Pediatric Feeding Evaluations, What to Expect

Pediatric Feeding Evaluations, What to Expect

Expert Corner normal speech milestones Parents' Corner

Many people believe that the role of a speech-language pathologist’s (SLP) is limited to speech and language, however, we have a list of responsibilities including pediatric feeding evaluations. SLPs are experts in the oral mechanism all the way down to the esophagus, allowing them to support individuals with feeding and swallowing difficulties. Feeding involves all the steps it takes to get food off the plate and into your mouth, while swallowing includes chewing, moving the food down the throat, and protecting the airway that leads into the lungs. A swallowing disorder is known as dysphagia. If your child has any aversion to certain foods or has trouble swallowing without coughing, your pediatrician may suggest you visit a speech-language pathologist. In order to assess your child’s feeding and swallowing abilities, the SLP will conduct a natural feeding evaluation. If this is recommended, here’s what you can expect…

Your Pediatric Feeding Evaluation, Step by Step

Baby feeding and swallowing problemsFirst, the therapist will conduct an initial interview. They will ask you questions about your child’s developmental history, family background, your family’s daily routine, feeding preferences, and wishes for therapy.

After the SLP and child become acquainted, she will complete an oral mechanism exam. From a parent’s perspective, this procedure may appear like your average snack time. However, the SLP is observing everything your child does to determine what needs to be done next. For young children, speech therapists often disguise this examination with play activities. Modeling and asking the child to make funny faces, the SLP will observe the child’s ability to move their oral structures (lips, tongue, cheeks, ect.) and any asymmetry or weakness is noted.

Next, the therapist will begin to offer the child different foods and textures. In order to create the most natural feeding possible, the SLP may request that you bring in some of your child’s favorite foods or utensils from home. Food and drinks of different consistencies will be presented in order to identify your child’s strengths and weaknesses. As the therapist and child enjoy the different foods, the therapist will observe the child’s ability to hold the food in their mouth, chew, and swallow without leaving residue behind. The evaluation may be video recorded for later analysis and the therapist will take notes throughout. A checklist such as The Developmental Pre-Feeding Checklist: A Sequential Approach (1987) may also be used to make a thorough diagnosis.  

Once the evaluation is complete, the SLP will be able to make recommendations for therapy. If further evaluation or intervention is needed, the therapist may refer you next to other professionals such as an occupational therapist or a physical therapist. For more information on pediatric dysphagia and feeding assessment, please visit ASHA’s website.

 

References:

https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934965&section=Assessment

http://72.29.72.224/~ohsnapor/wp-content/uploads/2017/02/FeedingChecklist.pdf

Baby talk: does it help or hurt how your baby learns language?

Baby talk: does it help or hurt how your baby learns language?

Language Building Skills Language Development Parents' Corner

Often referred to as ‘baby talk’, Motherese (or Parentese or Fatherese) is a term used to describe the quality of speech caregivers often use when speaking to a newborn child. Using a higher pitch, more exaggerated articulation, and great facial expressions, we seem to naturally talk in this manner to babies.

Many have debated the importance or hindrance that use of baby talk has on a child’s speech and language development. Some parents believe that baby talk is an important first step in teaching a child to talk and some believe that using baby talk limits a child’s language comprehension. Researchers have conducted studies to find an answer. While modeling adult language is beneficial to a child’s speech and language development, baby talk has withstood the test of time and been a useful tool in creating a bond between an infant and their parent. This attachment helps a child learn to develop relationships with others throughout life. Babies from many different cultures around the world, speaking many different languages have shown interest in this quality of speech as it grabs their attention. This type of interaction can also give an infant their first experience with social cues such as turn taking and eye contact, and speech sounds.

Within the first days of life, a baby’s brain has remarkable neuroplasticity, meaning they can create new neural connections quickly and absorb new information like a sponge. As they experience their first sights, smells, and sounds, they make many first impressions that are everlasting. Studies have shown that babies often learn to recognize and prefer the sound of their caretaker’s voice. Although researchers have not been able to identify whether it’s more beneficial to use adult speech right from the start, use of brain scanning technology has allowed us to see the reactions infants have to adults using baby talk in their native language as well as foreign languages. This TED talk by Patricia Kuhl discusses one of these studies.

Remember- there is no clearly defined right or wrong style of parenting or teaching. If you are a new parent, no matter how you choose to speak to your child, just make sure you do it! Even when you are not speaking directly to an infant, they’re constantly taking in information and making connections. Whether by choice or instinct, if you do use motherese with your child, it is recommended that this type of speech be weaned off as the child reaches toddlerhood and begins develop speech and language skills.

More resources to check out:

ASHA: How Babies Form Foundations for Language 

TED: The Surprisingly Logical Minds of Babies

Photo credit: www.prettymomguide.com

Speech Buddies Parents’ Corner – Thanksgiving Crafts to Make with the Kids

Speech Buddies Parents’ Corner – Thanksgiving Crafts to Make with the Kids

Games and Activities Parents' Corner
Thanksgiving Crafts

These cute little turkeys make great appetizers at the kids’ table and you can add names for place cards at the dinner table. Image source: www.chattingoverchocolate.com

Somewhere along the way it became November and Thanksgiving is almost here. These Thanksgiving crafts not only help your little ones get into the holiday spirit, but they are easy ways to help prepare for the holiday, too, even producing appetizers, table setting options, and decorations. Continue reading

Calling All Parents!

Parents' Corner

Graduate students at Rush University in Chicago are conducting research and need your help! Collaborative relationships between speech-language pathologists, children receiving treatment, and parents are important aspects of the treatment process. Help Rush students learn more about these relationships by filling out this brief survey: https://www.surveymonkey.com/r/FKJC8GW

Thank you for helping us continue to learn and improve speech services!

Bilingual Households and Speech Delays in Children

Bilingual Households and Speech Delays in Children

Language Development Parents' Corner Speech delay

Does growing up in a bilingual household create speech delays in children? The answer in the short term appears to be yes. Over the long term, however, children from bilingual homes tend to bounce back and may even derive special advantages from growing up in a household where both English and another language are spoken.

Tips For Raising a Bilingual Child

The key to raising a bilingual child is early exposure. The first few years of a child’s life represent the most rapid period in the growth of language pathways for speech development. Researchers say that a child’s brain in this critical period are like giant file cabinets that store up huge libraries of phonetic knowledge.

Scientists at Cornell University describe the acquisition of language as one of the greatest feats in human development. Their research indicates that an initial deficit in word learning or vocabulary was followed by “a fast pace of development,” ultimately reaching the same rate as children raised in monolingual homes. While many teachers and parents may be concerned that raising a child in a multilingual or bilingual household could be confusing, the scientific evidence indicates that bilingual children do not suffer from “language confusion, language delay or cognitive deficit.”

The Advantages of Raising a Bilingual Child

The cognitive advantages that your child will reap from bilingualism or multilingualism will likely aid his or her academic achievements later in life. In fact, far from causing problems in a child’s intellectual development, bilingual or multilingual kids enjoy special advantages over their monolingual peers, including easier access to other languages and cultures in ways that their peers often do not share. Moreover, exposure from birth to more than one language may yield the best results in achieving native-like proficiency.

Perhaps best of all, the children of bilingual or multilingual parents do not need to be “taught” a second language in order to get it right. Language learning is a complex process that children work through on a step-by-step basis, according to the sounds that they hear from their parents and overhear in other settings. So while exposure from birth to different languages is essential, moms and dads do not need to drill their children if they are developing normally. They can simply allow their kids to “discover” other languages on their own.

At the same time, however, parents can take concrete steps to facilitate multilanguage development that will enrich understanding and mastery, including:

  • Surrounding the child with conversations and social groups that utilize more than one language.
  • Exposing children to different languages through multilingual play groups.
  • Reading to and telling your child stories in different languages.

Another tip for parents raising the bilingual or multilingual child is for each parent to stick to his or her native tongue. This is known as the OPOL — “one parent, one language” — strategy for nurturing multilingual speech development. It’s based on the idea that kids will have an easier time if moms and dads consistently speak their own native tongues.

Of course, parents with children who have diagnosed language difficulties have special concerns regarding the effects of bilingualism. But research shows that, even among kids with language development challenges, it is possible for them to achieve bilingualism. According to one researcher, the evidence “suggests that…these children can acquire functional competence in two languages at the same time, within the limits of their impairment. Therefore, children with specific language impairment living in families where knowing two, or more, languages are useful and important, should be given every opportunity to acquire two languages.”

Parents who are unsure or have doubts should make sure that their children’s hearing has been tested; they should also consult an expert and remember that language development is a complex process that takes time and that some children will simply develop these skills at different rates.

Earth Day Activities for Children – Reading and Craft Ideas

Earth Day Activities for Children – Reading and Craft Ideas

Games and Activities Parents' Corner

Earth Day is almost here! Teaching your child to be eco-friendly can help them become aware of their environment and how they can make a difference in the world. Below are some fun suggestions for Earth Day activities for children for you to consider at home or at school. There are many children’s books that help children understand what it means to be eco-friendly and what Earth Day is all about. The Lorax by Dr. Seuss is a great children’s book that address environmental issues in a creative way. Other books to consider are The Giving Tree by Shel Silverstein and The Earth Book by Todd Parr. PBS Kids has several other “green” reading ideas to share with your kids.

If you do end up reading The Lorax with your kids, follow it up with an art activity about planting a new tree! You can make your own tree, either through cutting out then gluing the pieces together, or drawing all the parts of the tree, from root to trunk to leaves & fruit or flowers. It’s a fun activity both you and your little one can do together and let your imagination run.

Reading list for Earth Day

Another fun craft idea from Powerful Mothering is making a feather and pom pom tree. This activity is good for fine motor skill development in youngsters. Using piper cleaners and pom poms, your child can make their own truffula trees! The steps are simple and easy to follow.

And if your child is interested in getting down and dirty and planting a real tree, check out MillionTrees NYC. Here you can sign up to plant trees all over NYC or request a tree to be panted in your neighborhood. This is great way to get the whole family involved and discuss how trees are important to our environment, both locally and globally.

Additional Earth Day theme activities your child may enjoy include:

Super Simple Nature Prints: For this next activity, taking a nature walk or short hike with your child will be very helpful. While walking through the park, have your child gather and collect flowers, acorns, twigs, leaves, tree bark etc. Once you have gather all those things, you and your child can make nature prints using clay or play-doh.

Another eco-friendly activity that your child will love is building with recyclables. The possibilities are endless in what your little one can make by using egg cartons, plastic bottles, etc. Let your child build robots out of paper towel rolls or spaceships out of milk cartons. Want to be more creative try doing this activity- Fine Motor Play from Recyclables.

Local Earth Day activities for children in NYC:

Earth Day in Prospect Park (April 17) – There will be lots of fun interactive activities for the whole family to enjoy.

Earth Day New York 2016 at Union Square (April 17) – An annual event held at Union Square where you can enjoy live performances and interactive displays.

Arbor Fest (April 24) – Visit Queens Botanical Garden and enjoy various activities which include live music, face-painting and much more!

Parents' Guide to Reinforcing Speech Therapy at Home
Should you be concerned about your shy child?

Should you be concerned about your shy child?

Parents' Corner

I have always believed strongly in not “over-pathologizing.” As the term implies, I don’t think it’s helpful to a child or a family to be told that every behavioral quirk in a child is a clear deviation from normal and therefore must be clinically addressed. Speech-language pathologists have research-based evaluation tools to determine with good confidence whether an underlying speech or language challenge is present. If there is something that would need to be addressed, we can reliably determine this. What we’re really trying to do is find a “happy medium” between alarmism and ensuring that we don’t miss anything. This blog post is dedicated to putting a clinical lens on what we can somewhat simplistically term shyness so you, as a parent, can get an idea at various ages if your shy child may need a speech and language evaluation from a trained professional.

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Heartache and Joy: Communication Challenges with Autism

Heartache and Joy: Communication Challenges with Autism

Autism Parents' Corner

Life with a speech-delayed toddler is filled with heartache and joy. Along with the usual toddler demands comes the added difficulty of not being able to easily communicate. In my child’s case, her severe speech delay is due to autism spectrum disorder and motor planning issues. Our days are filled with struggle. My failure to understand her can send her into a rage or meltdown, further fueled by the autism. Yet we do find joys amongst the everyday struggles of communication challenges with autism.

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How to Talk to My Child about Speech Challenges

How to Talk to My Child about Speech Challenges

Parents' Corner

Recently I starting working with a 7 year-old boy who had trouble with his R sound, a very common situation in my practice. After the initial intake session the boy’s mother asked me about any strategies or suggestions for explaining his challenge to the boy’s younger sister, who was able to perfectly articulate R and all other speech sounds. “How do I talk to her about speech challenges?” I think I gave mom a good idea, in an off-the-cuff way, but it did get me thinking about how parents could be better equipped to explain to their kids about the best way for them to think about a speech challenge in a friend or family member. The name of the game here is empathy and the more we can foster this sense of empathy, no matter the severity of that speech challenge, the easier we can make the process of speech therapy. Therapy doesn’t just occur in the clinician’s office or in the school speech room, it also happens among friends and family members.

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4 Ways to Jumpstart Speech Therapy at Home

4 Ways to Jumpstart Speech Therapy at Home

Parents' Corner

With the body awash in insulin to metabolize all that holiday sugar and (if you’re like me) a mildly shocking reading from the scale, the New Year is a time to set new goals—resolutions, we like to say—to make us especially steadfast. While most New Year’s resolutions tend to involve personal disciplines like not eating so much barbecue or to get more exercise, as parents it is important to consider how our resolutions could positively influence our child’s education. Here are four easy-to-implement resolutions to either get your child’s therapy back on track or to further bolster their progress with a little speech therapy at home.

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