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Guest Post: Improving Verbal Imitation with Animal Face Posters

animal posterToday’s guest post on how to improve verbal imitation abilities of young children with language delay comes from Rachel Arntson, M.S., CCC-SLP of the  Talk It Rock It  Blog.

When you have a young child who does not imitate or does not understand the process of taking turns, what do we do to facilitate this skill?

How do we help a child pay attention to faces and the sounds that we make?

I have been a speech-language pathologist since 1980 and have used many toys, tools, routines, books, and objects over the years to facilitate verbal imitation, engagement, and turn taking. Of all of the tools I have used, however, Animal Face Posters are at the top of the list. Continue reading Guest Post: Improving Verbal Imitation with Animal Face Posters

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Guest Post: Eliciting Language from the “SHUT-DOWN” kid

Today’s guest post on how to elicit language from children with “shut-down” tendencies secondary to significant expressive language delay comes from Rachel Arntson, M.S., CCC-SLP of the  Talk It Rock It  Blog.

Have you ever worked with a child who would shut down the minute she thought you wanted her to say something? I find this phenomenon a lot with children who display significant motor planning issues and expressive language delay. One morning, I worked with a little two year old who showed exactly that pattern. She appeared to know that imitation of sounds and words is hard. And the more that her parents showed her that they wanted her to imitate, the more she shut down. What a dilemma. Continue reading Guest Post: Eliciting Language from the “SHUT-DOWN” kid

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Guest Post: Hearing Loss and Cochlear Implants for Infants and Toddlers: an Overview

Today’s guest post from undergraduate SLP in training, Jane Jusova, provides an introduction to pediatric cochlear implants. 

Pediatric hearing loss may occur due to many reasons, which include being born with parts of the ear that didn’t form correctly and as a result don’t work well. Other problems can occur due to illness, including serious infections, such as meningitis, as well as accidents resulting in head injuries. Many children may have recurrent ear infections, causing a build-up of fluid in the middle ear, which can also cause hearing loss.

There are two major kinds of hearing loss that children can experience: conductive hearing loss and sensorineural hearing loss. Conductive hearing loss occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones called ossicles of the middle ear. This type of hearing loss can often be corrected medically or surgically. Sensorineural hearing loss on the other hand happens when the cochlea is not working correctly because the tiny hair cells are damaged or destroyed. Depending on the loss, a person might hear most sounds (although they would be muffled), hear in quiet spaces but not in noise, hear only some sounds, or hear no sounds at all.

Sensorineural hearing loss is almost always permanent and a child’s ability to develop typically may be affected by it. Hearing loss in children can have a harmful effect on their speech and language development. There are several effective treatments for sensorineural hearing loss, one of which is cochlear implants. Children who are deaf or severely hard-of-hearing can be fitted for cochlear implants.

A cochlear implant is a surgically implanted device that replaces hair cells in the cochlea and under the skin behind the ear for the purpose of providing useful sound perception via electrical stimulation of the auditory nerve to restore hearing to a severely or profoundly deaf individual.

Since the first cochlear implant approved by the US Food and Drug Administration in the early 1980s, great advances have occurred in cochlear implant technology. In the United States, roughly 38,000 children have received them.

Cochlear implants can be implanted in prelingually or postlingually deaf children. A good candidate for a pediatric cochlear implant is a child at least 12 months of age with severe to profound sensorineural hearing loss in both ears who demonstrates limited or no functional benefit from conventional hearing aid amplification.

Cochlear implant evaluation can begin prior to 12 months of age. There is a comprehensive testing performed by audiologists and speech language pathologists to evaluate candidacy for a cochlear implant.

Children who end up receiving cochlear implants require ongoing audiological management and otolaryngological follow up. Ongoing management by an audiologist includes programming the implant parameters and monitoring device performance from electrical threshold and dynamic range data. Electrically evoked auditory brainstem responses (EABR), middle latency responses (MLR), or acoustic reflexes (EART) may be used intraoperatively with stimuli delivered to the cochlear implant prior to leaving the operating room or postoperatively on outpatient basis to facilitate the fitting process. These objective measures can be particularly useful in children who are either difficult to condition or otherwise unable to respond consistently to the electrical stimuli used to program the speech processor.

Follow up audiological evaluations are required to assess improvement in sound and speech detection and auditory reception of speech following implantation. Medical evaluation by an otolaryngologist should be performed as needed to monitor the postoperative course and medical status of the child.

Approximately one month after surgery, the audiologist activates the implant. Weekly, then monthly, extending to visits three to four times per year, the implant settings are adjusted. Biweekly auditory therapy is recommended for each child. Therapy may take place either by team therapists or by other professionals in the school or community. Annual evaluations with the audiologist, speech language pathologist and social worker document the child’s progress and allow any concerns to be addressed.

In addition to facilitating the child’s development of sound awareness and sound discrimination, the role of SLP also includes providing parental education about cochlear implants to ensure that the parents understand the importance of device compliance. This includes asking parents to keep track of how many hours a day the child wears the device, explaining to the parents the input that the cochlear implants provide and the importance of assuring the child wears the device consistently, teaching parents how they can ensure that the child continues to wear the device (e.g., distracting the child if he or she reaches to pull out the device as a means of interrupting the behavior, using praise once the child stops trying to pull out the device, etc.,)

Children who have lost all or most of their hearing later in life will benefit tremendously from cochlear implants. They learn to associate the signal provided by an implant with sounds they remember. This often provides recipients with the ability to understand speech solely by listening through the implant, without requiring any visual cues such as those provided by lip reading or sign language.

Cochlear implants, coupled with intensive post implantation speech therapy, can help young children to acquire speech, language, and social skills. Early implantation provides exposure to sounds that can be helpful during the critical period when children learn speech and language skills.


  • American Speech-Language Hearing Association. Degree of Hearing Loss.
  • American Speech-Language Hearing Association. Working Group on Cochlear Implants
  • American Speech-Language Hearing Association. Cochlear Implants and the SLP 
  • Koch, D.B. (2000). Hearing Loss & Cochlear Implants. The Children’s Hearing Institute.
  • Niparko, J., Lingua, C., & Carpenter, R. (2009). Assessment of candidacy for cochlear implantation. In J. K. Niparko (Ed.), Cochlear implants: Principles & practice (2nd edition, pp. 313-345). Baltimore: Lippincott Williams & Wilkins.
  • Papsin BC & Gordon KA. (2007). Cochlear implants for children with severe-to-profound hearing loss. New England Journal of Medicine, 357, 2380-2387.
  • Peters, B.R. (2006). Rationale for bilateral cochlear implantation in children and adults. White paper available from Cochlear Americas.

183857_490704327630675_423773830_nBio: Jane Jusova is currently an undergraduate in a Speech Language Pathology program at Adelphi University. Her interests include Early Intervention, Autism Spectrum Disorders as well as fluency.

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Guest Post: Makes Me Want To Sing – Improving Your Child’s Speech and Language Skills through Music

Rachel_Drew_6x6_300dpiToday’s guest post on how to use music to improve children’s speech language abilities comes from Rachel Arntson, M.S., CCC-SLP of the  Talk It Rock It  Blog.

Have you ever watched a group of pre-school children dance and sing to their favorite rendition of “The Wheels on the Bus” or “Twinkle, Twinkle Little Star”?  With a song in their heart, children show freedom in their movement, smiles on their faces, and uninhibited singing that most adults would only do in the shower.  There is something about music that seems to capture the very essence of who children are.  What draws children to sing and enjoy music so much? What do they learn from listening to and participating in music?  Can such a wonderful tool like music be used to help other areas of development? Continue reading Guest Post: Makes Me Want To Sing – Improving Your Child’s Speech and Language Skills through Music

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Guest Post: And Now a Word About Cup Drinking

In today’s guest post,  Natalie Romanchukevich discusses the importance of cup drinking. So without further ado here is what she has to say on this subject.

As I do my home- based evaluation or treatment visits, I often notice that many of my 2 and3 year olds still drink out of a bottle, when developmentally, they should be using cups and straws to drink.

While some parents do not want to engage in the process of weaning their child off the much beloved liquids container, others do not realize the importance of introducing a more “mature” way of drinking. Continue reading Guest Post: And Now a Word About Cup Drinking

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B-Day Extravaganza Day 31: Cost Effective Voice Therapy Tools for the School SLP and Text Message Inferencing Giveaway

Cost-Effective-Voice-Therapy-ToolsToday’s informative guest post on effective voice therapy tools for school-based SLPs comes from Jessica Chase of the the Consonantly Speaking blog. So without further ado, here’s what Jessica has to say on the subject.

In graduate school, I was lucky enough to spend a semester in the on-campus voice clinic. It was equipped with a Visi-Pitch, nasometer, and video laryngeal stroboscopy system. I was able to assess and treat vocal disorders ranging from vocal nodules to  hypernasality due to a cleft palate with ease. Fast-forward 4 years and you now can find me at a public school with no Visi-Pitch, nasometer, or video laryngeal stroboscopy system. Of course, I have used and continue to use many therapy techniques to work with my students with voice disorders, but I do miss the quality of the visual feedback the trio of hardware/software provided. Without the funding to purchase and host my own voice clinic within the school, as well as the minimal amount of voice clients on my caseload, I had to find other resources to provide visual feedback at a lower cost. In this post, I will talk about some of the cost-effective resources I have found to use with students on my caseload that provide visual and auditory feedback for my voice clients. Continue reading B-Day Extravaganza Day 31: Cost Effective Voice Therapy Tools for the School SLP and Text Message Inferencing Giveaway

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Guest Post: Becoming a Mindful Observer during Your Speech Sessions

Today’s awesome guest post is brought to you by Kimberly Scanlon of Scanlon Speech Therapy. 

Can I tell you a secret? When I was a young girl I wanted to be a detective. I loved Nancy Drew and daydreamed about being a real life Harriet the spy. Flash forward 20 years, I’m a speech language pathologist and mom. The closest I get to being a spy is eavesdropping on strangers’ conversations. This, of course, drives my husband nuts. Consider yourself warned if you ever sit at the table next to me.

Well, one thing I did pick up from my younger days of spying is how to be a pretty good observer. I love reading facial and body expressions. This quirky preoccupation actually helps to maximize my therapy sessions. But, you know what? When I’m stressed and rushing around, my keen powers of observation are greatly diminished. Continue reading Guest Post: Becoming a Mindful Observer during Your Speech Sessions

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Guest Post: A Sensory Story

Today I have the pleasure of  bringing you once again another great guest post by Connie Hunt on the topic of Sensory Processing Disorders, a condition which can be easily mistaken for problem behavior if one doesn’t know what signs to look out for.  So take a look at Connie’s story below. 

Let me tell you about a child….

Some might call her difficult. Others might call her spirited or spoiled.

Obnoxious. Annoying. Bratty. Bossy. Controlling. Hyper-sensitive. Lazy. Rude. Antisocial. Manipulative.

Unmanageable. Undisciplined. Uncooperative. Unlikeable.

Her poor family… Continue reading Guest Post: A Sensory Story

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Guest Post: Transition to Kindergarten: Are bilingual students with speech-language delays being placed in more restrictive settings?

In today’s guest post, a NYC based colleague, raises a few provocative and thought provoking questions regarding the appropriateness of restrictive classroom settings for bilingual children with limited English proficiency.  Read more to find out what she has to say on this highly relevant and timely topic. 

In a special education preschool, speech- language pathologists are an integral part of an interdisciplinary team.  This team is usually comprised of a special education teacher, a school psychologist, a speech- language pathologist (SLP) as well as occupational (OT) and physical therapists (PT).  Ideally, all disciplines meet together on weekly or bi- weekly basis to discuss each student’s relevant progress, persisting difficulties brainstorm ideas for further treatment.  This is the time when everyone ‘gets on the same page’.  Opinions are voiced.  Collaborative decisions are made. Goals are re- thought and outcomes are re- measured. Continue reading Guest Post: Transition to Kindergarten: Are bilingual students with speech-language delays being placed in more restrictive settings?

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Guest Post: Working with Children of Varying Ages: Activity Suggestions

While some speech language pathologists specialize in working with specific age groups of children only (e.g., preschoolers, elementary age children, adolescents, etc) most pediatric SLPs, especially ones serving schools, work with children of varying ages and abilities. Oftentimes, creating tasks and activities is a challenge especially for those of us who have particularly large caseload of students. Today, one of my guest bloggers, Teach Speech 365, will be offering some ideas on how to work with school aged children of different ages and abilities. 

I’m honored to be doing a guest post for Smart Speech Therapy, LLC! The bulk of my experience has been in the schools. I have worked with students ages 3-21, which has included elementary, middle, and high school aged students. With that variety comes some unique challenges, so I am sharing some things that I did while working with such a wide range of ages. Continue reading Guest Post: Working with Children of Varying Ages: Activity Suggestions