This is such an effective strategy that I use during my sessions with clients!

The First-then schedules are some of the simplest types of schedules that I use with clients during speech therapy sessions. A first-then schedule will tell the client what activities will occur and in what sequence.

First-then schedule are important for children because they:

• Help address the child’s difficulty with memory and organisation of time
• Assist children with language comprehension problems to understand what is expected of them
• Lessen the anxiety level of children with autism, and reduce the possible occurrence of challenging behaviours. The schedule provides structure for the child to predict events. For example, puzzle is coming up soon…. but only after playdoh)
• Assist children in transitioning independently between activities by telling/showing them what is happening next. Schedules can be used in all environments, including gym, classroom, home, Sunday School, speech therapy/OT sessions

How do I teach it and use it?

• Decide what you want your child to complete first (goes in the ‘first’ box). Place the reward item or activity in the ‘next’ box. Your child can have the reward item/activity immediately after the ‘first’ task is done.
• Put the visuals on the board – this could be photos, drawings, written words- that presents the activities.

Present board to the child with short instruction. Try to use least amount of words as possible. For example, ‘John, first playdoh, then puzzle’.

When the ‘first’ task is completed, refer back to the board and immediately provide the preferred, reinforcing item/activity. For example, ‘All done playdoh, now puzzle’.

Below you will find first-then schedule template that you can use with your child. Print and have a go with different pictures!

Written by Didem Karademir, Speech Pathologist at De Silva Kids Clinic

Questions to Ask Your Child After School

Parents may have lots of questions when their child comes home, either on the first few days or throughout the school year.

Does your child often answer with “nothing” or “good” when you ask “What did you do at school” or “How was school”. Below are some tips to talk to your child about school:

• Ask open-ended questions to KEEP the conversation going. Most often, you will get a one-word response if the question can be answered with one word
• Start with factual questions to START the conversation. For example “I know your class size in Art is much bigger this year than last year. What is it like?
• Ask positive questions to give your child the opportunity to express concerns.
• Avoid negative questions as they tend to stop a conversation

Conversation Starters After School

Questions                                        Try these instead

How was school?                                – What’s the biggest difference between this year and last year?

Who did you sit with?                       – Tell me 3 of the children who sat near you

Were the kids in your class nice?   – Who did you enjoy talking to the most?

Was the work hard?                          – What was the best thing your teacher asked you to do?

How was lunch time?                       – Who sat near you at lunch time?

– What was something funny that someone said at lunch time?

– What was a game you played at lunch time?

Keeping communication open between yourself and your child is important, especially when they are in school and away from you for hours each day.

Use the question (s) that work for you and your children. The important thing is to start talking to them on a regular basis

Written by Didem Karademir, Speech Pathologist

Praising children for their achievements are often used to increase children’s motivation.

Research shows that ‘process praise’, the type of praise that is related to the child’s effort, motivates children to:

• Work hard
• Learn
• Explore
• Have a healthy outlook on their abilities

We then might question as to “How we should praise young children?” Below are some ideas of how to effectively praise your child into everyday activities:

• Describe your child’s behaviour and effort – use statements that say what you see, like “You used all the blocks to build your tower” or “Your picture has beautiful colours”. Provide statements with specific information that will help him/her to continue the desired behaviour.
• Be mindful when praising after failure or mistakes – Praise such as “Try harder” does not give any information about how your child can improve his or her effort. It may best to use statements that identify your child’s behaviour and effort and then talk about what your child thinks he/she can do to improve their performance. For example, “You worked very carefully on using capital letters and full stops. What’s another way you could make your sentences longer”
• Reduce the amount of praise – our goal is to encourage children to be self-motivated and to embrace challenge. ‘Over praising’ can become a habit – which may make our children dependent on praise. You don’t need to use praise at all when your child is naturally interested and self-motivated in an activity.

By using praise, you’re showing your child to think and talk positively about themselves. You’re helping your child learn how to recognise when he/she does well and to pat himself/herself on the back.

Written by Didem Karademir, Speech Pathologist.

Are you the parent of a child who is struggling at school? There are some areas like art, sports, music, technology that they do well in however other more traditionally academic subjects which involve lots of talking and discussion are far more difficult for them? You may also find that they find it difficult to follow conversations and you sometimes find it hard to understand what they are trying to explain to you. It’s possible that your child may have ‘Specific Language Impairment’.

What is ‘Specific Language Impairment’?

Specific language impairment or SLI, as it’s sometimes known, is when someone has typical skills across all areas of their development with one exception; their ability to understand and use spoken language. Additionally, their difficulty with language must not be associated with any other condition e.g. hearing loss, autism or Downs Syndrome. Their difficulties could be quite mild and short-lived or they could have significant difficulties which continue into adulthood.

What are the typical traits of someone who has SLI?

• They frequently struggle to communicate their ideas to others
• They find it difficult to understand and remember long stories or instructions
• They find puns, idioms or other non-literal language confusing
• They may talk in sentences however they are frequently difficult to understand
• They find learning and using new words hard, often having words ‘on the tip of their tongue’
• They find word maths questions far more difficult than maths questions using numbers and symbols
• They may prefer physical play e.g. football instead of spending lots of their free time talking
• They may find it difficult to join their peers in conversations which may make it hard for them to make friends
• All of these difficulties may mean that they frequently become frustrated and some behavioural difficulties may occur as a result of this

How do I find out if my child has SLI?

Unfortunately there is no specific ‘test’ for SLI however it’s possible to diagnose by comparing the child’s language skills to their other cognitive abilities e.g. spatial awareness, non-verbal reasoning. In order to do this your child will need a language assessment which is completed by a Speech Pathologist and a cognitive assessment which is completed by a psychologist.

What causes SLI and how many children have it?

We know that there is a genetic link in people who have specific language impairment however there is no specific ‘cause’ which has been identified so far. Studies have shown that in 5 year olds, SLI affects about 2 children in every classroom (about 7%). It is more common in boys than girls.

How can we support children with SLI?

Children typically learn language naturally through listening to others and practising as they grow up, however the same cannot be said for children with SLI. These children need language to be specifically taught to them using visual support and having lots of opportunities to practice. A Speech Pathologist will be able to help your child with this. Additionally, they will be able to give teaching staff advice and strategies about how to adapt school work to maximise your child’s learning potential.

Written by Philippa Brown, Speech Pathologist.

Occupational Therapists often bring up the term ‘sensory processing’ when they assess a child’s ability to engage in a range of daily activities. Sensory processing is important in many areas of a child’s life, including fine motor skills, being calm and organised, playing sport and socialising.

But what is sensory processing and why is it important?

Sensory processing is the ability of a child to correctly take in, interpret and respond to sensory information that they receive from their environment. This includes what we hear, see, feel, smell, taste and touch. It also includes the lesser-known senses of vestibular (balance and motion) and proprioception (body position awareness).

Sensory processing forms the foundation of development, guiding how we understand, interpret and respond to the world around us.

Inefficient sensory processing can interfere with a child’s motor, emotional, social and academic development.

Common Sensory Processing difficulties include;

• Being easily overwhelmed by busy environments, including the sights, sounds, textures, smells or other sensory inputs. This contributes to ‘sensory overload/meltdowns’, an emotional response to sensory inputs.

• Seeking or avoiding certain movement inputs such as swinging, spinning, falling, jumping. This contributes to balance, motor planning and motor skills.

• Having difficulty safely organising your body in space, known as poor body awareness. These children often appear clumsy, have poor posture, appear accident prone, seek rough play, avoid motor play or take risks.

• Being under sensitive to sensory input (hyposensitivity), such as having a high pain threshold, low registration of touch, not noticing when your face is messy. This can impact on things such as self-care, safety and fine motor skills.

What can we do?

An occupational therapist can assess whether a child processes sensory information differently to their peers through a variety of formal and informal assessment including, parent and teacher discussions, observing the child and performing sensory motor assessments.

Occupational therapists are experienced and trained in sensory integration therapies, task modification and environmental adaptation to best support sensory motor development.

If you believe your child may have sensory processing difficulties that are interfering with daily life, please contact one of our Occupational Therapist.

Written by Laura Taylor, Occupational Therapist.

What is a voice disorder?

A voice disorder is a noticeable difference in a person’s voice or quality of their voice compared to other people of the same age and sex. This may present as a harsh or hoarse voice, gaps in sound and/or a voice that is too nasal.

Prevalence of voice disorders in children

Voice disorders in children are more common than people realize, with roughly 5% of children experiencing a chronic (long-lasting) voice disorder.

Voice disorders in children can have wider impacts than just their voice. It can impact their general communication with others and their self-esteem as they may feel embarrassed when speaking in class or when making new friends. Their participation in social activities and in the classroom could decrease, therefore affecting their overall education.

What to look out for:

● Harsh or horse sounding quality to their voice

● Gaps in their sound

● Quiet voice or lost their voice completely for periods of time

● Sounds as though they are speaking through a blocked nose, or

● As though too much air is coming out of their nose when they are speaking

What can cause a voice disorder?

Damage to the voice comes from overuse or misuse. This can be in the form of:

● Excessive screaming

● Excessive coughing

● Excessive clearing throat

● Talking very loudly

● Yelling

● Not drinking enough water

● Increased stress/anxiety

● Common childhood infections (nose, chest and throat infections)

How may it feel to have a voice disorder?

● Effortful to talk

● Vocally tired easily and quickly.

● Feel impossible to project their voice

● Sore

● The feeling of needing to clear their throat constantly

Caring for your child’s voice

There are many strategies that can help prevent your child from getting a voice disorder and assist them when dealing with a voice disorder.

Some of these strategies include:

● Try to create a quieter environment for your child to communicate in.

● Encourage your child to get closer to the person they are talking to, instead of having to raise their voice or yell.

● Schedule specific times in the day for your child to rest their voice.

● Help your child understand the difference between the loud and soft use of their voice in order to assist them with the instruction of “inside voice”.

● Praise your child and use positive reinforcement when they use their inside or gentle voice,

such as “Johnny you used your inside voice, well done”

● Discourage any negative voice behaviours, such as yelling, screaming, excessive shouting, talking over people or background noise and speaking in a harsh manner.

● Lastly, hydrate! Encourage your child to drink lots of water.

If you notice any changes to your child’s voice, you should contact your pediatrician or local GP where you will be referred to an ENT specialist and/or a Speech Pathologist.

Written by Student Speech Pathologist, Allie Godbold, for De Silva Kids Clinic

Using sign and gestures can be an important way to develop communication for some children.

The Research:

There is much confusion among parents, teachers and other health professionals about using key word sign with your child. The most common question I come across is “will signing cause my child to stop/delay speech development”. The current research indicates that signing will not stop speech development if the person is going to learn to speak. It may actually support their ability to speak!

What does this all mean?

Signing, or any other form of augmentative communication, can take the pressure of having to ‘talk’ while giving the person a way of communicating, of interacting and becoming social.

How do I teach my child?

The potential for using sign and gesture is unlimited, so where do you start?

• Choose key word signs: You don’t need to sign EVERY word you speak. Instead, select words that are common first words in typically developing children and just sign those when they come up in conversation. For example,
  • Nouns: dog, car, girl, boy, block, milk
  • Social words: no, stop, more, finish, my
  • Verbs: eat, throw, open, help, wash, sit down
  • Family: I (me), mum, dad, brother, sister
• Learn the key word sign: Using flashcards, with a picture of the word and the sign, is an effective approach.

• Use key word approach: Sign the words you have chosen by themselves, when doing the action or showing the object to your child, or when you say the word in a sentence. For example, if the sentence “Lucy, go wash your hands and eat your banana” was said, the words underlined will be signed as you say it.

• Repeat, model and be persistent: Some children may take a while to understand what is being said (and signed) and require consistent repetition and modelling. Children will learn to use sign quicker if they see it around them all the time! Below are some ideas of activities:

PLAY: When playing with the child:

• Sign the key concepts about what you and the child are doing when using toys in play (e.g. teddy bear jump, doll eating, big banana).

Books: When looking at books with the child

• Sign key concepts when completing routines throughout the day such as taking a bath and getting ready for bedtime (e.g. shoes off, in the bed).
• Sign the question word and key information when asking questions (e.g. “Where is the girl?).
• Sign the key words within you or the child’s comments when describing the picture and/or answering a question (e.g. “the girl is under the table”).

         Sing songs/nursery rhymes

• Sign the key words within the song (e.g. star in ‘Twinkle Twinkle’, the different animals in ‘Old Mac Donald’).

Daily Routines: For example:

• When asking for food (e.g. “I want apple please”).
• When asking for a drink (e.g. “Can I have water please?”).
• To go to the toilet (e.g. “I need to go to the toilet“).

Keep doing this and eventually your child may begin to imitate the signs or word on their own!!

Written by Didem Karademir, Speech Pathologist.

Bilingualism is the ability to speak two languages. There are many benefits of being bilingual including:

• Coming up with solutions to problems
• Good listening skills
• Connecting with others
• Use information in new ways
• Ability to learn new words easily
• Break down words by sounds, such as C-A-T for cat

Below are some myths that you, as a parent, teacher or professional, may have about bilingualism.

Q) My child is bilingual. Will bilingualism cause language delay?

Bilingualism itself does not cause language delay. Bilingual children may say their first words slightly later than monolingual children, but still in the normal range. Bilingual children also develop grammar along the same patterns as children who learn one language.

Q) My child mixes their language when speaking. Are they confused and having trouble becoming bilingual?

When your child uses both languages in a conversation, this is called ‘code switching’ or ‘code mixing’. This is a natural part of being bilingual and should be expected in bilingual children.

Q) Should I stop speaking my home language with my child if I want him/her to speak the dominant language?

Research shows that children can easily learn a second language if they have a strong foundation in their home language. There is no evidence that your child will learn a second language if it is frequently used in the home.

Some parents who are not fluent in the majority language may attempt to speak to their child because they want their child to learn that language. But this can result in conversations and interactions that do not feel natural or comfortable between parent and child.

Q) How can I support a bilingual child?

Some ways to support your child’s bilingualism:

• Do what feels comfortable for you and your family
• Avoid speaking a language with your child if you are not comfortable or fluent in that language
• Provide your child with as many opportunities to speak, hear, play and interact in your home language. Examples include:
  • Read and tell stories
  • Play games, such as bingo or memory
  • Sing songs
  • Dance and play music
  • Speak to family members
  • Organise play time with other children who speak same language
  • Listen to the radio
  • Get creative – incorporate the language into your child’s interests. If your child is interested in cooking, then use a cook book written in your language.

Don’t give up! Some days, your child may not want to speak in your native language. But just hearing you speak your native language will help your child learn it.

Written by Didem Karademir, Speech Pathologist.

Is your child moving out of the stage of life where they are dependent on parents for prompting and assistance for most activities of daily living into a more independent stage of their life? Or is this a goal for your family? Lack of motivation to complete tasks independently is often a barrier that can prevent the smooth transition between these stages of life.

Ask yourself… Would you go to work if you didn’t get paid? Although lots of us love our jobs, we probably wouldn’t go to work without our weekly paycheck coming in. This is the same for some children who do not have the motivation to change or complete a task. The main thing is to remember that they cannot change not caring about what you want them to care about and they can’t change the way they feel.

Some children have difficulties with foresight about the consequences of their actions and instead only think about here and now. Implementation of strategies to initiate the motivation for a child to change a behaviour may be beneficial.

Expectations

• May be that your expectations too high?
• Set goals that are realistic, measureable and achievable

Motivators

• Figure out what your child cares about and what motivates them
• Use rewards and incentives as a motivator
• Limit always using consequences to motivate your child
• Find a balance between use of rewards and consequences
• Use these with lots of empathy and understanding

Rewards

• Does not always need to be a physical thing, toy or object
• Might be choosing what’s for dinner, what movie the family will watch all together on the weekend, or what treat to eat while having movie night

Changing the behaviour

• Think about what the ‘good experience’ would look like for you and for your family
• Focus on a specific behaviour that you are wanting to change

For additional support or direction with strategies get in touch with an occupational therapist. Please feel free to give us a call at De Silva Kids Clinic on 8418 8544 and speak with an occupational therapist about your concerns.

Written by Alannah Santomartino, occupational therapist.

Imitation is an important skill for speech and language development. Often children learn to imitate from a very young age and they will imitate actions, sounds and words. Some children take a little longer to learn this basic skill and may need your help. Here are some tips you can follow to help create a conducive environment for encouraging imitation.

1. Create opportunities using things that interest them

Once you understand the things your child likes and dislikes, you can use them to create situations in which your child will be motivated to communicate. It is always best to use things such as food or toys that are most motivating to your child.

For instance, if your child likes playing with the car, you can roll it and make car noises. This will probably grab your child’s attention and make him look at you. After modelling the sound a few times, you can practice ‘waiting’, look at him in anticipation and use communication temptations. When you child does imitate, respond with great enthusiasm so that your child knows this is what you wanted.

2. Imitate your child’s actions in play

Use two sets of identical toys and imitate your child playing with the particular toy. Try to imitate your child’s gestures, body movements or vocalisations during the play activity. Exaggerate these imitations so your child realises you are imitating him/ her. When your child notices you are copying him/her, it may encourage him/her to try new actions with the hope of getting you to copy him/her again.

For instance when your child throws a ball or looks at the mirror, you can copy that and exaggerate the action. Once you get your child’s attention, this will often encourage the child to try new actions or to even imitate the parent’s actions.

3. Use song and dance

You can sing fun and engaging songs to encourage interaction and imitation. Using simple hand and dance movements, clap your hands or simply bang on the drum while singing a song. If your child starts moving his/her body to the song, imitate their body movements. For example, if your child starts banging on a drum with his/ her hand, you may use a drum stick and bang on the drum, and then pass the stick to the child. This will help your child imitate the action.

Also try to use food or toys that your child shows an interest in. This will set the stage for the development of imitation skills in your child.

These are just some ideas to try and encourage your child to imitate. The first step is to copy your child’s actions and follow their lead.

Written by Tasneem Abdul Samad, Speech Pathologist.