What Does a Speech-Language Therapist Do?

We are delighted to welcome a guest blogger, Craig Selinger, M.S. CCC-SLP, Speech Language Pathologist, who will share important information about speech-language therapy. Craig has nearly 20 years of experience in the field and is presently CEO and Founder of Brooklyn Letters, serving NYC metro area families with at-home in-person 1:1 specialized services.

A speech-language therapist (SLT), speech-language pathologist (SLP), or simply language therapist is someone who specializes in human communication and how it impacts individuals at school, home, and work. It is a licensed field governed by the state. To become a licensed SLP, one must complete a masters in Communicative Disorders, pass a national examination, and complete a Clinical Fellowship Year. Many people don’t realize the breadth and scope of what SLPs do. Some SLPs are also trained in bilingualism and multilingualism. A speech-language therapist’s main responsibility is to prevent, assess, diagnose, and treat speech, language, cognitive-communication, social communication as well as voice and swallowing disorders.

Speech-language therapy involves evaluation, assessment, and treatment of communication and speech and language disorders in young children, school age students, including working with teenagers, and adults. Speech language disorders may begin during infancy and progress into adulthood. In other instances, certain impairments may have resulted from a sudden injury or illness.

WHAT ARE SPEECH DISORDERS?

A speech disorder is characterized by difficulties with speech production, including articulation and enunciation. These include:

• Articulation disorders - Difficulties producing the correct sounds, such as consonants or vowels, in the beginning, middle, or end of words.
• Phonological disorders - Refers to systematic speech production error. A common example of this in children is the dropping of the /p/ sound at the beginning of words or substituting sounds, like /w/ for /r/.

On the other hand, communication disorders, which are not considered speech disorders, include:

• Fluency disorders also referred to as stuttering: These difficulties include partial-word repetitions (“t-t-two”) in which the flow of speech is interrupted by unusual stops, prolonging syllables and sounds (s-s-s-s-shape), and sometimes blocks.
• Voice resonance disorders: Problems with voice resonance make it challenging for someone to be understood by listeners. These involve difficulties with pitch, volume, or quality of the voice.

WHAT ARE LANGUAGE DISORDERS?

A language disorder refers to difficulties or problems in understanding spoken language compared to peers. It also involves trouble with putting words or sentences together to communicate ideas. A language disorder can impact individuals at various levels such as slow acquisition of grammar, word-finding difficulties, and telling less coherent narratives.

Language disorders involve vocabulary, grammar (verbs and sentence construction), and social language use. They are classified as:

• Expressive language disorder – Refers to difficulties with finding the right words and using age-appropriate grammar when speaking with others or expressing oneself compared to peers. It can also include children who produce less robust narratives, have reduced vocabulary, and demonstrate difficulties with social language.

• Mixed expressive-receptive disorder – A combination of expressive and receptive language disorders characterized by difficulties in listening, understanding, and expression. Someone with a mixed expressive-receptive disorder will typically have trouble, compared to peers, following directions, listening to stories, and understanding sequential information.

• Cognitive communication disorders – These are difficulties in communication skills that involve attention, memory, perception, regulation, organization, and problem-solving.

WHAT ARE DEVELOPMENTAL DISABILITIES?

Someone with a developmental disability is born with it and it is hopefully discovered in early childhood development. Developmental disorders become more apparent when a child has a significant delay compared to peers and doesn’t seem to outgrow it. Some of the most common developmental disabilities are:

• Autism spectrum disorders (ASD) – A neurodevelopmental disorder that affects social communication and interaction and involves restricted and repetitive behaviors. People with autism will often have trouble with joint attention, responding to social situations, and using verbal and nonverbal communication compared to peers.

• Attention-deficit Hyperactivity Disorder (ADHD) – A neurodevelopmental disorder characterized by lack of attention, hyperactivity, and impulsiveness, ADHD is diagnosed in childhood but also occurs in adults. ADHD interferes with how a student regulates their attention in a variety of settings.

WHAT DOES A SPEECH-LANGUAGE THERAPIST DO?

A speech-language therapist provides speech-language therapy to individuals of all ages, from babies to adults. They conduct therapy sessions on a one-on-one basis as well as provide information to families, support groups, and the public.

A speech-language pathologist is equipped and licensed to perform a variety of therapies or treatments to address a patient’s difficulties. These include:

• Language Intervention Practices: For younger patients, the SLP uses play, casual conversation, illustrations (such as pictures, books, objects), or on-going events to stimulate language development. A speech language therapist will teach and model the proper use of grammar and vocabulary and use repetition exercises to build up language skills. These interventions are targeted at students who struggle with their language skills.

• Literacy: SLPs help students with all aspects of literacy: reading comprehension, decoding, spelling, and writing skills. Many students who need help with their reading comprehension and writing skills also receive executive function support from their SLPs as well.

• Articulation Treatment: Articulation or sound production exercises involve having the therapist teach and model the correct sounds in sounds, syllables and words during play activities. The level of conditioning and exercises is individualized, age-appropriate, and targeted.

• Swallowing and Feeding Therapy: The SLP teaches how to use the lips, tongue, and jaw to handle food and liquids. The SLP can also introduce different food textures and temperatures to extend a child’s oral awareness during eating and swallowing.

WHO NEEDS SPEECH-LANGUAGE THERAPY?

An individual with the following conditions may consider speech language therapy:

• Learning difficulties

• Difficulties with producing age-appropriate vocabulary, sentences, stories, social language use.

• Difficulties with understanding age-appropriate vocabulary, directions, understanding stories, misinterpreting social language cues.

• Students who struggle with reading comprehension and their expressive writing skills.

• Articulation issues

• Cleft lip or cleft palate

• Fluency e.g. stuttering

• Cognitive (intellectual, thinking) or other developmental delays

• Autism

• Hearing impairments

• Traumatic brain injury

• Feeding and swallowing disorders

• Respiratory problems (breathing disorders)

• Chronic hoarseness (voice)

And more!

Many students with speech language disorders also demonstrate co-morbity with other disorder, such as ADHD.

Therapy should begin as soon as possible. Children who receive speech language therapy early on (before five years old) demonstrate more progress or results than those who begin therapy at a later stage.

 

HOW CAN PARENTS HELP?

Parents and family members play a vital role in the success of a child’s speech or language therapy. When parents are actively involved, children will progress more than when parents are less involved in speech language therapy.

With the SLP’s guidance, parents can further support their children by doing exercises and activities at home. Finally, it’s essential for parents and household members to understand that overcoming speech and language disorders will take time, effort, and patience. Many students with language disorders will struggle with language throughout their lifespan but language therapy will offer strategies to help overcome these language challenges.

Finally, parents who are concerned about their child’s speech, language, and communication development can seek the help of a speech-language therapist.

To learn more about speech language therapy, contact the American Speech Language Association (ASHA) for more information. You can also contact your insurance for in-network and out-of-network options as well. Each state also offers free Early Intervention services (birth-3 years of age). For children three and older, find out about free services can be provided through your child's school for children who have IEP's or Section 504 Plans. 

Letting Students Struggle May be the Key to Academic Success

 A piece earlier this month in The New York Times looking at research in how to maximize learning after the disruption of the pandemic examined the work of several educators -- and led to an interesting conclusion.

When students, especially students with learning challenges or those for whom teachers may have had historically low expectations, are not challenged, they do not get the depth of understanding that they would gain from strugging to master material. The article describes a number of ways of thinking about the process of struggling to learn material that can result in deeper learning and more complete understanding. 

Some educators use the metaphor of a "learning pit", a place where students can visualize the fact that they need to ask for help, work on the material, and through serious effort eventually "climb out" of the learning pit to a place of understanding. This process encourages students to become "comfortable with being uncomfortable". Another metaphor that has been used when students are encouraged to work through their discomfort with not understanding a lesson or subject is that of learning to ride a bicycle. If a teacher holds firmly to the back of the bicycle while the student is learning to ride, the student avoids the "cognitive wobble" that requires them to think more deeply. 

Dr. Manu Kapur, an educational psychologist whose meta-analysis of studies looked at how students learn best, found that simply teaching a topic was not the most effective method for achieving student mastery. Instead, students who had to struggle to solve problems before being taught precisely how to solve them learned better than when they were first taught a concept and then given a chance to practice it. 

For this "productive failure" approach to work most effectively, students should work collectively and should know that the goal of the lesson isn't to get to a specific correct answer. In addition, the problems presented should be difficult but not impossible and should have a number of possible solutions.

 All of the educators mentioned in the Times discussion noted that when work is too simple, and students do not have to struggle to understand and master material, they do not have the opportunity to deepen their learning. Especially now, when many students have been derailed by pandemic learning loss, it is important to make them aware that working hard, seeking help from their teachers and fellow students, and being comfortable with being uncomfortable can all contribute to better, deeper learning. 

Using visual routines to help toddlers learn new daily life skills

Former Yellin Center Learning Specialist Renée Jordan is back today with more tips from her work with younger children .

Kids have so many routines to learn in the early years. Whether it is potty training, washing their hands or getting out the door in the morning, there is a stepwise process that they need to learn. However, the CDC, in looking at developmental milestones by the age of two, notes that two or three-step directions are all that most kids that age can hold onto.  But most of these routines require kids to master way more steps than that. Kids simply don’t have the active working memory to navigate these routines yet, which often results in tantrums and resistance.

One way to help these pre-reader aged kids learn these routines, and stay on track during the process, is to use a visual routine. Each step is represented by a visual so they don’t need to be able to read the word. As they go through the routine, if they forget the next step they can independently look at the routine and figure out what they need to do next.

The first few times a visual routine is used, you will do it with the child and teach them the steps of the routine. However, after a few uses, they will be able to look at the chart and follow the routine on their own. Over time, they will internalize the routine and no longer need it. They will have learned the steps, and be able to navigate the process independently.

On the Earlybird platform you can find cut & paste versions of helpful visuals that let you personalize routines to your child, or you can print several of their premade routines for bedtime, laundry, morning, hand washing or learning to use the bathroom. Or, you can create your own visuals, perhaps using characters from your child's favorite book or video. 

Early Childhood Education Increases Academic and Professional Success

Today we are concluding our series on early childhood learning by former Yellin Center Learning Specialist Renée Jordan.

In the 1960’s, a pilot project, called the Perry Preschool Project, was conducted that gave children access to a preschool experience and supplemental home learning using high-quality programming that was designed to develop their cognitive, motor and social-emotional skills.  

Initial participants in the Perry Preschool Project showed greater academic achievement, as well as higher income earning later in life when compared to a control group (those who hadn’t had access to early learning). Participants also had higher graduation rates and IQ scores, as well as reduced incarceration rates and a higher likelihood to own their own homes.

Recently, researchers followed up with participants (now in their 50s) to see if these significant positive outcomes held -and they did. Not only that, but when researchers looked at the participants' children, they saw generational gains in terms of academic achievement and income. 

One interesting element of the Perry Preschool Project is that it included home learning support using the same rich educational programming. When parents and childcare providers provide developmentally appropriate materials and time for children to play with them, children reap immeasurable benefits that set them up for success in school and in life. 

However, it can be tricky as a parent or care provider to know what early childhood skills your child should be developing. Thankfully, there are resources, like Earlybird, that give you the information you need about child development, and the no-prep activities and materials you need to apply that learning. 

Photo by Andrew Ebrahim on Unsplash

The School Readiness Skills Your Child Needs

We are continuing our series on early childhood learning by former Yellin Center Learning Specialist Renée Jordan.

If you have a child under the age of five you may be wondering what skills you need to be working on to ensure they are school ready and set up for success upon starting kindergarten.

School readiness skills are the cognitive, social-emotional, motor, and attentional skills that lay the foundation for future school success. The thinking used to be that all your child needed was to recognize a few letters and numbers. However, current research shows that school readiness goes beyond just the basic literacy and numeracy skills. Motor and social-emotional skills are critical. Higher thinking skills such as creativity, problem solving, and imagination are of equal importance to academic skills (Pan, Trang, Love & Templin, 2019).

Sesame Workshop, the educational research organization behind Sesame Street, commissioned the Early Childhood Longitudinal Study to examine school readiness skills in today’s children. Their findings were released in the Kindergartners’ Skills at School Entry report. The study found  that 44% of children enter school with one or more developmental risk factors that have the potential to impact their success in school.

The good news is that you can develop these skills at home or childcare while your child plays, using the materials you already have around. Children are "hands-on" learners. They acquire knowledge through playful interactions with quality materials and meaningful interactions with their caregivers (Hedges, 2000; Whitebread et. Al., 2009).

Painting, play dough, and coloring build motor skills. Letters, colors, numbers and shapes can be reinforced while children play with their toys. Dramatic play is grounds for rich social-emotional learning. Higher thinking skills are cultivated as a child builds puzzles, solves mazes and engineering towers out of their blocks.

One great resource that makes sense of the early years for parents and caregivers is Earlybird. Beyond providing fun, engaging play-based learning activities, Earlybird will also teach you what developmental skills each activity is targeting, giving you the knowledge, confidence and resources to ensure your child is school ready. 

 

Making Sense of Early Learning for Parents and Childcare roviders

Today we welcome back blogger Renée Jordan, who last wrote for us in 2016. We are delighted to have her contributing to our blog once again. Read about her story and hear about the exciting learning resources she has helped create.

I used to be a learning specialist at The Yellin Center. I eagerly joined the incredibly talented team as soon as I finished grad school at Columbia. My years at the Yellin Center are where I grew my knowledge of child development and how a child’s brain learns and grows. Working alongside Dr. Yellin deepened my understanding of the neurodevelopmental constructs that are fundamental to the work of The Yellin Center and my commitment to helping families and children make sense of their cognitive strengths and challenges to ensure they find success in school and beyond.

I left the team in 2016 to return to my hometown to focus on fertility treatments in hopes of starting a family. Leaving NYC and The Yellin Center was one of the hardest decisions we have made to date. But finally, in 2018, we welcomed our son Anderson. While on maternity leave, I began creating and doing easy activities with Anderson that targeted the core neurodevelopmental domains. When I began sharing them on Instagram I generated a following of fellow parents and childcare providers who were looking to make sense of the early years for their own kids.

It was during this time that I met Sarah, the other half of Earlybird. Sarah is an entrepreneur with a robust business knowledge and incredible sense of design. After we both had our second children, we decided now was the time to partner and build a platform outside of social media where parents and childcare providers could come to find the information they needed to know about child development, as well as the evidence-based activities and materials they needed to apply that knowledge. So in the middle of the pandemic, with four kids under three-years-old between us, we launched Earlybird.

Earlybird’s goal is to nurture every child’s intellectual, physical and social-emotional development to ensure they are ready for school and life. Anyone caring for children will find that Earlybird equips them with the confidence, knowledge and resources they need to create child-centered and developmentally appropriate play-based learning experiences that build a child’s literacy, numeracy, motor, social-emotional and creative thinking skills.

We keep it simple for you by using everyday items in our little to no prep activity ideas. On the platform you can filter resources by subject, specific skills, and ages. Then do the activities now, or save your favorites to your saved folder for later. We take the guesswork out of the early years for you.

Stay tuned for more posts looking at the research behind the early childhood tools we have developed. 

ACT Exam to Use IEP/504 Accommodations

 Last week, the ACT Exam announced a change to how they would offer accommodations to students with learning, attention, and other disabilities. They now align with the College Board, which administers the SAT, AP, and other exams, and which implemented changes at the beginning of 2017. The College Board uses a "two question" inquiry for students seeking disability accommodations: 1) does the student's IEP or 504 Plan contain the accommodation they are seeking and 2) has the student used the requested accommodation for school exams?

 As the ACT noted in a press release, "Beginning with the 2021-22 testing year, students who already receive accommodations at their school under the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act will automatically be eligible to receive the allowable testing accommodations when they register for the ACT with accommodations."

This means that students no longer need to go through a separate process of providing evidence of their need for accommodations, such as extended time, to the ACT. If a student's school has approved accommodations as part of an IEP or 504 Plan, the ACT will simply require that for "examinees who have a valid, current Individualized Education Program (IEP) or Section 504 Plan (504 Plan) a copy of the IEP or 504 Plan will be sufficient to demonstrate eligibility and need for the same allowable accommodations on the ACT test." 

Note that the ACT still will exercise some oversight into which accommodations they will allow; they discuss certain Guiding Principles, which require that any accommodation should be reasonable and not fundamentally alter what the test is designed to measure. 

This is a welcome change, but it raises some questions. Among these are:

• What about students who don't have an IEP or 504 Plan?

The ACT still will consider the needs of such students for accommodations. The "shortcut" they have announced doesn't change that and they will continue to apply the "reasonable accommodation" standard of the Americans with Disabilities Act (ADA) that they have always used. 

• What about students who  have "informal" accommodations?

If students are enrolled in a public school, we urge them to formalize their accommodations via a 504 Plan or even an IEP, if appropriate. For most private schools, a 504 Plan is not an option, but private schools should consider creating a more formalized plan memorializing accommodations they provide.