Grammar and Syntax: Put the Fun in Fundamentals

Formation of language begins at birth, believe it or not. When a baby cries, they're communicating the need for help and attention. Later, babies begin to produce sounds when they want certain objects or even family members; they are naming them: ba ba (bottle), ma ma (mother), da da (father), etc. We don't recognize this as the beginning of the development of grammar and syntax, but it actually is. Children are "speaking" and we are responding, appropriately! When we respond appropriately, we are teaching them (slowly but surely) how to talk. As a child's language is developing, parents can help children learn grammar (classes of words, their forms and functions) and syntax (the arrangement of words and the sequence in which we put them together to create meaning). Children with speech and language difficulties often have problems understanding the even the simplest and smallest units of words (-ed, -ing, -s). So, sometimes their sentences may come off as immature dependent on their age.

Children realize early on that the more words they hear and repeat, the more the world around them is expanding, or rather, their understanding of it. As early as two years old, children are trying to use prepositions, nouns, pronouns and verbs altogether to make meaning; "Me up mama," want my ba," "you go dada." Even though children put together sentences that may lack sense to a parent, they should respond appropriately using correct grammar in order to teach the child appropriate use of language. Responding with baby talk is cute up until a certain age, but there comes a time when it only reinforces inappropriate use of language. You see, when we respond using baby talk, we are telling a child that this type of talk is appropriate (we may not directly see the innate thirst to learn language in our toddlers, but it's there). Use appropriate language and children will follow ("Suzy hitted me!" - "Did Suzy hit you?")

Children with speech and language difficulties often:

• Use words in the wrong order (their sentences don't make sense or are misleading)
• Struggle to use pronouns correctly (identifies self as 'she,' 'her,' or 'me' when 'I' is correct)
• Cannot grasp how to use word endings (-ed, -ing, -s) correctly
• Do not understand how to connect sentences or thoughts using conjunctions (and, but, or, yet)
• Do not understand verb tense (past, present and future)
• Need practical experiences to understand some concepts
• Need to use concrete materials to understand plurals (one doll, two dolls) 

Here are some strategies to use with children at home to help improve their use of grammar and syntax.

• Play sentence games. For example, cut out pictures from a magazine and verbally reenact the scene. This can help a child understand nouns, verbs, adjectives and where they belong (syntax). (Picture of a dog playing catch with his owner - "What is/was the dog/owner doing?" "The dog is/was/will..., His owner is/was..., The ball is/was... " As you can see, this can also helps children understand tenses. And it will be fun!
• Play sentence games. Cut pictures of individual items out of a magazine and paste them on cards. Mix them up, have your child describe the object to you and guess what it is. ("It has icing you can eat and candles that tell how old you are!")
• Scramble! Write words on small notecards, punctuation marks: everything that makes a sentence. Scramble them up and have your child put them together in the right order. Correct them when they're wrong, but in a way that challenges them to correct it themselves. If they're wrong about where a comma goes, ask "should the comma go here, or there?". This will engage them and help them pay more attention. 
• Mad Libs! Word searches, and puzzles galore!
• Use everyday objects around the house to teach plurals. "Jerry, how many spoons am I holding in my hand?"

Resources

Spivey, Becky L., M.Ed. Super Duper Publications © 2009 Handy Handouts. "Teaching the Fundamentals of Grammar and Syntax at Home"

Sound-Object Associations: The Foundation For Language Perception and Fluency

What are Sound-Object Associations?

We make all sorts of associations in our head. They're the building blocks of memory. Our strongest sense of memory associates with our sense of smell. Like Mom's perfume that one year, until she found a new one. You went on family vacation with her at Jersey Shore, and she used half the bottle for every dinner gathering. Ten years later, if she puts on that perfume, you can't help but feel a strong sense of nostalgia for that vacation; it's so vivid it's as if it were yesterday. Tiny associations create memory. Speech and language development requires a strong memory. Sound-object associations are associations we make with sound. They're quite simple: we hear the noise an object makes more than once and this association becomes engrained in us, like animal sounds.

Children begin learning sound-object associations very young. And as they grow older and experience more of the world, they continue to create these. One of their first associations is the sound of their caregiver's voice (Kjesbo 1).

So Why Are Sound-Object Associations So Important

Sound-Object Associations Help a child learn the environment around him. They make sense of the world every day with them. "The ability to hear, recognize and attach meaning to environmental sounds is a first step toward phonological awareness (the ability to indentify, mix together, break apart, and change around the sounds in words) and literacy" (Kjebo 1). It also aids children in developing both their vocabulary skills and overall comprehension of language. 

As well, different types of sound-object associations help children in increasing their perceptual skills. In other words, the way they perceive the world around them. It can keep them safe, and we can impress these on them. For example, a child hear's a dog growl and is automatically careful around it. Hopefully he didn't find out the hard way, and his parents told him "be careful when a dog growls like that." They associate the sound of a dog growling with the behavior of carefulness. Perceptually-speaking, if they hear a dog on the TV growling, they know they're safe, and won't elicit this behavior. This is why sound-object associations are so important. They are the building blocks of language and properly perceiving the world around one's self. 

Resources

Kjesbo, Rynette R., M.S., CCC-SLP. Super Duper Handy Handouts © 2011: Sound-Object Associations - Knowing What We Hear!

State Standards: Specific Guidelines for Each Grade and District

What Are State Standards

State standards are guidelines, set specifically for each grade, for the knowledge and skills students are expected to obtain. Each state sets its own benchmark for core curriculum areas like language arts, math, physical education, science, social studies, and technology. Every state hands their school districts specifics for what teachers should be teaching to each grade level, but these standards do not give specifics on how they are to meet the objectives of the learning standards of their students (Kjesbo, 1).

What do you think about this? In a previous blog, I had stated that these state standards are set forth initially by corporations, entities that are seemingly irrelevant in the mass education of our children. Why is this? Perhaps these corporations, with firm grips on the economic future, would prefer our young students be prepared for the advancing corporate future. On a cynical note, some corporations capitalize on the ignorance of the people: commodity businesses that rely on materialistic personalities to thrive, fast food companies that rely on the nutrition-oblivious, and the television set, which, if you haven’t noticed, has been creating sillier and sillier children shows than ever (Sesame Street was so informative!). Perhaps they’re preparing the wealthy to work and the poverty stricken to follow. There are portions of this country, generally wealthy spots, I must note, that are known for their vigorous educational standards. These same districts are well regarded for fostering successful students that are prepared for the career paths ahead of them. Then, there are school districts known for their poor standards, as well as their poor educational success rates.

Many debate about who’s to blame for this social stratification of America. Is it the school systems? Could this large gap between the rich and the poor root its perpetuation, or initiation, in grade school? It’s very possible. I believe, and in this moment I speak not for the Suffolk Speech establishment (although I feel they would agree), that we as a country should at least try to bridge the gap between social classes by drilling down on the equilibrium of state standards across the country. It’s a difficult debate, though, as these more poverty stricken areas don’t possess the capital for a fair game. Rather, if they are to match standards, they must match resources (quality teachers, quality schools, up-to-date libraries, etc.).

What About the Common Core State Standards Initiative

Right now, every state maintains its own set of academic standards, with no continuity in between them. However, there is talk about setting a national standard: expecting all states to have the same academic goals for students’ learning. The most well known of these initiatives is the Common Core State Standards Initiative which “is a state-effort to establish a shared set of clear educational standards for English language arts and mathematics that states can voluntarily adopt” (Common Core State Standards Initiative, 2010). Involved in the effort for implementing national standards are experts, teachers, school administrators, and parents across the country (Kjesbo, 1.)

How Can You Find Out More?

Ask your local school for information regarding grade level expectations for your children. If the answer does not suffice, take a look at the Department of Education Web site in your state in order to find out what the academic standards are in your state. http://www.educationworld.com/standards/states or http://www.academicbenchmarks.org/ will have information as well. For information on Common Core Standards, go to http://www.corestandards.org/. I implore you to take a look. It’s a very interesting read. This is your child’s future at steak. These organizations literally mold students’ young minds. We should have a say. What would you prefer? Is there a way to mix the best of both? Could “Common Core” work?

Resources

Common Core State Standards Initiative. (2010). Frequently asked questions. http://www.corestandards.org/frequently-asked-questions

Kjesbo, Rynette R., M.S., CCC-SLP. Super Duper® Publications Handy Handouts (2010): State Standards-Specific Learning Guides for Each Grade

Learning Social Skills Early On

For some children, social skills come naturally. They learn them vicariously through others: first, their parents and siblings, and later on, their peers. The umbrella phrase "social skills" includes a child's ability to communicate, problem-solving skills, decision-making skills, self-management and control, and relationships. Difficulties with social skills have several negative implications in one's life and can interfere with school, work, and life in general.

 

Poor social skills are very common in children with learning disabilities and especially nonverbal learning disabilities. Children who present serious difficulty with their social skills may have what is referred to as "pragmatic communication deficits". This develops with age. Early on, children with pragmatic communication deficits may display difficulties with physical communication; subsequently, they display verbal difficulties later on in life.

 

There are many red flags to determine if you should have your child evaluated for pragmatic communication skills. Physical difficulties include: poor eye contact (usually the first sign of a communication disorder), an inability or miscomprehension of socially appropriate conversational distance, body language that does not match speech (either too enthusiastic or no body language at all to facilitate context), or facial expressions that do not match speech (forgetting to smile, nod for approval). You can envision how this might make social relationships difficult. A dissonance between body language and context throws off the listener, which might deter a friendship in-the-making. It causes discomfort and confusion in the listener.

 

Verbal difficulties may include: an inclination to constantly talk about random topics, entirely irrelevant to a given conversation, a miscomprehension of when or how it is appropriate to interrupt someone else who is speaking, TMI (too much information) during initial encounters
(which might make the listener uncomfortable), trouble relating volume of voice to context, trouble receiving compliments or often insulting others without intent, trouble introducing one's self, avoiding groups and acknowledging others when entering a room.

 

Thinking difficulties may include: an inability to take into account another's emotional state before speaking (Can I see where you buried your dog today?), taking jokes or sarcasm literally, laughing or talking at inappropriate times or places, inability to pick up on cues to continue conversation, and an inability to "think" before "saying", which may result in insult to another or to one's self. (Spivey, 2)

 

Children with pragmatic communication deficits may have very little empathy: an attribute that is CRUCIAL to successful communication. Parents or caregivers can be the greatest role models for children if they work hard to be. They must learn to talk about behaviors and expectations. Here is a list of social skills that are imperative in a young one's life and are perfect for a parent to practice impressing on a young child they believe might be having difficulty in developing good communication skills...

•  Teach your child the importance of saying "please" and "thank you" while making appropriate eye contact
• Teach your child to deal with frustration appropriately, without yelling or acting out (be a role model on this one especially: if you get easily frustrated and act out, either learn to stay calm or be prepared for your child to do the same)
• Teach your child how to ask questions appropriately regarding touchy issues (How did your dog die?)
• Teach your child to accept responsibility for his/her own mistakes (it's also important to be a good role model for this one: if you are wrong, proudly admit it, and promptly)
• Teach your child ways to start or facilitate conversation appropriately, without interrupting
• Teach your child to accept "no" for an answer
• Teach your child to accept praise from others without "gloating"
• Teach your child how to greet others (familiar and unfamiliar) appropriately, with eye contact
• Teach your child the importance of following simple directions
• Teach your child about empathy, sympathy, and giving compliments
• Teach your child to seek attention when it's appropriate
• Teach your child to listen, respect the opinion of others even if they are different from their own or offensive to them, and finally, how to make and keep friends (Spivey, 2)

 

You were a child once before. You know how difficult it can be, but how EASY it can be at the same time to make new friends. It all depends on your own self-esteem, the way you communicate, and your hobbies. YOU are the biggest factor in aiding your child in developing successful social skills, and the earlier, the better.  



Resources

Spivey, Becky, M. E.d. "Why Is It Hard for Some Children to Learn Social Skills?" Handy Handouts (2009): http://www.superduperinc.com/handouts/pdf/144_Teaching_Social_Skills_to_Children.pdf



Why Unstructured Play is the Only Way

Unstructured play has no rules, no organization, no goals: sounds futile? Quite the opposite, actually. When a child plays without cause, tapping into his/her imagination, this promotes creativity and even fosters problem solving. It's also stress-free! But what has happened to it? I remember when I was a child (I'm 23 now) I used to play with my neighborhood friend every Summer day, shooting imaginary guns at each other, filling water balloons, circling his pool and creating a giant whirlpool. We did things for absolutely no reason, but we had fun. We saved the world a few times, also took it over I'm pretty sure. I rarely see children expand their imaginations this far anymore.

 

Unstructured play, according to the Archives of Pediatrics & Adolescent Medicine, has dropped a whole 25% between 1981 and 1997. I'm out of date on this one aren't I. Just picture the steady decline and what it's like today. Now, computers and electronic games have taken over play time. Children assume rules of fake characters on their PS3s (no need to use your imagination for that), play by someone else's rules in order to reach different levels of "competency" (established by whoever programmed said game). Yeah, I guess this sounds fun. But I'd rather be outside in the sun, sporting a black cape and turning my friends into geckos with my super powers. As ridiculous as that sounds, there is a high implication that unstructured play advantages a child creatively much more than structured play. So, why the change?

 

A lot of parents today are simply afraid of letting their children go outside. It's no good, unless, of course, you reside in a dangerous neighborhood. Parents feel more secure knowing their child is sitting in bed playing video games rather than outside climbing trees. It's understandable, especially when your child opts out of unstructured play and wants to follow the zeitgeist and force you to buy them every new video game that comes out biweekly. But research suggests that children are losing out, big time, when they succumb to sitting in front of a screen all day, every day. When children are paying outside, using their imagination, they are actually developing real life skills, such as problem solving, sequencing, organization, social skills, compromise, empathy, sympathy, etc.

 

Unstructured play miniaturizes a child's world, enabling them to analyze and deal with it. It primes children for learning, allowing them to create their own games with their own rules, strategy, level of success and failure, etc. This actually prepares children for entering society and school.

 

It also teaches them how to handle stress and conflict. Think about when you were a child, when arguments would spark between you and other kids playing your imaginary game. Children learn to smooth over conflict, mediate, compromise and work as a team just by playing.

 

Unstructured play also provides problem solving skills, believe it or not. Aliens are entering our atmosphere? Not to worry. Our children can use their fake computer system to knock down their defense systems, then either negotiate a peace treaty, or attack the malevolent beings.

 

Free playtime promotes discovery, which is the basis of learning. While they're out there frolicking amuk, they're learning things about the world. Yes, grass stains. Yes, we can Shout it out.

 

And, finally, free playtime gives children a sense of power in a world where they're essentially powerless. This is one of the main reasons we used to love free, imaginative play time. We felt empowered. All day, children are under the authority of others. Give them a chance to be their own authority, safely in your own backyard. Let their imaginations run wild.

 

So, what can YOU do to implore your child to participate in unstructured play? Many children are already hooked on their iPads and XBoxes. For one, change your mindset. Your child doesn't require structure all day every day: give them the time they need to play. Let children drop extra activities that they no longer show an interest in, especially if it takes a large portion of their day away. They may need that time for play. So, if your child is pouting over the trumpet lessons you're forcing upon them, maybe it's time to put the trumpet down. Let your child be bored. Boredom will force a child to create his/her own creative playtime. Offer them open-ended toys such as blocks, dolls, old clothes, bouncy balls; these types of toys encourage open-ended, imaginative play time. Set TV and computer game timing limits. It might an extreme task breaking the iPad habit, so easy does it. Gather the neighbors with other children to find a safe place for them to engage with each other and save the world, and take turns watching each other's children.

 

Childhood is the time for self-directed, unstructured play, which bridges the gap between imagination and creativity. Don't let your child miss out on the endlessness of their imagination before it's plucked away from them. Catch them in the rye.

 

Sources

Spivey, Becky L., M.Ed. "Whatever Happened To Unstructured Play?" (2013): n. pag. Handy Handouts - FREE Educational Handouts for Teachers and Parents. Web. 01 Oct. 2013.



Hearing Loss in Children: The Kit & Caboodle

Children develop their speech vicariously by hearing others speak and imitating the sounds in their environment. Thus, a child who is hearing-impaired finds difficulty in their speech development. They cannot hear the all of the sounds in their environment, so they find difficulty understanding, communicating, and learning about the world.

The causes of hearing loss in children vary from genetics, infections, or even injury. Children could be born with hearing loss or acquire the loss during infancy or childhood. A hearing specialist or ENT doctor can possibly determine the significance of a child's hearing impairment and suggest the appropriate treatment.

(((((How We Hear)))))

I learned the function of the ears during Biopsychology at SUNY Buffalo (where I received straight A's). When I say "it's complicated," I truly mean it. I'll abridge the current and most widely accepted theory about how the outer/inner-ears take in sounds as well as how the brain processes them. Sound waves first hit the outer ear, continuing on through the ear canal causing the ear drum to vibrate. This vibration triggers the bones in the middle ear to move up and down, creating waves in the fluid of the inner ear, AKA the cochlea (pronounced kɒk.lɪə or coke-leah; coolest word EVER). The microscopic hair cells inside the cochlea (yes, there's microscopic hair inside your ear and no, do not apply Nair) bend and stimulate the auditory nerve, which then transmits this auditory information to the brain to be further processed. This all happens within fractions of a second. Any single breakdown in this system (ie: Nairing your cochlear hair) can result in hearing loss. In all seriousness, hearing impairment in a child can drastically hinder their speech development, emotional development, intellect, and life in general. Luckily, large strides have been made over the past few decades in treating and even fixing hearing impairment. But, before we get into that, let's talk about the different types of hearing loss.

(((((Types of Hearing Loss)))))

Conductive hearing loss constitutes a signal breakdown near the outer or middle ear. Temporary conditions such as fluid build up in the middle ear, ear infections, or wax build up in the ear canal can cause conductive hearing loss. Malformations of the ear or ear canal can also cause breakdown of auditory signals.

Sensorineural hearing loss can result from damage or malformation of the inner ear or cochlea. This type of hearing loss is typically permanent, and often medical or surgical treatment cannot fix the issue. Children who have sensorineural hearing loss can sometimes benefit from wearing hearing aids or cochlear implants that amplify auditory signals or bypass the damaged inner ear.

Mixed hearing loss is a combination of both conductive and sensorineural components of hearing loss.

(((((Severity of Hearing Loss)))))

To determine the severity of a child's hearing impairment, an audiologist creates a graph called an "audiogram". The severity of hearing loss can vary from mild, to moderate, to severe, to profound. An audiologist can create a measurement of a child's hearing loss on an audiogram by measuring a child's detection for sound at a slew of different pitches ("frequency") and loudness levels ("intensity"). The lines on an audiogram create a "shape" that represents the child's hearing loss. A flat shape indicates that the child hears at about the same intensity level across all frequencies. A sloping shape indicates a need for more intensity as sound movers across the different frequencies. A "cookie bite" shape refers to a hearing loss milder in the low and high frequencies, with a more significant loss in the middle frequencies.

(((((Treatment of Hearing Loss)))))

Regardless of the type and severity of a child's hearing loss, it CAN be managed. Professionals such as audiologists or otolaryngologists devote their careers to this. Amplification systems are constantly being improved upon, and medical or surgical treatments can sometimes help increase a child's hearing ability. Hearing is directly related to a child's development of speech, reading and writing. So parents who suspect a hearing impairment in their child should seek testing and treatment immediately. Difficulties with speech can be treated by a Speech-Language Pathologist.

 

Resources

National Institute on Deafness and Other Communication Disorders, NIDCD, from the National Institute of Health, http://www.nidcd.nih.gove/health/statistics/hearing.asp retrieved September 26, 2013.

Super Duper Handy Handouts!. "Hearing Loss in Children" by Susie Lorraine, M.A., CCC-SLP

P.R.O.M.P.T. Therapy: Who, What, & Why?

PROMPT stands for Prompts for Restructuring Oral-Muscular Phonetic Targets. The technique utilizes tactile-kinesthetic (a fancy word for "learning through doing") articulatory cues on one's jaw, face, and under the chin to develop OR restructure speech production.
Many therapists at Suffolk Center for Speech are trained in PROMPT therapy, versed in manually guiding children in articulating specific sounds or words. PROMPT, for many children, can be boring and unengaging. But we know how to make it fun. Our therapeutic platform for children is heavily focused on motivating and rewarding. Many parents of patients tell us their children "can't wait for speech."

During PROMPT, a clinician will use their hands to cue and stimulate articulatory movement in the patient's mouth area, and simultaneously, discourage unnecassary movements to eliminate them. This type of therapy addresses cognitive, social, pragmatic, behavioral, sensory motor and physical domains. Each individual is evaluated for his/her strengths and weaknesses. Strengths are utilized to improve the clients communication skills with a focus on dimishing weaknesses. PROMPT therapy may be different for individual patients in terms of how a clinican helps the patient improve motor control, cognitive skills, and social interactions. At Suffolk Center for Speech, our main objective in PROMPT therapy is to improve functional, interactive, and verbal communication of young ones. PROMPT therapy is not for everybody.

Who Can Benefit?

Children and adults who suffer from Apraxia of Speech, Developmental Delays, Dysarthria, Phonological Disorders, Autism Spectrum Disorders, and Hearing Impairments can all benefit from PROMPT therapy.



What Does A PROMPT Session With A Child Involve?

A therapist will initially evaluate a child's degree of focus during the communication process. If a child is having difficulty paying attention to the therapist, maintaining eye contact, and/or generally focusing, a therapist will implement strategies to help the child "be present". The therapist may attempt to slow down the child's rate of speech, and prompt the child to use vowel sounds. Once the child begins to imitate or initiate vowel sounds for the purpose of communication, Parameter PROMPTS (processes that facilitate jaw/facial control and a degree of articulatory movements) are provided. These will shape speech production for a child in need. It won't happen overnight, but PROMPT is an extremely effective approach to teaching a child to proper communication skills(physically and verbally). Therapy structure will shift from focus and attention to functional speech exercises.
 

Can Parents Carryover PROMPT Therapy Goals At Home? 

They sure can. In fact, parental involvement is critical to the success of PROMPT therapy. Parents are NOT encouraged to attempt to imitate PROMPT training. PROMPT therapy is a specialty that requires in-depth training, and incorrect emulation can interfere with PROMPT therapy goals. Parents are encouraged to talk with their children about what he/she did during therapy: to ask them questions about it. This will help the child remember what he/she has learned during therapy (how to articulate certain sounds or vowels, or how not to). Parents are also encouraged to read stories that contains words that force out the articulators the child is finding difficulty with in a fun and engaging environment (particular to the child). If the child is still pronouncing sounds wrongly, inform them subtly. Make it fun for the child to learn correct pronunciations by playing games that include well rehearsed words or phrases. A fun and natural environment is important for the child to rehearse pronunciation; otherwise, they may not bring what they've learned at Speech Therapy home or to school. It's extremely important that parents acquire a solid rapport with their child's speech-language pathologist, so that strengths and weaknesses can be discussed as well as ways to foster successful therapy (homework, if you will). A skilled therapist will give ideas to a parent regarding situations and scenarios where a child may experience most effective practice.
 

PROMPT Trained and PROMPT Certified:
What's the Difference? 

A PROMPT-trained therapist is allowed to practice PROMPT therapy on patients in need, and are completely qualified as well. The only difference between a PROMPT-trained therapist and a PROMPT-certified therapist is a video project, which is extremely costly to the therapist. Other than that, there is no difference.