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)
Research has explored the connection between a child’s level of curiosity and their academic success. Researchers from University of Michigan’s Mott Children’s Hospital and the Center for Human Growth and Development found that kindergarteners who were described as curious demonstrated increased success in reading and math. This supports the need to encourage children to be curious about the world around them. There are many things you can do as a parent to cultivate curiosity in your child. The best place to start is to find something that is of interest to your child. Then, provide ways to explore and learn more about this topic. If your child shows an interest in building with blocks/Legos, you can find books that explain how buildings are constructed. You can also look for “blueprints” your child can follow to build a specific structure. While your child is engaged in these activities, you can highlight new vocabulary words, focus on following directions, have your child summarize what they learned, and work on problem solving skills. You will be promoting their curiosity and targeting speech and language skills all while engaging in an activity your child enjoys.
Curiosity Associated with Higher Academic Achievement, The ASHA Leader, July 2018, Vol. 23, 14. doi:10.1044/leader.RIB4.23072018.14. https://leader.pubs.asha.org/article.aspx?articleid=2687285
Ear infections are one of the most common illnesses in young children. Otitis media (OME) is the term for inflammation and fluid build-up within the middle ear. The accumulation of fluid causes the bones in the middle ear to not function properly and conduct sound effectively. Research indicates that OME poses disadvantages on hearing sensitivity and speech perception in children (Cai and McPherson, 2017). Speech sounds that are most affected by mild hearing loss are those high frequency sounds S, F, or SH. For more moderate hearing loss, a child may not be able to hear additional speech sounds or word-endings. It is important to identify and treat ear infections in young children to reduce these lapses in hearing sensitivity.
Your child may not be able to tell you his or her ear hurts, so it’s important to know the signs and symptoms (American Speech and Hearing Association):
- tugging or pulling at his or her ear
- fluid draining from his or her ear
- crying more than usual
- not responding to sounds
- trouble sleeping
If the cause of the ear infection is unknown, the doctor may decide to monitor the infection for 2-3 days to see if the fluid will drain on its own. Antibiotics can be prescribed for bacterial infections. For repeated ear infections or middle ear fluid that will not go away, it may be necessary for an ear, nose and throat doctor (ENT) to place a tube in the child’s eardrum that will allow for fluid drainage.
If your child’s hearing is compromised by an infection, it is important to facilitate communication by getting your child’s attention beforehand, speaking at eye level, reducing background noise (e.g., TV, music, talking) and using gestures and signs to enhance communication.
Technology is a part of our everyday lives. It is important to set boundaries and limits to children’s screen time so that their communication skills do not fall behind. In a poll of Speech Language Pathologists and Audiologist, the biggest concerns with children’s frequent screen time use include fewer opportunities for social interactions, delays in social development, delays in speech and/or language skills, and academic challenges. These concerns are present because children have fewer opportunities to hear language modeled by parents/peers and to practice their language, articulation, and social skills. The American Academy of Pediatrics (AAP) has established screen time guidelines to help parents balance technology and real-world experiences. They recommend no screen time (video chatting excluded) for the first 18 months, joint screen time of learning programs for children 18-24 months of age, 1 hour per day of learning program screen time for children 2-5 years of age, and to set up family guidelines for children 6 years and older that detail the amount and type of screen time allowed per day. In addition, the AAP recommends designating screen free zones and times. Here are a few screen-free activities to do with your child to encourage speech and language skills: go to the library and pick out books to read together, find a recipe your child can help you make, complete an art or science project together, or go to the park. By doing these types of screen-free activities, child will be learning and practicing important language and social skills.
As early as 2 and 3 years old, typically developing children begin producing narratives about what they see and do in their everyday life. As development continues, these narratives begin to include stories about the past, present, and future. Narrative language abilities are a foundational skill to higher level language such as analyzing, retelling, summarizing, and explaining written text. A deficit in narrative language production can affect a child’s academic performance and social skill abilities.
It is important that children utilize story grammar elements when developing narrative language skills, which act as a “cognitive map” to support the comprehension and production of narratives. Many kids who struggle to produce or comprehend narratives greatly benefit from visual supports (pictures, illustrations of a sequence of events) in order to teach story elements. Books, shared experiences, and videos can also be used to facilitate narrative language productions by emphasizing characters, setting, problem, solution, and other various story events. Many Speech-Language Pathologists use a variety of tools to supplement narrative development including topic boards, augmentative and alternative communication devices, sequencing pictures, and modeling.
Using picture sequences of a child performing a preferred activity is a great way to include sequential narratives into a daily routine. Once a child is accurately producing personal narratives, the focus can shift to summarizing and retelling stories from books.
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.
Research has shown that children given phonological awareness instruction in their first year of school have increased literacy skills. This was shown to be true for children with and without language disorders. After 10 weeks of phonological awareness instruction, these 5-year old children demonstrated greater gains in phonological awareness, reading, and spelling tasks compared to 5-year-olds that only received phonics-based literacy instruction. This study found that only 6% of the children who received phonological awareness instruction continued to demonstrate decoding difficulties. In contrast, 26% of the children who received phonics-based literacy instruction continued to have difficulty decoding following the 10 weeks of instruction. This research highlights the importance of understanding the sounds associated with letters and words for reading success.
Classroom Phonological Awareness Instruction Improved Literacy Outcomes. The ASHA Leader, August 2013, Vol. 18, 36. doi:10.1044/leader.RIB1.18082013.36.
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.
Now that the weather has warmed up, you and your children may be eager to get outside and enjoy what the city has to offer. During these outings, you can encourage carry-over of your child’s specific speech and language goals (e.g., expanding vocabulary, formulating sentences, describing interesting objects, retelling events, answering questions, practicing words with certain speech sounds) while having fun with the family!
- For an outing just beyond your front door, take a nature walk with your child and discuss what you see. Take notice of plants growing, bugs crawling, birds chirping, and animal tracks.
- It’s always fun and free to visit Lincoln Park Zoo. Go on Wednesdays and Fridays for free sing-alongs with Mr. Singer.
- Take advantage of free museum days for Illinois residents. Check out Sue the T. Rex at the Field Museum, the mirror maze at MSI or the underwater critters at Shedd for free!
- Visit Old Town School of Folk Music on Saturdays to take part in group singing and instrument-playing. You don’t need to be enrolled in a class to join the fun!
- Kids can learn about animals and pretend to be a variety of forest creatures at Animal Secrets at Kohl Children’s Museum.
These are just some of the ideas, compiled from https://www.mommynearest.com/edition/chicago/article/50-free-things-to-do-with-kids-in-chicago.
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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