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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  • Once stuttering reduces the child enters a maintenance phase where the treatment is slowly withdrawn under the supervision of a speech pathologist to minimise relapse risk, until stuttering is eliminated or almost eliminated.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.

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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.

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People often ask what is the best thing to put on to their toast in the morning for breakfast. There is a constant debate on whether butter is better as it is more natural or margarine is better due to its lower saturated fat content. At the end of the day it is up to you to decide what suits you best. A small spread of butter a day will not increase your cholesterol levels or affect your weight in a big way.

Bad cholesterol

Increased consumption of saturated fats raises the amount of LDL cholesterol in the blood which increases the risk of cardiovascular disease.

Good cholesterol

Consumption of monounsaturated fats raises HDL cholesterol which reduces the risk of cardiovascular disease. Hence, spreads which are low in saturated fat and high in monounsaturated fats are the healthiest.

Types of spreads:

Butter vs. Margarine

Butter contains about 51g of saturated fat per 100g. Margarine on the other hand contains 15g per 100g of saturated fat. Churning cream will make butter, whilst margarine is made from a combination of oils through a process known as hydrogenation.

Olive oil spread

Olive oil spread contains approximately 17g of saturated fat per 100g and a high amount of monounsaturated fat (more than 35g).

Avocado spread

Mother nature has given us an amazing fruit which is high in monounsaturated fat (good for cholesterol), antioxidants such as Vitamin C which is protective against heart disease as well as fibre(4g/100g) which is important for gut health and reduces the risk of diseases such as diabetes and high cholesterol. One can have mashed avocado on toast or make it into guacamole by adding lime juice, tomato, onion, garlic and chilli.

Flora Proactive spread

It has minimal saturated fat and added plant sterol which may help to lower cholesterol in conjunction with an overall healthy diet that includes sufficient amounts of fruits and vegetables.

Reduced fat cheese

Although it contains a decent amount of saturated fat, it provides a good quantity of protein and calcium. Above all, it can be a good option to include couple of days a week.

Hummus

Originated from the middle eastern cuisine, hummus is very popular due to its amazing flavour and nutritional properties. Hummus is made from chickpeas, tahini, olive oil, lemon juice, salt and garlic. It is low in saturated fat (bad fat) and high in monounsaturated fat (good fat). In addition, it is high in dietary fibre and low in calories (30 calories in 1 tablespoon).

Varying your diet with these different types of spreads can help break the boredom. It can also reduce the stress you might feel about over consuming saturated fat.

This article was written by our Dietitian and Nutritionist Juhi Bhambhaney. If you have questions about diet and nutrition contact your local doctor, who will arrange for you to see a dietitian and nutritionist. We‘ll provide you with a simple and effective routine targeted to your concerns. Contact us today!

The post What is the best spread for your toast in the morning? appeared first on ENT Wellbeing Sydney.

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Voice disorders are conditions involving abnormal pitch, loudness or quality of the voice, thereby affecting speech production. A voice disorder describes differences in voice that are inappropriate for an individual’s age, gender, cultural background, or geographic location. A person has a voice disorder if they express concern about having an abnormal voice that does not meet their daily needs. Even in the case where others cannot perceive the difference. Voice disorders are classified in a number of ways.

Most simply, voice disorders can be considered in three categories:

Organic

Organic voice disorders are physiological in nature and occur when there is a change to respiratory, laryngeal, or vocal tract mechanisms within a person’s body. There are two types of organic voice disorders: Structural and Neurogenic.

  • Structural voice disorders are caused by physical changes to the voice mechanism such as vocal nodules and oedema where the vocal fold tissue is altered by misuse or structural changes to the larynx that happen as a part of aging.
  • Neurogenic voice disorders are caused by dysfunction of the central or peripheral nervous system innervating the larynx, which in turn affects functioning of the vocal mechanism. This includes voice changes such as tremors caused through Neurogenic diseases such as Parkinson’s disease, paralysis of one or both of the vocal folds or involuntary movements known as spasmodic dysphonia.

Functional

A functional voice disorder is caused by the improper or inefficient use of the vocal mechanism. This is despite there being no abnormalities to the physical structures involves in voicing. Functional voice disorders can be caused by the presence of an organic disorder that leads to habitual, mal-adaptive vocal habits. Even after the organic change or long standing vocal habits have been treated. Some examples of functional voice disorders include vocal fatigue, muscle tension dysphonia, diplophonia and ventricular phonation.

Psychogenic

A psychogenic voice disorder occurs when there is no structural reason for the voice disorder. There may or may not be patterns of muscle tension (functional voice disorder) and the primary cause is psychological. While psychogenic components within voice disorder do occur, voice disorders caused by a psychological disorder are relatively rare. These individuals may benefit more from a referral to appropriate professionals other than speech pathologist such as psychologist or psychiatrist for treatment.

Most voice disorders fall into the first two categories and overlap is very common. One of the most common cases is when an individual has a functional disorder. This is where they habitually misuse their voice, and this leads to a vocal trauma. Eventually this can lead to an organic disorder such as vocal nodules. It is important to determine the correct diagnosis and cause for voice disorders. Treatment will differ depending on the type and cause.

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 speech pathology related questions, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post What is a voice disorder? appeared first on ENT Wellbeing Sydney.

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Take the time this holiday season while the kids are on break to get the whole family involved in some fun interactive activities and get those language goals down pat at the same time by playing some fun Christmas and holiday themed game show activities. Here are a couple to get you started:

Holiday Family Feud

Work on improving semantic associations between words and increasing your child’s vocabulary with Christmas themed words by setting up teams to play family feud with vocabulary tailored to a Christmas theme and to the level that your child is working at. For example, if you are targeting increasing vocabulary for food, you can make up a list of Christmas food, write them up on a board and cover each answer. Then get team members to answer for the category “Things we eat at Christmas”. The team that guesses the most correct answers wins.

Who wants to be a millionaire this Christmas?

Language comprehension, through both listening and reading can be targeted easily in a fun game of who wants to be a millionaire this Christmas. Start with a written passage that is handed to the child that they can read through if you are working on written comprehension. If you are targeting auditory comprehension, you can use a passage that is read out instead. Once the passage has been read, go through a list of pre-prepared questions and present on a board (or on paper), a list of four answers (one correct and 3 incorrect) that your child can choose from. Add on a bonus hierarchy of prizes to work up to make the game even more fun and motivating.

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 speech pathology related questions, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post Holiday Language Game Show Activities appeared first on ENT Wellbeing Sydney.

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