Thursday, April 29, 2010

Week 15 When Sounds Come In

In the last post we chatted about how activating the muscles in our mouths help our child speak clearer and eat better :)

Today I am going to share a secret that families are not aware of. When we learn to speak, each sound comes in at different times. Just like we have to crawl before we walk, we learn sounds in a specific pattern too.

The earliest sounds that come in are p, b, m, n, w, h. They show up by the age of 3.

The next group of sounds are k, g, d. These sounds come in anywhere from 2 to 4 years of age.

Then there is t, ng sounds which come in from 2 to 6 years of age.

Next f and y (like in yellow) come in from 2 1/2 to 4 years of age.

Then r and l come in from 3 to 6 years of age.

Next s can come in from 3 until 8 years of age.

And sh and ch start at 3 1/2 to 7 years of age.

Then z comes in from 3 1/2 to 8 years of age.

And j (like in jam) is 4 to 7 years of age.

And v is 4 to 8 years of age.

And the th (thumb) is from 4 1/2 to 7 years of age.

And the th (this/that) is from 5 to 8 years of age.

And lastly the zh sound (measure) comes in from 6 to 8+ years of age.

This list is from the Journal of Speech and Hearing Disorders. It states that these the lower end is the customary age limit to start production and the higher end is an age level at which 90% of children are customarily producing the sound.

OK, now I want you to really think about this! We all know 2 and 3 year old children that talk just like an adult and can say their sounds clearly. And those are the kids that we always compare our children to and feel that our children are behind. But the reality is that sounds have a progression of when they come in.

And that is because it takes very specific skills for the mouth to be able to actually produce the sounds correctly. And if the mouth is not developmentally ready to produce those sounds, then it is basically impossible for the child to be successful. Let's think about the easy sounds, they are all sounds that you make with your lips and blowing air...that's it and that's why they are the easiest.

To do the k, g, d, t sounds you need to be able to move your tongue tip up behind your top teeth or be able to close off the back of your throat...much more complicated than just moving your lips and blowing air.

Try making different sounds yourself and really think about what your mouth, lips and tongue are doing to produce those sounds. Try the r's one of the hardest.

This information should be very reassuring to you. If you have a 2 year old that is talking but hard to understand, look at the sounds they are producing well. And if they are the easy sounds, relax, they are right where they are supposed to be.

Also, remember the hints I gave you last week with the oral motor stimulation? This is the key to helping sounds come in as clear as possible. So, if you have a 3 year old and you are noticing that the k, g, d, t, sounds aren't even close, you can increase the oral motor stimulation that you are doing with your child. More blowing activities, putting peanut butter behind their upper teeth and having them push it off with their tongues, straw drinking, and increasing intensity of flavor and textures. All these will help so much.

Some speech therapists do not focus on oral motor stimulation as a technique to improve sound productions especially as a child gets older and I think that this is unfortunate because working on the muscles first makes it so much easier in the end (and it's fun :) Also I have found that some speech therapists work on sounds with children before it is developmentally appropriate which can make therapy frustrating. My suggestion is to check the sounds that your child is saying and compare it to the list above and then relax. If you wait until the sound is supposed to be made then your child will be able to learn it much easier than if you are trying to push it before they are ready.

As always, feel free to ask me any questions or share any concerns. I hope that you all have a fantastic week!!

Thursday, April 22, 2010

Week 14 How Sensory Issues Affect Our Communication and Eating

First off, sorry I wasn't able to post last Thursday...I had the flu!!!!

So, last time I was sharing with you about sensory issues and some things to look for and think about.

Today we are going to chat about how sensory issues affect your child's communication skills and how well they eat.

How many of you have a child that is a picky eater, that's right, raise your hand!! I see so many hands out there. OK, I am going to pretend that we are sitting face to face right now and I'm going to ask you some questions about your child's eating habits.

So, how are mealtimes, do they go easily or are they hard? "Oh, they are hard, no one stays in their seats."

Does your child eat what is prepared or do you make a different meal for them? "Oh, sure they eat what we do if we eat mac and cheese or chicken nuggets."

Do you eat together or do you feed the kids first? It's easier to just feed the kids first and then my husband and I can relax later and make a meal that we like.

What are your child's favorite foods? "Chicken nuggets, french fries, pancakes".

Is there anything that your child will not eat? "Parent laughs....well, no veggies, pretty much no fruit, no chewy meat, and they don't like mushy food and nothing green."

As you can see, I would be investigating, looking for clues, as to how your child's mouth is working...yes, their mouth. And here is where it ties into the sensory system. Think of your favorite foods for a minute. Are you a salty, crunchy sort of person? So you like smooth, creamy food? Do you like chewy foods like bagels, or jerky? Remember that taste is one of our senses and it too can be impacted negatively.

Your child might have some low tone in his mouth, he often times has his mouth open and might drool more than others. These kids have trouble with chewy foods (like meats) or bland foods (like applesauce, yogurt, mashed potatoes.) It might be hard for them to learn to suck through a straw, blow bubbles, give a kiss with a pucker and they might look like picky eaters. These kids usually love spicy, intense flavored foods (think salsa and chips) crunchy foods that are easy to chew (think Cheetos). This is because they need that extra intensity to actually find that food in their mouths and make it pleasurable. So you might want to add cinnamon to their applesauce, salsa to their scrambled eggs and dip bland veggies and fruits into yummy dips like salad dressings, or sauces. Sucking on a lemon or pickle is very yummy to these children. You might also want to encourage drinking from straws and actually increasing the thickness of what they are drinking (think milkshakes, smoothies, and yes, applesauce can be pulled through a straw). You might want to change the intensity of the drinks they are V8 juice, or cranberry juice or strong lemonade. With these guys the more flavors (sweet, sour, salty) that you can use helps them eat better and more variety.

Now here is the secret to communication with these tricks. First off, food is always a huge language motivator for requesting, expanding vocabulary, taking turns, etc. But, the more your child is using all the muscles in their mouths, and their tongue is moving all over inside and outside their mouths, the better their sound productions will be as they add words and phrases!! This is so exciting. So in addition to improving your child's eating you are also helping them to speak clearer.

One more suggestion. Buy a cheap electric toothbrush that the head can come off of (so you can put it in the dishwasher.) At times during the day, let your child explore his mouth with the toothbrush and then put flavors on that brush :) Like pixie stick powder, salsa, pudding, dry lemonade powder, pickle creative. These are all fantastic tricks to help your child's mouth become more neutral.

When you are trying these new things, don't force your child. Make this fun. Try one taste, make it a family thing to do together. And with the toothbrush, ideally you want them to be biting on the sides, being able to tolerate it on the roof of their mouths and on their tongues also, but baby steps may be needed because if they have been protective of their oral area this could be very scary and invasive.

Let me know if you need more hints...these are really powerful suggestions.
Have a great week!

Saturday, April 10, 2010

OK, as you can see I had trouble with this post. I originally saved the beginning of the post to edit and publish later but could not figure out how to do after wasting too much time trying to figure it out I just continued in a new post and published both....unfortunately they read a bit backwards so the best is to read the April 8 post first and then the April 10th. Sorry :(

Week 13 continued...trouble getting this entire post published!!

By looking at how your answered these questions about your child you can get an idea of how their sensory system is working. If you are finding that your child is struggling on a daily basis with sensory issues the first step would be to talk to your pediatrician, share your concerns and ask for an evaluation by a pediatric occupational therapist that is trained in sensory integration disorder. Another resource that could be helpful are the books "The Out of Sync Child" and "The Out of Sync Child Has Fun". Don't be surprised if you find yourself or other loved ones in this book :)

I must warn you, if you go online and search sensory integrative disorder, autism will come up. The reason that sensory integrative disorder and autism are linked is that pretty much everyone on the autism spectrum has sensory issues but all people with sensory issues do not have autism! As I said before, everyone has sensory issues to some degree and it is not a bad thing. The important thing is to look at how much these issues are interfering with your daily life and your families life. If your days are filled with melt downs and it is hard for you to function, then please look into this more.

The trick to dealing with sensory concerns is to desensitize your child to the things that are bothering them. You might be instructed how to do a brushing program; you might discuss weighted vests and blankets; you might discuss a sensory diet; you might learn about "heavy work"; you might find out about therapeutic listening techniques. But be assured, there are many techniques to help your child through this time.

Please look into this more if what I am discussing sounds like your child because unfortunately if your child is dealing with sensory issues they are probably struggling throughout their day and others will quickly label them as "naughty" or "behavior" issues. I have found that once the child receives the help they need, their behavior improves and they are happier children. And you know what??? They also will talk better and quicker if their sensory needs are being's definitely a win win situation.

Feel free to contact me if you need more information or would like to ask a specific question. Next time I will focus on sensory issues and how they can affect eating and communication.

Have a great week.

Thursday, April 8, 2010

Week 13 Sensory Integration

Please take a minute to answer these questions:

1. Do you ever cut tags out of clothing because they are itchy and bother you?

2. Do you like to sleep with lots of blankets or do you prefer just a sheet?

3. Do you enjoy theme park rides?

4. Do you like parties that are full of people, loud and there is alot going on or do you prefer a smaller, quiet gathering?

5. How do you feel about small places, like elevators or very crowded rooms?

6. Do you love music played loudly, parades where the fire department blows their sirens?

7. Do you like restaurants that strong food smells when you walk in?

8. How do you do with the smell of changing a diaper. Are you OK or do you gag?

9. Do you like when people wear cologne or perfume?

I'm sure that you all remember our 5 senses: hearing, touch, taste, smell and sight?

Sensory integration is how our body (nervous system) processes the senses that we experience. So by asking you those nine questions you can determine what sensory input is pleasurable or tolerated by your system and which sensory input is upsetting or not pleasant.

We all have sensory integration issues. We all tolerate some things that enter our nervous system and we all do not tolerate things that come into our nervous system. I am a person that cuts tags out of my clothing and will not wear wool against my skin...both make me feel itchy. But in the end I can function very well on a daily basis. Sometimes our body is so busy reacting to our sensory sensations that it is difficult to function well on a daily basis and that is when it is important to know some tricks to decrease the intensity of those "icky" feelings.

How would this look like in your child? Let me ask you some more questions?

1. Does your child like to be swaddled?

2. Is it hard for your child to settle down and sleep at night?

3. Does your child have trouble when their routine is not followed?

4. Is it difficult for you child to transition from you activity to another?

5. Is your child so active that it is exhausting and it's difficult for your child to calm?

6. Is your baby "fussy"

7. Does your child hug kids so hard that they fall over?

8. Does your child get the "naughty" label from others for being too rough or too loud or too busy?

9. Is it difficult for you child to stay with an activity?

10. Is your child upset by the vacuum or hair dryer?

11. Does your child run away from you outside?

12. Is you child unsafe at the playground or outside?

13. Does your child bite alot?

14. Does your child startle to unexpected noises?

15. Does your child like to sleep in total darkness or with a night light?

Thursday, April 1, 2010

Week 12 Guilt, Anxiety, Stress

Just what you want to read about today, guilt, anxiety and stress :) The reason I want to chat a bit about this topic is because so many families with small children are worried about doing the "right" things for their children. There is so much pressure out there on parents and perhaps I can give you some thoughts to decrease that pressure.

As parents of children that are typically developing or of children that have some delay, you usually feel at least some guilt. You look at yourself and your spouse and try to figure out what you did that is causing your child to "be" the way they are right now. And so often you are sure that it is something that you are doing or not doing that has caused this situation or is "making" your child be the way they are. Looking backwards and pointing fingers will not help your child make progress and it certainly is not going to make you or anyone in your family feel better.

Let me have you look at it in another way. I am going to share a personal experience that happened with my family. One of my children was switching schools in the middle of 5th grade and was very nervous. This child had been told by their last teacher that they were dumb in math and my child believed that. So when the child met the new teacher the first thing that popped of their mouth was "I am dumb in math". This wonderful teacher and wise woman said to my child "you can't be dumb in math because where you are right now is right where you are supposed to be. My job is to help you learn the next step and the next step so that you can understand math." I will never forget that feeling of joy and respect that I had for that teacher...she understood my child and was going to get them to the next level, with respect and love. Your child is perfect and right where they are supposed to be too, at this point in time. Our job as their family and maybe a professional that is working with your family is to help get your child to the next developmental step. And to do this with love, respect, encouragement and a bit of fun makes life a bit more joyful.

You can drive yourself nuts questioning yourself and your child. Why aren't they talking? What did we do wrong? When are they going to talk? What if they never learn to talk? Why do they hit? Why won't they eat? Why are they so clumsy? etc. etc.

A better way to approach this is to accept your child for who they are, 100%. You love this little person so dearly and instead of comparing them to all the other children their age that are doing things better or faster, just stop and look at this precious child you have that warms your heart and makes you laugh. Meet them where they are functioning now and look for a possible baby step that you can focus on that will help them get to the next level. You are not going to force them or make them reach that next step, but you are going to set up opportunities for your child to learn and grow and try and suddenly, poof, they have made that baby step!!! Woo Hoo!!!

Children can read us very, very well. And they will pick up on the cues you are giving them if you are frustrated or guilty or angry or stressed. And our ultimate goal is to have your child become a confident we don't want them to feel bad about how they are communicating right now. We want them to feel inspired and clever and smart with every sound or sign or grunt or point they make....they are letting us know what they want or what they are thinking and we can act upon that.

Try to block out the media and sometimes even the loving family members that all have tricks and stories about how to "fix" your child. Your child is not broken, they are perfect just as they are. You know what is best for your child. When you are reading and researching and dealing with professionals, always make choices for your child that are based on what feels right to you and that are right for your family. They don't have to be the popular choices or the ones that you are being told to do if they just don't feel right. You will be able to make the best decision for your child if you listen to your gut and look at your family unit and then decide what makes sense.

I hope that this entry might lighten your load a bit. Parenting IS the hardest job out there and I have never met a parent that is not trying the best they can to do the right thing for their child. Feel confident in your choices and try to filter out the noise of all the "you should's" or "you shouldn't"opinions that you will hear. I know that you will do the right thing.

Have a wonderful week. Happy Easter :)