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Apraxia: To Diagnose or Not? When? Who?

Unfortunately, apraxia of speech is over diagnosed by many speech pathologists. Majority of children at our practice that come in with this diagnosis from early intervention are not truly apraxic. This diagnosis should not be given very early on and only given by a seasoned speech pathologist that has expertise in apraxia and understands the empirical research behind this disorder. Furthermore, children who do have apraxia are often not provided with the appropriate course of treatment as this article alludes to. The focus of intervention should be on improving the planning, sequencing and coordination of muscle movements for speech production. Exercises to strengthen the oral muscles do not help with speech production. Consistent practice with the correct exercises is key.

Click here for the story of just one of the inspirational stories out there, along with links to learn more about Childhood Apraxia of Speech http://blog.asha.org/2015/02/03/know-your-cas/

My Baby Can Play: How Productive Play Promotes Literacy

Taken from http://blog.asha.org/2013/02/28/my-baby-can-play-how-productive-play-promotes-literacy/

If you pay attention to the current toys, television shows, and materials for children like Your Baby Can Read! you should notice a cultural shift to the promotion of literacy, especially early literacy skills. From older shows such as Sesame Street and Between the Lions to newer shows such as WordGirl, WordWorld, and Super Why! we see the push for phonological awareness skills and reading skills, which encompass rhyming, letter/sound naming and identification, sound segmenting and blending, and so on.

The available research clearly shows the importance of promoting literacy skills early, and the overall consensus is that oral language provides the building blocks for literacy. So if oral language is the foundation, and if we achieve language through quality language input, how is that input provided for infants and toddlers? Through play!

Besides daily care-taking routines that parents and children engage in (feeding, grooming, sleeping), the next most important activity they engage in (where crucial language input is provided) is play.

So, if appropriate play skills predict appropriate language skills, and if strong language skills predict literacy skills, then I see a clear link between play and reading.

I’m not suggesting reading to infants and toddlers is not valid and necessary; I am suggesting that perhaps there should be a greater, or at least equal, push for promoting quality play. My meaning of play, however, is where the play partner of the child is engaging the child and providing quality language input naturally but purposefully.

In a nutshell, let’s not bypass the building block of play because we’re so concerned that children be able to read.

As a personal example, both of my toddlers love books. From the time my four-year-old daughter was one, she would quietly sit on the floor going through baskets I had set around the house full of little books, and she would flip through the pages “reading” one book after another. I often find my two-year-old son sitting in a rocking chair in his room surrounded by books “reading.” He spontaneously points out characters and talks about the pictures. His big sister also helps him out, making up stories for him based on the pictures as though she is reading…and he believes every word!

Click here for full article: http://blog.asha.org/2013/02/28/my-baby-can-play-how-productive-play-promotes-literacy/

Sensory and Sensory Processing Disorder

Taken from http://mamaot.com/sensory-processing-disorder/

1. What is sensory processing (or sensory integration)?

A basic explanation of “sensory processing” (also referred to as “sensory integration”) is this — the brain’s ability to organize sensory information coming from all parts of the body in order to be able to use it. The human body takes in sensory input from several different sensory systems, organizes it in the brain for functional use, and then sends out signals to the rest of the body to activate the appropriate motor, behavior, or emotional responses (known as an “adaptive response”). In individuals with intact sensory processing, this happens automatically, unconsciously, and nearly instantaneously. A simple example would be when you go to pick up a cup or open a door you think is light (but is actually heavy), you automatically, unconsciously, and nearly instantaneously increase the amount of force you are using in order to actually pick it up or open it. Or if you are walking along a curb and you start to lose your balance, you automatically react to the sensation of being off-balance by either trying to regain your balance or by stepping down off the curb. These are all basic examples of sensory processing in action.

2. What sensory systems are involved with sensory processing?

When occupational therapists talk about sensory processing or sensory integration, we are typically referencing seven sensory systems. Most people have heard of the classic five senses but never knew there are two additional “hidden” sensory systems that play a powerful role in our body’s ability to function on a day-to-day basis. (There are actually more “hidden” sensory systems and receptors as well, but we’ll focus on these ones right now for the purpose of this post).

Here are the seven sensory systems you’ll typically hear OTs talk about:

Click here for full article: http://mamaot.com/sensory-processing-disorder/y/

More than a Picky Eater: How to Really Know?

Taken from http://blog.asha.org/2015/01/08/more-than-a-picky-eater-how-to-really-know/

The struggles of a parent during mealtime with a picky eater can range from bad to worse. It often begins with the ever-present protest of “No!” then ends with screaming, tantrums and food flying across the room. The question remains: is the food refusal normal of a picky eater or could the signs be more consistent with a feeding disorder?

A pediatric feeding problem is often accompanied by a developmental delay or medical disorder. These can include, but are not limited to, autism spectrum disorders, Down syndrome, gastrointestinal motility disorders, cerebral palsy, respiratory disorders or cystic fibrosis.

Children who were hospitalized for an extended time at birth or who received a tracheotomy or feeding tube may also have difficulty transitioning to an age appropriate feeding pattern. However, children who are considered typically developing can also develop a fear of food. Research shows that 25 percent of children suffer with some degree of a feeding disorder. In children who suffer from a developmental, neurological or genetic disorders, that number rises to 80 percent (Branan & Ramsey, 2010).

A feeding disorder is characterized by any difficulties eating or drinking including chewing, sucking or swallowing. Children who have not developed age appropriate feeding skills and/or have a genetic, developmental or behavioral disorders can have difficulty during mealtime.

Some signs and symptoms of a problem feeder include:

- Trouble breathing when eating or drinking

- Choking, gagging or excessive crying during mealtimes

- Tantrums when presented with new foods

- Excessive drooling or spillage of foods/liquids from the mouth

- Difficulty chewing or swallowing food

- Restricted variety of foods eaten—usually less than 20

- Refusal of categories of food based on texture or basic food group

- Refusal to eat meals with the family

In order to better treat children with feeding problems, it is important to understand those children who do not meet the criteria. Children who are picky eaters present with the following signs and symptoms (Toomey 2010; Arvedson 2008):

- Eat a limited variety of foods; but have around 30 foods they will eat

- Intake enough calories a day for growth and nutrition

- Lose interest in a certain food for a period of time, but accept it again after a few weeks

- Eat at least one food from all major food groups (protein, grains, fruits, etc.)

- Tolerate a new food on the plate, even if they don’t eat it

Although mealtimes with either issue can be difficult for parents, distinguishing between the two helps SLPs create the best individualized treatment approach.

Once a professional diagnoses a child with a feeding disorder, there are three key concepts to remember:

- Contact a child’s pediatrician, nutritionist and other health care providers in order to create the best treatment plan for that child. A multidisciplinary approach provides various viewpoints that bring the whole child into consideration.

- Choose foods that are meaningful to the family. If no one else in the family eats broccoli, it may not be a necessary food to add to the child’s eating repertoire.

- Create both short term and long term goals to track progress and keep both the child and family motivated.

Treating a child with a feeding disorder is a challenging but rewarding task. The end goal of treatment should always be a safe, happy and healthy eater.

April Anderson, MA, CCC-SLP, is a Speech-Language Pathologist at National Speech/Language Therapy Center in Bethesda, MD. She works with infants and toddlers, as well as school-aged children with feeding disorders. April can be reached at april@nationalspeech.com.


Do you know the early warning signs of communication disorders?

Taken from http://www.philly.com/philly/blogs/healthy_kids/Do-You-Know-the-Early-Warning-Signs-of-Communication-Disorders.html?c=r

Would you know how to identify a potential communication disorder in your child?

If you’re like many parents, the answer may be “no.”

Communication disorders, which are characterized by difficulty speaking or hearing, are common in children. In fact, roughly 8-9 percent of young children suffer from a speech disorder, and hearing loss affects 2 in every 100 children. Autism and other developmental or medical conditions also may be distinguished in large part by trouble communicating.

Despite this, a recent national poll of speech-language pathologists and audiologists (the professionals who treat these disorders) found that speech and hearing disorders frequently go undetected for months or even years in children. Lack of public awareness was identified by 45 percent of those professionals as the leading barrier to early detection. A staggering 64 percent of professionals reported that parents of young children are unaware of the early warning signs of speech disorders. As the current president of the American Speech-Language-Hearing Association (ASHA) and a speech-language pathologist, this is troubling.

Why is it so critical for parents to be attuned to early indicators?

Unlike other conditions, early intervention can prevent or reverse a communication disorder. The consequences of communications disorders can be devastating, affecting academic success, social interactions, and almost all aspects of life in some way. Many children may endure bullying, and suffer life-long frustration and angst. With timely recognition and treatment, much of this may be avoided.

Exacerbating the lack of awareness about the signs is the hesitation or delay many parents have in taking action when they first notice symptoms. Some parents may feel their child might “outgrow” these difficulties. Others may have little difficulty understanding their child or what their child is trying to communicate and not recognize that the child is rarely understood by or communicating with others. We know that children who receive services prior to age three have better outcomes than those receiving services after age five, so parents shouldn’t delay seeking an assessment if they suspect a problem.

Click here for full article: http://www.philly.com/philly/blogs/healthy_kids/Do-You-Know-the-Early-Warning-Signs-of-Communication-Disorders.html?c=r