Through The Years Speech Therapy

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Social Communication

People rely heavily on social cues to help their conversations flow in a productive manner during regular-everyday interactions. These social language skills, referred to as Pragmatics, help facilitate smooth dialogues. Using pragmatics helps our brains decipher what to say and how to convey it, as well as how to understand what is being said. Individuals who obtain poor pragmatic skills are unable to convey their thoughts or feelings as successfully than others, which can create a lack of understanding between the speaker and listener, and usually results in anger and frustration for both parties.

Pragmatics governs three vital communication skills: using language, changing language and following the rules.

Using language for different purposes allows us to greet, inform, demand, promise, request, etc. For example, if a child says, ‘Can we play outside, please?’ they are using language properly by appropriately requesting something.

Changing language allows the speaker to alter their speech for the given situation or for the listeners’ needs. For example, a person dining in a restaurant or working at the office may speak more formally in those settings than they would if they were at a baseball game. An adult talking to a baby would likely change the inflections in their speech from a more adult monotone sound into a more sing-song sound and rhythm referred to as ‘motherese’.

Following the rules of conversation is most critical. Turn taking, staying on topic, repeating when misunderstood, maintaining eye contact and understanding facial expressions are just a few of the rules that one should follow in order to have a productive conversation.

In many cases, poor pragmatic skills are often associated with other disorders or conditions. For example, individuals who fall anywhere on the Autism Spectrum Disorder (ASD) will usually show great difficulty with pragmatics. Because ASD affects one’s social abilities so tremendously, it is especially difficult for people with ASD to convey their thoughts and understand the thoughts being conveyed to them, as efficiently as those who are not on the spectrum. In addition to ASD, poor pragmatic skills can also be associated with other specific language impairments (SLI), developmental delays, and even traumatic brain injury (TBI) and strokes.

Speech-language pathologists are highly skilled in treating clients with pragmatic impairments. Effective pragmatic treatment can be accomplished through storytelling, role-playing activities, and prompting the client to practice ‘using’ language, as well as many other treatment methods.

By Olivia Carbonette

http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934980&section=Treatment

http://www.asha.org/public/speech/development/PragmaticLanguageTips/

http://www.ttyspeechtherapy.com/

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Typical Language Development

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Children go through a number of stages as language develops and it is amazing to see their progress. In just 5 years, a child can go from only cooing to using over 2,000 words! Having an understanding of typical language development is beneficial for parents who suspect their child may not be reaching milestones at an age-appropriate time. You can use this chart to gain perspective on standard (norm-referenced) language- development. Early detection and treatment is key in remediation.

By: Olivia Carbonette

http://www.asha.org/public/Early-Detection-of-Speech-Language-and-Hearing-Disorders/

http://firstyears.org/miles/chart.htm

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English Language Learners and Syntax

When learning a new language, all universal components of language are affected. Out of all components, syntax is a huge obstacle for English language learners. Syntax involves the rules that govern the word order and structure of a sentence in order to make it comprehensible. For example, when an English speaker states their age, they will say: “I am 25 years old.” When a Spanish speaker states their age, the English translation will say: “I have 25 years.” In this instance, a syntactical transfer is being displayed. A syntactical transfer is when one uses the same verb from their first language to the help form a sentence in their second language. This is a confusing concept for both English language learners and Spanish language learners because in the two languages the verbs being used have different functions of meaning. Another example of a syntactical obstacle for second language learners could be the formation of sentences with a negative. For example, a native English speaker would say “I do not sing” and an English language learner would most likely say “I no sing.”

Speech Pathologists help with syntactic transfer, a difficult feat for one to master independently. It is important to use correct word order when speaking a second language so that the message gets across clearly, accurately, and without distraction.

http://www.asha.org/policy/TR2003-00044/

http://www.power-of-speech.com/accent_reduction.html

By Olivia Carbonette, Speech Pathology Student and Intern

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Scenes from a #productive day ✅ (left from top): Therapists setting up for an articulation client; new intern, Olivia hard at work; brainstorming in action: new SLP, Sydney and intern, Vai; sensory integration area; obstacle course 1; obstacle course 2. Big things are happening, stay tuned! #speechtherapy #physicaltherapy #pediatrics #sportsmedicine #slp #occupationaltherapy #collaborate #nyc #newyorkcity (at The Galleria)

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What is Cleft Lip and Cleft Palate?

Cleft lip and Cleft Palate are birth defects that occur in utero when the baby’s lip and/or mouth do not form properly. A child may have both cleft lip and cleft palate, or one or the other. Cases range in severity, though most of them require surgical intervention and ongoing speech-language and feeding therapy.

How does it happen?

While the fetus is developing in the womb, the joining of tissues on the face forms facial features like the lips, mouth and nose. When the lip tissue does not completely join together before birth, an opening in the upper lip occurs. This opening can range from a small slit to a considerably large opening that can even open up to the nose. That is Cleft Lip. Cleft palate is when the roof of the mouth, known as the palate, is separated by a gap in either the front or back or even both, for the same tissue development reason as cleft lip. As one may assume, these openings on the facial features of the mouth or inside the oral cavity can cause tremendous problems with speaking and feeding.

How is it diagnosed?

Unlike many other congenital health complications, cleft palate and lip can be detected before birth and treated immediately after. This atypical development of the lip can be detected in the fetus by an ultrasound, however diagnosing cleft palate usually happens after birth.

What does treatment entail?

Treatment usually requires a team of professionals to reconstruct, care for and help regulate daily functions. These teams usually consist of a surgeon, orthodontist, speech-language pathologist, ENT, and nutritionists. Speech pathologists play a huge role in post-surgery therapy. Speech pathologists design feeding techniques and work to normalize speech-language development.

The implications of untreated Cleft Lip and Palate can be devastating, ranging from difficulty speaking to fatal malnutrition. The required medical and therapeutic attention necessary is extremely costly which is why many organizations were formed to assist families who have children born clefts in undeveloped or low-income nations/regions. These organizations like Operation Smile or Smile Train, along with many others, report to areas in need with a team of health professionals to perform the quick and easy surgery to see the magnificent and life changing transformation. Through The Years Speech Therapy has supported such organizations, as we treat cleft lip and palate as well, and love seeing the difference they make in the life of children and their families.

Click the link below to donate and help a child a smile today! https://secure.smiletrain.org/site/SPageNavigator/donate_now.html

By: Olivia Carbonette, intern.

http://www.cdc.gov/ncbddd/birthdefects/cleftlip.html http://www.asha.org/public/speech/disorders/CleftLip/#treats

www.TTYspeechtherapy.com/

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Collaborative Therapy

The job descriptions of physical therapists, occupational therapists, and speech therapists entail different responsibilities; however, each discipline may strengthen the effect of the others by working together towards client/patient goals. Therapists often consult each other about individual goals to broaden the overall progress of the client. Both pediatric and adult clients benefit from an integrated therapy model.

I recently had the valuable experience of working as a clinical intern in Ecuador. I was placed in the pediatric rehabilitation department of a major hospital. The physical therapists, occupational therapists, and speech therapists assisted and communicated daily regarding their clients, and met weekly about the short and long term goals for the child. Even though the responsibilities of each therapist differed, I saw firsthand how overall client progress can reach its highest potential through proper partnership. I am very excited that Through The Years Speech Therapy will be teaming up with other disciplines to ensure each client meets their maximum potential. Stay tuned for updates on their website www.TTTSpeechtherapy.com

By Vaidehi Shah, Intern, Through The Years Speech Therapy

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About your hearing...

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Speech and Hearing: The Marvolous Cochlear Implant

Our ears have the ability to hear sounds at different thresholds. Meaning, we have different levels at which we are able to detect sound signals. Many people however, suffer from profound hearing loss and are unable to hear some of the sounds, which to others are extremely loud, such as a plane taking off. Hearing loss is classified into several degrees of loss. HL can range from normal hearing loss to profound hearing loss. Profound hearing loss is the loss of hearing at 80 dB or more. It is a type of hearing loss, that even with amplification such as a hearing aid, it is extremely tough to hear. Many of us may be familiar with the “hair cells” at the entrance of our ear canal. Those suffering from profound hearing loss or severe hearing loss have damaged both inner and outer hair cells, which inherently makes it tough to distinguish sounds and localization. One of the most common, most helpful, and successful treatments for profound hearing loss is Cochlear Implants. More than 188,000 people worldwide are cochlear implant candidates. Cochlear implants can be implanted in one ear or both depending on severity of hearing loss in both ears. CI’s bypass the inner ear and directly connect to the auditory nerve to improve hearing in those with profound hearing loss. A person suffering from profound hearing loss may have problems understanding conversational speech, and may not be able to detect some of the loudest sounds. The severity of the hearing loss has reached a point where traditional hearing aids give limited help. The implantation of cochlear implants is a relatively easy surgical process, which involves a sound processor (internal and external implant) and an electrode implantation. There are different types of implants available, and can be adjusted depending on the clients needs. With the help of Cochlear Implants, children and adults of all ages can benefit from cochlear implants whether they suffer from pre-natal or post-natal hearing loss.

Blog by

Vaidehi Shah

http://www.hearingloss.org/content/cochlear-implants

http://www.aussiedeafkids.org.au/describing-the-severity-of-a-hearing-loss.html

www.TTYspeechTherapy.com

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How does music relate to speech therapy? There are many ways. Melodic Intonation Therapy (MIT) is a type of therapy used for those suffering with aphasia. MIT helps in facilitating speech through singing by using their right cerebral hemisphere. It also helps to facilitate and produce everyday sentences in a song-like manner, which, over time, helps to ease communication. Sung intonation produces words and sentences in a similar prosody to that of a spoken sentence. It has also can be beneficial to those suffering form Broca’s aphasia. Participants of MIT are directed to say phrases or words with a songlike prosody. MIT helps to aid an aphasic patient with an alternative way to recall missing words.  Putting words in a song like prosody can also help with other speech related impairments. Not only can MIT help those who suffer from aphasia, but it is also a big component for recovery for those who stutter and aphasic patients. Many parts of our brain are stimulated with music. Our auditory cortex, cerebrum, cerebellum are only a few of the parts which work together when listening to music.

Our auditory cortex can play a big role in our perception and analysis of music. By doing so, we are better able to understand the music to help us produce the lyrics. Singing helps those who stutter by improving rhythm with increased phonation duration. Rhythm helps us facilitate the timing of a certain beat, while holding that sound can help us inadvertently. Stuttering often occurs due to the anxiety of producing spontaneous speech, but with memorization and anticipating rhythm, that can be eased over time. Music also shows improvement for those with Autism. For parents whose children suffer with stuttering, parents can look towards music for a new and different way of therapy. Music also helps Autistic patients recognize emotions like happiness and sadness in the auditory cortex. Autistic patients often show poor understanding of emotions, therefore with music therapy, research has shown beneficial effects for behavioral problems. Rhythm relaxes, and over time, has shown increased involvement and better attention/eye contact. Whether it is for adults, or children, music therapy is beneficial for people of all ages.

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Social Language Therapy for Adults and Teens

Social Language Therapy for Adults

The music at your friends’ 21st birthday is way too loud yet you somehow have the ability to characterize your friends’ voices and hold a conversation. How does that work?

The “cocktail party effect” can help to explain our ability to detect signals, even when background noise is present. It is our ability to focus on one sound stream even when multiple signals are present in a social interaction. The brain is able to selectively focus on one conversation, and mute the other voices, allowing it to determine what is “noise”. Speech-Language Pathologists are trained to target interventions for social language settings and different linguistic environments. Language is a socially dependent tool, which largely depends on the environment. Therapists are trained to understand the linguistic background and environment of their clients in order to understand the possible reasons for impediments.

Language, and our style of communication, is dependent on the social setting. We speak differently with our families than we do with our friends or our co-workers. Speech Pathologists are professionally trained to understand different linguistic environments to help individuals adapt to social settings by enhancing language and communication skills. Whether it is a noisy party or a small get-together, an SLP knows the proper techniques to enhance communication skills. Depending on what environment we are in, SLPs differentiate social interactions through variances of communication. Social Communication Disorders (SCD) often result from problems with social interaction and pragmatics. SCD can occur from interactions with peers, child care providers, and even family by simple behaviors as eye contact, and general body language. Different modalities of treatment include

Computer and Video Based Instruction:

Augmentative and Alternative Communication (AAC):

a type of observational learning which incorporates technology to help teach social skills.

AAC is the the use of speech along with another supplemental form such as aided/unaided objects or drawings.

Speech Pathologists are able to provide speech therapy which helps in cognitive processes which can help with social interactions

ASHA

Social Therapy

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Effective English Speaking through Speech Therapy

Effective communication is an invaluable skill that businesses seek from current and prospective employees. Communication, both written and verbal, is essential in the business context because it is the vehicle by which employees express their ideas, opinions and emotions. For most new citizens and outsourced employees hired by US firms, English is a second language. This language barrier can have a negative impact on the employee’s ability to effectively communicate in the workplace – sometimes leading to unsatisfactory job performance and limited career progression. Fortunately, there are options available to these new citizens and outsourced employees to help them to overcome the language hurdle.

Speech therapists are specially trained on the proper techniques of effective communication, which can help new citizens and outsourced employees hired by US firms. By helping to improve semantics (the study of meaning), syntax (the study of word order or sentence structure), phonetics, and non-verbal language, speech therapists can help non-native English speakers to better communicate in the workplace. According to the American Speech and Hearing Association (ASHA), accents can negatively impact perceived communication skills due to possible frustration, and misunderstanding. This can cause native English-speaking colleagues to focus more on an accent than the substance of the conversation. Accent reduction services can help improve communication skills with one’s co-workers. Speech therapists can help to evaluate one’s pronunciation, rhythm and intonation in order to create goals, which will ultimately reduce the severity of one’s accent. Speech therapists can provide individualized sessions that utilize personal evaluations, to ensure that goals are customized on a case-by-case basis. By specializing in services such as accent reduction, speech therapists can help new citizens and outsourced employees hired by US firms to become effective communicators, enabling them to achieve their full career potential.

http://www.asha.org/public/speech/development/accent-modification/

Blog by

Vaidehi Shah

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Speech and Social-Emotional Development

Speech and language disorders can have a great effect on a childs’ social development, emotional development, and self-esteem, especially in the early school-aged years. Studies support this as they have shown that children whose speech and language impairments are not resolved by the time they start school are more likely to have later academic, social, and emotional difficulties. As we know, spoken language is crucial for learning and development in primary school children. During this time children learn that their predominant means of communicating with others will be through speech. The skills that are taught in a classroom can be quite overwhelming for children who have already experienced delays before coming into school. The following are things that can be negatively impacted by speech or language disorders:

Friendships: the ability to socialize with peers is a key part of childhood. For children with speech impairments, making and especially maintaining friends can be a challenge. It becomes increasingly difficult as children get older, when the complexity of communication and understanding thoughts and feelings of others greatly increases. Studies show that there is a high positive correlation between good communication skills and popularity.

Expressing Emotions: children learn to express their emotions from an early age. They learn to share their feelings in words, and reflect on what they feel. These skills require the language to put their thoughts and feelings into words. Children with impairments may lack these skills, which may result in frustration and poor behavior.

Self-Esteem: the emotional, social and behavioral skills that children with speech and language impairments tend to lack, result in the development of negative perceptions of themselves. With prolonged difficulties, children’s self-esteem and self worth continue to suffer.

The damage to a childs social and emotional development, as well as self esteem will ultimately impact their academic performance. With a low self-esteem, children are more likely to do poorer in school because they don’t have the confidence they need to succeed.

Blog by Debbie Waldman

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How Do We Convey Meaning Through Speech?

Suprasegmental features are features of speech that occur simultaneously with vowels and consonants in an utterance; they go beyond the “segments” of speech, known as the International Phonetic Alphabet. Suprasegmental features play a very important role in producing intelligible speech. They contribute to the prosody of speech, and therefore are also known as prosodic features. More specifically, these features project the differences among sentence types (declaratives vs. interrogatives), alter meaning through stress, and also play a role in the listener’s ability to derive meaning from what the speaker is saying. These features include variations in stress (accent), pitch (tone and intonation), and length (duration):

Stress is used to reference the degree of emphasis on individual syllables within words (lexical stress), or individual words within sentences and phrases (sentential stress). The stress of syllables and words vary among languages and even among dialects of the same language. These dialectal variations are known as accents.

Pitch refers to the perception of a sounds frequency. We perceive sounds as being either high-pitched or low-pitched. When talking about pitch, tone and intonation are never far behind.

Tone refers to significant pitch differences between words. There are two types of tone, lexical tone (when the pitch level of the word is the essential feature of its meaning) and grammatical tone (when the pitch level marks differences in grammatical features). Like stress, there are tone differences across languages, and there are even languages, like English, that are non tonal.

Intonation is the rise and fall of pitch over entire sentences. Intonation is especially important when children first acquire language. Children start to speak using single word utterances, conveying a wide range of sentence types from statements to requests. The way we know whether a child is asking for something or telling us something is through their intonation of speech.

Length, or duration, of a sound is another suprasegmental that serves many functions. It refers to the amount of time it takes to produce a sound. Variations in length can be used to differentiate words. In many languages, changing the sound length can change the meaning of a word. We see examples of this in Hawaiian, where the vowel length can actually change the meaning of the word, even if the spelling appears to stay the same.

Suprasegmental features play an important role in the way we speak to one another every day. Suprasegmentals help us distinguish sentences from questions, or sentences from commands. We use them every day and might not even know it.

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Linguistics DOES relate to Speech Therapy

Linguistics is the scientific study of language and its structure. The major aspects to the study include the study of morphology, syntax, phonetics/phonology, semantics, and pragmatics. Linguistics can be divided into sub-disciplines. The sub-discipline of linguistics that is related to speech-language pathology is clinical linguistics, which is the use of linguistics to describe, analyze, and treat language disabilities. It is the application of linguistic theory to the field of speech-language pathology. Studying the linguistic aspect of communication disorders is important to understanding language more generally. Clinical linguists conduct research aiming to improve the assessment, treatment, and analysis of disordered speech/language. Their research often offers insights to formal linguistic theories, as well. Examples of when clinical linguistics (branch of applied linguistics) comes into play are as follows: • Brain damage due to an accident or stroke can lead to a complete or partial loss of language ability. When there is a partial loss of language ability, the aspects of language that are affected can differ from patient to patient. Clinical linguistic analysis helps speech therapists find out which aspect of language was affected, so that proper treatment can be provided. • Aphasia patients exhibit symptoms like agrammatism, which is the inability to speak using proper grammar (ex: improper word order). This symptom can be better treated and understood with a thorough knowledge of linguistics/the grammar of the concerned language. This knowledge can be helpful for establishing the exact type of grammar defect that has affected the speech of the patient, as well as providing therapeutic intervention. • The assessment of any language deficit, such as the phonological, syntactic and semantic errors of patients with congenital hearing loss, demands good knowledge of linguistics. The assessment of autistic patients, who exhibit pragmatic deficits, demands knowledge of linguistics as well. • Transcription, which is a part of linguistics, is also used for the assessment of speech and language disorders. Transcriptions of speech samples can always be referred back to as it serves as the basis for all aspects of language analysis. • Linguistics is a hot topic when discussing language acquisition (how children acquire language). There are many theories about how children develop language and these theories are put into practice when working with children who have a language delay. Two opposing points of view on language acquisition are that of Noam Chomsky’s language-wired brain and B.F. Skinner’s language learning theory. Many speech therapists adhere to one of these schools of thought and practice accordingly. Clinical linguistics is becoming increasingly recognized for its contribution to speech-language pathology. Speech therapists use knowledge of linguistics to analyze and assess patients across groups and disorders.

Noam Chomsky, “The Father of Linguistics”

Some interesting Linguistic links:

Standard vs. Dialectal English http://www.theguardian.com/books/2013/dec/31/one-way-speak-english-standard-spoken-british-linguistics-chomsky

The Amazing Tim Doner, Polyglot Kid http://polyglotpal.blogspot.com/

http://www.nytimes.com/2012/03/11/nyregion/a-teenage-master-of-languages-finds-online-fellowship.html?pagewanted=all&_r=0

Just for fun http://www.ojohaven.com/fun/