What is a written language disorder?:

A written language disorder is one that involves significant impairment or difficulty across written language, including reading and writing comprehension, word recognition, and ability.

About written language disorders:

Written language disorders can occur alongside another language disorder, or may be in the presence of another condition, such as attention-deficit hyperactivity disorder (ADHD), intellectual disability (ID), or autism spectrum disorder (ASD). Spoken and written language are often thought to go hand in hand, so a written language disorder is often diagnosed with a spoken language disorder, or vice versa. Symptoms often vary across individuals, so signs and symptoms of one individual may be different from that of another. Symptoms are influenced by the language domains affected, age, severity, and state of linguistic development. Individualized treatment plans are implemented by a speech-language pathologist for individuals diagnosed with a language disorder. 

Difficulties may occur among the various reading and writing components:

     Reading decoding – the ability to transform the patterns of alphabetical letters into the phonological patterns of corresponding words. An individual with a written language disorder may struggle with reading a word or letters and expressing the corresponding sounds.

     Word Recognition – the ability to identify words when reading. An individual with a written language disorder may struggle with identifying specific words when reading, either through processes of decoding or sight word recognition. 

     Reading Fluency – the ability to read words quickly, smoothly, and accurately. An individual with a written language disorder may struggle with reading words accurately in a set amount of time, and the ability to quickly identify words through decoding or sight word identification.

     Reading comprehension – the ability to understand written text. An individual with a written language disorder may struggle with making sense of different structure and understanding vocabulary. 

     Writing process – the ability to plan, organize, draft, reflect on, revise, and edit written text. An individual with a written language disorder may struggle with one or more aspects of the writing process. 

     Written product – the end of the writing process. An individual with a written language disorder may struggle on the word, sentence, or text level.

     Click here for a more comprehensive list of signs and symptoms of written language disorders from The American Speech-Language-Hearing Association. 

 

Note: This is by no means a suggestion of self-diagnosis or  unknowledgeable diagnosis of a child that may have a written language disorder or any other disorder or disability, and should not be used as a supplemental measure to diagnose any individual. If you believe that your child may have an written language disorder, visit a speech therapist for a professional evaluation. The information provided is strictly informational.

 

 

What is a Spoken Language Disorder?:

A Spoken Language Disorder, or SLD, is an impairment in the use and understanding of language across the five language domains. An SLD may be lifelong, but symptoms can change over time. Therefore, it is important to monitor the symptoms of a child with an SLD. If a professional diagnosis suggests that an SLD is present, assessment and/or treatment on a regular basis is important. SLDs may be accompanied by other conditions, such as intellectual or developmental disabilities. When they occur without the presence of another condition, they are considered a Specific Language Impairment, or SLI. They may also occur with another language disorder or difficulties in reading and writing, and social communication could also be an issue.

 

Five Language Domains and Potential Deficits:

Phonology – Phonology is defined as the system of relationships among the speech sounds that constitute the fundamental components of a language.

Phonological deficits may include:

• Delay of phonological skills (unable to understand the differences or relationships among sounds).
• May vocalize less or with less complexities when they do speak than children their age
• (in younger children) problems with early speech sounds
• Difficulty learning speech sound systems that may progress into later life with poor skill sets and abilities

 

Morphology – Morphology is defined as the structure and construction of words,  and skills that require an understanding and use of the appropriate structure of a word.

Syntax – Syntax is defined as the arrangement of words and phrases to create well-formed sentences in a language.

Morphological and syntactic deficits may include:

• Late understanding of definitions
• Restricted mean length of utterance (MLU) (restricted number of morphemes per utterance (morphological unit that cannot be further divided or broken down)) and shorter utterances in words
• Errors in verbs, function words, and pronouns
• Errors of omission and misuse
• Difficulty comprehending grammatical morphemes
• Difficulty in understanding prefixes, suffixes, past, present, future markers, etc
• Difficulty in judging grammar mistakes and/or correcting them
• Difficulty in identifying parts of speech
• Problems comprehending syntactic structure
• Simple utterances and issues with comprehending complex words/utterances

 

Semantics – Semantics is defined as the branch of linguistics and logic concerned with meaning. There are a number of branches and subbranches of semantics, including formal semantics, which studies the logical aspects of meaning, such as sense, reference, implication, and logical form, lexical semantics, which studies word meanings and word relations, and conceptual semantics, which studies the cognitive structure of meaning.

Deficits in semantics may include:

• Slower vocabulary development
• Delayed first words or word combinations
• Delays in verb skills
• Difficulty understanding new words
• Overuse of filler words
• Difficulty in asking for clarification or understanding verbal questions
• Problems with figurative language, synonyms and antonyms, etc
• Problems with organization of thought process when it comes to expression

 

Pragmatics – Pragmatics refers to the branch of linguistics dealing with language in use and the contexts in which it is used, including such matters as deixis, taking turns in conversation, text organization, presupposition, and implicature.

Deficits in pragmatics may include:

• Difficulty in socializing or playing with peers
• Problems understanding others
• Immaturity in language
• Difficulty expressing oneself
• Difficulty initiating and sustaining conversation
• Trouble with turn taking in conversations
• Uncertainties about appropriate and inappropriate language/conversations
• Trouble with organization and story cohesion/connecting thoughts out loud

 

The Role of a Speech Therapist:

Speech therapists play a crucial role in evaluating, assessing, diagnosing, and treating children that have an SLD. They can provide resources to individuals and parents of individuals that have or are at risk of having an SLD, as to suggest treatment options or the need for an evaluation, and they conduct assessments maintained for your child and the diagnosis your child has if they do have an SLD or other language disorder. Speech therapists can also provide referrals for other services. Children with an SLD all have unique attributes, so a specialized treatment plan is often implemented during therapy.

 

Note: This is by no means a suggestion of self-diagnosis or unknowledgeable diagnosis of a child that may have an SLD or any other disorder or disability, and should not be used as a supplemental measure to diagnose any individual. If you believe that your child may have an SLD, visit a speech therapist for a professional evaluation. The information provided is strictly informational.

Hearing and speech are two very important skills for children to build upon as they grow older. They help us listen and communicate with others, which leads to important developments, and there are always ways for parents to facilitate speech and language in the home with their child. There are numerous milestones that children are generally able to accomplish between certain years of their childhood. This week, we’ll focus on the milestones for children from birth to six years of age. If you feel that your child is not meeting these age-appropriate milestones, call our office for an evaluation, or speak to your child’s pediatrician for a referral for a speech therapy evaluation. For more information, you can access the website for The American Speech-Language-Hearing Association.

 

Birth to Two Years:

Your child will certainly be retaining a lot of information in their first few years of life, and it’s important that you help them learn skills that are valuable to their growth! For children two and under, you will want to be encouraging the formation of sounds. You can do so by making simple sounds, like ma, ba, and, da. Younger children like to mimic the movements and noises you make, so it can often be helpful to make movements and gestures while you make sounds. Peek-a-boo is a simple, yet fun, example of doing this. When they begin to mimic your sounds, repeat them back! Have silly conversations in gibberish. You’d be surprised just how much it helps! You can also talk to your child while performing daily tasks. While doing this, you can simply explain what you’re doing, where you’re going, who you’re going to see, etc. If you are giving your child a bath, you could say “You are taking a bath! There are lots of bubbles. Look at the bubbles!” Also try pointing out everyday objects and saying what it is called, such as pointing at some of their toys and saying “ball!” or “toy!”. Repetition can make more of a statement, so be sure to repeat these words a few times whenever you say them. You can also help them make connections between words and sounds, or even pictures. Saying things such as “The dog says woof!” or showing them simple pictures in a picture book and saying the name of the object can be really helpful in establishing these connections for your child. When reading picture books, be sure that the pictures are simple and plain. Your child may easily get tired of looking at a busy picture and lose interest in what you are showing them.

 

2 to 4 Years:

    When your child transitions into their toddler years, you’ll want to begin speaking more clearly and precisely. Your child’s speech becomes a sort of reflection of yours. You can start using more advanced words and creating simple sentences that he or she can repeat. This can include yes or no questions that they can answer, such as “Do you want juice?”. Questions that give them a choice are also helpful in creating an option for them to speak in phrases. You could ask “Do you want apple juice or orange juice?” Begin pointing out more objects and asking what they are called, as to create a better connection between the name or sounds and the visual. Singing songs is also a very good activity because it helps your child to develop a rhythm of speech. This will develop their skills to speak in clear sentences as they get older. Asking your child about familiar people and what their names are will help him or her to recall the information they have heard and repeat it back to you.

 

4 to 6 Years:

    At this stage, your child will begin to understand more complex language. You should start incorporating new words and language skills into your conversations, such as directions (the car is on the left), opposites (up and down, quiet and loud, etc), requests (go get your jacket please), and rhyming (cat, sat, that, mat, etc). You can start asking questions or stating sentences that require your child to fill in the information or guess the answer, such as “What do we say when someone gives us a gift?”. As they have a more complex understanding of the things you are saying, they can start following 2 or 3 step requests, such as “Go to the closet and get your jacket”. You can practice communication skills in any situation, while at the grocery store or while making dinner.

 

Next week we will be addressing speech and language by grade level and later years, which may involve children with dyslexia, down syndrome, autism, etc. Check back for an updated post, and thanks for reading!

 

Welcome back to Helping Hands Pediatric Therapy’s blog!

School is back in motion, and your child’s pencils should be, too! We thought that handwriting would be a great topic to discuss this week, and we have the perfect suggestions for any child learning to write, or children that need to improve their skills. If you’re interested, we also have some general milestones in handwriting and drawing for children 1-6 years written by MamaOT. The link to her blog is at the bottom of this page, along with some of her knowledge on age-specific milestones.

 

Handwriting is a learning process for children that may require some additional tools or guidance. You want to start off on the right foot (or hand!) and prevent any bad habits that your child could pick up. Often times this begins with your child’s grip. When your child begins learning how to write letters and words, their grip should be somewhat established by fine motor skills learned through simple tasks they have performed with their hands. As always, you still want to encourage a sturdy grip that does not block movement of the writing utensil, cause discomfort in the wrist or hand, or one that causes poor legibility. The primary grip that a child will learn as they begin handwriting is the tripod grip, shown below.

This way of grasping a pencil helps to reduce discomfort and improve legibility. Sometimes adding a rubber pencil grip helps to allign the fingers into this position. Practicing scissor cutting or play-dough activities can also promote muscle memory as to improve their grip as well.

Your child’s posture is also an easy way to make handwriting more comfortable. While writing on a desk or table, your child should be sitting upright in their chair with both feet flat on the floor. Also, make sure the paper they are writing on is stable by having your child hold the paper with one hand while they write with the other.

When your child begins writing, you may want to start with paper that has large spaces between the lines, as many children have larger handwriting to begin with. The lines on the paper are very helpful in establishing the start and end of letters, as well as spacing between those letters and words. Graph paper may also be helpful when your child is learning how to practice spacing. Beginning with a model of the alphabet is an easy way to establish precise letters. Some companies sell booklets with pages full of modeled letters and words, such as Handwriting Without Tears. Tracing these letters will set a good example of what your child’s letters should look like. Auditory explanations of how to write a letter can also be helpful sometimes, such as “top to bottom, left to right” for a ‘t’. You may also want to encourage your child to say the letters or words aloud as they write them, or use the cues that you have taught as guidance. Practicing cursive handwriting may also be helpful when it comes to improving legibility.

There are also many tools that are available for improving handwriting:

1. Workbooks – there are many handwriting workbooks available for specific grade levels and types of writing, such as print or cursive. Handwriting without tears is a great company to go to if you are interested in such workbooks. Click on the link below to be taken to their workbook page.

Handwriting Without Tears Workbooks

2.) Slant boards – these will establish a position that is efficient for wrist extension that facilitates a tripod grasp, as well as shoulder stability. Click on the link below to view the Therapy Shoppe’s slant boards.

Therapy Shoppe Slant Boards

3.) Pencil grips and claws – grips encourage stable pencil grasps and facilitate a tripod grasp. Click the link below to view the Therapy Shoppe’s grips and the C.L.A.W grips.

Therapy Shoppe Grips

The Writing Claw

4.) Therapy Putty – putty helps to facilitate fine motor skills and muscle memory. Click the link below to view the Therapy Shoppe’s therapy putty options.

Therapy Shoppe therapy putty

 

Keep in mind that your child should be reaching some general writing and drawing milestones before they begin handwriting. MamaOT has a great list of these, shown below.

 

1-2 years
•Scribbling
•Imitating vertical lines, horizontal lines, circular scribbles

2-3 years
•Imitating cross
•Copying vertical line, horizontal line, circle

3-4 years
•Drawing circle without a model

4-5 years
•Imitating square
•Copying cross, square, right and left diagonal lines, X shape, some letters and numbers
•May be able to write own name
•Drawing a recognizable face with eyes, nose, mouth
•Drawing a basic stick figure with 2-4 body parts
•Coloring inside a circle and filling it at least halfway

5-6 years
•Copying triangle
•Printing own name
•Copying most capital and lowercase letters
•Drawing a person with at least 6 body parts

 

Check out MamaOT’s blog for plenty more information regarding these milestones! We have provided the link below:

MamaOT Blog: Developmental Progression of Handwriting Skills

 

As always, thanks for reading, and check back next week for an updated post!

 

We have welcomed Paige as our new office manager here at Helping Hands! She has shared some of her experience as being a mother of a special needs child and some advice for other parents as well. Take a look!

 

    “As a mother of a son with special needs, I think the best thing I have to offer other parents as well as therapists is my ability to listen. I enjoy having conversations with other parents about our struggles and the accomplishments that our kids have made through therapy. As parents of children on the spectrum we understand that not every child is the same, but it is important to feel as though you have a friend who is going through some of the same hardships as you, and having someone there to listen to your concerns and frustrations, without casting any judgement is one of the best things you can have. Everyone needs to vent. I strive to make myself available to listen and give input where it is needed every day. After a hard session or even a session where a child has accomplished a goal they have been working on for months, the therapists need someone they can vent to, or give praise, too, and I hope I am able to be that person for them in between clients. I hope I can share with other families that admitting your child needs a little extra help doesn’t mean you have failed as a parent, it means that you love your child enough to do whatever it takes to give them the resources and tools they need to achieve the life they deserve.

    My son was just diagnosed as being on the spectrum 2 weeks ago, so I am still learning to understand his diagnosis and what resources are out there for families like ours. We noticed our son was behind in hitting his milestones at a very young age (6 months), and even though we were initially scared of the words autistic and special needs and thought, “no that can’t be our perfect little boy”, we decided then and there that we would do whatever it took for our son to live his best life. I love taking him to the pool, or the splash pad. He loves water, and the joy that he feels while in the water makes everything worth it. To see that big cheesy smile and his “happy arms” makes every worry or concern I have for him magically disappear, for that moment. We also love playing “ball”. He loves to sit on the floor and roll the ball back and forth with me. His giggles and smiles bring me so much joy, it’s my favorite part of the day. My son has so many amazing qualities, there is no way I could choose only one. I have learned so much from him in his short 2 years. I love his innocence, I hope he is able to hold on to a piece of that throughout his life. He has a very caring heart, and has just recently started giving us kisses and hugs. And I love his ability to make me smile no matter what is going on or challenge we are facing. His personality is one of a kind and another one of my favorite qualities he possesses. Overall he is an amazing kid, and I cannot wait to see where the future leads us.”   

 

    The calendar has quickly wound its way down to August and back to school season. Balancing your special needs child’s schedule as well as yours can always be stressful – and let’s be honest, it will be! – but we have a few tips on how to keep calm this year. From staying on top of the easy stuff to making morning routines just a little bit easier, you can definitely find a way to make this school year flow for you and your child. Don’t worry, we’ve got your back!

    It may seem like everything is fast approaching, but you can slow it down just a little by keeping track of the small things first. Of course, you should always stay in contact with your child’s teacher(s)! You’ll want to stay in the know about weekly activities and how your child is performing in class. Parent-teacher conferences are easily scheduled for elementary school-aged children, and we recommend you keep them in your schedule. A quick thirty minutes with your child’s teacher is a great way to stay updated on his or her activity throughout the school day. For children in middle or high school, parent-teacher conferences may not always be easily scheduled due to having more teachers throughout the day for some children, but you can always email your child’s teacher(s) or set up a meeting with their school counselor if necessary.

    It is important to follow up with your child’s IEP as well. You should make sure that it is being followed throughout the school year and that any updates you may have made are being implemented as well. If you feel the need to review it, don’t hesitate! Make sure that it is accommodating to your child and find what works best. You may also want to speak to your child’s teacher(s) about integrating a comfortable seating arrangement and including a break from classroom activities when they have become overstimulated. For children that are easily overstimulated due to sensory issues, you may want to implement the use of headphones with quiet classical music to reduce auditory distractions. Some children may also have trouble paying attention, which could be helped with appropriate seating. Sitting at the front of the classroom in a corner seat is often helpful to reduce distraction and to maintain your child’s attention. You and your child’s teachers’ top priority is to help your child learn and develop everyday skills, so it is important to create an environment that will help them do just that!

    Not only should you focus on your child’s performance at school, but their performance at home as well! A visual routine could be very helpful in setting an example of how every day will be. A visual routine is a way to show your child what they will be doing throughout the day and to get them accustomed to a regular routine. You may want to take pictures of tools or items in the classroom rather than using cartoon pictures to create the connection with your child. Go over what they may be doing or using during class time. Making your child comfortable with these things will make you more comfortable that they are doing great in a classroom setting and reduce some stress you may have. A visual routine could also be helpful for getting ready in the morning as well. We all know that the morning routine can get extremely stressful, especially with a special needs child that may need more help getting ready. Take pictures of activities you and your child will do every morning and practice these activities in the order they go in to make getting ready more comfortable. Include the basics, such as brushing teeth and hair, as well as getting dressed and packing up to go.

    Planning ahead is a fantastic way to reduce the time it takes to get out the door in the morning, too! Lay out the next day’s outfit the night before, and plan the morning’s breakfast with a picky eater. Make your routine interactive! Have your child perform basic chores and include a balanced sensory diet every day in order to encourage interaction in the classroom and improve their attention to the teacher during instruction. Learning is so valuable to any child, and it’s important to make sure they can do it to the best of their ability!

     At the end of the day, both you and your child will probably be at least a little stressed out or tired, so it’s always a good idea to find ways to de-stress and make the day easier. Here at Helping Hands, we understand how getting back to school can be hectic, but we sure hope that our tips might help make your day a little bit easier.

 

Thank you for reading! Check back next week for an updated post.