Katie was asked back on to BBC Radio Lancashire to discuss the modern-day relevance of the techniques the film The King’s Speech highlights to manage a stammer, and lots of other speech and language-related matters!
Listen to the show.
Monthly Archive for April, 2010
When people think of a speech and Language therapist the first thing most of them seem to assume is that we treat people who cannot say their sounds properly. I hope this site and blog have given you a greater insight than that. A large number of children do have speech sound errors though and they range from very simple with only one or two sounds being changed, to very complex as in dyspraxia. As they are learning to speak all children alter words to make them easier to say. How each child does this is unique to him or her, although there are some common simplifications that are frequently used. Below are the common substitutions that children use at each age.
12 – 18 Months
All sounds are present but not consistent. Babbling and repeating syllables e.g. “dada”.
2 Years
Final sounds are missed off words e.g. dog → “do”. One consonant is used throughout word e.g. cat → “tat”.
2 Years & 6 Months
Final sounds are missed off words e.g. dog → “do”.
3 Years
These sounds are often ‘stopped’ into shorter sounds, such as d, t, b or p. The sounds k/c and g are often replaced with t or d.
4 – 5 Years
Children are beginning to use clusters of consonants e.g. spoon. “th” is replaced with “f” and “r” is replaced with “w” until 6 years.
Unfortunately some children continue to have difficulties with speech sounds and do not learn how to say the words correctly themselves. This can make them difficult to understand by people who are not close family. It may also affect your child’s behaviour and their ability to make friends.
There are some general tips that may help:
- When your child makes a mistake, say the word back to him using the correct production. Avoid correcting him
- Encourage your child to use natural gestures and pointing to help you understand what they have said
- If you are unable to understand them, be honest and ask them to show you in another way if they can
- Accept other ways your child may be communicating with you, such as sounds, facial expressions and gestures
- Remember if your child cannot say certain sounds they are not being lazy. To change how they say sounds takes a lot of practice, thought and effort. Try it yourself – talk about a subject of your choice (e.g. television, holidays, football, etc) for 5 minutes and miss out all the “s” sounds
Speech and Language Therapists usually follow small steps to change how a child produces a sound in their speech. Below is a quick idea of the stages that are used.
- Producing the sound on its own e.g. “s, s, s, s”
- Producing the sound within a word e.g. for “s” - sand (beginning of the word), kiss (end of the word), or basin (middle of the word)
- Practicing using the sound correctly in short sentences e.g. “I found a sock”
- Saying rhymes and tongue twisters that include words with the sound in them to practice
- Finally, using the sound in conversations
At all stages the Therapist will make deliberate errors of their own to check that the child can hear the difference between the sound and the one they are replacing it with. Games are a vital element of the practice to ensure it is fun and less pressured.
Also the effort rather than perfection is often rewarded especially at the beginning as a child is learning where their tongue should go.
Each child will obviously progress at different rates and it is not uncommon for a child to get stuck at one stage for a number of weeks. Helping children to say sounds correctly is never as straight forward as it seems.
The ability to communicate is central to everything we do, who we are and how we interact with others. Teaching in school requires children to listen, understand and then respond verbally, before reading and writing even begin. This means that any problems in speech, language and other areas of communication can significantly affect a child’s ability to learn. Relationships in our lives depend on us being able to express how we feel and understand how some one else may be feeling. Difficulties in understanding and using language can therefore also have a negative impact on a child forming relationships, and can impact on behaviour as well as self-esteem.
It is now beginning to be recognised that children with emotional and behavioural difficulties often have underlying speech and language difficulties. Research has shown that between 60% and 90% of children with social, emotional and behavioural difficulties have underlying speech and language needs that have never been diagnosed or addressed. In addition to this, many children from an unsettled family and educational background also miss out on developing the language skills they require to negotiate and interact appropriately with both peers and adults. They have no appropriate role models to follow.
However there is still limited information in the sector detailing the impact that speech and language difficulties can have on a child’s ability to learn and their potential to achieve, especially after leaving education.
It has been reported by John Bercow (MP):
“Nearly two-thirds of young offenders have speech and language impairment or communication needs…”
This is a generalised figure. Until a full assessment is done who knows how accurate this is? One thing is clear – communication difficulties can greatly affect the course of a person’s life.
Students presenting with social, emotional and behavioural difficulties would benefit from the following support in their school placement:
- An assessment of their speech and language skills, leading to the development of appropriate Speech and Language Therapy targets and programmes
- Teaching of basic vocabulary and particularly those words needed to describe emotions and feelings
- Discussion on problem solving and social skills in both group sessions and to individual students
- Staff training to enable teachers to recognize and understand the educational implications of speech and language difficulties, and equip them with the skills to maintain a programme of therapy
Improving communication skills cannot erase the difficult background, or horrific life changing events in students, but it can reduce the difficulties they have in learning and enable them to communicate their needs and feelings in a more effective manner.
In a previous blog I talked about stammering in 2-5 year olds and gave some general advice about trying to prevent the stammer remaining. This post is about the kinds of direct treatment that you may receive if you visit a Speech & Language Therapist with your child who has a stammer.
Parent Child Interaction
This style of treating young children with a stammer was developed by the Michael Palin Centre. It works from the idea that parents can have a huge influence on their child’s talking (although they are in no way responsible for their child beginning to stammer). This maybe the first approach a Therapist will use to help a young child who is stammering. It focuses mainly on trying to alter the parent’s style of interaction with their child in order to help the child to use smooth speech again.
This was developed by professor Mark Onslow in Australia. It focuses on training a child to speak fluently by praising smooth speech and gently correcting “bumpy” talking by acknowledging it and at times asking a child to say it again smoothly. The parents are taught to carry out practice daily with their child to ensure smooth speech.
Older children
With children over 8 years old who are aware of their stammering/stuttering often therapy focuses on two main areas: Techniques to practice smooth speech and discussion on their feelings about talking and communication in general. Techniques to create smooth speech include slow speech, breathing, talking gently through stammers (easy onset) and catching stammers before they happen (block modification). Often group work can help older children as they can meet other people in the same situation as themselves and practice techniques in a ’safe’ environment. There is a lot of information on the internet about stammering; it is a controversial subject, as opinions about how to look at stammering varies from person to person.
Talking is a tricky business. You need to decide on a subject, find the words to make the sentence and put them in order with the correct little words (”if” and “is”, etc.), find the sounds for the words, tell the mouth what to do, breathe and speak. Little wonder then that children learning to talk frequently begin to stumble over their words and sentences. If your child is still in nursery or pre-school the chances are that there will be at least one or more children in their class stammering. If it is your child – don’t panic. Frequently children grow out of this phase quickly and their speech becomes smooth and fluent again.
Here are some tips for helping any child who is getting stuck when they are talking:
- Take time to listen to all that they are saying. It’s easy to try and finish off their sentences, particularly when you are in a rush and they have started the word or sentence for the 5th time. It will mean they feel pressure to finish what they have to say.
- Give them eye contact and get down to their level so that they know you are giving them your full attention.
- Slow your speed of speech. This will encourage your child to feel that there is no need to rush to tell you their thoughts, needs, or stories. Adding longer pauses also gives this impression. It sounds easy, but needs practice – trust me!
- Set aside time just for them. As little as 5 or 10 minutes each day for your child to talk about their day and what’s on their mind will reduce the interruptions and mean they don’t have to fight to tell you what is important. The time can also be spent playing a game or doing a puzzle.
- Encourage turn-taking. If your child is trying to say something over someone else it is an extra process added to get your attention. Making sure all the family takes their turn in conversation and games will make it fair and easier on you and your family.
- Ignore the stammer and focus on what is said. This may be hard at times, but if your child does not seem to notice it then drawing their attention to it by asking them to slow down, say it again or breathe before talking may affect the way they view their talking and make their speech look and sound more unusual.
- If your child comments on their talking or is distressed, talk about it openly. Try to make it as easy as possible by saying something like “That was a bit bumpy wasn’t it?” and go on to explain that everyone can be bumpy at times. Even pointing out when you stammer will help reduce anxiety and stop the subject becoming “taboo”.
As with all stammering contact your local Speech & Language Therapy service for specific direct advice as soon as you can, as early help is very important.
Imagine you are in full-flow conversation about the latest film you have seen and suddenly whilst you are raving about it you are unable to recall the name of it or the lead actor’s name. You probably spend a few seconds desperately thinking, followed by describing the actor, the plot of the film, other films similar for others to fill in the names you have forgotten. If this is successful you all laugh and move on. If not you then end up feeling frustrated and continue to think it over trying to remember. It effectively ends the conversation.
Then at night just as you are dropping off – Ping! the name appears like magic, there all along. It happens to all of us occasionally. Can you imagine that happening over the simplest of words in every sentence you wish to say? Frustrating is the word. Also imagine that you have no strategies to help someone guess the word you wish to say – you end up in silence or give up and move on. Some children live with this every day. For some it is part of a greater language difficulty; for others a result of lacking in vocabulary or learning a large amount of vocabulary suddenly.
These problems can make children difficult to understand as they use different strategies to overcome their difficulties. They might:
- Say a word that means a similar thing but is incorrect
- Say a word that sounds similar e.g. “telephone” instead of “television”
- Say a made up ‘jargon’ word e.g. “bubet” instead of “bubble”
These children are often referred to the Speech and Language Therapist because they cannot say the sounds in words correctly, but the cause is much more complex and the treatment very different. Children with word-finding difficulties often have lots of vocabulary, but it is like a messy desk with each word represented by a piece of paper on the desk. There is no order, or system in place to help locate the one piece of paper (word) they need. What Speech and Language Therapy aims to do is turn the messy desk into a well-ordered filing cabinet with cross referencing to help a child to locate a word or describe it easily when they are really struggling.
Therapy focuses on organising words into categories, syllables in words and the length of words, knowledge of first sounds in words, and rhyming words, and linking all this knowledge together. So if you think a child is hard to understand, please don’t just assume they cannot say their sounds. They could be searching for the right words to say.