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Speech Pathologists What do they do? Assessments – Speech  Articulation Assessments Assessments – Speech  Articulation Assessments –Literacy  Literacy.

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Presentation on theme: "Speech Pathologists What do they do? Assessments – Speech  Articulation Assessments Assessments – Speech  Articulation Assessments –Literacy  Literacy."— Presentation transcript:

1 Speech Pathologists What do they do? Assessments – Speech  Articulation Assessments Assessments – Speech  Articulation Assessments –Literacy  Literacy tests (SPAT) –Language  CELF, TOLD –Swallowing –Voice Treatment for children who have: Treatment for children who have: –Trouble saying words clearly –Comprehension or understanding difficulties –Delayed verbal expression and conversational skills –Decreased ability to understand relationships between sounds and letters (early literacy development) -Delayed sound and letter sequencing ability -Swallowing/ oral motor difficulties

2 Speech Jargon Areas of Language Receptive Language (comprehension) Receptive Language (comprehension) Short Term Auditory MemoryShort Term Auditory Memory Auditory ProcessingAuditory Processing Expressive Language Expressive Language Semantics (meanings, vocabulary)Semantics (meanings, vocabulary) Morphology and Syntax (sentence Structure)Morphology and Syntax (sentence Structure) Phonology (speech sounds/articulation)Phonology (speech sounds/articulation) Phonological Awareness (Manipulation of sounds  early literacy)Phonological Awareness (Manipulation of sounds  early literacy) Metalinguistics (sound awareness)Metalinguistics (sound awareness) Pragmatics (Social skills)Pragmatics (Social skills)

3 Identification What do I look for? To know what is ‘abnormal’, it is vital one understands ‘normal’ development: Generally, between the ages of 3 and 6 years: Sentences continue to develop in length and complexity, some grammatical errors can still be present.Sentences continue to develop in length and complexity, some grammatical errors can still be present. Sentences frequently include connectors (and, then, because, but, if, so) and some more adult forms begin to appear (actually, well..)Sentences frequently include connectors (and, then, because, but, if, so) and some more adult forms begin to appear (actually, well..) Vocabulary expands and more adult-like words appearVocabulary expands and more adult-like words appear

4 Language is used for social purposes (asking questions, commenting, instructing, negotiating, ‘basic thinking’ – planning, organizing, suggesting, defining).Language is used for social purposes (asking questions, commenting, instructing, negotiating, ‘basic thinking’ – planning, organizing, suggesting, defining). Ability to retell stories, recount events accurately and with little support.Ability to retell stories, recount events accurately and with little support. Understanding of more complex questions and concepts occursUnderstanding of more complex questions and concepts occurs Ability to follow 3 stage instructions developsAbility to follow 3 stage instructions develops Speech is generally intelligibleSpeech is generally intelligible

5 Classic Red Lights in the classroom Sentences remain simple (no use of connecting words to join ideas) Sentences remain simple (no use of connecting words to join ideas) Can not retell a story or an event, with minimal support Can not retell a story or an event, with minimal support Speech is echolalic (repetition of friends, teachers) Speech is echolalic (repetition of friends, teachers) Poor understanding of more difficult concepts (e.g.. Before/after, in front of, last/first, high/low). Poor understanding of more difficult concepts (e.g.. Before/after, in front of, last/first, high/low). Difficulty following instructions of 2+ stages (e.g.. Get the ball, then get the sock and pen) Difficulty following instructions of 2+ stages (e.g.. Get the ball, then get the sock and pen) Difficulty with more ‘thinking’ questions (e.g.. How are these same/different? What will happen next?) Difficulty with more ‘thinking’ questions (e.g.. How are these same/different? What will happen next?) Understands only very basic story plots Understands only very basic story plots

6 Not using language to tell stories, argue, instruct, question, plan, explain basic negotiation Not using language to tell stories, argue, instruct, question, plan, explain basic negotiation Not developing more sophisticated play (e.g.. Fantasy play) Not developing more sophisticated play (e.g.. Fantasy play) Poor conversational skills (e.g. Can’t keep on topic, very reliant on conversational partner, perseverates on topics) Poor conversational skills (e.g. Can’t keep on topic, very reliant on conversational partner, perseverates on topics) Poorly developed social skills (e.g.. Ability to deal with conflict) Poorly developed social skills (e.g.. Ability to deal with conflict) No awareness of rhyme, sounds (e.g.. My name starts with a..) No awareness of rhyme, sounds (e.g.. My name starts with a..) Speech is difficult to understand on occasions (child at this age should have most sounds) Speech is difficult to understand on occasions (child at this age should have most sounds) Stuttering Stuttering

7 Delayed Development in Comprehension A child with comprehension difficulties can often be seen as naughty, an inconsistent performer, easily distracted and may: A child with comprehension difficulties can often be seen as naughty, an inconsistent performer, easily distracted and may: Have difficulty in following instructionsHave difficulty in following instructions Need to have instructions repeated or simplifiedNeed to have instructions repeated or simplified Not respondNot respond Give incomplete or inappropriate answers to questionsGive incomplete or inappropriate answers to questions Show lack of understanding of abstract language concepts (e.g.. Letters, sounds)Show lack of understanding of abstract language concepts (e.g.. Letters, sounds) Have little awareness of their own poor comprehension and not know when or how to ask for helpHave little awareness of their own poor comprehension and not know when or how to ask for help Find it difficult to interact with their peers (e.g.. In games, conversation)Find it difficult to interact with their peers (e.g.. In games, conversation)

8 The child with difficulties understanding language will often try very hard to fit in and to do what other children are doing. Many develop very effective coping strategies which can mask the difficulty the child is having. They may: The child with difficulties understanding language will often try very hard to fit in and to do what other children are doing. Many develop very effective coping strategies which can mask the difficulty the child is having. They may: Rely on watching and following other childrenRely on watching and following other children Become overly dependant on routine and unable to function readily outside the classroom routineBecome overly dependant on routine and unable to function readily outside the classroom routine Become the ‘naughty’ child – the child has learnt that by being non co-operative the teacher is likely to give 1:1 attention, to simplify/separate instructions and may even use gesture to get the message across – all of which aid comprehension.Become the ‘naughty’ child – the child has learnt that by being non co-operative the teacher is likely to give 1:1 attention, to simplify/separate instructions and may even use gesture to get the message across – all of which aid comprehension.

9 Delayed Development - Semantics A child with difficulties in this area may: A child with difficulties in this area may: Use a lot of non-specific words such as ‘this’, ‘that’, ‘there’, or ‘over there’Use a lot of non-specific words such as ‘this’, ‘that’, ‘there’, or ‘over there’ Use gesture and pointing instead of wordsUse gesture and pointing instead of words Use ‘made up’ words (jargon) instead of real wordsUse ‘made up’ words (jargon) instead of real words Have significant word finding difficulties requiring extra time to search for an appropriate word.Have significant word finding difficulties requiring extra time to search for an appropriate word.

10 The child may have difficulty in: The child may have difficulty in: Understanding the meaning of words/concepts and the relationship between words (semantic relationships)Understanding the meaning of words/concepts and the relationship between words (semantic relationships) Understanding adjectives and adverbs (e.g.. Tall/short, near/far, first/last)Understanding adjectives and adverbs (e.g.. Tall/short, near/far, first/last) Recalling adjective sequences (e.g.. A small, yapping gray dog)Recalling adjective sequences (e.g.. A small, yapping gray dog) Understanding prepositions (e.g.. On/in, under, behind, in front of)Understanding prepositions (e.g.. On/in, under, behind, in front of) Understanding more complex concepts such as except, not withoutUnderstanding more complex concepts such as except, not without

11 Delayed Syntax / Grammar A child should be able to hold a conversation with an adult. They should be able to: A child should be able to hold a conversation with an adult. They should be able to: Use some complex sentences and connectorsUse some complex sentences and connectors Use some descriptive wordsUse some descriptive words Use tense markersUse tense markers Monitor and if necessary repair (correct themselves/others)Monitor and if necessary repair (correct themselves/others) A delayed child: A delayed child: Has difficulty forming sentencesHas difficulty forming sentences Uses simple, short utterancesUses simple, short utterances Uses few joining wordsUses few joining words Omits word endings (omits ‘ink's etc)Omits word endings (omits ‘ink's etc)

12 Delayed Sound Awareness (Metalinguistics) Metalinguistics is the term used to describe a child’s ability to think about and manipulate the units of language (sounds and words) and to understand how they combine to produce meaningful oral and written language. Metalinguistics is the term used to describe a child’s ability to think about and manipulate the units of language (sounds and words) and to understand how they combine to produce meaningful oral and written language. By the end of pre-primary a child not showing at least some of these skills should be referred for assessment: By the end of pre-primary a child not showing at least some of these skills should be referred for assessment: Awareness of rhymeAwareness of rhyme Production of rhymeProduction of rhyme Awareness of first sound in own nameAwareness of first sound in own name Ability to clap syllablesAbility to clap syllables Some awareness of sounds/letter namesSome awareness of sounds/letter names

13 Delayed Pragmatic Development A child with appropriate pragmatic development should be able to: A child with appropriate pragmatic development should be able to: Hold a conversationHold a conversation Use appropriate eye contactUse appropriate eye contact Change a topic appropriatelyChange a topic appropriately Take turnsTake turns Use a range of language functionsUse a range of language functions Maintain good body placement (maintain own space)Maintain good body placement (maintain own space)

14 A child with delayed pragmatic skills is often seen as ‘different’ and may exhibit: A child with delayed pragmatic skills is often seen as ‘different’ and may exhibit:  Poor eye contact  Invades personal space  Bring in irrelevant topic/responses  Poor listener awareness  Difficulties in peer group relationships  Poor understanding of social boundaries (e.g.. Very affectionate)  Unusual voice pattern  Need help to maintain conversation

15 Articulation / Phonology (Speech) Articulation refers to a child’s speech sound production. Speech sounds develop through the first seven years of life. Articulation refers to a child’s speech sound production. Speech sounds develop through the first seven years of life. Neurological (dyspraxia), motor disorder or lack of sound awareness/self monitoring. Neurological (dyspraxia), motor disorder or lack of sound awareness/self monitoring. ‘Normal’ development can differ between children. ‘Normal’ development can differ between children. Various factors may influence a child's ability to produce a sound and some may be physical (e.g.. A child who has lost their front teeth would have difficulty producing a ‘s’ sound). Various factors may influence a child's ability to produce a sound and some may be physical (e.g.. A child who has lost their front teeth would have difficulty producing a ‘s’ sound).

16 Normal Development AgeSoundComments 1.6 to 2.6 M, p, b, w, n, t, d - easier sounds - Put lips together and tongue up behind the teeth 2.6 to 3.6 H, k, g - back of tongue up to the back of the soft palate 3 to 3.6 F, s - still appropriate to lisp on ‘s’ until to 4 V, z, l, y, blends - some difficulties still may persist (e.g. ‘lellow’ for ‘yellow’) 4 to 5 Sh, ch, j - middle of the tongue up to the palate 5 to 7 R, th - lisping should stop - Treatment for ‘r’ and ‘th’ is often left until 7.

17 Stuttering Approximately 1% of the population stutter Approximately 1% of the population stutter Observable verbal feature of a stutter may include: Observable verbal feature of a stutter may include:  Repetitions (c, c, cat)  Prolongations (ccccc, at)  Blocks (i.e.. Silent struggles)  Fillers (e.g.. ‘er’, ‘um’) Associated non-verbal characteristics may include: Associated non-verbal characteristics may include:  Body tension  Eye blinking  Reduced eye contact  Facial grimaces  Unnecessary body movements  Avoidance of speaking situations DON’T WAIT TO SEE IF A CHILD’S STUTTER WILL GO AWAY. THE EARLIER A CHILD IS SEEN THE QUICKER AND EASIER THERAPY IS. DON’T WAIT TO SEE IF A CHILD’S STUTTER WILL GO AWAY. THE EARLIER A CHILD IS SEEN THE QUICKER AND EASIER THERAPY IS.

18 Useful Contacts Audiologists  John Bench (Monash University) –  Peter Altidis (Hampton Park and other clinics) –  Simon Davis (East Melbourne – Medicare Rebate) Optometrists Melbourne Optometry Clinics:  Casey Community Health Center (Free glasses) – Behavioural Opthalmologist  Norman Russo (Dandenong)  Contact Tim Fricke

19 Referring within the school Handout – fill in according to child’s displayed behaviors Handout – fill in according to child’s displayed behaviors Give consent form to parent to be filled out Give consent form to parent to be filled out Put consent form and referral form into ‘Specialist In Tray’ ?office. Put consent form and referral form into ‘Specialist In Tray’ ?office. These sheets will then be distributed to appropriate specialist (Psychologist, Speech Pathologist) and assessment/treatment can be commenced quickly. These sheets will then be distributed to appropriate specialist (Psychologist, Speech Pathologist) and assessment/treatment can be commenced quickly. To be organized at the beginning of Term 3. To be organized at the beginning of Term 3.


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