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Simplify Your Language to Help Your Child Understand

2012-05-13T23:58:32Z

This is third in a series of how to help your child understand what you are saying to him/her.

Talking Tips for Parents:

1. Use a slower speech rate. Even a small changes in your speech rate can improve your child's understanding of language.

2. Use shorter remarks. Pretend you're sending a telegram. It includes only the most important content words. Use phrases and sentences just beyond your child's language level. For example, a child who says single words should be given two-word phrases. For a child who is using two words at a time, three-or four-word phrases would be apporopriate. Some examples are: "Do you want juice?" becomes "Want juice?" "That big horse is over there" becomes "See the big horse."
"Do you want the cookie or the cracker?" becomes "Want cookie? Want cracker?" "First you'll take your bath and then I will read you a story" becomes "Your bath is first. Then your story."

3. Use simple sentences. Sentences that contain a bsic subject+verb+object or adjective are the easiest. For example: Tommy + drank + milk. Dog + is + big. He+ ran + home. As your child's language develops, include more information in your remarks, e.g. Tommy drank all the milk. The dog is big and brown. He ran quickly home for dinner.

4. Use repetition. When you repeat words, phrases, and sentences, your child has a better chance to learn and understand. Expand on your child's utterances.
     Child: Doll
     Parent: Sue's doll.
     Parent: Your doll is pretty.
     Child: I like your doll.
New vocabulary was added each time and different sentence structures were modeled, but the child's message was kept and repeated.

5. Exaggerate important words with your voice. Your child will pay more attention to words that you stress when you talk. Put more stress on words you want your child to hear and remember. For example: "Big dog." "Juice all gone." "You're a good boy."

6. Use gestures when you speak. Gestures help your child understand the meaning of your spoken message. Include natural gestures, i.e. facial gestures (excited, happy, sad, upset, interested), hand gestures (Come here. Give to me. I want. You want. Stop. Go. etc.), body gestures (arms out to indicate a hug, folded arms to indicate anger).

If you have any questions about the above information, please comment and I will reply.

Tips for Parents on Learning at Home

2012-04-22T22:54:17Z

Being a parent is a very special role. Parents are responsible for teaching their children about life and how to live it fully. This can be a very big job, especially if your child has communication difficulties. Parents often need information about how to best meet the needs of their child.

Your child's speech and languge pathologist can give you helpful information about your child's speech and language development. The speech language pathologist can also suggest specific activities to help your child learn at home. In addition, there are a few basic guidelines on teaching and learning which can help you and your child succeed.

Tips for Parents:

1. Let your child feel loved. Touching, hugs, kisses, gentle words, or an approving smile will help your child feel relaxed and confident about learning.
2. Remember that your child is just a child. It's important to keep your expectations appropriate to your child's abilites. Ask your speech language pathologist about your child's language abilities. That way, you won't expect too much-or too little.
3. Give your child approval. Appreciate any success in learning your child accomplishes. Compliments will encourage your child to continue to learn. Let your child know that you accept both your child's strengths and weaknesses.
4. Help your child to feel important. Take time to do things with your child. Your child will appreciate your time and attention.
5. Remember that learning can be fun. Have a good time with your child. If you do not enjoy what you are doing with your child, neither will your child. Follow your child's lead in f inding fun things to do.
6. Talk to your child. Talk often about what you are doing together. Give your child time to respond.
7. Really listen to your child. Get down to your child's eye level, and look at your child as you are listening. Respond to what your child says.
8. Share your ideas and experiences with your child's speech language pathologist. Let her/him know about situations which may affect your child's learning, such as illnesses or problems at home.
9. Take an interest in your child's schoolwork or therapy. Help your child learn to be enthusiastic about learning. Talk about school and therapy in a positive way.

Summary
You are your child's first, and most important, teacher. You set an example for your child of how to listen and talk with others. You can make a big difference in how well your child develops communication skills. As your child uses new skills in everyday activities, you can feel proud of your child's success.

Even though this information is from 1988, it is timeless information. These are basic building blocks for developing your child's communication. No amount of technology will replace what parents give their children as they go their day.

Pam Hass
Speech Languag e Pathologist

Reference
Margaret Schrader, M.S. CCC/ Speech Language Pathologist
Communication Skill Builders (1988)

Motor Experiences and Social Skills

2012-04-08T13:12:46Z

An article in the Advance for Speech-Language Pathologists & Audiologists (sEPTEMBER 19, 2011) described a new way to think about development. Early motor experiences can shape infants' preferences for objects and faces, according to a new study. The findings demonstrate that providing infants with "sticky mittens" to manipulate toys increases their interest in faces, suggesting advanced social development.

When 3-month-olds were given mittens affixed with strips of Velcro, known as "sticky mittens", a brief swipe of their arm made toys covered in Velcro stick, as if they had successfully grasped the object. Parents demonstrated this by attaching a toy to the mitten. The toy was removed and the infant was encouraged to reach independently for the toy again. When another group of infants were fitted with aesthetically similar mittens and toys that did not have Velcro, they were only passive observers, as parents provided stimulation by moving a toy and touching it to the inside of the infants' palms.

After two weeks of daily training, the active group showed more interest in faces than objects, while the passive group showed no preference. Infants in the active group focused on faces first, suggesting strenghtening of a spontaneous preference. The more reaching attempts infants made, the stronger their tendency to look at faces. Motor experiences seem to drive social development.
A key question researchers hope to answer next is whether these early changes will translate into future gains for these children. This new research could point in a new direction for research on social development in children.

Opininion by Pam Hass, Speech-Language Pathologist. Kids begin pointing to indicate what they want or need or for joint attention to communicate between 9-12 months of age. If this process can be boosted through training with the use of more motor experiences at a younger age, kids, who may have social delays or social disabilities, may benefit from this early training. The research needs to continue in order for this to become evidence-based practice.

Reference
Libertus ,K., Needham, A. (2011) Reaching experience increases face preference in 3-month-old-infants, Developmental Science, online, Sept. 9.

Colorful Plates Boost a Picky Eater's Appetite

2012-04-03T01:30:42Z

Reference: speech-language-pathology-audiology.advanceweb.com/
2/5/2012

Parents of picky eaters can encourage their children to eat more nutritionally diverse diets by introducing more color to their meals, according to a new study that found colorful food fare is more appealing to children than adults. Specifically, food plates with seven different items and six different colors are particularly appealing to children, while adults tend to prefer only three items and three colors (Acta Paediatrica, January 2012).

"Compared with adults, children not only prefer plates with more elements and colors but also their entrees placed in the front of the plate and with figurative designs," said co-author Keven Kniffin, PhD.

Other co-authors were Mitsuru Shimizu, PhD, of Cornell, and Francesca Zampollo, a doctoral student at London Metropolitan University.

For more information about adding color and variety to children's plates, visit http://foodpsychology.cornell.edu/outreach/child-plate.html.

Obstacles to Fluent Speech

2012-03-25T18:39:40Z

Reference: Advance for Speech-Language Pathologists and Audiologists Sept. 19, 2011

Stuttering affects 3 million Americans and four times as many men as women. Approximately 5 percent of young children go through a period of stuttering that lasts six months or more. The majority recover by late childhood, leaving only about 1 percent with a long-term stutter.

Adolescent and adult stutterers have a different awareness of the disorder as a result of a lifetime of disfluency. Of particular interest to Courtney Byrd, PhD, assistant professor in the Department of Communication Sciences and Disorders, College of Communication, at the University of Texas in Austin, is seeing if the unique behaviors she has identified in young children at the onset of stuttering persist into adulthood.

Learning how stutterers select and organize the sounds they use to make words helps researchers identify the obstacles that result in stuttering and develop therapies to overcome them. In the Developmental Stuttering Lab, which she established at the college five years ago, Dr. Byrd and her team of graduate and undergraduate students evaluate how typically developing presechoolers acquire language and learn how to put sounds together fluently. These evaluations range from observing parents laying and talking with their children, to analyzing characteristics of disfluent speech, to measuring speech fluency as a child describes a picture, to asking children to identify words based on partial sounds. The data are used to create benchmarks against which to compare children who stutter and pinpoint the breakdown in fluency.

Children who stutter take longer to select sounds because they are not efficiently organized, which means stuttering is not strictly motoric, or a speech behavior, but there is a linguistic component as well, Dr. Byrd's research suggests.

Up until about age 2-and-a-half, she said, children's speech consists of a constellation of unrelated but familiar words, such a mommy, daddy, baby, milk, and book. During a vocabulary growth spurt by age 3, they start to organize language into global syllable shapes, or neighborhoods, of words that differ by only one individual sound segment, such as back, bath, bag, bad, and bat.

"This global syllable shape selection strategy enables 3-year-olds to efficiently organize and access their limited vocabulary," said Dr. Byrd. "However, by age 5 an expanded vocabulary compounded by faster utterances and longer, more complex phrases makes it inefficient for typically developing children to rely on this strategy. In fact, it inhibits their ability to produce speech fluently."

In contrast to typically developing children and adults, she said, "'my research has shown both children and adults who stutter continue to rely on the global syllable shape organization system, which is inefficient and slows their ability to access the individual sound segments that represent the words they're trying to say. The outcome is what we perceive as stuttered speech."

She hopes her research will lead to the identification of key etiological factors that could be used to transform treatment. "But stuttering is a complex disorder," she said. "It waxes and wanes, and its origins are unclear."

"While we work with clients to improve their fluency through speech therapy, we also give them practical coping mechanisms. For example, the simple act of self-disclosure can ease the burden and make the stutterer and others feel comfortable," Dr. Byrd stated.

How You Talk with Your Child Is Important

2012-02-27T01:57:00Z

Here are several ways Diann D. Grimm, M.A. CCC. Ed.S. recommends speaking with your child to facilitate more language and communication from your child. I have provided a summary of each strategy.

1) Talk about the here and now. Talk about objects, people, and events that can be seen, heard, and touched. Say "I put the ball in the box" while doing the action. Name objects that the child can see. " A dog. I see a dog. Look at the dog". Talk about people around you, e.g. "There's a police officer. She helps us."

2) Talk about what is important and interesting to your child. If a child is playing with blocks on the floor, you can say, "Those are big blocks. This one is red." Common objects such as pots and pans, boxes, and rocks can be interesting to them.

3) Talk out loud about what you are doing. Us simple phrases and sentences to describe what you are doing, seeing, and thinking. For example, while making a cake: "I'm putting in the eggs. Now I"m mixing the batter. Going around and around. It needs more flour. I'll put in a little more.

4) At times, talk for your child. By doing this, you give your child words and sentences to remember for future use. If your child is playing, you might say: " That's a big car. Make it go. It goes so fast. There's a little car. It can go too." It is also important to put your child's feelings into words. For example, " I can see that you are angry. Tommy broke your truck. We can fix it.

5) Expand your child's remarks. If your child says "juice". You can say "You want juice." If your child says, "doggie run", you can say " The dog runs fast". The use of expansion is a non-threatening way to model good language for your child.

6) Add a little more information to your child's remark. Add a new idea. If your child says, "Truck here", you can say "Yes, there's a big red truck."

7) Don't ask your child to repeat what you say. You only need to provide good language models. Your child will learn to say things you do-without pressure and at the child's own pace.

8) Praise your child's language attempts. Keep talking and keep learning fun!

Kids' Brains Benefit from Praise

2012-02-06T01:21:11Z

St. Louis Post-Dispatch 1/31/12

Washington University study reports that positive reinforcement may increase brain size. by Blythe Bernhard bbernhard@post-dispatch.com 314-340-8129

If your child forgets his lunch or struggles with school work, a little more loving might turn things around.

Supportive mothers who practice positive reinforcement seem to help their children's brains grow, according to new research from Washington University.

Brain scans show that school-age children of nurturing mothers have a 10 percent larger hippocampus-the region of the brain that plays a role in memory, learning and stress response-compared to the brains of children whose mothers were deemed less supportive.

The take-home message for working and stay-at-home parents is to praise children more than you scold them, the researchers said.

"Parents might feel guilty because they're working, and we work a lot as well," said Dr. Kelly Botteron, a professor of child psychiatry and co-author of the study. "But when you're home in the evening and you're trying to rush through homework and trying to get dinner ready, if you remember to say a a couple nice, really positive things... I think a lot of parents could do that and it's a practical thing that has very little risk to it."

It's long been known that orphans and other neglected children who are placed in loving homes can improve their behavior and health. And while a link between nurturing mothers and their offspring's brain growth has been established in rats, the study is the first to show the same anatomical process in humans.

As part of their ongoing research on childh00d depression, staff members watched how two groups of 92 children ages 3-5 interacted with their caregivers (usually mothers) during a stressful task. One group of children had symptoms of depression and the others were assigned to a control group.

For the task, the mothers were told to fill out a questionnaire. The child was given a wrapped present but told not to open it right away. The eight-minute "waiting task," as it's known, has been used by researchers as a reliable indicator of parental nurturing skills. The task is thought to simulate situations at home, such as a parent distracted by cooking dinner while the child needs to focus on homework.

Researchers who reviewed the taped interactions rated the mother's responses to their children's behavior. Mothers received points each time they praised the child's patience or offered encouragement to not open the gift.

The researchers acknowledged they're not getting a complete picture of family life, especially if Mom was having a bad day. But they are confident that the results of the MRI brain scans on the kids, performed four years after the "waiting task," indicate that children who have more supportive mothers also have bigger brains.

Children with less supportive mothers had a hippocampus volume that was 9.2 percent smaller than the children of more nurturing mothers. In children with depression, the effects of nurturing were not as positive, and the researchers think the disease process has a greater impact on brain development.

The researchers plan to run second and third MRI brain scans on the children, who are now preteens, to watch for brain development over time.

Although the study wasn't designed to look at fathers, foster parents or grandparents, the researchers said the positive effects of nurturing can come from any caregivers, which can be reasonably stretched to include teachers.

"If you know your child is in a difficult situation, to reinforce to them that you know it's a hard situation but they're doing such a great job, that's the kind of parenting we would try to encourage," Botteron said.

The researchers were careful to point out they're not opposed to disciplining children or giving them boundaries.

"You should be supportive and nurturing, which is not the same as spoiling, and not the same as smothering," said the study's lead author Dr. Joan Luby, a professor of child psychiatry.

One local mom said it was exciting to hear that something she already believes in could have an effect on her children's intellectual, and not just emotional, development.

"For a nurturing parent it's both beautiful and frightening because many of us who spend a lot of nights wondering whether we're doing everything we possibly can for our children, this falls into the category of one more thing to worry about," said Danielle Smith of O'Fallon, MO, who has two young children and writes the blog extrordinary-mommy.com. "It sounds like a bonus to me, but I have to embrace the idea that what I'm doing is enough."

Comment from Pam Hass, Speech Language Pathologist: As we as caregivers and teachers of our children, in addition to being nurturing and supportive of our children, we also need to include our children in day to day conversations and make reading to our children a daily event. Talking with our children, listening and responding to our children while they play or while we do our daily chores will help develop children's language skills. Reading to our children and talking with them about the story is very important in developing their language and cognitive skills.

In my next blog, I will begin to list some language activities that families can do to stimulate both the understanding and expression of language.

Asleep at School

2012-01-13T15:52:50Z

Reference: Advance for Speech Pathologists and Audiologists 12/14/11

Sleep deprivation impacts academics and safety.

From memory to judgment, attention span, emotional stability and even immunity, sleep deprivation negatively affects school-age children," reports Kristin Avis, MD, a sleep specialist and assistant professor of pediatrics at the University of Alabama at Birmingham (UA. Of children under age 18, 60 percent polled by the National Sleep Foundation (NSF) complained of being tired during the day, and 15 percent reported falling asleep at school.

The NSF has guidelines for how much sleep children of various ages require. Three-five year-olds need 11 to 13 hours per night, while 5-to 12-year olds need 10-11 hours.

"As for adolescents, it's a common myth that they need less sleep and can handle only seven or eight hours," said Dr. Avis. "They actually need nine hours of sleep. That's typically the most sleep-deprived population in school.

A student can make up for the lack of one good night's sleep, but going an entire school week without sufficient rest can be detrimental, she noted. "You can sleep until noon on Saturday and feel caught up, but then you will go to bed later that night, sleep in on Sunday, and then repeat the cycle into the new school week."

Children need a suitable amount of sleep every night. Their bedrooms should be as tranquil as possible, which means removing noise-makers.

"On average, there are three to four electronic gadgets in a kid's room," Dr. Avis reported. "It's been shown that even sleeping with a television on deprives them of 20 minutes of sleep per night, which may not sound like a lot but adds up over a week's time.

'Cell phones are often used as an alarm clock, but for about $5 you can invest in a real alarm clock so the phone can be turned off," added Stephanie Wallace, MD, assistant professor of pediatrics at UAB.

Dr. Avis is exploring further what a bad night's rest can do to a child. She and David Schwebel, PhD, professor of psychology and director of the Youth Safety Lab at UAB, are studying sleep deprivation and pedestrian injury and general safety among children.

SLPCorner: Everyday Language Activities: Grocery Shopping with a Toddler

2012-01-02T02:39:41Z

by Becca Jarzynski, MS, CCC-SLP

Reference: www.pediastaff.com/blog/guest-blog-everyday-language-activities
Posted on December 28, 2011

'This article was posted as a guest blog on www.pediastaff.com and written for parents.

I included this post in my blog because I think it is important for Moms to realize they cannot do it all, but incorporating language stimulation in the midst of everyday life can be a nice balance. -Pam Hass, M.A. CCC-SLP

In her post, Ellen explains that her son Max gets therapy sessions throughout his week but that "the sessions are only 45 minutes to an hour long and it's the ways we put those therapy techniques into practice that matter most." She goes on to describe how attempting to accomplish therapy carryover at home used to be overwhelming and somewhat guilt-provoking, especially when therapists would leave long lists of tasks to be accomplished. Then, Ellen reflects on how she has learned to do only what she can and let the rest go (yah!) and, most importantly, how she has learned to integrate the things Max needs into fun family activities that they were doing anyway. Yes, I thought when I read her post. Yes. That's exactly what we are trying to encourage families to do when we work with them and their children as early intervention professionals.

With that in mind, I took my two-year old daughter grocery shopping. I'm learning that much of life is to be found in the joy of daily activities, so I decided to slow the activity down-to enjoy it and her along the way. As I did, I realized how much skill development was occurring right in the context of this simple and potentially mundane daily routine.

1) Two-year olds are developing and understanding simple concepts, so we wove them into our trip. She put things "in" the cart and "under" it as well. The cat litter was heavy (I let her drag it to the cart so she could experience what heavy meant) and the chips were light (as she threw them up and over the edge of the cart). The bread was soft (and a bit squished after we were done) and the cans were hard. The apples were big and the grapes were small. I paired actions with words as we compared and contrasted all these things, and by the end of the trip, she was starting to use some of the words on her own to describe what she was doing or what she felt. Even better, she had a blast helping gather the food, throwing things into the cart, and just generally being involved in the experience.

2) Toddlers this age are also just starting to use simple grammar elements such as: plural -s (cans), possessive -s (daddy's), and -ing (pushing). I used expansion and indirect correction to model her sentences back to her, a bit more correctly. If she said, "two apple," as we counted them and put them in the bag, I said "Yep, two apples!" When she commented that she was holding, "daddy plum", I responded with, "These are daddy's plums!" And when she said "I push!"
while pushing the cart down the aisle (and almost into the pickles), I replied that "Yes, you're pushing!"

3) Two-year olds are also merging into the world of pretend play and we wove this into our trip as well. At one point, a jar of olives was a microphone and we were rock stars. People may have thought us a bit odd, but we were certainly having fun.

The beautiful part of all of this is that it made the activity joyful for both of us. She was learning and I was shopping, but most of all, we were just being mother and daughter, loving up life.

I must note, of course, that this won't work for everyone, in every activity. My daughter loves grocery shopping. My son? Hated it. With him, getting through grocery shopping was an exercise in survival; my sole focus was on keeping him contained long enough that we could get the groceries we needed. It wouldn't have worked to slow it down, even if I had tried to engage him more. It's just how he was as a toddler, full of boundless energy that was exceedingly hard to corral. When he was little, it was much easier to weave learning into football than into grocery shopping. The activity has to fit the child, not the other way around.

And, there is also the danger of believing that every single activity throught the day has to be a learning experience. It doesn't. Sometimes grocery shopping just needs to be grocery shopping, and that needs to be okay. But when it doesn't, when time can slow down just a bit, when children can learn in the context of an activity, that is truly a delight for everyone involved, that's the sweet spot for sure.

Featured columnist: Becca Jarzynski, MS, CCC-SLP

Motor Experiences and Social Skills

2011-11-27T21:52:49Z

A New Way to Think About Developement

Reference: Advance for Speech Language Pathologists and Audiologists, (Sept.19, 2011)

Early motor experiences can shape infants' preferences for objects and faces, according to a new study. The findings demonstrate that providing infants with "sticky mittens" to manipulate toys increases their interest in faces, suggesting advanced social development.

The study, conducted by Kennedy Krieger Institute, in Baltimore, MD, and Vanderbilt University, in Nashville, TN, supports a growing body of evidence that early motor development and self-produced motor experiences contribute to infants' understanding of the social world around them. Conversely, this implies that delayed or impaired motor skills, such as in autism, could negatively impact social interactions and development.

The results provide "a new way to think about typical and atypical development," said lead author Klaus Libertus, Phd, of the Center for Autism and Related Disorders at Kennedy Krieger. "The mind is not independent from the body, especially during development. As motor skills advance, other domains follow suit, indicating strong connections between seemingly unrelated domains. Such connections have exciting implications, suggesting interventions could target the motor domain to foster social development."

Previous research found that infants with autism spectrum disorders (ASD) show less interest in faces and social orienting. While the new study was conducted with typically developing infants, it indicates that infants at risk for ASD or showing signs of abnormal social development may benefit from motor training as early as 3 months of age.

"This means that early motor development is very important and parents should encourage motor experiences and active exploration by their child," said Dr. Libertus. "Fostering motor development doesn't have to be complex. Any interactions or games that encourage a child to develop independent motor skills are important."

Researchers divided 36 typically developing 3-month-olds into two groups. One had active motor experiences, and the other had passive experiences. Infants in the active group were given mittens affixed with strips of Velcro known as "sticky mittens". A brief swipe of their arm made toys covered in Velcro stick, as if they had successfully grasped the object. Parents demonstrated this by attaching a toy to the mitten. The toy was removed, and the infant was encouraged to reach independently for the toy again.

Infants in the passive group were fitted with aesthetically similar mittens and toys that did not have Velcro. They were only passive observers, as parents provided stimulation by moving a toy and touching it to the inside of the infant's palms.

After two weeks of daily training, the researchers tracked the infants' eye movements while they watched images of faces and toys flash on a computer screen. Infants in the passive and active groups were compared with each other and to two control groups of untrained infants comprised of non-reaching 3-month-olds and independently reaching 5-month-olds.

The active group showed more interest in faces than objects, while the passive group showed no preference. Infants in the active group focused on faces first, suggesting strengthening of a spontaneous preference. Their social preferences were similar to those of the 5-month-olds, indicating advanced development following training.

Individual differences in the motor activity of all the 3-month-old infants were predictive of their spontaneous orienting to faces. Regardless of experience, the more reaching attempts infants made, the stronger their tendency to look at faces. Thus, motor experiences seem to drive social development.

"The most surprising result is a connection between early motor experiences and the emergence of orienting toward faces," said Dr. Libertus. "Logically, one would predict the opposite. But in the light of seeing actions as serving a social purpose, it makes sense."

A key question researchers hope to answer next is whether these early changes will translate into future gains for these children.

"Our results indicate a new direction for research on social development in infants," said Dr. Libertus. He and his colleagues will continue to observe the children to see if the social development benefits achieved during the current study are sustained a year later.

Grants from the National Institutes of Health provided support for the study.

Reference
Libertus, K., Needham, A. (2011). Reaching experience increases face preference in 3-month-old infants. Developmental Science, online, Sept. 9.

Motorcycle Helmets Hard on Hearing

2011-11-14T01:44:21Z

Reference: The ASHA Leader (Oct. 11, 2011)

The distinctive roar of a motorcycle engine is loud, but studies have revealed the biggest source of noise for motorcyclists is generated by air whooshing over their helmets. Even at legal speeds, the sound can exceed safe levels. Researchers in the United Kingdom placed motorcycle helmets on mannequin heads, mounted them in a wind tunnel, and turned on fans. By placing microphones at different locations around the helmet and at the mannequin's ear, researchers found that an area underneath the helmet and near the chin bar is a significant source of the noise that reaches rider's sensitive eardrums. Future tests will move beyond the wind tunnel to riders on the open road. The findings, described in the Journal of the Acoustical Society of America, may lead to quieter helmet design. Search "hard on hearing" at www.aip.org/aip.

Severe Language Delay

2011-11-07T02:50:46Z

Folic Acid Associated with Reduced Risk

Reference: Advance for Speech-Language Pathologists Audiologists (Nov. 4, 2011)

The use of folic acid supplements by women during the periconceptional period has been found to be associated with a reduced risk of children having severe language delay at age 3, according to a Norwegian study.

Randomized controlled trials and other studies have demonstrated that folic acid supplements taken during the period from four weeks before conception to eight weeks afterward reduce the risk of neural tube defects. "To our knowledge none of the trials have followed up their sample to investigate whether these supplements have effects on neurodevelopment that are only manifest after birth," the researchers reported.

The new study was conducted by Christine Roth, ClinPsyD, MSc, of the Norwegian Institute of Public Health, in Oslo, and colleagues. They investigated whether maternal use of folic acid supplements was associated with a reduced risk of severe language delay among offspring at age 3.

"Unlike the United States, Norway does not forify foods with folic acid, increasing the contrast in relative folate status between women who do and do not take folic acid supplements," the researchers noted.

Pregnant women in Norway were recruited for the study beginning in 1999. Data were included on children born before 2008 whose mothers returned the three-year follow-up questionnaire by June 16, 2010. Maternal use of folic acid supplements within the interval between four weeks before and eight weeks after conception was the exposure.

The primary outcome measured for the study was children's language competency at age 3 as gauged by maternal report on a six-point ordinal language grammar scale. Children with minimal expressive language (only one-word or unintelligible utterances) were rated as having severe language delay.

The main analysis for the study involved 38,954 children: 19,956 boys and 18,998 girls. A total of 204 (0.5 percent) of the children (159 boys and 45 girls) were rated as having severe language delay. Children whose mothers took no dietary supplements in the specified exposure interval comprised the control group. there were 9,052 children in this group, including 81 (0.9 percent) with severe language delay.

The researchers reported the data for three patterns of exposure to maternal dietary supplements: 1) other supplements, but no folic acid 2) folic acid only; and 3) folic acid in combination with other supplements.

The first group numbered 2,480 children, including 22 (0.9 percent), with severe language delay. The second group, of folic acid only, had 7,127 children, 28 (0.4 percent) of whom had severe language delay. The last group was comprised of 19,005 children, including 73 (0.4 percent) with severe language delay.

Maternal use of supplements containing folic acid within the periconceptional period was associated with a substantially reduced risk of severe language delay in children at age 3, the researchers discovered.

"We found no association, however, between maternal use of folic acid supplements and significant delay in gross motor skills at age 3," they reported. "The specificity provides some reassurance that there is no confounding by an unmeasured factor. Such a factor might be expected to relate to both language and motor delay."

No previous prospective observational study examined the relation of prenatal folic acid supplements to severe language delay in children.

"If this relationship were shown to be causal in future research, it would have important implications for understanding the biological processes underlying disrupted neurodevelopment, for the prevention of neurodevelopmental disorders, and for policies of folic acid supplementation for women of reproductive age," the investigators said.

Reference: Roth, C., Magnus, P., Schjolberg, S. et al. (2011). Folic acid supplements in pregnancy and severe language delay in children. JAMA, 306 (14): 1566-73

Mild Hearing Loss

2011-10-30T20:05:39Z

Reference: Advance for Speech-Language Pathologists and Audiologists (Oct. 3, 2011)

Mild Hearing Loss
Linked to brain atrophy in older adults

Declines in hearing ability may accelerate gray matter atrophy in auditory areas of the brain and increase the listening effort necessary for older adults to comprehend speech successfully, a new study has shown. When a sense is altered, the brain reorganizes and adjusts. In the case of people with poor hearing, researchers found that the gray matter density of the auditory areas was lower in people with decreased hearing ability, suggesting a link between hearing ability and brain volume.

"As hearing ability declines with age, interventions such as hearing aids should be considered not only to improve hearing but to preserve the brain," said lead author Jonathan Peelle, PhD, a research associate in the Department of Neurology, Perelman School of Medicine, at the University of Pennsylvania in Philadelphia. "People hear differently, and those with even moderate hearing l0ss may have to work harder to understand complex sentences."

In a pair of studies, researchers measured the relationship of hearing acuity to the brain, first measuring the response of the brain to increasingly complex sentences and then measuring cortical brain volume in the auditory cortex.

Older adults, ages 60-77, with normal hearing for their age were evaluated to determine whether normal variations in hearing ability impacted the structure or function of the network of brain areas supporting speech comprehension.

The studies found that people with hearing loss showed less brain activity on functional magnetic resonance imaging (fMRI) scans when listening to complex sentences. People with poorer hearing also had less gray matter in the auditory cortex, suggesting that areas of the brain related to auditory processing may show accelerated atrophy when hearing ability declines.

In general, research suggests that hearing sensitivity has cascading consequences for the neural processes supporting both perception and cognition. Although the research was conducted in older adults, the findings have implications for younger adults, including those concerned about listening to music at loud volumes.

"Your hearing ability directly affects how the brain processes sounds, including speech," said Dr. Peelle. "Preserving your hearing doesn't only protect your ears but also helps your brain perform at its best."

Audiologists should monitor hearing in patients as they age, noting that individuals who still fall within normal hearing ability may have increasing complaints of speech comprehension issues.

Grants from the National Institutes of Health funded the research.

Peele, J.E., Troiani, V., Grossman, M., et al. (2011). Hering loss in older adults affects neural systems supporting speech comprehension. The Journal of Neuroscience, 31 (35): 12638-43

TV for Toddlers not a Good Idea, Doctors Say

2011-10-25T22:31:12Z

Reference: St. Louis Post-Dispatch Oct. 19, 2011

Educational value is called nil; they urge more time for play.

by Benedict Carey (New York Times)

Toddlers and TV

Key Findings by the American Academy of Pediatrics:

1) Children under 2 receive no benefit from watching TV or any other screen.

2) Video programs for toddlers are marketed as "educational," but evidence does not support
       this.

3) Unstructured playtime is more valuable than electronic media.

4) Young children learn best from interaction with humans.

5) Parents who watch TV or videos with their child may add to the child's understanding, but
      children learn more from live presentations.

6) Television viewing around bedtime can cause poor sleep habits.

7) Young children who have watched a lot of TV are at risk for delays in language development.

Omegas Battle Stroke Severity

2011-10-14T00:22:49Z

Reference: The ASHA Leader (October 11, 2011)

A diet rich in omega-3s could reduce the severity of brain damage after a stroke. Researchers from Universite Laval in Quebec, Canada, observed that mice that had been fed a diet rich in DHA, an omega-3 fatty acid, for three months had 25% less brain damage following stroke than mice that had eaten a control diet. The full study was published in Stroke (doi:10.1161/STROKEAHA.111.620856).

ADHD Links to ASD

2011-10-14T00:16:44Z

Reference: The ASHA Leader (October 11, 1011) from the American Speech and Hearing Association

New research has identified more genes associated with attention deficit hyperactivity disorder (ADHD) and found an overlap between some of these genes and those found in other conditions such as autism spectrum disorders (ASDs). Researchers studied the DNA of 248 unrelated patients with ADHD; 19 of 248 patients had inherited changes. Within this group of inherited changes, researchers also found genes previously identified in conditions such as ASD; conversely they found ADHD genes in nine of the patients previously diagnosed with ASD. The study appears in Science Translational Medicine(http://stm.sciencemag.org/content/3/95/95ra75).

Social Skills Equal Spatial Skills

2011-10-10T01:00:28Z

Reference: The ASHA Leader (September 20, 2011)

People who can empathize with others are also more likely to be proficient in spatial skills. In a study, 48 adults viewed a toy building surrounded by seven faceless figures. Participants described the visual perspective of each figure, and were assessed on measures of five traits associated with autism spectrum disorders: social skills, perseveration, attention to detail, communication, and imagination. Overall social acumen correlated strongly with participant's accuracy in taking the figures' perspectives. Visit http://psycnet.apa.org/journals/slm/37/4.

Make Your Child Laugh: The Developmental Stages of Humor

2011-10-02T16:55:00Z

Reference: http://sos-research-blog.com

This article was posted and seemed so relevant to our very serious approach to special needs that we forget as professionals that laughter is a great way to learning. Here is the post.

Many children with special needs have problems with friendships. The problems can surround not understanding nonverbal communication, to not being able to identify emotions, to confusion over humor and more. One thing we know for sure is that life without friendships and human connections is a very lonely life.

Humor is something that can bring two people together. Laughter signifies that people are having fun and is good for a healthy relationship. Sharing jokes and funny stories provides a connection between two people.

Children love to laugh. But children with special needs such as autism, ADHD, Sensory Processing Disorder, and more often take things quite literally. This results in them missing a joke or the humor in a situation. If a child can't share laughter with a group, then she is missing a part of the bonding that occurs and this affects the development of friendships.

Before you can work on humor with your child, you need to understand humor from a developmental perspective. This is a general guideline and actual ages vary depending on the child.

    1) By six months of age, babies will laugh at behaviors that are not typical of their parents.
         Making exaggerated faces will get a baby to laugh.
    2) A one year old baby loves the game of peek-a-boo.

At this stage, you can play peek-a-boo and other games that do not end at a predictable time, such as jack-in-the-box. This can be played with a four or five year old child with special needs (or even older) if she has not acquired this basic level of humor. There are many different kinds of jack-in-the-boxes, such as Sock Monkey Jack in the Box and SpongeBob Squarepants Jack-in-the-box, so you should be able to find one that will appeal to your child.

      3) Starting at age one or one and a half, children start pretend play and will make believe that
            an object is something other than what it is or will use it in a "wrong" way. For example,
            a child may put a sock on his hand and laugh.
       4) By age two to three as language skills develop, children enjoy giving objects the wrong
            name. "Bathroom" humor may also begin at this time.

For the two stages above, you can create a game to play with your child. Take a box and fill it with familiar objects. Pull something out and pretend it is something else. For example, you can take a sock out of the box and say it is a hat and put it on your head. After you take a few turns, let your child try.

        5) By age three, children enjoy playing with the sounds of words. They may create
             variations of common words or generate rhyming words. Some of these children may
              also enjoy making nonsensical sentences.

Saxton Freymann and Joost Eiffers created a set of books containing photographs of fruits and vegetables depicting emotions, vehicles, and other objects. The pictures can help children with special needs to not only identify moods and emotions, but to also appreciate the silliness of the photographs. The books are titled "How Are You Peeling? (Scholastic Bookshelf), "Fast Food", and "Food Play".

         6) Around age five, children start telling riddles or knock-knock jokes that don't make any
               sense.

"What Do You Hear When Cows Sing?: And Other Silly Riddles (I Can Read Book 1) contains
twenty-two riddles with the use of wordplay.

         7) By age six or seven, the nonsensical part of the riddles and knock-knock jokes disappear
               and children find true riddles and knock-knock jokes very humorous.

"Good Clean Knock-Knock Jokes for Kids" contains a couple hundred jokes.

Knowing the developmental stages of humor is important. When attempting to teach humor to a child with special needs, you need to make sure that you are teaching what is developmentally appropriate and not what is appropriate based on the child's chronological age. In addition to helping to develop your child's humor, other benefits will be seen, such as improved eye contact and a fun emotional connection between you and your child.

Early Enrichment Boosts Later Achievement

2011-09-18T21:05:22Z

Reference: The ASHA Leader August 30,2011

What parents do with their children, even before they begin to talk, has more bearing than children's social background on how they ultimately perform in school. According to a large United Kingdom study-the Avon Longitudinal Study of Parents and Children-children who visited the library more often and owned more books at age 2 achieved higher scores on school assessment tests. Visit www.education.gov.uk/publications/eOrderingDownload/DFE-RR134.pdf.

Study Digs Deeper into Dyslexia

2011-08-07T22:03:31Z

Reference: St. Louis Post Dispatch August 4, 2011

Disorder has roots in failure to recognize the sounds of speech.
by Pam Belluck New York Times

Many people consider dyslexia simply a reading poblem in which children mix up letters and misconstrue written words. But scientists increasingly have come to believe that the reading difficulties of dyslexia are part of a larger puzzle: a problem with how the brain processes speech and puts together words from smaller units of sound.

Now, a study published last week in the journal Science suggests that how dyslexics hear language may be more important than previously realized. Reasearchers at the Massachusetts Institute of Technology have found that people with dyslexia have more trouble recognizing voices than those without dyslexia.

John Gabrieli, a professor of cognitive neuroscience, and Tyler Perrachione, a graduate student, asked people with and without dyslexia to listen to recorded voices paired with cartoon avatars on computer screens. The subjects tried matching the voices to the correct avatars speaking English and then an unfamiliar language, Mandarin.

Nondyslexics matched voices to avatars correctly almost 70 percent of the time when the language was English and half the time when the language was Mandarin. Experts not involved in the study said that was a striking disparity.

"Typically, you see big differences in reading, but there are just subtle general differences between individuals who are afflicted with dyslexia and individuals who aren't on a wide variety of tests," said Richard Wagner, a psychology professor at Florida State University. "This effect was really large."

Sally Shaywitz, a director of the Center for Dyslexia and Creativity at Yale University, said the study "demonstrates the centrality of spoken language in dyslexia-that it's not a problem in meaning, but in getting to the sounds of speech."

That is why dyslexic children often misspeak, she said, citing two examples drawn from real life.

"A child at Fenway Park watching the Red Sox said, 'Oh, I'm thirsty. Can we go to the confession stand?' " she said. "Another person crossing a busy intersection where many people were walking said, 'Oh, those Presbyterians should be more careful.' It's not a question of not knowing but being unable to attach what you know is the meaning to the sounds."

Gabrieli said the findings underscored a critical problem for dyslexic chidlren learning to read: the ability of a child hearing, say, a parent or teacher speak to connect the auditory bits that make up words, called phonemes, with the sight of written words.

If a child has trouble grasping the sounds that make up language, he siad, acquiring reading skills will be harder.

The research shows that spoken language deficiencies persist even when dyslexics learn to read well. The study subjects were mostly "high-functioning, high-IQ young adults who had overcome their reading difficulty," Gabrieli said. "And yet when they had to distinguish voices, they were not one iota better with the English-language voices that they've heard all their life."

Experts said the new study also shows the interconnectedness of the brain processes invoiced in reading. Many scientists had considered voice recognition to be "like recognizing melodies or things that are primarily nonverbal," Gabrieli said.

Voice recognition was thought to be a separate task in the brain from understanding language.

But this research shows that normal reading involves a "circuit, the ability to have all of those components integrated absolutely automatically," said Maryanne Wolf, a dyslexia expert at Tufts University. "One of the great weaknesses in dyslexia is that the system is not able to integrate these phoneme-driven systems" with other aspects of language comprehension.

Any questions or comments about this article are welcome at www.interactivetherapy.net!

To start the discussion:

A speech language pathologist is often involved with a child's articulation and/or phonological disorder at earlier ages before a child starts to read. One cannot predict if a child with an articulation or phonological disorder will have a reading/writing problem. It behooves us as educators and speech language pathologists to monitor a child's development in reading and writing for those children who may be at risk for dyslexia because of difficulty in perceiving, processing and producing sounds in speech. If anyone is doing research on predicting dyslexia based on articulation/phonological disorders, please let me know. It would be a worthwhile study. It would be good to know if those of us working in the field of speech language pathology could lessen the degree of dyslexia before a child learns to read/write or even prevent it.
Pam Hass, Interactive Therapy Inc