R Secrets for Speech Therapy

Does your child sound like they’ve got a “foreign accent”? Parents report this often. It may be an /R/ problem and the earlier you catch it, the better. Let it go too long and reading and spelling may be affected.

Symptoms of High Functioning Autism

As a practicing speech and language pathologist since 1993, I have worked with numerous children and adults with the diagnosis of Autism. In this brief article, I would like to share my experience regarding the subtle differences that those individuals with high functioning autism experience on a daily basis, more specifically the adults, who tend to try and compensate for their own disorder.

Social interaction deficits are a symptom of high level autism. Difficulty maintaining eye contact is just one of these symptoms. Internally, there may also be an actual fear of situations, because often, the individual with high functioning autism may not completely understand certain situational cues, or the higher elements of language, like humor. I believe that these individuals internally understand that they cannot follow these social cues or elements of language and as a result, utilize social”scripts” that have been developed many years earlier to assist in specific communicative interactions. These self- taught “scripts” have assisted the individual in the past and may or may not help in the present moment.

Individuals with high functioning autism continue to prefer routine and order, even as adults. Although these symptoms have presented themselves in early childhood, they tend to improve as the individual ages, if the person has the desire to improve themselves and get “out of their comfort zone”. Personal relationships are usually problematic, secondary to the inability to appropriately communicate wants, needs feelings with loved ones.

Other symptoms of high functioning autism may include irregularities with coordination, motor skills and gastrointestinal disturbances.

Studies show that individuals with high functioning autism, either diagnosed or undiagnosed are very intelligent people.  With that said, it is my experience that if an adult individual truly wants to improve their communication abilities, then that individual will have to  learn various communication “rules” that are present in our society.  Some of those communication rules that I address in therapy include:  Initiate conversation in appropriate situations, use contingent queries and responses, respond to clarification requests from the listener, give appropriate verbal feedback when asked,  give appropriate non-verbal feedback,  allow appropriate pause time between interchanges,  not interrupt and/or overlap partner, give appropriate amount of information, make relevant comments,  ask questions that are relevant, send clear and concise messages to the listener and use polite/friendly form, as appropriate.

Please leave your comments below or feel free to contact me here for more information about communication and high functioning autism.



Tired of Waiting? Go Private today for Speech Therapy Services in Tucson.

If you’ve been waiting for speech therapy services in the Tucson area for over 6 weeks, you’ve been waiting too long. Go private by contacting us today. We provide some of the best speech and language services in this community, and we are proud of it. We continue to see adults and children with speech, language, voice or swallowing difficulties.

We accept almost all insurances, so call today and go private!

Speech Delay and Behaviors

As a speech pathologist, I have seen all kinds of behaviors in children (and adults).  Some behaviors can be as mild as a simple verbal “no” or as aggressive as a hit, punch, swing or spit. Some kids cry and fall like trees.  Some kids become “bulldozers” as they scoot across the treatment room.  In 1993, I had a kid “roll” down the hallway, past the administration office and end up in the PT gym.

While it’s no secret that children who have difficulty communicating can exhibit behaviors, we as parents and caregivers need to take certain steps so that the child understands their own expectations and boundaries.  Our ultimate goal is for our kids to become effective, functional communicators.

Here are some ways that I manage inappropriate behaviors in children with communication difficulties:

1. Verbally rewarding the GOOD behaviors:  Good behaviors such as sitting in the chair, completing a task, or using a good “inside voice” require immediate rewards.

2. Listening to the child:  Some children with severe speech deficits require more attention from the parent to understand ideas being communicated.   Try to pick out one or two words communicated and expand on this with the child.  This will allow the child to be “heard”.

3. Remain calm and be patient:  Kids feed off of adult reactions. Too often, I have seen parents “argue”  with their child when they become frustrated or upset.

4. Boundaries:  When you place a boundary upon a child, stick to it.  Kids know who’s buttons to push because the parents may allow it.

Don’t be afraid to tell your child, “no”.  Because when we do, it will give added value to your “yes”.

For more information about speech therapy services in Tucson, or if you would like to schedule a consultation, please contact me directly here.



It’s What We Hear That Helps Our Speech Change Quickly!

I’m about to share a secret with you all. It’s about speech – sound training, and it’s very important. When working with children who are a little older, around the ages of 6 to 12, I find that “ear training” can evidence more success in changing speech behaviors than addressing just individual sounds.

As we age, speech patterns and speech errors become more difficult to correct. In speech therapy, I start with making sure the child can produce the sound. Then, I drill it! You see, I was trained 20 years ago by experts in the field of speech therapy who always told us that in order to change behavior, you had to change motor planning, and that meant drilling speech sounds. But to make the sound “stick in the child’s head”, the child needed to recognize when it was being produced incorrectly. That’s why I use techniques like minimal pairs in my speech therapy activities. Also, I will repeat or record/playback the child’s speech productions using my secret weapon found on my iPhone. It’s not uncommon to find me working across various 2 and 3 syllable word combinations, while recording the child’s productions so that we can improve awareness to the overall speech intelligibility in phrases, sentences and conversation. It’s not uncommon for a child to look at me with a big smile and say, “I didn’t say that”!

At the Therapy Group of Tucson, people are talking! We strive to make speech therapy fun, effective and rewarding. If you have a question about speech therapy services in Tucson, or would like to schedule an appointment, please contact me here.

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

Wretches & Jabberers: A Movie About 2 Adults With Autism

The Autism Society paired with Wretches & Jabberers to commemorate National Autism Awareness month, in April 2011.

Two men with autism embark on a global quest to change attitudes about disability and intelligence.

The album for the movie was released on iTunes in January, 2011 and profits from its sales will be donated to the Autism Society.

More information about Wretches & Jabbers can be found here.

Accent therapy for Cantonese speakers

Web-based speech therapy and online speech therapy is an effective way to assist people in other countries who wish to receive quality speech therapy for accent reduction when working on their English. The process is simple, so if you wish to get started, contact me here.

When working with native Cantonese speakers, it is helpful to know that there are certain phonemes (sounds) in the English language that are not found in Cantonese language. Those sounds are as follows:

/b/, /d/, /g/, /v/, /z/, /sh/ (like SHip)/, /g/ (like viSIon), /r/ (like Red), /ch/ (like CHew), /dg/ (like Jet) , /ð/ (like THis), and /?/ (like THin).

This is where speech drills work effectively. I take the above target sounds and assist the client with the correct and precise articulation of each phoneme at the sound level. Once the client can master the target at the sound level, we then move forward to words, phrases and finally sentences and conversation.

When teaching native Cantonese speakers to correctly produce English, some of the more common errors I hear are as follows:

– leaving out the final consonants during conversation,
– /s/ for /th/ in initial position of the word; “sank you” for “thank you”
– /f/ for /th/ in final position of the word: “toof” for “tooth”
– /d/ for /ð/ in initial or medial position of words: “dese” for “these”
– /s/ for /z/ in initial, medial, or final position of words: “sipper” for “zipper”
– /f/ for /v/ in initial or medial position of words: “fest” for “vest”
– /w/ for /v/ in initial or medial position of words: “west” for “vest”
– /l/ for /r/ in initial, medial, or final position of words: “led” for “red”
– /s/ for /sh/ in initial, medial, or final position of words: “see” for “she”

The American Speech and Hearing Association (ASHA) has more information about the Cantonese phonetic system here.

For more information about speech therapy services online or reducing your accent via online speech therapy, contact me today to schedule an appointment.