A Preschool Teacher’s Guide to Speech and Language Intervention

1. A Preschool Teacher’s Guide to Speech and Language Intervention Presented by: Sarah Tidmore, M.S. CCC-SLP

2. What is Speech Language Pathology: • A health profession that evaluates, diagnoses, and treats speech, language, cognitive-communication, and swallowing disorders.

3. Language VS. Speech • Language is made up of socially shared rules that include: • What words mean • How to make new words • How to put words together • What word combinations are best in what situations • Speech: The actual act of producing the sounds http://www.asha.org/public/speech/development/language_speech.htm

4. Language is made up of socially shared rules 3 Subtypes of Language: • Receptive Language- How the child understands and processes what is being said to them. • Expressive Language- How the child shares thoughts, ideas, and feelings using speech. • Pragmatics- The social and emotional use of language http://www.asha.org/public/speech/development/language_speech.htm

5. Speech: The actual act of producing the sounds Components of Speech include: • Articulation: the movement of the lip, tongue, and jaw to produce the sounds of speech • Intelligibility: The percentage that you are able to understand what the child is saying • Dysfluency (Stuttering): The many forms of interruptions in the production of speech that prevent easy, effortless, and smooth flow of speech. • Voice: The use of vocal folds and breathing to create sounds • Oral Motor: How the child uses oral strength and coordination to produce adequate articulatory precision, and swallow safely and efficiently. http://www.asha.org/public/speech/development/language_speech.htm

6. Speech and Language Milestones Adapted from the American Speech-Language - Hearing Association’sHow Does Your Child Hear and Talk?(http://www.asha.org/public/speech/development/chart.htm)

7. Receptive Language: Startles at loud sounds Quiets or smiles when spoken to Seems to recognize familiar voices and quiets if crying Increases or decreases sucking behavior in response to sound Shared attention with another person Expressive Language: Makes pleasure sounds (cooing and gooing) Cries differently for different needs Smile when he/she sees you Birth to 3 months http://www.asha.org/public/speech/development/chart.htm (http://www.asha.org/public/speech/development/chart.htm)

8. Receptive Language Moves eyes in direction of sounds Responds to changes in tone of your voice Notices toys that make sounds Pays attention to music Emerging two-way engagement (peek-a-boo) Responds to name Expressive Language Babbling sounds more speech-like with many different sounds including /p/,/b/,/m/ Chuckles and laughs Vocalizes excitement and displeasure Makes gurgling sounds when left alone and when playing with you 4-6 months: http://www.asha.org/public/speech/development/chart.htm

9. Receptive Language Enjoys games like pat-a-cake Turns and looks in direction of sounds Listens when spoken to Recognizes words for common items like "cup", "shoe", "book", or "juice“ Begins to respond to requests (e.g. "Come here" or "Want more?") Expressive Language Babbling both long and short groups of sounds ex: "tata upup bibibibi“ Uses speech/non-crying sounds to get/keep attention Uses gestures to communicate (waving, holding arms to be picked up) Imitates different speech sounds Has one or two words (hi, dog, mama) around first birthday. 7 months to 1 year: http://www.asha.org/public/speech/development/chart.htm

10. What can I do to help? Birth to 1 year • Check the child's ability to hear. Pay attention to ear problems and reoccurring infections. • Reinforce the baby's communication by making meaningful eye contact, and imitating vocalizations. • Repeat/Imitate laughter and facial expressions. • Teach the baby to imitate actions, such as peek-a-boo, pat-a-cake, or waving bye-bye. • Talk while you are doing things ex: dressing or feeding • Talk about where you are going, what you are doing, and who or what you'll see. • Talk about colors, practice counting, teach animal sounds http://www.asha.org/public/speech/development/chart.htm

11. Receptive Language: Points to a few body parts when asked. Follows simple commands and understands simple questions ("Roll the ball," "Kiss the baby," "Where's your shoe?"). Listens to simple stories, songs, and rhymes. Points to pictures in a book when named. ExpressiveLanguage: Says more words every month. Uses some one- or two- word questions ("Where kitty?" "Go bye-bye?" "What's that?"). Puts two words together ("more cookie," "no juice," "mommy book"). Uses many different consonant sounds at the beginning of words. At 19-24 months should be 25-50% intelligible Participates in back and forth two way engagement and communication. 1 to 2 Years http://www.asha.org/public/speech/development/chart.htm

12. What can I do to help? 1-2 years • Talk while doing things/going places. Point to familiar objects and say their names. • Use simple but grammatical speech that is easy for the child to imitate. Ex: More cookie • Remember OWL: • Observe what the child is interested in • Wait 10-15 seconds for the child to initiate • Listen to what the child has to say • Expand on words. • Read to the child everyday, talking about the pictures on each page • Have the child point to and/or name pictures and objects. http://www.asha.org/public/speech/development/chart.htm

13. Receptive Language: Understands opposites ("go-stop) Follows two requests ("Get the book and put it on the table"). Listens to and enjoys hearing stories for longer periods of time Expressive Language: Has a word for almost everything. Uses two- or three- words to talk about and ask for things. Uses /k/, /g/, /f/, /t/, /d/, and /n/ sounds. Speech is understood by familiar listeners most of the time. Asks for/directs attention to objects by naming them. Speech is 50-75% intelligible 2-3 Years http://www.asha.org/public/speech/development/chart.htm

14. What can I do to help? 2-3 years • Use clear, simple speech that is easy to imitate. • Show interest, repeat what the child has said and expand on it. • Ask the child to repeat things that you do not understand and model correct production. • Expand on the child's vocabulary by reading books with simple sentences. • Name objects and describe the pictures in books, stating synonyms for familiar words. http://www.asha.org/public/speech/development/chart.htm

15. What can I do to help? 2-3 years (cont.) • Make a scrapbook to practice naming pictures, use gestures and speech to teach object function. • Look at family photos and name the people. Write simple phrases/sentences to describe what is happening in the pictures. • Ask the child questions that require a choice, rather than simply a "yes" or "no" answer. Ex: Do you want milk or juice? • Continue to sing songs, play finger games to introduce the child to the rhythm and sounds of language. • Help the child group objects into categories. http://www.asha.org/public/speech/development/chart.htm

16. Receptive Language: Hears you when you call from another room. Hears television or radio at the same loudness level as other family members. Answers simple "who?", "what?", "where?", and "why?" questions. Expressive Language: Talks about activities at school or at friends' homes. Unfamiliar listeners understand child's speech. Uses sentences with 4 or more words often. Talks easily without repeating syllables or words. Masters 50% of consonant and blends Speech is 80% intelligible 3-4 years http://www.asha.org/public/speech/development/chart.htm

17. What can I do to help? 3-4 years • Make silly pictures and help the child explain what is silly about the picture. • Sort pictures and items into categories, increase the challenge by asking the child to point out what is different • Expand vocabulary and the length of the child's utterances by: reading, singing, saying rhymes, talking about the surrounding environment http://www.asha.org/public/speech/development/chart.htm

18. What can I do to help? 3-4 years (cont.) • Read books that have a simple plot, talk about and reenact the story with the child. • Look at family pictures; have the child explain what is happening. • Take turns asking questions about each picture. • Expand on social communication and storytelling skills by "acting out" everyday activities. • Ask the child to repeat what they said if you do not understand. http://www.asha.org/public/speech/development/chart.htm

19. Receptive Language: Pays attention to a short story and answers simple questions about them. Hears and understands most of what is said at home and in school. Expressive Language: Uses sentences that give details ("The biggest peach is mine"). Tells stories that stay on topic. Communicates easily with other children and adults. Says most sounds correctly except a few /l/, /s/, /r/, /v/, /z/, /ch/, /sh/, /th/. Says rhyming words. Names some letters and numbers. Uses the same grammar as the rest of the family. 4-5 years http://www.asha.org/public/speech/development/chart.htm

20. What can I do to help? 4-5 years • Talk about spatial relationships (ex: in, on) and opposites • Offer a description or clues and have the child identify what you are describing. • Work on forming and explaining categories (Ex: sorting pictures of animals, foods, etc.) • Follow the child's directions as she or he explains how to do something. • Give full attention and praise to the child when he or she is speaking. • Build on the child' s vocabulary, provide definitions and use new words in context. • Encourage the child to ask for an explanation if he or she does not understand what a word means. http://www.asha.org/public/speech/development/chart.htm

21. What can I do to help? 4-5 years (cont.) • Expand on the child' s language skills by taking turns, ex: playing "I Spy“ • Give the child two-step directions • Encourage the child to explain how they have done something. • Draw a picture, and write down the child's story. The child will soon grasp the power of storytelling and written language. • Play age-appropriate board games with the child. • Have the child help you plan and discuss daily activities, asking for their opinion. http://www.asha.org/public/speech/development/chart.htm

22. What can I do to help? 4-5 years (cont.) • Play games incorporating things that are the same or different. • Sort items into categories, having the child point out more subtle differences between objects. • Expand on social communication and narration skills (telling a story) by role-playing. • Read and act out stories with easy-to-follow plots. • Help the child predict what will happen next. • Ask "wh" questions http://www.asha.org/public/speech/development/chart.htm

23. Stuttering • Adapted from Zebrowski, Patricia M., Ellen M. Kelly. Manual of Stuttering Intervention. Clifton Park: Singular Publishing Group, 2002. Zebrowski & Kelly, 2002

24. Normal Disfluencies • Types of Stuttering • Phrase Repetitions (I love..I love school) • Interjections (I , um, love school) • Word Repetitions (I..I love school) • During their preschool years children are rapidly acquiring language and speech sounds.  • A child acquires receptive concepts before expressive concepts often leading to the child knowing what they want, but not how to express it. • Many children will begin to display characteristics of disfluencies, as the child's speech and language improve, the child's disfluencies improve. Zebrowski & Kelly, 2002

25. Disordered Dysfluencies • Types of stuttering • Part Word Repetitions (W.W.Wow, I love school) • Prolongations (WWWWow, I love school) • Blocks ({ silent pause}...I love school) • Frequency: More than 10% of the conversation consists of dysfluencies • Duration: Stuttering events last longer that 1 second • There are secondary characteristics with stuttering instances: • Eye blinks • Facial tension • Labored or heavy breathing • You must look to see if it's frequent or inconsistent and if there is noticeable struggle when speaking Zebrowski & Kelly, 2002

26. Bibliography • Guitar,Barry Ph.D., University of Vermont, Edward G. Conture, Ph.D., Vanderbilt University. “7 Tips for Talking with Your Child.” The Stuttering Foundation. April 2008. Stuttering Foundation of America. http://www.stutteringhelp.org/Default.aspx?tabid=632 • “How Does Your Child Hear and Talk?” American Speech-Language-Hearing Association. 02 June 2010. <http://www.asha.org/public/speech/development/chart.htm> • Shipley, Kenneth G., Julie G. McAfee. Assessment in Speech-Language Pathology: A Resource Manual Second Edition. San Diego: Singular Publishing Group, 1998. • Templeton, 1957; Wellman et al., 1931, in Sanders- Journal of Speech and Hearing Disorders, 1973. • “What is Language? What is Speech?” American Speech-Language-Hearing Association. 02 June 2010. http://www.asha.org/public/speech/development/language_speech.htm) • Zebrowski, Patricia M., Ellen M. Kelly. Manual of Stuttering Intervention. Clifton Park: Singular Publishing Group, 2002.