Making an Experience Book with Your Child

By Alexa Demyan,

By: Claire Slavik, M.A., CF-SLP

An experience book captures the everyday moments that your child finds important in their daily life. This is a homemade book put together by you and your child to help foster and guide conversation. All you need is some paper, a pen or crayons, and some creativity!

How do we make one?

  • Sit down with your child and ask them what they did during the week that was fun! They may say they loved going to the zoo, for example!
  • Write down words your child says and draw a simple picture to go with it. Your child can help to draw and color. Make it fun! If you still have the zoo ticket, tape it to the page to remind the child of their experience.
  • Talk about the experience! Ask your child questions. If it was about the zoo, ask: “What did we do first?” “What did you like better: the bears or the lions?” “What color were the elephants?”
  • Work into your weekly routine! Find a time each week to create a new page.

What are the benefits of creating an experience book? ​Creating each page with your child will provide opportunities for:

  • Answering Wh- questions: As mentioned above, this will foster opportunities for your child to practice answering questions about something they enjoyed.
  • Sequencing a story: Help your child put the events in order by asking, “What did we do first? Second? Last?”
  • Describing a scene: Help your child add detail to their story! If your child said, “I like the bear,” you could ask: “Was the bear big or little?” “Was he fury or bumpy?”…now, you are able to say, “Oh! You like the big, fury bear.”
  • Making predictions: Use “I wonder statements” to help your child predict different scenarios! (ex: “I wonder what would happen if the bear stepped in the water!”

Tantrums Vs. Meltdowns

By Alexa Demyan,

By: Natalie Day, M.S., CCC-SLP

Three of our talented speech therapists, Sarah Denman, Eileen Adamo, and Joelle Umstead, shared a presentation with our speech staff at a recent staff meeting! They taught us about tantrums versus meltdowns: how to recognize the difference, how to know when one is coming, and some strategies to prevent them from happening. Here are some highlights and helpful takeaways!

Tantrums vs. Meltdowns: What’s the difference?

Tantrums

  • An intentional change in behavior to get a desired result
  • Require cognitive functioning (i.e. the child is thinking about and choosing to behave this way)
  • Children often check in to make sure they have an adult’s attention

Meltdowns

  • An involuntary reaction to overwhelming stimuli
  • Could be a sensory-related response
  • Could be a response to an overwhelming cognitive load or demand
How can I know when my child is going to have a meltdown? Some (but not all) warning signs of an oncoming meltdown are:

1. Pacing back and forth or in circles

Increasing self-stimulatory behaviors (flapping, self-talking)

3. Perseverating on one topic

4. Extreme resistance to stopping a ritual or routine

What can I do to help prevent meltdowns from happening?
  1. Have clearly defined physical areas to help the child understand expectations (e.g. eat dinner at table, then play in living room). Structured, predictable environments are comforting.
  2. Allow the child to keep a security item, like a small toy or comfort object, if it helps them feel calm when difficulties arise.
  3. Address any sensory needs the child might have and teach them how to ask for a break if/when they become overstimulated, and manage the child’s anxiety with things like deep breathing, breaks/walks, or calming boxes.
  4. Provide clear expectations about routines and schedules, and keep them as predictable as possible.
  5. Use visual supports and schedules to help provide predictability. A special picture can be used for when the routine unexpectedly changes; the plan will change but the picture will be familiar.

The most important thing to do is to use these strategies during calm times so they can be effective to avoid meltdowns.

Navigating the IEP Process

By Alexa Demyan,

By: Lora McConnell, M.A., CCC-SLP

What do you do if you have a concern about how your child is functioning at school? There are several specific steps you should follow and information you should know in order to get your child the help he/she might need.

  • First, talk to his/her teacher and see how they are doing in the classroom setting.
  • Write a SPECIFIC letter/email outlining your concerns and ask for an evaluation. Be sure to document everything! Send it to the principal, school psychologist, and speech-language pathologist (if an area of concern).
  • Be sure to provide any evaluations/testing/reports you may already have.
  • Instead of an evaluation, you could ask that your child begin interventions though the RTI (Response to Intervention) process, where your child would be provided with interventions targeting the specific area of concern.
  • If you request an evaluation, the school has 30 days from receiving the request to explain the process, get your permission, and set up testing.
  • The school has 60 days from receiving your permission to do full testing in the area(s) of concern. They will write an Evaluation Team Report (ETR) documenting testing conducted and testing results. An ETR is conducted every 3 years.
  • If your child qualifies for services, an initial Individualized Education Plan (IEP) meeting will be scheduled to set up specific goals for your child. Within another 30 days from the ETR and, as soon as possible, services begin. The IEP is reviewed annually.
  • This can be a long process, so stay on top of it! Know your rights and your child’s rights. You will be given the document “Whose IDEA is This?”, which is a helpful guide for special education.
  • Remember: a child is eligible for school services only if the disability adversely affects his/her educational performance.
If the school doesn’t feel your child needs further services but you still do/disagree:
  • You may request an Independent Educational Evaluation (IEE) – done by an outside site only in the areas tested by the school. The school will provide you with participating locations. An IEE may be paid for at public expense or by the parent, depending on location.
  • You can also seek additional services/tutoring/therapy elsewhere.
WHAT DO ALL OF THOSE LETTERS MEAN?!?!
  • SLP – Speech-Language Pathologist
  • OT/PT – Occupational Therapy/Physical Therapy IS – Intervention Specialist
  • RTI – Response to Intervention
  • ETR – Evaluation Team Report
  • IEP – Individualized Education Plan
  • IEE – Independent Educational Evaluation
  • ODE – Ohio Department of Education
HOW DO I STAY INVOLVED IN MY CHILD’S PROGRESS?
  • The school will sent periodic reports updating goals. Review these carefully.
  • Be sure to attend parent/teacher conferences. Additional professionals working with your child often attend these as well.
  • Attend all IEP related meetings. Ask lots of questions.
  • Remember: the IEP team is on the same team with you – they want your child to succeed , too!
  • Set up time at home for nightly homework and targeting your child’s goals in a natural setting. Your child’s IEP team can give you ideas.
Additional Resources:
  • Parent Mentors – free service, parent of a child with a disability employed by each school district, parent who can help answer questions and provide support.
  • Parent Advocate – an advocate for you and your child paid by you to help to try and get the services you desire for your child.
  • OCECD – Ohio Coalition for Education of Children with Disabilities (Marion, OH) – statewide, non profit organization serving children and their families, and educators, agencies providing service to them.
  • Interpreters are available if requested and set up prior to a meeting All of the above can help with transition services
  • Whose IDEA is This? document
  • Ohio Department of Education Website
  • John Peterson Scholarship – funds for therapeutic services if your child has an IEP but is attending a private school.
  • Autism Scholarship – funds for additional therapeutic services if your child has received a diagnosis on the autism spectrum.
  • Talk Tips to Go! Columbus Speech & Hearing Center’s monthly newsletter highlighting various speech and language topics and resources for all ages. Email jails@columbusspeech.org to sign up!

When Do Children Develop Certain Speech Sounds?

By Alexa Demyan,

By: Natalie Day, MS, CCC-SLP

As children develop, so does their speech! It takes time for all speech sounds to be produced correctly, so it’s normal for some sounds to not be produced correctly in young children. But when should we expect sounds to develop? New research is available to guide our decision making about the development of speech sounds!

According to a compilation of 15 studies on English speech sound acquisition, the average child will master each sound by the ages noted below:

  • 2-3 years of age- p, b, m, d, n, h, t, k, g, w, ng, f, y
  • 4 years of age- l, j, ch, s, v, sh, z
  • 5 years of age- r, zh, th (voiced)
  • 6 years of age- th (voiceless)

Things to take away:

  • Most children correctly produce the majority of consonants by the time they are 5 years old.
  • Children generally develop speech sounds in the same order.
  • Variation between individual children is expected; not all children will develop speech sounds according to this timeline. Some may be in a different order or some may be earlier or later than what is noted here.

Visual Supports In The Classroom

By Alexa Demyan,

By Julie Aills, M.S., CCC-SLP

One of our wonderful and talented speech therapists, Danielle Nader, was a presenter at OCALICON this year. OCALICON is a 3- day conference for related professionals and families of individuals with autism, sensory disabilities, and low-incidence disabilities. One of Danielle’s presentations focused on the importance of using visuals aids in the classroom. Here are some highlights and key takeaways from her presentation!

WHAT are visuals supports?

Visual supports are things that we see that enhance the communication process

WHY should visual supports be used in the classroom?

So much of communication is non-verbal….meaning it’s visual! Gestures, facial expressions, body movement and objects in the environment.

  • Portray expectations and teach routines. Visuals schedules allow children to predict and anticipate what will happen.
  • Teach positive behaviors or new skills. Visuals can teach vocabulary, sequencing and cause and effect.
  • Empower children to learn. Using visuals as a way to teach children how to make a choice EMPOWERS the child.
  • Choices provide an opportunity to communicate when a child might not have the words.
  • Helps teachers and teams run a more efficient classroom. Visuals can have a big impact on teachers and classroom efficiency! They reduce the need to repeat verbal directions, increase the time students stay on task and improve classroom management
HOW can visual supports be used in the classroom?
  • Visual schedules: Can be used for schedules (what is going to happen throughout the day) and routines (the “in between” steps to get you from one task to another)
  • First-then boards: Can be used to manage behaviors (e.g. first clean up, then outside), teach a sequence (e.g. first soap then water) or teach a new skill (e.g. setting the table)
  • Making Choices: Make sure to follow through with the child’s choice, even if it seems the choice was made by accident!
  • Managing behaviors and expectations: Teaching acceptable vs. unacceptable behaviors within routines in a way that is not disruptive to the rest of the class

Autism…It’s Different For Girls!

By Alexa Demyan,

By Lauren Polster, M.S., CCC-SLP

Approximately four boys for every one girl are diagnosed with autism spectrum disorder (ASD). Therefore, scientists have focused their research on boys, and we have had little information about how autism might present differently in girls. 

New research suggests that methods currently used to diagnose autism can overlook girls. More research is showing that girls with autism might differ from the typical diagnostic criterion outlined in the DSM (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition). Here are some examples:

  • Boys showed more repetitive and stereotyped behavior than girls (Van Wijngaarden-Cremers, 2014).
  • Girls with autism were more socially motivated and reported friendships that were more intimate than those of boys with autism (Sedgewick, 2016)
  • Girls with ASD are more likely to internalize their feelings (instead of tantrums, hyperactivity, etc.) and might present as shy or quiet. Internalizing could lead to anxiety or depression (Solomon, 2012).

Clinical observations suggest that girls with ASD may “socially camouflage” and superficially demonstrate social and emotional skills to help them fit in or not be noticed.

Ami Klin, director of the Marcus Autism Center at Emory University School of Medicine, and other experts advise teams to look for:

  • More age-appropriate intense interests.
  • “Pretend play” that is actually repetitive or strict.
  • Possibly at-age or above-age language use, but perhaps echolalia or differences in receptive/expressive language.
  • Less obvious self-stimulation behavior, as the girl may have replaced her natural self-stimulation with something more socially acceptable.
  • Exhaustion after social stimulation (school, playgroups).
  • Sensory issues—intolerance of crowds or of certain sounds or textures, for example.
  • Difficulty with conversation skills and social engagement—turn-taking, staying on topic, initiating and contributing to the conversation.

(Volkers, 2018)

Sedgewick, et al., J Autism Dev Disord. 2016; 46: 1297–1306.

Gender Differences in the Social Motivation and Friendship Experiences of Autistic and Non-autistic Adolescents

Solomon, et al., J Autism Dev Disord. 2012 Jan; 42(1): 48–59.

Autism Symptoms and Internalizing Psychopathology in Girls and Boys with Autism Spectrum Disorders

Volkers, ASHA Leader. 2018 April; 48-55. 

Invisible Girls

Van Wijngaarden-Cremers, et al., J Autism Dev Disord. 2014 Mar;44(3):627-35.

Gender and age differences in the core triad of impairments in autism spectrum disorders: a systematic review and meta-analysis.

E-I-E-I-O and Other Vowel Sounds

By Alexa Demyan,

By Eileen Adamo, M.S., CCC-SLP

When a child’s speech is difficult to understand, adults often assess what consonant sounds the child is or is not producing. However, when it comes to “speech intelligibility” (the ability to be understood), vowels have a major role in understanding the message. It is much easier to tell what a child wants if they are able to say “buh” for bubbles and “boo” for peekaboo with the correct vowels, even if some other consonants are not yet in place.

Here are a few tips to remember when working on vowel sounds at home:

  • Use a Mirror – Using a mirror to practice sounds can help your child pay attention to your mouth and make it easier for them to imitate what you are doing.
  • Be Specific – Rather than “say your OO sound,” use specific vocabulary about what your mouth is doing, to help your child understand what their mouth needs to do.
    • For example, saying “keep your lips back” for the “EE” sound, or “make circle lips” for the “OH” sound, helps guide their mouth into the correct position. Ask your clinician for tips.
  • Break it Down – If you are noticing that your child is having trouble accurately producing vowels in words or sentences, start at an easier level and increase the challenge once they are more successful.
    • This may mean starting with just the vowel by itself. Use a variety of vowels, including:
      • AY (like “play”), EE (like “tree”), Eye (like “pie”), OH (like “bow”), OO (like Boo”), OW (like “cow”), AH (like “mad”), AW (like “saw”), IH (like “kick”), UH (like “hug”)
    • Then try adding in a few Consonant + Vowel sound combinations:
      • Consonant-Vowel (ex: Bye), Vowel Consonant (ex: Up), Consonant-Vowel- Consonant-Vowel (ex: BooBoo), Consonant-Vowel-Consonant (ex: Hat)
    • Then work your way back to single words and short phrases.
  • Keep if Fun! – Making the activity fun and play-based will maximize your child’s engagement and willingness to practice (Remember, these sounds are hard to learn at first!)

Why Early Intervention?

By Alexa Demyan,

What is early intervention?

Early intervention refers to a range of services to help children 0-3 years of age who have developmental delays or specific health conditions. This may include speech-language therapy, occupational therapy, physical therapy, etc. Services may be provided through a variety of sources, including Ohio’s statewide program called Ohio Early Intervention (Help Me Grow). 

Why start so early?

Early intervention is important for the following reasons: 

  • Neural circuits are most flexible or “plastic” during the first 3 years of life. 
    • Over time, they become increasingly difficult to change. 
    • Studies found that children with Autism Spectrum Disorder (ASD) make the most changes in their language development before they are 6 years old. 
  • Studies show that children who acquire language/social skills earlier have better overall outcomes than those who acquire skills later. 
  • Services often provide caregiver training, such as giving strategies/techniques/ideas to use at home
    • Parents are with their children more hours/week than any therapist – they can  implement techniques from therapy services into everyday life 
    • Increased carryover of skills for the child

Overall, intervention is likely to be more effective and less costly when it is provided earlier in life rather than later. 

What should I do?

  • Seek help if you are concerned – If a child’s speech/language or other skills are behind, seek out an evaluation as soon as possible to determine if help is needed. 
  • Encourage others to seek help if they are concerned Whether a relative, friend, neighbor, or acquaintance, encourage others who have voiced concerns to also seek out an evaluation. 

References:

The National Early Childhood Technical Assistance Center. (2011). The Importance of Early Intervention for Infants and Toddlers with Disabilities and their Families.

Lowry, Lauren. The Hanen Centre. (2016). New information about why early intervention is key for children with Autism Spectrum Disorder.

Beep! Beep! Speech & Language Practice For The Car

By Alexa Demyan,

By Sam Secrist, M.A., CF-SLP

From play dates, swim lessons, and soccer games to picking up dinner or stopping by the grocery store, families are always on the go! It’s no wonder that setting aside time for speech practice is so difficult! While ultimately speech practice should become a natural part of everyday interactions with your child, it is also important to set aside time to target specific skills. So, why not utilize the time you spend in the car?

Language Practice

  • I Spy: This game is great for describing, asking/answering questions, and taking turns. To begin, one person spies something and keeps it a secret. The other players take turns asking questions until someone guesses the item correctly.
  • 20 Questions: This game targets describing, categories, and vocabulary. Have your child think of a person, place, or thing and hold it in their mind. Ask your child questions involving salient features to identify what they are thinking of (e.g., what does it look, where can I find it, what is it used for, what category does it belong to?). The goal is to guess what your child is thinking of in 20 questions or less.
  • The Category Game: Think of a category and have your child name or find 3 items that belong in the category (e.g., something green, restaurants, etc.).
  • Talk: It’s that simple, just talk! Talk about where you are going, sequence the events that you are going to do once you get there, have your child tell you three things they did during their day, etc.
  • Sing Songs: The Wheels on the Bus, ABC’s, nursey rhymes…the possibilities are endless!
  • Books: If you child can’t read encourage them to name objects in the photographs, describe what they see, or make up their own story using the pictures. If they can read, have them read to you. Afterwards, ask them questions about what they read or ask them to retell the story

Articulation Practice

  • Flashcards: Keep a folder of speech words or a deck of homemade articulation cards for your child to practice while in the car.
  • Look Around: Challenge your child to find 10 to 20 items inside of outside of the car that contain their speech sound. Have your child repeat each target word 3 times and then put it into a silly sentence.
  • Books: Have your child search for pictures or words in a book that contain their speech sound. You can even have them practice their speech sound(s) while reading to you aloud.
  • Paper & Crayons: Ask your child to draw pictures of words that contain their speech sound. Encourage them to practice their target word while coloring.
  • Tablet Apps: Download apps like Articulate It! or Articulation Statation onto a tablet. Your child can easily and indepdently use the app(s) to practice their speech sound(s) while in the car.

Playing With Toys!

By Alexa Demyan,

By Abbey Vielhaber

Pick toys without batteries, lights, and sounds. Research shows children communicate less when playing with electronic toys.

Find or make toys that your child is interested in and play at their level-some children like to taste toys, some like to put things inside containers, and some like to pretend.

Be flexible! Toys can be used in a lot of different ways-not just how they were made to be used. Let them put blocks in the microwave, throw stuffed animals in the air, or put Mr. Potato Head parts in the wrong places.

Sometimes the best toys are household or outside objects. Strainers can be fun bath toys or be used to put dry spaghetti in. Laundry baskets can be used as a car, boat, or a place to hide under. Leaves can be blankets for a doll, and pinecones and sticks can be drumsticks.

Have fewer toys available. Research shows that when there are fewer toys available to a child, they become more creative in finding different ways to play. It also increases their attention span. Rotate a new set of toys every month or two to change it up. Also, be aware that things like background tv noise can decrease attention to toys.