Creative Therapy Associates Blog

Strokes - What You Need to Know

Thu, 26 Sep 2019 08:27:52 GMT

Stroke has been and is still a very common disease today. If you or your loved one has suffered a stroke, below is everything you need to know.

What Is a Stroke?

Stroke is a disease that occurs when blood stops flowing/reaching the brain i.e. due to a torn blood vessel or blood clot. A stroke can either be mild or severe. A stroke can also be temporary or permanent. A stroke usually affects a person’s speech, vision, behaviour as well as the ability to think and move certain parts of the body. The effects usually vary depending on factors such as the area of the brain that is affected, the extent of the damage as well as how fast normal blood flow can be restored in the affected area. In very severe cases, a stroke can cause death.

Types of Stroke

There are five main types of stroke namely;

Ischemic Stroke
Embolic Stroke
Thrombosis Stroke
Hemorrhagic Stroke
TIA (Transient Ischemic Attack)

a. Ischemic Stroke

Ischemic stroke results from a clot or mass clogs in blood vessels which cut off blood flow to the brain.

b. Embolic Stroke

Embolic Stroke results from a blood clot which forms somewhere else in the body (in most cases the heart) and travels via the bloodstream to the brain. Once the blood clot reaches the brain, it travels to a small blood vessel blocking its passage.

c. Thrombotic Stroke

This type of stroke occurs when one of the arteries (or many arteries) responsible for supplying blood to the brain are blocked impairing blood flow. Thrombotic stroke derives its name from the fact that clots that form on blood vessels deposit what are known as a thrombus. The underlying cause of blood-clot strokes is unhealthy blood vessels i.e. blood vessels which are clogged by cholesterol and fatty deposits.

d. Hemorrhagic Stroke

As the name suggests, this type of stroke is caused by hemorrhage i.e. when one or many blood vessels rupture resulting in an accumulation of blood in the surrounding tissue. Hemorrhagic Stroke can be caused by injury, weakening of specific regions of blood vessels as well as the abnormal formation of blood vessels.

e. TIA (Transient Ischemic Attacks)

TIAs are small/mini strokes which are caused when a blood clot temporarily blocks an artery. As a result, TIA symptoms/effects are usually temporary.

Symptoms of a Stroke

How Do You Know If You/Your Loved One Is Suffering from a Stroke?

The main stroke symptoms include;

Facial Weakness (Especially on One Side)
Arm Weakness
Slurred Speech (In Severe Cases, a Person May Be Unable to Speak)

It’s also worth noting that there are many other symptoms to look out for i.e. visual problems, balance problems, falling and headaches. You should also be on the lookout for body function problems since a stroke affects the brain which is the organ responsible for controlling all body functions.

Important: If you or a loved one experiences any one or more of these symptoms, seek medical attention immediately. Seeking immediate medical care early is important because it lessens the effects of the stroke.

How Is a Stroke Diagnosed?

A Stroke is usually diagnosed via physical examination as well as diagnostic studies. A patient’s medical history also helps in diagnosis. Doctors usually perform an MRI or CT scan on patients suspected to have suffered a stroke. The scan helps doctors establish whether a patient has a clot anywhere or if they are suffering from internal bleeding.

Diagnosis may also involve ultrasound, magnetic resonance angiography (scan to evaluate blood flow), angiogram (artery x-ray) as well as other lab tests/x-rays if a patient is suspected to have a stroke caused by artery disease.

Treatment

As mentioned above, it is crucial to seek immediate medical attention if you have any of the above stroke symptoms to increase your chances of recovery/reduce the severity of the effects of suffering a stroke.

If you suffer from a stroke caused by a blood clot/s, there is medication for dissolving blood clots. If you receive such medication in time, your chances of having a full recovery will be higher. Besides medication, treatment may also include surgery in severe cases.

Physical therapy is also a common and effective stroke treatment administered to individuals who develop muscle strength and balance problems after a stroke.

Speech therapy is also effective for helping stroke patients who have speech problems. Medical professionals like speech and language therapists (SLTs) can help stroke patients work on their speech as well as related activities i.e. drinking and eating which may be affected by a stroke.

In cases where a patient’s leg or arm in paralyzed, a medical professional like an occupational therapist can assist a patient to learn how to perform important tasks i.e. dress, bathe, cook, etc.

What Are Swallowing Disorders?

Thu, 26 Sep 2019 08:14:41 GMT

Dysphagia, the name used for swallowing disorders, is characterized by difficulties in swallowing. Individuals suffering from dysphagia may take more effort to swallow food. The problem has a number of causes the most notable being stroke.

Dysphagia is common in approximately 65% of all stroke patients. The disorder is linked to nerve and muscle problems common among older people.

Understanding Dysphagia

To understand dysphagia in-depth, it’s important to understand the swallowing process. Contrary to popular belief, swallowing is a complex process. The process can be broken down into three main steps.

Dysphagia causes difficulty anywhere in the processes described below;

Seeing, smelling & tasting: The swallowing process starts way before food enters the mouth. Seeing and smelling food is part of the swallowing process because it helps in the production of saliva. Tasting is the last of the initial stages of swallowing.
Chewing: Once the food is in the mouth, it must be chewed to break it down and make it softer after which the tongue pushes it towards the back of the mouth into the pharynx. Once food has reached the pharynx, swallowing becomes an automatic reflex action.
When food is travelling towards the back of the mouth, the voice box (larynx) closes preventing any food and liquid from entering the windpipe. The automatic gulping action pushes food into the esophagus. The muscular walls of the esophagus contract and expand pushing food down to the stomach to complete the swallowing process.

Types of Dysphagia

There are two main types of dysphagia namely; high dysphagia and low dysphagia.

1. High dysphagia (Oropharyngeal dysphagia): As the name suggests, this type of dysphagia happens high up in the swallowing process i.e. in the mouth or throat. High dysphagia is usually caused by tongue weakness (after a stroke) or when a person has difficulties producing saliva. Besides stroke, high dysphagia is also caused by other neurological problems i.e. Parkinson’s disease or amyotrophic lateral sclerosis.

2. Low Dysphagia (esophageal dysphagia): This type of dysphagia affects the esophagus. Low dysphagia results from blockage or irritation. In most cases, low dysphagia can be treated using a surgical procedure.

Symptoms of Dysphagia

There are many symptoms associated with dysphagia. The most common include; Choking when eating, gagging or coughing when swallowing, drooling, food/stomach acid backing up frequently into the throat, hoarseness, sensations of choking/food getting stuck along the way i.e. in the throat or chest, regurgitation, difficulty swallowing, recurrent pneumonia, unexplained weight loss and difficulty producing saliva in the mouth.

Important: It’s worth noting that some people may suffer from dysphagia without being aware of it due to the seemingly harmless nature of some symptoms i.e. drooling. Some dysphagia symptoms may also be mistaken as independent health problems. The importance of proper screening can’t, therefore, be over-emphasized especially among high-risk individuals i.e. older individuals who have suffered a stroke. If left undiagnosed, dysphagia can lead to chronic dehydration and malnutrition.

Main Causes of Dysphagia

1. Stoke: Stroke impairs blood flow to the brain cells causing them to die due to lack of oxygen. Dysphagia is caused when the brain cells responsible for controlling swallowing are affected.

2. Amyotrophic lateral sclerosis: Amyotrophic lateral sclerosis is an incurable neurological disease that causes progressive neurodegeneration. The disease causes the nerves in the brain and spine to progressively lose function.

3. Parkinson’s disease: Parkinson’s disease also causes dysphagia by causing progressive neurodegeneration which impairs a person’s motor skills.

4. Other causes: Dysphagia can also be caused by; multiple sclerosis, radiation, myasthenia gravis (Goldflam disease), eosinophilic esophagitis, scleroderma, esophageal cancer and xerostomia (dry mouth).

Diagnosis

Dysphagia is diagnosed by determining where the swallowing problem lies. Other considerations that are made during the diagnosis process include; how long the patient has been having swallowing difficulties, whether the swallowing problems are brought about by solids, liquids or both. A swallow study is also conducted by a speech therapist. Patients may also undergo barium swallow tests aimed at highlighting muscle activity in the esophagus via X-rays.

Diagnosis may also involve endoscopy (looking into the esophagus using a camera) and manometry (studying pressure changes in the esophagus). Manometry is commonly used in diagnosing dysphagia when endoscopy results are normal.

Treatment

How is dysphagia treated? Well, it depends on the type.

a. Treating high dysphagia (oropharyngeal dysphagia)

Since oropharyngeal dysphagia is usually caused by neurological problems, effective treatment can be challenging. In cases where dysphagia is caused by Parkinson’s disease, treating Parkinson’s using medication may help dysphagia too.

Oropharyngeal dysphagia can also be treated via swallowing therapy administered by speech and language therapists. Swallowing therapy teaches patients new ways of swallowing. Some exercises are also used to improve the strength and overall health of muscles that assist in swallowing.

Dieting can also treat oropharyngeal dysphagia. This treatment is administered with the help of a nutritionist. Patients get customized diets that are balanced/nutritious but easy to swallow.

b. Treating low dysphagia (esophageal dysphagia)

Surgical intervention is required to treat esophageal dysphagia. Dilation is a common surgical intervention for treating esophageal dysphagia. The intervention involves widening the esophagus by inserting and inflating a small balloon. The balloon is then removed when the esophagus is widened.

In cases where esophageal dysphagia has been caused by cancer, patients are referred to oncologists for treatment which may require surgical removal of cancerous tumours.

Botox can also be used to treat esophageal dysphagia. Botox is used to relax stiff esophagus muscles.

Language Is More Than Words -- What Is Aphasia?

Thu, 26 Sep 2019 08:02:48 GMT

To understand aphasia in-depth, it’s important to understand language.

Contrary to popular belief, language isn’t just words. Language encompasses a person’s ability to recognize as well as use words/sentences. Much of a person’s capability to recognize and use words/sentences resides on the left side of the brain.

Your ability to use language is affected if you suffer from a stroke or any other injury affecting the left hemisphere/side of your brain.

How Does L anguage Help?

Language helps us communicate, understand what others are saying, ask questions, read, write, speak, listen as well as comment and interchange. When a person suffers from a stroke among other injuries affecting the left side of their brain, that person has difficulty using language in one or more of the above ways.

What Is Aphasia?

Aphasia can be defined as a language disorder that affects a person’s ability to communicate or use language. The disorder is usually caused by strokes which affect the areas of the brain responsible for controlling speech and language.

Symptoms of Aphasia

Aphasia symptoms are exhibited as difficulties in using language/communicating. The most notable symptoms include;

Difficulty understanding what others say
Difficulty asking questions
Difficulty reading and writing
Difficulty speaking and listening
Difficulty commenting

Effects of Aphasia

Contrary to popular belief, aphasia doesn’t affect intelligence. Individuals who suffer from stroke remain mentally alert although their ability to use language is compromised or impaired. Aphasia patients tend to have fragmented or jumbled speech that is hard and sometimes impossible to understand.

Aphasia patients may also have trouble finding words, speaking, processing long/infrequent words and doing math.

Connecting with People Who Have Aphasia: How Do They Feel?

When a person has problems using language, they tend to feel isolated since they can’t communicate effectively with others at home, work and even in social settings. Aphasia sufferers also have problems doing daily activities because they can’t communicate with others effectively. Aphasia can also result in frustration and confusion. People with aphasia tend to act differently because of the language/communication disconnect.

Before discussing how you can help someone with aphasia, let’s first take a look at the main types of aphasia.

Types of Aphasia

Aphasia is characterized mainly on where the damage occurred and/or the severity. There are 3 main types of aphasia namely; Global aphasia, Broca's aphasia and Wernicke's aphasia.

a. Global aphasia

Global aphasia affects a person’s ability to speak, repeat phrases, name objects as well as follow commands. A person with global aphasia can’t be able to do all these things entirely/completely. Global aphasia patients have severe communication difficulties i.e. understanding words/sentences, forming words/sentences, pronouncing a few words consecutively.

b. Broca’s aphasia

Broca’s aphasia (also referred to as expressive aphasia) inhibits a person’s ability to express themselves although a person knows exactly what he/she needs or wants to say. People suffering from Broca's aphasia can’t find the perfect words to use when communicating. Broca’s aphasia affects the frontal area of the left side of the brain making it very difficult to form complete sentences as well as understand sentences. Patients with Broca's aphasia also have problems following directions that involve left and right, above and below, etc. They tend to make mistakes when following directions where such words are used.

c. Wernicke’s aphasia

Individuals suffering from Wernicke's aphasia have severe difficulties understanding what other people are saying as well as controlling what they are saying. As a result, Wernicke's aphasia sufferers tend to say things which don’t make sense and fail to realize it. Wernicke’s aphasia sufferers also tend to have difficulties understanding what others are saying as well as what they are saying since the disorder affects the region of the brain that is responsible for helping us understand and use words.

How Can You Help?

Is your friend or family member suffering from aphasia? Do you want to help them but you don’t know what to do? If yes, here’s what you can do.

First and foremost, it’s important to help your loved one seek the best medical attention. Aphasia sufferers need to seek help from speech-language pathologists (SLPs). Aphasia sufferers also need to see a counsellor to help them with the stress and frustrations caused by the disorder. You should find the best speech-language pathologist to help your loved one recover in the best way possible.

Family members & friends are also encouraged to be open about the challenges of their loved ones so that other people can understand them as well. It is also advisable to simplify language/communication into yes or no questions as well as short sentences which are straight to the point. It is also important to help aphasia patients cope with their frustrations. You can do this by being patient when communicating with a person who has aphasia. You should also involve them when making decisions that affect them.

Symptoms of Autism and its Relationship With Speech and Language & Occupational Therapy (OT)

Thu, 26 Sep 2019 07:48:01 GMT

Autism which is also known as ASD (Autism Spectrum Disorder) is a complex neurodevelopmental disorder characterized by social, communication as well as language problems. It’s worth noting that children with autism exhibit different symptoms that tend to vary in regards to severity. The symptoms also tend to be accompanied by other medical problems that may also vary in severity. Below is a discussion of the main symptoms of autism as well as the most effective treatments for those symptoms.

Symptoms of Autism

Autism symptoms can be divided into four broad categories namely; social challenges, communication problems, repetitive behaviours as well as physical and mental issues that tend to accompany autism.

a. Social Challenges

Infants tend to be social by nature i.e. they turn towards voices, gaze and sometimes smile at faces etc. Most infants who develop autism have problems having these kinds of social engagements with people by 2-3 months. They tend to have a reduced interest in people. They may also fail to respond to their names by 8-10 months of age. As toddlers, most children with autism have problems playing social games. Unlike typical children, they don’t imitate action. They also prefer playing alone and seem disconnected most of the time.

All persons with autism (children and adults) have difficulty interpreting other people’s feelings and thinking. They tend to find little meaning to subtle social cures like a smile or wave. This inability to interpret facial expressions and gestures makes the social world bewildering in the eyes of persons with autism. Individuals with autism also tend to have problems regulating their emotions which may sometimes be interpreted as immaturity.

b. Communication Problems

Children with autism also tend to have communication problems. One of the most common and earliest communication problems is babbling. Children with autism experience significant language delays. They don’t have a fundamental grasp of language until late. However, with treatment such as speech-language therapy, children with autism can learn how to communicate using spoken language.

Individuals with autism may also exhibit unusual speech if/when they start speaking. Most have problems constructing meaningful sentences. They tend to converse in single words or repeat phrases over and over. Mildly affected children tend to exhibit slight delays in language or develop mature language or unusually large vocabularies but still have problems sustaining a conversation. Children, as well as adults with autism, also tend to engage in monologues giving others very little to no opportunities of commenting.

Another notable communication problem is the failure to understand body language as well as tones or expressions that should not be taken literally. For instance, children and adults with autism have difficulty interpreting sarcasm. They also tend to have gestures, movements and facial expressions that don’t match their words which can make it hard for other to know what they mean, want or need.

c. Behavioural Symptoms: Repetitive Behaviours

Autistic individuals also tend to exhibit repetitive behaviours such as; rocking, arranging/rearranging objects, hand-flapping, repeating sounds/words/phrases, jumping, and twirling, etc. In most cases, the repetitive behaviour has a self-stimulating aspect and most individuals with autism get extremely upset when their repetitive behaviour is disrupted. Their repetitive behaviours resemble obsessions.

d. Physical & Medical Issues/ S ymptoms Accompanying Autism

Autism is linked to many physical and medical issues. For instance, autism is linked to sensory processing problems. Many people with autism have problems processing sensory information i.e. sight, sounds, tastes, smells and/or movement. People with autism also tend to suffer from seizure disorders like epilepsy which is prevalent in approximately 39% of all individuals with autism. Autism also linked to Pica (a tendency to eat non-food items i.e. chalk, clay, dirt etc.). Pica is common among children with autism aged between 18 and 24 months).

Treating Symptoms of Autism

Treatment should start with an evaluation by an SLT (speech & language therapist) also referred to as a speech-language pathologist. Evaluation is important to determine the exact language, communication, social skill and behavioural needs of an individual with autism.

SLTs are also important for formulating treatment plans that meet the exact needs of individuals with autism as well as their families. Although medication and dietary restrictions are used to treat autism, the disorder is best treated using a combination of; traditional speech & language therapies/approaches and occupational therapy. Augmentative & alternative communication, as well as behavioural interventions, can also be included to enhance treatment.

a. Speech-Language Therapy

Most autism treatment programs include speech-language therapy which incorporates a variety of techniques that address the speech and language challenges (communication symptoms) exhibited by most individuals with autism. Speech-language therapy is a very important part of treating autism since the therapy addresses communication challenges such as; speech difficulties as well as challenges understanding nonverbal cues.

Speech-language therapy coordinates the meaning as well as the social use of language. The therapy starts with an individual evaluation. Individuals with autism visit a speech and language therapist to assess their communication challenges. From the information collected during the evaluation, the SLT designs a program to help deal with the unique communication needs of their patient. Speech-language therapy is highly effective for treating autism because it is highly specialized.

An SLT will help a child with autism talk, read and write. SLTs also help children with autism develop social skills i.e. play/get along with other children, understand as well as use gestures in communication, learn how to take turns in conversations, start/stop conversations, ask/answer questions, write/construct sentences etc.

b. Occupational Therapy (OT)

Occupational therapy is another effective therapy for treating/dealing with autism symptoms. OT deals with a combination of physical, cognitive and motor skills. The goal of OT in treating autism is helping individuals with autism gain age-appropriate independence. The social, communication, behavioural, as well as physical/medical symptoms, brought about by autism expose individuals with autism to challenges such as over-dependence on caregivers. OT helps individuals with autism gain useful skills that promote independence i.e. self-care, play/leisure skills. With OT, individuals with autism can finally be able to perform everyday tasks independently.

Like speech and language therapy, occupational therapy starts with evaluation. An occupational therapist evaluates a patient’s developmental levels and related social abilities, learning styles and environmental needs. Based on the evaluation, the occupational therapist formulates goals and selects appropriate strategies for enhancing crucial skills. The goals can be anything from improved social skills to independence in grooming and feeding.

What Is Occupational Therapy?

Thu, 26 Sep 2019 07:32:10 GMT

Occupational therapy is a form of therapy that offers support to people with health problems that prevent them from doing daily activities which matter to them. Occupational therapy (OT) is administered by occupational therapists. The main role of occupational therapists is identifying the strengths and difficulties a patient might have on a daily basis i.e. dressing, going to the store, etc. and helping work out practical solutions for such problems.

Occupational therapists help their patients identify goals that will help them maintain, regain or improve their independence using different techniques, new equipment and/or effecting changes in a patient’s environment.

Who Needs Occupational Therapy? Who Can Benefit from It?

Occupational therapy is great for anyone with difficulties performing everyday tasks because of a medical condition i.e. rheumatoid arthritis, injury (from an accident), a learning disability or a mental health condition like bipolar disorder. Occupational therapists work with all kinds of people in all age groups and from all walks of life. They also offer their services from anywhere i.e. home, school, workplaces, etc.

When to Seek Treatment?

Occupational therapy is highly recommended for treating and managing a wide range of health conditions and needs that may be present from birth, or that may have developed with age or resulted from an accident.

Occupational therapy is usually used as part of rehabilitation programs designed to help individuals recover from injury or illness. Below are some of the main instances occupational therapy is used;

a. Treating medical conditions

Occupational therapy is used to treat medical conditions such as; arthritis, depression, multiple sclerosis, Parkinson’s disease, dyspraxia and chronic fatigue syndrome.

b. Treating conditions in children

Occupational therapy may work for some conditions in children such as; cerebral palsy, down’s syndrome, learning disability and spina bifida. In general, occupational therapy may be used to help children with developmental disabilities, sensory processing difficulties, and psychosocial needs. OT is also used to promote wellness programs in schools i.e. preventing childhood obesity.

c. Addressing ageing challenges

Occupational therapy is also used to treat challenges brought about by ageing i.e. movement problems, dementia, stroke, etc. Elderly individuals who have problems getting out of bed, climbing stairs, etc. can often perform these tasks after undergoing occupational therapy, or additional aids to help keep them independent.

d. Mental health

Occupational therapy is also used to treat mental health problems such as schizophrenia, anxiety disorders, trauma and stressor-related disorders, deficit/hyperactivity disorder, autism spectrum disorder and learning disorders. Occupational therapists assist patients who have mental illnesses get the skills they require to care for themselves as well as others. Such skills include; self-care/hygiene skills, coping skills, routine building, social skills, and money management.

e. General health and wellness

Occupational therapy is also useful in general health and wellness. The therapy is used in the prevention of disease, injury, and secondary conditions. Occupational therapy is also used to promote the well-being of individuals suffering from chronic illnesses. OT is also used to reduce health care disparities as well as promote healthy living practices.

Occupational Therapy Techniques

How Do Occupational Therapists Help?

Occupational therapists start by identifying the difficulties faced by a patient on a daily basis. There are four main ways an occupational therapist can help.

They include the following:

1. Helping the patient perform activities they have problems with i.e. by breaking down the activities into manageable steps/stages.

2. Teaching the patient different ways of completing challenging activities.

3. Recommending changes that make challenging activities easier to perform.

4. Recommending devices to make challenging activities easier to perform.

For example, many seniors have problems climbing stairs. An occupational therapist can recommend useful devices i.e. stair lifts that help individuals climb stairs in their home easily.

Stages of the Treatment Process

a. Individualized evaluation: Occupational therapy begins with individualized evaluation. During this stage, a patient visits an occupational therapist (the therapist can also visit the patient). During the visit, the therapist identifies the patient’s personal challenges and goals.

b. Custom intervention: After carrying out an evaluation, the therapist recommends custom interventions meant to improve the patient’s ability to perform day-to-day activities and reach their personal goals.

c. Outcome evaluation: During this treatment stage, the therapist evaluates the patient to see if the custom intervention/s recommended have worked. If not, the therapist recommends changes to the patient’s custom intervention plan.

Occupational therapists follow a systematic sequence of actions referred to as; the occupational therapy process. Although there are many versions of the process, all versions have the basic evaluation, intervention and outcome components.

Occupational therapists among other practitioners in the field focus on holistic treatment techniques i.e. they focus on adapting the environment or the task or both to fit a patient. The patient is a key player in the therapy team. This treatment process is very effective. Occupational therapy treatment is evidence-based and deeply rooted in science.

How Do You Access Treatment?

The first step to accessing occupational therapy treatment is visiting your doctor. Your doctor shouldn't have a problem referring to you to a certified occupational therapist. You can also get referrals from a nurse or any other healthcare professional.

Areas of Practice

Occupational therapists can work in very many different settings. They can also work with all kinds of patients and practice in many different specialities. Occupational therapists have a broad spectrum of practice which makes it difficult to categorize all the different areas of OT practice that exist especially in regards to different countries as well as different healthcare systems.

There are many areas of OT practice, and these divisions are mainly defined by the group they serve. For instance, mental health or acute physical settings (i.e. hospitals), sub-acute settings (i.e. long-term care facilities), community settings and outpatient clinics.

In every area of practice in OT, occupational therapists can work with in different settings with different populations, diagnosis, and specialities. The first step of treatment i.e. evaluation should be able to guide occupational therapists to proceed with treatment or refer patients to specialized care.

Alternative Communication Methods refers to the tools and strategies used to solve communication challenges

Thu, 26 Sep 2019 07:25:05 GMT

The term, Augmentative and Alternative Communication (AAC), sounds complicated to most people. In simpler terms, AAC refers to the tools and strategies used to solve communication challenges faced by individuals who have problems using oral speech.

Brief History of Augmentative and Alternative Communication (AAC)

The term augmentative communication was coined to refer to communication systems that supplement natural speech as opposed to replacing it. The term alternative was added later as it became evident that for some people, non-speech systems were the only means of communication.

Overview

AAC includes every form of communication other than oral speech. As a result, we all use AAC in a way. Augmentative and alternative communication includes; facial expressions, gestures, symbols, pictures as well as text i.e. all other forms of communication apart from oral speech.

People with speech and/or language problems rely heavily on AAC to communicate. AAC is effective for such individuals because communication can take very many forms. As long as the intention and meaning of one person is understood by the other person, it doesn’t really matter what form of communication is used. AAC operates on this basis.

Although speech is one of the most popular and heavily relied upon modes of communication, it can always be supplemented with other forms when communicating parties have severe speech and/or language problems.

AAC utilizes special augmentative aids like pictures, symbol communication boards, electronic devices, etc. to help people with speech and language problems express themselves, increase their social interaction and feeling of self-worth.

Who Can Use AAC?

AAC can be used by anyone in need of enhancing their communication.

This includes all individuals with congenital conditions like;

Autism
Cerebral Palsy
Intellectual Disability

AAC is also effective for individuals with acquired conditions like;

Traumatic Brain Injury
Aphasia
Amyotrophic Lateral Sclerosis

AAC is effective for individuals with the above conditions as well as anyone else with severe speech-language impairments which make it difficult for such people to be understood.

Types of AAC (Augmentative and Alternative Communication)

There are two types of AAC systems namely; unaided communication systems and aided communication systems.

a. Unaided C ommunication Systems:

As the name suggests, unaided communication systems rely on someone’s body to communicate/convey messages. Unaided communication systems include; body language, gestures, facial expressions and/or sign language. The systems don’t require any external tools. Body language and facial expressions are informal types of unaided communication systems.

More formalized unaided communication systems include gestural codes i.e. the Amer-lnd which is based on the Plains Indian Sign Language and used mostly with children suffering from severe profound disabilities. The Amer-lnd is also used by adults suffering from a variety of conditions from aphasia to dementia and dysarthria.

Unaided communication systems stand out because they are an efficient way of communicating. For instance, unaided communication systems like sign languages permit expression of countless messages. Another notable benefit of unaided communication systems is; they are available to users throughout.

b. Aided C ommunication Systems

Aided communication systems require tools and equipment as well as a user’s body. Aided communication methods range from writing to the use of communication books/boards as well as devices which produce voice output (SGF’s or speech generating devices). Aided communication systems include electronic communication aids which allow users to use letters, words, phrases and picture symbols to create messages. Devices which allow aided communication can be programmed to meet the specific needs of a user i.e. specific language needs.

The Role of Speech-Language Pathologists When Working with Persons Who Use AAC

Speech-language pathologists (SLPs) are the best suited medical professionals for helping people who use AAC. SLPs are responsible for establishing AAC techniques and strategies including the development, selection, and prescription of AAC systems and devices.

SLPs perform assessments on individuals with speech and language impairments requiring the use of AAC systems before developing, selecting or prescribing AAC systems and devices. SLPs also assess communication partners as well as the environments where communication occurs.

SLPs use authentic assessment procedures to evaluate as well as determine an individual’s communication skills and needs. SLPs conduct thorough oral peripheral exams meant to identify communication difficulties, an individual's potential to use of natural speech, opportunities for communication, barriers of communication, etc.

SLPs may work alongside other medical professionals to conduct comprehensive assessments. They may also involve loved ones (friends and family members) to help them understand as well as be a part of the prescribed communication solution/s.

Articulation Delays in Children - signs, causes and treatment

tricia@thesimpleweb.ca (Tricia Littlefield) — Thu, 26 Sep 2019 07:15:46 GMT

What are articulation delays?

To understand articulation delays, it’s important to understand articulation.

What is Articulation?

Articulation can be defined as the process by which syllables, words, and sounds are formed when the tongue, teeth, jaw, lips and palate alter the airstream originating from the vocal folds. When a person can’t produce or distort age-expected sounds i.e. when a person has articulation problems, this usually draws attention away from the message. Articulation problems can be defined as motoric errors. They can occur at any age. However, they are usually common in children.

Articulation Delays

Articulation delays which can also be referred as pronunciation delays occur when speech sound errors persist past a certain age. It’s worth noting that different sounds develop during a certain age range. When this doesn’t happen, a child is said to have articulation delays which should be a cause for concern.

Signs of Articulation Delays

There are many signs a parent can look out for to determine if their child has articulation delays or not. For instance, children with articulation delays tend to have problems producing speech sounds. Articulation delays may affect a range of sounds or a particular sound. Articulation delays may lead to other problems i.e. slow language learning, difficulty to be understood as well as problems forming social relationships.

Causes

Articulation delays may be attributed to a variety of issues ranging from neurological disorders (i.e. cerebral palsy) to physical impairments like cleft lip, poor oral-motor skills or difficulties with placements of articulators (tongue, lips, jaw, etc.).

Hearing loss may also cause articulation delays. Children who suffer from frequent ear infections have a higher risk of suffering from articulation delays. Other causes include developmental disorders like autism, genetic syndromes like Down syndrome.

Seeking Help

It is worth noting that it is age-appropriate for a child (at certain ages) to make errors or have problems with certain sounds. However, if a child continues to produce an error or errors with a sound/s they should have acquired at a certain age, then that child is said to have articulation delays.

In such a case, the child needs to be assessed by a speech-language pathologist (SLP). Speech-language pathologists are the best-suited professionals for evaluating children’s speech problems and determining if they have acquired their sounds correctly depending on their age.

Why Does Treatment Matter?

Seeking help is very important since articulation delays have detrimental effects. For instance, articulation delays compromise;

A child’s reading and spelling skills.
Language and social skills development.
A child's interactions with others.
The emotional well-being of a child which has a close relationship with behavioural issues.

If articulation delays are ignored, your child could end up having one or more of the above problems i.e. reading and spelling problems, language and social skill development issues, interaction problems as well as emotional well-being problems.

Treatment: The Role of SLPs in Treating Children with Articulation Delays

Articulation delays are treated through speech and language therapy administered by SLPs or speech pathologists. Speech-language pathologists teach children with articulation delays how to place their articulators (lips, tongue, jaw, teeth, etc.) correctly. SLPs also teach children with articulation delays how to voice correctly and achieve targeted sounds. SLPs use numerous speech strategies as well to help children with articulation delays maintain their achievements.

The work of SLPs can be difficult since they have to change the way children with articulation delays speak. SLPs do way more than teach sound articulation. Once a child has learned how to say a certain sound correctly, they must follow a certain hierarchy or risk forgetting or losing their ability to make the sound.

The hierarchy begins with an isolation level i.e. a student learning how to say a certain sound by themselves through practice. The learning moves on to nonsense syllables, words, phrases, sentences, reading and then conversation. Learning is usually administered through therapy sessions and children must achieve 80% or more accuracy to move to the next level.

SLPs must carry out intense therapy sessions i.e. make children with articulation delays say a certain sound hundreds of times ( mostly 200 times) per session while ensuring children stay interested and motivated to master every sound during every level and position. We play various board games while teaching sounds to keep children engaged.

Therapy sessions are also highly specialized to meet unique needs of each and every child (i.e. interests). Therapy sessions also include a parental training component. SLPs, therefore, do more than ''play games’’ with children with articulation delays.

Stuttering, What You Need to Know - symptoms, causes, and treatment

Thu, 26 Sep 2019 07:04:11 GMT

Do you stutter or know someone who stutters and you’re wondering what you can do to help? What do you need to know?

What is Stuttering?

Stuttering can be defined as a communication disorder characterized by speech disruptions or 'disfluencies''. People who stutter experience physical tension in their speech muscles which cause them to struggle as they speak. Stuttering usually causes anxiety and/or embarrassment. People who stutter also tend to fear speaking which in turn makes it extremely difficult for them to communicate effectively.

Stuttering can vary in regards to degree i.e. mild to severe stuttering. Stuttering usually begins during childhood and in most cases lasts throughout life if the problem is not treated early. Stuttering isn’t necessarily a problem in itself. However, it impedes communication, making life difficult. If you are unable to communicate effectively with others, the quality of life you live will be affected.

It is, however, worth noting that people who stutter are normal in every other respect.

Signs and Symptoms of Stuttering

Stuttering is depicted as abnormal repetitions of words and/or parts of words. For instance, a person may say; H-H-H- How are you doing? i.e. they have a problem transitioning from the ''H'' in ''How'' to other words on the first attempt.

Stuttering also encompasses prolongations of speech sounds. For instance, a person may say ''SSS orry for that'' i.e. make the ''s'' sound for a prolonged time.

People who stutter also tend to be ''out of breath'' or tense when talking. They also tend to have stopped or blocked speech i.e. the mouth may be open and position to say a certain sound but very little to no sound is forthcoming. Stutterers also require more effort than normal to complete words.

Stuttering Prevalence and Statistics

Stuttering affects approximately 1% of the U.S. population. The same prevalence is reflected in most places globally. It is also worth noting that males are 3 to 4 times more likely to stutter than females.

Developmental stuttering i.e. stuttering which develops in childhood is the most common type of stuttering. It usually occurs in children aged 2 to 8 years.

Also, approximately 4-5% of people stutter sometime during childhood. The majority, however, become fluent before adulthood.

Causes of Stuttering

Although there is still ongoing research on precise causes of stuttering, stuttering is generally considered to be a neurological condition by many researchers.

Stuttering has also been linked to genetics. Furthermore, stuttering has also been proven to have emotional and situational triggers. The disorder is basically physiological and neurological.

Diagnosis

Although many people think it is easy to identify individuals who stutter by simply listening to their speech, stuttering affects more than an individual’s observable speech. There are a number of stuttered speech characteristics that typical listeners can’t detect. As a result, a diagnosis should be done by a certified SLP (Speech-language pathologist).

How Do Slps Diagnose Stuttering?

SLPs conduct thorough evaluations aimed at identifying the types and number of speech disfluencies produced by a stutter in various situations. SLPs also assess how stutterers react to/cope with disfluencies. SLPs may also gather information on factors which might make stuttering worse.

Many other assessments are made by SLPs i.e. on language skills, speech rate, etc. depending on a person’s history and age. Assessments are also conducted on how bad the stuttering affects a person’s ability to perform as well as participate in typical daily activities. SLPs also assess and make predictions whether the problem will continue when dealing with young children. Evaluations involve a series of tests, interviews, and observations.

Although there are many risk factors that are considered by SLPs during diagnosis, family history, prolonged stuttering (that lasts more than six months), the presence of any other speech/language disorders and fears/concerns about stuttering by a person and their family are the most common factors considered.

Treatment: Is Stuttering Curable?

If you're wondering if there is a cure for stuttering, here’s what you need to know. Although there is no single simple cure for stuttering that works for everyone who stutters, SLPs can teach people who stutter how to speak and communicate better. SLPs are also capable of helping stutterers regain their confidence and feel better about their speaking ability.

It's also worth noting that early intervention increases the chance of a full recovery. Children who receive treatment early can overcome their speaking challenges fully. The importance of taking your child or loved one to a speech-language pathologist as early as possible can't, therefore, be overlooked. Treatment can, however, benefit everyone regardless of age. For older individuals, however, treatment is centred on management as opposed to getting rid of stuttering completely.

Treatment Focus

Stuttering treatments focus on teaching people specific behaviours or skills that improve overall communication. For instance, many SLPs teach stutterers how to control the rate/speed at which someone speaks and breathes as they speak. By learning such controls, it is possible to reduce and eventually eliminate stuttering.

How Can You Help Someone Who Stutters?

You should practice patience when dealing with a person who stutters. It is also important to be sensitive to the feelings of a person who stutters. For instance, you should not rush them to speak or put them in uncomfortable positions. It is also important to seek help on their behalf. For instance, you can set up an appointment with a qualified SLP and take part in the entire process to learn as much as you can about the problem and how you can be supportive. Speech therapy which is administered by SLPs is the most effective treatment for stuttering.

Voice Disorders: What Are They?

Thu, 26 Sep 2019 06:52:06 GMT

Voice disorders also known as vocal disorders are all kinds of medical conditions that result in abnormal pitch, loudness or poor quality of the voice (sound produced by the larynx). Voice disorders affect speech production. They include but aren’t limited to vocal fold nodules, vocal cord paresis, vocal fold cysts, Chorditis, Puberphonia, Laryngitis, Laryngeal papillomatosis, Bogart-Bacall syndrome, Reinke’s edema and foreign accent syndrome.

Causes of Voice Disorders

Many things can cause abnormal pitch, loudness or poor voice quality. These causes revolve around things that injure the vocal cords i.e. too much screaming or constantly clearing the throat which in turn cause problems like polyps, nodules, and sores on vocal cords. Other causes of vocal disorders include infections, growths (due to viruses), cancer, acid movement from the stomach to the throat as well as diseases know to paralyze vocal cords i.e. colds, allergies, bronchitis, etc.

Symptoms of Voice Disorders

There are a couple of symptoms that suggest that a person's voice isn’t healthy. One of the most obvious signs is hoarseness or when a person is unable to produce any voice at all. Other notable symptoms include; raw, achy or strained feeling in the throat, sudden voice deepness and an inability to hit certain notes when singing despite being able to hit those same notes before.

Individuals who suffer from voice disorders also start struggling to talk suddenly i.e. they need more effort. Anyone can exhibit voice disorder symptoms when you have a cold. As a result, voice problems should be a cause for concern when they are persistent i.e. last for weeks after the flu or cold has gone away. It is also important to consider normal voice changes that happen during puberty.

Diagnosis

Voice disorders are diagnosed by ENTs (Ear, Nose and Throat specialists) and laryngologists (physician voice specialists) in conjunction with other voice/speech specialists such as speech-language pathologists.

Diagnosing voice disorders is a multi-step process that follows comprehensive steps. The first step usually involves taking the history of the voice disorder in question to find out info like; when the voice disorder occurred, how it occurred, frequency, triggers, etc.

During this step, a comprehensive head, neck and laryngeal exam is done. The Diagnostic tests are also done as well as a detailed medical evaluation. This may be followed up with special tests i.e. voice box examinations to check for abnormalities.

Treatment

Voice disorders are treated depending on the underlying cause. If diagnosed early, most voice disorders can be treated. There are three main types of voice disorder treatments namely; medical, voice therapy and surgical treatments.

a. Medical Treatments

Voice disorders like Laryngitis are usually treated using anti-reflux medicines. Voice disorders caused by hypothyroidism are treated by effectively monitoring and treating low thyroid hormone levels. Botulinum toxin is used to treat voice disorders caused by muscle disorders.

b. Voice Therapy

Voice therapy is a crucial part of voice disorder treatment. The therapy which is administered by speech-language pathologists (SLPs) focuses on treating disorders caused by voice misuse or abuse. Voice therapy is popular for treating voice disorders which aren’t that complicated. The therapy helps patients get rid of bad voice habits. Voice therapy also teaches patients proper voice techniques as well as guides recovery among patients recovering from surgery.

c. Surgical Treatments

Sometimes it may take surgery to treat certain voice disorders. The most common types of surgical approaches for treating voice disorders include;

Phonomicrosurgery: This surgical treatment is performed using a microscope (for viewing). It is common and effective for removing vocal fold lesions/abnormalities which hamper vocal fold vibration.
Laryngeal framework surgery: This surgical treatment involves manipulation of the voice box to improve vocal closure which is crucial for healthy voice production.
Injection augmentation: This surgical procedure involves surgical injections of fat among other substances that add bulk to a person’s vocal folds to aid in better vocal fold closure.
It’s worth noting that treatments can be combined to offer the best results. For instance, individuals suffering from stomach acid backflows may require voice therapy as well as anti-reflux medication.

Also, for treatment to be effective, an early, thorough and accurate diagnosis must be conducted by a highly trained, skilled and experienced voice specialist. The right treatment options/strategies must also be used.

Prevention: How Do You Keep Your Voice Healthy?

A person’s voice can be kept healthy by; avoiding screaming and yelling.

Parents should discourage their children from screaming and yelling as these are major causes of voice disorders among children.

Adults should avoid excessive voice clearing. Using good breath support is another good preventive measure. You should also avoid smoking to avoid causes of voice disorders like cancer. Drinking plenty of water also goes along in keeping the vocal cords healthy (hydrated).

Parental Guide to Social Language Skills Delays

Thu, 26 Sep 2019 06:38:07 GMT

Social language skills refer to the verbal and nonverbal rules which dictate social interactions. Although some social language skills vary from one culture to another, there are many universal social skills used across all cultures on a daily basis.

First and foremost, it’s important to note that we don’t need to say anything to use social skills. Social language skills encompass nonverbal language as well. Ideally, when someone we know enters a room, people who are already present in that room make eye contact as well as nod or speak to them. People may acknowledge such presence in many other ways i.e. a smile, wave etc. These are perfect examples of what people usually do in social situations when they see people they know.

Although these social responses may seem natural, some children may find it difficult deciding what they should do in social situations. If your child has problems deciding how to respond in social settings despite his/her peers being able to do so effortlessly, he/she may have impaired social skills or simply, a social language skills delay.

Since social language skills delays aren’t always apparent to outsiders, children who exhibit such delays may be mistaken to be bad or weird.

Signs of Social Language -Skills Delays

Children who have social language skills delays exhibit many inabilities the most common being;

An inability to use language in social settings i.e. greeting, questioning, requesting and explaining.
Inability to change language effectively when a situation dictates it. For instance, children with social language skills delays have trouble using appropriate language volume indoors/outdoors.
Inability to follow universal rules of social communication such as; taking turns in conversations, initiating as well as maintaining a topic, using good nonverbal social language skills like eye contact and facial expression.

Effects of Social Language -Skills Delays

Children who take longer than normal to develop social language skills have problems making friends. This usually results in many other serious problems such as low self-esteem and depression. Social language skills delays also affect children’s performance in schools. It is, therefore, important to seek medical attention if your child exhibits any of the above signs of social language skills delays.

Causes of Social Language - Skills Delays

Social language skills delays are usually associated with autism. They can, however, develop independently. Other disorders associated with language skills delays include Asperger’s. Other common causes include emotional trauma which is known to derail social development. It’s also worth noting that children may have difficulties communicating appropriately in social situations simply because they don’t know/haven’t learned how to communicate socially.

Treatment of Social Language - Skills Delays

If you sense your child may have social language skills delays because they exhibit one or more of the above signs, you should seek professional help from a speech-language pathologist (SLP). SLPs are the best-suited language professionals for addressing social language skills delays in children. Seeking medical help immediately is critical since it ensures your child doesn’t fall behind.

Fortunately, social language skills can be learned. Speech-language therapists offer children the much-needed assistance to boost their social skills. In cases where social language skills delays are caused by underlying neurological disorders, treatment of such disorders alongside speech therapy can help children learn all the basic social language skills they need to communicate effectively in social settings.

What Can You Do as a Parent?

Parents who have children with social language skills delays can help their children develop good social skills as they get professional treatment from speech-language pathologists. For instance, parents can offer opportunities for their children to practice social speech i.e. provide role-play situations. Parents can also organize playgroups, play dates, enroll their children in daycare, etc. to offer them perfect opportunities for learning social language skills.

Parents can also involve children with social language skills delays in simple tasks such as encouraging their children to order their own food in restaurants, participating in conversations with other children, etc. Parents can also purpose to be good role models of conversation/social skills. For instance, you can help your child keep a conversation going by asking a question on their behalf as well as encouraging them to keep expressing themselves. Ensuring you make eye contact when your child is talking to you can also go a long way. Since children learn by imitating their parents, your child is bound to learn critical social language skills if you purpose to teach/practice good social language skills yourself.

Receptive Language Delays

Thu, 26 Sep 2019 06:23:50 GMT

Does your child have both verbal and nonverbal language problems? Here’s what you need to know.

Receptive language delays can be defined as the inability to comprehend both verbal and nonverbal language. Children who suffer from receptive language delays have problems understanding both spoken as well as written and gestural language.

Receptive language includes skills such as; answering questions, responding to gestures, following directions, participating in conversation as well as identifying age-appropriate concepts and vocabulary.

Receptive language delays occur when children appear to be achieving language developmental milestones later than expected (compared to their peers in the same age group). There are many signs to look out for if you want to know if your child is experiencing receptive language delays. Below are some of the main signs/symptoms.

Signs and Symptoms of Receptive-Language Delays

Children with receptive language delays tend to experience difficulties following directions, answering questions and understanding gestures/nonverbal cues. Other common problems include; difficulties engaging in conversation as well as identifying age-appropriate vocabulary/concepts.

If your child suffers from a receptive language delay, he/she may not seem to listen when spoken to. Children who suffer from receptive language delays may also find it hard to listen when there is any kind of background noise. Receptive language delays also cause disinterest in language tasks i.e. reading story books. These language difficulties usually result in language skills that are below the expected level.

Since children go through developmental stages that dictate their language level, there are a number of clues you can look out for in regards to age. For instance, all children aged 1 (15 months and above) should be able to look as well as point at objects and people. All children aged one and a half years should be able to follow simple language directions i.e. ''come here''. At age 2, children are able to point to body parts when they are named. By age 3, children should be able to understand action words. If your child can’t do one or more of the above, he/she may be experiencing a receptive language delay.

Diagnosis

Receptive language delays are diagnosed using some tests and evaluations. First and foremost, an evaluation is conducted to assess whether the difficulties in understanding and using both verbal and nonverbal language are as a result of a hearing problem. Hearing problems are common causes of language problems. If there are no hearing issues, an evaluation is carried out by a speech-language pathologist (SLP).

Speech-language pathologists tests for the ability to understand spoken as well as written and gestural language. Tests are usually carried in the child’s primary language. This is usually the case since testing using a second language may make it seem like the child may have a language disorder when that’s not the case.

Speech-language pathologists also conduct interviews with the aim of observing and analyzing speech in different situations/environments. Interviews are meant to assess how weak a child’s communication skills are i.e. how they prevent him/her from doing what other children do i.e. playing certain games.

Speech-language pathologists also use different tactics aimed at figuring out how their patients may respond to different treatments. After diagnosis, speech-language pathologists work closely with their patients to develop effective treatment plans. Since different children respond differently, treatment is highly personalized to meet the exact needs of every child.

Treatment

Individual speech therapy and psychotherapy are ideal enough to treat receptive language delays. In fact, over 70% of all children (with receptive language delays) who undergo individual speech therapy and psychotherapy show significant improvements after treatment. SLPs work with their patients to help them build their vocabulary as well as improve their grammar. In some cases, children with receptive language delays may require psychological help to enable them cope with the emotional difficulties they face because of their language issues.

What Can You Do for Your Child at Home?

As a parent/family member/caregiver, there are a number of things you can do to help a child with a receptive language delay. First and foremost, it is advisable to communicate with the child as much as possible to help the child build his/her vocabulary. It is also advisable to practice patience since children with receptive language delays usually have problems comprehending and communicating in verbal as well as nonverbal communication. For instance, you should avoid rushing responses.

Parents are also advised to make reading as well as other language experiences as interactive as possible. For instance, you should discuss book pictures with your child and encourage your child to act out stories with puppets. Supplementing professional speech therapy treatment with the above interventions at home increases the chances of your child experiencing a full recovery.

Literacy Delays (Reading and Writing) Facts and Important Information For Parents

Thu, 26 Sep 2019 05:53:59 GMT

Is your child having problems reading and writing? If yes, here’s what you need to know. For you to understand literacy delays in-depth, let's first define literacy.

What is Literacy?

Literacy is the ability to read/write or use language proficiently. It’s worth noting that children go through language milestones during the first few years of development. During this period, children learn essential skills before they can be able to read and write. These skills include but aren’t limited to; book awareness, phonological awareness, letter-sound correspondence, decoding (sounding words out) and sight word recognition. These skills pave the way for children’s ability to read and write (learn in general). If a child takes longer than expected to learn these skills, he/she may be said to be experiencing literacy delays.

Some factors must, however, be taken into account i.e. intelligence. For instance, some children learn faster than others. In such cases, children who are slow learners aren’t necessarily suffering from literacy delays.

Effects of Literacy Delays

Literacy delays are known to inhibit learning abilities as well as cause behaviour problems. Research studies indicate that literacy delays increase risks of a child dropping out from school. Literacy delays are also to blame for chronic unemployment and other socio-economic problems like poverty if left unchecked. The importance of seeking immediate medical attention can’t, therefore, be overlooked. From the above information, it is clear that the future of your child is heavily dependent on his/her literacy skills. If your child can’t read by mid-first grade, it is advisable to take action.

Literacy Statistics

Literacy problems are more common than most people think. For instance, According to NAEP statistics, approximately 40% of all 4th-grade students in the U.S. fail to achieve basic levels of literacy (proficiency more so reading). Fortunately, it is possible to deal with most children’s literacy problems effectively if they are detected early.

Causes of Literacy Delays

Children with literacy delays are usually intelligent enough to learn. However, they may be unable to acquire literacy skills at expected levels. Literacy delays tend to be caused by the following;

Dyslexia: Dyslexia is a learning disorder that interferes with a person’s ability to read, spell as well as develop fluency (in written text). Dyslexia has many underlying causes i.e. brain anatomy differences, unpredictable brain activity, genetic causes, etc.
Motor/Cognitive Dysgraphia: Motor Dysgraphia is a motor coordination disorder that interferes with a child’s ability to learn how to write. Cognitive Dysgraphia affects the production of written language/communication.
Non-verbal language disability: This disorder affects all or most cognitive functions affecting literacy skills where language isn’t involved i.e. body language.
Language learning disorder: Language comprehension and production problems also affect the development of literacy skills.

Diagnosis and Treatment of Literacy Delays

Literacy delays are usually exhibited as slow academic progress since literacy is a prerequisite for academic success. If your child fails to thrive academically despite receiving adequate instructions over the years and he/she is of average intellect, this is a sure sign that he/she may be experiencing literacy delays.

Diagnosis commences with assessing a child’s academic success/progress and proceeds with investigations aimed at assessing if the literacy delays originate from developmental problems or coexisting conditions. Numerous tests are done during this phase. Depending on the underlying cause, other tests may be carried out. Diagnosis is aimed at finding out a specific and consistent underlying cause/s of the literacy delay/s in question.

Treatment is usually administered depending on the underlying cause. Literacy delays may, therefore, be treated by a variety of professionals. If the cause is dyslexia, for instance, treatment is usually administered by psychology as well as special education professionals. Literacy specialists i.e. speech-language pathologists (SLPs) also help children experiencing language delays learn age-appropriate literacy skills faster. SLPs are also the best-suited professionals for helping children with literacy delays cope with all the challenges associated with literacy problems.

What Can You Do as a Parent?

Parents can help children with literacy delays in some ways. As your child receives professional treatment, you can get them involved in reading/writing groups and games to boost their literacy skills. Parents can also form a habit of reading to their children on a daily basis. You can also help your child learn how to read and write faster by setting a good example. For instance, setting up a library at home and taking the time to read every day is a perfect way of helping your child cultivate a culture of reading and writing which will compensate for slow learning.

Expressive Language Delays: Everything You Need to Know

Thu, 26 Sep 2019 05:45:08 GMT

Is your child having trouble expressing himself/herself using language? If yes, look no further. Your child may be experiencing expressive language delays. Below is everything you need to know.

Definition: Expressive Language Delays

Some children tend to take longer than others to reach typical language milestones during the first three years. When children take longer to convey information in speech, writing, gesture or sign language, these kinds of language delays are known as expressive language delays. Children who experience expressive language delays early in life but eventually catch up are commonly known as ''late-talkers''. Children who continue experiencing difficulties expressing themselves verbally may be diagnosed with expressive language disorder or other language impairments.

Common Signs/ Symptoms of Expressive Language Delays

Children with expressive language delays have problems combining words to form correct phrases and sentences. For instance, children with expressive language delays may use an incorrect verb tense i.e. ''goed'' instead of ''I went'' or omit certain important grammatical words i.e. say ''I going'' instead of ''I am going''. In most cases, expressive language delays result in shorter phrases and sentences. Children with expressive language delays also tend to have a smaller/more basic vocabulary than normal i.e. below average for their age level.

In a nutshell, children with expressive language delays tend to experience difficulties putting phrases and sentences together to express their thoughts and ideas. They also tend to have problems recalling words as well as using language appropriately in different settings/with different people.

It’s worth noting that the symptoms of expressive language delays may differ from one child to another. The symptoms also tend to depend on a child’s age as well as the degree of impairment. The most common signs/symptoms include;

Summary of Signs/ Symptoms Exhibited by Children With Expressive Language Delays

Making simple grammatical errors i.e. leaving out words.
Using noticeably fewer words/phrases/sentences compared to children of the same age.
Using shorter/simpler sentence construction compared to children of the same age.
Limited/more basic vocabulary compared to children of the same age.
Trouble finding the correct words.
Limited/more basic/non-specific vocabulary.
Overreliance on limited content/standard phrases in speech.
Confusing the meaning of words in sentences.
Hesitant speech.
Repeating a speaker’s words.
Trouble making a point or simply, talking ''in circles''.
Inability/problems holding a conversation.
Difficulties with oral as well as written work.

What Causes Expressive Language Delays?

The causes of expressive language delays aren’t known for most children. Some children, however, experience language delays alone while they develop progressively as expected in other areas. Expressive language delays have also been associated with developmental difficulties/impairments such as autism, Down syndrome or hearing loss. It’s also worth noting that children who suffer from expressive language delays tend to have receptive language delays as well (problems understanding language).

Expressive language delays can be caused by acquired or developmental impairments. The delays can also be as a result of injury/trauma on the head or a medical condition. Research also suggests that expressive language delays have genetic causes. Malnutrition is also a probable cause.

Diagnosis of Expressive Language Delays

If your child has difficulties speaking and/or using language to express themselves i.e. they exhibit the above signs/symptoms, he/she may be suffering from expressive language delays. To be certain you are dealing with serious language delays as opposed to normal developmental delays, it’s important to take your child for assessment.

Speech-language pathologists are the best-suited professionals for diagnosing expressive language delays. During diagnosis, a hearing test is conducted. Specific assessments are also done to identify the specific areas of language a child experiences difficulties. Assessments are usually done with the best interests of the child at heart i.e. they are not stressful and parents are allowed to be present.

Besides hearing tests, speech-language pathologists may recommend auditory processing tests that focus on assessing learning difficulties. These kinds of tests assess cognitive functions like thinking and intelligence which are known to have an impact on a child’s language skills.

Treatment of Expressive Language Delays

Expressive language delays which persist longer than normal are usually treated depending on the severity of the impairment in question. Treatment may include;

Individual or Group Sessions With a Speech-Language Pathologist.
Special Education Assistance.
School-Based Language Intervention Programs.
Speech Pathology Sessions Alongside Home Programs.

Treatment is usually meant to deal with language learning problems as well as related problems like; low self-esteem and social problems. As a result, treatment may include therapy sessions meant to address related problems.

Early Language Delays: Important Facts/Information

Thu, 26 Sep 2019 05:33:35 GMT

Babies start to communicate long before they start speaking. Babies use smiles, giggles, crying, gestures, etc. to communicate their needs long before they start using language.

To be able to understand early language delays, it’s important to understand the language milestones that every child goes through for the first two years.

1st Year

By year 1 most babies can; respond to their names most (if not all) of the time. Most babies are also able to respond to sounds appropriately i.e. look and find where a sound is coming from. 1-year-old's can also say at least one word, say dad and mom as 'da da' and 'ma ma' as well as point to things they want.

2nd Year

Between ages 1 and 2, most toddlers will be able to follow simple commands communicated to them using both language and gestures. Most toddlers aged between 1 and 2 years will also be able to name some common objects, learn new words every week and use gestures and words effectively.

By age 2, most toddlers are able to say several two-word sentences, communicate in a language that many adults can understand about 50% of the time. By age 2, most toddlers can be able to point to pictures in books, body parts as well as common objects, say 50-100 words as well as say a few three-word sentences.

Early Language Delays

Early language delays occur when the above milestones are delayed. If your child can’t follow simple language commands, he/she can't name common objects and/or learn new words on a weekly basis, he/she may have early language delay problems.

It is worth noting that language delays usually occur alongside some behaviors. For instance, if your baby stops doing certain things he/she used to do/like doing or he/she stops talking, this kind of behavior is common with children suffering from early language delays.

Common Behavior Signs

Your baby doesn’t return a smile.
Your baby doesn’t enjoy cuddling like other babies.
He/she doesn’t notice certain noises.
He/she acts distant/doesn’t notice you in a room.
He/she can’t use simple words to communicate needs.

There are some of the most common behavioral signs to look out for among children experiencing early language delays.

Although some children learn how to use language later than others, some children (who experience language delays) tend to exhibit certain behavioral problems which portray their frustration when they are unable to express their needs and wants. Simple language delays may be temporary or solvable with a little help from family members. In severe cases however, a child may require professional help from a speech-language therapist (SLP).

Early language delays shouldn’t be avoided since some delays are warning signs of more serious problems i.e. hearing loss, developmental delays in other areas or even ASD (autism spectrum disorder).

Diagnosis

Early language delays should be diagnosed by speech-language therapists. The sole purpose of diagnosis is finding out whether the delays are normal or not. Parents are usually asked questions to find out information such as; when the delay started, behavior changes, medical history of the child, etc. Diagnosis also involves and interaction session between the child and the speech-language therapist in an effort to learn more about the language delay as well as the child’s development. A hearing test is also conducted during diagnosis. A speech-language therapist's main job is evaluating a child’s ability to understand speech as well as gestures.

Treatment

Depending on the diagnosis, the SLP may recommend various treatments. Early language delays are usually treated using early language intervention programs. If your child has expressive language delays only, the SLP should be able to recommend some home remedies and/or recommend formal speech therapy.

If your child has a delay in both language and understanding i.e. receptive language and the hearing test turns out normal, your child will require further evaluation to determine the root cause of the language delays. In typical early language delay problems, speech therapy alongside ways of improving a child’s social skills and behavior are adequate enough to deal with the delays effectively. In severe cases, direct therapy and special equipment may be used. Treatment also involves parent training and support.

Sometimes your doctor may tell you not to worry i.e. it’s just a normal language delay problem. If that’s the case, there is no cause for concern. It is, however, advisable to get a second opinion if the problem persists for months.

Ergonomic Assessments

Thu, 26 Sep 2019 05:25:37 GMT

Ergonomics is the science of matching the work to the worker. Ergonomics in the workplace focuses on making the environment, products and tasks efficient for the user to improve worker safety and comfort.

Creative Therapy Associates’ registered Occupational Therapists (OT) offer a variety of ergonomic programs from workstation assessments to employee training sessions. Applying ergonomic principles in the work environment will provide your employees with increased comfort, improved morale and job satisfaction, and will lead to enhanced worker productivity.

As an employer, you will benefit from injury prevention, early return to work, reduced absenteeism, decreased costs resulting from fewer sick days, lower compensation payments, and improved worker morale.

Creating a comfortable, safe work environment often involves applying a few simple adaptations and strategies identified and implemented by individuals qualified in ergonomics. Creative Therapy Associates can work with you to develop the program best suited to meet the needs of your business.

Individualized Workstation Assessments

These personalized examinations of workstation ergonomics will include a physical demands analysis by a registered OT. A written recommendation will highlight how to optimize workstation function for each employee including:

Workstation Setup
Lighting/Glare
Ease of Movement/Clutter
Optimal Heights and Angles for Equipment (Such as Computers, Keyboards)
Posture and Proper Body Mechanics
Recommended Strategies (Taking Breaks, Exercises and Stretches)
Specialized Equipment (Such as Seating Support, Adapted Equipment)

Return to Work

An essential part of any return to work strategy is the development of an individualized ergonomic plan incorporating adaptive strategies for employees returning to the workplace after a short or long-term disability leave. Beginning with a physical demands analysis looking at the essential functions of a job, the registered OT will prepare a written report including recommendations for a successful return to work strategy. All elements included under “Workstation Assessments” will also be addressed if applicable.

Job Demands Analysis

Looking more generally at the physical, mental and environmental requirements of a specific job or position, a Job Demands Analysis can be used to enhance a job description for hiring purposes or assist with a return to work plan for an employee.

The written report will include:

A summary of tasks required and equipment involved
Potential risk factors/safety concerns
Identification of essential and nonessential functions
Physical effort as related to job demand

Home Management and Safety

Thu, 26 Sep 2019 05:15:21 GMT

Illness, injury, surgery or aging can all affect our ability to function safely and independently within our own homes. An Occupational Therapist can work with you to ensure that your home is safe and functional. After assessing the environment and the activities you do each day, they will make recommendations to reduce the risk of falls or injuries in your home, or to make it easier for you to complete everyday tasks.

This might include suggestions such as improving lighting or removing small rugs that could cause tripping, or recommendations for assistive devices or equipment, such as grab bars in the bathroom, to make it easier and safer to transfer to the tub or shower for safer bathing.

Falls account for 85% of hospital emergency room admissions for people over the age of 65. For suggestions on how to make your home safer, read Preventing Falls -- Safety in the Home , and arrange to have an Occupational Therapist complete a home safety assessment by contacting our office, or your healthcare provider.

Preventing Falls - Safety in the Home

Thu, 26 Sep 2019 05:06:45 GMT

Falls are the main reason older adults lose their independence. There are ways to prevent falls in your home by making simple changes around your home, exercising regularly, having your vision checked and having your medications reviewed by your healthcare provider. You may also benefit from having an Occupational Therapist complete a home safety assessment. Contact Our Office to find out more.

Here are some ways to prevent falls and maintain your independence:

1. Make Your Home Safer

Remove small throw rugs and secure all rugs to the floor with double-sided tape
Remove things you can trip over, such as books or shoes, from stairs and places where you walk
Have grab bars installed in your tub or shower and next to the toilet
Ensure there are sturdy handrails for indoor and outdoor stairs
Use non-slip mats in the bathtub and on shower floors
Keep items you use often where you can reach them without use a step stool
Improve the lighting in your home, especially on the stairs

2. Medications

Have your doctor or pharmacist review the medicines you take, even over-the-counter medicines
Avoid mixing alcohol with medications

3. Exercise

Be active every day; exercise will improve your strength and balance
Walk regularly if you can and find an activity you enjoy
Even a few minutes count! Ten minutes of activity a few times a day adds up

Nutrition

Consult with your doctor, nutritionist or dietician about the best diet for you
Eat regular healthy meals with lots of fruits and vegetables
Drink plenty of water

4. Vision

Poor vision can increase your chances of falling. See an eye doctor at least once a year to review your prescription and be checked for glaucoma.

If You’ve Fallen Before…

About one-third of people aged 65 years and over typically fall once or more per year. You are at higher risk of falling if you’ve fallen before.

Find out why you fell. Tell your healthcare provider if you’ve fallen. A fall can be a sign of an underlying medical condition.

Don’t let the fear of falling prevent you from being active. Inactivity actually increases your risk of falling.

Stroke and Acquired Brain Injury - Motor Speech Disorders

Thu, 26 Sep 2019 04:57:50 GMT

Speech requires the coordination of a range of muscles, including those controlling the larynx and the vocal cords, the lips, the tongue, the jaw and the respiratory system. The brain plans the movements and puts them into motion. Difficulties in this process may result in apraxia or dysarthria.

Apraxia is a disorder where messages from the brain to the mouth are interrupted, making it difficult for someone to move his or her lips or tongue to the right place to say sounds correctly. It does not mean there is muscle weakness. A common cause of apraxia is a stroke . Other causes include Traumatic Brain Injury , such as from a motor vehicle accident, Dementia , brain tumours, and progressive neurological disorders, such as ALS. Speech is often slow, laboured and halting.

Dysarthria results from the impaired movement of the muscles used for making speech sounds, including the lips, tongue, vocal folds, or diaphragm. It is caused by damage to the brain, which can happen at birth (cerebral palsy), or later in life due to injury, stroke or neurological illnesses. Symptoms of dysarthria can include slow or rapid speech, speech that is difficult to understand, and abnormal pitch, rhythm and voice quality.

Aphasia

Aphasia is a communication disorder that results from damage to the parts of the brain that contain language. This damage can happen because of a stroke, traumatic brain injury (such as a car accident), or neurological disorders. Aphasia may causes difficulties in speaking, listening, reading, and writing, but does not affect intelligence. Our clinicians are experienced in assessing and treating aphasia, providing functional tasks and activities to allow you to rehabilitate your language skills.

Cognition and Memory

People who have experienced a brain injury or have suffered a stroke frequently have changes in their thinking skills, or cognition. This may affect areas such as communication, reasoning and memory, such as finding the right words, understanding what others are saying, using appropriate social interactions, controlling impulses, organizing thoughts and thinking creatively.

Our therapy team members are highly qualified in providing cognitive-linguistic therapy, which targets higher-level cognitive (thinking and reasoning) tasks, such as time, math and money, and task sequencing, as well as memory and language tasks. Using a client-centred approach, we will work with you and your family to build skills to live a fuller, more independent life.

Our Speech-Language Pathologists are experienced in evaluating and treating communication problems arising following a stroke or from an acquired brain injury. If you have concerns, speak to your healthcare practitioner or Contact Our Office to arrange and assessment.

Auditory and Language Processing Disorders

Thu, 26 Sep 2019 04:51:32 GMT

Auditory processing refers to how the brain becomes aware of sounds and makes sense of them, while language processing is how the brain becomes aware of and makes sense of language. Children with auditory or language processing challenges may be able to express themselves quite well, but find it more difficult to understand what is being said, especially when a lot of information is presented at one time.

They may:

Have difficulty following directions, especially if they include multiple steps or sequential concepts (first do this and then do that) or temporal concepts (do this before you do that).
Use words that may not be specific (pass me that “stuff”).
Misunderstand directions.
Tell events out of order (jumping from the beginning to the end and then the middle).
Have a difficult time answering “who what where when why” questions.
Have difficulty with rhyming.
Have difficulty reading.
Appear to have not been paying attention.
Have poor organizational skills.

If you have concerns about your child’s language, speak to your health care practitioner or Contact Our Office to arrange for an assessment with one of our qualified speech-language pathologists.

Autism Spectrum Disorder

Thu, 26 Sep 2019 04:44:07 GMT

New Program Developments

We launched our autism services in Thunder Bay, ON at Creative Therapy Autism Centre , 1201 Amber Drive.

Autism Spectrum Disorder, or simply Autism, refers to a complex neuro-developmental disorder usually diagnosed in childhood. Its symptoms include challenges with social skills, speech and communication issues, repetitive behaviours, and often special abilities and intense interest in a specific area.

There isn’t one autism but varying degrees, and each individual is unique. The term “spectrum” captures the many differences, challenges and strengths that each person with autism has. People on the autism spectrum see, hear and feel the world differently than other people.

Most autistic people have difficulty interpreting both verbal and nonverbal language, including tone of voice, facial expression, and sarcasm. They may experience language delays and disorders and may have difficulty with communication.

Repetitive behaviours are common, and changes in routine can be challenging for children with autism. This is often accompanied by highly focused interest in a specific area, and over- or under-sensitivity to sensory stimulation such as sounds, touch, tastes, smells, light, colours, temperatures or pain.

Our multidisciplinary team of Speech-Language Pathologists, Communicative Disorders Assistants, and Occupational Therapists believes that a collaborative approach is the best way to meet the needs of children with autism.

As your child’s parent, you know them best, and we will work with you to support your goals and work towards helping you and your child meet their full potential.

Developmental Milestones: Fine Motor Skills

Thu, 26 Sep 2019 04:41:31 GMT

While all children develop differently, there are a number of milestones that may indicate your school-aged child is having difficulty with fine motor skills and would benefit by seeing an Occupational Therapist for an assessment and therapy, or intervention, plan. If you have a concern, consult your healthcare practitioner, or contact [insert link] our office for more information or to arrange an assessment.

3-4 Years

Buttons/unbuttons large buttons.
Unzips zippers.
Holds pencil in fingers using a tripod (3 fingers) or quadrupod grasp (4 fingers).
Copies simple shapes.
Draws a person with 2-3 parts.
Cuts with scissors on straight line, some curves, around corners.
Colours large object with some attempt to stay in lines.

4-5 Years

Manages most clothing fasteners (zippers, fastening Velcro shoes).
Copies more complex shapes (diagonals, squares, X).
Prints some letters (primarily uppercase) and numbers.
Cuts with scissors fairly accurately (turns paper with “helper hand”).
Colours with some accuracy.

5-6 Years

Able to tie knot and possibly shoelaces.
Uses knife to spread and is beginning to cut.
Draws triangle.
Prints most upper and lower case letters and numbers.
Draws a person with 6 parts.
Draws recognizable picture.
Hands work in a coordinated manner (scissors use).
Colours with accuracy.

Emergent Literacy in Children

Wed, 25 Sep 2019 03:32:13 GMT

While literacy includes reading and writing skills, it also involves a relationship with expressive language (communication). Many of the same basic skills needed for oral language are also needed for written language, with the addition of some higher-level skills.

Early indicators a child may have difficulty with literacy:

Family history of reading disability.
First word not produced until after 15 months of age.
Words not combined until after 24 months of age.
Difficulty pronouncing words when older than 6 years of age.
Lack of awareness and ability to use rhymes during preschool years.
Inability to segment words into syllables after age 5.

Writing

Writing is the most complex form of language. A child's language difficulties may be most obvious in his or her writing, and children with oral language problems are more likely to have difficulties with writing, such as, spelling errors, word order errors, incorrect word choices based on meaning, and grammar errors including leaving out words and word endings. Writing difficulties can affect a child's success in school and can lead to problems in all subjects.

Phonological Awareness

Phonological awareness is the ability to recognize sounds that make up words. This includes identifying words that rhyme, deciding if words begin or end with the same sounds, understanding that sounds can be changed to create new words, and separating words into their individual sounds.

Children who have literacy difficulties usually have poor phonological awareness.

Most Children Develop Phonological Awareness Skills as Follows:

By 3 years

Familiar with known nursery rhymes (Jack and JilI).
Recognizes alliterations (words that begin with the same sound like “my muffin”).
Recognizes words that rhyme (cat and hat ).

By 4 years

Can break a sentence into separate words.
Can break a multi-syllabic words into syllables (“hotdog” has two parts, “hot” and “dog”).
Says words that rhyme.

By 5 years

Counts the number of syllables in words.
Can break the beginning sound from the rest of the word (c-at).
Blends the beginning sound with the rest of the word.
Identifies a word that does not rhyme with another (hat does not rhyme with dog and fog).

By 6 years

Makes up rhymes.
Matches initial consonants in words (dog and dad begin with the same sound).
Blends two or three sounds to make a word.
Segments initial consonant blends from the rest of the word (divides track into tr- and -ack).
Can separate the final consonant from the rest of the word (make = ma- and -k).

By 7 years

Counts the number of sounds in a word.
Blends isolated sounds to form words.
Can break out sounds within words.
Spells by sounding out words.
Adds sounds to, or deletes sounds from words.

By 8 years

Rearranges sounds in a word to make a new word (e.g., moves t- in tar to the end to make art).
Can separate blended consonant sounds (basket = “s” and “k”).
Deletes blended consonant sounds (???? samples).

Adapted from Assessment in Speech-Language Pathology, Shipley (2009)

If you have concerns about your child’s development of language skills, see your healthcare practitioner or Contact Our Office to arrange an assessment.

Language Delays and Disorders in Children

Wed, 25 Sep 2019 03:21:39 GMT

Development of Language: There are many factors that affect a child’s language development ranging from early learning experiences, their physical development, to social interaction. It can also be influenced by a developmental delay, hearing impairment, genetics, or autism. Children with language delays or disorders may also have difficulties with reading, spelling and school subjects, so early assessment and treatment (intervention) is important.

Early Indicators

Children with receptive language issues may have trouble understanding what other people say, following simple directions, and organizing information they hear. A receptive language issue can be hard to spot in very young children. Click here for more information on auditory and language processing. [link]

Problems with expressive language (speaking) are the most common sign of language disorders and are easier to identify early. Children may be late to start talking and not speak until two or later. At three, they may be speaking but hard to understand.

Here Are Other Signs of Expressive Language Issues:

Lack of eye contact as an infant.
Delayed babbling as an infant.
A smaller vocabulary compared to children the same age.
Frequently says “um” and substitutes general words like “stuff” and “things” for more precise words.
Has trouble learning new vocabulary words.
Leaves out key words and confuses verb tense.
Uses certain phrases over and over again when talking.
Seems frustrated at not being able to communicate thoughts.
May not talk much or often, but understands what other people say.
Is able to pronounce words and sounds, but sentences often don’t make sense.
Uses a limited variety of sentence structures when speaking.

If you have concerns about your child’s language, speak to your health care practitioner or Contact Our Office to arrange for an assessment with one of our qualified speech-language pathologists.

Speech and Language Milestones in Children

Wed, 25 Sep 2019 03:03:35 GMT

Speech and language development is important for reading, writing, and learning. Early identification of challenges leads to early treatment and better outcomes in school. The following are standard milestones and may indicate a speech or language disorder. If you have concerns, see your healthcare practitioner or Contact Our Office to arrange an assessment.

By 6 Months

Turns eyes or head toward a sound.
Watches your face when you speak.
Smiles and laughs in response to your smiles and laughs.
Has different cries for different needs.
Makes sounds and/or moves body in response to you.

By 9 Months

Responds to his/her name.
Babbles e.g., bababa, mamama.
Plays social games with you, e.g., peek-a-boo.

By 12 Months

Follows simple one step directions, e.g., "come here."
Brings toys to show you.
Looks across the room to something you point to.
Gives familiar object on verbal request.
Points to things he/she wants.
Uses gestures, e.g., waving "bye-bye."
Gets your attention using sounds, and gestures, while looking at your eyes.

By 18 Months

Identifies several body parts when asked.
Points to pictures using one finger.
Says approximately 20 words consistently.
Understands basic concepts such as, "in/out", "off/on."
Pretends to feed a doll/teddy bear or pretends a bowl is a hat.
Uses at least 4 consonant sounds, e.g., /p,b,m,n,d,g,w,h/.

By 2 Years

Combines at least 2 words, e.g., "car go."
Follows 2 step directions, e.g., "go find your blankie and show it to daddy."
Uses at least 100 words, including action words, e.g., "eat, go, fall."
Enjoys playing with other children.
Puts together two pretend play actions, e.g., tucking doll into bed and saying goodnight.

By 3 Years

Understands simple who, what, where, & why questions.
Creates long sentences combining at least 5 words.
Uses adult-like grammar, such as plurals, and past tense verbs, e.g., cookies, I jumped, mommy's shirt.
Can engage in a short conversation.
Speech is understood approximately 75% of the time.
Engages in pretend play with others using many actions, e.g., having a tea party.

By 4 Years

Follows 3 step directions, e.g., "finish your snack, bring your bowl in the kitchen, and put it in the sink."
Uses sentences with adult-like grammar, e.g. "We're going to the store now."
Tells a story.
Speech is understood by unfamiliar listeners the majority of the time.
Can act out different roles with their friends, e.g. shopping in the grocery store.

If a Child Is Experiencing Any of the Following at Any Age, Seek Further Assessment

Problems with chewing or swallowing.
Stuttering
Ongoing hoarse voice.
Has lost words he/she used to say frequently.
Limited interest in toys and/or plays with them in an unusual way.

Adapted from Ontario Ministry of Children and Youth Services.

Speech Disorders in Children

Wed, 18 Sep 2019 18:49:25 GMT

Articulation: An articulation disorder is when someone has difficulty producing sounds or sound sequences, such as saying "th" for "s" sounds. They may, for example, say "thun" for "sun". For a checklist of Typical Ages for Sound Acquisition Click Here .

Phonology: A phonological disorder is when a child has difficulty learning and using rules for sounds and sound sequences, such as deleting all final the consonant on words. An example of this would be saying "ca" for "cat" and "ba" for "back".

Motor Speech Disorders: This is a communication disorder where children have a hard time saying sounds, syllables, and words. It is not caused by physical reasons, but because the brain has problems planning to move the body parts needed for speech. The child knows what he or she wants to say, but his or her brain has difficulty coordinating the muscle movements necessary to say those words. One type of motor speech disorder is Childhood Apraxia of Speech (CAS). A child with apraxia may have inconsistent errors (especially when repeating a word), a limited number of sounds that can be made correctly, and unusual rhythm (prosody). They typically can understand more language than can be produced.

Voice Disorders

A voice disorder may be present when a child’s voice is noticeably different from others the same age and gender. They may have a harsh or hoarse-sounding voice, or a voice that is too high, low, loud or nasal. Poor voice quality may make it difficult for a child to communicate effectively and they may lose self-confidence, concerned with how other people see them. People with voice disorders often complain that their voices tire easily.

Voice Disorders Can Be Caused By:

Vocal Abuse (Yelling, Screaming, Talking Loudly, Frequent Crying)
Vocal Nodules (Growth on the Vocal Cords)
Chronic Throat Infections (Laryngitis)
Reflux
Other medical conditions
Physical differences in the body parts used for voice.

A Speech-Language Pathologist can assess your child and work with you to develop a therapy plan that includes vocal health and training in proper voice use.

Stuttering

Stuttering (disfluency) is when speech is broken up by the repetition of sounds or words, or even blocks where no sound is coming out at all. It is a communication disorder where the rate of flow of speech is interrupted. Stuttering is usually unpredictable and can be different from day to day and in different situations. Many preschoolers go through a period of normal stuttering during times of rapid language development. For most of them, it will resolve on its own, but for some, it can lead to long-term issues.

Children who stutter can have difficulty in school and may feel anxious about speaking in front of others. A Speech-Language Pathologist works with children, young adults, and adults to help them with their stuttering by developing strategies and exercises to minimize the interruptions during speech, and providing support to address any emotional or social concerns.

If you have concerns about your child’s speech, speak to your health care practitioner or Contact Our Office to arrange for an assessment with one of our qualified speech-language pathologists.

Typical Ages for Sound Acquisition

Wed, 18 Sep 2019 18:34:15 GMT

Age 2-3

Age 4

Age 5

/ch/
/j/
/l/
/sh/
/s/
/ng/

Age 6

Age 7

/r/
/th/

Visual Motor Skills

Wed, 18 Sep 2019 18:00:05 GMT

A child who has difficulty with visual motor skills has a hard time completing tasks that involve eye-hand coordination.

This can include:

Completing puzzles or connect-the-dots.
Understanding concepts such as in, out, on, under, next to, up, down, in front of.
Seeing the difference between similar letters, shapes or objects, and may confuse the letters d and b, or p and q.
Reversing numbers or letters when writing.
Remembering left and right.
Telling the order of symbols, words or images (sequencing).
Skipping lines when reading.
Remembering the alphabet in sequence.
Dressing (i.e. matching shoes or socks).
Having trouble staying within the lines or margins when writing.
Bumping into things.
Difficulty copying from a book or the board.
Remembering sight words.
Having trouble finding a specific piece of information or object on a page, such as “Where’s Waldo.”
Keeping organized, and may appear messy.
Forgetting homework assignments.
Loses track of time.

If you have concerns about your child’s visual motor skills, consult with your health care practitioner or Contact Our Office to arrange an assessment.

Motor Vehicle Accident Rehabilitation

Wed, 18 Sep 2019 17:56:32 GMT

If you have been involved in a Motor Vehicle Accident and have experienced physical injury or trauma, our multi-disciplinary team of occupational therapists and speech-language pathologists can support you. We have experience working within Ontario’s system for automobile insurance benefits, the Statutory Accident Benefits Schedule (SABS), and are licensed by the Financial Services Commission of Ontario (FSCO) as service providers through Health Claims for Auto Insurance (HCAI).

Your insurance company, legal team or rehabilitation management company may require assessments to understand the impact that your injuries have on your daily life. Our therapists understand the need for thorough assessment and provide a complete report outlining recommendations for assistance, assistive devices, and any therapy to help you on your road to recovery.

An Occupational Therapist can assess personal care, housekeeping, caregiving, work or school activity and leisure activities. They will address your physical, cognitive/perceptual and emotional status, and identify any barriers preventing your involvement in your normal day-to-day activities.

These Assessments Include:

Home Safety
Home Accessibility
Attendant Care Needs
Housekeeping and Home Maintenance Assessments
Situational Functional Assessments
Cognitive Assessments
Job Analysis / Physical and Cognitive Demands Analysis

From there, the therapist will develop goals and a treatment plan for working towards those goals.

A Speech-Language Pathologist can complete an assessment of speech, language and cognitive impairments that can be caused by physical or emotional injury. Trauma to the head can cause a change in normal brain function that results from a disruption of the blood circulation in the brain due to either a blockage or bleed. Brain injuries may cause permanent or temporary damage depending on what part of the brain has been affected. If the damage occurs on the left side of the brain, language is typically affected and can lead to aphasia. If the damage occurs on the right side of the brain, cognition and memory are typically affected. Changes in how the brain communicates with the parts of the body that work to create speech sounds, such as the lips, tongue and even the respiratory system, may result in motor speech disorders called dysarthria and apraxia.

For more information about rehabilitation services for either occupational therapy or speech-language pathology, Contact Our Office .

Difficulty or Pain with Swallowing

Wed, 18 Sep 2019 17:28:06 GMT

Difficulty with swallowing is called dysphagia and can be caused by a variety of reasons including degenerative diseases, such as ALS, dementia, and injury. Dysphagia can lead to taking food or water into the lungs (aspiration), choking and malnutrition.

Symptoms of Dysphagia Include:

Pain when swallowing (odynophagia)
Being unable to swallow
Feeling like food is getting stuck in your throat
Holding food in the mouth
Drooling
Wet or gurgly voice
Hoarse or raspy voice, throat clearing
Bringing food back up (regurgitation)
Frequent heartburn
Weight loss
Coughing, gagging or choking when swallowing

When working with clients, it is our primary goal to ensure they avoid aspiration or choking, and that they get adequate nutrition and hydration, while allowing a diet with the least restrictions. Our clinicians are trained in clinical examinations to assess for swallowing disorders (dysphagia), as well as experienced in behavioural and dietary treatment.

If you are concerned that you may have Dysphagia, see your family doctor or contact our clinic for more information.

Creative Therapy Associates Blog

Strokes - What You Need to Know

What Is a Stroke?

Types of Stroke

a. Ischemic Stroke

b. Embolic Stroke

c. Thrombotic Stroke

d. Hemorrhagic Stroke

e. TIA (Transient Ischemic Attacks)

Symptoms of a Stroke

How Do You Know If You/Your Loved One Is Suffering from a Stroke?

How Is a Stroke Diagnosed?

Treatment

Related Posts

What Are Swallowing Disorders?

Understanding Dysphagia

Types of Dysphagia

Symptoms of Dysphagia

Main Causes of Dysphagia

Diagnosis

Treatment

Related Posts

Language Is More Than Words -- What Is Aphasia?

How Does L anguage Help?

What Is Aphasia?

Symptoms of Aphasia

Effects of Aphasia

Connecting with People Who Have Aphasia: How Do They Feel?

Types of Aphasia

How Can You Help?

Related Posts

Symptoms of Autism and its Relationship With Speech and Language & Occupational Therapy (OT)

Symptoms of Autism

a. Social Challenges

b. Communication Problems

c. Behavioural Symptoms: Repetitive Behaviours

d. Physical & Medical Issues/ S ymptoms Accompanying Autism

Treating Symptoms of Autism

a. Speech-Language Therapy

b. Occupational Therapy (OT)

Related Posts

What Is Occupational Therapy?

Who Needs Occupational Therapy? Who Can Benefit from It?

When to Seek Treatment?

Occupational Therapy Techniques

How Do Occupational Therapists Help?

How Do You Access Treatment?

Areas of Practice

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Alternative Communication Methods refers to the tools and strategies used to solve communication challenges

Brief History of Augmentative and Alternative Communication (AAC)

Overview

Who Can Use AAC?

Types of AAC (Augmentative and Alternative Communication)

a. Unaided C ommunication Systems:

b. Aided C ommunication Systems

The Role of Speech-Language Pathologists When Working with Persons Who Use AAC

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Articulation Delays in Children - signs, causes and treatment

What is Articulation?

Articulation Delays

Signs of Articulation Delays

Causes

Seeking Help

Why Does Treatment Matter?

Treatment: The Role of SLPs in Treating Children with Articulation Delays

Related Posts

Stuttering, What You Need to Know - symptoms, causes, and treatment

What is Stuttering?

Signs and Symptoms of Stuttering

Stuttering Prevalence and Statistics

Causes of Stuttering

Diagnosis

How Do Slps Diagnose Stuttering?

Treatment: Is Stuttering Curable?

Treatment Focus

How Can You Help Someone Who Stutters?

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Voice Disorders: What Are They?

Causes of Voice Disorders