Wednesday, January 29, 2014

Pediatric Hearing Disorders

Hearing is one of the five senses and I believe that the ability to hear is truly a gift that God provides. Some people may not view hearing as a special ability because they may have the mind set that most people can hear, see, touch, taste, and smell. However, there are many children and adults that are a born unable to hear or have an acquired hearing loss due to an accident or medical condition. According to the National Institute on Deafness and Other Communication Disorders, 2-3 infants out of 1000 in the United States are born deaf or with hearing loss.  Here in the U.S., most babies receive a newborn hearing screening in the hospital before they go home. If the baby does not pass the screening, they are scheduled for a repeat screening or a more in depth hearing assessment by an audiologist or a licensed healthcare professional who assesses, diagnoses, and provides treatment for such individuals. School aged children also receive hearing screenings at school and there are audiologists who are available to provide services as needed. 

Children diagnosed by an audiologist with a pediatric hearing disorder may have hearing disorders ranging from mild to severe hearing loss. The hearing loss may be unilateral (present in one ear) or bilateral (present in both ears). Parents often feel varied emotions when they find out that their child has a hearing loss. However, it is important for them to know that such a diagnosis does not prevent their child's ability to be successful in life. Instead, due to hearing limitations they may very well become more resilient than a typical child because they very likely will have a different path to learn how to communicate, academic content at school, social skills, and life skills. 

I believe that it is important for parents with children with hearing disorders to take an active role in advocating for their child's hearing needs. This includes being proactive about selecting hearing aids for their child or connecting them with others in the Deaf community if their hearing can not be remediated by a hearing aid or cochlear implant. A cochlear implant is a device that is surgically implanted that provides direct stimulation of the auditory nerve in the inner ear that allows a person who is profoundly Deaf to hear. For more info about this implant you may click on this link: 
Here is a picture. 

As far as communication abilities for children who have hearing disorders, these skills range based on the severity of the hearing loss. Some children will have substantial hearing that enables them to acquire spoken language, others will learn to communicate via sign language, and some children will communicate verbally and with sign language. 

A few years ago, I worked at a middle school where I provided speech-language services for children who had varying degrees of hearing loss. They communicated verbally, with American Sign Language (ASL), and Signed Exact English (SEE). The teachers who taught them were excellent educators who were able to teach them not only the academic content, but also provided valuable tools to improve their confidence as a middle school student who was Deaf or had a hearing disorder. They taught the students that despite their hearing challenges, they can still strive for excellence in all that they do. I enjoyed providing speech-language services for these students. In graduate school, I took courses in American Sign Language and then I took refresher courses that were offered through my church's Deaf and Hard of Hearing Ministry while working at the school. It was a joy for me to assist my students improve their communication and language skills they needed to succeed at school and in life. I recently saw one of my students who is now in high school at a community Nutcracker ballet recital. We were both excited and surprised to see each other and communicated with sign language. I was happy to hear that she is now a senior and is doing well in school. 

Working with children who are Deaf or have hearing loss is a special opportunity to plant seeds that will have long lasting blossoms. 

For more resources about Pediatric Hearing Disorders, please visit these links:

National Institute on Deafness and Other Communication Disorders (NIDCD)

American Society for Deaf Children (ASCD)

Alexander Graham Bell Association for the Deaf and Hard of Hearing

Have an exceptional week!


Tamara Anderson, Ed.S., CCC-SLP
Speech Language Pathologist 

Monday, January 20, 2014

Pediatric Language Disorders

I enjoy providing interventions for children who have language disorders. Children with communication impairments may receive a diagnosis of receptive language disorder, expressive language disorder, or mixed receptive/expressive language disorder due to significant language challenges. Toddlers may experience delays in their language development that may be identified as a language disorder by the time they are in preschool. Other children may not be identified with a language disorder until they are attending elementary school. However, it is important to seek an evaluation by a speech-language pathologist if a parent, pediatrician, teacher, or guardian has concerns about a child's language development. Children need to be provided access to speech language therapy services as soon as possible to optimize their ability to attain language skills that are lacking. 

The majority of students on my caseload that I provide speech-language services for have language disorders that impact their ability to understand information and communicate their ideas clearly. This directly impacts their ability to learn and explain the academic curriculum at their grade level. Therefore, school aged children with language disorders require intervention from a speech language pathologist to foster growth in their area of need. Many of these students are also identified with a language based learning disability and receive literacy support in reading and writing instruction from a special education resource teacher. 

Children with a receptive language disorder have difficulties with both listening and reading comprehension. They struggle with processing information that they hear or read in order to make meaning of the message that is being communicated. They benefit from short concise oral directions so that they can better understand language until they improve their ability to understand verbal directions. Students with receptive language difficulties need direct instruction in the areas of vocabulary such as basic concepts (e.g. sequential terms- first, spatial- prepositions, temporal- before/after, qualitative-adjectives), multiple meaning words, synonyms, antonyms, parts of speech terms (e.g. nouns, pronouns, verbs) and use of context clues to decipher the meanings of unknown words. They also need to improve their ability to comprehend and answer literal who, what, where, and when questions and inferential why and how questions. Additionally, children with receptive language disorders need to learn critical thinking skills essential to analyze language concepts such as compare/contrast, cause/effect, problem/solution, fact/opinion, drawing conclusions/inferences etc. 

There are so many language areas that a speech-language therapist provides interventions for children. Many of  these areas relate directly to the English/Language Arts curriculum standards in the school setting that are also reinforced by a child's classroom teacher. However, the speech-language therapist provides specialized individualized or small group instruction while breaking down a skill in a manner that allows a child to adequately process and learn the information that is being taught. 

Children with an expressive language disorder have significant challenges verbally communicating their thoughts. They may struggle with forming a complete sentence to express their basic wants or needs, retelling a fiction story, summarizing facts from nonfiction material, explaining the meanings of vocabulary, using correct grammar at the word level (e.g. using plural nouns, irregular past tense verbs), or using correct grammar at the sentence level. 

Children with Autism Spectrum Disorders typically have coexisting pragmatic language disorder. This means that they do not know how to independently use language in social settings. They are unable to read social cues about an appropriate time to start a conversation with a peer or adult, make comments related to the topic of conversation, or ask questions in conversation. Many children with autism who are able to communicate verbally talk about their areas of interest only and do not know how to consider another person's perspective or area of interest in conversation. They only identify with language from their vantage point as they prefer to remain in their social world. A Speech-language pathologist provides direct instruction in pragmatic language so that these children can improve their abilities to begin conversations with others, make comments, take turns in conversation, etc. 

This is Pediatric Language Disorders 101. Language skills are essential for children to understand and explain information. Children who have a disability in this area need intervention support from both a speech language pathologist and special education teacher to improve their language skills. Parents definitely can also participate in their children's development by providing opportunities for them to engage in language activities at home and on family outings in the community. Language is everywhere!!! Everyday is an opportunity to promote increasing the receptive and expressive language skills for children. This sets them on the path of building a successful life. 

Parents and professionals who would like more information on this topic may visit the American Speech Language Hearing Association (ASHA) resource page:     

Have a great week!

Tamara Anderson, Ed.S., CCC-SLP

Sunday, January 12, 2014

Winter Land: English/Language Arts Activities

Hello there. I hope everyone had a great weekend. I had a nice weekend and was able to spend time with my precious niece that was born last Monday. I also had time to finalize my newest speech-language therapy/educational resource: Winter Land: English/Language Arts (ELA)Activities that is available in my TPT online store here:

There are three activities included in this packet. First, there is a Winter Land Game Board that students can play by taking turns answering speech, language, and academic related questions. My students enjoyed playing this last week with the included categorization cards. 

There are two levels of English/Language Arts vocabulary categorization cards included in this activity. The first is the basic level that targets Tier I or everyday vocabulary words. The second is Tier III or ELA curriculum specific vocabulary words that students are required to learn in elementary school such as types of sentences, parts of speech, and types of literature. There are a total of 32 vocabulary questions cards included. 

The first level targets questions for students in grades K-2 and the second level targets questions primarily for students in grades 3-5. However, I also suggest using the Tier I words with upper grades students as a warm up activity to help them recall the skill of categorization. Then, they can work on learning how to name vocabulary words in the Tier III categories.

The Winter Land Game Board may be used with my other TPT products such as: Winter Word Associations and English/Language Arts Common Core Standards Vocabulary. 

Thanks for stopping by! Have a great week. 

Tamara Anderson, Ed.S., CCC-SLP

Pediatric Speech Disorders

Often times when people think about speech language therapy they immediately think about someone helping children correctly pronounce their sounds. That is definitely one of the roles of a speech language pathologist (SLP) to provide services for a child with speech sound disorders. However, that is only a component of speech disorders. 

Pediatric speech sound disorders include difficulties with articulation (pronouncing sounds) and phonological processes (sound patterns).  As children develop, they all incorrectly pronounce certain sounds and these patterns of error are known as phonological processes. 

If these errors persist beyond a certain age, a child that is experiencing challenges with expressive communication may receive one of the following diagnoses following a speech therapy evaluation from a SLP.

An articulation disorder involves difficulties pronouncing consonant sounds. These sounds can be substituted, omitted, or changed. These errors may make it hard for people to understand what a child is attempting to communicate. Speech intelligibility is 
the percentage or measure of how much a child's speech is understood by a listener. 

A phonological disorder occurs when there are patterns of sound errors. For example, substituting all sounds made in the back of the mouth like "k" and "g" for those in the front of the mouth like "t" and "d" (e.g. saying "tup" for "cup" or "doat" for "goat.")

There are also pediatric speech disorders that are due to a child's challenges coordinating speech muscle movements essential for effective verbal communication. The child's speech disorder may be secondary to another diagnosis such as cerebral palsy or it is his or her primary disorder. The following are diagnoses that a child with these characteristics may receive from a SLP:

Childhood Apraxia of Speech is a motor speech disorder that occurs because the brain has problems planning to move the body parts (e.g. lips, jaw, tongue) required for effective verbal communication. Children with this speech disorder have difficulty coordinating the muscle movements necessary to say sounds, syllables, and words. They often know what they want to say, but are unable to verbally express it  accurately.

A fluency or stuttering disorder occurs when a child experiences involuntary interruptions or dysfluencies in his or her speech. There are many types of dysfluencies. A child may repeat a sound at the beginning of a word (e.g. b-b-book), part of a word (e.g. bo-bo-book), entire word (e.g., book, book), or an entire phrase (e.g. my book, my book). Other dysfluencies include sound prolongations (e.g. I want s-s-s-ome), interjections (e.g. I want um-um-um some juice), and blocks (e.g. struggle behavior with no audible speech). Some children may also show excessive body tension, eye blinks, facial movements, or other body movements. 

Dysarthria is a motor speech disorder that results from neurological impairment (brain injury) due to a stroke, traumatic head injury, cerebral palsy, or muscular dystrophy. This leads to weak speech muscles and respiratory system.  A child with dysarthria may exhibit verbal communication that has a slow rate of speech, slurred, soft volume, hoarseness, and limited movements of speech muscles (tongue, lip, jaw). A child will often have poor saliva control and chewing/swallowing difficulty.

Voice Disorder is the term used to describe a category of speech sound disorders that are due to a benign growth on the vocal folds/cords or a child's overuse of his or her voice.  Nodules or polyps may grow on the vocal cords that prevent the necessary movement of vocal folds that is needed for verbal communication. A child with a voice disorder may have a hoarse, breathy, scratchy sounding voice accompanied with ear pain and/or discomfort in their neck/throat area. If a child has a hoarse voice for more than 2-3 weeks, it is wise that he or she is seen by the pediatrician. 

If you suspect that your child may have a speech disorder, please tell your child's pediatrician and get a referral for a private speech therapy evaluation. You may also discuss your concern with your child's teacher and request that the speech-language pathologist complete a speech screening. 

Thanks for reading the blog today,

Tamara Anderson, E.d.S.,  CCC-SLP


Tuesday, January 7, 2014

Pediatric Communication Disorders 101

I hope you all had a wonderful end of 2013 and are excited for all things to come in 2014! On December 14th, I proudly graduated with my Education Specialist Degree (Ed.S.) degree in Curriculum and Instruction!! Yeah for me! :)

Today, I am enjoying my "coldcation" in Atlanta, Georgia as many of the school districts are closed due to single digit temperatures and wind chill! This is the coldest that I recall it being since I moved here almost 10 years ago!! Hence, I have been indoors today. 

I am pleased to announce an informative series, Pediatric Communication Disorders 101 that I will feature on this blog during the month of January. One of the missions of Building Successful Lives Speech and Language Services is to promote knowledge about pediatric communication disorders. These are speech and language disorders that occur in childhood. Did you know that the American Speech Language Hearing Association asserts that communication disorders are one of the most common disabilities in the United States? According to the American With Disability Act, a person with a disability has a physical or mental impairment that substantially limits one or more major life activities. See the full definition here:

Communication is definitely a significant life activity that influences individuals' abilities to process and understand language as well as express their ideas verbally, in writing, via sign language, and/or through augmentative/alternative communication. Communication disorders are due to neurological impairments in the language centers of the brain. 

Therefore, it is important to know the three main types of disorders that may negatively influence a child's ability to communicate: speech disorders, language disorders, and hearing disorders.  Many children that have these identified disorders also have co-occurring learning disabilities, intellectual impairment, autism, cerebral palsy, Down syndrome, and other neurodevelopmental disorders. 

Some toddlers with communication delays may be considered late talkers who over time learn to communicate without the  need for long term speech-language therapy. For more information on later talkers, I recommend the book, The Late Talker What to Do If Your Child Isn't Talking Yet by Marilyn Agin, M.D., Lisa Geng, and Malcolm Nicholl.  
You can preview the book here:  
However, this is not the same as children who are identified with pediatric communication disorders by a speech-language pathologist.

Stay tuned for future posts about: speech disorders, language disorders, hearing disorders, speech/language therapy resources, and language arts resources. Have a great January!


Tamara Anderson, Ed.S., CCC-SLP

Speech-Language Pathologist