Friday, April 1, 2011

Correcting Articulation at Home - Step 1: Does My Child Have a Problem?

In the realm of speech and language issues with children, one of the most common questions home educating moms ask at online forums and message boards is, "What do I do to help my child pronounce words correctly?" Occasionally I'll pipe up and offer my 2 cents because I was a speech language pathologist (speech therapist) before retiring to stay at home and educate my boys.  I have seen it all from a speech, language and cognitive perspective.

Now, after a year of false starts and deleted posts, I'm finally ready to tackle these questions on my blog -- a sort of resource for home educators (or not -- the information applies to all). 

And, instead of re-writing what is readily available on the internet, I decided to peruse the web and find what I think are the best sites to answer questions that parents might have about articulation problems. Now, there is a LOT on information on the web about these issues, but I am taking a slightly different viewpoint than many of my colleagues. First, here's what I believe:

  • Mama (and Daddy) knows best.  You know your child, personality, development, and how s/he interacts with the world.  Moms (and Dads) need to be listened to throughout the process.  If you are concerned, be your child's advocate and work to get answers. Listen to your intuition. 
  • Therapy is not rocket science for basic articulation disorders such as a child is saying "w" and not "l" or "r." Or perhaps you here "d" instead of "th" sounds.  I totally believe that parents can be trained to offer exercises and engage in activities with their child to help their child make positive changes in their speech (and language, too, but I'm just focusing on speech right now). 

I need to offer a caveat to my definition of "basic."  When I say basic articulation disorders, I mean  that a doctor, audiologist, and/ or speech-language pathologist has looked at your child and ruled out neurological problems, hearing problems, developmental, and physical problems.  Motor-planning problems (apraxia of speech) also can cause significant speech and language delays.  Adding any of these issues is not "basic." If you are dealing with any of these sorts of complications (and other categories I could be forgetting), I still believe parents can play a huge role in the therapy component, yet they might need additional guidance, planning and strategizing from a professional therapist.
  • Therapy is best when it is more than a couple times a week.  This is where you, as parents, play a huge role. I've worked with children who received therapy in public school as well as outpatient.  Without a doubt a child makes more progress when the parent continues activities at home as well as practicing skills within natural family conversations.  Without. a. doubt.  My most successful patient was a 4-year-old who saw me once every week or two.  I gave her mother an extensive home-program to work on specific articulation errors.  When I saw the child, I added or changed the program as necessary.  We had a fantastic working relationship that was successful, economical, and efficacious.

OK, so now that I've told you where I am coming from, here are some fantastic links to resources to help parents understand speech development (and I totally apologize for making the preceding explanation horribly long).

1. What is Speech?  What is Language?  Sometimes people use these terms incorrectly. It's important to start on a level playing field so we are all talking the same language.

2. And, along these lines, lets define an articulation disorder and compare it to a phonological process disorder.  I'm still not in love with how ASHA defines phonological processes so I'll take a stab at it:
When children are young (toddlers) and just beginning to learn to talk, they may have a lot more words and sentences to say than correct sounds to use to say them.  Their ability to shape their tongue, lips, and mouth to correctly produce the sounds of English may be less mature than their vocabulary.  So, kids do the next best thing:  they make do.  They substitute easier sounds for harder ones.  For example, "k" and "g" sounds are a lot harder to say than "m, d, p, t and ing" sounds. So, kids will say "mee-maw" for "grand-ma" or "tih-tee" for "kitty."  When kids use the substitutions consistently across lots of words and sounds, we call these patterns "phonological processes."  They are totally normal.  Then, as a child ages and gets more adept at shaping new sounds, the stop using these patterns and begin to articulate words as expected:  grand-ma, kitty, go (not "dough" anymore).  However, sometimes these patterns become ingrained habits that make communicating hard-- thus the need for therapy.
If you are interested in learning more about these sound substitution patterns, you can view a great chart here:  Phonological  Processes After looking over that chart, if you are interested in the general, typical age ranges that children stop using these patterns, you can view this chart called Elimination of Phonological Procceses.
3.  What is normal?
Let me explain what it means. The left side of each pink or blue bar shows when 50% of children at that age have mastered the sound.  The right side indicates when 90% of children at that age have mastered the sound.  For example, at age 2, 50% of boys and girls can articulate k, g, d, t, and "ing" sounds (adding to the p, m, h, w and b sounds they are developing). Of course, the bars are not rock solid and should not be interpreted to mean that a child doesn't begin to use the sound before the lowest age range.  The chart is a good guide to help you see what is typical and what is not.
Another thing to consider is the Overall Measure of Intelligibility (or clarity) -- how well your child can be understood in a conversation. I've worked with plenty of kids who could say a majority of their sounds correctly one word at a time, however when they were trying to tell me something, I could barely understand them!  Take a look at this general guideline:

It's important to remember that close family and caretakers (and brothers and sisters) generally have a better perception of a child's intelligible speech than strangers or others who don't spend lots of time with your child.  I've worked with families that have absolutely no trouble understand and decoding their child's speech, but I can only understand their child a tiny bit.
Alright, I'm just going to post this now so I can move on to my next post in this series:  How to Do Therapy at Home.  If something I've written here is totally unclear or confusing, please let me know!  I really want this to be helpful!  And, please let me know what you'd like me to write about in this series!

1 comment:

Sara @ Embracing Destiny said...

This is really helpful info! Thanks for sharing it. I'm doing some at-home therapy with my 4 year old daughter who is on the autism spectrum. I'm always looking for things to do at home with her to help her communicate.