My Child Cannot Articulate/Pronounce Some Sounds....
Could It Be a Speech Sound Disorder?
If parents are concerned that their child may have speech intelligibility problems, it may be helpful to ask and answer the following questions.
1. How clearly does my child speak compared to his/her peers?
Observe how their speech compares with the speech of other children their age. Is their speech significantly less clear or harder to understand?
2. Can strangers understand my child easily?
Assess whether people who do not know the child, such as teachers or parents of friends, can easily understand what the child is saying.
Pay attention to whether the child shows signs of frustration or has to repeat himself frequently to be understood.
4. Are there certain sounds or words that my child has difficulty with?
Determine if there are certain sounds, words, or types of speech that seem problematic to the child.
5. Has there been a noticeable change in speech clarity over time?
Consider whether the child's speech clarity has improved, stayed the same, or worsened in recent months or years.
6. How well does my child understand and follow verbal instructions?
Assess whether the child has difficulty following verbal instructions; This may indicate a deeper problem with speech or language.
7. Does my child use nonverbal communication to compensate for unclear speech?
Notice whether the child often uses gestures, facial expressions, or other nonverbal cues to help communicate.
8. Are there concerns of other developmental problems?
Because speech intelligibility problems can sometimes be part of a broader developmental problem, consider whether there are other areas of development or skills that may be lagging behind.
If concerns persist after considering these questions, do not hesitate to consult a speech-language pathologist for a professional evaluation. A comprehensive evaluation or intervention may be required.
Online Speech and Language Therapies
Online language and speech therapies, which were also carried out before the Covid-19 pandemic, have started to be carried out more frequently with the Covid-19 pandemic. Although online language and speech therapies carried out simultaneously in different places initially emerged as a necessity, they later provided great convenience. Online language and speech therapies, which were initially approached with skepticism, were seen to be as effective and efficient as face-to-face language and speech therapies over time. In fact, in some cases, online language and speech therapies provided more successful, faster and more efficient results than face-to-face language and speech therapies. In addition, it saved time for individuals and their families with busy work schedules. Instead of wasting time on the road, individuals or their families preferred to receive online language and speech therapies from their homes. However, as with every language and speech disorder, obtaining successful and effective results from online language and speech therapies largely depends on a good evaluation process and both whether there is a need for therapy and meeting the eligibility criteria for online language and speech therapy.
If we examine these eligibility criteria, we can divide them into 4 categories as client, speech and language therapist, speech and language therapy materials and physical conditions. First of all, the individual who is expected to benefit from online therapy must have the appropriate level of prerequisite communication skills such as attention and waiting. It is difficult for someone, who is hyperactive and easily distracted, to continue online therapies, therefore, they do not meet the most important eligibility criteria for online speech and language therapy. For this reason, the individual who is asked to receive online speech and language therapy must be at least four years old. After this age criterion is met, he/she must be able to work with the speech and language therapist in cooperation for a certain period of time without losing his/her attention in front of the computer.
The speech and language therapist who will conduct and perform online speech and language therapy also needs all the knowledge, skills and experiences, which he/she uses in face-to-face therapies, in online speech and language therapy as well. In addition, they should know how to effectively use the computer applications and platforms where online speech and language therapies will be performed and carried out, and if necessary, they should provide information and guidance to their clients or parents on how to use these platforms. The same applies to the necessary computer programs, tablet applications or software other than these platforms and applications. In addition, another of the most basic skills that a speech and language therapist should have is to keep the attention of the individual, for whom they are performing speech and language therapy, alive and to ensure that they continue their participation. In some cases, even if individuals meet the online therapy criteria in terms of age and prerequisite communication skills, their attention or participation may not be sufficient for a therapy session. In this case, the speech and language therapist should step in and refresh the individual's attention and help maintain their participation in therapy.
When it comes to physical conditions, the most common problem is screens that are not large enough. In some cases, we hear that online speech and language therapies are performed on smartphone screens, and in some cases, we receive questions such as "Can we connect from a smartphone?" The answer to this question is of course "no". The individual receiving online speech and language therapy performs all communication with the speech and language therapist through this screen, and therefore a sufficiently large screen is essential. In addition, the individual receiving online speech and language therapy should be able to hear both the speech and language therapist clearly and convey their own speech to the speech and language therapist clearly. There should be no distracting environmental stimuli and sounds. Another frequently experienced problem is insufficient and interrupted Internet connection to work. Both the speech and language therapist and the individual receiving online therapy should have a good Internet connection so that time and efficiency loss can be prevented.
Finally, another issue that should be considered is the suitability of the materials used in online speech and language therapies. Just as materials suitable for the client and therapy goals are selected in face-to-face speech and language therapies, materials should be prepared or selected according to these criteria in online speech and language therapies. In addition, care should be taken to ensure that the materials to be used are visually and audibly suitable.
In this recommendation article, we have discussed the suitability criteria for online speech and language therapies and the conditions required for them to be efficient in four categories. Online speech and language therapy is no longer a necessity but a matter of choice. If the correct assessment is made and the eligibility criteria are met, online speech and language therapies will be at least as effective and efficient as face-to-face speech and language therapies. Individuals or their parents who are thinking of receiving online speech and language therapy can decide whether to choose face-to-face or online speech and language therapy by taking these criteria into consideration.
Language and Speech Therapies in English
Although speech and language therapists mostly perform therapies in their native language, they may also need to perform speech and language therapies with individuals who speak English as their native language or as a second language from time to time. This is often the case for individuals living in our country who use English as their native language or as a second language. In some cases, individuals whose native language is Turkish but who need and are motivated to speak and communicate in English may need to receive therapies in both Turkish and English. Although not very often, it may be necessary to perform English therapies with individuals living in different countries and having different native languages, as a common language, through online sessions in English.
In order to perform therapies in a language other than the native language, there are therapy eligibility criteria on both the therapist and the client side. First of all, the therapist who will perform therapies in English must have advanced command of spoken and written English. For this, he/she must have advanced vocabulary, grammar and usage knowledge in this language. As can be seen, all of these are at the knowledge level and it is not enough to remain at the knowledge level. The therapist should be able to use the vocabulary, grammar and usage knowledge he/she has effectively in speaking, listening, writing and reading skills in the target language. In this sense, competence and proficiency in all components and areas of the target language in which language and speech therapies are performed are required.
There are some variables on the client side. If the client's native language is already English, therapies in the target language can be started and continued after a detailed and meticulous evaluation, just as language and speech therapies performed in Turkish. However, if the client uses English as a second language, the situation is a little different at this point. It is almost certain that the existing language and speech disorder will be seen in both the native language and the second language, English. In other words, it is almost impossible for a language and speech disorder that exists in one of the languages ​​used by the individual not to exist in the other. Therefore, even if therapies will be performed only in English, the client's proficiency and development level in both languages ​​should be evaluated, information should be collected and determined correctly. It should definitely be looked at how this proficiency and development level is used in daily speech and communication. Although there are not very big differences, depending on the changing factors, an individual may be more competent in one language than the other. An individual receiving English therapies is supported by the therapist. The therapist should definitely inform the parents or relatives of the client about the therapy goals, applications and process, and if possible, speech and language therapists should ask them to support the individual with practice at home in the language other than English. Another group of clients who need language and speech therapies in English are individuals whose native language is Turkish but who need and are motivated to communicate in English. Here, the competence and proficiency levels in both languages ​​should be evaluated and determined correctly, and priority should be given to Turkish and the language and speech therapy goals should be achieved in both languages.
As can be seen, although performing therapies in another language is similar to therapies performed in the native language, it also has differences. The first thing that is important here is correct assessment, diagnosis and determining realistic goals. After these, the variables and factors mentioned above should definitely be taken into consideration. In this way, language and speech therapies will be more effective and efficient.
Roles and Duties of Parents in Language and Speech Therapies
There are various factors that determine the effectiveness of speech and language therapy. One of these is family. Families play a very important role in the effectiveness of the progress and development obtained from therapy. For this reason, families should pay attention to the following points during the therapy process.
Participate in Therapy Activities: Follow the exercises and activities recommended by the therapist. Practicing at home can reinforce what the child has learned in sessions. Find out from your therapist what is being studied, for what purpose and how you should study. In a successful speech and language therapy, the therapist maximizes the child's participation in the session. Establishes a realistic and lively interaction with the child. Be realistic and lively when you do the exercises at home. Try to maximize your child's participation in studies.
Provide a Supportive Environment: Create a positive and encouraging atmosphere for the child to practice speech and language skills. Appreciate and validate their accomplishments, no matter how small. Don't dismiss it with simple expressions like "Well done, great". After saying these, help the child understand what he did right by giving clear feedback about his correct behavior or language-speech goal. Most importantly, be sincere and realistic because children easily spot fakeness.
Communicate with Therapist: Stay in regular contact with the therapist to understand your child's progress and new strategies or goals. Share your observations about your child's behavior and development and ask questions where you are inadequate. Get brief information from your therapist at the end of therapy sessions.
Incorporate Therapy Goals into Daily Life: Use everyday situations to exercise speech and language skills. For example, if the therapist focuses on vocabulary in sessions, be careful to use new words during meals or while playing games. Avoid acting like a teacher at this stage because our goal is not to teach but to use upright and speech targets for meaning and communication in context throughout the day. It is important to remember that when applying therapy goals to daily life, use simple and short language structures.
Be Patient and Consistent: Every child is different. Even if they have the same language and speech problem, differences emerge after a short time as a therapist. Progression rates, development charts and learning styles vary. Progress may be gradual, so it is important to maintain patience and consistency. Encourage your child even if progress seems slow. Identify your hasty and unrealistic expectations and replace them with accurate ones. Rushing and unrealistic expectations are one of the most important factors that harm development.
Educate Yourself: Learn about your child's special needs and therapy techniques. This can help you better support their development and understand their challenges. But when educating yourself, be selective and critical about your sources of information. Of course, you will use the internet to get information, but protect yourself from the misinformation that exists on the internet because most of the time, you are likely to worry about misinformation while trying to access information. Therefore, make sure you consult the right references and information sources.
Make sure you are working with the right areas of expertise: Make sure that the language and speech problem you are experiencing is correctly evaluated and diagnosed. Does your child really need this support? When is the right time to start therapy? Apart from this, are there any additional therapies and training you need to receive? Don't hesitate to ask these questions. Just as it is wrong not to receive therapy when therapy is necessary, it is also wrong for someone who does not need therapy to receive therapy or for someone who no longer needs therapy to continue therapy. Because the child's time and energy will be wasted at the wrong time or purpose.
By actively participating and performing the right tasks and roles at the right time, parents can greatly increase the effectiveness of speech and language therapy and support their child's overall development.
Prerequisite Communication Skills
Once the baby is born, he/she begins to acquire the sounds and rules of the language it is born into. As long as there are no physical or environmental problems, the baby's language, speech and communication development continues together with other areas of development. However, in some cases, language, speech and communication development may be interrupted in the early years of life. In such a case, a comprehensive language, speech and communication evaluation can contribute to the solution of the problem with early intervention or follow-up. In the early years of life, meaningful interactions and communication with the environment come to the fore rather than speech production. Healthy language and speech development will be built on meaningful and healthy interactions and communication development in the first years of life. If not else, healthy communication and interaction skills in the first years of life will form the basis for language and speech development. So what are the prerequisite communication skills required for this?
During the first years of life, babies develop important communication prerequisite skills, including:
- Listening: babies learn to pay attention to sounds and words, which is very important for language development. By separating meaningful speech sounds from other sounds, they acquire the phonological rules of the language they were born into. Additionally, the baby begins to follow the person speaking and generate meanings from the speech produced.
- Vocabulary: Building a strong vocabulary is very important. Children need to learn words to express themselves effectively. They establish a connection between the events and objects in their environment and their speech productions. To make word acquisition more effective and efficient for babies, speaking slowly and in short sentences while talking to them will facilitate their language processing skills.
- Nonverbal Communication: Understanding and using gestures, facial expressions and body language to convey meaning will make communication and interaction, and therefore language acquisition processes, more effective.
- Turn Taking: Learning to take turns in conversations and interactions helps develop social communication skills. Instead of making meaningless sounds at the same time, taking turns producing speech and allowing the baby to contribute to the interaction will help develop this skill.
- Imitation Skills: Children often learn by imitating the speech and actions of adults and their peers. The imitations mentioned here are purposeful attempts to communicate with the people around them rather than meaningless movements or sound productions. During these imitations, the baby plays with the language he was born into and makes language games while exchanging emotions and intentions with the person he communicates with.
- Eye contact: Developing the ability to initiate and maintain social interactions, such as making eye contact and responding to social cues, has a large share in overall development in the first years of life. Lack of eye contact or lack of eye contact may be a sign of a situation that requires attention.
- Emotional/Sensory Regulation: The ability to manage emotions and sensory stimuli is crucial to effective communication. Excessive changes in emotional fluctuations or environmental stimuli causing excessive sensory fluctuations will hinder the ability to initiate, maintain and complete communication. At the same time, such a situation will negatively affect the acquisition of language, speech and communication skills.
These skills are fundamental to the child's overall development and success in school and social interactions. Parents, caregivers and educators play an important role in developing these skills in a child's early years.