Does Treatment Time Affect SLP Outcomes in Preschoolers?

kids hug

Written by Emily K. Hulse

Are you wondering if treatment time affects outcomes in preschoolers? The answer is yes! Speech Language Pathologists collect data to determine what factors may affect progress in preschoolers and to rate children’s speech and language skills. The data collected indicates that the outcomes children achieve vary with the amount of treatment they receive. More treatment time is associated with better outcomes for children! Treatment time, service delivery model, and completion of a structured home program appears to be key elements associated with articulation progress. Data proves that preschoolers who participate in 10+ hours of individual treatment and a successful completion of a structured home program are making the best progress (91%). Call and schedule an evaluation with us today!

Why is play so important for language development?

As a speech therapist, I get to play with kids and toys all day. Part of my routine evaluation of children 3 and under is to assess their play skills. Below are some play skill milestones that you can use to decide if your child is developing normal play skills.

0-24 months: Solitary Play. Plays alone without concern for activities of others around him; minimal attention to other children in the area.

24-34 months: Parallel Play. Plays beside children rather than with other children., usually with similar toys/materials; somewhat attentive to others.

30-36 months: Associative Play. Plays with other children, such as sharing toys and talking about the play activities, even though agendas may be different.

36-48 months: Cooperative Play. Plays with children in an organized fashion toward a common goal.

3-5 years: Rough and Tumble Play. Boisterous and physical activity done in a playful manner.

3-5 years: Games with rules. Participates in an activity with accepted rules or limits; displays shared expectations and a willingness to conform to agreed upon procedures; preset standard game or made up game.

Play skills are crucial to social and language development and should be fostered and developed. Atypical play behaviors include: no focus or intent; stares blankly; wanders with no purpose, attached to unusual object, perseverates on certain objects, lines up toys, focuses on parts of objects. If you notice your child is exhibiting some atypical play behaviors it may be time for a speech and language evaluation. Play skills are the way we learn to socialize with our peers and they must be addressed like any other developmental delay.

Parental Tips

As a family centered clinician,  I rarely take credit for my client’s progress.  I know that it is what parents practice at home every day that helps the child reach their goals.
Today I decided to ask parents of my clients who have made rapid progress toward their speech therapy goals to tell me their secrets.  What do they do at home that helps their child make progress so quickly?

Here are some of their tips:

  1. Set aside 20-30 min everyday at the same time to work on therapy goals
  2. Take advantage of every opportunity that arises to practice a goal, whether in the car, at a stop light, or at the park
  3. Involve everyone in the family, including Grandma! This helps goals generalize into new settings and with new communication partners. The more people that are helping your child with his goals, the faster he will achieve them.
  4. Use siblings as a model during games.
  5. Keep it positive. Take a break if the child becomes frustrated
  6. Never show frustration
  7. Keep praise specific- “good try” vs. “That’s right!”
  8. Use a reward system
  9. Practice goals in different ways. This facilitates carryover.

Step Away From the Sippy Cups!

As an SLP who treats babies with feeding challenges, I frequently hear from parents how excited they are to begin teaching their baby to use a sippy cup.  Problem is, those sippy cups seem to linger through preschool.
Parents often view it as a developmental milestone, when in fact it was invented simply to keep the floor clean and was never designed for developing oral motor skills.  Sippy cups were invented for parents, not for kids.  The next transition from breast and/or bottle is to learn to drink from an open cup held by an adult in order to limit spills or to learn to drink from a straw cup.

Once a child transitions to a cup with a straw, I suggest cutting down the straw so that the child can just get his lips around it, but can’t anchor his tongue underneath it.   That’s my issue with the sippy-cup: It continues to promote the anterior-posterior movement of the tongue,  characteristic of a suckle-like pattern that infants use for breast or bottle feeding.  Sippy cups limit the child’s ability to develop a more mature swallowing pattern, especially  with continued use after the first year.  The spout blocks the tongue tip from rising up to the alveolar ridge just above the front teeth and forces the child to continue to push his tongue forward and back as he sucks on the spout to extract the juice.

Discontinue use of the sippy cup if the child is over 10 months.  Allow your child to develop the next milestone by mastering a mature swallow pattern.  That is, unless you want to go to an orthodontist and speech language pathologist!

I get asked all the time to share early indicators of Autism. Here are a few:

Signs and symptoms of autism in babies and toddlers

If autism is caught in infancy, treatment can take full advantage of the young brain’s remarkable plasticity. Although autism is hard to diagnose before 24 months, symptoms often surface between 12 and 18 months.  If signs are detected by 18 months of age, intensive treatment may help to rewire the brain and reverse the symptoms.

The earliest signs of autism involve the absence of normal behaviors—not the presence of abnormal ones—so they can be tough to spot. In some cases, the earliest symptoms of autism are even misinterpreted as signs of a “good baby,” since the infant may seem quiet, independent, and undemanding. However, you can catch warning signs early if you know what to look for.

Some autistic infants don’t respond to cuddling, reach out to be picked up, or look at their mothers when being fed.

Early signs of autism in babies and toddlers

  • Doesn’t make eye contact (e.g. look at you when being fed).
  • Doesn’t smile when smiled at.
  • Doesn’t respond to his or her name or to the sound of a familiar voice.
  • Doesn’t follow objects visually.
  • Doesn’t point or wave goodbye or use other gestures to communicate.
  • Doesn’t follow the gesture when you point things out.
  • Doesn’t make noises to get your attention.
  • Doesn’t initiate or respond to cuddling.
  • Doesn’t imitate your movements and facial expressions.
  • Doesn’t reach out to be picked up.
  • Doesn’t play with other people or share interest and enjoyment.
  • Doesn’t ask for help or make other basic requests.

The following delays warrant an immediate evaluation by your child’s pediatrician

  • By 6 months: No big smiles or other warm, joyful expressions.
  • By 9 months: No back-and-forth sharing of sounds, smiles, or other facial expressions.
  • By 12 months: Lack of response to name.
  • By 12 months: No babbling or “baby talk.”
  • By 12 months: No back-and-forth gestures, such as pointing, showing, reaching, or waving.
  • By 16 months: No spoken words.
  • By 24 months: No meaningful two-word phrases that don’t involve imitating or repeating.

Don’t let your accent hold you back from climbing the corporate ladder!

Accents are a beautiful thing.  It makes people unique and mysterious.  I love listening to someone with a foreign accent—as long as I can understand them!
We have all been in a situation before when we were talking to someone who had a strong accent.  Sometimes, that accent made it difficult to understand what the other person was saying.  If it was a social setting, it was a huge disaster.  Imagine if it had been at work.

If you have been speaking to someone lately and they had difficulty understanding you, you may have a strong accent.  This strong accent can interfere with your ability to hold meetings at work, give a sales pitch, or work effectively at a call center.

What is accent modification therapy?

Accent modification therapy begins with an assessment of your speech and articulation.  The first step is to identify which sounds you say incorrectly for English.  Next, a treatment program is established with your specific goals in mind.  The program usually takes 12-13 weeks with 2 visits per week at 30 min a session.

Does Insurance cover the cost?

NO.  NEVER.  Accent Reduction is like plastic surgery, it is elective.  It is not medically necessary.  If you are electing to take accent modification therapy, it is private pay.

What is Apraxia? How does it affect speech and language acquisition?

When I diagnose a child with Apraxia, the mother always goes home to do research on her computer about the disorder.  This is a very pragmatic thing to do.  However, there is a lot of doom and gloom about Apraxia on the internet.  Like any disorder, there are many different severities of Apraxia. 

Apraxia is a difficulty with motor planning for speech sound production.    Many of the children whom I treat for speech therapy have a form of Apraxia.  These children have difficulty imitating new words and have very unintelligible speech.  Children who do not have Apraxia, can hear a grown-up say a word and then say it.  Children with Apraxia often have to rehearse a word multiple times and still may not be able to say the word correctly.  This leads to frustration and often tantrums.

What can a parent do if they suspect their child has Apraxia?

First, have a speech and language evaluation to determine the diagnosis.

Second, introduce some baby signs to give your child a way to communicate immediately.  Start with signs that he would use for requesting, as this is the most motivating form of communication.  Kids love to sign “cookie” and receive a “cookie.”

Second, shorten the target words that you are trying to have your child imitate.  Think about words like: ball, cat, dog.  These words are less complex and will be easier to imitate.

Last, give your child multiple opportunities to rehearse the word until he achieves success.

And as always, keep it fun!