Is My Preschooler at Risk for Reading and Writing Difficulties?

We live in a modern world with so many distractions that it’s often a challenge to complete tasks and to “be” in the present.  We are thinking about what needs to be done in our households, we are checking our phones, rushing around to school drop off, to work and on errands.  We can only empathize with our children who are growing up in this fast paced environment.  I personally become distracted by all the stimuli and it certainly takes considerable practice and effort to focus my attention when my mind is buzzing. 

 How Can We Support Our Child's Attention With All of This Stimuli? 

 Below I have comprised a list of philosophies and techniques that have served me both as a speech-language pathologist and as a mother of two boys.

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WHAT IS A LISP?

A frontal lisp is the most common lisp pattern I see in young children and adolescents. This pattern of movement presents as the tongue protruding forward to the front teeth or between the teeth to produce /s/ and /z/ sounds (sock= “thock”, zoo=”thoo”). Often times the tongue also moves forward for other sounds like /t/, /d/, and /n/. In addition children tend to carry their tongue forward beyond the lower teeth when their mouth is at rest.

A lateral lisp is another type of lisp that is NOT developmental in nature and should be addressed as early as 3 years. With a lateral lisp, air moves laterally through the sides of the mouth vs. forward and medially.

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 Does your child say "wabbit" for rabbit, "maw" for more or "bor" for bird? Did you know that the "R" sound is one of the TRICKIEST sounds to learn and one of the most frequent sounds in the English language? In fact, there are 32 variations of the "R" sound!! The "R" is somewhat of a CHAMELEON because it varies depending on what vowels surround it. There is the initial, middle and final "R", not to mention /r/ blends (e.g. cr, pr). Sounds like "B" or "F" are alot easier for a child because they can "see" how it is produced or easily understand a description of how to say it. Production of "R" is produced far back in the mouth and it can be produced with not only one way but two ways!  Try saying these words, care, air, rose, fire, truck. You will notice that the placement of your tongue changes for each word.

We see MANY children that have been receiving private therapy for "R" distortion for months and years without success. We also see many kids that are currently receiving speech therapy at school with the same subpar resluts.  WHY IS THIS?  Mainly because they are taught in groups and not given 1:1 indiviualized instruction.  In addition, they are not being taught HOW to move their articulators to produce an accurate "R". Often times during an evaluation I will ask a child such as this, How do you make your "R" sound"?  Sadly most of these kids in therapy cannot describe the physical process.  They also cannot determine if their sound is correct or incorrect.

"R" is certainly one of the last sounds to be mastered by children, often by 6 to 7 years of age and although it is a late sound, many children have this sound earlier. Since the sound is late developing many parents figure it will come with age or "correct itself". In many cases it will correct, but in some cases therapy may be the best line of fire. Some research suggests selecting sounds for which the child has least ‘productive phonological knowledge’ because they will be easier to learn (e.g., Williams, 1991; Barlow & Gierut, 2002; Gierut, 2001). We at Huntington Speech and Feeding find that younger children are more maleable to learning sounds versus older children that have to "re-learn".

Not producing a correct "R" sound can impact letter-sound correspondence and of course spelling and writing output. It can also negatively impact esteem/interaction with peers and public speaking in front of the class.
So what can a parent do? An evaluation would be the first step in determining where to begin. In this evaluation the clinician can look at all "R" sounds in all word positions and determine where to begin.  The evaluator can also determine if there are any underlying oral motor issues like low muscle tone in the oral-facial region or structural issues such as tongue tie that may impact tongue movement. Once the evaluation is completed the therapist can develop a specific treatment plan and train the parent in carrying over activities and newly acquired skills.

If your child is not producing the "R" sound by first grade, you should consider consulting with a Speech-Language Pathologist. Please feel free to contact Huntington Speech & Feeding if you have any questions!

THERAPY WORKS!!

 Is your child a picky eater? Do you worry about your child’s intake or resistance to certain foods? Does the dinner table become a battlefield? Are you and your child stressed during meals?

Typical picky eating behavior often surfaces around one year- a time when new consistencies are being introduced. It can even be seen earlier when lumpy purees are presented. Picky eating often peaks during toddlerhood when kids are running around the house, touching and dumping everything in sight.   

A toddlers stomach is approximately the same size of his/her clenched fist so keep this in mind when you are thinking about portions. Toddlers are naturally picky. They gain weight at a much slower rate than when they were infants, therefore, they do not grow as quickly. Toddlers are also leaning many new skills like walking, climbing, running and talking. It is a busy time. During times of change, toddlers often seek “sameness” in their foods and routines. We as parents need to bend with them and realize that they are going to be inconsistent on a consistent basis!!!

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ARTICULATION VS. PHONOLOGICAL DISORDERS

How well words can be understood by parents?
-By 18 months a child's speech is normally 25% intelligible
-By 24 months a child's speech is normally 50 -75% intelligible
-By 36 months a child's speech is normally 75-100% intelligible
Lynch, Brookshire & Fox (1980), p. 102, cited in Bowen (1998).

At Huntington Speech & Feeding, many children come through our doors with “difficult to understand” speech. The majority of these kids either have an articulation or phonological disorder. What is the difference between the two and why are some children easily understood while others are not? What else do we need to look at?

1. HEARING

We always want to begin by recommending a hearing screening to our clients to ensure that the child is hearing at all frequencies and that structure is intact. We also want to understand if there has been a history of ear infections since birth. Hearing loss can have a profound impact on sound development and processing in the early years.

2. ARTICULATION

Poor articulation is another factor resulting in reduced intelligibity. Articulation is the physical process by which sounds, syllables, and words are formed when your tongue, jaw, teeth, lips, and palate alter the air stream coming from the vocal folds. When an individual cannot produce or distorts age-expected sound/s, it draws attention away from the speaker’s message. Articulation errors are motor in nature and can occur among people of any age; however, they are most common in children. Most common articulation errors include difficulty producing /s/, /th/, /r/, /l/ and /sh/. Vowels can also be impacted. Kids can even have difficulty producing /k/ and /g/ sounds in the back of the mouth.

3. PHONOLOGICAL

A phonological disorder is also a sound disorder where simplification of the sound system affects intelligibility. Students with phonological disorders demonstrate difficulty in acquiring a phonological system; involving organizing the patterns of sounds in the brain and the output, not necessarily in the motor production of the sounds like articulation errors. Errors become categorized as disordered when they do not naturally remediate by a certain age.

A phonological process is a patterned modification of the adult speech system. For example, a phonological process called fronting is when back sounds /k/ and /g/ are replaced with FRONT sounds (car=tar, doat/goat, etc). This error pattern should not persist past the age of 3 years but it is typical before then.

Listed below are some common error patterns.

1. Fronting- /k/ is substituted by /t/ (e.g. car=tar)
2. Stopping- /s/ is substituted with /t/ (e.g. sun=tun)
3. Syllable Deletion- (e.g. underwear=unwear)
4. Cluster Reduction- /st/ is reduced to /s/ or /t/ (e.g. star=tar or sar)
5. Gliding- (rabbit=”wabbit”/ lamp= “wamp”)

These kids are typically

1. Very difficult to understand even with high cognitive abilities.
2. Show frustration when communicating and may shut down.
3. Use one sound for several different sounds.
4. Cannot self correct when they have an error.
5. Imitate a sound in isolation but they do not use this sound in spontaneous speech
6. Confuse pronouns (I/me, him /he) and show grammatical errors.

*Please see the chart at the bottom of the blog defining the different phonological processes and the age in which they should no longer be used. There is also a chart on customary consonant development.

Both articulation and phonological disorders place a child at risk for writing and reading disorders. Phonological awareness difficulties are highly representative in children with dyslexia.

 WHEN TO GET HELP

If your child is demonstrating some of the errors mentioned above, it would be helpful to contact a licensed speech-language pathologist. We are well versed at with sound disorders at Huntington Speech & Feeding and can provide a comprehensive assessment and intervention plan for you!  Please call us for more information!

Common Phonological Errors Chart (push here)

Age of Customary Consonant Production Norms Chart (push here)

Reading books to our children is a  fun and important tradition.  There are so many wonderful children's books at the local library however; I often find that books can be too wordy, not wordy enough, too simple or too complex for the kids I work with.  Some children may have difficulty processing a lot of information while other children may memorize the pages of books and retell without flexibility.  Other kids may need higher level information and explanantions.  As parents, we know how important it is for our children to answer "what", "who", "where", "why" and "when" questions.  Sometimes however, we forget that is equally, if not MORE important for our child to tell us about the story on their own, add information to a book and talk about/reflect upon their experiences based on the topic.  

By adapting books we can alter the content, build on themes and concepts to add interest and participation.  We can expand on books and break away from reading the exact wording on the pages.  We can make the book come ALIVE.

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JOEY is a bright and talkative 3 1/2 year old.  He speaks rapidly and tends to substitute sounds or leave sound out entirely (especially final sounds).  This makes it difficult for others to understand him.  Joey does not have many of the sounds his peers have in their repetoire.  Joey did not qualify for services through his county because of his high intelligence and comprehension skills. His mother is not sure if she should still be concerned.

BENJAMIN is 2 years old and he is not using many words.  He has less 50 words in fact, and he is not yet combining words. He uses the words "this" and "that" when requesting and exhibits considerable frustration during communicative attempts.

SARA is a timid 5 year old.  She has difficulty producing back sounds K and G.  In addition she leaves out the /s/ in s blends (e.g. star=tar).  Teachers and peers often ask her to repeat herself which results in significant frustration.  Sara is not able to make back sound when her mother demonstrates how to make the sound. She sometimes has difficulty moving her lips outward for sounds like /sh/ and /ch/.    

MADDY is a 6 1/2 year old with sound substitutions.  She often confuses /s/ and /f/ and she says "wabbit" for rabbit.  Because of her difficulty producing these sounds, she is now struggling in school with spelling and reading.  She shows difficulty remembering what sound each letter makes.  

JORDAN is 7 year old who had speech as a younger child.  His speech can be described as slushy and he sometimes loses saliva when he is speaking and eating. Jordan's tongue peeks between his teeth when producing t, d, n, and s.  He sounds as if he has a lisp.  He has been denied services from his school district.

MATTHEW has difficulty answering various types of questions (what, who, where, when).  He is 4 years old.  His sentence length is short compared with his peers.  He does not talk about what he did at school on a given day or share information with others regarding vacations, outings to carnivals, birthday parties etc. 

So WHAT qualifies a speech or language PROBLEM?

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As a seasoned speech-language pathologist I am often asked what toys encourage speech and language development. Today I would like to share my 10 tips for selecting toys as well as my top 10 toys for toddlers and preschoolers. Maybe this will give you some ideas for holiday shopping this year!

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As parents, we are used to our babies mouthing and drooling! Drooling is a sign of teething, so it is very common for babies to have excessive saliva in and around their mouths from infancy up until 2 ½ years old. When teething stops, at around 2 1/2 years, drooling becomes less evident. This is because children develop more muscle control, coordination and awareness as they grow. Drooling should not persist past 4 years of age and if it does, there may be one or several factors operating behind the scenes.

Extra saliva in the mouth has been known to cause speech delays, skin breakdown, sleeping issues, swallowing difficulty and social impact. Here are 7 reasons why your child may still be drooling,

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It is sometimes difficult and anxiety provoking to determine why our kids are pushing away certain foods or even resisting coming to the table. Our internal dialogue tells us, "Maybe he's eating too much sugar", "Maybe he is teething", "Maybe he's tired", "Maybe this is typical for his age". There is clear information regarding this specific topic in current research so I will share this infomation along with my clinical experiece over the years working with this population.

PICKY EATERS

1. Have a decreased range or variety of foods- 30 foods or more

2. Lose food due to "burn out" but usually regain those foods after 2 weeks.

3. Are able to tolerate new foods on their plate and usually can touch or taste a new food.

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