TALK's Whole Child Approach

Do you ever find that your children behave differently depending on where they are or who they’re with? Do you ever wish that your children’s teachers and therapists could see the same thing?

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So do we! That is why TALK promotes a whole child approach to therapy.

A whole child approach to therapy means that we take into account more than just what we see and hear during our sessions. We want input from you, their teachers, their pediatricians and other providers.

From your very first visit, we get a detailed client history report from you, the parent, on what you think your child needs to work on, what has or hasn’t worked in the past, and how best to motivate him/her. We also ask you to bring any relevant reports with you so that we can get other professional opinions from the very start. And we ask you to sign a release form to allow us to send our reports to your pediatrician. Getting everyone on the same page from the start is so important!

Once your child gets comfortable with us, we also love to do home visits. Home visits help with parent carryover and generalization of skills. We come to your house (with your permission!) to observe behaviors and offer suggestions on how to promote your child’s speech and language progress. All our suggestions are small tweaks to your daily routines and are intended to help your child do their best at home!

We also love seeing your kids in action at school. School visits give us such valuable information about how your children are learning in academic and social settings and what we can do to help support them. We are also happy to do visits to OT, PT, ABA, swim class, music class – you name it!

Of course if time or scheduling does not allow for home and/or school visits, we are also happy to do phone check ins with your children’s teachers, doctors, other therapists, and you! We just need your permission. Remember, we won’t ever talk about your child to a different provider without your written consent.

A whole child approach really allows us to see your whole child and write individualized goals and supports for therapy.

Alexia Mazzone
Speech Sound Norms
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As a parent, it can be tough to figure out if your child’s speech sound errors are cute and age-appropriate or if there is reason to be concerned. According to a recent compilation of 15 studies*, here are the average ages English speakers acquire their consonants:

2-3 Years

By 3 years most children should have the following sounds: p (pig), b (bat), m (mat), d (dog), n (nap), h (hot), t (toss), k (cat), g (go), w (win), ng (wing), f (fish), y (yes)

4 Years

By 4 years, most children should have the following sounds: l (love), j (jump), ch (chip), s (sun), v (van), sh (ship), z (buzz)

5 Years

By 5 years, most children should have the following sounds: r (run), zh (measure), voiced th (that)

6 Years

By 6 years, most children should have all sounds, including voiceless th (think)

Remember, these are the average ages children acquire their speech sounds. It is also not uncommon for sounds to emerge in certain positions but not others. If you have any concerns about your child’s speech sound development, please contact a speech-language pathologist.

*McLeod, S. & Crowe, K. (2018). Children’s consonant acquisition in 27 languages: A cross-linguistic review. American Journal of Speech-Language Pathology. Available from: https://ajslp.pubs.asha.org/article.aspx?articleid=2701897

Alexia Mazzone
Making Social Inferences

The Speech Corner Photo Cards for Social Inferences and Subtle Cues is one of our favorite tools for targeting social skills. Created by Rachele Ellsworth, M.S., CCC-SLP, the deck contains fifty large color photographs of people engaged in various activities (e.g., waiting at a doctor’s office, helping someone in need, sharing a meal together). Questions on the back of each card target understanding of the subtle social cues depicted. It allows us to practice making inferences and predictions as well as understanding emotions and body language all with one material!

For example, one of the cards shows a fireman helping a woman who has just been in a car accident. Some questions on the back read:

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  • Do these people know each other? How do you know?

  • What just occurred to bring these people together?

  • What might the man say? What might the woman say?

  • How might the woman feel? How might the man feel?

  • Where is the woman going now? How do you know?

  • Do you think more people are near these people? 


We love using these cards with children who are struggling with interpreting social cues. One child that we used these cards with went from needing a great deal of support to interpret body language and relationships between people to independently making predictions and interpreting body language both in picture scenes and in her real life!


Alexia Mazzone
The Ins and Outs of Play

Play is an integral part of children’s cognitive, language, social, and emotional development. It allows children to explore the word in safe and meaningful ways. Play is important. But how do you work on it?

Start by recognizing your child’s play level. In simplified terms, there are four main stages of play:

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1.     The first stage is exploration. Think of a baby who explores objects by looking at, touching, and mouthing them.

2.     The second stage is dump and fill. Remember when Bobby thought putting all the balls in the basket and then dumping them out was the funniest thing?

3.     The third stage is functional play. Functional play is when kids use objects for their intended purposes (e.g., rolling a toy car, building a block tower).

4.     The fourth stage is pretend play.

 Play stages usually overlap with each other. Your two-year-old may be doing a little dump a fill, a little functional, and a little early pretend play. But understanding where your child is in their play helps determine what they’re ready for.

 Adults should model play that’s about one step above what children do when they play by themselves. This will make the play interesting and engaging enough for the kids without it going completely over their heads!

 If you think your child is ready for pretend play, start modeling it from the simplest level.

·  Beginning pretend play involves using one object for one function (e.g., pretending a doll is sleeping or using a banana to “call” someone).

·  Pretend play then evolves into play sequences with one object (e.g., kissing the doll and then put her to sleep).

·  Children then start adding more objects and more steps (e.g., having a mommy doll help brush the baby doll’s teeth, turn off the light, and go to sleep). Pretend play continues to develop on from here.

 What pretend play should you model? Draw inspiration from your kid’s everyday life and routines. Set the scene (e.g., going to the beach, going to the doctors, or getting ready for bed) and see if they join in and start to add steps. Don’t forget the small steps like pretending to put on your seatbelt, turning the key (or pushing the button!) to start the car, or adjusting the water temperature so it’s not “too hot.” Add some unexpected problems like a flat tire or it starts to rain. You can also draw inspiration from your children’s favorite stories or shows.

 Lastly, remember: play is supposed to be fun! If you and your child aren’t having fun, something needs to change. If you have any concerns or questions, please don’t hesitate to contact your child’s teacher or us.

Alexia Mazzone
Frequent and Consistent Therapy at TALK

Frequency.  Consistency.  Frequency...Consistency.  More than likely, you have probably heard your speech therapist mention these terms more than once.  You have a solid treatment plan.  You have amazing and skilled therapists.  BUT we still need to talk about frequency and consistency.  These two factors are the drivers of success in therapy.

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Once your child has finished the diagnostic therapy period and we have held the initial parent meeting to go over the evaluation and treatment plan, it is now time to dive in and target those carefully selected objectives! Treatment plans with short-term objectives are written for a four-month period and progress of all goals will be reviewed at the following parent meeting, with all data graphed and analyzed. Functional, measurable goals are implemented to target your child’s communication needs.

Consistency and frequency of therapy are two of the most important factors for demonstrating progress in speech therapy. AT TALK, all clients attend therapy for a minimum of two times per week. Researchers in the field of speech and language development find that therapy once per week tends to promote maintenance of skills. More frequent and consistent therapy is vital for making greater progress across all domains of speech and language. If your child is making slower progress than desired, take a look at their attendance of sessions.  Have they missed numerous sessions?  Have they taken several breaks?   Talk to your therapist about increasing frequency of services, if appropriate. 

You can also ask your therapist if implementing a home practice program is suitable for your child. Maintaining mastered skills at home can help progress with inconsistent skill levels targeted in speech therapy.  The more frequent and consistent the intervention, the higher the chances are of meeting their goals!

Alexia Mazzone
Supporting Language At Home

A question we get all the time from parents is, “What can I do at home to support my child’s language development?” As simple as it sounds, one of the best things parents can do at home is to model the correct language target and provide auditory bombardment.

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Auditory bombardment is an evidence-based treatment strategy where the therapist (or parent) repeats the target stimulus multiple times for the child to hear. Auditory bombardment can be used in conjunction with articulation therapy and language therapy. If your child is working on their /s/ sound, consider bombarding them with /s/ words during car rides. If your child is working on their pronouns, bombard them with sentences using correct pronouns while at the park or the zoo. When your child makes an error, model the correct target and repeat a few times. So, if your child says, “Look!! The dog eating!” respond with, “You’re right! The dog IS eating! It must be hungry because the dog IS eating it’s food!”

Doing these small things throughout the day can help make a difference in your child’s progress on their speech and language goals.

Alexia Mazzone
Look, Listen, and Infer
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The Look, Listen and Infer Fun Deck created by Clint Johnson, M.A., CCC-SLP and Erin Riojas with Super DuperⓇ Publications is a therapy material that can be used to help improve critical thinking, auditory comprehension, and inferencing skills. It is a great therapy tool for school aged children in second grade or higher. The deck assists clients with inferring the meaning of a message by listening to a scenario while also looking at a picture to provide an appropriate and logical answer given a social scenario.  

This tool is beneficial because it teaches children to improve their inferencing skills by reminding them to look at all the details in the picture to help determine the meaning of the message. One of our clinicians recently began using this with a seven year old child who has difficulties with critical thinking and inferencing skills. The pictures and the scenarios listed on the cards has helped the child look at the big picture and the small details to determine the meaning of a message. 

An example of the type of scenario given is a picture of an older sister and younger brother standing outside a closed door. In the picture, the older sister appears to be carrying a heavy fragile item with both of her hands, as the younger brother is holding what appears to be a light box since he is carrying the box in one arm only. Below the picture the card has written, “Your sister asked, ‘Can you give me a hand?’ What should you do next?” If the child has difficulty providing a logical and appropriate answer, there are multiple choice options provided. “Applaud her for carrying such a heavy box; Give her a high five; Help her open the door.” The most appropriate answer would be to help her open the door. 

The Look, Listen and Infer Fun Deck is a quick, fun way to target skills that many children struggle with.

Alexia Mazzone
Five Common Myths about Language Development
 
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  1. “Using sign language will make my child talk later.”

    Using signs before a child can talk actually promotes language!

  2. “Late-talkers always catch up.”

    Some late-talkers catch up, but many do not! We’d rather see kids earlier so they can catch up sooner rather than later.

  3. “Learning two languages at the same time causes language delays.”

    There are so many benefits to bilingualism! When we evaluate bilingual kids, we look at their combined language skills.

  4. “He’s not talking much, but he’s a boy.”

    Girls and boys actually develop language at the same rate. But boys have a higher risk of language delays/disorders.

  5. “I should use flashcards to help build my child’s vocabulary.”

    Kids learn new words best when they hear them multiple times in natural environments.

For more information, please check out asha.org.


Alexia Mazzone
Expanding Language

 Can you tell me more? EET To The Rescue!

 One therapy tool that gets a lot of use around the TALK clinic is the Expanding Expression Tool (EET).  The Expanding Expression Tool (EET) is a multi-sensory tool that helps children organize and retrieve information when providing oral and written descriptions or definitions. It was developed by Sarah Smith, a Speech-Language Pathologist.  The EET consists of a rope with seven large colored beads. Each bead provides a reminder for the type of information that can be included in a description. It is considered a multi-sensory tool because the child is simultaneously using their sense of touch, sight, and hearing while using the EET. This makes the EET a powerful teaching tool for children with various learning styles.

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The parts of the EET are:

Green bead (Group) – What category does the object belong to?

Blue bead (Do) – What does the object do? What can you do with the object?

Eyeball bead (Look like):  - What does it look like? (e.g., shape, size, color)

Wooden bead (Made of) - What is it made of (or come from)?

Pink (Parts) - What are its parts? What parts go with it?

White (Where) - Where do you find it? Where does it come from?

Question Mark - What else do I know? What is the child’s prior knowledge?

This simple strand of beads has magical powers when it comes to teaching clients to understand and expand their knowledge of categories, function, and important features of everyday objects.

Alexia Mazzone
Guess Who Is Improving Their Speech and Language?!

Movement, crafts, themed activities and games are just a few ways we like to make our therapy session FUN and MOTIVATING. Apart from the obvious fun, games are used in session for several important reasons that targets a range of skills in the areas of: receptive and expressive language, articulation, phonology, motor speech, fluency, voice, and social communication skills. One of our favorite games at TALK is Guess Who, which is an engaging game that incorporates a range of concepts.

Guess Who is a great way to reward our kids while practicing their skills. The game itself targets a wide range of speech and language development goals. Let’s break it down by some areas:

Receptive/Expressive Language:

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·       Basic concepts (e.g., boy/girl, colors, etc.)

·       Following directions

·       Reasoning and processing

·       Comprehension skills by responding to questions to put down the correct people in order to narrow down the choices

·       Using descriptive vocabulary to gain specific information

·       Forming yes/no questions (e.g., “Is your person a woman?”)

·       Understanding and using negation (e.g., “My person doesn’t have glasses.”)

You can also create your own visuals to assist in asking questions, such as a visual aid for carrier phrases (e.g., “Does your person have ______?” or “He/she is wearing _______.”).

Articulation:

·       Target speech sound errors at the structured conversation level

·       The phonemes /s/ and /z/ are sounds that come up frequently in the game (e.g., “Does your person have a mustache?)

·       The phoneme /r/ (e.g., “Is your person wearing a hat?”)

·       Monitor in conversation when your child is not paying attention to their articulation

Fluency:

·       Praise/reinforce smooth speech in the moment when asking questions

·       Video tape your child during the game and watch it together after the game. Have him/her identify when smooth or bumpy speech was used

·       Practice using smooth speech with learned stuttering modification and strategies (e.g., easy onset, pull out, cancellations, light articulatory contact, etc.)

Voice:

·       Practice speaking rate, pitch and volume when asking and answering questions 

Social Communication:

·       Elicit turn-taking

·       Encourage help and self-advocacy skills by reminding your child to ask for a repetition of the question or ask for clarification

Fortunately, Guess Who is very adaptable for specific goals. For example, create your own cards for each window to target verbs, places and nouns. You can even glue family members’ pictures on the back, and have your child ask social questions by formulating questions associated to their likes and dislikes (e.g., “Does your person like to play basketball?”). Games can easily be modified in therapy or at home to increase engagement. Modify the rules, instruction length or match concepts to what is most appropriate. The sky is the limit! The reward of playing games can help to encourage ongoing progress for overall success!

Alexia Mazzone