What is Speech Therapy?

Speech Therapy is a specialised intervention designed to help individuals overcome challenges related to communication, language, speech, and even swallowing. For young children, it often focuses on addressing delays or disorders in language development, helping them communicate more effectively.

If you're a parent, you might wonder whether your child is reaching the expected speech and language milestones or if they need extra support. Understanding the basics of Speech Therapy, including language milestones, the differences between expressive and receptive language, and how to encourage early communication, can help you guide your child through their language journey.

Speech Therapy and Language Milestones

Children typically develop language and speech at their own pace, but there are general milestones that can indicate whether a child is progressing typically. Missing these milestones doesn't always mean there's a serious issue, but it can be a sign that extra support might be beneficial.

Here are some key language milestones to look out for in the early years:

• By 6 months: Your baby should respond to sounds, coo, and laugh.

• By 12 months: Your baby may start using simple words like "mama" or "dada" and understand basic instructions like "no" or "bye-bye."

• By 18 months: Your child should have a vocabulary of 10–20 words and be able to point to objects they want or need.

• By 2 years: Your child should be using short phrases like “more milk” and have a vocabulary of 50+ words. They should also start to understand and follow two-step directions (e.g., “pick up the ball and give it to me”).

• By 3 years: Children are usually forming complete sentences, using pronouns like “I” and “me,” and being understood by strangers about 75% of the time.

If a child isn't reaching these milestones, a Speech-Language Pathologist (SLP) may be able to help.

Expressive vs. Receptive Language

A common distinction in Speech Therapy is between expressive language and receptive language. Understanding this difference is crucial when assessing a child's communication skills.

• Expressive language refers to the ability to use words, sentences, and gestures to express thoughts and feelings. Children with expressive language difficulties may struggle to find the right words, form sentences, or communicate in a clear and organized manner.

• Receptive language refers to the ability to understand spoken or written language. Children with receptive language difficulties may have trouble following directions, understanding questions, or making sense of what is being said to them.

Sometimes, children may have strong receptive language skills but struggle with expressive language (or vice versa). Speech Therapy targets these specific areas based on a child's individual needs.

Encouraging Early Language and Communication

As a parent, there are many ways to encourage your child’s language development and communication skills, even from a very young age. Here are some simple strategies:

1. Talk and Narrate: Talk to your baby throughout the day. Narrate what you're doing, point out objects, and describe actions. For example, “We’re putting on your shoes. One shoe, two shoes. Now we’re ready to go outside!”

2. Read Together: Reading books is one of the best ways to foster language development. Start with picture books and label objects or actions. As your child grows, ask them questions about the story to engage their thinking and encourage them to use language.

3. Play Interactive Games: Simple games like peek-a-boo, pat-a-cake, or singing songs with hand motions encourage your baby to listen and respond, building their communication skills.

4. Ask Open-Ended Questions: Instead of asking questions that can be answered with “yes” or “no,” try open-ended questions that encourage more language use. For example, instead of “Did you have fun at school?” ask, “What did you do at school today?”

5. Expand on What Your Child Says: If your child says “dog,” expand on it by saying, “Yes, that’s a big brown dog. The dog is barking.”

6. Limit Screen Time: Interactive conversations and play are much more beneficial for language development than passive activities like watching TV. Encourage face-to-face interaction as much as possible.

7. Model Good Speech: Speak clearly, use simple words, and repeat key phrases. This helps your child learn how to form sentences and expand their vocabulary.

When to Seek Help

If you’re concerned about your child’s speech or language development, it’s never too early to consult with a Speech-Language Pathologist. Early intervention can make a big difference in a child’s communication skills and overall development. A Speech Therapist can assess your child’s strengths and challenges, offer tailored strategies, and guide you through activities to support your child at home.

Conclusion

Speech Therapy can be a valuable tool in supporting a child’s communication and language development. By understanding language milestones, the differences between expressive and receptive language, and how to encourage early communication, you can give your child the best start possible. Whether your child is progressing typically or needs some extra support, speech therapy provides the guidance needed to help every child find their voice.

Encouraging language is a journey that starts early, and with the right tools, every child can learn to communicate effectively!

Charlotte Unwin

Speech Therapist

What is a Sensory Profile?

We all have a Sensory Profile, it is what makes up how we perceive and react to the sensory world around us. In saying this, we may all respond to various sensations i.e. touch, taste, sound, smell and sight differently. Those with a Sensory Processing Disorder can experience difficulty within their everyday environment and completing day to day tasks if adjustments are not put in place.

An Occupational Therapist can help to put in place strategies to help manage a child’s response to their sensory input, as well as to assist their sensory need being met in order to help the child remain in a ‘calm-alert’ state.

Some examples of children experiencing sensory processing challenges include:

• Having large emotional meltdowns to various sensory input i.e. loud or unexpected sounds, such as, sirens, a dog barking, garbage truck moving and strong smells/odour’s.

• Constantly getting in and out of their chair when doing work i.e. difficulty sitting still.

• Fussy or picky eaters.

• Difficulty looking at the board and following simple instructions.

And a lot more!

When a child is scored on a standardised assessment called the Sensory Profile, to determine their sensory preferences, they can either be categorised as being low registration, sensory seeking, sensory sensitive or sensory avoiding OR a combination!

Low registration means that your child may have difficulty picking up on sensory input such as not noticing objects in a room, therefore may trip or fall easily or do not respond to their name the first time they are called. 

Sensory seeking means that your child may go out of their way to seek more sensory input i.e. they are the thrill seekers! For example, love movement and have lots or energy or like to try out various different smells/flavours.

Sensory sensitive means that your child may get distracted easily by sensory input, for example, a dog barking in the distance or the fan spinning in a room. Children who are sensory sensitive may display behaviours of having difficulty with concentration.  

Sensory avoiding means that your child may avoid sensory input as it may cause them to become overwhelmed easily. For example, children that are sensory avoiding may avoid ‘messy’ play i.e. with sand, mud or water as they do not like the feeling it has on their hands.  

Each child is unique, and thus knowing one’s sensory profile often can be difficult to understand. Therefore, it is important that therapists gather enough information to get a clear picture of the child and their needs. It is also important to note that our sensory profile is always changing, for example, often when children are younger they do not enjoy eating certain foods, however, as they grow older they may in fact begin to enjoy that type of food.

Some sensory strategies which your Occupational Therapist can recommend for your child to have their sensory needs met include:

• Fidget toys.

• Sensory play i.e. water, sand and dirt.

• Weighted blankets/toys/vests.

• Essential oils.

• Incorporating movement breaks throughout the day.

• Headphones.

• Move and sit cushions.

• Visual cues/boards.

• Listening to calming music in the car.

• Having a quiet space at home with soft pillows/cushions.

• Chew sensory toys.

Please note: these are generic examples and a full OT assessment is required for determination of you or child’s sensory needs.

Wondering if you’re child has difficulty with their Sensory needs? Please do not hesitate to contact Creative Minds Therapy at Medical on Miami on 07 5576 5832 to book in for an initial consultation.

Abigail Spanner

Occupational Therapist

What is Proprioception? and what activities target the Proprioceptive System?

The Proprioceptive System receives input from the muscles and joints in the body about body position, weight, pressure, stretch, movement and changes of position in space. When a child’s proprioceptive system is ineffective, children may constantly be in a ‘flight or fight’ mode in which they have anxious, emotional or behavioural responses due to their challenges of identifying their body position in space. To create proprioceptive pathways to manage these responses, children need to engage in proprioceptive activities to assist them to feel or remain in a ‘calm-alert’ state throughout the day. Furthermore, the goal of proprioceptive input is to decrease hypersensitivity (over-sensitivity) to various sensory input as well to improve children transitioning from one activity to the next, have appropriate energy levels and modulation, sleeping patterns and quality of interactions with others.

In addition, proprioceptive input is the performance of tasks that involve heavy resistance and input to the muscles and joints (proprioceptive receptors), and is essential in helping the body to assimilate and process both movement (vestibular) and touch (tactile) information.

Activity ideas include:

Cardiovascular activities:

·      Jumping on trampoline

·      Bouncing on bed, floor or couch (when supervised)

·      Running

·      Climbing at the playground e.g. monkey bars, stairs, or backwards up the slide

·      Bouncing on hopper or therapy ball

 Weight bearing activities:

·      Animal walks (wheelbarrow walks, crab walk, bear walk, army crawl)

·      Rolling over a large therapy ball and placing weight in hands/arms

·      Completing an obstacle course or climbing through a tunnel

 Oral activities:

·      Chewing gum

·      Eating chewy or crunchy foods e.g. raw vegetables or rice crackers

·      Using a straw and drinking thick liquids e.g. smoothie. The size of the straw and thickness of the liquid can vary to change the degree of resistive suck required

·      Using an electric toothbrush

Deep pressure:

·      Bear hugs or tight squeezes

·      Use of a therabrush

·      Deep pressure massage

·      Use of a body sock

·      Weighted products e.g. pillow, toy or blanket

·       Rolling therapy ball over child, being mindful of their head

·       Play dough and theraputty activities such as rolling and pinching, or hiding beads inside and getting the child to find them

·       Squashing child with pillows and playing sandwich games (child is place between beanbags, sofa cushions, mattresses and light pressure is applied to top layer)

·       Catching and throwing a large ball

Heavy work (pushing/pulling):

·       Carrying heavy items (e.g. groceries, books in a backpack, laundry baskets)

·       Play "row, row, row your boat" both sitting on the floor, pushing and pulling each other

·       Rough and tumble play

·       Play tug of war

Similarly, to proprioception, some children have inactivated vestibular or so called balance systems. This means that children will find it challenging to identify where their head is in space and how the body is moving in space, and thus may appear uncoordinated or have a fear of movement. Targeting the proprioceptive system can assist children with their vestibular system, however, some further activities which specifically target the vestibular system can include:

·      Movement in a body sock

·      Riding in a swing

·      Swaying or slowly dancing to music 

·      Rocking back and forth in a rocking chair

·      Yoga

·      Rocking on a therapy ball

·      Using a balance board

·      Tuck and roll

·      Animal walks where the head is inverted e.g. bear walks

·      Bowling backwards through the legs

·      Swinging in a blanket

·      Rocking in a hammock

·      Riding a scooter board

·      Spinning

Please see the Astronaut Program handout for more information regarding the vestibular system.

*Please note not all activities will be suitable for your child, please contact your local Occupational Therapist for further advice and recommendations.

Abigail Spanner

Occupational Therapist

Top 6 Tips for Early Talkers!

The first five years of life are a critical time for a child’s development. Positive experiences and relationships that stimulate children’s development creates millions of connections in their brains. Did you know that research has shown that children’s brains develop connections faster in the first five years than at any other time in their lives? These first five years set the foundations for health, communication, learning and behaviours. Follow the below top six tips for talking that will support your little ones’ development!

1.     Target meaningful and functional words during everyday routines: During your daily routine, you will be able to work out target vocabulary that you often use and how to find ways to teach your child a little bit more each day. For example, I will often say to parents that bath time is a great way to work on verbs or even opposites! (e.g. You are splashing! or Uh-oh it’s all wet/all dry). Children who are late to talk often have lots of naming words but are missing the important building blocks for sentences which include action verbs, pronouns and descriptive words. Try to stay away from counting, shapes and letters at a young age, as these are not very meaningful. Time is better spent creating language rich experiences with verbs!

2.     Focus on being a ‘commentator’ and ‘narrator’ rather than a parent that ‘tests’: Sometimes we can get wrapped up in trying to ‘test’ our little ones that we forget to just ‘comment’ which enables your child to be exposed to great language! We want to create opportunities for children to communicate rather than testing them on what they probably do or don’t know. Caregivers can often try to teach language through asking questions such as “Say X” or “What’s this?”. Most of the time, the child may or may not know what it is, but then this is a missed opportunity as the child does not have the ability to use a word or to label this yet. So, remember to support language try to turn the ‘testing’ questions into ‘comments’. E.g.  instead of “What’s. that?” TRY “Oh you have a ball! Let’s bounce the ball!”.

3.     Be face to face and follow your child’s lead: Get down to your child’s level, be face to face and eye level. This will ensure your child is able to focus on what you are saying.

4.     Observe, wait listen: This is by far my favourite strategy from Hanen. This will be attached in a document on this page for your free review!

5.     Imitation: Imitation involves a child’s ability to not only copy words but also actions of objects (e.g. pushing a car), gestures and body movements (e.g. clapping your hands) and sounds or words. Typically, children learn to imitate in infancy. Imitation provides a back-and-forth interaction and acts as an early conversation without words. Imitation can be completed in your everyday routines (e.g. Singing Twinkle Twinkle Little Star or Old Mac Donald Had a Farm).

6.     Forced Choice: To support your child to make choices, instead of asking large open ended questions “What food do you want?”, you can ask “Would you like an apple or banana?”. This assists the child by having the key words, to then be able to make a decision.

Adriana Astras

Speech Language Pathologist

Tips for Toileting for Children who display ‘Signs/Readiness’ of needing to go to the toilet

·      Use lots of positive reinforcement !

·      Use visuals in the bathroom to support learning

·      Use chants/songs e.g. let it go! Let it go! Or push it out, push it out, way out! Or pee pee in the potty, pee pee in the potty! Or I just want to potty all the time, potty all the time, potty all the time!

·      Watching Youtube videos:

o   Potty Training Song CoComelon https://www.youtube.com/watch?v=UH2Sm0Wj3Dw&ab_channel=Cocomelon-NurseryRhymes

o   The Potty Time Song – signing https://www.youtube.com/watch?v=36FCnfctPTU&ab_channel=PocketPreschool

o   The Poop Song by Growing Sound https://www.youtube.com/watch?v=Vtq1XV6ZVOc&list=PL8Y4OuJRiFFm-iL-tRBMisdo5vuxCk3k1&ab_channel=GrowingSound

·      Dolly play: using your child’s favourite stuffed animals, dolls, figurines etc

·      Prompting with a timer e.g. every 60 mins

·      Whenever you go, they go!

·      Reward charts e.g. if they indicate they need to go to the toilet 5 x in one week they get a gift!

·      Read social stories

·      Use forward chaining: teach one step at a time e.g. walk to bathroom then sit on toilet

·      Use backward chaining: child completes last step e.g. dry’s hands then wash hands, dry’s hands

·      Encourage child to watch others e.g. older adults or siblings go to the toilet

·      Talk through steps with child

Abigail Spanner

Occupational Therapist

What is Crossing the Midline?

Crossing the midline refers to the ability of a child to cross over an ‘imaginary’ line which divides the body equally into left and right sides, from our head to our toes.

This skill enables a child to use both the right and left sides of the body together to perform tasks accurately.

Examples of tasks which require crossing the midline include: writing, cutting, tying shoelaces, eating with a knife and fork, kicking a ball, hitting a ball with a bat, dancing and more.  

It is important that a child learns how to cross the midline in order to perform tasks with ease. If a child has difficulty crossing the midline it may mean that the two sides of their brain are not communicating with one another and therefore it is important that tasks are completed to assist the child cross the midline.

Tasks to assist with crossline the midline include:

·         Stacking blocks

·         Dancing to music

·         Washing the car

·         Painting – encouraging the child to paint on both sides of the paper

·         Playing with cars

·         Playing sports e.g. tennis

·         Wiping the table with a cloth

·         Catching/throwing a ball

·         Watering flowers with a hose

·         Playing games which involve both sides of the body e.g. simon says

·         Draw large figure eights

·         Kicking balls

·         Playing with bubbles using a bubble wand

·         Crumpling up paper

Crossing the midline is typically developed at around 8-9 years of age.

Abigail Spanner

Occupational Therapist

What is muscle tone?

What is muscle tone?

Muscle tone refers to the amount of tension within a muscle when it is relaxed. It helps us maintain posture and positioning, control movement, and is fundamental to the development of motor skills, balance and coordination.
Muscle tone can be thought of as a spectrum, with some people having higher tone and others having lower tone.
 
What is LOW muscle tone?
Low muscle tone, also known as hypotonia, refers to muscles which have less tension or resistance to movement. It is the resting state of a muscle (not the power that it can actively create against resistance, which is strength). Hypotonia occurs when the muscle is abnormally long and the muscle fibres do not overlap at an optimal level. Less tension within the muscles causes less support of the joints, resulting in the need for muscles to work harder to receive the same level of joint support as individuals with higher tone.

Signs of LOW muscle tone

·      W sitting or hands braced on floor to widen their base of support and reduce demand of core muscles (may pose difficulties in a class setting where kids are told to sit cross legged with hands in their laps) 

·      Slouching or unable to maintain postures at the table

·      Fatigue/poor endurance due to extra effort require to activate muscles

·      Mouth hung open due to stretched mouth muscles 

·      Leaning against objects 

·      Dyspraxia - difficulties controlling and coordinating movement

·      Hyper-extending, locking joints or dislocations due to floppy muscles un-effective at holding joint together

·      Applying to much or too little pressure to pencil as not getting enough feedback from muscles

·      Slower protective reflexes like putting hand out or foot if lost balance

Impacts of LOW muscle tone

Children with low muscle tone often experience difficulty maintaining posture and stability, and coordinating and controlling movement. As a result, low muscle tone has the potential to cause delayed motor skill development and difficulty executing functional tasks such as feeding and toileting. Children with low muscle tone may also experience difficulty performing fine motor tasks such as grasping a pencil and manipulating objects within the hand. They often also present as hypermobile, meaning that their joints move beyond the normal limits. Both speech and breathing are also often impacted by low muscle tone.

 A key challenge associated with low muscle tone is becoming easily fatigued. Low tone results in excess energy being used to maintain posture and produce movement, causing an increase in fatigue. Often, children with low muscle tone avoid participation in gross motor tasks and find it difficult to persist with such tasks.

Can you improve muscle tone? Although muscle tone itself cannot be improved, there are many ways to improve muscle strength and physical endurance. Muscle strength is the ability of muscles to produce force against some form of resistance, allowing appropriate movement to occur. As muscle strength and endurance improves, low muscle tone has the potential to become less of a barrier. Therefore, improving muscle strength is key for children with low muscle tone. Some great strategies to assist in improving muscle strength include:

Warm up (preparatory) activities
Engaging in warm up activities trains the muscles to activate more quickly. Activating the muscles required to perform a specific task will assist in improving strength and extend the duration for which the activity can be participated in. Depending on the task being performed, warm up activities may include climbing up the stairs into the clinic, completing an obstacle course on way into the therapy room, bouncing on a trampoline, doing star jumps or playing with play dough or putty.

Gross motor activities
Engaging in gross motor activities which require use of the whole body will assist in building muscle strength and endurance. These activities may include:

• Playground activities (such as swinging on monkey bars and climbing) – these activities are a great way to improve upper body strength and encourage positive engagement in gross motor tasks.

• Animal walks (such as frog jumps and bunny hops) – this activity is a fun, simple way of encouraging gross motor movement and building muscle strength.

• Obstacle courses which incorporate multiple gross motor movements (such as running, jumping and climbing) – this activity promotes activation of various muscles within each element of the course, aiming to build both strength and endurance whilst being motivating for your child.

• Swimming – this activity engages every muscle in the body to produce movement and encourages development of postural control.

• Gymnastics – this activity builds both muscle strength and endurance and promotes improvements in balance and postural control.

Providing regular rest breaks
Providing regular rest breaks and opportunities to recover is key for children with low muscle tone. This will prevent excessive fatigue, possible injury, and ensure that your child remains motivated to participate in tasks.

Tips for success when working with children who have hypotonia:

• Give your child feedback when they are performing activities to help them to develop awareness of tone and posture

• Break larger tasks down into smaller tasks to ensure they are manageable

• Ensure activities are fun and engaging to assist in improving alertness and tone

• Allow child to work in prone position on elbows

• Allow opportunities to change position in class

• Provide significant encouragement and positive reinforcement to motivate your child to continue to engage in the activity

Abigail Spanner

Occupational Therapist