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Only a few more sleeps until Christmas and for all those who do not want to fall behind with speech practice, here are some great Christmas conversation starter. While these topics are great for targeting all sounds, they are separated into the three most commonly targeted sounds for kids in speech pathology.

The ‘r’ sound

  • Rudolph the red nose reindeer is a classic Christmas song that is a great talking point not only for sounds but also as a teaching tool. Have a discussion around how Rudolph teaches us about importance of embracing our individual differences and how they can be a positive impact in our lives.
  • Having a chat about some ideas for Kris Kringle gifts is a good way to get in a lot of practice with the ‘r’ sounds in clusters.
  • The Grinch story is a great conversation starter for more practice with those ‘r’ clusters as well as teaching the importance of being appreciative of non-material gifts that the holiday season brings us.

The ‘th’ sound

  • A child friendly version of the story of Father Christmas or Saint Nicolas would be a good topic to discuss with late primary and early high school students. It gives an opportunity to practice those ‘th’ sounds and discuss the importance of helping those who are less fortunate.
  • The Twelve days of Christmas is a good theme with the words ‘fourth’, ‘fifth’, ‘sixth’, ‘seventh’, ‘eighth’, ‘ninth’, ‘tenth’, ‘eleventh’ and ‘twelfth’ providing an abundance of ‘th’ sounds to work on.

The ‘s’ sound

  • The classic discussion of what kids want Santa to bring them for Christmas is a great one for practicing the ‘s’ sound. It even works for kids that refer to Santa as Saint Nic or Father Christmas.
  • The story behind the mistletoe tradition is a good one for teens that may find the topic interesting and still have a bit of trouble with their ‘s’ sounds.
  • If your kid’s participate in a Secret Santa with cousins or friends, you can discuss what they received from their Secret Santa.
  • Tales of Ebenezer Scrooge and the Ghost of Christmas past, Christmas present and Christmas future is a topic loaded with ‘s’ sounds, good for late primary and early high school kids.

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 Christmas Conversation Starters for speech appeared first on ENT Wellbeing Sydney.

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There are two subcategories for therapy targeting Speech Sound Delays and Disorders. These include Articulation therapy and Phonology therapy. The two are often confused so below is some information about both and the differentiating features between the two therapy types.

What is Articulation Therapy?

Articulation therapy is a type of therapy method that targets speech errors that affect one sound in every position due to difficulty producing the sounds. For example someone with a lisp may have difficulty producing the ‘s’ sound and may instead make an ‘s’ sound that is slushy. The error is global, meaning that they produce the same error every time for that one sound. It is possible to have multiple articulation errors at the same time as well. For example an individual may have a lisp and also have difficulty producing the ‘th’ sound in all positions within a word and instead produce an ‘f’ sound (e.g. ‘thing’ becomes ‘fing’).

Therapy is very structured and begins at the level of sound production. Then those sounds are placed into words, phrases, sentences, stories and finally incorporated into conversation. Another differentiating feature of Articulation therapy is that the Speech pathologist makes specific references to the sound and its production and provides cues in terms of placement of the lips, tongue and palate to help produce the sound.

What is Phonology Therapy?

Phonology therapy on the other hand is used to target sound error patterns. For example, some children have difficulty producing sounds at the end of words and is not specific to one sound. For example, a child may substitute the word ‘sail’ with the word ‘say’ as they have trouble producing the ‘L’ sound at the end. In the same way they may substitute the word ‘beam’ with the word ‘bee’ as they are having trouble producing the ‘m’ sound at the end.

Therapy of this style is focused on meaning. The speech pathologist highlights the communication breakdown to help the child register that they have not in fact produced the word that they meant to say. The child must then try to correct their production of the word to ensure they are producing the intended word correctly.

If the child is unable to produce the sound themselves, the cues of the articulation therapy are often incorporated to help with physical production of the sound. The therapy style in this case would be a combined treatment approach.

Contact us for results focused on 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 speech sound therapy? appeared first on ENT Wellbeing Sydney.

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Carbohydrates and diabetes

It is common knowledge that carbohydrate foods affect our blood sugar levels. To explain this further, it is important to first understand carbohydrates. The carbohydrate food group includes fruits, breads and cereals, rice, pasta, lentils, certain starchy vegetables like potato and corn, and dairy. When we eat carbohydrate-containing foods our pancreas secretes the insulin hormone. This takes the glucose from carbohydrates. In normal circumstances, the cells are unlocked so they take the glucose up and use it as energy. Type 2 diabetes is a chronic condition which affects the ability of the cells in the body to react to the insulin being secreted and take up the glucose. As a result, the glucose remains in the blood and this is what causes high blood sugar levels.

However, this does not mean a diabetic patient has to avoid carbohydrates entirely. It does come down to the type of carbohydrate being consumed. For example, refined carbohydrates such as biscuits, confectionery, fruit juice, sugar and rice malt syrup would cause a spike in the blood sugar, but healthier carbohydrate options such as wholegrain breads and cereals, lentils and dairy cause a more steady release of glucose. Carbohydrates are ranked from 1-100 according to their effect on the blood sugar levels. This is known as the glycaemic index. Carbohydrates with a higher glycaemic index tend to cause a spike in blood sugar levels while carbohydrates with a lower glycaemic index cause a steady release of glucose.

What about fruit and diabetes?

Fruits have a low glycaemic index and do not need to be completely avoided to manage diabetes. In fact, consuming fruit can promote better management of diabetes. There are a number of plausible explanations for this:

  • Fruits contain fibre which promotes satiety and prevents unnecessary grazing throughout the day. Fruits are low in calories and can therefore help with weight management. Excess weight especially around the abdomen is one of the main causes of diabetes.
  • Fruits are rich in vitamins and minerals. Fruits are rich in antioxidants that protect the cells of the body from damage caused by free radicals. Free radicals are molecules containing oxygen which can easily react with other molecules through a process known as oxidation. In normal circumstances, the free radicals help protect the body against disease. However, when there are not enough antioxidants in the body and therefore more free radicals than needed, they can cause damage to the cells of the body. This is known as oxidative stress which is commonly observed in patients with diabetes.

In fact, a study found that there was no benefit of decreasing fruit intake on the Hbac1c levels (3 month aggregate blood sugar levels) of diabetes patients.

How much fruit can a diabetic person consume?

Although fruit has a low glycaemic index, the portion size does matter. Too many carbohydrates can spike up the blood sugar level. This is because the GI of a carbohydrate-containing food is not the only factor that influences the blood sugar level. It is also the glycaemic load.

Glycaemic Load = GI of food * carbohydrate ( g) content per portion ÷100

Furthermore, filling up in excess on one food means that you are not eating other food groups that could provide valuable nutrients. Hence, the Australian dietary guidelines recommend having not more than two servings of fruit and it is advisable to spread it out in the day. One serving of fruit could be one apple/one banana/two small apricots/two kiwi fruit/a cup of diced fruit. It is also important to watch out for differently sized fruits sold in the supermarket.

For example with banana, 1 medium banana constitutes as one serve. Larger sized bananas would constitute as more than one serve.

What about fruit in other forms?

  • Fruit juice: causes a higher rise in the blood sugar level compared to fruit. For example, the glycaemic index of an orange is 6.2 and glycaemic index of juice is 13.4.This is because of the low fibre intake and higher sugar content in juice compared to the natural fruit.\
  • Don’t count wine as part of your fruit intake: Wine is made from grapes and does contains resveratol, an antioxidant found in fruit. However, it does not contain all the other antioxidants found in fruit because they are insoluble and lost in the process of making wine. Wine is also loaded in calories compared to fruit.
  • Smoothie: A better option to juice as the fibre is retained in making a smoothie. However one has to be careful to not add more sugar from fruit juice and instead opt for reduced fat milk. It is advisable to go for homemade smoothies rather than store brought.

Whether you’re diabetic or not, include two serves of fruit everyday as part of a balanced diet to obtain the amazing vitamins, minerals and fibre that fruit has to offer!

Contact us for results focused nutritional advice

This article was written by our dietitian and nutritionist Juhi Bhambhaney. If you have any questions regarding health and nutrition, make an appointment with one of our dietitians. We‘ll provide you with a simple and effective routine targeted to your concerns. Contact us today.

The post Should people with diabetes avoid fruit: exploring the myth appeared first on ENT Wellbeing Sydney.

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On visiting a speech pathologist, the session often starts with a discussion around the area of concern, whether it is regarding speech, language, literacy, voice, stuttering or swallowing. Once you have established what your concerns are, there are a few key components that a literacy assessment is composed of including:

Case History

This includes any background history such as any developmental concerns; both physical and mental, or family history of literacy difficulties such as dyslexia. The clinician may also ask for some background information about the individual’s speech and language skills. This is because often an individual’s speech and language ability affects their literacy skills. This is due to the importance of sound production in spell and read words as well as the ability to comprehend and put together a sentence in order to read or write a passage. The speech pathologist may have to conduct a speech and language assessment in addition to the literacy assessment, if they feel that deficits in this area may be underpinning the literacy concerns brought forward.

Phonological Awareness test

This test is done to determine if the individual is able to identify and manipulate sounds within a word. This is important for accurate reading and spelling. Individuals that struggle with phonological awareness may spell words like ‘splash’ as ‘slpash’ as they are not able to process the sounds within the word.

Decoding and encoding test

These are tests of single word reading and spelling. This often includes both words that can be sounded out phonetically as well as sight words. This highlights whether the individual has a good understanding of which sounds correspond to which letters or letter groups. Individuals that struggle with decoding or encoding may not understand that the ‘aye’ sound in the word ‘stain’ is represented by the ‘ai’ group of letters.

Reading comprehension test

This component of the assessment picks up higher order literacy difficulties. An individual may be able to sound out the letters to form the words, however they may struggle to process the words together as a sentence, fail to gather the main idea, hold on to key information within the test or fail to understand the implications of the text and make predictions from it.

Written language assessment

This component assesses the individual’s ability to put together a written piece such as a narrative or a persuasive. Individuals who struggle to write sentences, follow a logical written order or structure as well as those that struggle with punctuation will have difficulties with this component of the assessment battery.

After the assessment has been completed, your speech pathologist will provide you with the results, which will include a diagnosis and recommendations about which treatment programs would best suit the individual. Each diagnosis is different and based on the individuals presenting symptoms, which guide the type of therapy provided. For this reason, it is essential a literacy assessment is conducted by a qualifies speech therapist prior to commencing therapy.

Contact us for results focused on 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 to expect in an initial literacy speech pathology assessment appeared first on ENT Wellbeing Sydney.

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People often ask dietitians ‘what is the best diet for losing weight?’, and we end up disappointing them by explaining that there is no perfect diet. What really works for long-term weight loss are the lifestyle changes a person makes. It is also essential to understand the importance of a balanced diet. Following an overly restrictive diet can lead to disordered eating patterns and nutritional deficiencies.

Medical management of obesity

There are accepted weight loss drugs and surgery methods to manage obesity. However, these are usually only used as a last resort if lifestyle management has not been successful and if weight is affecting the person’s daily activities like breathing and walking, or is putting them at risk of other immediate life threatening health issues.

Can medicines or surgery be a quick fix for weight loss?

The simple answer is no. These methods still need to be used in conjunction with lifestyle management strategies in order for the weight loss to be maintained. It is also important to be aware of the side effects weight loss drugs can have, especially if there is a non-compliance to the required dietary changes while on the medication. For example, the orlistat drug promotes weight loss by reducing absorption of fat by 30%, however, if excessive fat is consumed while on orlistat, there are side effects such as oily stools, faecal urgency and spotting. There can also be side effects with weight loss surgery, including leakage occurring at the suture line or a reduced absorption of calcium, iron and vitamin B12.

Although weight loss drugs or surgery can be a requirement for some, patients will not see the benefits unless lifestyle changes are also made. Furthermore, making lifestyle changes sooner rather than later can eliminate the need for weight loss medicines or surgery altogether.

How to maintain weight loss

Surveys conducted with people who managed to lose weight and keep it off have indicated certain characteristics and strategies that lead to their successful long-term maintenance of weight loss. The first characteristic was a healthy relationship with food. This occurred when one was able to enjoy a variety of foods in moderation, and did not eat to satisfy external factors like boredom or emotional eating. Other successful strategies included eating breakfast regularly and maintaining a fairly consistent eating pattern throughout the week. This prevents overeating and unnecessary snacking throughout the day.

What should be the weight loss goal?

It is important to understand that trying to lose enormous amounts of weight is not always a realistic goal. In some circumstances, even 5-10% of weight loss can make a huge difference in reducing the incidence or progression of chronic diseases such as diabetes or heart disease. A pre-diabetic person, for example, may be able to avoid getting diabetes by achieving 5-10% weight loss. This is because the loss of abdominal fat reduces insulin resistance which is the underlying cause of diabetes. Insulin is the hormone released by the pancreas, and is responsible for allowing glucose from carbohydrate-containing foods to be used as energy. When one has excess abdominal fat, the insulin hormone cannot work as efficiently which leads to high blood sugar levels. Loss of abdominal fat increases the efficiency of the insulin.

The bottom line is regardless of which route you take to achieve weight loss, one cannot avoid the need to make consistent lifestyle changes in order to keep the weight off.

Contact us for results focused on nutritional advice

This article was written by our dietitian and nutritionist Juhi Bhambhaney. If you have any questions regarding health and nutrition, make an appointment with one of our dietitians. We‘ll provide you with a simple and effective routine targeted to your concerns. Contact us today.

The post Maintaining weight loss appeared first on ENT Wellbeing Sydney.

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