By

From time to time, I come across parents of children that have shopped around to different speech pathologists after finding that their child does not seem to be making progress with their communication or feeding concerns. There are many reasons why this may be the case and even times where progress has been made however not perceived.  There are a few things to keep in mind when gauging progress in speech therapy and finding the right treatment for your child.

1. Am I clear on the speech therapy goals set out for my child and were they chosen in conjunction with my concerns and what my child requires most?

Some parents enter into an assessment session with a clear picture of what their child requires, only to be told the issue is something completely different. At times, this may truly be the case if there is an underlying issue that is causing the concern you came in to address in the first place. Other times your speech pathologist may have noticed, a concern unrelated to the initial one, however it may be a more pressing matter or more time sensitive. One example would be if your preschool aged child has speech issues, however your speech pathologist diagnoses a stutter.

While the speech may be your main concern, you speech pathologist will most likely advise you of how time critical it is to treat the child’s stuttering while they are at an age where they are most receptive to effective treatment programs. Having said this, as a parent,  you have the final say when deciding what treatment your child obtains and just like with any other health service, it is up to you to make an informed decision as to how best to support your child. We are after all here to help by providing the most up to date and relevant information to help you in making an informed choice.

If you are not satisfied with the therapy goals selected then you may feel the service is irrelevant and not continue. So ensure that you clearly understand the therapy goals and how to measure success in reaching those targets. This can be done through reassessment with your speech pathologist or daily measures of your child’s communication or feeding ability.

2. Is the treatment evidence based and am I following the correct procedure as outlined by my speech pathologist?

Speech pathology is an active therapy and just like other forms of medical treatment, it needs to be provided in the correct dose and have an adequate level of evidence to support its effectiveness. Your speech pathologist should provide you with information about the treatment you or your child is undertaking, how often and how long it should be performed.

Many parents give up on speech therapy before properly administering the techniques. Just like a tablet, if you don’t take it every day then it will not be effective. Many speech treatments require daily practice as outlined by the research behind it, so make sure to give it a proper go before calling it quits and you should see great results.

Contact us for results focused speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have questions about language activities, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post How to Make Speech Therapy Effective appeared first on ENT Wellbeing Sydney.

By

A person’s discourse and the way their conversation flows can sometimes be overlooked when assessing for communication difficulties. This may be because the child’s verbal language understanding, grammar and vocabulary may be quite strong, which can mask difficulties with discourse.

Signs of difficulties with discourse include:

  • Jumbled up or illogical flow of conversation.
  • Missing references to key characters within a story.
  • Mixing up of tenses throughout a conversation, although the use of tense may be correct. e.g. rather than explaining “Billy was playing football then started eating apples and once he finishes he will go home” the individual may instead say “billy started eating apples then he was playing football and he will go home.”
  • Missing a start and end marker to the conversation or story.
  • Difficulties with discourse may sound like the individual is unable to get to the point of their story. Or it may seem as though there is no point to their conversation.

These individuals are often able to tell you the basics of what happened without any trouble, in vivid detail and answer any questions you may have about the story or conversation you have just had, without asking questions. However, they are often unable to get their message across effectively. This may have a significant impact on numerous areas within everyday life which require clear and logical communication.

Conversational flow is important for these areas:

  • Effective communication with family and friends when recounting their day or events they may have witnessed or hear about.
  • Clarifying information provided to them by others
  • Answering broader questions in a direct manner with a central point
  • Summarising information written or orally at school or within the work place during presentations and other mandatory tasks.

Therapy for those who have difficulties with discourse

Discourse treatment is all about exposure and can be treated effectively by a trained speech pathologist. All speech pathology treatments, especially discourse treatment, should be tailored to meet the functional communication needs of the person. Therapy provides an abundance of opportunities to practice their newly learnt skills. This allows treatment to have real impact on everyday communication to reduce communication breakdowns and foster effective communication.

Contact us for results focused speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you require speech therapy, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post Conversational Flow and Discourse appeared first on ENT Wellbeing Sydney.

By

Syllable-timed speech

Syllable-timed speech techniques (STS) like the Westmead Program have been used for hundreds of years.  The technique works by saying each syllable with equal stress to a rhythmic beat like a robot.  The Westmead Program differs from older STS treatments as it doesn’t require any props such as a metronomes maintain the beat; the child doesn’t  have to speak very slowly in a monotone voice or pre-programmed steps that start with single sounds and work slowly up to conversation.

The program has a few similar features to the Lidcombe Program in terms of structure.

Here are some of the key features

  •  Two stage program
  • Administered by parents or other carers who measure average stuttering severity
  • Measures taken daily using the Lidcombe Program’s 1-10 scale.
  •  The technique is learned and practiced 4-6 times a day for 5-10 minutes each session
  • Once stuttering reduces the child enters a maintenance phase where the treatment is slowly withdrawn under the supervision of a speech pathologist to minimise relapse risk, until stuttering is eliminated or almost eliminated.

The theory underpinning the program is that syllable stress variations in natural speech are a stuttering “trigger” in children with a vulnerable speech motor system. STS is believed to induce long-term improvements in stuttering severity before a child’s neural pathways for speech are established.  The treatment works only for children and the effects of STS are usually only temporary for adults who stutter.  The Westmead Program does not yet have the same level of evidence to support its effectiveness as the Lidcombe Program however; there has been some headway in the growing evidence to support this program.

Cheryl Andrews and her colleagues from the ASRC, have just published the results of their Phase II trial of a syllable-timed speech treatment particularly focused school-aged stutters which has previously been an age group without evidence based program for treatment. Results from the study have been very promising and looks to be a viable option for children who have not had successful treatment through the Lidcombe program for one reason or another or are too old for Lidcombe to be an effective treatment option.

It gives speech pathologists practical clinical support (and confidence) to keep working with families to tailor evidence-based treatments to the particular challenges and needs of school-age children who stutter.

Contact us for results focused speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have difficulties with speech, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post The Westmead Program for Stuttering Therapy appeared first on ENT Wellbeing Sydney.

By

Syllable-timed speech

Syllable-timed speech techniques (STS) like the Westmead Program have been used for hundreds of years.  The technique works by saying each syllable with equal stress to a rhythmic beat like a robot.  The Westmead Program differs from older STS treatments as it doesn’t require any props such as a metronomes maintain the beat; the child doesn’t  have to speak very slowly in a monotone voice or pre-programmed steps that start with single sounds and work slowly up to conversation.

The program has a few similar features to the Lidcombe Program in terms of structure.

Here are some of the key features

  •  Two stage program
  • Administered by parents or other carers who measure average stuttering severity
  • Measures taken daily using the Lidcombe Program’s 1-10 scale.
  •  The technique is learned and practiced 4-6 times a day for 5-10 minutes each session
  • Once stuttering reduces the child enters a maintenance phase where the treatment is slowly withdrawn under the supervision of a speech pathologist to minimise relapse risk, until stuttering is eliminated or almost eliminated.

The theory underpinning the program is that syllable stress variations in natural speech are a stuttering “trigger” in children with a vulnerable speech motor system. STS is believed to induce long-term improvements in stuttering severity before a child’s neural pathways for speech are established.  The treatment works only for children and the effects of STS are usually only temporary for adults who stutter.  The Westmead Program does not yet have the same level of evidence to support its effectiveness as the Lidcombe Program however; there has been some headway in the growing evidence to support this program.

Cheryl Andrews and her colleagues from the ASRC, have just published the results of their Phase II trial of a syllable-timed speech treatment particularly focused school-aged stutters which has previously been an age group without evidence based program for treatment. Results from the study have been very promising and looks to be a viable option for children who have not had successful treatment through the Lidcombe program for one reason or another or are too old for Lidcombe to be an effective treatment option.

It gives speech pathologists practical clinical support (and confidence) to keep working with families to tailor evidence-based treatments to the particular challenges and needs of school-age children who stutter.

Contact us for results focused speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have difficulties with speech, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post The Westmead Program for Stuttering Therapy appeared first on ENT Wellbeing Sydney.

By

Unlike pre-schooler stuttering, the evidence-base for successful treatment of school-aged children who stutter is limited. Currently, the most viable contenders for school-age stuttering treatments include:

Speech restructuring

These programs work on manipulation speech to help control stuttering like the Camperdown Program, which slows down speech rate to assist with fluency control. Speech restructuring can be successful for older children in their early teens however children below the age of 10 years often do not like using the speech pattern, and relapse is common.

Verbal response contingent treatments

For school-aged children that are less mature and not as old, the Lidcombe Program, which uses behavioural reinforcement for stutter free speech and stuttering, has some evidence to support its use (e.g. Koushik et al., 2009).  These types of treatment do not work nearly as well for school-aged children as they do with pre-schoolers.

Video-self modelling

Video-self modelling works by allowing children to watch themselves as they produce a desired behaviour (stutter-free speech) to help facilitate said behaviour.  Studies have been done with children as young as 8 years old, with low-level evidence to support its use (e.g. Bray & Kehle, 1998).  The treatment is safe and easy to facilitate with video-recording technology so readily available however it is not successful with all individuals so it needs to be trialled on a case by case basis.

Syllable-timed speech treatments

Syllable-timed speech techniques (STS) like the Westmead Program which has also been termed ‘robot talk’ have been used (in different forms) for hundreds of years.  They involve speaking with very little difference in stress across syllables.  The Westmead Program like many predecessors of its type works by producing equal stress on all syllables in a rhythmic beat. Recent studies conducted this year have shown promising evidence to support this form of treatment and currently, this type of treatment looks to be the most promising contender for this age group.

It should be noted however that each individual is different and in order to determine the best course of treatment for your child it is essential that he or she be properly assessed by a qualified speech pathologist to determine whether the child fits the criteria for the selected treatment.

Contact us

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have difficulties with speech, make an appointment. We‘ll provide you with effective therapy targeted to your concerns. Contact us today.

The post What treatment is available for school-aged kids who stutter? appeared first on ENT Wellbeing Sydney.

Call (02) 8188 2570
or our local call number 1300 123 368

Stay Connected

Contact Us

    Your Name (required)

    Your Email (required)

    Your Message

    [recaptcha]

     

    Translate

    ENT Clinic Sydney - Suite 70B, Royal Randwick Shopping Centre, 73 Belmore Road, Randwick, Sydney, Australia

    FRACS
    ASOHNS
    DAA
    MUH
    university-of-newcastle
    university-of-sydney
    university-of-queensland
    university-of-oxford
    australasian-college-of-dermatologists
    nutrition-blog-network
    speech-pathology-australia