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A Beginner’s Guide to Augmentative & Alternative Communication

By Melanie Stinnett No CommentsPosted in Speech TherapyTags: , , , , , , , ,
AAC user for web

A Beginner’s Guide to

Augmentative & Alternative Communication

Written by: Rachel Ball, MS, CF-SLP

 

Singing along to your favorite song in the car. Ordering food at the drive-thru. Saying, “I love you” to someone special. Speech is often a concept taken for granted in our day-to-day activities. However, for many people, verbal output is not a viable option for communication.

 

When an individual is unable to use speech to communicate functionally, families and caregivers are often directed to seek out alternative options. It can be a daunting task when choosing what mode of communication works best for your loved one. Outlined below are terms and definitions that are useful for navigating through the confusing world of acronyms and jargon common to professionals in the field of assistive technology and alternative communication.

 

Assistive Technology (AT): An umbrella term that encompasses any item, equipment, software or product system that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities. This information and more can be found here.

 

Augmentative and Alternative Communication (AAC): Any mode of communication other than speech. Some examples include facial expressions, gestures, symbol systems (e.g. PECS), pictures, writing, sign language and high tech communication devices. The American Speech-Language Hearing Association explains more here.

 

Augmentative Communication Device (ACD): Equipment used as an alternative and/or supplement to speech for communicative purposes. ACDs help individuals overcome their inability to speak due to a disease or medical condition that interferes with participation in daily activities. Examples include communication picture books/boards, speech amplifiers/enhancers and electronic devices that produce speech or written output.

 

Speech-Generating Device (SGD): Electronic AAC devices that produce digital or synthesized speech as a result of selections made by the user. They are often used to supplement or replace the natural speech and/or writing for individuals who have severe speech impairments. SGDs can also be referred to as voice output communication aids (VOCA).

 

Dedicated: Communication devices that have hardware and software designed to be used strictly for communication purposes. In contrast to integrated devices, dedicated ACDs do not have the capability of accessing other features common to your everyday tablet (e.g. applications, internet, music, camera, etc.)

 

Core Vocabulary: Words that are most commonly used in a language. Usually core words consist of pronouns, simple verbs and helping verbs, articles and prepositions. Core vocabulary is typically more general and can be used across a wide range of settings with various communication partners. Much research has been done to define the “best” set of core words, leading to differences in software/programing for ACDs.

 

Fringe Vocabulary: A more specific set of words that lend themselves to the individual, environment or topic. Fringe words are often nouns and specific verbs. Every AAC user has a unique set of fringe vocabulary that best fits their needs, and people’s fringe expands according to their own experiences. These words are not often found at the forefront of an ACD, as they are not used with as high of frequency as the core set. In the example below, the fringe words are in bold, italicized font.

 

“I want to go swing at Oak Park with Bobby and Suzy, please.”

 

Explore some more!

Check out the links below to learn more about the wonderful world of AAC.

 

http://www.asha.org/public/speech/disorders/AAC/

http://praacticalaac.org

https://www.isaac-online.org/english/what-is-aac/

http://www.atia.org/i4a/pages/index.cfm?pageid=1

 

Contact us via social media, email, or by phone for more information about AAC!

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Voice Treatment for Parkinson’s

By Melanie Stinnett No CommentsPosted in Speech Therapy
Written by: Melanie Stinnett, MS, CCC-SLP

The Michael J. Fox Foundation for Parkinson’s Research published a post on their FoxFeed blog entitled “10 Lesser-Known Parkinson’s Disease Symptoms“. One of those symptoms included was ‘Voice Volume’ and here is what they had to say, “Parkinson’s can cause slurred speech and a quieter voice. People with Parkinson’s who sing may also find that their musical side is affected, too. A speech therapist, especially through the LSVT LOUD program, can help this symptom. Singing in a choir or on your own can also help strengthen your voice.”

Here at TheraCare, we are proud to offer this service to our community and encourage individuals with Parkinson’s disease who may be having this type of symptom to ask their doctor for a referral. From difficulty talking on the phone to a decrease in volume of singing voice and everything in between, our therapists are skilled at helping you regain the skills you once had.

 

Feel free to contact us via our social media links, email, or by phone to discuss any questions you have.

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Tongue Tie Podcast

By Melanie Stinnett No CommentsPosted in Speech Therapy
Written by: Melanie Stinnett, MS, CCC-SLP

In August, I had the privilege of joining Dr. Poppy Daniels on her radio show, The Dr. Poppy Show. We discussed various issues potentially caused by the presence of a tongue and/or lip tie. Take a listen and let us know your thoughts!

Click here to listen!

In addition to providing education to the community in varying forms, I am now offering 20 minute consultation appointments to assess oral structure and function, including presence of tongue, lip, and other ties in children birth through 12 months. This consult includes a thorough oral examination. Any necessary recommendations for referrals based on your family’s individual needs will be provided. If you are interested in this service, please contact us by phone at 417-890-4656 for more information.

Feel free to contact us via our social media links, email, or by phone to discuss any questions you have.

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5 Easy Ways to Improve Your Baby’s Communication Skills

By Melanie Stinnett No CommentsPosted in Speech TherapyTags: , , , , , , , ,

5 Easy Ways to Improve Your Baby’s Communication Skills

Written by: Allison Slone, MS, CCC-SLP

Ten tiny fingers and ten tiny toes.  Two big eyes staring at you with a toothless grin.  Chubby cheeks that are made for squeezing and a perfect little head that’s made for smothering in kisses.  We sure love our sweet babies, don’t we? As we become parents, we are hit hard with that intense feeling of love for our children.  We’ll do anything for them, and we want to give them the best life possible.

Then reality sets in, laundry and dishes pile up, sleep deprivation turns us into walking zombies, and the sheer amount of information and conflicting opinions on how to raise our kids makes us want to crawl under a blanket and wave a white flag of surrender.  Yet those two big eyes keep staring at us, and we’ve promised to give this parenting thing our best effort.  After all, our babies will never need us quite as much as they do in their first year of life.

Breathe easy, moms and dads.  Here are five simple things you can do with your babies to improve their communication skills.

1. Talk to Your Baby

 

See, you’re doing great already!  Sometimes we try to overcomplicate things by reading Shakespeare aloud with one hand as we work on baby’s pincer grasp with the other hand while playing Mozart in the background.  Simply talking to our babies about what we are doing throughout the day will do wonders for helping them learn the sounds in our language, as well as begin to associate vocabulary with tangible meaning.

Here are a few basic tips for talking to your baby:

  • Feel free to use an excited, animated voice (most people naturally use this kind of voice when talking to babies) to increase interest when talking to your baby, but use real words with their proper sounds.  You don’t need to say “Whewe is Wodney’s wattle?” for “Where is Rodney’s rattle?” (Do you have any idea how hard it is to teach kids to say the /r/ sound?  They need all the proper modeling they can get from an early age! ☺), or “Do you need your baba?” for “Do you need your bottle?”, but you can be as enthusiastic as you want when you say “OOOOO, mama’s HUUUUNGGRRYYY!!!!  Are YOU hungry too?”
  • Ask your baby questions and then pause for a response.  Even if they don’t say anything, they are learning about “conversational turn-taking”, even as a baby.  Mommy gets a turn to talk, then it’s baby’s turn!
  • Turn daily routines into something predictable for your baby.  For example, every time you give your baby a bath, sing “This is the way we wash our belly, wash our belly, wash our belly.  This is the way we wash our belly to get my Ellie clean” for each body part you wash.  They’re not only hearing the names of their body parts, they’re learning that at bath time, this is what we do.

2. Read to Your Baby


One of the absolute best things we can do for our babies to set them up for a lifetime of success is to read to them.  As babies get older, they may not sit quietly and listen to a book politely.  As a matter of fact, they will most likely use the books to mouth, taste, and throw.  That’s okay!  Make sure you get sturdy board books for your babies that won’t easily be destroyed.  And if they won’t sit still for an entire story, let them roam and read the rest of the story aloud anyways.  They are still listening!  Remember, you are building up their attention span, listening skills, vocabulary development, and pre-literacy skills, just by reading aloud to them and exposing them to lots of books!

The best books for babies are ones that have the following characteristics:

  • Good rhythm and rhyme to help them learn the different sounds of a language (Mother Goose rhymes or Dr. Seuss books)
  • Lots of repetition (For example, “Brown Bear Brown Bear, What Do You See?” by Bill Martin Jr. and Eric Carle)
  • Sounds that are silly or dramatic (My daughters’ all time favorite is “Mr. Brown Can Moo, Can You?” by Dr. Seuss.)
  • Bright colors to catch the eyes (Example, “The Everything Book” by Denise Fleming)
  • A “touch and feel” or sensory/interactive component.  Babies are “hands on” (and probably mouth on) learners.  Isn’t it so much more meaningful for them to feel a lamb in a book with a bit of wool on it to talk about how it’s “soft” or a sandpaper rock to talk about it being “rough”?  Older babies also delight in being able to lift a flap or open a door to find something for you.

3. Play With Your Baby


As I said before, these are things you naturally do as parents!  Little did you know the silly games you play with your baby are teaching them the crucial building blocks they need for communication skills.  These skills include joint attention, reciprocation and imitation, following directions, social greetings, predictable routines, vocal play, turn taking, development of intentionality, cause and effect, and more.  Here are a few simple games every baby loves:

  • Peek-a-Boo
  • Imitating actions like clapping, blowing kisses, waving hi and bye
  • Pat-A-Cake
  • Finger plays like “Itsy Bitsy Spider”
  • Blowing bubbles

4. Give Your Baby Your Undivided Attention

 

We live in a busy, “go, go, go!”world where there are plenty of distractions to prevent us from getting quality one-on-one time with our babies.  If we are distracted, we might miss out on opportunities to recognize our babies’ attempts to communicate with us.

  • That shift in their gaze means they notice the dog walking across the room and they want us to notice it too.
  • Their serious stare into our eyes as we talk to them means that they are memorizing the faces of the people they love the most, and watching how our mouths move to form sounds.
  • That smile that melted your heart means “Dad, PLEASE make that hilarious zerbert noise again!”
  • That soft coo means they are perfectly content, snuggled up in our arms.

As parents we so often worry about getting them “the best” of everything—we do crazy amounts of research, seeking out the very best educational toys, the very best and safest carseats, even the very best pacifiers to soothe them.  In reality, babies need very little.  Are we giving them the very best of ourselves?  That’s what they need the most, even if it’s just for 30 minutes a day.

5. Consider a “Mommy and Me” Summer Enrichment Class


So you’re talking to your baby, you’re reading to your baby, you’re playing with your baby, and you’re giving that sweet baby some serious uninterrupted one on one time.  What now?  Well, you do something really fun to enhance your baby’s growing communication skills, of course!  TheraCare Outpatient Services is excited to provide “Mommy and Me” summer enrichment classes.  This hands-on summer camp is for parents to enjoy special bonding time with their baby as they learn how to better enhance their budding speech and language skills in a way that’s meaningful to babies: through play!  Guided by a certified speech-language pathologist, parents will come away from this class with improved parent/baby attachment and interaction, specific strategies for enhancing your baby’s speech and language skills through play, and fun memories with new friends!  Visit our summer programs page here for more information on session dates, times, and prices.  It’s going to be a blast!  Oh, and it’s called “Mommy and Me” because alliterations are fancy.  Dads are welcome too!

Chime In:
What are some of your favorite games to play
or books to read with your baby?

 

Feel free to contact us via our social media links, email, or by phone to discuss any questions you have.

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Orofacial Myology – Part 5: Orofacial Myology and Orthodonics

By Melanie Stinnett No CommentsPosted in Orofacial Myology, Speech TherapyTags: , , , ,

Orofacial Myology and Orthodontics

 

Orofacial myofunctional disorders (OMD) can cause changes in the growth and shape of the upper and lower jaws, as well as other facial bones and teeth. In some situations a narrowing of the roof of the mouth (hard palate) can occur. When this is the case, it is important to consult an orthodontist to consider the possibility of palatal expansion. Generally, optimal outcomes with orofacial myofunctional (OM) therapy are achieved when this expansion is completed.

 

While we may refer for an orthodontic evaluation, this does not mean that your child must wait to move forward with therapy. Orthodontic treatment can coincide with OM therapy and long term effectiveness of orthodontic treatment can in fact be enhanced by OM therapy.

 

At TheraCare, we work hand in hand with several local orthodontists and we would be happy to talk with you about the positive impact orofacial myofunctional therapy could have for you or your child.

 

Feel free to contact us via our social media links, email, or by phone to discuss any questions you have.

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Orofacial Myology – Part 4: Orofacial Habits – Thumb Sucking and More

By Melanie Stinnett No CommentsPosted in Speech TherapyTags: , , , , , , , ,

Orofacial Habits

This will be a short introduction to orofacial habits. These habits are of concern because they can be caused by or contribute to other orofacial issues in the areas of both structure and function.

Orofacial habits include, but are not limited to:

  • Mouth Breathing
  • Thumb or Finger Sucking
  • Tongue or Cheek Sucking

Let’s briefly take a look at these.

 

Mouth Breathing -

There are many factors that can cause mouth breathing. If your child breaths through their mouth consistently throughout the day or during the night, an evaluation to assess the root cause of this posture should be considered. If allowed to continue this posture while breathing. a child’s tongue will sit unnaturally low in the mouth. This can cause concerns related to development of the face, upper and lower jaws, as well as possible speech articulation issues.

 

Thumb or Finger Sucking & Tongue or Cheek Sucking – 

Thumb sucking can be seen as early as 18 weeks in utero. Human infants lose the essential need for sucking around the age of 4 months. At that point, it can quickly become associated with comfort and pleasure; therefore, making it difficult to break the habit as the child gets older.

Thumb and finger sucking can cause inappropriate shaping of the palate and chin. In addition, it can cause changes in the tone of the tongue and facial muscles, as well as a lower resting posture of the tongue. An anterior open bite can sometimes be the result of prolonged thumb and/or finger sucking.

Tongue and cheek sucking, while similar, could stem from a number of causes. It is important to find a knowledgeable professional who can complete a thorough evaluation to diagnose and make necessary referrals for adequate treatment.

 

What can speech therapy do to help with orofacial habits?

At TheraCare, we offer evaluations that can help to pinpoint the root cause of these concerns. Through our treatment programs, we address these concerns and work with your family to devise a program tailored specifically to you or your child. We utilize a multimodal approach that has seen proven results – utilizing proprioceptive techniques and a hierarchy of exercises as needed, along with positive reinforcers.

 

Feel free to contact us via our social media links, email, or by phone to discuss any concerns you have.

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Orofacial Myology – Part 3: Tongue Tie

By Melanie Stinnett No CommentsPosted in Speech TherapyTags: , , , , , , , , ,
This is a very basic overview of tongue tie and possible concerns related to speech production. Please call our office for more information if you have any concerns or questions.

What is a tongue tie?

The lingual frenum (or lingual frenulum) is the cord that stretches from under the tongue to the floor of the mouth.

‘Tongue tie’, ‘Ankyloglossia’ or ‘short frenum’ are the terms used when the lingual frenum is short and restricts the mobility of the tongue.

Tongue tie can be defined as a structural abnormality of the lingual frenum.  When the frenum is normal, it is elastic and does not interfere with the movements of the tongue in sucking, eating, clearing food off the teeth in preparation for swallowing and, of course, in speech. When it is short, thick, tight or broad it has an adverse effect on oromuscular function, feeding and speech. 1

Often dismissed by professionals as unnecessary to treat, tongue tie can cause many issues that, at the time, may seem unrelated or unimportant. However, when viewing the body as a whole and assessing the parts of your system that a tongue tie can impact, it is highly important that you consider having this assessed if you have any concerns.

Symptoms that may be seen when a tongue tie is present include:

  • Heart shape of tongue when raised or protruded (see pictures below)
  • Cannot extend tongue out to a point
  • Tongue curves down when extended
  • Difficulty licking an ice cream cone or kissing
  • Extended time period in orthodontics
  • Possible speech problems
  • Possible digestive problems
  • Swallowing deficits, difficulty swallowing pills
  • Cannot suction the tongue to the roof of the mouth

Included here are a couple of images of my own child’s tongue prior to his tongue tie release. You can clearly see the heart shape of his tongue. We had been noticing symptoms which included frequent choking and gagging with solid foods, speech articulation delays, inability to click his tongue, downward curve of the tongue when extended and the heart shape. Once his tongue was released (via laser at a local orthodontic clinic), we noticed immediate improvements in his swallowing function and ability to click his tongue, as well as increased imitation of speech sounds. After approximately 2.5 months, his speech articulation skills were gaining and were considered within normal limits.

Tongue Tie - heart shape image from front

 

Tongue Tie - heart shape image from side

 

While it is important to note that some of the symptoms listed above could be caused by other factors, a quick check of the tongue by a knowledgeable professional can ensure that treatment is targeting the root cause of these concerns.

The specialty of orofacial myology is something gained outside of traditional schooling for most speech-language pathologists. Be sure to ask your speech-language pathologist if they have training in this area and if they are confident in their skills to treat deficits related to tongue tie.

What can speech therapy do to help with tongue tie?

When we identify a tongue tie is present, we refer to a provider who can complete a tongue tie release/revision, also known as a frenectomy. Once the procedure is completed, speech therapy can assist with:

  • providing gentle stretches post surgery
  • addressing jaw stability
  • developing suction to the roof of the mouth
  • addressing any speech concerns, if present

 

Here are a few links that give great information related to tongue tie.

http://www.kiddsteeth.com

http://www.drghaheri.com

http://www.tongue-tie-education.com

 

Feel free to contact us via our social media links, email, or by phone to discuss any concerns you have.

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1 http://www.tonguetie.net/index.php?option=com_content&task=view&id=2

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Orofacial Myology – Part 2

By Melanie Stinnett No CommentsPosted in Orofacial Myology, Speech TherapyTags: , , , , , , , , , ,

Part 2

What Causes an Orofacial Myofunctional Disorder?

 

1. Airway Changes

Could you check yes to any of the following for your child?

  • Snoring
  • Chronic middle ear infections
  • Asthma
  • Lack of core trunk strength
  • Velopharyngeal Insufficiency
  • Pediatric Obstructive Sleep Apnea
  • Enlarged adenoids or tonsils

All of these things could cause airway changes or be the result of an airway change. These may increase the amount of time your child spends breathing through their mouth. When a child is consistently breathing through their mouth instead of their nose, it may cause a resting tongue posture to present lower in the bottom of the mouth instead of resting the tip against the roof of the mouth. When this occurs for an extended period of time, the tone, strength, and function of the tongue can be impacted resulting in an orofacial myofunctional disorder.

 

2. Tongue Tie (Ankyloglossia)

Our next blog post will specifically target this concern but here is a quick overview.

Tongue tie or Ankyloglossia can be defined as “a structural abnormality of the lingual frenum (membrane extending from the floor of the mouth to the underside of the tongue). When the frenum is normal, it is elastic and does not interfere with the movements of the tongue in sucking, eating, clearing food off the teeth in preparation for swallowing and, of course, in speech. When it is short, thick, tight or broad it has an adverse effect on oromuscular function, feeding and speech. It can also cause problems when it extends from the margin of the tongue and across the floor of the mouth to finish at the base of the teeth.” 1

A tongue tie can impact the range of motion for sticking the tongue straight out, moving the tongue back and to the molars, and lifting the tongue up to the roof of the mouth. When considering these restrictions, depending on the severity, it is easy to see why a tongue tie could cause many issues for the orofacial musculature.

We look forward to exploring this area in a more in depth manner in our upcoming blog post. Stay tuned!

 

3. Habits

These include the following:

  • Thumb or finger sucking
  • Nail biting
  • Tongue and Cheek sucking
  • Clenching and Grinding

As mentioned previously, the change in function of the tongue, in this case due to a habit, may result in changes of the tone, strength, and function of the tongue, as well as other muscles of the orofacial musculature.

Our clinic specializes in presenting clients with feasible and intentional ways to remove these habits.

 

4. Lack of Necessary Palatal Space

A high, narrow palate may be due to many different reasons but can also be caused by an orofacial myofunctional disorder. If the roof of the mouth is considered to be narrow, palatal expansion may need to be considered for optimal outcomes with orofacial myofunctional therapy.

 

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Reference

1 http://www.tonguetie.net/index.php?option=com_content&task=view&id=2

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Orofacial Myology – Part 1

By Melanie Stinnett No CommentsPosted in Orofacial Myology, Speech TherapyTags: , , , , , , , ,

Part 1

What is Orofacial Myology?

Q: Has your dentist or orthodontist mentioned that you or your child has a tongue thrust?

You may need to consider seeking treatment by an individual trained to address this concern.

Q: Have you always thought that being tongue tied was just an expression used for a person who couldn’t get their words out?

It is possible for a person to truly be tongue tied. This occurs when the lingual frenulum (tissue that connects the floor of the mouth to the under side of the tongue) is connected to far forward or is too short/tight.

You may be asking: How does that answer the question? What is Orofacial Myology and how can it help myself or my family member? Let’s go over the basics.

Orofacial myology is the study of facial muscles and oropharyngeal complex, their associated movements and how those movements word together. These movements can affect the functions of:

1. Respiration

2. Chewing

3. Gathering and movement of food and liquid in the mouth

4. Speech production

5. Oral resting posture

When a change in patterning occurs, a resulting change in muscular function and/or structure may occur. Changes can be attributed, but are not limited to genetics, birth trauma and anomalies, lack of patent airway, surgical intervention affecting the head and neck, inappropriate development of the swallow, or noxious habit patterns. (1)

In addition to the above mentioned concerns, orofacial myologists also evaluate and treat

1. Jaw Stability/Dissociation

2. Lip Seal/Competence

3. Tongue Tie (Ankyloglossia)

4. Drooling/Saliva Control

 

Q: I thought TheraCare Outpatient Services offered speech therapy. How does speech therapy fit into this?

Any speech language pathologist (SLP) can gain additional training to become skilled in orofacial myology. Our lead SLP, Melanie Stinnett, MS, CCC-SLP,  has completed this extensive training and is currently providing therapy to clients in the Greater Springfield Area. If you have questions about this type of therapy you can contact us through our Contact Form on the website or call our office at 417-890-4656.

Make sure to stay tuned for more discussions in Part 2: Causes of Orofacial Myofunctional Disorders, Part 3: Tongue Tie, Part 4: Bad Habits, and Part 5: Orofacial Myology and Orthodontics.

 

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1. Mary Billings, MS, CCC-SLP, COM (2013) – President Elect – IAOM

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Come Welcome Us to the Neighborhood!

By Melanie Stinnett No CommentsPosted in Speech TherapyTags: , , , , , , ,

Open House

 

We are prepared for a wonderful day of fun!

 

Local authors of the book Stars in Her Eyes: Navigating the Maze of Childhood Autism will be here signing books. They are also giving away one paperback copy and one ebook copy of their book, as well as a handmade necklace created by one of the authors. You don’t want to miss meeting these wonderful women!

 

Local Christian radio station 88.3 the WIND will be broadcasting live from the parking lot and collecting clothes for their annual Harvest of Clothing to benefit Victory Mission.

 

Giveaways throughout the day will include:

2 – LeapPad2 Custom Edition – one pink and one green

2 – $20 LeapFrog digital download cards

5 – $10 gift cards for various local businesses

 

In addition to all these fun activities, we will also have cupcakes from TwentyOne Cakes. We love this company for their wonderful cupcakes but also because they donate 10% of all their sales to the Down Syndrome Group of the Ozarks. If you haven’t ever had one of their cakes, you’ll want to stop just to get a little taste!

 

We look forward to meeting you and showing you around our beautiful clinic!

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