Drooling – What’s Normal and What’s Not?

By Chatterboxes 

Q: Isn’t drooling normal in childhood?
 
A: Yes, drooling is quite normal throughout infancy and the toddler ages. Periods of excessive wetness can especially coincide with teething. As teeth poke through the skin, the brain is triggered that something is in the mouth and therefore, more saliva needs to me produced. Initially, excess saliva may help sooth a child’s sore gums, but it may also become unmanageable.
Q: Why do children drool?
 
A:Children continue to drool beyond the age which it is expected for four main reasons:
1.   Saliva Awareness: Child is not aware, or doesn’t care about saliva escaping 
2.   Swallow Frequency: The child does not swallow often enough
3.   Swallow efficiency: The child does not swallow effectively
4.   Poor Lip Closure: The child keeps lips parted most of the time
Q: Can drooling be eliminated?
 
A:Excess drooling can be controlled, reduced and eliminated in many cases, but not all cases. Success depends on factors such as: child’s cognitive level, oral-tactile sensitivity, dental status, willingness to participate in activities, and oral tone.
 
Tips to Decrease Drooling:
  •  Teach the concepts of “Wet” and “Dry.” For example:
    •  Show the child how to feel wetness and dryness in various situations such as bath time, washing hands, when cleaning a counter top, when blowing bubbles, when a spill happens
    • Then, teach the concept of a wet and dry chin. Ask the child to feel his chin and describe it: “Are you wet? Or dry?” Teach the child that we like for their chin to be dry
  • Swallowing: For Example
    • Show the child how to use his own hands to feel his swallow
    • Show him how it feels to swallow while drinking water from a cup.
  • Strengthen the Lips: Simple activities done on a regular basis can improve the strength and control of the lips. Examples include:
    •  Give kisses (full pucker) to a teddy bear 20 times in a row
    • Press the lips together tightly while waiting for a traffic light to turn green
    • Blow up cheeks and keep the lips closed
    • Say “mommy” 10 times in a row

Communication Milestones (Ages 4 to 5 Years)

By Chatterboxes 

RECEPTIVE LANGUAGE:

• Pays attention to a short story and answers simple questions about it.
• Hears and understands most of what is said at home and in school.

EXPRESSIVE LANGUAGE

• Makes voice sounds clear like other children’s.
• Uses sentences that give lots of details (e.g., “I like to read my books”).
• Tells stories that stick to topic.
• Communicates easily with other children and adults.
• Says most sounds correctly (except a few including l, s, r, v, z, ch, sh, th).
•Uses the same grammar as the rest of the family.

Communication & Play Milestones: (Ages 2.5 to 3 Years)

By Chatterboxes 

RECEPTIVE COMMUNICATION:
  • Understands the use of objects; for example:
    • Show what you use to cook food or Show me what you watch.
    • Show me what you can ride or Show me what you wear on your feet
  • Understands part/whole relationships, for example:
    • The wheel on the bike
    • The tail of the cat
  • Understands descriptive concepts, such as “big” “wet” and  “little”
  • Follows 2 step related and unrelated commands, without cues:
    • Get the cup and give it to me
    • Take off your coat and hang it up. 
EXPRESSIVE COMMUNICATION:
  • Uses Plurals, such as “horses” or “blocks” or “babies.”
  • Combines 3+ words in spontaneous speech.
  • Answers “What” and “Who” Questions
  • Uses Verb + ing
  • For example, “The girl is playing.”
  • Uses a variety of nouns, verbs, modifiers and pronouns in spontaneous utterances.
  • Uses prepositions
  • Understands the concepts of one vs. all. For example,
  • Give me just one block.
  • Put all of the blocks in the box.
PLAY:
  • Performs longer sequences of play activities
  • Acts out familiar routines
  • Pretends to perform the caregiver/parent routines.
For more information on our Evaluations & Therapy, or to schedule a visit for your child, visit  www.TeamChatterboxes.com 

Speech & Language Developmental Milestones

By Chatterboxes 

Children’s Speech and Language Development follows a typical pattern of development. The below milestones are speech and language skills that children acquire starting as young as 6 months.
If you have concerns about your child’s speech and/or language development, please feel free to Contact our Team to talk in more detail about your child’s development.

 

The 4 Stages of the Learning Process

By Chatterboxes 

When mastering new therapeutic skills or goals, your child typically advances through a predictable series of learning stages.
 
Initially, your child may be uncertain as he tries to use the target skill.
 
With his therapist’s feedback and lots of reinforcement, your child will become more fluent, accurate, and confident in using his new skill.
 
From a parent’s perspective, It can be very useful to think of these phases of learning as a hierarchy. The learning hierarchy (Haring, Lovitt, Eaton, & Hansen, 1978) has four stages: acquisition, fluency, generalization, and adaptation:
 
Stage 1: Acquisition:
 
Your child is starting to be able to complete the target skill correctly, but he is not yet accurate or fluent in the the skill.
 
The goal in therapy at this stage is to improve his accuracy.
 
 
Stage 2: Fluency:
 
Your child is now able to complete the target skill accurately, but he works slowly and thoughtfully in order to do so. 
 
The goal of this phase in therapy is to increase the student’s speed of responding.
 
 
Stage 3: Generalization:
 
Your child is now accurate and fluent in using his new skill, but he will not typically do so in different settings/environments. Other times, your child may confuse this new target skill with other ‘similar’ skills. 
 
The goal of this therapy phase is for your child to use the skill in the widest possible range of settings and situations, or to accurately discriminate between the target skill and ‘similar’ skills.
 
 
Stage 4: Adaptation:
 
Your child  is accurate and fluent in using the target skill. He also uses the skill in many situations or settings. However, your child is not yet able to modify or adapt the skill to fit novel task-demands or situations. 
 
The goal of this stage of therapy is for your child to be able to identify elements of previously learned skills that he can adapt to the new demands or situation.

Learn more about us at www.TeamChatterboxes.com


 
 
 
 

 

Private Speech Therapy vs School-Based Speech Therapy: How do they Stack Up? (Part 1 of 2)

By Chatterboxes 

 
“Should I Stay with School Therapy or Should I go Private?”  
 
Alot of parents are asking themselves this question at some point during their child’s speech therapy care. Parents may struggle to see progress with school speech therapy,  Yet, going to a Private Practice entails an increased cost when compared with school-based therapy.

 

Training
 
Both a Private Speech-Language Pathologist and a School Based Speech Pathologist who are “CCC-SLP Certified” have the same level of educational training after all, so how can there be a difference in services?

 

Here’s why: The school SLP must work under the confines of her school district’s regulations. Due to the intense need for speech & language services at school, the Speech-Pathologist practicing in a Public School typically faces an ever-increasing set of demands during the school year; thus she’s presented with an expanded scope of practice. School SLP workload responsibilities include:
 
Therapy Timeline
 
By law, in Massachusetts, once the public school has received parental consent, the school has 30 working days to perform an Evaluation. Once the testing is complete, a team meeting must be scheduled within 45 school working days.
 
Time-Out. 75 Days? That’s a substantial period of ‘waiting’ time in a child’s academic school year.
 
In a private setting, an evaluation is typically scheduled within 1 week. The report is then produced in 7-10 days and therapy often begins the week after the evaluation.
 
Eligibility & Qualification
 
Your child needs to meet state issued eligibility standards to qualify for speech/language services in the Public Schools. In Massachusetts, “To be eligible for special education services, a student must first be found to have a  disability which is causal to an inability to make effective progress in school.”
 
In a Private Setting, your child does not need to be ‘eligible’ for our services. A parent calls with concern and we arrange for an Evaluation during a preferred time in your schedule.
 
The Evaluation Process
 
In a school-based testing situation, the SLP is confined to measuring performance solely based on standardized test results.
 
A private evaluation entails standardized testing (like in the schools), yet the Private Therapist has the discretion to include her Clinical Impressions. She has the ability to consider that your child may have had an off-day, or that he can exhibit a particular skill in play, but not during testing. You can also weigh in with your thoughts on your child’s performance, as chances are, you’re in the room.
 
With your parental consent, the private SLP can share her immediate impressions of your child’s evaluation results upon completion of the evaluation.
 
Therapeutic Environment
 
We all know that kids make progress when they are engaged and having fun. In a child- therapy situation one of the keys to success is the clinical environment. Do you know where your child’s school-therapy takes place? A hallway? A noisy classroom? An office? Background noise is distracting.

Interested in learning more about us? Visit: www.TeamChatterboxes.com

Private vs School Based Speech Therapy: How do they Compare? (Part 2 of 2)

By Chatterboxes 

Part 2 of 2
Three’s a Crowd & Four’s a Party
 

It’s most likely that if your child is receiving speech therapy services at school, they are doing so in a group setting. Kids in the group may or may not be targeting similar therapeutic goals.

Imagine hearing,  “Students: I’ll be modeling ‘How to Play Cards’ this session, but one of you will learn Gin Rummy, the other Poker, and Timmy, you’ll learn to play Hearts.”

 

Private speech sessions are typically one-to-one; whereas 100% of the SLP’s attention is focused on your child the entire 45-60 minute session. Home Programs, like these,  are included with each session. After the session, parents are walked through the homework, and given suggestions on how to implement strategies for increased carryover of newly learned skills.
 
 
Caseloads & Workloads
 
It wouldn’t be uncommon for a School-Based SLP to provide services to 95 children in one week. At Chatterboxes, a full-time therapist provides 25-30 visits per week on average.
 
Aside from designing and executing therapy to her caseload of 95 students, the School-Based SLP is also responsible for attending IEP meetings and writing and revising IEP Reports for each student. High caseloads reduce a therapist’s availability of time for planning.
 
 
Whole Child Approach
 
At Chatterboxes, our private model gives us the ability for our Speech-Pathologists to carry lower caseloads while allowing for the therapist to treat the ‘whole child.”
Whole Child Info Graphic.jpg
 
At Chatterboxes, we incorporate a child’s daily hobbies and interests, such as home-life, siblings, family happenings, into the child’s Weekly Therapy and Home Program.  
 
With parental permission, we involve the child’s teachers, babysitters, or siblings into our Therapy Program. Ensuring that all the people involved in the child’s life are educated on his or her goals and implementing strategies consistently provides the support a child needs to make progress.
 
While making therapy meaningful and relevant to a child’s interest and life from a subject perspective, our private-based model to treat the Whole-Child allows for a child to experience increased progress & carryover newly learned skills outside the therapy environment.   
 
_______________________________
 
“To the doctor, the child is a typhoid patient; to the playground supervisor, a first
baseman; to the teacher, a learner of arithmetic. At times, he may be different things to
each of these specialists, but too rarely is he a whole child to any of them.”
—From the 1930 report of the White House
Conference on Children and Youth

Interested in learning more about our practice? Visit: www.TeamChatterboxes.com
 

The Checkout Line

By Chatterboxes 

Caden Bubbled with Excitement to See Me and Tell me Everything.

He jumped into my arms after daycare announcing: “Duh Twains Twashed!  Dat one, you know, Pewcy da Dween one, Wost a Yeel!!  I was starting to notice that the more excited he became, the faster he spoke, and the faster he spoke, the less I could interpret.


The Checkout Line
We were in the Supermarket just after Caden’s 3rd Birthday and my heart broke as an elderly woman in the checkout line wanted to engage with Caden. The exchange went something like this:

Woman:  “You must be a good Big Brother. What’s your name?”
Caden:     “Das my bruder, Midal.”
Woman:  “Oh. Wow isn’t he cute! And what’s your name?”
Caden:     “Daden.”
Woman:  “Daden? How lovely.”
Caden:     “No, DA-Den.”
Woman:  “Daden. Ok! Daden! Have fun today!”


Getting from Daden to Ca-den
That afternoon, during Caden’s nap, I called to set up a Speech Evaluation.
The results of the Evaluation revealed Caden had a moderate speech delay and some of his errors, like substituting /d/ for /k/ were not developmentally appropriate for his age. That next week, we started Caden in weekly sessions.

Caden’s Grandma drove him to Speech Therapy for 6 months.

One of the 1st sounds Caden learned to say was “Kuh” and within a month, he was saying “Ca-den!” I was just thrilled with the fact that he could introduce himself. Caden continued working through a step-by-step process on his speech goals, and we were really vigilant with his home practice.

Caden appeared to have caught-up his peers, so we decided we could take a break from Speech Sessions for the Summer. Summer quickly turned into Fall and Caden started a new Preschool when he turned four. He loved school and was playing T-Ball for the Royals on weekends.


When You Feel Like Quitting: Remember Why You Started
Now at age 7, Caden is in second grade. At his parent-teacher conference this year, his teachers expressed concern with his letter-sound correlations, and his ability to sound-out words. His teacher recommended Speech Therapy, as the mispronunciation of sounds was interfering with his reading and his ability to decode words.


“We never formally finished Speech Therapy back when he was 3.” I announced to his teacher.

Now at age 7, we agree that Caden’s unresolved articulation errors are impacting his reading.  My husband and I feel responsible; as if Caden’s new trouble in reading could have been avoided.
Sticking to a program and committing to the program’s completion is so critical.  You may feel that your child is ‘doing well,’  but please don’t be tempted to make the call on your own to discontinue therapy. I can now look back and wish we would have completed what we had started and can’t help but think that Caden’s speech difficulties wouldn’t have escalated into the academic issues we have today.

-Submitted by: Melanie Bergeron

Interested in learning more about our practice? Visit www.TeamChatterboxes.com

Maddie, her Mom and a “My Little Pony” named ‘Sparkle’

By Chatterboxes 


Maddie, her Mom and a “My Little Pony” named ‘Sparkle’ came in last October. Sara was privy to Maddie’s love for horses and glitter prior to meeting her that day.


“I’m tearing Up Thinking about How Far Maddie Has Come. Financially, it was a stretch for my husband and I to invest in private speech; but the impact Sara Look., CCC-SLP has made on our daughter’s happiness is invaluable”  shared her Mom.


At 6 years old, Maddie was just starting first grade. She was a late-talker and didn’t start combining words until age 3. Her mom recalls, “Once she started speaking in longer sentences, her thoughts and language still sounded immature.”  Maddie’s Mom noticed she confused pronouns, like he/she, and mixed-up verb tenses.  She noted, “Her words just seem disorganized and jumbled.”
Maddie’s language issues were becoming more evident in her school work and seemingly impacting her self-confidence amongst her peers. Her Mom expressed, “Maddie’s academic journey was just beginning. As parents, we worried her educational identity was at stake.”


“I Found Myself Peering at Maddie through the Rearview Mirror on the way over. As I watched her, my heart began to race. How would I tell her that her Dad and I are worried about her language development? Should I explain that she needs to be tested?” “Should we even go through with this today?” relays her Mom.


Sara’s instant interactions with Maddie were so natural and comforting. “Within moments of our arrival, Sara squatted down to Maddie’s level and softly hinted, “Oooh. Your Glittery Pony is Magical! Have you ever made your very own Rainbow-Sparkle-Kingdom?”   


“At that moment, it’s like I knew:  As a Team, We Could Do This.” notes Maddie’s Mom.


Sara collaborated with Maddie’s parents to develop a therapy plan that targeted goals such as grammar, word retrieval and syntax.  Throughout therapy, Sara developed a close working relationship with Maddie and her Parents, as well as her Babysitter and Teachers. We could all see that Maddie really looked up to Sara, which meant she was motivated to follow through on her Home Programs.


Maddie will be starting 2nd Grade this Fall and has made amazing progress.  Maddie is now closer than ever to accomplishing age-appropriate language skills.  


Maddie, her Mom and ‘Sparkle’ continue to visit Chatterboxes on a bimonthly basis.

Visit us at www.TeamChatterboxes.com for more information on our services.