Posted on 1 Comment

Tips Corner: Creating Opportunities for Spontaneous and Functional Communication

In today’s guest post,  Natalie Romanchukevich advises readers on how to create opportunities to expand children’s spontaneous communication skills.

Helping young children build speech- language skills is an exciting job that both caregivers and educators try to do every second of the day.  We spend so much time giving our children directions to follow, asking them a ton of questions, and modeling words and phrases to shape them into eloquent communicators.

What I find we do NOT do enough, sometimes, is hold back on our never ending “models” of what or how to say things, questions, and directions, instead of allowing our children initiate and engage with us.  Greenspan refers to these initiations as opening circles of communication (Weirder & Greenspan “Engaging Autism”, 2006).

Speech- language development can be thought of as having three interacting and equally important domains- Form ,Content, and Use (Lahey, 1988).

Form refers to the grammatical correctness of our words and sentences (eat vs. eat+ ing).

Content is what the we are essentially communicating- the meaning of our words and sentences.

Use (also known as pragmatics) refers to the function of our words or for what purpose we are using them.

The communicative functions that slowly emerge and characterize communication over the course of language acquisition in vary in typically developing young children.  Children communicate to greet others, comment on objects/actions, request desired objects, request assistance, protest, deny (a statement), ask questions, regulate others (e.g. “blow!”, “open!”), entertain, and narrate events.

In order for children to be able to express these functions, aside from the intent to communicate, there must also be opportunities to express ideas, wants, needs.  For example, why would Timmy request for an object (nonverbally or verbally) if the caregiver hands everything to the child at the slightest sign of a tantrum.  Why ask a “where?” question if every toy or beloved object is comfortably in sight?  Why ask for help if the caregiver readily assists the child with all activities.  The educators describe it as assuming the child’s needs.

Of course we do it out of love and care for the child, and, let’s be honest, sometimes, to save time.  However, it is important with both typical and delayed children to be mindful of what (form, content, use) we model, when (timing is crucial in teaching) we model it, how (facial expression, tone of voice, etc) we model it, and why (is it developmentally important to teach it now?) we model it at this very moment.

Just as it is important for kids to comprehend concepts, follow directions, and understand the different wh- questions, it is also paramount that your child is able to initiate communication.  After all, communication is the ability to express ideas, thoughts, and wants, not just understand those expressed by others.  Answering questions and following commands is not initiating.  Language that is elicited by us- is not spontaneous.

To use language spontaneously, effortlessly and creatively, children need opportunities to practice the skill, to experience taking the lead.  In order for our children to get there, we must first offer models of how to initiate communication and do so appropriately.  We can then create opportunities for the child to speak up.

The most basic strategies you can use to encourage spontaneous initiations (whether nonverbal or verbal) may seem seem initially as counterintuitive.  I mean what is the point to introducing attractive new toys or displaying a yummy snack and then putting it away? Yet it is exactly that action which may very much encourage your child to run after you with gestures or words.  Even then, you may still choose to play “dumb” and be “unsure” as to what it is your child wants.  Does s/he want that bag with new toy or snack “opened?” and “out?”

If the child is nonverbal, his use of gestures to regulate your actions to get the desired item out and open may be the child’s initial step toward sound imitation.  If you are working on getting the child to request help (not just objects), here is your opportunity to model “help” if the child can’t open the item independently.  On a side note, I often hear educators model “help me please!” when the child is clearly at a single word level.  This is not a developmental way of teaching.   Yes, it is nice to hear a full sentence but your child may not be ready for it.

While playing with your child and actively commenting on your joint play, you may find it productive to suddenly become quiet and cease all attempts to ask questions.   This often works beautifully in my therapy sessions; usually, after I have engaged the child into some sort of cooperative and enjoyable play! But it takes a conscious effort and self-control on the part of the adult, since we are so used to engaging in this adult- directed (telling the child what to do as opposed to letting him/her lead and you follow) approach to teaching.

However, once you are able to contain your speech and actions (I promise you it is possible), you may be surprised to hear some immediate or delayed imitations of words/ phrases as well as spontaneous meaningful language.  The language produced, to me, is an indication that the child wants more of the experience- more language enriched play.  Use this opportunity to expand on what s/he is already saying.

Here, timing is really important as you want to imitate back everything your child is doing.  This is another way to communicate with your child.  Build on your child’s language to further describe the objects or people in play without using long sentences.  So, allowing nothing to happen for a few minutes at a time may just be the push to help your child come out with some form of communication.

In addition, stopping a novel activity or toy exploration at the very height of your child’s excitement also works well with many children.  You don’t have to be  confrontational about it, “if you don’t imitate my word/ phrase I just won’t give it back to  you”.  make sure to create these “obstructions”, as Greenspan refers to them, in a friendly, playful and positive manner.  Obstructions or fabricated “problems” are also a big part of social-cognitive and constructivist theories of language learning.

The idea behind these “obstructions” is that the children are forced to problem solve and use resources (language being one of them!) so they can get what they want.  Allowing your child to problem solve is critical to overall cognitive development that affects and shapes speech and language. Presenting your child with developmentally appropriate activities that involve thinking and figuring out of how to get X is an invaluable strategy that I always use with all of my children.

In sum, stop access to items that are already loved, tape up containers, close boxes and jars with favorite snack and toys, give your child all but ONE important item that is needed to complete an activity (glue, scissors), give your child the “wrong” item, or offer the “wrong” solution to the problem.  All of these “problems” will push the kid to think and figure out what to do next.  This, in turn, facilitates spontaneous language use.

Letting go of control and just allowing for things to spill, break, or simply not follow the predictable comfortable routine, too, elicits a ton of speech- language and fun communication.  These are the most teachable moments as our children experience all the new words and concepts first hand.  Perhaps, this is why many children learn “dirty” or “wet” attributes before they learn their colors.  These concepts are more easily learned because they are experiential and bring about relevant words to describe these personally relevant and emotional experiences.  Cleaning up and taking turns arranging things back in place is super educational too as our children need to learn responsibility and helping others.

Moreover, exposing children to objects that are completely novel and foreign (but safe!) may help elicit an attempt to ask a question “what this?” because the child wants to know.  The motivation is there.  Now s/he needs language to get the answer from you.  Some children may use a word with a rising intonation, which too is a question form, just not grammatically mature one.  For example, “Hat?” is as much of a question as “Is that a hat?!”.  If all your child is capable of verbalizing is “wow”, then you can go ahead and model “what IS that?” question a few times.  Of course, you want to pair it up with an exaggerated expression of surprise and excitement in your voice.

To sum up, do not be afraid to experiment, get “messy”, stay silent, entice, intrigue and just wait for a few minutes to see what your child will do.  Yes, we want to teach our children to attend, sit down for a structured activity, and identify objects, shapes, colors, and actions; but these adult- directed activities do not allow for self- expression or spontaneous language use.  You also want to follow your child’s natural interests and inclinations as this is frequently a way into their world.  If you show interest in your friend’s ideas and you let him/her speak, will they not want to bond with you even more? Will they not want to communicate with you?

Creative and talented teachers are those who can use unconventional materials presented in unexpected ways while targeting all the skills that must be learned!  Learning to manipulate the environment to get the most out of your child’s skills can be difficult but indescribably rewarding.

References:

  1. Lahey, M. (1988). Language disorders and Language Development.
  2. Greenspan, S. & Weider, S. (2006). Engaging Autism: Using the Floortime approach to help children related, communicate, and think.
  3. Wetherby, A. & Prizant, B. (1990). Communication and Symbolic Behavior Scales. ChicagoIL: Applied Symblix. 

nrslp

Natalie Romanchukevich has a MS in Communication Sciences and Disorders from Long Island University (LIU) as well as Bilingual (Russian/English) Certification, which allows her to practice speech- language pathology in both Russian and English. Following graduation, Natalie has been working with both monolingual and bilingual 0- 5 population in New York City, and has been an active advocate for preschoolers with disabilities in her present setting.  Natalie’s clinical interests and experience have been focused on  early childhood speech- language delays and disorders including speech disorders (e.g., Articulation, Childhood Apraxia of Speech (CAS), Pervasive Developmental Disorders, Autistic Spectrum Disorders,  Auditory Processing Disorders, Specific Language Impairment (SLI), as well as Feeding Disorders. Presently she is working on developing her private practice in Brooklyn, NY.

Posted on 3 Comments

Improving Emotional Intelligence of Children with Social Communication Disorders

Our ability to recognize our own and other people’s emotions, distinguish between and correctly identify different feelings, as well as use that information to guide our thinking and behavior is called Emotional Intelligence (EI) (Salovey, et al, 2008).

EI encompasses dual areas of: emotion understanding, which is an awareness and comprehension of one’s and others emotions (Harris, 2008) and emotion regulation, which are internal and external strategies people use to regulate emotions (Thompson, 1994).

Many students with social communication challenges experience problems with all aspects of EI, including the perception, comprehension, and regulation of emotions (Brinton & Fujiki, 2012).

A number of recent studies have found that children with language impairments also present with impaired emotional intelligence including impaired perception of facial expressions (Spackman, Fujiki, Brinton, Nelson, & Allen, 2005), prosodic emotions (Fujiki, Spackman, Brinton, & Illig, 2008) as well as abstract emotion comprehension (Ford & Milosky, 2003).

Children with impaired emotional intelligence will experience numerous difficulties during social interactions due to their difficulty interpreting emotional cues of others (Cloward, 2012).  These may include but not be limited to active participation in cooperative activities, as well as full/competent interactions during group tasks (Brinton, Fujiki, & Powell, 1997)

Many students with social pragmatic deficits and language impairments are taught to recognize emotional states as part of their therapy goals. However, the provided experience frequently does not go beyond the recognition of the requisite “happy”, “mad”, “sad” emotions. At times, I even see written blurbs from others therapists, which state that “the student has mastered the goals of emotion recognition”.  However, when probed further it appears that the student had merely mastered the basic spectrum of simple emotional states, which places the student at a distinct disadvantage  as compared to typically developing peers who are capable of recognition and awareness of a myriad of complex emotional states.

03well_eyes-tmagArticle

That is why I developed a product to target abstract emotional states comprehension in children with language impairments and social communication disorders. “Gauging Moods and Interpreting Abstract Emotional States: A Perspective Taking Activity Packet” is a social pragmatic photo/question set,  intended for children 7+ years of age, who present with difficulty recognizing abstract emotional states of others (beyond the “happy, mad, sad” option) as well as appropriately gauging their moods.

Many sets contain additional short stories with questions that focus on making inferencing, critical thinking as well as interpersonal negotiation skills.  Select sets require the students to create their own stories with a focus on the reasons why the person in the photograph might be feeling what s/he are feeling.

There are on average 12-15 questions per each photo.  Each page contains a photograph of a person feeling a particular emotion. After the student is presented with the photograph, they are asked a number of questions pertaining to the recognition of the person’s emotions, mood, the reason behind the emotion they are experiencing as well as what they could be potentially thinking at the moment.  Students are also asked to act out the depicted emotion they use of mirror.

Activities also include naming or finding (in a thesaurus or online) the synonyms and antonyms of a particular word in order to increase students’ vocabulary knowledge. A comprehensive two page “emotions word bank” is included in the last two pages of the packet to assist the students with the synonym/antonym selection, in the absence of a thesaurus or online access.

Students are also asked to use a target word in a complex sentence containing an adverbial (pre-chosen for them) as well as to identify a particular word or phrase associated with the photo or the described story situation.

Since many students with social pragmatic language deficits present with difficulty determining a person’s age (and prefer to relate to either younger or older individuals who are perceived to be “less judgmental of their difficulties”), this concept is also explicitly targeted in the packet.

This activity is suitable for both individual therapy sessions as well as group work.  In addition to its social pragmatic component is also intended to increase vocabulary knowledge and use as well as sentence length of children with language impairments.

Intended Audiences:

  • Clients with Language Impairments
  • Clients with Social Pragmatic Language Difficulties
  • Clients with Executive Function Difficulties
  • Clients with Psychiatric Impairments
    • ODD, ADHD, MD, Anxiety, Depression, etc.
  • Clients with Autism Spectrum Disorders
  • Clients with Nonverbal Learning Disability
  • Clients with Fetal Alcohol Spectrum Disorders
  • Adult and pediatric post-Traumatic Brain Injury (TBI) clients
  • Clients with right-side CVA Damage

Areas covered in this packet:

  1. Gauging Age (based on visual support and pre-existing knowledge)
  2. Gauging Moods (based on visual clues and context)
  3. Explaining Facial Expressions
  4. Making Social Predictions and Inferences (re: people’s emotions)
  5. Assuming First Person Perspectives
  6. Understanding Sympathy
  7. Vocabulary Knowledge and Use (pertaining to the concept of Emotional Intelligence)
  8. Semantic Flexibility (production of synonyms and antonyms)
  9. Complex Sentence Production
  10. Expression of Emotional Reactions
  11. Problem Solving Social Situations
  12. Friendship Management and Peer Relatedness

This activity is suitable for both individual therapy sessions as well as group work.  In addition to its social pragmatic component is also intended to increase vocabulary knowledge and use as well as sentence length of children with language impairments. You can find it in my online store (HERE).

Helpful Smart Speech Resources:

References:

  1. Brinton, B., Fujiki, M., & Powell, J. M. (1997). The ability of children with language impairment to manipulate topic in a structured task. Language, Speech and Hearing Services in Schools, 28, 3-11.
  2. Brinton B., & Fujiki, M. (2012). Social and affective factors in children with language impairment. Implications for literacy learning. In C. A. Stone, E. R. Silliman, B. J. Ehren, & K. Apel (Eds.), Handbook of language and literacy: Development and disorders (2nd Ed.). New York, NY: Guilford.
  3. Cloward, R. (2012). The milk jug project: Expression of emotion in children with language impairment and autism spectrum disorder (Unpublished honor’s thesis). Brigham Young University, Provo, Utah.
  4. Ford, J., & Milosky, L. (2003). Inferring emotional reactions in social situations: Differences in children with language impairment. Journal of Speech, Language, and Hearing Research, 46(1), 21-30.
  5. Fujiki, M., Spackman, M. P., Brinton, B., & Illig, T. (2008). Ability of children with language impairment to understand emotion conveyed by prosody in a narrative passage. International Journal of Language & Communication Disorders, 43(3), 330-345
  6. Harris, P. L. (2008). Children’s understanding of emotion. In M. Lewis, J. M. Haviland-Jones, & L. Feldman Barrett, (Eds.), Handbook of emotions (3rd ed., pp. 320–331). New York, NY: Guilford Press.
  7. Salovey, P., Detweiler-Bedell, B. T., Detweiler-Bedell, J. B., & Mayer, J. D. (2008). Emotional intelligence. In M. Lewis, J. M. Haviland-Jones, & L. Feldman Barrett (Eds.), Handbook of Emotions (3rd ed., pp. 533-547). New York, NY: Guilford Press.
  8. Spackman, M. P., Fujiki, M., Brinton, B., Nelson, D., & Allen, J. (2005). The ability of children with language impairment to recognize emotion conveyed by facial expression and music. Communication Disorders Quarterly, 26(3), 131-143.
  9. Thompson, R. (1994). Emotion regulation: A theme in search of definition. Monographs of the Society for Research in Child Development, 59(2-3), 25-52

a Rafflecopter giveaway

Posted on Leave a comment

Improving Social Skills of Language Impaired Children

social kids

Many children on our caseloads have social pragmatic language goals aimed at improving their social emotional functioning in a variety of settings.  In therapy we often target our clients ability to engage in interpersonal negotiations, interpret ambiguous facial expressions, as well as appropriately relate to peers.

However, oftentimes finding appropriate and relevant real-life photos is a challenge for busy clinicians. That is why I created the “Social Pragmatic Language Activity Pack“.

This 30 page social pragmatic photo/question set is intended for children ages 6 and older. It is organized in a hierarchy of complexity ranging from basic social scenarios to more abstract and socially ambiguous situations.  Some photos contain additional short stories with questions that focus on auditory memory, processing, and comprehension.

There are on average 10-20 questions per each photo, and each photo takes up one page.  While some scenarios may be suitable for younger children, most are suitable for children ages 8-9 and older. Select scenarios containing abstract concepts may be suitable only for upper elementary or middle school aged students.   These sets are suitable for both individual therapy sessions as well as group work. Depending on the student’s abilities and extent of deficits, one set (one page) may take up to 30 minutes to complete.

Areas covered by the questions:

  1. Recognizing Emotional Reactions
  2. Explaining Facial Expressions
  3. Making Predictions
  4. Making Inferences (re: people, locations, thoughts, feelings, and actions)
  5. Multiple Interpretations (of actions and settings)
  6. Interpersonal Negotiations
  7. Sympathy/Empathy
  8. Peer Relatedness (Support)
  9. Interpreting Ambiguous Situations
  10. Problem Solving
  11. Determining Solutions
  12. Determining Causes
  13. Determining Perspectives
  14. Social Judgment
  15. Safety Rules

So don’t delay and grab your set today. You can find it HERE in my online store.

Posted on 1 Comment

Free Literacy Assessment Resources for SLPs

A few years ago I wrote a post, which offered a compilation of FREE literacy resources for parents and professionals. Today I would like to expand upon my previous article by providing professionals with a compilation of free literacy assessment tools.

Assessment tools tend to be expensive. Few professionals have unlimited budgets to purchase the myriad of tests needed to appropriately assess a host of skills associated with reading, spelling, and writing. Below is a list of helpful free materials to assist SLPs on tight budgets testing children with suspected reading, spelling, and writing deficits.

First, let us briefly review a few essential components involved in skilled reading, which are:

Continue reading Free Literacy Assessment Resources for SLPs
Posted on Leave a comment

Spotlight on Syndromes: An SLPs Perspective on Spinal Muscle Atrophy

The following is an informational post on the disease SMA (spinal muscle atrophy) by Rose Ann Kesting M.A. CCC-SLP. After reading, please visit her blog post “My Wednesday Morning Wake Up Call,” for a personal account of her experience with a very special boy with Type 1 SMA and his amazingly dedicated family. Continue reading Spotlight on Syndromes: An SLPs Perspective on Spinal Muscle Atrophy

Posted on 3 Comments

Pediatric Background History Questionnaire Giveaway

peds questionnaireToday I am very excited to introduce my new product “Pediatric Background History Questionnaire”. I’ve been blogging quite a bit lately on the topic of obtaining a thorough developmental client history in order to make an appropriate and accurate diagnosis of the child’s difficulties for relevant classroom placement, appropriate accommodations and modifications as well as targeted and relevant therapeutic services.  
Continue reading Pediatric Background History Questionnaire Giveaway

Posted on Leave a comment

FREE Resources for Working with Russian Speaking Clients: Part III Introduction to “Dyslexia”

Image result for дислексияGiven the rising interest in recent years in the role of SLPs in the treatment of reading disorders, today I wanted to share with parents and professionals several reputable  FREE resources on the subject of “dyslexia” in Russian-speaking children.

Now if you already knew that there was a dearth of resources on the topic of treating Russian speaking children with language disorders then it will not come as a complete shock to you that very few legitimate sources exist on this subject.

Related imageFirst up is the Report on the Russian Language for the World Dyslexia Forum 2010 by Dr. Grigorenko, the coauthor of the Dyslexia Debate. This 25-page report contains important information including Reading/Writing Acquisition of Russian in the Context of Typical and Atypical Development as well as on the state of Individuals with Dyslexia in Russia.

Related imageNext up is this delightful presentation entitled: “If John were Ivan: Would he fail in reading? Dyslexia & dysgraphia in Russian“. It is a veritable treasure trove of useful information on the topics of:

  • The Russian language
  • Literacy in Russia (Russian Federation)
  • Dyslexia in Russia
    • Definition
    • Identification
    • Policy
  • Examples of good practice
    • Teaching reading/language arts
      • In regular schools
      • In specialized settings
    • Encouraging children to learn

Image result for orthographyNow let us move on to the “The Role of Phonology, Morphology, and Orthography in English and Russian Spelling” which discusses that “phonology and morphology contribute more for spelling of English words while orthography and morphology contribute more to the spelling of Russian words“. It also provides clinicians with access to the stimuli from the orthographic awareness and spelling tests in both English and Russian, listed in its appendices.

Finally, for parents and Russian speaking professionals, there’s an excellent article entitled, “Дислексия” in which Dr. Grigorenko comprehensively discusses the state of the field in Russian including information on its causes, rehabilitation, etc.

Related Helpful Resources:

  1. Анализ Нарративов У Детей С Недоразвитием Речи (Narrative Discourse Analysis in Children With Speech Underdevelopment)
  2. Narrative production weakness in Russian dyslexics: Linguistic or procedural limitations?

 

Posted on 12 Comments

Articulation Assessment ToolKt

In February 2013 I did a review of the Sunny Articulation Test by Smarty Apps. At that time I really liked the test but felt that a few enhancements could really make it standout from other available articulation tests and test apps on the market. Recently, the developer, Barbara Fernandes, contacted me again and asked me to take a second look at the new and improved Sunny Articulation and Phonology Kit (SAPT-K), which is what I am doing today. Continue reading Articulation Assessment ToolKt