Speech Therapy Archives | Page 2 of 3

Gestalt Language Processing

Educational, General, Speech Therapy, Therapy | May 01, 2023 3 min read

Let’s unpack some buzz words that you may have been hearing lately:

“Echolalia” is the repetition of language spoken by others. It can be repeated either immediately or after some delay. With echolalia, language is stored as a “chunk”, or a whole unit.

“Scripting” is another term that refers to echolalia. “To infinity…and beyond!” is an example of a script from media. “See you later alligator” is an example of a script that may be heard in conversation. When children are “scripting”, they may be observed reciting dialogue from a TV show, singing lyrics from a YouTube song, or copying phrases they’ve heard other people use. The message is often identical to the source where they heard it, and has the same melody.

“GLP” stands for Gestalt Language Processing. This is a form of language development where children learn the meaning of language in chunks first, then over time learn to break the chunks down and formulate their own original language.

Let’s bust some myths:

Are most autistic children GLPs? YES!

Does being a GLP automatically mean a child is on the Autism Spectrum? NO! Some neurotypical children learn language via chunks as well.

Unsure if your child may be a “GLP”? Here are some common signs:

1. They echo back what you say or the last part of phrases you say, without appearing to process the language.

2. They have difficulty answering questions in conversation.

3. They like to hum or sing songs rhythmically.

4. They have a preference for intonation-rich sound input, such as music or videos.

5. They replay certain portions of video clips over and over.

6. They like to repeat play scenes in the same way over and over.

7. They like to play with the WHOLE set – if a figurine is missing, they are not pleased. They are seeing the world in a “gestalt” way.

8. They like to label objects they see around them and can recite their ABCs or count 1-2-3, though have trouble using their language to ask for help or communicate other important functions.

I think my child is a GLP… Now what?

1. Find a Speech-Language Pathologist near you that has been trained in Gestalt Language Processing. They can help determine which stage of the Natural Language Acquisition framework your child is in and give tailored advice on how to support your child’s language development at home.

2. Follow social media accounts such as @meaningfulspeech and @bohospeechie, which provide brief, useful posts related to GLP.

3. Take a look at free resources on the website www.meaningfulspeech.com. If you have extra time, consider taking Meaningful Speech’s parent friendly course.

4. Check out Marge Blanc’s book, “Natural Language Acquisition on the Autism Spectrum. The Journey from Echolalia to Self-Generated Language.”

Things to Keep in Mind:

Echolalia is not just a “stimming behavior” that should be ignored, decreased or extinguished… Echolalia communicates.
We should acknowledge children’s scripts by nodding our heads or repeating back what they say, even if we are unsure what they mean.
Speech therapists are here to help!

By Julia Navarra MA CCC-SLP

Comparing/contrasting occupational therapy school vs. clinic based services

Educational, Speech Therapy, Therapy | Aug 08, 2022 2 min read

Happy August! I hope that our families are currently enjoying this home stretch of summer, perhaps taking in a few more beach days or afternoons at the park, going on fun trips out of town, having play dates with friends, and simply indulging in this time before our thoughts turn to autumn. No doubt, many of us are already planning for returning to the “school routine” of classes, schedules, and services, including keeping up therapies in school and in-clinic. It can be a lot to juggle!

In case you are wondering what the similarities and differences are (or would be) between your child’s occupational therapy (OT) services at school vs. in the clinic, here is a basic principle: outpatient OT can address any deficit area within our scope of practice, as long as funding sources allow, and school-based OT addresses deficit areas that directly impact the student’s access to their education. In the latter case, the student must have an IEP (Individualized Education Program).

In our outpatient clinic setting, we may directly address areas of need such as:

Fine motor / visual-motor skills
Gross motor skills
Overall coordination, core strength, balance
Sensory processing
Self-regulation / emotional regulation
Activities of Daily Living (ADLs): dressing, hygiene, grooming, etc.
Feeding and oral-motor skills
Executive functioning
… plus others!

School-based OT services also address the above areas, however, the goals must be related to deficits seen within the student’s educational setting. For example:

Fine motor and visual-motor skills related to writing, typing, completing assignments and homework
ADLs within the school day: changing into gym clothes, independence at lunch time, etc.
Executive functioning skills for organization, attention, planning, time management, getting through a routine schedule
Sensory processing challenges that affects the student’s ability to participate in their school day
Core strength, affecting the student’s ability to maintain appropriate posture for attending to and completing school tasks

Of course there are many more differences between these two OT settings, and the best advice is to consult with your child’s physician, clinic Occupational therapist, and/or educational team to determine which kind of services are appropriate and necessary.

Lastly, if your child already receives both clinic and school-based OT, we’ve found that it’s often beneficial for both therapists to sometimes consult and be aware of what the other is working on, for an even more harmonious OT experience for your child!

Written by: Pam Verde, MOT, OTR/L

Incorporating basic concepts into america’s holidays

Activities, Educational, Speech Therapy, Therapy | Jul 01, 2022 4 min read

Happy Birthday month to our beautiful country, America! To many families, Fourth of July means fireworks, family reunions, concerts, barbecues, picnics, parades, and baseball games. For our speech therapists, holidays are a great opportunity to target several different language goals such as temporal, spatial, and quantitative concepts. It is important to remember that before a child can use the concept in their speech (expressive language), we must first be sure they have a full understanding (receptive language).

Temporal concepts

Temporal concepts (before, after, during, first, next, last) are words that are used to describe time. Celebrating special days that occur at the same time every year help provide children with a sense of time that passes in the duration of a year. We can converse with our kids about the upcoming holiday and model using temporal concepts. We may also show them a calendar and allow them to flip through and visualize the temporal order.

Verbal model examples: “Before the Fourth of July, we celebrate Valentine’s Day. After the Fourth of July, we celebrate Christmas. First is Valentine’s Day, next is Fourth of July, and last is Christmas. During the Fourth of July, we will have a cookout and watch fireworks.”

Visual examples: Try showing your child a calendar with pictures on each holiday. Allow them to flip through and visualize the temporal order. Start with two holidays and discuss before and after. You can also try three holidays using first, next, and last. For the children that are new to learning the concept, see if they can use their receptive language and flip to the first holiday! To target expressive language, ask your child a question such as “Which holiday comes first?”

Spatial concepts

Spatial concepts (in/out, up/down, on/off, over/under, behind/in front, next to/in between) or prepositions describe an object’s location in relation to another object. Understanding spatial concepts is critical for following directions and describing objects. Just like temporal concepts, we can use spatial concepts in conversation with our children as well as incorporating visuals to aid in understanding.

Verbal model examples: “Let’s shoot the fireworks up in the sky”, “Should we put the flag on the pole?”, “The float is in front of the dancers!”

Visual examples: Grab a cup and any mini object at home. First, see if your child can follow simple directions such as, “Put the eraser under the cup”. Once your child has mastered this, now you can move the object and ask the child “Where is the eraser?”. If you notice that the open task becomes too difficult, you can also provide your child with two options such as “Is it on top or under?”, changing it to a closed question that will be easier to answer while still prompting the child to use expressive language.

Quantitative concepts

Quantitative concepts (a little/a lot, all/none, more/less, most/least) can describe the size and amount of an object. Similar to spatial concepts, understanding quantitative concepts is important for following directions and describing objects.

Verbal model examples: “I hope we receive a lot of candy at the parade!”, “Do you think this is more candy than last year?”, “I wonder who found the most candy”.

Visual examples: Beginning with receptive language, pull out a large quantity of something such as legos, blocks, or marbles. Ask your child to give you all of the blocks, a little bit of legos, and a lot of marbles. You can also try this while cooking with your child; asking for more chocolate chips, a little bit of sugar, and less flour.

Holidays are a great way to organize our year with temporal concepts and use themes to make language concepts more fun for everyone!

Written by: Alexa Murman, MS CCC-SLP

Let’s play outside!

Activities, Educational, Speech Therapy, Therapy | Jun 02, 2022 4 min read

Summer is here and what better way to spend it than playing outside! Studies have shown that being outdoors promotes mental wellness; therefore, not only will your child benefit from being outdoors, but so can the whole family. Outdoor play can be anywhere from the backyard, your neighborhood park, the beach or a hiking trail. Summer also means school is out and your child might have some extra energy to burn. This is the perfect time to plan an activity incorporating all of the eight senses that your child may be working on during their occupational therapy sessions.

Eight senses:

Auditory: how we process sounds
Gustatory: how we process taste
Interoception: how we process what we feel within our body (hunger, toileting, stomach ache)
Olfactory: how we process smell
Proprioception: how we process where our body is in space
Tactile: how we process touch
Vestibular: how we process movement and balance
Visual: how we process what we see

Let’s go to the beach:

Tactile play/fine motor skills – Building a sand castle
Hand strength/grading of force – carrying a bucket of water, digging a hole in the sand
Visual scanning – Looking for seashells or rocks
Proprioceptive Input – Getting buried in the sand or running with the waves
Body/Safety awareness – Being aware of their surroundings and not wandering too far
Auditory – listening to the sounds of the waves

Let’s go on a nature walk:

Proprioceptive/vestibular input – walking up a hill or steep incline, safely balancing on a tree stump
Visual scanning – I spy a/some….
Tactile play – picking up different leaves and flowers
Auditory – listening to the sound of birds
Olfactory – smelling flowers

Let’s go to the park:

Vestibular input – Going down the slide and swinging
Proprioceptive input/motor planning – climbing up the play structure
Visual scanning – I spy a/some…
Tactile: playing in the sand box

Let’s play in the backyard:

Tactile/fine motor skills – water play: filling up containers to pour and scoop water
Vestibular input – Setting up a little obstacle course to climb, crawl, and jump to get from one end to another
Proprioceptive input/motor planning: animal walks around the backyard
Visual motor skills – drawing on the sidewalk with chalk

All of these examples will not only target the eight senses but it can also work on core and upper body strengthening, motor coordination, sequencing, endurance, self-regulation, social skills and building your child’s confidence to navigate their natural environment. Children learn more about themselves via play and can become more aware of their surroundings when playing outside. Studies have shown that there has been a decrease in outside play due to screen time and busy school schedules with extracurricular activities. Being around green plants and play yards reduce children’s stress levels; the natural space and surroundings can stimulate a child’s imagination and creativity. While playing outside, children can also benefit from natural sunlight, fresh and natural elements that contribute to bone development, a stronger immune system and physical activity. Green outdoor environments also promote improved attention and mental well-being.

June is safety awareness month and with outdoor play, it is important that your child also learns to be aware of their surroundings and their peers. You can practice having your child safely navigate their environment and provide verbal cues to stay within safe boundaries. You can initiate outdoor play in a smaller space before moving into a large space to practice safety. Although you want your child to engage in free play outside, it is important to create rules, safe zones and buddy systems. Remember to explore, have fun, let your child get dirty and enjoy the outdoors!

Monica Kem, M.S. OTR/L, SWC

What is a tongue-tie and how can it impact my child’s speech?

Educational, Speech Therapy, Therapy | May 23, 2022 4 min read

Tongue-tie (medically known as ankyloglossia) occurs when the lingual frenulum – the membrane beneath the tongue which attaches the tongue to the mouth base – is too large and restricts tongue movement. This anatomical change restricts the tongue from reaching certain points in the mouth, often necessary for producing certain speech sounds. A tongue that lacks a full range of motion may fall short of the target placement required to make certain speech sounds, causing an articulation disorder. Tongue-tie may also impact feeding and oral hygiene.

Doctors typically recommend Lingual frenectomies when infants exhibit difficulty latching or suckling during nursing. In older children, their tongue may protrude out when drinking from a cup or eating from a utensil, increasing the chance of choking and resulting in messy eating.

Visually, the tongue may appear fattened due to the inability to completely extend to its full length without great effort. In more severe cases, it may appear heart-shaped with a cleft in the center from being pulled back.

How does a tongue-tie impact speech?

Because many speech sounds require the lifting or retraction of the tongue to produce, there is evidence that in many cases, a tongue-tie may contribute to speech sound errors. Sometimes, sounds impacted are “l” and “r .” In other instances, tongue-tie may contribute to a lisp. For example, since the production of “s” and “z” requires the tongue tip to lift up to the alveolar ridge, they may not be able to be produced if the tongue is anchored down.

To compensate for this inability, the jaw and tongue body is often thrust forward, causing the tongue tip to emerge between the teeth in a lisp. As a result, single words, phrases, or short sentences may be produced without errors. Still, the demands made on the tongue during conversation (i.e., fast rate and a variety of surrounding speech sounds requiring complex movements) become too great for the anchored tongue, resulting in disordered speech.

Why should my child get a frenectomy?

Scheduling a lingual frenectomy to correct tongue-tie is recommended for those with resulting speech and feeding issues as these issues will likely persist without treatment. While children with untreated tongue-tie can improve their speech through skilled therapy, progress may be slow or limited by the anatomical restriction. While many parents are concerned about their child’s short-term discomfort, surgery is fast – often performed with a laser by a pediatric dentist – and the incision heals quickly.

After a lingual frenectomy has been completed, the tongue is typically still weak from being anchored down, so skilled speech therapy is still needed in most cases. The degree of success in speech outcomes following a frenectomy will also be affected by individual factors such as the size of the oral cavity and the tongue’s posture. The child’s age also plays a significant role; Children typically undergo frenectomies before the age of 3. Speech outcomes are best when frenectomies occur at this young age because children over the age of 3 have passed the age of orofacial development. As a result, more skilled therapy will still be necessary to instruct jaw and tongue positioning after age 3.

Research has long shown a correlation between tongue-tie and articulation disorders. Increasing the tongue’s range of motion allows for less effortful lingual placement during speech. In light of this science, the long-term benefits of a lingual frenectomy on articulation far outweigh short-term discomfort.

If your child is experiencing speech sound distortions and has a tongue-tie, to maximize speech therapy outcomes, talk with your ENT or pediatric dentist about scheduling a lingual frenectomy as soon as possible. It may be critical for your child’s success in speech.

Kat Winger, M.S. CCC-SLP

Can speech therapy correct a lisp?

Educational, Speech Therapy, Therapy | May 04, 2022 3 min read

What is a lisp?

Lisping is one of the most common and most well-known articulation disorders resulting from abnormal tongue positioning, which causes a perceived sound distortion. It is estimated that 90% of speakers who have some kind of articulation difficulty exhibit some degree of lisping behavior¹. While lisping most frequently impacts “s” and “z,” it can affect other sounds as well, such as “th” and “sh.”

Lisping is considered a mechanical issue that may be either structural, from an overbite or underbite, or behavioral, from a tongue thrust. Factors that impact it includes tongue weakness or jaw instability, as a lowered jaw impacts the ability of the tongue to lift. Typically, jaw instability and tongue weakness coexist when a lisp is present. However, causes are nearly always behavioral and can be treated with skilled therapy.

What are some common types of lisps?

The most common and well-known variety is a “frontal lisp” or “interdental lisp.” Most people think of a frontal lisp as a “th” substitution, as in the production of “thun” for “sun .” However, this is not the case. The tongue does not protrude as far out as during a “th” production. Instead, it may not even protrude, positioned on or between the teeth, and is frequently visible during “s” production. Frontal lisps are nearly always behavioral in nature, not often resulting from structural issues. As a result, they are not a concern for children below 5. Following age 5, it is considered disordered and requires skilled therapy to treat.

Another common type of lisp is known as a “lateral lisp.” This is never developmentally appropriate, meaning that it is disordered in a child of any age and must always be treated with skilled therapy. It results from a flattened tongue so that airflow, rather than moving in a forward trajectory, emits out the sides of the mouth, causing a “slushy” sound. Treatment of lateral lisps involves an emphasis on lifting the tongue to streamline airflow. Ensuring the child’s self-awareness and ability to monitor their speech is also essential during treatment.

Why should a lisp be treated in speech therapy?

While overall intelligibility is not as significantly impacted as with other articulation disorders, the effects of a lisp often have social-emotional ramifications. One study by Ellen-Marie Silverman indicated that lisps draw negative attention and impact perceptions relating to intelligence, personality, and likability.² The phenomenon of lisping impacts the perceptions of others and the self. In a study by Veríssimo et al., participants who presented with lisps felt insecure and that their speech disorder negatively impacted their social life or work.³

Many parents first seek out speech therapy in elementary school when their child begins to feel shame or experiences bullying related to their speech. Then, the child, parent, and speech therapist can work together to resolve the issue. Following articulation therapy, children are proud of their speech and confident in their ability to communicate with their peers.

References

Fairbanks, G. (1940) Voice and Articulation Drillbookt. New York: Harper and Row.
Silverman, E. (1976). Listeners’ impressions of speakers with lateral lisps. Journal of Speech and Hearing Disorders, 41(4), 547-552. doi: 10.1044/jshd.4104.547
Veríssimo, A., Van Borsel, J., & de Britto Pereira, M. (2012). Residual /s/ and /r/ distortions: The perspective of the speaker. International Journal of Speech-Language Pathology, 14(2), 183–186.

Kat Winger, M.S. CCC-SLP

What is Pediatric Occupational Therapy and how would I know if my child would benefit?

Educational, Featured, Psychology, Speech Therapy, Therapy | Apr 04, 2022 6 min read

Occupation refers to functional tasks or activities that bring meaning to your life. And our children’s main activity is PLAY. Did you know that kids play to learn and that play requires motor, sensory processing, cognitive, and social skills? All these skills work together for learning. However, when the necessary skills for play are observably difficult, it can make grasping new competencies challenging for kids.

Occupational therapy addresses all the skills needed for play. It works on strength, coordination, and control to support their movement. OT also helps with sensory processing difficulties by identifying the way your toddler receives or responds to sensory input and teaching fun ways for you to support your child. And finally, Occupational Therapy promotes executive function skills building on motor, attention, and regulation foundations for learning.

Though play can look different and vary from child to child, there are general toddler development skill ranges necessary for learning to happen. When these are not progressing or missing, they can inhibit engaging in and learning through play.

The development of sensory processing and motor skills begins immediately at birth. The brain is where all the magic happens. Newborns take in sensations, but their body is unable to organize them—their reflexes are neurological responses to stimulation, including the senses of light, sound, touch, or pressure input such as stroking and vestibular sensory input with sudden movement.

The sensory processing and motor skill development looks random and clumsy at first with the baby’s initial kicking of their legs or trying to find their mouth with their hand. As they continue to be exposed to the sensation and repeat the movement, it becomes more purposeful.

Babies are holding, pulling, pushing, and dropping toys as they learn about cause and effect. More and more skills work together to explore and learn through play.

For your toddler, the years from 1 to 3 are very busy. They are essential years of curiosity, trial and error, and learning about what they can do. At age one, toddlers are very active. Give them a container, and everything comes out; maybe a few things go back inside. Set something on the table, and they pull up to see if they can get it. They make sounds and babble and may tug on your heart with Ma Ma or Da Da words!

Toddlers are in a transition of building more independence. During the terrible twos, a stage that everyone stresses about, they continue to learn about their environment, manipulate things, and communicate their experiences. Their development takes all the work that the baby’s brain and body did and uses it in play to build confidence, control movement, and explore new sensations. Toddlers experience big emotions. They must learn about these feelings and how their body responds to them. How we react and support them is important.

They also learn to transition from one activity to another, even when they don’t want to.
For example, two-year-olds usually can stack a few blocks, string a few large beads on a shoelace, feed themselves with a spoon, drink from an open cup or a straw, remove/pull on clothing, brush teeth, help wash their body at bath time, jump, run, and walk up and down a few steps. They can also throw a small ball toward a target, help clean up, and put toys away. Though the terrible twos try on parents and toddlers, they don’t last long. And both parents and kids learn a great deal!

As we strive to develop more patience during these times, our toddlers are growing far more in their quest for independence. Two-year-olds should be able to attend and learn a new play activity for 4-6 minutes. Some research even suggests that this age group should be able to focus on a task for 10 minutes.

Though many toddlers can sit and play for extended periods of time with preferred toys or activities they have initiated themselves, a better learning opportunity is to give them a new task to work on to develop manipulation skills like using a tool to scoop, fill a container, feed themselves with a spoon or fork, stack or build with blocks, lace beads on a string, or roll a ball back and forth.

Notice how your child works through activities. When development is not smooth, there will be clues in how your child moves, plays, speaks, or acts. See if you observe any of these challenges:

unable to manipulate toys in play, they continue to dump, empty containers, or throw them around the room
difficulty using tools to scoop, squeeze, hammer, draw
unable to demonstrate repetitive play activities. May run around, only roll the car back and forth
moves between many play activities quickly, not engaging in any of them
requiring or demanding your attention and unable to initiate or engage in play by themselves for short periods
difficulty imitating actions in movement, imitating mouth or tongue movements, silly faces, or being unable to throw a ball at a target. Difficulty moving from sitting to moving under structures, crawling through a tunnel
unable or very clumsy with jumping, climbing, moving between different level surfaces, climbing ladder to slide
unable to take turns in play activities such as rolling ball back to you, stacking blocks
seems fixated on the television, tablet, or phone and unable to engage with other toys in play
difficulty putting things together such as connecting blocks, lacing, and beads
unable to tolerate play on a swing, on a slide
unable to play near or with other children
unable to tolerate tactile messy play or engagement with media like play-doh, finger paint, or shaving cream
difficulty removing pull on clothing from dress-up activities

Play is one of the most significant areas that can provide clues about your toddler’s development. As we’ve outlined, there is so much growth happening during this time. If you see your child struggling in any of the areas we mentioned, occupational therapy can help develop and strengthen the skills needed for learning.

Occupational therapists are experienced experts and can help identify the areas inhibiting your child’s primary occupation and introduce fun activities for successful skill development.

Children are tiny individual humans with varied interests and gifts. We embrace and work together with parents to help children reach their greatest potential.

Come in and check us out in April for Occupational Therapy month!

Author: Pamela Vasiloff, OT

How to help children on the spectrum develop friendships

Clinic, Educational, Speech Therapy, Stories | Mar 07, 2022 5 min read

In my high school, a peer known for his social awkwardness greeted me in a monotone voice, “Pratt, do you have anything to say to me?” I replied, “Yes, good morning. How are you doing today?” Satisfied with the exchange, he nodded and walked to class. He did not return the greeting, nor did I expect him to. He also never asked me how I was doing.

There is an expression that “the only way to have a friend is to be one.” But what if you struggle to read facial expressions, body language, and tone of voice? For children on the autism spectrum, making friends can be challenging. From the young child who sits alone on the playground to the high schooler who chooses to stay in the computer lab rather than interacting with their classmates at lunch, it may appear that these children have no interest in pursuing friendships. Unfortunately, this is a common misconception held by neurotypical people (not on the autism spectrum).

The child on the playground and the teenager in the computer lab may be overwhelmed by the noise and chaos of the children around them or the location where social interaction occurs. Other behaviors of children on the spectrum include lack of eye contact, fidgeting, and repetitive movements (arms flapping, rocking, etc.). Many of these actions help limit overstimulation, manage anxiety or help with focus, but they can be perceived as a lack of interest by their neurotypical peers. Neurotypical children may conclude that their counterparts with autism are disinterested. But appearances can be misleading.

Children on the spectrum often long for friendships but do not know how to develop them. The importance of peer relationships is well understood. Friendships can provide opportunities to learn important social and emotional skills, including empathy, cooperation, problem-solving, and similar prosocial skills. Unfortunately, the opposite is also true; negative peer relationships involving bullying, rejection, and manipulation result in feelings of isolation, anxiety, depression, and confusion about relating to others.

Luckily, there are many ways to support children on the spectrum. Here are some steps you can take to support your child in making a new friend:

1. Explain what a friend is:

For young children, keep things simple. For example, explain to them that “a friend is someone who is nice to you and likes to spend time with you.” Understanding abstract concepts can be difficult for young kids on the spectrum. It helps to discuss characters in a movie or tv show that the child enjoys. Ask questions such as, “Is Character X being nice to Character Y? Do they like playing together?”

2. Social Stories

Children with autism often learn better when they are provided with visual support. Social stories lead a child through specific situations using pictures and words. Each story can be tailored to the child. For example, writing a script or drawing out the course of a conversation can help children understand the basics of how to talk to a friend. ***Carol Gray is a good resource.

3. Practice is Key

The best way to try something new is to explore it first in a safe and familiar environment. Have your child practice social skills (greeting others, asking and answering questions, self-advocating, suggesting ideas for play) among people the child already knows and is comfortable with (siblings, cousins, neighbors, and other adults). Through practice and repetition, you and your child can problem solve challenges he might have before encountering them at school or on the playground.

4. Finding Your Tribe

To build friendships, children must first share common interests. Find what your child is good at or enjoys, and then find a community based on that interest. For example, if your child loves board games, find a gaming group. If your child plays an instrument, get them into the band at school. Finding a shared activity is key, and it provides the groundwork for children to further grow friendships by sharing their feelings or by sharing a positive emotional experience.

Sometimes, however, it’s not about what groups children with autism join; it’s about getting other children to join them. Some schools implement a playground ambassadorship program, where neurotypical students are tasked with engaging students who tend to remain on the periphery of the playground. These children look for peers who are not engaged and reach out to them/ask them to play. Parents may want to ask their schools if this program is already in place or can be implemented. You are your child’s best advocate.

SmallTalk wants your children to “find their tribe” and make long-lasting connections with peers. Therefore, SmallTalk offers small social skills group sessions at each clinic location to help teach your children the foundations of social skills and offer guided practice of engaging in different social scenarios with peers. If you are interested, please call us at (619) 647-6157 to schedule an appointment.

Feeling the LOVE

Activities, Educational, Speech Therapy, Stories | Feb 03, 2022 3 min read

February is here! And so are our themed therapy activities. We love thematic learning – it is relatable and helps kids make meaningful connections within their everyday lives.
Here are some of our favorite ideas to try incorporating at home:

Books about Feelings and Love

Themed books are a great way to teach vocabulary, encourage early literacy, and promote positive relationships and acceptance. When reading books with your child, we recommend using the “PEER” approach.

P: Prompt your child with a question about the story. Prompting your child focuses attention, engages the child in the story, and helps the child understand the book.
Point to something in the picture, for example, a balloon. “What is that?”

E: Evaluate your child’s response.

“That’s right! That’s a balloon.”

E: Expand on what your child said.

“That’s a big, red balloon! We saw one of those in the grocery store yesterday.”

R: Repeat or revisit the prompt you started with, encouraging your child to use the new information you’ve provided.

“Can you say big, red balloon?” Each time the book is reread, the expanded vocabulary words are verbalized again.

Here are some books worth checking out:

Froggy’s First Kiss, by Jonathan London
The Day it Rained Hearts, by Felicia Bond
Guess How Much I Love you, by Sam McBratney
Love Splat, by Rob Scotton
Love Monster, by Rachel Bright
Love You Forever, by Robert Munsch
The Giving Tree, by Shel Silverstein
Llama Llama I Love You, by Anna Dewden
No Matter What, by Debi Gliori

Making Valentines

Arts and crafts activities are a great way to work on making choices, requesting and describing during play. Here are some useful strategies to incorporate during the craft at home:

Provide two choices during card-making: “Do you want the heart or the lip sticker?” or “Do you want the purple or red crayon?”
Model the use of adjectives: “Ooo, I pick the sparkly, red and white heart!” or “I’m going to draw a big chocolate candy.”
Teach location concepts: “Do you want to put the sticker in the middle or on the side?” or “Let’s write your name on the front.”
Practice “who” questions by asking who your child wants to make the card for.
Sabotage. Give your child an unsharpened pencil or a glue stick with the lid still on it so that they need to ask you for help.

Trip to the Post Office

Once your Valentines are complete, we recommend taking your kids on a trip to your local post office. Here are some ideas on how you can incorporate speech and language skills into the outing:

Teach related vocabulary: stamps, envelope, delivery, etc.,
Model comments: “I see a mail truck!” or “Wow, look at all of those mailboxes!”
Verbally sequence the steps to mailing a package: “First you fill the box, then you tape the outside, next you write the label…”
Take turns dropping mail into the mailbox and discussing who the mail is for.
Practice ordering stamps at the counter.
Bonus: Let your therapist know if you went on the outing, that way it can be a topic of conversation in their speech session. :)

We wish you a Happy Valentine’s Day and look forward to hearing how your activities go! We LOVE meaningful activities, making connections, and all of our wonderful families at SmallTalk.

Author: Julia Navarra, M.A., CCC-SLP, Speech-Language Pathologist

Does my child need Occupational Therapy?

Clinic, Educational, Speech Therapy, Therapy | Jan 03, 2022 3 min read

What is Occupational Therapy? Does that help my child get a job? No! “Occupations” are daily activities, so that means playing and learning for your child. Children develop daily living and self-care skills through actively exploring their environments and playing with others. Occupational therapy addresses sensory processing, motor delays, and social-emotional components that may be impacting your child’s ability to develop independence at home and school. If any of the following characteristics resonate with you, your child may benefit from occupational therapy!

Sensory Processing

Overly sensitive or heightened reactivity to sound, touch, or movement
Under-responsive to certain sensations (e.g., high pain tolerance, doesn’t notice cuts/bruises)
Constantly moving, jumping, crashing, bumping
Easily distracted by visual or auditory stimuli
Emotionally reactive
Difficulty coping with change
Inability to calm self when upset

Social Interaction Skills

Difficulty interacting socially and engaging with family and peers
Difficulty adapting to new environments
Delayed language skills
Overly focused on one subject (e.g., space, universe, dinosaurs, trains)
Can’t cope in the school environment

Play Skills

Needs adult guidance to initiate play
Difficulty with imitative play
Wanders aimlessly without purposeful play
Moves quickly from one activity to the next
Does not explore toys appropriately
Participates in repetitive play for hours (e.g., lining up toys)
Does not join in with peers/siblings when playing
Does not understand concepts of sharing and turn taking

Oral Motor/Oral Sensory

Excessive drool
Chews food in the front of the mouth, rather than on the molars
Difficulty using a cup at an age-appropriate time
Difficulty with drinking from a straw at an age-appropriate time
Lengthy bottle or breast feedings
Tiredness after eating
Baby loses excessive liquid from their lips when bottle or breastfeeding
A child loses excessive liquid or food from his or her mouth when drinking or chewing
A child appears to be excessively picky when eating, only eating certain types or textures of food
A child excessively mouths toys or objects beyond an age-appropriate time

Fine Motor Skills

Manipulating toys and puzzles
Holding a pencil
Using silverware or straws at an age-appropriate time
Using scissors
Using zippers, buttons, shoelaces
Coloring, drawing, tracing, prewriting shapes
Poor handwriting, letter/number formation
Not developing a hand dominance at an age-appropriate time
Avoiding tasks and games that require fine motor skills

Gross Motor Skills

Going up and down stairs at an age appropriate time
Coordinating both sides of the body
Understanding the concept of right and left
Poor ball skills
Poor balance
Fear of feet leaving the ground
Not crossing the midline of their body during play and school tasks
Avoiding tasks and games that require gross motor skills

Visual Processing

Difficulty with the spacing and sizes of letters
Difficulty with recognizing letters
Difficulty with copying shapes or letters
Difficulty with visual tracking and crossing midline
Difficulty finding objects among other objects
Difficulty with copying from the board or another paper
Difficulty with the concept of right and left

Learning Challenges

Unable to concentrate and focus at school
Easily distracted
Difficulty following instructions and completing work
Tires easily with school work
Poor impulse control
Hyperactivity or low energy
Not keeping up with workload at school
Difficulty learning new material
Makes letter or number reversals after age seven

Do you feel like your child has difficulty in any of the areas as mentioned above? Are you questioning whether an Occupational Therapist should see your child? If so, our SmallTalk therapists are here to help strengthen these skills and answer any questions through structured and unstructured table and gym activities with weekly/bi-weekly therapy sessions. Please call to schedule an evaluation today!

Authors: SmallTalk Occupational Therapists