Tongue thrust also referred to as a “reverse swallow” is a common orofacial myofunctional disorder. It is a pattern where the tongue protrudes between the teeth while eating, speaking, or at rest.
There are many possible causes of tongue thrust including:
- Oral habits – thumb/finger sucking, extended pacifier use, etc.
- Respiratory issues – enlarged tonsils/adenoids, allergies, mouth breathing, etc.
- Premature loss of baby teeth which allows the tongue to move forward into the spaces created by missing teeth
- Difficulty with tongue coordination
Effects of Tongue Thrust
Over time, a tongue thrust can affect your child’s speech and the alignment of their teeth. When the tongue continually presses against the teeth, it can push the teeth out of alignment requiring orthodontics. After orthodontics, if the tongue thrust is not corrected, it can push the teeth out of alignment again. It also can affect a child’s speech. The most common articulation errors are “s,” “z,” “j,” “ch,” and “sh.”
Diagnoses and Treatment
A speech-language pathologist may diagnose tongue thrust after evaluating the child for speech sound errors. If the child does not display any speech sound errors, the diagnoses may come from a dentist or orthodontist.
Treatment will depend on the child’s individual needs. The SLP may refer to other professionals to correct any additional needs that may be underlying or contributing to the tongue thrust pattern. Generally, treatment focuses on eliminating any negative oral habits, learning a new habitual rest posture, establishing a new swallow pattern, and correcting any speech sound production errors.
A variety of gestures have been shown to be a predictor for later language development in children with autism, children with Down Syndrome, and typically developing children. Gestures are described as actions produced with the intent to communicate and are usually expressed using the fingers, hands, arms, and facial features. Early use of gestures has been linked to increased language production, language comprehension, and object naming. A child’s joint attention skills, such as giving or showing objects may also predict later language skills. Lack of joint attention behaviors between the ages of 2 and 3 years old may be an indication of developmental deficits.
The frequency of gesture use as a form of intentional communication is an important factor when identifying children with communication deficits. Typically developing children use gestures to communicate about one time per minute by 12-months, 18-month-olds about two times per minute, and 24-month-olds about five times per minute. The amount of gestures used by infants is related to later verbal development.
Playing familiar games, singing songs, and performing routines can encourage children to utilize gestures as a form of early communication. Songs such as “The Itsy-Bitsy Spider” or using hand gestures to signal bubbles popping can become interactive opportunities for children. Communicative gestures in these familiar contexts can later be generalized to new contexts.
Do SLPs work on reading comprehension?
Yes, SLPs are responsible for oral language (comprehension and expression) and literacy (reading, writing, and spelling). We can offer relevant skills for reading comprehension because we have knowledge of language subsystems (syntax, semantics, morphology, pragmatics) and development. SLPs understand how oral language skills transfer to reading.
What is reading comprehension?
Reading comprehension is a complex and active process where the reader applies meaning to what they read.
What skills are involved in reading comprehension?
- Background/world knowledge
- Word/vocabulary knowledge
What strategies can help develop reading comprehension abilities?
There are many evidenced-based strategies that can support children with reading comprehension difficulties. The type of text (narrative or expository) can influence which type of strategies to use, as well as, the area of deficit.
- Active-prior/background knowledge – making connections between existing knowledge and new information. Use a Know/Want to Know/Learned (KWL) organizer which helps children think about their own experiences and make relevant connections to new information.
- Questioning answering – teaches children to ask questions about the text prior to reading and answer them after reading.
- Comprehension monitoring – Used with expository texts primarily. Helps children determine if they are/are not understanding the text. When children are not understanding, they need to utilize “fix up” strategies. The therapist models the process, teaches the child to look back in the text, re-read, question answering, and look up words.
- Mental Image/Visualize – In this technique you ask the reader build images in their mind of the text.
- Story/text structure – This strategy can be used with both expository and narrative story structure but the way it is taught differs.
o Expository – helps kids look for the language used in different expository text structures (sequence, compare/contrast, problem solving, procedural, enumeration, classification).
o Narrative – teaching kids to look for the setting, characters, problem, and solution.
Many young children go through a stage between the ages of 2-5 years when they may exhibit some stuttering. The first signs of stuttering tend to appear when a child is about18-24 months old as there is a burst in vocabulary and kids are starting to put words together to form longer utterances. In many cases, stuttering goes away on its own by age 5; in others, it lasts longer. Whether or not your child exhibits stuttering behaviors, here are some great tips to think about when you’re talking with him/her.
1. Speak in an unhurried way, pausing frequently. Model slow, relaxed speech for your child.
2. Reduce the number of questions you ask. Try commenting on what your child has said.
3. Use your facial expressions and other body language to show that you are listening.
4. Set aside a few minutes at a regular time each day when you can give your undivided attention to your child. During this time, let the child choose and direct you in activities.
5. Help family members learn to take turns talking and listening. Decrease interruptions!
6. Observe the way you interact with your child. Try to increase those times that give your child the message that you are listening to him/her and he/she has plenty of time to talk. Try to decrease criticisms, rapid speech patterns, interruptions, and questions.
7. Above all, convey that you accept your child as he/she is. This support is so important!
Speech-Language Pathologists (or SLPs, as they’re often called) are experts in supporting communication. They work with children who present with a wide range of delays and disorders. You may be surprised to learn just how many areas an SLP can help your child with!
1) Articulation Skills/Speech Intelligibility: SLPs teach children how to produce speech sounds and sound patterns, thus improving their ability to be understood by others.
2) Expressive Language Skills: SLPs help children learn new words and teach them how to put words together to form phrases and sentences.
3) Receptive Language/Listening Skills: SLPs help children understand language to improve their ability to follow directions, answer questions, and participate in conversations with others.
4) Speech Fluency/Stuttering: SLPs teach children strategies to control stuttering behaviors to improve the flow of their speech.
5) Voice and Resonance: SLPs work with children to decrease vocally abusive behaviors and improve the quality of their voices.
6) Social/Pragmatic Language: SLPs teach children social language skills so that they can more appropriately participate in conversations with others.
7) Cognitive-Communication Skills: SLPs help children build skills in areas such as attention, memory, abstract reasoning, awareness, and executive functions.
8) Augmentative and Alternative Communication (AAC): AAC refers to all forms of communication other than oral speech that are used to express thoughts, needs, wants, and ideas. AAC can be used as a bridge to speech.
9) Swallowing/Feeding Issues: SLPs have knowledge of the structures and functions of the oral cavities and beyond!
10) Educating and Empowering YOU on how to best help your child: SLPs can help you incorporate more communication opportunities into your everyday routines.
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Is music a useful tool in speech therapy when working with children with ASD? Yes, when using other valuable treatment methods in addition. Music can be used to help establish joint attention, learn words, take turns, imitate, follow-directions, and ask and answer questions. It is a stimulant therefore it helps enhance memory which leads to an increase in attention and alertness. This is extremely valuable when teaching new concepts to children! Read more about it in the links below.
Daily routines (e.g. bathing, meals, shopping, car rides, getting dressed, etc.) provide great opportunities for language development in natural settings. Within these routines, children learn how their worlds are organized, begin to associate words/phrases with specific activities, make sense of social interactions, and practice participating in conversations. Through repetition of routines, children gain confidence and gradually take on more active roles. If a parent waits for the child to start a routine, such as squeezing the toothpaste on the toothbrush, the child can begin to understand his/her role as an initiator. A child’s motivation to understand is heightened in a situation in which he/she is an active participant. In addition, as specific vocabulary is repeatedly attached to an experience or activity, the clearer the meaning will become.
Fern Sussman, Program Director at the Hanen Centre, suggests the following guidelines to build opportunities for participation and learning into daily routines:
- Break routines into a series of small consistent steps so that there’s a shared understanding of how the routine works.
- Be flexible as young children learn best when you follow their lead.
- Label what the child is interested in at the very moment it seems to be his/her focus.
- Be creative! Routines can be made out of anything you do regularly!
A cognitive scientist, Mark Seidenberg, at the University of Wisconsin, Madison found that only a third of the nation’s schoolchildren read at grade level. He cites that the way children are taught to read is disconnected from how language and speech actually develop in a child’s brain. The current research shows that reading success depends on linking print to speech. Skilled reading is associated with children’s spoken language, grammar and the vocabulary they already know. Seidenberg claims that the basic science (of reading) does not go into the preparation for teachers and argues that literacy is not an “either/or” of phonics and whole language. He claims that children need both.
Researchers from the University of Washington recently conducted a 5-year longitudinal study of 241 families to study home literacy and its impacts. The participants included a group of first- to fifth graders and a group of third- to seventh graders. The study found that children with higher reading and writing achievement at school engaged in more reading and writing activities at home. Parental rating scales also indicated that children’s ability to self-regulate attention spans remained consistent throughout the study, however, executive functioning skills including goal-setting, often improved.
Wilson Reading System is a research-based, systematic, multi-sensory reading program designed to improve the five areas of reading including phonemic awareness, phonics, fluency, vocabulary, and comprehension. It is a 12-step program, with the first 6-steps teaching consistent foundational patterns, and the later 6-steps teaching more complex concepts. Letter-sound knowledge is taught systematically and paired with a multisensory approach as it is the building blocks for reading and writing. The multi-sensory approach is shown to activate more neurons during language learning and improve the chances that it becomes stored in long-term memory. The program is for students in grades 2-12 who have word-level deficits and poor sound/symbol systems for both reading and spelling. This program is appropriate for students with language-based learning disabilities, labored readers, students who know words by sight but have difficulty reading non-sense syllables, and students who speak and understand English but cannot read or write it. Wilson is frequently taught in schools in a group setting, pull-out services or through private reading tutors who are Wilson certified.
In speech therapy, Wilson concepts can be useful to many of our students who have poor phonological awareness and have difficulty learning to read. Using a multi-sensory approach to learning gives our students more than one pathway to retain and learn the information as they may struggle with the auditory channel alone.