All posts by Christine

Stuttering

What is stuttering?

Stuttering is a speech-motor disorder where difficulties controlling and coordinating speech movements results in the disruption to the flow (fluency) of speech. A person knows exactly what they want to say, however has difficulties producing smooth, fluent speech.

There are three different types of stuttering:

  • Repetitions – This is when the person repeats whole or parts of phrases (e.g. I want the… I want the… I want the red one), single words (and-and-and-and the blue one), parts of words (chi-chi-chicken please), or sounds (b-b—b-but you said).
  • Prolongations – This is when the person stretches or lengthens certain sounds in the words e.g. wwwwhere is my ball? I can’t ssssee it
  • Blocks – This is when the person becomes ‘stuck’ and is not able to produce speech. Blocks can be accompanied by other behaviours such as head shaking, blinking, twitching or other body movements

A person may exhibit one or more of the different types of stuttering.

Stuttering in children

Did you know that up 1 in 10 children stutter?

Stuttering usually begins between 2 – 5 years of age, at a time when the child is learning to speak in longer, more complex sentences. For unknown reasons, three times more boys than girls stutter.

 If left untreated, stuttering can continue into adulthood. Whilst some children may “grow out” of stuttering, it is impossible to know which children will grow out of stuttering and which children will go on to stutter as adults. As stuttering can become more difficult to treat with age, early intervention is key. The earlier a child and their parent begin treatment, the better chance that child has at becoming a fluent speaker.

Some children may not realise they stutter. This is particularly true for younger children. For other (especially as children get older) stuttering can be incredibly frustrating or embarrassing. Some children who stutter may experience bullying. Stuttering can be worrying for parents.

Stuttering in adults

Approximately 1 in 100 adults stutter. Some adults may have stuttered since they were children. This is called developmental stuttering. Other adults may begin to stutter following a stroke or any other type of head trauma resulting in brain damage. This is called neurogenic stuttering.

For some adults, stuttering can have a large negative impact on their daily functioning. It may be frustrating or embarrassing to engage in conversation. Certain tasks such as talking on the phone or work/university presentations can be incredibly difficult. Stuttering may impact occupational or educational opportunity.

What causes stuttering?

The cause of developmental stuttering has not yet been determined but there is thought to be a genetic influence, with stuttering often running in families. Often people who stutter have a parent, sibling, aunt, uncle, grandparent or cousin who stutters.

What can impact stuttering?

Some factors may affect amount of stuttering. It is important to note that whilst these may increase the amount of stuttering, they are not the cause of the stuttering. The factors that increase stuttering will be different for each child. They can include:

  • Emotional states (e.g. excitement, nervousness, being upset)
  • Physical states (e.g. illness, tiredness)
  • The length of the sentence the person is trying to communicate
  • How complex the sentence or idea is that the person is trying to communicate
  • The topic of conversation
  • The environment (e.g. who is there, where the person is, if it is a new environment, what the person is doing)
  • Life events (e.g. new siblings, death in the family, moving house or schools)

What can I do to help my child?

A lot! If your child begins to stutter, it is important you make contact with a Speech Pathologist to book in an assessment.

In the meantime, the following strategies can help:

  • Try to listen to your child’s message when they are stuttering – this will reduce their frustration
  • Respond to your child’s message – let them know what they’re saying is important
  • Try to let your child finish what they are saying – no one likes being interrupted!
  • Be a good speaking role model for your child – speak in a slow, relaxed manner
  • Praise your child when they speak fluently
  • Praise your child when they do other tasks well – this will improve their confidence
  • Praise your child when they try their best and persevere at other tasks (even if they “fail” or find the task difficult) – this will encourage a “growth mindset”
  • If your child asks about their stuttering – speak openly about it and let them know it is okay
  • Try to prevent other children (including siblings) teasing your child who stutters
  • Inform your child’s teachers and ask them to use the above strategies
  • For an older child, it may be appropriate to discuss with their teacher allowing your child extra time or preparation for oral work (e.g. round reading, telling news, presentations) or an alternative way to demonstrate their knowledge (e.g. a pre-recorded presentation, one on one reading time

I am a teenager/adult. What help is available?

Whilst stuttering can be more difficult to treat as someone grows older, a lot can still be done. Book in an appointment with a Speech Pathologist who can help you become a more confident speaker.

A Speech Pathologist can help by:

  • Providing you with strategies to improve your speech fluency (reduce stuttering)
  • Helping to reduce anxiety or other negative emotions around speaking
  • Increasing your speaking confidence – including conversations with friends, family, and co-workers, telephone calls, ordering meals, and public speaking

As well as the above, it is important to have social support. Finding a support group for people who stutter can be helpful.

You can find out more information from the Australian Speak Easy Association

Other useful links:


Speech Pathology Australia: http://www.speechpathologyaustralia.org

Australian Stuttering Research Centre: http://sydney.edu.au/health-sciences/research/centres.shtml

Toastmasters International: http://www.toastmasters.org.au/

International Stuttering Association: http://www.isastutter.org/

International Fluency Association: http://www.theifa.org/

Social Development & Play Skills

Speaking of social and play skills, what are they?

Play is a critical part of children’s development.  When a child plays they build many different skills, including:

  • Language skills
  • Social and emotional skills
  • Problem-solving and thinking skills

Social skills are the skills we use every day to interact and communicate with others.  Social skills play an important role in supporting a child’s overall development, including:

  • Their ability to build friendships
  • Their ability to copy and learn from others
  • Allow them to express their wants, needs, thoughts, and ideas.

 

How do children benefit from play?

Play provides time for:

  • Thinking
  • Experimenting
  • Investigating objects and materials
  • Planning and problem-solving
  • Acting out life experiences (making sense of their world)
  • Talking about their actions and intentions
  • Taking on different roles
  • Communicating with others
  • Sharing emotions with others (noticing their reactions, anticipating and accommodating the needs and wants of others)

How can adults help?

Adults have an important role in children’s play:

  • Recognizing when they want to play and when they want to stop
  • Follow the child’s lead rather than telling them what to do
  • Show your support by commenting on what they are doing
  • Offer open-ended materials e.g. dress-up clothes, large cardboard boxes, blocks, natural materials such as sand or water
  • Show your interest and involvement through what you say, your facial expression and your body language

A final thought…

In young children, studies have shown that:

  • Better pretend play skills at age 3 and 4 are linked to better language skills at ages 8 and 9.
  • The more varied and flexible a young child’s pretend play, the more advanced his thinking skills are at ages 8 and 9.

Auditory Processing Disorder

Auditory processing disorder (APD) is a condition where a person has difficulty processing complex sounds, such as speech, even though their hearing is normal. It can affect both children and adults, although it is not typically diagnosed until at least the age of 7. Some people are born with APD, while others acquire it as a result of recurrent middle ear infections, stroke or traumatic brain injury. Symptoms of APD may worsen with age as they interact with normal aging processes.

Adults with auditory processing disorder may have difficulty with the following tasks:

  • Understanding speech in noisy environments (e.g., at a party or in a busy office)
  • Understanding speech over the phone
  • Understanding rapid or accented speech
  • Using someone’s tone of voice to interpret humor or sarcasm
  • Following complex instructions
  • Multi-tasking (e.g., listening and taking notes at the same time)
  • Learning from information that is presented orally
  • Learning a foreign language
  • Appreciating music

If you have auditory processing disorder you may find it helps to:

  • Turn off the TV or radio or moving to a quiet room before starting a conversation
  • Have important conversations via email rather than on the telephone
  • Use earplugs or noise-canceling headphones to block out background noises like air-conditioners
  • Repeat back instructions to the person talking to you to confirm you have understood them

Auditory processing disorder is diagnosed by an audiologist, but a Speech Pathologist can assess which areas of communication are most affected by APD. Speech Pathologists can also provide therapy to improve processing skills and compensatory strategies.

http://www.ldonline.org/article/5919/

https://www.additudemag.com/auditory-processing-disorder-in-adults/

Developmental Language Disorder: Comprehension difficulties

What is a Developmental language disorder?

It is a problem with using and/or understanding language that is not caused by a biomedical condition such as cerebral palsy or hearing impairment, and which persists into school age and beyond. It affects about 1 in every 14 children and impacts on progress in school and in everyday life. Difficulties with using language, such as limited vocabulary or poor grammar, are often the most obvious signs of developmental language disorder. However, children with this disorder often also have difficulty with comprehension. They may be labeled as distracted, forgetful, poor listeners or even naughty, when in fact these children are having difficulty understanding what is said to them.

Children with a developmental language disorder may have difficulty:

  • Following complex instructions or instructions with multiple steps
  • Answering questions
  • Following the plot of a story
  • Understanding what they are reading
  • Learning from information that is presented through words (spoken or written)

These children may find it easier to learn at home and in the classroom if you:

  • Reduce distractions when presenting important or difficult information
  • Break down instructions into simpler steps
  • Speak more slowly and pause between important pieces of information
  • Repeat instructions and information several times
  • Provide information in non-verbal formats (e.g., pictures and diagrams) and provide hands-on experiences for learning
  • For students who are reading, provide written notes that can be re-read as many times as necessary

Comprehension skills can be improved through therapy with a Speech Pathologist. If you think that your child has comprehension difficulties, talk to your Speech Pathologist about what can be done to help.

Click below for a video explaining developmental language disorder.

https://www.youtube.com/user/RALLIcampaign

Helping your child to read

Using decodable books to help your child read

A decodable book is a book that contains a set of words a person can sound out. That is, they are great for early readers or ones that are struggling.

A decodable book contains sound-letter types and word types that the reader has been taught therefore, the reader has the opportunity to read sound types they have been taught in the context of a story that they CAN decode.

The amazing thing about decodable books is that they give us a proper way of identifying a book that is right for the reader and ensures that their literacy lessons match what they are reading!

English is one of the most complex languages to learn to read and write in for example; we have multiple spellings for the “o” sound (e.g. Boat, low , toe) and the “i” sound (e.g. height, might, kite, lie).

Early readers or ones that are struggling cannot learn this all at once and shouldn’t be expected to learn by just memorizing.

By giving the reader a decodable book, we instantly give them a chance of success, reinforcement of what they have already learned and encourage them to DECODE, not guess from memory.

You can find free printable decodable books here online:

https://www.readinga-z.com/books/decodable-books/

Adults with speech and language difficulty

Communication with adults with speech & language difficulty

As part of Speech Pathology Australia Week, 2018 Speech Pathology Australia has provided general tips for successful communication. These tips can be applied when communicating with adults who present with speech or language deficits such as Apraxia and Dysarthria:

Tips For Successful Communication
  • Always treat the person with the communication disability with dignity and respect
  • Be welcoming and friendly
  • Understand there are many ways to communicate
  • Ask the person with the disability what will help with communication
  • Avoid loud locations, find a quiet place
  • Listen carefully
  • When you don’t understand, let them know you are having difficulty understanding
  • If you think the person has not understood, repeat what you have said or say it a different way
  • Try asking the person yes or no questions if you are having difficulty understanding them
  • Ask the person to repeat or try another approach if you don’t understand
  • To make sure you are understood, check with the person that you have understood them correctly
  • If you ask a question, wait for the person to reply
  • Allow the person time to respond, so always be patient
  • Speak directly to the person and make eye contact. (Though be mindful that there are some people who may not want you to look at them, e.g. some people with autism spectrum disorder)
  • Speak normally. There is no need for you to raise your voice or slow your speech.

*Source: Adapted from SCOPE, Communication for All Booklet, http://www.scopeaust.org.au

More information:

Apraxia of speech in adults/ Dysarthria in adults

What is a Language Development Centre?

A Language Development Centre (LDC) is a specialised school that is attached to a mainstream Perth metropolitan school and is funded by the government (that is, it’s classed as a public school).

An LDC provides a full time supportive educational placement for children from Kindergarten to Year 1 (most) or Year 3 (South East LDC only), whose primary diagnosis is a developmental language disorder, not in the presence of any other diagnosis (i.e learning disability). The classroom appears like any mainstream classroom, is in-line with the Australian school curriculum standards, but caters to students’ individual language needs.

LDC’s have significantly reduced class sizes and are staffed by experienced and trained teachers, speech pathologists and education assistants. The LDC addresses the individual needs of the students in a way that is not possible in mainstream classrooms. Comprehensive assessments are conducted, covering all areas of speech and language so that individual goals (forming an Individual Education Plan or IEP), monitoring of progress, and planning for the intervention can take place. 

If your child is a late talker or you think that your child is delayed in their speaking, talking and/or understanding of language, speak to a speech pathologist to determine if your child would meet criteria for placement at an LDC.

What is Childhood Apraxia of Speech?

Childhood Apraxia of Speech (CAS) is a disorder that affects a child’s’ clarity or articulation of speech sounds. When a child is often very difficult to understand and has limited consonants and vowels, a speech pathologist may be concerned that they have CAS. It is also known as Developmental Apraxia of Speech.

CAS can occur in conjunction with other genetic conditions (e.g. Autism) and also occur as an idiopathic speech disorder; meaning that the child does not present with any neurological abnormalities or other developmental conditions.

Below are the three characteristics that differentiate CAS from other speech sound disorders as reported by the American Speech-Language-Hearing Association (ASHA):

  • Inconsistent errors with consonants and vowels (the child may say the same word in different ways when asked to repeat the word multiple times).
  • A difficulty with the transitions between sounds or syllables in words (resulting in long pauses between sounds/ syllables which impacts the clarity of a child’s speech.)
  • A difficulty with using correct intonation and stress when speaking (e.g. placing equal stress on all syllables within a word which can result in the child’s speech sounding monotone or flat).

The presentation of CAS is not limited to the above characteristics. For further information on the prevalence, diagnosis, symptoms and treatment of CAS, see the links below.

Apraxia Kids

Incidence and Prevalence – ASHA