Children with Speech Production Challenges at Risk for Reading Difficulties


Children with persistent speech difficulties beyond 5 years of age are more at risk for later challenges with reading and spelling skills. Children who have difficulty with speech input (identifying differences between sounds), have an imprecise storage of words, or have difficulty producing speech may present with challenges in reading and writing. These children may have difficulty with phonological awareness skills, such as knowing the sequence of sounds in words (beginning, middle, and end of a word) or being able to accurately repeat a word to evaluate its word structure. Children with speech production difficulties may also have difficulties with counting syllables and blending and segmenting sounds. For more information regarding your child’s pre-literacy skills, contact your child’s treating therapist!

Parent Hotline for Children who are Deaf or Hard of Hearing


A parent hotline is now available to help parents and caregivers of children who are deaf or hard of hearing. This hotline is available through The Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell). This hotline is designed to assist parents of children who have been recently diagnosed as deaf or hard of hearing find the resources and support they need. When calling the hotline, parents/caregivers are connected with other parents of children who are deaf or hard of hearing. Additional information about this hotline can be found on the AG Bell website.

Normal Disfluency vs. Stuttering in Young Children

Between the ages of 2-5, many children go through a period of decreased speech fluency. At this time in development, children are acquiring language and learning both speech and non-speech motor control. These factors, in addition to normal daily stressors and excitement while speaking, can contribute to breakdowns in fluency. Repetitions are the most common type of disfluency seen in young children along with interjections, revisions, prolongations, and pauses.

There are several important factors distinguishing a child who is normally disfluent from a child who stutters:

  • Frequency of disfluencies: Typically developing children display an average of about 7 disfluencies per 100 words. Children who exhibit a higher level of disfluency are considered borderline, or potentially stuttering.
  • Proportion of certain types of disfluencies: Research has shown that children who present with borderline or beginning stuttering have a higher number of part-word and whole-word repetitions, prolongations, and blocks when compared with normally disfluent peers.
  • Number of times a word or sound is repeated: A higher number of sound or syllable repetitions per disfluency may indicate borderline or beginning stuttering.
  • Tension: Children who stutter demonstrate signs of muscle tension, changes to airflow, irregular rate of repetitions and fixed articulatory postures.
  • Escape behaviors: These behaviors can be present in children who stutter, and include eye blinks, head nods, interjections, limb movement etc.
  • Awareness and frustration: Children who stutter typically show awareness and frustration when moments of disfluency occur.

If these factors are present, the child may require speech/language evaluation and intervention.



Guitar, Barry. Stuttering: an Integrated Approach to Its Nature and Treatment. 4th ed., Wolters Kluwer, 2019.


Working Memory

We rely on many different forms of memory to function in daily life including short-term and long-term memory. Out of all forms of memory, working memory is oftentimes less understood and less recognized. Working memory is what allows people to process, store, and retrieve information for later use. Working memory relies on the ability to attend to, concentrate on, sequence, and decipher important information. Some have described working memory as a bucket in which content is continually added to over time.

Research shows that in a screening of over 3000 school-aged children, 1 in 10 was identified as having working memory difficulties. Other studies conclude that between 10-15% of all children have working memory deficits, which causes significant under-performance in many areas of learning including math, reading comprehension, problem solving, and test-taking in the academic setting. Reduced working memory impacts children in their early years of preschool and kindergarten up through college and beyond. Working memory deficits can be associated with many more-recognized disabilities including ADHD and Dyslexia.

Working memory is what allows children to successfully follow multiple step directions, count, decode (read), encode (spell), follow mathematical operations, keep their place within text, answer questions, rapidly name basic concepts (e.g. colors, shapes), paraphrase information, and recite early-learned patterns from rote memory (e.g. days of week, months of year.) Understanding the connection between working memory and language is integral for supporting the developmental needs of children. An understanding of working memory is essential for identifying a child’s strengths and weaknesses for learning in the home and school environment.

Facilitating Problem-Solving Skills


Does your child struggle with reasoning, critical thinking, and problem-solving skills? Try to incorporate problem solving discussions throughout your day to day activities. Having your child be a part of the problem-solving process, even for small problems throughout the day, will help them develop problem solving skills. Try asking your child questions such as “How else could we have solved that problem?” and “Why did that happen?” to facilitate a conversation.  Check out the link below to find wordless videos that emphasize a character facing a problem!

Importance of Fingerplays

Fingerplays are a great way to engage your toddler or preschooler in language learning. Lisa Erwin, M.S., CCC-SLP discusses 5 ways using fingerplays are beneficial to young children. Fingerplays help develop literacy skills because the songs contain rhyme and rhythm and it introduces story grammar (character, setting, problem, solution) as the songs tell a story. Fingerplays help develop interactions with parents and caregivers because it is an activity that is done together and it helps young children develop motor skills by isolating finger movements. Finally, fingerplays don’t require any toys or batteries so they can be done anytime!

Erwin, Lisa. Getting Back to Basics: 5 Reasons to Use Fingerplays in Sessions. ASHA Leader Live.December 7, 2018.

Behavioral Strategies for Young Kids with Developmental Delays

Jessie L. Ginsburg, MS, CCC-SLP has identified a problem many teachers, parents and professionals face when trying to facilitate a child’s transition from one activity to the next.

Counting down is a widely used strategy, where the adult sets a time frame and counts the final seconds before the transition will take place. Example: “It’s time to clean up and move on to our next activity in 2 minutes. (2 minutes passes) “We will clean up in 10 seconds…5…4…3…2…1. It’s time to clean up!”

Ginsburg points out that this count-down strategy can be dysregulating for children with communication disorders, autism, or sensory processing issues, who often have difficulty with transitions. She suggests a new approach, which lets the children feel in control by identifying their own time frame and answering questions about what will happen next.

Instead, the adult should ask what, who, where, when and how questions (e.g., “It’s been two minutes. What are we going to do now? Where are we going?) to help the child feel in control of the situation. Give choices for the child when asking these questions (e.g., How much longer would you like to play with cars, 1 or 2 minutes?”). Simply changing the language from commands to questions may help the child feel more in control and regulated during a necessary transition.

For more suggestions on this topic, check out Jessie L. Ginsburg’s post on ASHA Leader:

Listening to Audiobooks with your Child

Audiobooks are a fun and engaging way for your child to practice their listening comprehension and literacy skills. Find a book that is of interest to your child and listen to the book together. You can stop the book a few times to ask your child questions about what has happened, make predictions for what will happen next, and to summarize what has happened so far. After finishing the book, your child can retell the story to someone who did not listen to it, illustrate the story, or act it out.

Using Picture Books to Develop Vocabulary

November is National Picture Book Month, and the perfect time to introduce some new stories or well-loved classics to your child.

A 2016 study by Dominic Massaro, psychology professor at the University of California, Santa Cruz, suggests that while the amount of spoken language parents use with their children can increase their vocabulary, reading to them is even more effective.

Picture books contain richer language and less common vocabulary than we use in our everyday speech.  Giving a simple definition for unfamiliar words found in a story and pointing to the illustrations will help your child understand what the word means and help to build their vocabulary.  You can make learning new words even more fun by acting out or demonstrating what a word means. Make shared picture book reading part of your daily routine.  If you have older children, they can share books with their younger siblings-or you can all read together. Taking turns, listening and asking questions are all skills that will help your child when he starts learning to read.

The Books4All Blog has great book recommendations and suggestions for how to use them to promote language development.  Check out their website here:

Rapport in a clinic-based setting

Some speech therapists may define ‘rapport’ as being well-liked by the clients they serve. According to Webster’s International Dictionary, rapport is defined as a transient “relationship characterized by harmony, accord, and affinity.” Three qualities have consistently been identified which help establish rapport in the therapy setting- empathy, respect, and warmth.

Research shows that the outcomes of treatment tend to be predicted by the quality of a therapist and client relationship. Positive relationships between therapists and their clients often yield positive outcomes and progress within therapy. For speech therapists, relationships with clients matter just as much as the actual purposes of therapy. Research into therapist-client relationships suggests that children are often more able to remember their therapist’s personality rather than the tasks they completed in a given session. In a study of therapist-client relationships, parents rated overall rapport in the school setting as lower than in a more private, individualized setting. Research shows that the key to developing rapport especially with young children is to integrate play with work and to make therapy as child-oriented as possible. Rapport is often established in the earliest parts of therapy but is what ensues throughout the duration of therapy. Research shows that rapport must not just be established at the very beginning, but must also be maintained over time. As therapists at Wee Speech, P.C, we are as intentional in developing rapport as we are in providing treatment to our clients because the attitude clients have about therapy sets the stage for what they can achieve.



Establishing Rapport with Young Children During Speech and Language Diagnostic Evaluation (Geraldine Pattison, Thomas Powell)-National Student Speech Language Association Journal, Volume 17, 77-80 (1989-1990)