Do you have difficulty understanding your child? Does your child have sounds they cannot say correctly? Do you want some ways to help them? You have come to the right place!
Hi, Chelsea here. I have been a pediatric speech-language pathologist (fancy name for a speech therapist) since 2015. I covered some possible reasons you might not be able to understand your child last week, and today I am here to share some practical strategies that may help you help them!
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Overview
In last week’s post, I covered some possible reasons you may not be able to understand your child. I highly recommend you check out this post: 6 Reasons You Cannot Understand Your Child When They Talk to help you sort out some possible reasons why your child may be struggling to say specific sounds, syllable types, words, etc.
I also want to be clear that I am a certified speech-language pathologist, but I am not your child’s speech-language pathologist. Therefore, I would recommend you speak to your child’s healthcare provider and request a referral to speech therapy, if you feel that your child is not understood as well as they should be according to their age. Your child may be able to receive early intervention, school therapy, university clinic therapy, outpatient therapy, private practice speech therapy, or any combination of these depending on their age and the resources available in your area.
Some Terms
- Articulation: This will be the term I use most to reference how your child produces sounds.
- Speech Sounds: The sounds we use to form words.
- Disorder: I may use this term with several others (e.g. articulation disorder, speech sound disorder) to reference any type of production that is not typical in development.
- Articulators: The oral structures involved in producing speech sounds. This includes lips, teeth, jaw, tongue, palate (hard and soft), and cheeks.
Why Might My Child be Difficult to Understand
In my previous post, 6 Reasons You Cannot Understand Your Child When They Talk, I went into a lot of detail about some possible reasons why your child may be having difficulty. But to provide an overview, your child may have a speech sound disorder (articulation or phonological), childhood apraxia of speech, oral weakness or orofacial myofunctional disorder, a structural disorder (e.g. cleft lip or palate), hearing impairment, or any combination of multiple disorders listed.
When your child cannot form sounds correctly, it is important to investigate why, so that an appropriate treatment plan can be determined.
In the previous post on why your child may be having difficulty, I provided an example of how the articulators develop, and this starts long before they are making intentional sounds, such as coos or babbles. It starts from the very beginning – when they suck and swallow, they are using the same muscles as they will use to produce sounds.
Inappropriate sucking and swallowing, often resulting in feeding challenges, can also affect how the articulators develop strength and range of motion as well as how they rest when not in use. All of these factors directly impact your child’s ability to form sounds, create sound strings (e.g. words), and use sounds in words in sentences.
Want more infant information? Check out Why Infants Don’t Need Baby Food When Starting Solid Food or Help! My Baby Doesn’t Like Solid Food.
If you are past the infant stage, keep reading!
What do we need for appropriate articulation
There are many things that have to happen in order for us to produce sounds. Air comes up from the lungs, travels through the trachea, passes through the vocal folds (either open for voiceless sounds or closed + vibration for voiced sounds), through the pharynx, and then into either the mouth or nose, where it gets further manipulated by the articulators. The jaw stabilizes; the tongue, lips, and cheeks move; and it all happens in milliseconds. If there is any interruption at any point in this chain of events, there can be an issue.
How do we improve articulation at home
I am going to provide a list of ideas and activities here that may help your child’s sound productions. It is important to note that not all of these activities will work for each child nor does this replace the advice of a qualified professional who works directly with your child to determine a treatment plan. These are ideas that may help. I broke the list into some simple sub-categories to make it easier.
Oral Posture:
- Avoid Overuse of Oral Habits (e.g. pacifiers, thumb or finger sucking)
- Encourage Closed Mouth Resting Posture + Nasal Breathing
Why: Oral posture is extremely important for how the mouth and face develop. This is what our mouths are doing when they are not in use. Teeth closed lightly, lips closed, and tongue on the roof of the mouth.
The tongue’s purpose on the roof of the mouth is to help form and maintain the correct shape of the palate, upper jaw, and teeth. If the tongue doesn’t rest on the roof of the mouth, the palate becomes more narrow, the upper jaw grows outward, the teeth become misaligned, and the mouth is usually open at rest.
In my example above, you see how every single structure is involved in sound production, these structures begin developing right away, and they have a direct effect on speech production.
We can support appropriate oral resting posture right from the beginning by helping babies close their lips when not in use. Now, I am not saying hold them closed!!!! Just gently close them if they are open and release right away.
As children get older, you can use a simple phrase “close your lips, breathe through your nose”. Model this for your child and even exaggerate it so they can understand.
Eating/Drinking
- Straw and Open Cup Drinking
- Eat a Variety of Foods
- Avoid Squeeze Pouches
- Avoid Sippy Cups
- Drink Thick Consistencies Through Straws
- Use a Preferred Food to Find Spots in the Mouth
Why: Remember my “same muscles” response to why a speech therapist works with feeding challenges. The reverse is true… an excellent way to address speech sound productions is through eating and drinking tasks!!!
From the time your child starts solid foods, which usually starts around 6 months of age, they can also learn how to drink from a straw and open cup. These two skills advance the oral muscles and skill development, which is necessary to develop more numerous sounds.
Did you know that “sippy cups” are not developmental milestones, but straw and open cups are? Sippy cups were designed for convenience, not with developmental appropriateness in mind.
When children chew a variety of foods and textures early on (what we promote in our approach to starting solid foods Why Infants Don’t Need Baby Food When Starting Solid Food), they can develop strong jaws.
Strong jaws allow for adequate stability for sound production. When children manipulate a variety of foods, they learn how to use their tongues all around their mouths to take food from their lips, sweep it from their cheeks, gag to protect their airway, and gather it into a cohesive bolus to propel down to their bellies.
When children are not exposed to a variety of food types and textures, they do not get the adequate practice and strengthening opportunities for their articulators. This can be a negative factor for both speech and feeding skills.
Similarly to the need to be exposed to a variety of textures and appropriate cups/straws for oral skill advancement, use of squeeze pouches promotes an immature oral pattern. If these are used often, we are removing the child’s ability to correctly manipulate the food orally and build necessary strength.
Read more on this: Why Infants Don’t Need Baby Food When Starting Solid Food
Non-Speech Oral Motor:
- Make Silly Sounds
- Blow Bubbles, Whistles, Cotton Balls, Tissues, Fog a Mirror
- Make Silly Faces Together
- Make “Taco Tongue”
Why: When we learn how to make silly sounds and silly faces, we are learning how to manipulate our oral structures in different ways. It also builds oral awareness and isolation of movements (dissociation).
Awareness and dissociation of each structure are crucial for making different sounds, especially when speaking in longer, connected sentences. If a child is reliant on the jaw to move their tongue, they are not going to be able to move it as quickly as necessary to say all the sounds in all the words.
Blowing tasks often get a bad reputation by a lot of therapists, but I think they have their place. For a child with impaired oral airflow, these teach the movement of air through the mouth. When you have an immediate feedback response (e.g. bubbles, fog on the mirror) they can see their success!
Blowing tasks also help coordinate breathing and moving the articulators, which can be really helpful in several instances, such as childhood apraxia of speech or neuromuscular disorders.
Visuals:
- Use Face-to-Face Conversations with Your Child
- Use Overarticulation to Help Them Visualize the Sounds
- Use a Mirror if Eye Contact is Difficult
- Use Clapping or Tapping
- Use Hand Gestures
- Use Visuals
- Watch a Video of How to Produce the Sound
Why: Children benefit from multi-sensory learning and observation. When we speak directly to children, they not only learn the appropriate social and language skills, they also can see what you are saying and how you are saying it. Learn more about modeling and how to support your child’s language development, Narrating for Successful Language Development
When I am working with a child who is struggling with speech sounds, I often implement at least 1 if not multiple visuals to see what works for them. Hand gesture cues that match what the mouth is doing allow the child to imitate the gesture (often first) then learn to imitate the sound. Additionally, clapping or tapping help children with syllable breakdowns or even rate of speech difficulties.
I hesitated to add the last item to the list, because here at TRT we advocate for limiting screentime. Read more about that: Screen Time. But, I do believe that technology has its place, and many children benefit from short videos that instruct them on how to manipulate their mouth to produce sounds.
Feedback:
- Ask Your Child to “Show” What They Are Saying
- Ask Them to Say it a “Different Way”
- Use a Natural Consequence if You Don’t Understand
Why: Feedback will really vary depending on the age, cognitive level, and severity of articulation difficulties. This is one thing I highly recommend you talk to your child’s speech therapist about. Understanding what is and what is not helpful for correcting and responding to their speech can make a difference in their overall learning and confidence.
In general, if you do not understand your child, asking them to show you what they mean or saying it in a different way can be helpful ways to meet their needs, allow the opportunity to correct their speech breakdown, and complete the loop of communication in a positive way.
Another one of my favorite strategies for a child who is starting to become aware of their speech and attempting to correct themselves is to provide a natural consequence. For instance, you have been working on the “s” sound. Your child asks for their “socks” but says “talks”… so instead of giving them their socks, you talk to them. They pause. Point to their socks, and you emphasize “sssss-ocks”. No need to directly correct their sound, because you provided a natural consequence (didn’t meet their need) and then you modeled the correct production.
Child-Specific:
- Know What is Typical for Their Age
- Sort Out the Types of Difficulties They May be Having
- Consider a Hearing Screening or Evaluation
- Describe the Sound Placement in the Mouth
Why: Many parents are often concerned with speech sounds or intelligibility at a young age. It is important to look at sound milestones and have a basic understanding of what is normal in development, recognizing that many sounds develop much later, and it is normal to not be 100% intelligible until late toddlerhood/preschool years.
While I say this, there are many “red flags” that may indicate underlying concerns, such as orofacial myofunctional disorders (OMDs), that we can identify early. Read more about the underlying causes of articulation disorders in 6 Reasons You Cannot Understand Your Child When They Talk.
Therefore, you can definitely implement many of these suggestions listed here as a preventative measure and/or some basic intervention. But, you should absolutely consider seeking help from a professional if you think your child may have speech sound deficits that are not normal for their age, more severe than is to be expected at their age, and/or weakness or OMDs.
Ultimately, you are the expert on your child and you are capable of making an informed decision for what is best for them!!
Final Notes:
I obviously think all of this information is important… but if I were to pick 3 takeaways that would help the outcome of your child’s eating, articulation, and oral development, I would say:
- Promote a closed mouth posture with nasal breathing
- Use straws and open cups most of the time and sippy cups minimally or not at all
- Emphasize eating “real” food and avoid squeeze pouches
Our next series will prepare you for what to expect at a speech therapy evaluation and/or early on in speech therapy treatment. This can be an intimidating and unknown process for a lot of parents. We look forward to helping you feel more confident and prepared.
References:
Jaws: The Story of a Hidden Epidemic (2018). Sandra Kahn & Paul R. Ehrlich. ISBN-13: 978-1503613584.
Cover image and Pinterest images are not originals from Three Roads Therapy LLC. Obtained from Canva: Karola G from Pexels; Alina Matveycheva from Pexels; Yan Krukau from Pexels; Ivan S from Pexels; Alfo Images.
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