they will learn to do the same.

The practice of gratitude is a gift that we can give ourselves and our children; which in turn becomes a gift for others in our families' life journeys.

Katie Sullivan, M.S., SLP-CCC has been a pediatric Speech Language Pathologist for 22 years, and is a Therapy Supervisor with Theracare. She is the mother to five children, ages 7-17, including twin teenage sons with special needs. You can follow her at the My Sweet Homeschool blog, facebook, twitter, and instagram.

Using Books to Support Speech-Language Development

Books can be a wonderful way to help support your child's speech language development. Reading to your child, even if you feel they aren't paying full attention to the story, helps foster language and literacy skills while building vocabulary and joint attention. Books that offer repetitive sentence patterns on each page help improve speech automaticity, while rhyming books help increase phonemic awareness. Here are a few tips to help you use books to support your child's speech/language development.

Read to your child every day.
Studies show the benefits of reading to your child 20 minutes a day to be numerous. If your child is unable to sit for 20 minutes, read a story aloud while they are preoccupied with another activity, such as floor play or in the bathtub. Just hearing the language, words, inflection, and story will help support their speech/language development.

Choose books according to your child's developmental level, attention span, and preferences; not their chronological age.
If your child has a short attention span for reading activities, choose books with vibrant pictures, but less words per page, or shorten the story to fit their attention span. It is better to praise a child for sitting for 2 minutes (even if that meant you skipped pages), than to have both parent and child feel frustration by the end. Children with special needs, like any children, have "favorites". Reading time will go smoother, if your child is able to incorporate their preferences when picking books to read. For me, this meant I read "Thomas the Tank Engine" books for what seemed like forever, but I would just remind myself "Literacy...any way I can get it".

Acknowledge sensory needs before and during reading time.
When a child's sensory needs are met, they are more equipped to pay attention; for example, sitting in a bean bag during reading time can provide a child more grounding sensory input than sitting in a chair where their feet do not touch the floor. Doing reading following a gross motor activity, such as pushing a laundry basket filled with clothes or giving receiving bear hugs, can also improve attention. Other ideas to help meet sensory needs during reading time are using a weighted lap blanket, allowing your child to wrap themselves up in a blanket, or giving them a squishy ball to squeeze.

Vocabulary Building
Sometimes, reading time with a younger child may mean pointing at different pictures on the pages and labeling them for your child. This is a wonderful way to help your child learn new words while still practicing joint attention to the book and its pictures. For a child who has words (or signs), you can point to the picture and ask them to tell you the name. Receptively, asking your child "Where is the ____" and having them locate the corresponding picture via pointing helps build receptive vocabulary and comprehension.

Choose books without pictures sometimes.
While vibrant picture books are wonderful choices to help gain and keep your child's attention, it is also important to read stories without pictures. Reading stories without pictures allows your child to use their own imagination to picture the main character, setting, and events of the story as they "see" them, as opposed to the book's illustrator. If your child is new to stories without pictures, choose short rhyming stories or even poems.

Inferencing Happens
When we make an inference, we take clues from text or pictures plus background knowledge to make an assumption of what has happened or what is happening. You can build your child's inferencing skills during reading time by asking questions such as "I wonder what is going to happen next?", "I wonder what (character) will do now?" or "I wonder how that made (character) feel?".

Fun with sounds
Books with rhymes or strong alliteration patterns are fun to listen to! This is why "Cat in the Hat" books are so popular. But books can also be used to support a child's speech sound practice/therapy. For example, if your child is working on the /r/ sound, then reading aloud books such as "Little Red Riding Hood" or "Rotten Ralph" provide examples of the target sound throughout the reading time, which will indirectly support your child's progress towards making the sound correctly themselves.

Support Social Skills
Social skills can be indirectly introduced, taught, and reinforced through reading time stories ("How Do Dinosaurs Eat their Food" was a favorite with my boys when working on table manners.) In fact, through books, you can teach and reinforce everything from saying please (Please, Mr. Panda), how to make friends ("Peanut Butter and Cupcake") to fire safety (No Dragons for Tea). For older children, the characters in books can demonstrate the characteristic of empathy, and teach consequences of action in a safe and positive framework.

Be Silly.
Being silly during reading time (making different character's voices, over emphasizing inflection) is a great way to increase your child's engagement in the story. Over emphasizing inflection helps support the acknowledgement of tone of voice and their different meanings which many children with special needs have difficulty understanding. This also helps show your child that reading can be fun and not a chore; a life skill that will continue to serve them through their school years.

I hope these suggestions have given you some ideas on how you can support your child's speech/language skills during reading time, while making it go more smoothly for those of you with younger children.

Katie Sullivan, M.S., SLP-CCC has been a pediatric Speech Language Pathologist for 22 years, and is a Therapy Supervisor with Theracare. She is the mother to five children, ages 7-17, including twin teenage sons with special needs. You can follow her at the My Sweet Homeschool blog, facebook, twitter, and instagram.