Rehabilitation Specialists, Inc.

Dysphagia. Seems like a funny word when you don’t know the definition of it. A person might not even come across this word unless their mother or father get diagnosed with dementia or Parkinson’s or if a loved one has a stroke or the SLP dreaded, aspiration pneumonia. Even a bad enough UTI can cause someone to have the symptoms of dysphagia! Dysphagia is, according to ASHA, defined as problems involving the oral cavity, pharynx, esophagus, or gastroesophageal junction. That’s just a lot of words to tell you it means “difficulty swallowing”. It can be the scariest part of an SLP’s job, but in my opinion, it can be one of the most interesting. An SLP can work with patients with dysphagia in a variety of settings. Either in a skilled nursing facility, hospital, long term care, and yes, even in schools. Prevalence of dysphagia is difficult to assess as it can be seen over many different diagnoses and diseases, but approximately 1 in 25 adults will experience a swallowing problem in the Un...

I feel like people say, "Did you know that the brain isn't fully formed until 25!?" often as a "shocker-did-you-know" fact. Yes, in fact, newest studies are showing that the pre-frontal cortex may not even be fully formed until our 30s. So, what gives? Aren't we fully functioning adults at the age of 18? While we are responsible for our own decisions legally at the age of 18, the frontal lobe of our brain, or the portion right behind our foreheads, takes significantly longer to fully develop. This part of our brain is responsible for executive functions . Executive functions are the tasks of anticipation, inferencing, planning, selecting goals, self-monitoring, taking and using feedback, and completing purposeful activities. If you are like me and are a 30-something (or older), you can see that the use of these executive functions definitely did not develop fully until at least your mid-twenties. This does not mean that you cannot make good decisions, be ...

My two "Early Communicators" Other than, " When should my child be making this sound? ", the most asked questions about my job are how to get the youngest children speaking more (birth to age 3). First, I have two kiddos of my own in this age range. Second, I love working with little ones and really discovering how children communicate and watching them grow. So, I am really passionate about this subject. Today's post will be some basic information that all parents of small children can incorporate into their daily routines to promote language development. These are general strategies; that is, an SLP can help you to incorporate more routines specific to your child. If you feel that your child is not meeting language milestones, please contact your local early intervention institution (a free government-mandated program). We can also evaluate your child here in our office or help you to find other services. First and foremost, I cannot emphasize the im...

Cueing Strategies For the most crucial part of this topic (in my opinion), we will talk today about how to cue your child for certain sounds. I believe that this is the most crucial part because you will understand more how to make your child successful with speech sounds and give them self-confidence that they can incorporate these sounds into their life! Without further ado, I give you a list of some of the most common cues and strategies I suggest in my practice: Use a mirror for visual feedback. You can practice words in front of a large mirror, or just have a hand-mirror handy while you are doing your fun activities I talked about on Monday! Hand motions to cue how the sound should be made. I cannot make a list of all of the hand motions I use (especially since they change depending on what works for the child!). I can suggest asking your SLP what hand cue they use for certain sounds. Some common ones may be lightly dragging a finger up the arm for /s/ or touching y...

Target Selection Hello to part 2 of this week's topic of articulation therapy. Yesterday, we talked about building rapport to begin working on speech therapy. Today, we will be discussing why and how your SLP chooses which sounds to work on. So, this can get very clinical, but I am not going to “go there” within this blog post. I am just geeky enough that I will talk to anyone about how much the Cycles Approach has been helping out my therapies, and how I prefer many words to just a few personally in my practice, but that’s just too much. What I will do in this section is explain what speech “targets” are and explain a little but about how you can become an active member in helping your SLP determine what sounds would be most beneficial for your child first. So, first, there are a few different ways that speech therapists can determine what sounds to work on first. If your child only has 1-2 sounds in error, it is much easier to decide which sounds to work on. Otherwi...

This past week, I actually had a lot of feedback about this little blog of ours. So, to all of you reading, thank you! Make sure to leave comments below to start further conversation. In one of the bits of feedback, a friend from high school and college shared a story with me about her experience with speech therapy as a child and how she was made to feel very vulnerable, embarrassed, and unsuccessful with her articulation, or speech sound, therapy. She asked if I could share strategies on how to make therapy less traumatic for children and make them motivated for working on their sounds. I loved this idea and thought for a bit about how I wanted to address this issue. I think the three key elements to getting your child a) excited for speech therapy and b) excited to work on sounds with you would be: 1. Rapport 2. Target selection 3. Cueing strategies In order to avoid an extremely long post, I will be breaking this topic into 3 separate posts. So, t...

This blog post has a lot of information in it. What better way to relay a lot of information than…lists? I got most of my information from the book If Your Child Stutters: A Guide For Parents from the Stuttering Foundation. We have several copies at our office that we are willing to lend out. Without further ado, let’s start those lists! What stuttering is not: A bad habit A disease Normal disfluency (which is what everyone experiences at times; not everyone stutters though Caused by neglectful mothers (a theory from the 1970s; thank goodness we have evolved in both psychology and evidence-based practice)  Signs of stuttering: Primary characteristics: Multiple repetitions Whole word repetitions Can-can-can we do that? Part-word repetitions W-w-w-we have donuts! Filler words Um-um-um-um yea, I like going on the slide. Schwa sound Also known as the “uh” sound Unlike a part-word repetition, this distorts the word Muh-muh-muh-mouse  P...

Hello again! I am very happy for our next installment of our “5 Questions With…” series on this blog (second one in a row!) Today, we will be discussing five questions with Dr. Sarah Wallace, one of my wonderful professors from Duquesne University. To me, she is the absolute expert on aphasia, alternative and augmentative communication, and research in the field of speech and language pathology (only partly because she taught all of those classes to me). To introduce my guest, I will be pulling directly from Duquesne University’s Speech-Language-Hearing Clinic’s website: Sarah E. Wallace, Ph.D., CCC-SLP is the Program Director for the Adult Language and Cognition Clinic and Associate Professor in the Department of Speech-Language Pathology. Dr. Wallace received her B.Ed. from Miami of Ohio University, M.A. from Western Michigan and her Ph.D. from the University of Nebraska-Lincoln. Her clinical, research, and teaching interests include assessment and interventions for adults with n...

Just a quick note from me (Kathleen) before getting into our blog post for this week! Julie finally has some time in her schedule to write some blog posts on the clinical subjects she is passionate about as well. For her first post, we are welcome our audiology professor from Duquesne University for our second installment of "5 Questions With..." to discuss hearing screenings. Please read on to find out why this 5 minute screening test is so important! It’s that time of year again! Ya know, when your child comes home with a paper that says the school nurse, a speech therapist, or if you’re super lucky, an audiologist is coming to screen the kids for hearing. Personally, I always dreaded hearing screening day at school, especially in high school. Growing up, I had at least 6 tubes in my ears as a kid and plenty of visits to the doctor for chronic ear infections, which I still get, even at 30. I was that weird kid at pool parties who couldn’t go underwater (still ...

If you have ever sung a childhood rhyme or read a Dr. Seuss book, you recognize that rhyming is a big part of children’s lives. But why? Rhyming is a really hard concept to explain. Luckily, most kids pick up on it from these sources intuitively, but many children do not. I used to explain that rhyming words sound the same at the end. But then why don’t bed and nab rhyme? So, I explain that they sound the same in the middle and end of the word. Well, what about two syllable rhymes? Seven and eleven rhyme, even though one is 2 syllables and one is 3, but seven and dozen do not. Rhyming is so complex because it is a higher-level phonological awareness skill. Phonological awareness is explained as the rules of sounds and an ability to manipulate sounds. This includes a child being able to identify sounds and words, be able to identify the number of sounds or syllables in words, blend sounds and syllables, change/add/delete a sound in a word to create a new word, and rhyming. Phono...

Something I have not been able to do as much as I had before I had children is reading. I love being transported to new worlds but more so, I love learning new things. I have always preferred non-fiction. My favorite author is Malcolm Gladwell, teaching us social issues and tiny minutia of life that actually has huge impacts. Because of my love for learning new things and tiny things that actually have a huge impact, I love learning about the brain. Perhaps it is part of why I became a speech therapist. This weekend, my husband and I actually went on a date and we chose to just chill out at the library. I was able to relax with a book on the brain called The Man Who Mistook His Wife For A Hat . This book reminds me a lot of my favorite book on neurology, Phantoms In The Brain . These books talk about how important certain areas of our brain are in everyday functions that we don’t even realize are important until they are damaged in some way. One of the first stories in The Man Who ...

For today’s blog, I really wanted to take a moment to talk about how to get your child to answer your questions. What do I mean by this? Well, I mean decreasing the instances of you asking your preschooler a question and they just stare at you, so you repeat and repeat with no response in the end. What I also mean is eliminating you asking your school-age child, “How was school?” and only hearing “Good.” If you are reading this and thinking, “Wow, I really could benefit from this” or even if you’re thinking, “I’m afraid my child still wouldn’t answer” because of delays or language disabilities, please read on because I will also explain both scenarios. So, to first talk about how to get a conversation going, we first need to talk about how to listen to our children, not just prompt them. You may be saying, “Of course I listen to my children”; but, do you wait long enough to get the whole answer? Some children may only need 1 second to respond to a question; some may need 5 seconds. Th...

I recently told my husband about our new blog and how my goal was to get information out to the public on various topics involving speech therapy. I asked him what he thinks the most important thing parents should know about speech therapy as he is someone who knows more about my profession than most (if you don’t, check out our other blog post “What Is An SLP?”). He told me that when we are together, the most asked question he hears other people ask is, “My child can’t say X sound. Should they have that by now?” Thus, here we are with this week’s post! So, let’s make this information easy to understand and to the point. The following chart is from www.talkingchild.com and is adapted from the two leading research articles on speech sound development for children by sex and age: I also attached this information from www.asha.org , which shows what children should be doing in regards to sounds since birth: The chart below shows the age range for each speech sound. By ...