Speech Pathologists What do they do?

Speech Pathologists What do they do? • Assessments – Speech  Articulation Assessments • Literacy  Literacy tests (SPAT) • Language  CELF, TOLD • Swallowing • Voice • Treatment for children who have: • Trouble saying words clearly • Comprehension or understanding difficulties • Delayed verbal expression and conversational skills • Decreased ability to understand relationships between sounds and letters (early literacy development) • Delayed sound and letter sequencing ability • Swallowing/ oral motor difficulties

Speech Jargon Areas of Language • Receptive Language (comprehension) • Short Term Auditory Memory • Auditory Processing • Expressive Language • Semantics (meanings, vocabulary) • Morphology and Syntax (sentence Structure) • Phonology (speech sounds/articulation) • Phonological Awareness (Manipulation of sounds  early literacy) • Metalinguistics (sound awareness) • Pragmatics (Social skills)

IdentificationWhat do I look for? To know what is ‘abnormal’, it is vital one understands ‘normal’ development: Generally, between the ages of 3 and 6 years: • Sentences continue to develop in length and complexity, some grammatical errors can still be present. • Sentences frequently include connectors (and, then, because, but, if, so) and some more adult forms begin to appear (actually, well..) • Vocabulary expands and more adult-like words appear

Language is used for social purposes (asking questions, commenting, instructing, negotiating, ‘basic thinking’ – planning, organizing, suggesting, defining). • Ability to retell stories, recount events accurately and with little support. • Understanding of more complex questions and concepts occurs • Ability to follow 3 stage instructions develops • Speech is generally intelligible

Classic Red Lights in the classroom • Sentences remain simple (no use of connecting words to join ideas) • Can not retell a story or an event, with minimal support • Speech is echolalic (repetition of friends, teachers) • Poor understanding of more difficult concepts (e.g.. Before/after, in front of, last/first, high/low). • Difficulty following instructions of 2+ stages (e.g.. Get the ball, then get the sock and pen) • Difficulty with more ‘thinking’ questions (e.g.. How are these same/different? What will happen next?) • Understands only very basic story plots

Not using language to tell stories, argue, instruct, question, plan, explain basic negotiation • Not developing more sophisticated play (e.g.. Fantasy play) • Poor conversational skills (e.g. Can’t keep on topic, very reliant on conversational partner, perseverates on topics) • Poorly developed social skills (e.g.. Ability to deal with conflict) • No awareness of rhyme, sounds (e.g.. My name starts with a ..) • Speech is difficult to understand on occasions (child at this age should have most sounds) • Stuttering

Delayed Development in Comprehension • A child with comprehension difficulties can often be seen as naughty, an inconsistent performer, easily distracted and may: • Have difficulty in following instructions • Need to have instructions repeated or simplified • Not respond • Give incomplete or inappropriate answers to questions • Show lack of understanding of abstract language concepts (e.g.. Letters, sounds) • Have little awareness of their own poor comprehension and not know when or how to ask for help • Find it difficult to interact with their peers (e.g.. In games, conversation)

The child with difficulties understanding language will often try very hard to fit in and to do what other children are doing. Many develop very effective coping strategies which can mask the difficulty the child is having. They may: • Rely on watching and following other children • Become overly dependant on routine and unable to function readily outside the classroom routine • Become the ‘naughty’ child – the child has learnt that by being non co-operative the teacher is likely to give 1:1 attention, to simplify/separate instructions and may even use gesture to get the message across – all of which aid comprehension.

Delayed Development - Semantics • A child with difficulties in this area may: • Use a lot of non-specific words such as ‘this’, ‘that’, ‘there’, or ‘over there’ • Use gesture and pointing instead of words • Use ‘made up’ words (jargon) instead of real words • Have significant word finding difficulties requiring extra time to search for an appropriate word.

The child may have difficulty in: • Understanding the meaning of words/concepts and the relationship between words (semantic relationships) • Understanding adjectives and adverbs (e.g.. Tall/short, near/far, first/last) • Recalling adjective sequences (e.g.. A small, yapping gray dog) • Understanding prepositions (e.g.. On/in, under, behind, in front of) • Understanding more complex concepts such as except, not without

Delayed Syntax / Grammar • A child should be able to hold a conversation with an adult. They should be able to: • Use some complex sentences and connectors • Use some descriptive words • Use tense markers • Monitor and if necessary repair (correct themselves/others) • A delayed child: • Has difficulty forming sentences • Uses simple, short utterances • Uses few joining words • Omits word endings (omits ‘ink's etc)

Delayed Sound Awareness (Metalinguistics) • Metalinguistics is the term used to describe a child’s ability to think about and manipulate the units of language (sounds and words) and to understand how they combine to produce meaningful oral and written language. • By the end of pre-primary a child not showing at least some of these skills should be referred for assessment: • Awareness of rhyme • Production of rhyme • Awareness of first sound in own name • Ability to clap syllables • Some awareness of sounds/letter names

Delayed Pragmatic Development • A child with appropriate pragmatic development should be able to: • Hold a conversation • Use appropriate eye contact • Change a topic appropriately • Take turns • Use a range of language functions • Maintain good body placement (maintain own space)

A child with delayed pragmatic skills is often seen as ‘different’ and may exhibit: • Poor eye contact • Invades personal space • Bring in irrelevant topic/responses • Poor listener awareness • Difficulties in peer group relationships • Poor understanding of social boundaries (e.g.. Very affectionate) • Unusual voice pattern • Need help to maintain conversation

Articulation / Phonology (Speech) • Articulation refers to a child’s speech sound production. Speech sounds develop through the first seven years of life. • Neurological (dyspraxia), motor disorder or lack of sound awareness/self monitoring. • ‘Normal’ development can differ between children. • Various factors may influence a child's ability to produce a sound and some may be physical (e.g.. A child who has lost their front teeth would have difficulty producing a ‘s’ sound).

Normal Development

Stuttering • Approximately 1% of the population stutter • Observable verbal feature of a stutter may include: • Repetitions (c, c, cat) • Prolongations (ccccc, at) • Blocks (i.e.. Silent struggles) • Fillers (e.g.. ‘er’, ‘um’) • Associated non-verbal characteristics may include: • Body tension • Eye blinking • Reduced eye contact • Facial grimaces • Unnecessary body movements • Avoidance of speaking situations • DON’T WAIT TO SEE IF A CHILD’S STUTTER WILL GO AWAY. THE EARLIER A CHILD IS SEEN THE QUICKER AND EASIER THERAPY IS.

Useful Contacts Audiologists • John Bench (Monash University) – 9531 8181 • Peter Altidis (Hampton Park and other clinics) – 9799 2233 • Simon Davis (East Melbourne – Medicare Rebate) - 9416 3285 Optometrists Melbourne Optometry Clinics: • Casey Community Health Center (Free glasses) – 9791 5700 Behavioural Opthalmologist • Norman Russo (Dandenong) - 9792 3077 • Contact Tim Fricke - 9349 7455

Referring within the school • Handout – fill in according to child’s displayed behaviors • Give consent form to parent to be filled out • Put consent form and referral form into ‘Specialist In Tray’ ?office. • These sheets will then be distributed to appropriate specialist (Psychologist, Speech Pathologist) and assessment/treatment can be commenced quickly. • To be organized at the beginning of Term 3.

Speech Pathologists What do they do?