Play Levels Of Social Interaction In Speech And Language Therapy

 

Play Levels Of Social Interaction In Speech And Language Therapy

There are different levels of play used in the assessment of children’s speech and language. These levels are used to measure children’s play skills. However, there are also play levels of social interaction that can give a general overview of the child’s play skills.

In general, there are six play levels of social interaction that children go through respectively. Each level becomes more complex than the previous one, and requires more communication and language skills than the other.

Unoccupied Play

The first level of play is unoccupied play. In this kind of play, the child may seem like he is simply sitting quietly in one corner but actually is finding simple things that he sees around him to be rather amusing. A typical adult may not notice that what the child is doing is already considered to be play, unless they observe meticulously.

The child may just be standing and fidgeting at times, but this could already be unoccupied play at work. 

Onlooker Play

The second level is onlooker play. In this level, the child watches other children play but doesn’t engage in play himself. This is when children learn to observe others. Such play level can show a child’s attention and awareness skills.

Solitary Play

The third level is solitary play where the child plays by himself and doesn’t intend to play with anyone else. This level shows an outright manifestation that the child do have play skills, only that it is still at a level that no interaction is required.

A child can be at this level when he is already able to play functionally with an object, can play by himself up to fifteen minutes, and is able to follow simple play routines.

Parallel Play

The fourth one is parallel play. This level characterizes children who play side by side but don’t communicate with each other. Neither do they share toys. It is said to serve as a transition from solitary play to group play and is at its peak around the age of four years. 

A child is said to be in this stage when he is able to play alone, but the activity he is doing is similar with the play activity that other children beside him are engaging in. The child also doesn’t try to modify or influence the play of other children around him. Here, the child is playing ‘beside’ rather than ‘with’ the other kids in the area.

Associative Play

Next is the associative play. This is where the children still don’t play with each other but are already sharing the toys that they are playing with. This level shows the child’s awareness of other children, although there is no direct communication between them, other than the sharing of toys and the occasional asking of questions.

Their play session doesn’t involve role taking and has no organizational structure yet. The child still carries on the way he wants to play, regardless of what the other children around him are doing. 

Cooperative Play

The last level is cooperative play. This is the final stage wherein the children are already playing together, sharing toys and communicating with each other.

This level usually happens at about the age of five or six, where children engage into group games and other highly structured play activities.

These levels can be utilized by the therapist as a guide when it comes to the interactions that he wishes to have with the child through play activities.

Importance Of Play In Speech Therapy

Importance Of Play In Speech Therapy

Play has a very important role in speech therapy. It is actually one way that speech therapy can be conveyed, especially if the one undergoing therapy is a child.

What’s Play Got To Do With It?

Play isn’t just used during the therapy proper. In fact, play is already used during the initial phases of assessment. Kids can be very choosy with people that they interact with, so seeing a therapist for the first time doesn’t promise an instant click. Rapport has to be established first, and this is usually done through play.

Benefits Of Play

Other than using it as a tool to establish rapport, play also gives a lot of benefits. First off, it gives an over view of the child’s skills, whether it be their abilities or limitations. 

Then, therapy wise, play can be used to make a child cooperate with whatever exercises a therapist has lined up for him/her. Since play doesn’t put much pressure on a child, he/she would likely cooperate to do the exercises and not know that what he/she is doing is already called therapy.

When the child is more relaxed, he can be at a more natural state. If a child is at his more natural state, then his skills could show more naturally. Thus, this would be a benefit on the therapist’s part, since the therapist could get a more comprehensive assessment of the child’s skills. 

Play could also make therapy more fun and less scary. Since play is an activity to be enjoyed, the child would not get bored with monotonous therapy activities that seem like chores, rather than activities. 

Play As A Skill

In fact, play is considered to be a skill itself, because it is a natural activity that children do. If a child doesn’t play, then there must be something wrong with him, most probably with his Inner Language skills. This is because; play is a representation of a child’s inner language. This is just one of the many reasons why play is important. 

It actually has a domino effect, if you look at the bigger picture. Play is needed to have Inner language, which is in turn needed to have Receptive language that is a prerequisite of Expressive language. Thus, if a child has no play abilities, then his whole language system may be affected.

Play And Cognition

Play is also a basis of a child’s cognition skills. The more developed a child’s play skills are, the higher the probability that his cognition skills would be at a fair state. However, play and condition are not the same. Play is more likely a prerequisite or a co-requisite of cognition.

What Parents Have To Say

Unfortunately, most parents may have a negative impression when they see the therapist playing with their child. Initially, parents get surprised and shocked that they paid a very valuable amount for therapy, only to find out that their child would only be playing.

That’s why it is very important for therapists to explain the procedures that they are going to do with the child to the parents. To make the session more interesting, the therapist could also include the parent/s in the play session with the child. 

In this way, the child would definitely think that it is a play session. Additionally, the parent can also do the play activity at home with the child. Doing this, could serve to be practice of the targeted skill of the play activity.

Early Learning To Listen Sounds And Speech Therapy

Early Learning To Listen Sounds And Speech Therapy

Babies must first hear the sounds frequently and memorize them before learning to speak or learn their meaning. For children with hearing impairment, among the many activities that can facilitate listening to sounds are sound-object association activities also known as “learning to listen sounds”. 

This type of activity involves associating a sound to a referent, an item such as transportation vehicle or animal with a routine meaningful action. Linking a sound to a referent is considered an important activity for auditory-based intervention because it encourages the child to attend to sounds, facilitate the recognition that sounds are different and help the child understand that different sounds have different meaning. 

This activity also develops stored perceptual representation for specific sounds or language-based phonemes. It also develops auditory familiarity with the spoken language.

Considerations

There are some important things to consider when facilitating this kind of activity. One thing is to incorporate toys or personal action for very young child. This allows children to actively participate in the learning and listening process as this activity is meaningful and enjoyable for them. 

Another thing is the variation of the supra-segmentals of these sounds. This restructures the auditory schema of a child for a particular sound each time he hears it in a different context. Also, toys used for learning to listen sounds should be simple representational items that are easily recognizable by young children. 

Adults should also remember that “hearing comes first” for an effective auditory-verbal strategy. This means that the adult should first vocalize the sound before showing to the child the toy.

Magical Transportation Sounds

An example of learning to listen sound associated with transportation vehicle is aaaah(airplane) which is a good basic vowel and even the deafest kid typically comprehend and use it quickly. The clinician can vary the suprasegmentals of this sound as he shows to the child how he moves the airplane up and down. 

Another sound is buhbuhbuh. It is one of the first consonants that the babies learn and besides from that, it is also an easy sound for the babies to imitate and produce on their own. The toy bus can be move around as the clinician vocalizes the sound. Ooooo is one sound that is good for stimulation of pitch variation with the same vowel. 

The clinician can use a fire truck as he produces the sound with alternating high-low configuration. Other learning to listen sounds associated with transportation vehicles include brrrrrr(car), p-p-p-p-p(boat), and ch-ch-ch-ch(train). These sounds concentrate on stimulating the lip articulator and develop listening for some high frequency sounds. 

Familiar Animal Sounds

Learning to listen sounds is also associated with animal sounds. A common sound that is use by clinicians is mooo(cow) which is a good vowel combined with the initial consonant /m/. This sound is produce with low voice and this change in voice is interesting for children. 

The repeated tongue clicking for the hoarse is also a good sound because it is another prespeech skill. Most children are fascinated with the tongue clicking, thus, it is good for stimulation. This sound also exercises the movement of tongue. Meow has some nice vowel transition and clinician may use this to also produce inflectional variations within a two-syllable combination. 

Other learning to listen sounds for animals include arfarfarf(dog), ssss(snake), quakquakquak(duck),hop-hop-hop(rabbit), oinkoink(pig), ba-a-a-a(sheep), and squeak(mouse).

There are also learning to listen sounds that can be associated with eating, sleeping, and clock. These sounds are mmmm, shhhhhhh, and t-t-t-t-t correspondingly.

Delineating Speech And Language Therapy

Delineating Speech And Language Therapy The field of speech and language therapy is somewhat a vague body of knowledge that only a few people understand. What most people don’t know is that there is a difference between speech therapy as a whole and language therapy. Although the term ‘speech and language’ therapy is widely used, since speech and language problems coexist most of the time. Differentiating Speech And Language Therapy The truth of the matter is, that speech therapy and language therapy differ in some key areas. First off, they differ on the problems that they are targeting. The techniques and activities used during therapy are also different. Although there are times that these activities are done simultaneously, to target two problems at a time. Speech Therapy Speech therapy is done to treat speech problems. Such speech problems deal with how or the manner a person speaks. These speech problems are categorized into three general kinds. First, is voice or resonation disorders. Second, is articulation disorders. And, lastly, fluency disorders. Voice disorders mainly deals on problems with the voice box or the larynx itself. These may be due to physiological malfunction, anatomical differences, fatigue, or neurological problems. Some voice disorders present problems in pitch, volume, and tone. The presence of breathy, raspy, nasal and weak voice is viable too. Articulation disorders, on the other hand, deal with the manner a person speaks. The problem is rooted from the articulators themselves. Articulators are composed of the tongue, teeth, hard palate, soft palate, jaw, and cheeks. Articulation disorders may be due to weakness or physiological malfunction in any of the articulators, which results to distorted or incomprehensible speech. Fluency disorders would deal on problems regarding the fluency of the person. It may be the case that he talks too fast or too slow. Stuttering and Cluttering are two of the major fluency problems that speech therapists deal with. Speech therapy activities would likely include different exercises to practice speaking. Since most of the time, weak muscles are present; the therapy proper would usually include activities that can help strengthen these muscles. Different compensatory strategies are also taught, so that the patient can compensate for lost speaking skills. Language Therapy Language therapy mainly deals with problems regarding your inner language, receptive language and expressive language. Cognition skills can be the main cause of language problems. Unlike speech disorders, that manifest physical differences, most language disorders are due to problems the brain’s language processing. Receptive language problems mainly deals on difficulties understanding received language, like what other people are telling you and comprehending written data. Expressive language problems on the other hand are difficulties on expressing oneself. You may have a hard time knowing which words to use verbally or even through writing. Language based problems are usually treated through mental exercises. Workbooks are often used to practice and develop language skills. For very young children, play therapy is used to develop inner language, so that the therapist could later on target improving receptive and expressive language, respectively. In some cases, speech and language problems are both present. This is especially true for individuals that had traumatic brain injuries or accidents that had an effect on the brain. They may manifest physiological problems due to damaged nerves that result to articulation or voice problems. The can also have language problems like aphasia, especially if their brain was hit on its language areas.

Conditions For Speech Therapy: Laryngectomy

Conditions For Speech Therapy: Laryngectomy

A speech therapist has a vital role in the pre- and post op management of laryngeal cancer, because Laryngectomy patients have to undergo speech management. So here are some of the things to know about laryngectomy.

A Team Approach

Firs off, the management of laryngeal cancer requires a team approach. The patient gets to see a surgeon, radiologist, audiologist, speech-language pathologist, oncologist, physical therapist, maxillofacial prosthodontist, and a psychiatrist. All of these health care professionals work together to work on the management of the patient.

What Is Laryngectomy?

Laryngectomy is the total removal of the larynx. It is also the partition of the airway from the nose, mouth, and esophagus. A person that undergoes this kind of operation would have to breathe via an opening on the neck, called stoma. 

Laryngectomy is done when a person has laryngeal cancer. It may be considered to be a traditional way of managing laryngeal cancer, since a lot of laryngeal cancer cases nowadays are treated with the use of chemotherapy, radiation, or other laser procedures. In severe cases that these don’t work, that is the only time laryngectomy is opted for.

Other than the larynx, other structures are also removed. These other structures includes Sternocleidomastoid, Omohyoid muscle, Internal Jugular vein, Spinal Accessory vein (CNXI), Submaxillary salivary gland. In most severe cases, the external carotid artery, strap muscles of the neck, Vagus nerve (CN X), Hypoglossal nerve (CN XII) and the lingual branch of the Trigeminal nerve (CN V) are also removed.

How Common Is Laryngectomy?

It is estimated by the American Cancer Society, in 2003, that around nine thousand five hundred people in the US were diagnosed of laryngeal cancer. This condition occurs about 4.4 times more predominantly with men than with women. Though, similar with lung cancer, laryngeal cancer is becoming increasingly frequent with women. 

Tobacco smoking is so far the supreme risk factor in having laryngeal cancer. Other factors include radiation exposure, asbestos exposure, alcohol abuse, and genetic factors. In United Kingdom, laryngeal cancer is rather rare, since it only affects less than 3,000 people per year.

Possible Problems

After total Laryngectomy, possible problems may occur. These include having a scar tissue at the tongue base, narrowing of the esophagus, partial tongue base resection, dysphagia, Xerostomia, mouth sores and changes in smell, taste, appetite and weight.

Effects And Impacts Of Laryngectomy

Laryngectomy has two mechanistic effects. One, it separates respiration from speech. Two, it keeps the pharyngoesophageal region intact. 

There are also impacts that Laryngectomy brings about. The main impact would be the loss of voice for communication. You may also lose the ability to express emotions such as laughing. You also get physical problems with regard to tasting and feeding. 

Laryngectomy is frequently successful in treating early-staged cancers. Still, undergoing through the procedure would require major lifestyle change. There is also a risk of having severe psychological stress due to unsuccessful adaptations. 

After The Procedure: Voice Replacement And Care

After the patient’s larynx is removed, voice prosthetics is used. This serves as a replacement for the lost larynx, so that the person will still be able to communicate and speak. In this case, Laryngectomees would have to learn new methods of speaking. 

They should also be constantly concerned in taking care and cleaning their stoma. Severe problems can arise if foreign materials and water enter their lungs via their unprotected stoma. 

Conditions For Speech Therapy: Autism

Conditions For Speech Therapy: Autism

Autism is one condition that requires speech therapy treatment. However, autism is often misunderstood and thought of to be something that can be left untreated. However, that should not be how things work. Autism presents a lot of problems, but the intensity of these problems could be decreased if given the correct treatment.

In Relation To Autism: Vocabulary

A lot of terms are commonly heard in relation to autism, such as: classic autism, infantile autism, Pervasive Developmental Disorder (PDD), Atypical PDD, Autistic like, PDD-NOS, Asperger’s Syndrome and high functioning Autistic.

What Is It Exactly?

Basically, Autism is a neurological disorder. It is classified to be a Pervasive Developmental Disorder. The main characteristic of Autism is that it affects three major areas in relation to speech and language. This triad is the impairment of the child’s: social interaction, communication and imaginative play.

Pervasive Developmental Disorder is actually an umbrella term for Autistic Spectrum Disorders. With the use of the term ‘pervasive’, it is emphasized that the disability’s range of deficits is beyond psychological development. On the other hand, the term ‘developmental’ puts emphasis that the occurrence of the condition is during the child’s development rather than later in life.

Autism is actually only one condition under this umbrella. Other conditions include Rett’s Disorder, which is a neurodevelopmental disorder that begins to show its symptoms during early childhood or infancy. 

Another is Childhood Disintegrative Disorder; it somewhat resembles Autism but the difference is the first two to four years of the child’s life is rather normal, then the symptoms start to show.

Asperger’s syndrome is also in this umbrella. It is sometimes called high functioning autism. Lastly, PDD-NOS or Pervasive Developmental Disordere—Not Otherwise Specified is also related to Autism. These are children that present symptoms similar to but don’t quite match the other conditions.

What Causes Autism?

Even though a lot of research has been done, there is no identified single factor that causes Autism. Several factors are said to play a part in the occurrence of Autism. One of these is brain disorder. Recent studies show that there is a difference in the brains of people with Autism. Their cerebellum seems to be smaller than normal, and their limbic system is impaired.

Chemical imbalances are also said to play a part here. It was found that in some cases, symptoms came from food allergies, chemical deficiencies, hormonal imbalances or elevated brain chemical levels. 

Heredity is also an important factor. A lot of genetic disorders have Autism as a symptom. An example would be the fragile-X syndrome. Other factors include pre-, peri-, post-natal trauma, brain damage complications and MMR immunization.

Whatever the cause may be, the child with Autism should be given the same structured training in able to stimulate his learning, language and social skills. 

Diagnosis

For a child to be diagnosed of having Autism, he should first qualify for the Diagnostic Criteria for Autistic Disorders according to the DSM-IV. 

Treatment: Therapy And Others

Due to the triad of Autism effects on the child, speech therapy becomes a vital part of Autism management. However, other members of the team are also needed such as pediatrician, pediatric neurologist, child psychiatrist, psychologist, occupational therapist, behavior therapist, and educators like schoolteachers or Special Education teachers.

Role Of Speech Therapist In Autism Rehabilitation

The Speech Therapist assesses hearing. He also evaluates whether the speech and language difficulties of the child is really due to Autism or another disorder. This can be taken from analyzing the child’s expressive language, receptive language, oral-motor functions, voice quality, articulation and fluency, auditory processing and pragmatic skills. 

Aphasia’s Speech And Language Problems Targeted For Speech Therapy

Aphasia’s Speech And Language Problems Targeted For Speech Therapy
Aphasia can bring about a lot of speech and language problems that are to be treated for speech therapy. The kind of speech and language problems brought by Aphasia would highly depend on the kind of Aphasia that you may have.

Broca’s Aphasia

Broca's Aphasia is also known as motor aphasia. You can obtain this, if you damage your brain’s frontal lobe, particularly at the frontal part of the lobe at your language-dominant side. 

If Broca’s Aphasia is your case, then you may have complete mutism or inability to speak. In some cases you may be able to utter single-word statements or a full sentence, but constructing such would entail you great effort. 

You may also omit small words, like conjunctions (but, and, or) and articles (a, an, the). Due to these omissions, you may produce a "telegraph" quality of speech. Usually, your hearing comprehension is not affected, so you are able to comprehend conversation, other’s speech and follow commands. 

Difficulty in writing is also evident, since you may experience weakness on your body’s right side. You also get an impaired reading ability along with difficulty in finding the right words when speaking. People with this type of aphasia may be depressed and frustrated, because of their awareness of their difficulties.

Wernicke’s Aphasia

When your brain’s language-dominant area’s temporal lobe is damaged, you get Wernicke's aphasia. If you have this kind of aphasia, you may speak in uninterrupted, long, sentences; the catch is, the words you use are usually unnecessary or at times made-up. 

You can also have difficulty understanding other’s speech, to the extent of having the inability to comprehend spoken language in any way. You also have a diminished reading ability. Your writing ability may be retained, but what you write may seem to be abnormal. 

In contrast with Broca’s Aphasia, Wernicke’s Aphasia doesn’t manifest physical symptoms like right-sided weakness. Also, with this kind of Aphasia, you are not aware of your language errors.

Global Aphasia

This kind of aphasia is obtained when you have widespread damage on language areas of your brain’s left hemisphere. Consequently, all your fundamental language functions are affected. However, some areas can be severely affected than other areas of your brain. 

It may be the case that you have difficulty speaking but you are able to write well. You may also experience weakness and numbness on the right side of your body.

Conduction Aphasia 

This kind is also known as Associative Aphasia. It is a somewhat uncommon kind, in which you have the inability to repeat sentences, phrases and words. Your speech fluency is reasonably unbroken. There are times that you may correct yourself and skip or repeat some words. 

Even though you are capable of understanding spoken language, you can still have difficulty finding the right words to use to describe an object or a person. This condition’s effect on your reading and writing skills can also vary. Just like other types of aphasia, you can have sensory loss or right-sided weakness. 

Nominal Or Anomic Aphasia 

This kind of aphasia would primarily influence your ability to obtain the right name for an object or person. Consequently, rather than naming an object, you may resort to describing it. Your reading skills, writing ability, hearing comprehension, and repetition are not damaged, except by this inability to get the right name. 

Your may have fluent speech, except for the moments that you pause to recall the correct name. Physical symptoms like sensory loss and one-sided body weakness, may or may not be present.

Transcortical Aphasia 

This kind is caused by the damage of language areas on your left hemisphere just outside your primary language areas. There are three types of this aphasia: transcortical sensory, transcortical motor, and mixed transcortical. All of these types are differentiated from others by your ability to repeat phrases, words, or sentences.