Child Speech Therapy Services: When To Start?

I wanted to briefly share on this topic, because it is very important, and parents ask this question all of the time, “How can you provide speech therapy services to an infant or young child”.

Speech therapy addresses sound and phonological development, but language treatments help children understand and express words and meaning, and that is what I work on with infants and small children.

Research tells us that children speak their first words by 12 months of age, but there are some very important developmental precursors to consider before a child says their first word.

Here are some developmental milestones that I look evaluate in young children:

3-6 Months: Young children should turn their heads towards the person talking and localize to the sound. Expressively, children this age should be laughing, and babbling and imitating “talking”.

6-9 Months: Children at this age should start recognizing their mommy or daddy’s name, attend to music, wave “bye-bye”, make 2 syllable combinations and attempt to sing and shout to gain attention.

9-12 Months: By this age, the child should attend to new words, give an object upon verbal request, understand a small,simple question, use a word to call a person and start speaking 1 to 2 words spontaneously.

These are just a few language milestones that I look for in small children. More information on developmental milestones can be found here, on the American Speech and Language Association website.

If you are concerned about your child’s speech or language development or would like to know more information about speech therapy services in Tucson, please don’t hesitate to contact me here. We take many insurance plans as payment for our services, so contact me today for Tucson speech therapy services.

Using Everyday Items to Reinforce Speech and Phonics

When working with your child on speech sounds and phonology, use your time riding in the car, doing chores, or waiting in line to play games together. When doing this, take care to focus that your child will experience success.

1. Take turns playing rhyming games. Use only one sound during a session, and make sure to talk about the sound that you are making.

2. Play a name game together. Start with, “Let’s name two things that start with ________”. Choose a beginning sound, like the letter S and play from memory or by using everyday objects (eg: sun and sign). For example, ask your child to look around your surroundings and say, “Find two things that start with the S sound”.

3. A phonics game can be played using your shopping or errand list. Ask your child to first say and sound out the beginning letter of each word on the list. For example, first say the letter B and then say “the B sound is for butter”, and so forth as you choose or bag items in the store.

Remember, everyday activities and daily living provide ample opportunities to reinforce speech sounds and phonics lessons with your child. It doesn’t have to be homework! Keep it simple, and know that when parents keep it fun and interesting, their children learn quickly.

For more information about speech therapy in Tucson, Tucson speech therapy services, or web- based speech therapy services anywhere in the world, please email me right here.

Vocal Makeovers

The New York Times
July 21, 2005

My Voice Has Got to Go

When the telecom bubble burst a few years back and David LaBerge, 45, found himself looking for work as an independent marketing consultant, he decided it was time to spiff up his act. New clothes. New haircut.

New voice.

“I was just not happy with the way I presented myself,” said Mr. LaBerge, who works in San Jose, Calif. “I’d hear myself on tapes of meetings or on my office answering machine and I had this monotonous delivery. The tone didn’t go up or down. Even when I was very enthusiastic I sounded dull. I would end statements with a rising pitch, which made it sound like a question, or like even I wasn’t convinced by what I was saying.”

The problem spilled over into his personal life. “You go to a party, and there’s always someone who can tell a story in this really engaging way. I’d tell a story and it always seemed to fall flat, even though I think I know some pretty good stories.”

Sounding dull wasn’t Cynthia Sam’s problem. “My voice is kind of unique,” said Ms. Sam, a respiratory therapist in New York, whose high-pitched little-girl’s voice sounds like a cartoon character’s. “When you talk like this, it’s sometimes hard to be taken seriously. People can be very cruel.”

Emily Schreiber, 25, a second-grade teacher in Manhattan who has to raise her voice above a roomful of 7-year-olds, suffered repeated bouts of laryngitis. “I was perfectly healthy but I couldn’t speak above a whisper,” Ms. Schreiber said.

A beautiful and commanding voice has always been important to actors and singers. But now many others want one. And why not? If gorgeous hair, sculptured torsos, flawless skin and sparkling white teeth are worthy of pursuit, why shouldn’t a richer, more sonorous voice be one more item on the checklist of perfection?

About a third of the members of the Voice and Speech Trainers Association, an organization of professionals who originally focused on actors, now work with the public at large, said the association’s president, Lisa Wilson, a professor of theater at the University of Tulsa.

Speech pathologists, trained to treat speaking disorders, are also getting some of the business. “Fifteen years ago I rarely had people come to me because they simply didn’t like the sound of their voice,” said Thomas Murry, a speech pathologist at the Voice and Swallowing Center of Columbia University. His clients were people with medical conditions like polyps on their vocal cords. “Now about a third of the people simply want to sound better,” he said.

Dr. Murry estimated that of the 90,000 members of the American Speech-Language-Hearing Association, as many as 1,000 devote their practices to what he calls “voice styling,” helping people improve the sound of otherwise healthy voices.

With so much of our lives these days conducted on the phone, vocal quality is gaining attention as a factor in making friends and influencing people. “More and more of my work is done in conference calls,” said Grace Vandecruze, 37, an investment banker in New York who has worked with Lucille S. Rubin, a veteran voice coach. “The depth of your knowledge and the impact of your voice – the two are equally important.”

Voice quality matters in face-to-face meetings, too. “Studies show that in hiring situations, two things play a big role in who gets hired: what someone looks like and the sound of their voice,” Dr. Murry said.

Sometimes people don’t know that their voice gets in their way. Susan Berkley, a voice coach in Englewood Cliffs, N.J., and the author of “Speak to Influence,” told the story of a friend who met a woman on an Internet dating site. “Her photo was drop-dead gorgeous. They finally set a time to talk on the phone. He’s convinced she’s going to bear his children, right? So he calls and she answers.” Here she produced a high-pitched nasal “Hello” that called to mind Lily Tomlin’s telephone operator. “It was over in five seconds. He couldn’t bear the thought of spending the rest of his life with that voice.”

To evaluate voices, speech therapists listen and look. Hoarseness can be assessed with a strobovideolaryngoscopy, which creates a moving image of vibrating vocal cords. Roughness, breathiness, weakness and strain are judged more subjectively using a 0 to 4 rating system.

How much can voice quality be altered? A lot, judging by how easily Carol Fleming, a San Francisco voice coach, made her own voice shift as she impersonated her typical clients. “You get people who talk way at the back of their throats, like this,” she demonstrated in her office, producing a strained, raspy voice that speech therapists call glottal fry. “Or people whose voices are way up here in their sinuses,” she said, speaking with a harsh nasal twang. “Or way down here in their chests.”

Her voice seemed to change location as she spoke.

“What you want is to teach people to place the voice here, at the front of the mouth, with a lot of resonance,” Dr. Fleming said, speaking with riveting authority. “That way, you literally sound like you stand behind what you say.”

Many coaches say they work to eliminate specific problems, not an entire accent. “The letter R is a problem in many dialects, for instance, so we’ll work on that,” said Susan Miller, a coach in Washington.

Kate Rice, 35, decided to change her voice when she was hired as a spokeswoman for a California retail firm. “I’m from Wisconsin, where people speak with a nasal quality,” Ms. Rice said. “Words get shortened. Swimming becomes swimmin’. Fishing becomes fishin’. You don’t even realize you’re doing it.”

Age can take its toll on how people sound, as voices become weak or shaky. Exercises can strengthen the vocal muscles. Dr. Miller demonstrated one, putting her lips together and blowing, making a sound in her throat while her lips fluttered. She also made a sound like a siren and then repeated a tongue-twister – “red leather, blue leather, yellow leather, red leather, blue leather, yellow leather” – at top speed. She recommended both exercises for anyone preparing to give a talk.

The ancient Greek orator Demosthenes is said to have overcome stammering speech by trying to speak distinctly with pebbles in his mouth and by reciting verses when out of breath from running uphill. None of the voice coaches interviewed mentioned pebbles. But Ms. Miller did say she runs in place to get her lungs pumping before a speech.

“Having a voice coach is like having a trainer at the gym; you work on intonation, breathing patterns, physical exercises,” said Jonathan Clemmer, 47, whose friends in the theater steered him to Dr. Rubin, who trains actors as well as doctors, lawyers and businessmen and women. Mr. Clemmer recently moved to San Francisco, where his job as a medical research consultant involves giving talks to scientists. “I find I have more power in my voice now and better inflection,” he said.

The cost of coaching ranges from $100 to $225 a session. Some people learn all they need in just three sessions. Others may require 12 or more. A typical “voice makeover” costs about $1,000, Dr. Miller said.

Working with Dr. Fleming, Mr. LaBerge read short stories aloud to give his voice variety and practiced ending his statements with a falling rather than rising pitch. “Now I’m learning how to put a lot more animation in my voice,” he said.

In her five sessions with Dr. Murry, Ms. Schreiber, the teacher, learned to breathe more from her stomach than her chest and to relax her jaw, which puts less strain on vocal cords.

People with weak voices are often counseled to stand straighter and to take a breath before starting a sentence. Simply hearing a good recording of their voices helps some people adjust for better pitch and variety, Dr. Murry said.

When clients first come to her office, Dr. Fleming begins by making small talk while a tape recorder spins silently on her desk. “After 10 or 15 minutes, I play people’s voices back to them so they can hear how they really sound,” she said.

It is a moment that can make them wince, often because they are not used to hearing themselves as others do. “We hear our own voices as sound waves conducted through bone, not through the air,” Professor Wilson explained.

The discovery is not always unpleasant. “People will come to me because they don’t like their voice on an answering machine,” Dr. Fleming said. “Well, who does? The recording quality makes everyone sound tinny. When people hear their voice on a high-quality recording, they often think, Hey, that’s not so bad.”

Not everyone who goes to a voice trainer decides to change the way he or she speaks. With the help of Ms. Berkley, Ms. Sam learned that she could deepen her voice. “I found that I do have more range, and that I can use it when I want to,” she said. But she also discovered that there’s gold in her little-girl voice. Since taking a voice-over class, she’s done the talking for several toys in an animated film and is now auditioning for more roles.

Copyright 2005 by The New York Times Company