children

Conquering the High Cost of Speech-Language Therapy

Laura LeBlanc MA, CCC/SLPLeave a comment

Families with a speech disordered child often face a financial burden due to the high cost of speech therapy and other needed treatments. In fact, a survey published in Public Health Reports found that 40% of American families with children with special needs report feeling the strain of the financial toll that those healthcare needs cause. The survey further reported that children with disabilities are more likely to grow up in single-parent households, and that those parents often hold lower-paying jobs. As pricey as speech therapy is, you may be able to reduce the high cost of speech therapy with these tips:

Insurance

If you’re not sure if your insurance will cover the cost of speech therapy, talk to your employer’s human resources representative. If you’re uninsured or underinsured, contact the appropriate department in your state for information on insurance programs.

Flexible Spending Accounts

Ask your employer if he offers a flexible spending account (FSA). An FSA allows you to designate a portion of your income for qualifying medical and childcare expenses. The income is not subject to payroll taxes, which can save you a nice chunk of change.

Sliding Scale

Many hospitals, clinics, and early childhood centers offer services based on a sliding scale. It’s always worth asking your child’s speech therapist if she offers a reduced fee or sliding scale program based on your income.

The Gardiner Scholarship (For Home-Schooled Children)

The Gardiner scholarship is for Florida students 3 years old through 12th grade or age 22, whichever comes first, with one of the following disabilities: Autism spectrum disorder, Muscular dystrophy, Cerebral palsy, Down syndrome, Phelan McDermid syndrome, Prader-Willi syndrome, Spina bifida, Williams syndrome, Intellectual disability (severe cognitive impairment), rare diseases as defined by the National Organization for Rare Disorders, anaphylaxis, deaf, visually impaired, dual sensory impaired, traumatic brain injured, hospital or homebound as defined by the rules of the State Board of Education and evidenced by reports from local school districts, or three, four or five year-olds who are deemed high-risk due to developmental delays.

The term “hospital or homebound” includes a student who has a medically diagnosed physical or psychiatric condition or illness, as defined by the state board in rule, and who is confined to the home or hospital for more than 6 months.

  • Students need an IEP written in accordance with the rules of the State Board of Education or with the rules of another state OR the diagnosis of a Florida physician or psychologist or a physician who holds an active license issued by another state or territory of the United States, the District of Columbia or the Commonwealth of Puerto Rico.
  • Students must be at least 3 or 4 on or before Sept 1. Students entering kindergarten must be 5 on or before Sept 1. Students entering first grade must be 6 on or before Sept 1.
  • Students can participate in the Gardiner Scholarship program as part of home education. However, they cannot be enrolled in a public school or receive any other state-sponsored scholarship (McKay Scholarship or the Florida Tax Credit Scholarship).

As always, if you feel that your child is in need of speech-language services, be sure to contact an ASHA Certified provider.

 

 

Speech Sound Disorders: Articulation vs. Phonological

Laura LeBlanc MA, CCC/SLPLeave a comment

Parents often asked me about the difference between an articulation disorder and a phonological disorder.  Here is the difference:

Articulation (Phonetic) Disorder:

Articulation is the process by which sounds, syllables, and words are formed when your tongue, jaw, teeth, lips, and palate alter the air stream coming from the vocal folds. When an individual cannot produce or distorts an age-expected sound, it affects the ability of the person to be understood.  With an articulation disorder, the child has difficulty saying certain sounds or consonants- for example “wake” for “rake” or as seen with a lisp. Articulation disorders are motor errors than can occur among people of any age; however, they are most common in children whose articulators have not fully developed properly.

Phonological Process Disorder:

A phonological disorder is a simplification of the sound system that also affects intelligibility. Children with phonological processes have difficulty in acquiring a phonological system; involving organizing the patterns of sounds in the brained the output.; not necessarily in the motor production of the sounds like articulation errors.  For example, “fronting” is when sounds that should be produced  by the tongue moving up in the back of the throat are replaced with front sounds -“cake” becomes “take” or “gold” becomes “dold”.  This is typically seen in children whose speech would be considered unintelligible, but can also be seen in children through kindergarten that are developing normally.  Other examples of phonological processes include initial and final consonant deletion, cluster reduction, stopping, backing, gliding, syllable reduction, and consonant harmony.

Both articulation and phonological disorders put a child at risk for difficulties in school, both academically, as well as socially.  If you feel that your child may have a speech disorder, be sure to have his/her speech evaluated by a licensed speech-language pathologist.

 

 

 

What is a Lisp?

Laura LeBlanc MA, CCC/SLPLeave a comment

You’ve heard of a lisp-but what exactly is it? A lisp is an articulation disorder where a child is having difficulty correctly producing the “s” and “z” sounds. Sometimes the “sh”, “ch” and “j” sounds may also be in error.  There are 4 main types of lisps:

  • Interdental/frontal lisp: This type of lisp is characterized by a protrusion of the tongue out through the teeth- for example, saying “thwim” instead of “swim” or “thoup” for  “soup”.
  • Dentalized lisp:  A dentalized lips happens when the tongue pushes up against the top teeth during production of  “s” and “z” sounds, cutting off the airflow.

Both interdental/frontal and dentalized lisps are considered developmental in nature and are typically seen in normal speech development.  In other words, the child will most likely “grow out” of it.  It is perfectly normal development for a child to produce an interdental or dentalized lisp until they are about 4.5 years old.

  • Lateral lisp: This type of lisp results in a “slushy” or “spitty” sound.  A lateral lisp occurs when the tongue tip is in a similar position as when making the “l” sound but the air flow escapes out the sides of the sides of the tongue, instead of directly forward and out of the oral cavity.
  • Palatal lisp: A palatal lisp occurs when the mid section of the tongue comes in contact with the soft palate.  The sound of a person with a palatal lisp attempting to produce the “s” and “z” sounds will closely mimic the production of an “h” and a “y”.

Both lateral and palatal lisps are never normal in development and most likely will require speech therapy intervention to correct.  If you feel your child is in need of a speech evaluation, be sure to contact an ASHA certified speech-language pathologist.

 

Predicting First Words in Infants

Laura LeBlanc MA, CCC/SLPLeave a comment

According to new research from Indiana University, children’s visual experiences could influence their first words.   The research team, led by Linda Smith (a professor in IU Bloomington’s Dept. of Psychological and Brain Science) found that infants may link objects they most frequently see with words they most often hear.  This new theory of language has been coined “pervasiveness hypothesis”.  Smith went on to add that “visual memory may be the initial key to getting words stuck on objects-familiar objects like table, shirt, bottle, or spoon. It’s an aggregated experience, those very first words may be learned-slowly and incrementally-for a few visually pervasive objects. This may be how infants break into language before their first birthday.”

The results of the study may help inform future interventions for children with language disorders; difficulty learning words could be caused by visual-processing problems.  For more information on this topic, see the March 2017 issue of The ASHA Leader.

If you are concerned about your child’s speech and or language development or skills, be sure to contact an ASHA certified SLP for an evaluation.  A list of providers can be found at http://www.ASHA.org

Could Your Child’s Phonological Disorder Really Be Apraxia of Speech?

Laura LeBlanc MA, CCC/SLPLeave a comment

According to Edith Strand, the leading expert in child apraxia, “childhood apraxia of speech (CAS) typically occurs alongside other language delays or phonological impairments.  This can make diagnosing it a major challenge.”

Characteristics that are often present, but not discriminative, in childhood apraxia include:

  • Limited consonant and vowel repertoire
  • Use of simple syllable shapes and frequent omission of sounds
  • Numerous errors-poor standard scores on articulation tests
  • Poor intelligibility

More “discriminative” characteristics of apraxia of speech include:

  • Difficulty moving from one articulatory movement to another  (ie saying the word “pancake” at a fast rate)
  • Groping and/or trial and error behavior
  • Vowel distortions
  • Prosodic errors (putting stress on the wrong syllable)
  • Inconsistent voicing errors (“teck” for “deck” or “van” for “fan”)

Distinguishing CAS from Phonological Impairment

The primary characteristics of  childhood apraxia of speech (CAS) are vowel distortions, segmentation and/or equal stress, awkward movement transitions and error behavior in words and phrases. On the other hand, children with only phonological impairment may make substitution errors of exhibit phonological processes that are fairly consistent.  The movements for those incorrect sounds will be accurate though, and rate and prosody are typically good.  For more information on this topic, see the March 2017 issue of The ASHA Leader “Appraising Apraxia”.

If you are concerned about your child’s speech or language be sure to contact an ASHA certified speech-language pathologist for an evaluation.   A list of providers can be found at http://www.ASHA.org

3 Reasons Your Child Has Reading Comprehension Difficulties

Laura LeBlanc MA, CCC/SLPLeave a comment

Approximately 85% of children diagnosed with learning difficulties have a primary problem with reading and language skills.  What baffles many parents is the “where” and “why” the process breaks down. Problems may occur in any area -decoding, comprehension, or retention.  Many experts, however, believe the root of reading problems lies in decoding.

Decoding Difficulties

Decoding is the process by which a word is broken into individual phonemes (sounds) and recognized based on those phonemes.  For example, a proficient reader will separate the sounds “fr” “aw” and “guh” in the word “frog”.  Someone who has difficulty reading may not hear and differentiate these phonemes.  Even experts do not understand why this is.

Signs of decoding difficulty:

  • trouble sounding out words and recognizing words out of context
  • confusion between letters and the sounds they represent
  • slow oral reading rate
  • reading without expression
  • ignoring punctuation while reading

Comprehension Difficulties

Comprehension relies on mastery of decoding; children who struggle to decode find it difficult to understand and remember what has been read. Because their efforts to grasp individual words are so exhausting, they have no resources left for understanding.

Signs of comprehension difficulty:

  • confusion about the meaning of words and sentences
  • inability to connect ideas in a passage
  • omission of, or glossing over detail
  • difficulty distinguishing important information from minor details
  • lack of concentration

Retention Difficulties

Retention requires both decoding and comprehension of what is written. This task relies on high level cognitive skills, including memory and the ability to group and retrieve related areas. As students progress through grade levels, they are expected to retain more and more of what they read. From third grade on, reading to learn is central to classroom work. By high school it is an essential ask.

Signs of retention difficulty:

  • trouble remembering or summarizing what is read
  • difficulty connecting what is read to prior knowledge
  • difficulty applying content of a text to personal experiences

 

 

10 Signs Your Child May Have Asperger’s Syndrome

Laura LeBlanc MA, CCC/SLPLeave a comment

Asperger’s syndrome is a neurological disorder which falls under the category of autism spectrum disorders- a group of disorders characterized by impaired communication and social interaction. About 1 percent of the world’s population is affected by this disorder. Although exact symptoms may vary from child to child, there are many behaviors that may be signs of Asperger’s syndrome.  Here are the most common:

1. Unusual Body Language

Your child may make unusual facial expressions or stare at others a lot.  More likely, however, a child will avoid making eye contact all together.

2. Fixation on One Activity

Many children with Asperger’s are preoccupied with a single or few interests for hours on end and do not engage in play with other children.

3. Overly “Formal” Speech

Children with Asperger’s have advanced verbal skills and tend to speak more formally than expected for their age or prefer talking with adults.

4. Difficulty Reading Social Cues

Social difficulties is one of the most “obvious” of the Asperger’s symptoms.  Reading body language may be hard, as well as turn-taking or accepting others point of view and sticking to a topic of conversation.  A child may talk incessantly without giving others a chance to speak, or notice that others are becoming bored with the conversation.

5. Lack of Empathy 

Many child with Asperger’s have a lack of empathy for others and have no idea that others have feelings or wants.

6. Delayed motor development

From fine motor (ie writing) to gross motor (ie riding a bike), poor or delayed motor skills could be a sign of Asperger’s syndrome.

7. Sensory Sensitivities 

It’s possible for a child with Asperger’s to have heightened sensory sensitivity.  Things such as loud noises, strong lights, or even certain textures can cause them to become overstimulated and overwhelmed.

8. Can’t Understand Speech Subtleties

Some people with Asperger’s have a hard time understanding speech tone, pitch, and accent.  They may take words very literally and not comprehend humor or jokes.

9. Strong Need for Routine 

Many people with Asperger’s prefer to adhere to a strict routine for everything from bedtime to meals and showers.  Having structure is very important, otherwise they may feel unsettled or confused.

10. Emotional Meltdowns

When a child with Asperger’s becomes overwhelmed they often have a meltdown.  This is a common result of routines or plans not going as expected.

Stuttering in Children-What you need to know

Laura LeBlanc MA, CCC/SLPLeave a comment

If your child has difficulty speaking and tends to hestitate on or repeat syllables, words, or phrases- he may have a stuttering problem.  However, he may also be going through periods of “normal” dysfluency that most children experience as they learn to speak.  Dysfluencies occur most often between 1.5 and 5 years of age and they tend to come and go.  Signs of an actual fluency disorder include the following:

  • Dysfluencies are accompanied by tension and struggle behavior (ie facial grimaces or eye blinking).
  • The pitch of the voice may rise or the child will experience silent “blocks” (no sound comes out.)
  • Dysfluencies may still come and go but are more present than absent.
  • Your child is repeating words more than twice (ie “what..what..what”)

What you can do:

  • Try and model slow and relaxed speech when speaking with your child.
  • When your child asks you a question, try to pause a second or so before you answer. This will help your child to be less hurried and more relaxed when speaking.
  • Try not to be upset or annoyed when stuttering occurs.
  • If your child is frustrated or upset when stuttering occurs, reassure him.  Some children respond well to hearing “I know it’s hard to talk at times…but lots of people get stuck on words.  It’s ok.”

 

If you are concerned about  your child’s stuttering and would like assistance, be sure to contact an ASHA Certified speech-language pathologist (www.ASHA.org) for an evaluation.

Articulation in Children Top 5 Speech Questions

Laura LeBlanc MA, CCC/SLPLeave a comment

What is articulation?

Articulation is the ability to make speech sounds clearly. Children learn correct sound production by listening and imitating appropriate speech role models. Articulation develops gradually over a period of 8 years.

When should I be concerned about my child’s articulation?

Under the age of 3, it is common for children to make quite a few sound errors and substitutions.  By age 3, a child should be using at least 200 words, using 3-5 word phrases and be understood at least 80% of the time.  By age 4, a child should be 100% intelligible even if they continue to have some articulation errors.  Sounds which are “later developing” include “sh”, “ch” “j” and “th”.  Sometimes the “s” and “r” sounds are more difficult to remediate and require more speech therapy.

What sounds do children learn to produce first and in what order?

Most children are able to produce the “bilabial” sounds (made with the lips) of “b”, “p” “m”and “w”. They may also produce sounds such as “d”, “t”, and “n” early on as well.  Child acquire sounds developmentally and by age 8 should have mastered all of the sounds.

What causes an articulation disorder?

Although the cause is often unknown, the following are may cause an articulation disorder:

  • Hearing loss
  • Illness
  • Developmental Disorder (ie Autism)
  • Neurological Disorder (ie Cerebral Palsy)
  • Genetic Disorder (ie Down Syndrome)

How do you treat an articulation disorder?

If you feel that your child is in need a speech evaluation, it is vital to seek treatment from an ASHA (American Speech Hearing Association) Certified provider who will conduct a comprehensive evaluation and provide services as needed.