Collaboration

ASHA's Code of Ethics governs the practice of Speech Language Pathologists and other care providers in the field of communication sciences and disorders. ASHA requires respectful, family centered care and professionalism in all settings and situations. SLP requires team care and open communication between all care providers, including SLPs, doctors, ENTs, audiologists, family members, etc. It is crucial that SLPs collaborate with families and their patients to best meet their needs and serve them to the fullest extent. Families serve as great sources of information and can provide practitioners with great insight into how to best treat their patients. By including families in therapy and shared decision making, families will be empowered and better able to support their children with communication disorders. This is important as families play a large role in a child's development and therapy. Families will affect the patient, just as the patient will affect the family. As a future SLP I must realize that I will not work with just patients with communication or feeding disorders, but also with their entire families and many other professionals as well. I must be aware of the fact that disorders and disabilities add a great deal of stress and challenges and must be sensitive to these challenges and stressors. It is my responsibility as a future SLP to address and treat communication disorders in the most effective manner while always serving as a resource to my patients and their families. My hope is to always include families in therapy and make them feel welcome and respected by collaborating often and always maintaining open lines of communication. My ultimate goal to ensure that everyone has access to effective communication. ASHA's Code of Ethics can be found at http://www.asha.org/docs/html/ET2010-00309.html.

Cleft Palate and Cleft Lip

Cleft palates and cleft lips are disorders that result in an opening in the lip or an opening in the roof of the mouth (palate). Cleft palates and cleft lips can occur alone or together and can be bilateral or unilateral. Cleft palates and cleft lips can negatively affect a child's feeding, hearing, and speaking. Children and families with cleft palates or cleft lips should see a speech language pathologist, an audiologist, and an ENT, as middle ear trouble is common in children with cleft palate and can lead to hearing loss. Many children with cleft palate and cleft lip will need repairative surgery, but SLP's can address the children's speech and help to develop and strengthen the appropriate facial muscles, articulators, and palatal muscles. Many children with clefts will have difficulty eating, especially as infants, because milk will often come out of their noses. This can lead to malnutrition. Parents and families can have difficulty coping with the physical appearance of cleft palates or cleft lips and the challenges associated with caring for a child with a cleft. Doctors, SLPs, ENTs, Audiologists, and other families familiar with clefts can be a great support and resource for families with children with clefts. More information on cleft lips and cleft palates can be at http://www.asha.org/public/speech/disorders/CleftLip/ or the American Cleft Palate Craniofacial Association (http://www.acpa-cpf.org/).
Below are examples of a cleft palate and cleft lip found on google images.

In continuing with the language-based learning disabilities topic, I found some specific strategies that families, teachers, and SLP’s can use to help children with the disorders improve their communication, reading, writing, and spelling. According to ASHA, “Individualized programs always relate to the school work. Therefore, materials for treatment are taken from or are directly related to content from classes (e.g., textbooks for reading activities, assigned papers for writing activities, practice of oral reports for English class). The student is taught to apply newly learned language strategies to classroom activities and assignments. To assist the child best, the SLP may work side-by-side with the child in his or her classroom”. If comprehension or speaking and listening is the issue, family members, SLP’s, and teachers can help the child focus on key details by teaching him/her comprehension strategies, discussing written pieces with the child, and/or have the child state and write answers to questions about the story, even asking the child to give a written or verbal summary of the story. If articulation, pronunciation, or letter-sound ID/distinguishing sounds is the issue, treatment can include rhyming activities, tapping out syllables, or asking children to read or write lists of printed words containing the target sounds. In general, it is helpful to provide simple, step-by-step directions and information in writing and orally. It is also helpful to speak slowly and provide many examples and definitions of vocabulary words. 

It is important to remember that each child and his/her needs are unique and that only once a child has been observed and evaluated can an effective and individualized treatment plan be created. As with all disorders, the more supportive individuals that are in the child’s life, the better his/her prognosis and development will be. For that reason, it is very important that teams of parents/caregivers and professionals work together to support and address each child’s needs. Helping families understand disorders/disabilities, helping them to create realistic goals and expectations for their children, giving them helpful resources, and allowing them to have an important role in their children’s therapy is very important for the family and for the child.   

More info on language based learning disabilities can be found at: http://www.asha.org/public/speech/disorders/LBLD/

Language-Based Learning Disabilities

When exploring the ASHA website I came across several articles on Language-Based Learning Disabilities. As I mentioned earlier on my blog, communication disorders can affect children socially and academically. Language-based learning disabilities are an example of how poor speech and language skills can negatively affect learning and academic performance. “Language-based learning disabilities are problems with age-appropriate reading, spelling, and/or writing” (ASHA). Dyslexia is an example of a language-based learning disability. Children with language-based learning disabilities often have trouble with: the spoken and written word, expressing ideas clearly, learning new vocabulary, understanding questions and following written or oral directions, recalling numbers or words in sequence, reading and comprehending material, learning words to songs or rhymes, identifying letter sound relationships, spelling, etc. (AHSA).

Language-based learning disabilities can affect not only the children, but also his/her family in many ways. The child’s poor school performance can result in stress and tension in the family, as most parents want their children to do well and are frustrated by the child’s misbehavior or seeming inability to do simply things, such as following directions or recalling numbers or words. Stress can also result in terms of strained relationships and financial burden, as tutors and speech language pathologists can be costly. Luckily, there are resources for these families and their children. Language-based learning disabilities can be addressed and overcome with the help of knowledgeable and supportive teachers, speech language pathologists, and family members. The first step is to diagnose the disorder and identify specific areas of need and/or concern. By working with the child and family and observing them in several situations, SLP’s can collaborate with teachers and the family to create an individualized plan of care that addresses the child’s reading, spelling, and/or writing. By recognizing and treating a children’s language-based learning disability she/he will benefit socially and academically and parents will know what to expect and how to help their children. 

PECS

In exploring effective communication strategies for children with Autism I came across the article USING THE PICTURE EXCHANGE COMMUNICATION SYSTEM (PECS) WITH CHILDREN WITH AUTISM: ASSESSMENT OF PECS ACQUISITION, SPEECH, SOCIAL-COMMUNICATIVE BEHAVIOR, AND PROBLEM BEHAVIOR by Marjorie H. Charlop-Christy. The article discusses the effectiveness of the Picture Exchange Communication System known as PECS in terms of increasing verbal speech, social communicative behaviors, and decreasing problem behaviors.

PECS is an augmentative communication system that uses behavioral principles and techniques such as shaping to teach children functional communication using pictures.  The child will keep the PECS board, a notebook with velco, and is taught to use the pictures to create sentences such as “I want” card plus “juice” (a picture of juice) card. The picture below is an example of a sentence a child could create with his/her PECS board.

    

PECS encourages nonverbal children to make requests (“I want [juice]”), answer questions (“What do you want?”), and make social comments (“I see [the ball]”). The PECS books are used internationally with children with Autism and are beneficial for many reasons. PECS encourages and teaches children to communicate, but it does not require very complex motor skills or the learning of a new language, such as sign language, it is inexpensive and can be used across varied settings, and can be taught fairly quickly. PECS is unique in that it requires children to approach listeners and initiate communication, instead of just answer questions.

The article stated that the study found that PECS does significantly improve verbal speech (both spontaneous and imitative speech), does improve social communication behaviors, and does decrease problem behaviors, such as aggression. All three participants (3 young boys with Autism) experienced gains in speech and in the mean length of utterances. This was very encouraging to me because PECS is an effective strategy/resource that I can use with my future SLP patients and something that I can recommend to families to use with their children with Autism. A simple system such as PECS can improve the communication and quality of relationships within the family and reduce stress that is caused by a lack of communication and problem behaviors associated with Autism.

This journal article can be found at    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1284381/pdf/12365736.pdf.

Here is a short video of a parent using PECS at home to communication with her son:  http://www.youtube.com/watch?v=98b_oSlxLvU&feature=endscreen&NR=1

Communication disorders can often occur as a result of, or in combination with, other disorders/disabilities. One such disability is Autism. Children on the Autism spectrum often experience deviant or delayed speech and language skills (Charlop). While the amount of communication varies for each child (ranging from nonverbal to fully capable of speaking in depth), many children with autism have a very difficult time expressing themselves through expressive language and verbal communication. Nearly 50% of children with autism will remain mute and many children with autism lack social skills (Charlop). Having a nonverbal child can be incredibly challenging. Not only is it difficult to meet your child’s needs, it can also be difficult to bond with a child who does not communicate or show affection. Children with autism often display frustration and problem behaviors as a result of not being understood and/or listened to. For parents of children with autism, learning to communicate effectively is crucial. I found an interesting article called Learn to Speak Your Autistic Child’s Language that describes ways that parents can effectively communicate with their children on the autism spectrum and ways to teach their children how to better communicate. The article states that children with autism attend heavily to shapes and pictures and that it is best to communicate with children with autism visually. This means drawing pictures, pointing, and writing sentences whenever possible. The article also encourages parents to allow children with autism to communicate visually with them through pointing, drawing, or even typing. The article suggests using highly visual imagery when talking to children with autism. For example if you want them to eat their breakfast, instead of saying “Come eat your breakfast” it is better to say “I want to see your bottom in the kitchen chair so that you can look at your cereal as you eat it”. Children with autism are usually very literal and have a hard time picking up on emotions and subtle gestures. For this reason, it is best to be very literal and direct with your child. Telling a child with autism to "get on their coat" could result in the child literally standing on his/her coat. Instead it would be best to say, "Please put your coat on your body so that you will not be cold outside".

In general, parents of children with autism need patience and an understanding of how their child’s brain works. Even if your child cannot or does not use verbal language, you can still communicate with your child in other ways and teach him/her how to express themselves. The article I read can be found at http://www.everydayhealth.com/autism/learn-the-language.aspx. I think speaking to children with autism visually is a great strategy that could be beneficial for many children, parents, teachers, and other professionals working with children with autism. I am going to continue looking for other communication strategies/techniques for children with Autism this week as well.

To learn more about Selective Mutism (SM), which is a relatively low incidence disorder, I read a journal article called Multiple informants’ report of emotional and behavioural problems in a nation-wide sample of selective mute children and controls by H. Kristensen. In the study, children ages 4-16 with and without SM were assessed using the Child Behavior Checklist, the Teacher Report Form, and the Youth Self Report. This article found that many children with SM have internalizing and externalizing problems, but that children with SM differ mostly from their non SM counterparts in terms of the withdrawn scale. This proves that SM is an expression of severe social anxiety. Children with SM can appear withdrawn, sullen, depressed, fearful, anxious, and/or be very easily startled. It is believed that most children with SM experienced an event that was viewed as traumatic by them, causing a great deal of anxiety and/or embarrassment. These “traumatic” events can be as subtle as being laughed at when speaking or not liking the sound of one’s voice. Children with SM have been found to: have low self esteem, lack confidence, and have difficulty socializing in situations outside of the home. However, SM has not been linked to other behavior issues and having SM has not been shown to lead to the development of other behavioral problems/disorders.  

To get a parents perspective on SM I also read the article The Children Who Choose to Stay Silent. In the article parents discuss what it is like to have a child with SM. One parent describes having a normal, talkative, even outgoing, child at home but one who transforms into an anxious and silent student within feet of her school. Zoe, the mother of a young girl with SM, said: “How can anyone so young feel that much fear? I’ve been told she will talk in her own time and I have to be patient, but it’s so hard to watch, especially when you know how different your child can be at home. It just breaks my heart for her.” I can only imagine how sad and frustrating that must be as a parent. To know your child can be open and social, but not know how to help him/her overcome their fear of certain situations must be really hard. As an SLP, I will need to remember how important is is to address family's needs as well as my patients, as it is obvious that disorders/disabilities impact the entire family. The article can be found at: http://www.dailymail.co.uk/femail/article-2124284/The-children-choose-stay-silent-The-sad-surprisingly-common-plight-youngsters-selective-mutism.html#ixzz1r5NjoAmbhttp://

While reading one of my classmate’s blogs, I came across the communication disorder known as Selective Mutism (SM). SM is when a child has full capability to talk, but refuses to speak in certain situations, such as at school. According to ASHA, “A child with selective mutism does not speak in certain situations, like at school, but speaks at other times, like at home or with friends. Selective mutism often starts before a child is 5 years old. It is usually first noticed when the child starts school”. The child’s decision to be selectively mute is often linked to intense anxiety in social situations. ASHA lists treatments for this behavioral disorder as well things teachers can do to support and encourage speech. These suggestions can be found at http://www.asha.org/public/speech/disorders/selectivemutism.htm and include:

·         Stimulus fading: involve the child in a relaxed situation with someone they talk to freely, and then very gradually introduce a new person into the room

§  Shaping: use a structured approach to reinforce all efforts by the child to communicate, (e.g., gestures, mouthing or whispering) until audible speech is achieved

§  Self-modeling technique: have child watch videotapes of himself or herself performing the desired behavior (e.g., communicating effectively at home) to facilitate self-confidence and carry over this behavior into the classroom or setting where mutism occurs

If specific speech and language problems exist, the SLP will:

§  target problems that are making the mute behavior worse;

§  use role-play activities to help the child to gain confidence speaking to different listeners in a variety of settings; and

§  help those children who do not speak because they feel their voice "sounds funny".

Work with the child's teachers includes:

§  encouraging communication and lessening anxiety about speaking;

§  forming small, cooperative groups that are less intimidating to the child;

§  helping the child communicate with peers in a group by first using non-verbal methods (e.g., signals or cards) and gradually adding goals that lead to speech; and

§  working with the child, family, and teachers to generalize learned communication behaviors into other speaking situations.

Parents play a critical role in helping children with SM as well. SLP’s often have to rely on parents and family members to give them information about the child, such as if any other problems (schizophrenia, PDD, etc.) exist, the environmental factors in the household, child’s symptoms, child’s amount of verbal expression and where this verbal expression does and does not occur, family history, and the child’s speech and language development. SLP’s also review a child’s educational history, do a hearing screening, and an oral-motor examination before creating a therapy plan for each child with SM.

Only about 10% of Selective Mutism children appear to have a language, learning or speech articulation problem. Because SM seems like more of a behavioral issue than a true communication disorder, I would like to look into the amount of children with SM that also have other behavioral issues, such as anxiety disorder.   

While researching communication disorders and resources for families of children with communication disorders/delays I realized that not all people will have access to the internet. For this reason, I decided to look for additional resources that might be more readily available to all families. I was able to find many books written on the topic that might serve as sources of information and support to families. These books include:  The Parent’s Guide to Speech and Language Problems by Debbie Feit, More Than Words: Helping Parents Promote Communication and Social Skills in Children with Autism Spectrum Disorder by Fern Sussman, It Takes Two To Talk: A Practical Guide For Parents of Children With Language Delays by Jan Pepper, The Late Talker: What to Do If Your Child Isn't Talking Yet by Marilym Agin, and Childhood Speech, Language, and Listening Problems by Patricia McAleer Hamaguchi. I was happy to find a great short book about stuttering that was written for children (Sometimes I Just Stutter by Eelco de Geus). This book discusses stuttering in an open and encouraging way and includes letters from many people who stutter. I was also able to find activity books and videos that promote speech and language development, such as Let's Talk Together - Home Activities for Early Speech & Language Development by Cory Polland and Baby Babble DVDs.

All of these resources are written by experts, SLP’s, and/or parents who have experienced raising a child with a communication disorder. I found all of these books and DVD’s at my local library, which is a great free resource that all families can use.

Stuttering

Today I am going to discuss the communication disorder known as stuttering. According to The Stuttering Foundation, “Stuttering is a communication disorder in which the flow of speech is broken by repetitions (li-li-like this), prolongations (lllllike this), or abnormal stoppages (no sound) of sounds and syllables”. In American alone there are about 3 million people who stutter. Of those 3 million people approximately 70% are children. 5% of all children will experience stuttering at some point in their lives, but most cases of stuttering last only 6-12 months. Stuttering affects boys four times more than it affects girls and can be the result of genetics, neurophysiology, family dynamics, and/or child development (The Stuttering Foundation). Stuttering can negatively affect children’s abilities to effectively communicate, their self-esteem and confidence, and the development of social relationships. Family members of children who stutter are also affected by the disorder as they feel pressure to correct their child’s stuttering and sometimes feel that they are the cause of their child’s stuttering. This can add stress to the family in the form of guilt, frustration, strained relationships, etc., as some parents find it hard to listen to their child when s/he is stuttering. It has been found that stuttering is not an emotional or psychological problem and is not caused by parents or family members (The Stuttering Foundation).

To help a child who stutters early intervention and support is key. Parents should not correct their child while she/he is speaking, as this only draws attention to the inaccurate fact that something is wrong with the child or the way he/she speaks. Parents should be good listeners, talk slowly and concisely so children can imitate this speech, and make time for each child. Speech Language Pathology is especially helpful in teaching children how to manage their stuttering and develop more fluency in their speech. For additional information on stuttering and tips, videos, and resources on how parents can help their children who stutter visit:   http://www.stutteringhelp.org/Default.aspx?tabid=151,  http://www.stutteringhelp.org/Default.aspx?tabid=4, or http://www.mnsu.edu/comdis/kuster/Parents/childwhostutters.htmlm.

In the last post I discussed resources and services available to families with children who have communication disorders. Family members play a very important role in the therapy and development of children with communication disorders. Parents and family members can extend speech therapy at home by encouraging and helping the child practice his/her language, sounds, and oral-motor movements for a few minutes each day. For example, family members can model sounds and mouth movements for the child, engage the child in conversations that use the target sounds, read books with the target sounds, play games that encourage the use of the sounds or words, engage children in social scenarios and authentic language experiences to enhance their social skills, etc. Doing tongue twisters, blowing bubbles, and other exercises can help children develop and strengthen muscles necessary for speech and swallowing. Even a simple reminders such as "use your good sounds", "lips together", "tongue up" can be very helpful. The more children with communication disorders talk and experience speech, the more they benefit. Being supportive, talking to and with your child, and practicing the sounds and oral-motor movements frequently at home is the best thing that family members can do. Often times SLP's encourage families to participate in the therapy sessions and suggest specific activities to do at home as well. For an article on additional ways to help children overcome speech disorders visit:  http://voices.yahoo.com/how-help-child-overcome-speech-disorder-3519661.html

      A child does not grow up in isolation. Each child affects and is affected by many aspects of their environment.  Families, schools, churches, culture, etc., all impact a child’s development and his/her beliefs and values. For this reason, a childhood communication disorder affects the entire family.    
         Once getting a diagnosis of a speech/language disorder, families might feel a sense of grief, fear, anger, helplessness, etc. Raising a child with any type of disability is associated with successes and joys, but also with specific challenges and stressors.  Challenges and stressors that families with children with communication disorders face include, but are not limited to: an inability to communicate with your loved one, an inability for your loved one to express his/her needs, feeling the need to always speak for your child or family member, locating resources and services for your family member, the feeling that your family member is not listening or complying with rules, and seeing your child or family member struggle to read, understand, interact, and develop important social skills and relationships on a daily basis. Communication disorders can also add additional emotional and financial strains.            
         The most important thing families of children with communication disorders can do is get informed and educated about your child’s specific communication disorder. There are great online and print resources about almost every communication disorder, as well as support groups, and pamphlets at local hospitals and schools. Understanding the disorder and its symptoms can not only help families cope, but it can also help families create realistic goals and be effective advocates for their family members. It is also very helpful to get in touch with local service providers, speech language pathologists, and schools to create individualized plans of care. Because early intervention is so crucial, Help Me Grow, Child Focus, and Head Start Preschools are great resources for families of infants, toddlers, and young children with communication disorders. Once in an elementary school, children with communication disorders are entitled to an IEP (Individualized Education Plan) and services from the school-based SLP. Local hospitals, such as Children’s Hospital, also have great speech language pathologists that work with and address the needs of children and their families in respectful and caring manners. Parents and families have every right to participate in the formation of IEP’s, goals for their children, and the actual therapy itself. Parental/family involvement and support is highly encouraged and very beneficial to the children with the communication disorders.

Additional information and resources for parents and teachers of children with communication disorders can be found at: http://www.voicenation.com/resources/article-library/a-childhood-language-and-communication-disorder-guide-for-parents-and-teachers.shtml.

  

While researching more about apraxia of speech, I came across an interesting article about Childhood Apraxia of Speech (CAS). It is written from a parent's point of view and gives insights that only a parent of a child with a speech disorder could have. The article gives great information about CAS, as well as some parental accounts of when they suspected that their children might have a speech/language disorder. The article can be found at: http://www.curiousparents.com/Parenting/xq/asp/article.408special/qx/parenting_article.htm

The term “communication disorder” covers a broad range of disorders that affect speech and language. A communication disorder can be categorized as: an articulation disorder, a fluency disorder, a voice disorder, a language disorder, and/or a phonological disorder. Communication disorders can occur alone or can be a result of another condition, such as autism, brain damage due to birth defects, etc. The link below provides some facts and figures about these types of communication disorders: http://www.rhsc.org/files/communication-disorders.pdf. 

            Today I am going to discuss the communication disorder known as Childhood Apraxia of Speech (CAS). “Childhood Apraxia of Speech is an oral-motor disorder (mouth-movement problem) that causes the child’s speech to be hard to understand. It is usually detected after two years of age, when speech development is noted to be delayed” (Cincinnati Children’s). According to http://testyyettrying.blogspot.com/2011/04/what-is-childhood-apraxia-of-speech-and.html, CAS is “a relatively uncommon neurological disorder caused by problems with motor planning and programming of the movements necessary to produce speech. Children with Childhood Apraxia of Speech do not have a problem with the actual structures and muscles involved in speech production. There is no evidence of weakness in the muscles of the face, jaw, lips, or tongue. Children with CAS also generally do not have problems knowing what they want to say. They can formulate the message in their mind and the muscles are capable of producing speech. The message just doesn't travel from the brain to the mouth properly.”         

            Ultimately, apraxia of speech in the inability to say or “get out” what you want to say, even though you have the ability to form a clear message in your mind and the physical strength and structures to produce sounds/words (lips, tongue, palate, etc.). Usually children with CAS are late talkers who babble infrequently and use one or two sounds for everything, often relying on grunting and pointing for communication. Some characteristics of CAS that SLP’s and families can look for are:  “child makes more errors when attempting to produce longer words or phrases (multi-syllable words or multi-word sentences), child has abnormal prosody (unusual stress patterns, intonation, volume control, and rate issues), errors are inconsistent, if the child says the same multi-syllable word three times it will come out differently each time, child has a reduced number of vowels and demonstrates vowel errors, child has significant difficulty imitating words and phrases, child uses predominantly simple syllable shapes (they substitute shorter, simpler words for longer, more complicated ones)”.

            I can only imagine how frustrating CAS would be for the child and for the family members. Luckily, CAS can be addressed with speech therapy. Some interventions/methods of therapy for CAS include helping children learn new motor skills (movements for speech sounds and words), frequent practice of sounds, and rebuilding of connections from the brain to the mouth. It is important that parents practice these sounds and movements at home with their children as well. Articulation picture cards for one and two syllable words, games, forming and ordering words into sentences, mirror work, and message boards are all things that SLP’s and parents might use to address CAS. 

Additional information and resources for parents can be found at: http://testyyettrying.blogspot.com/p/childhood-apraxia-of-speech-resource.html

http://www.asha.org/public/speech/disorders/childhoodapraxia.htm

www.cincinnatichildrens.org/health/v/verbal-apraxia/

A speech language pathologist (SLP) works with a wide range of diverse children. As an SLP in a school, inpatient, or outpatient setting, you work with children with communication disorders and their entire families.  A disorder or disability can impact the entire family, both positively and negatively. It is the SLP’s job to address the patient’s needs, but also to provide information, resources, and counseling to the family members of their patients. When first getting a diagnosis of a disorder/disability, families encounter many emotions: fear, sadness, anger, uncertainty, grief, etc. According to Mary Friehe, “When a child is diagnosed with a communication disorder, family members often are confused and in shock. They are not prepared for the challenges associated with a long-term communication disorder, and family-focused resources are not readily accessible. The sense of loss related to the diagnosis may provoke a grief reaction, which, if not resolved, could lead to depression and other problems for the family and the child”.

Speech language pathologists are committed to working with families to best meet their patients’ needs. Parents and families play integral roles in their children’s therapy and development, are often the children’s strongest advocates, and can provide SLP’s with critical information about their child’s development, culture, etc. “As part of the team of specialists who work with a family throughout the phases of diagnosis and intervention, speech-language pathologists (SLPs) need to understand the impact on the family of a sense of loss that may accompany a communication disorder diagnosis and how best to assist with coping strategies” (Stone, 1992). The SLP functions as a counselor and educator whose role is to help the family adapt (American Speech-Language-Hearing Association [ASHA], 1999).

SLP’s play an important role in helping children communicate effectively, but in order to provide the most effective interventions and therapies, a collaborative relationship must be established with the young patients’ families. Not only is it important to understand the role that families play in overcoming communication disorders, it is also important to understand that there are numerous communication disorders, all with their own implications, affecting children and families in different ways and requiring individualized therapies and interventions. With each patient, an SLP must create a plan of care that is tailored to the patient and his/her family. As I explore communication disorders more, my goal is to discuss one disorder at a time, how that disorder can affect children and their families, and what specific interventions and resources are available to them.  

      I have been looking into communication disorders that affect children and found a great website that explains what a communication disorder is, characteristics of children with communication disorders, and how communication disorders affect learning/education. The site is: http://www.cec.sped.org/AM/Template.cfm?Section=Communicative_Disorders&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=37&ContentID=5626. According to this site, "Children with communication disorders have deficits in their ability to exchange information with others. A communication disorder may occur in language, speech, and/or hearing. Language difficulties include spoken language, reading and/or writing difficulties. Speech encompasses such areas as articulation and phonology (the ability to speak clearly and be intelligible), fluency (stuttering), and voice. Hearing difficulties may also encompass speech problems (e.g., articulation or voice) and/or language problems. Hearing impairments include deafness and hearing loss."
      Communication disorders can be incredibly frustrating both to the individual with the disorder and his/her family members. The site above goes on to explain that children with communication disorders may have difficulty: following directions, initiating and attending to a conversation, pronouncing words, perceiving what is said, expressing oneself, and/or being understood. Can you image how frustrating it would be to not be able to express your wants or needs, for others to not understand what you are saying, or for you to not understand what others are saying to you? Communication disorders affect family members too. It can be extremely challenging and isolating to not be able to effectively communicate with your own family member. Your child or brother or sister not being able to talk to you, not following your directions, and not initiating any type of conversation, even a simple "Hi" or "I love you" can be very stressful and can affect bonding and the type of care and support children receive. Luckily, there are resources and therapies available to help children and families learn to communicate effectively, such as SLP's, speech therapy, and augmentative and alternative communication. In later blogs I hope to discuss in more depth how communication disorders affect families (positively and negatively), specific communication disorders, and resources that are available to help these children and their families.   

I wonder how having a child (or children) with speech, language, and/or feeding disorders affects communication, bonding, and relationships that develop within the context of a family. What resources are available to these children and their families? Through this inquiry blog, I hope to learn about and discuss several speech/language disorders that affect children and the ways that these disorders impact families. I also hope to find and share some ideas and resources that SLP's, teachers, and families use to develop and achieve effective communication and close relationships.