an overview of speech and language development nicola hall speech and language therapist
TRANSCRIPT
AN OVERVIEW OF SPEECH AN OVERVIEW OF SPEECH AND AND
LANGUAGE DEVELOPMENTLANGUAGE DEVELOPMENT
Nicola HallNicola Hall
Speech and Language TherapistSpeech and Language Therapist
Background to speech and language Background to speech and language therapytherapy
What is communication?What is communication?
Where the breakdown can occurWhere the breakdown can occur
Speech and Language Therapy InputSpeech and Language Therapy Input
Questions and AnswersQuestions and Answers
AgendaAgenda
A Speech and Language Therapist is a person trained to work with people of any age with communication or swallowing difficulties.
We are trained to deal with neonates up to elderly
This may include:
Assessment
Diagnosis
Treatment
Pre-referral Work and Health Education
BackgroundBackground
What does a Speech and Language Therapist do?What does a Speech and Language Therapist do?
What is What is Communication?Communication?
What do speech and language therapists consider?
Where can the Where can the breakdown occur?breakdown occur?
ListeningListening
STAGE 1 – 1STAGE 1 – 1STST yr: yr: Period of extreme distractibility Period of extreme distractibility
STAGE 2 – 2STAGE 2 – 2ndnd yr: yr: The child can concentrate for some time The child can concentrate for some time on a concrete task of his own choosingon a concrete task of his own choosing
STAGE 3 – 3STAGE 3 – 3rdrd yr: yr: Attention is single Attention is single channelled, but more flexiblechannelled, but more flexible
STAGE 4 – 4STAGE 4 – 4thth yr: yr: Child can control his Child can control his own attention focusown attention focus
STAGE 5 – 5STAGE 5 – 5thth yr: yr: The child’s attention The child’s attention becomes two channelledbecomes two channelled
STAGE 6 – 6STAGE 6 – 6thth yr: yr: Integrated attention Integrated attention is well established and well sustainedis well established and well sustained
AttentionAttention
LanguageLanguage
STAGE 1: DISCOVERER (birth to 8 months)STAGE 1: DISCOVERER (birth to 8 months)
The infant goes from communicating reflexively to becoming really The infant goes from communicating reflexively to becoming really
interested in others and wanting attention. She does not yet know interested in others and wanting attention. She does not yet know
how to send messages directly to another person to get what she how to send messages directly to another person to get what she
wants.wants.
STAGE 2: COMMUNICATOR (8 to 13 months)STAGE 2: COMMUNICATOR (8 to 13 months)
The infant sends purposeful messages directly to others using a The infant sends purposeful messages directly to others using a
combination of eye gaze, facial expressions, sounds and gestures. She combination of eye gaze, facial expressions, sounds and gestures. She
becomes very sociable.becomes very sociable.
STAGE 3: FIRST WORDS USER (12 to 18 months)STAGE 3: FIRST WORDS USER (12 to 18 months)
The infant cracks the language code and begins to use single words.The infant cracks the language code and begins to use single words.
STAGE 4: COMBINER (18 to 24 months) STAGE 4: COMBINER (18 to 24 months)
The child demonstrates a burst in vocabulary and begins to combine The child demonstrates a burst in vocabulary and begins to combine
words. She also starts to take more turns in conversationwords. She also starts to take more turns in conversation
STAGE 5: EARLY SENTENCE USER (2 to 3 years)STAGE 5: EARLY SENTENCE USER (2 to 3 years)
The child progresses from using two-word combinations to five-word The child progresses from using two-word combinations to five-word
sentences and can now hold short conversationssentences and can now hold short conversations
STAGE 6: LATER SENTENCE USER (3 to 5 years)STAGE 6: LATER SENTENCE USER (3 to 5 years)
The child uses long, complex sentences and holds conversationsThe child uses long, complex sentences and holds conversations
Speech DevelopmentSpeech Development
50% children 90% children
All common vowel sounds 1.5yrs – 2yrs 3yrs
p, b, t, d, m, n, w 1.5yrs – 2yrs 3yrs
k, g, f, h, y as in ‘yet’ 2.5yrs – 3yrs 4yrs
s, ing as in ‘ring’ 2.5yrs – 3yrs 5yrs
l 3yrs – 3.5yrs 6yrs
sh as in ‘shoe’, ch as in ‘chin’, j as in ‘joke’, z, v
3.5yrs – 4.5yrs
6yrs
r, th as in ‘thin’, voiced th as in ‘there’
4.5yrs – 5yrs 7yrs
Where there are 2 sounds at the beginning of a word, eg st, sn, br, fl, these take longer to develop. Often not before 5yrs old
FluencyFluency
Children will often stop, pause, start again and stumble over Children will often stop, pause, start again and stumble over words when they are learning to talk.words when they are learning to talk.
Between the ages of two and five years it is normal for a child to Between the ages of two and five years it is normal for a child to repeat words and phrases and hesitate with ‘um’s and ‘er’s when repeat words and phrases and hesitate with ‘um’s and ‘er’s when they are thinking what to say next.they are thinking what to say next.
About 5 in every 100 children stammer for a time when they are About 5 in every 100 children stammer for a time when they are learning to talk. Many find it easier to talk as they get older. learning to talk. Many find it easier to talk as they get older. Others continue to find talking difficult and often get stuck.Others continue to find talking difficult and often get stuck.
More boys than girls have persistent stammers.More boys than girls have persistent stammers.
Warning bells:Warning bells:
o does anyone else in the family have (or had) a stammer?
o has the child been stammering for longer than 6 months?
o is the child beginning to do other actions eg screwing their face up, blinking, foot tapping, word avoidance to ‘help’ their speaking?
o has the child had difficulties with speech and language skills previously?
Social SkillsSocial Skills
Can be the result of underlying language difficulty ASD Aspergers Syndrome
Social Communication
Social Interaction
Play skills
Eating and Drinking - Risk FactorsEating and Drinking - Risk Factors
Prematurity or low birth weight Syndromes – Down Syndrome, Prader Wili Neurological Disorders – cerebral palsy, meningitis Acquired trauma – head injury Delayed introduction of textured food Structural problems – cleft lip/palate, tracheostomy Heart disease Gastro-intestinal conditions
Signs and SymptomsSigns and Symptoms
Poor feeding Difficulties chewing Difficulties in drinking Refusing food/drink Coughing/choking Eyes watering Colour change Gurgly/wet voice Breathing difficulties
Gagging/vomiting Frequent chest infections Poor weight gain General distress around
eating/drinking Avoiding certain
foodstuffs eg. Crunchy things, lumps that require lots of chewing
Prolonged feeding times
Speech and Language Speech and Language Therapy InputTherapy Input
Not just the disorder but how this impacts on the Not just the disorder but how this impacts on the individual child and familyindividual child and family
How does this affect the child’s development in everyday How does this affect the child’s development in everyday life?life?
What does this stop the child/family doing?What does this stop the child/family doing?
How does this make the child/family feel?How does this make the child/family feel?
Who Should I Refer?Who Should I Refer?
Role of the Speech & Role of the Speech & Language TherapistLanguage Therapist
Pre-referral (Public Health)
Referral Open referral system
Triage
Assessment Determine level of SLT risk Diagnosis & description Intervention plan
Intervention Direct Indirect
Discharge
General AdviceGeneral Advice
Suggest nursery placement for children not yet in education.
In Greater Glasgow give Helpline number to parents
In all situations, asking children to repeat what they are saying is likely to increase stress. Advise parents not to pressure the child into repeating or speaking to people. Listen to WHAT the child is communicating not HOW
Consider referring to audiology if any concerns about hearing.
Consider involving other services eg CDC if any concerns regarding social interaction.
Wednesday: 1.00pm to 4.00pm
274 2075
Consultation & Advice Line
Friday: 9.30am to 11.30am
531 6843
Anyone involved with a child can call (Glasgow only at the moment)
Staffed by an experienced speech and language therapist who can give general advice and/or advise on appropriateness of referral
BilingualBilingual FamiliesFamilies
Where there are 2 (or more) languages being spoken…..
o Never advise giving up mother tongue
o The adults should be consistent with the languages, try not to mix them
o SLT would be involved if child has problems in all languages, not just learning English
www.talkingpoint.org
www.rcslt.org
www.hpc-uk.org
www.stammering.co.uk
www.talktoyourbaby.org.uk
www.afasic.org.uk
www.nas.org.uk
Useful WebsitesUseful Websites
