All children develop at their own pace and in their own way, each displaying their own strengths. This is as true for speech and language development as it is for anything else. But while the traditional wisdom when it came to late talkers was to simply wait-and-see, medical professionals are increasingly urge parents to have their kids evaluated sooner than later. Our Fort Myers speech therapists encourage the same, knowing that while some kids really are late bloomers, a language problem becomes more difficult to correct the longer you wait.
Sometimes, this message can get a bit muddied when reports of some studies, such as one published by The American Academy of Pediatrics, are reported under headlines such as, “Late Talkers Do Fine as They Grow Up.” This ends up giving many parents a false sense of assurance. That study tended to show little to no lasting behavior or emotional problems associated with late-talking toddlers by age 5. However, it didn’t assess the language outcomes, so it’s a leap to say those kids went on to be “fine.”
Somewhere between 70 percent and 80 percent of toddlers who talk late will outgrow that language delay – but only if it is an expressive language delay (difficulties with verbal and written expression). Those with receptive language delays (understanding what is being said to them) may have a more difficult time. What our speech therapists want parents to bear in mind is that while many toddlers will outgrow a language delay, 20 percent to 30 percent will not – unless they have access to early intervention like speech therapy.
Medical providers are increasingly relying on telehealth services to ensure patients' needs are met - by meeting patients where they are. It's been used by nurses, psychologists and therapists too. FOCUS Fort Myers is now among the first providers in Southwest Florida to offer online speech therapy for kids.
Sometimes called virtual therapy or teletherapy, it's any therapy that can be conducted via technological device (iPad, phone, computer, laptop, etc.). FOCUS began offering online speech therapy services sporadically about 18 months ago. Recently, we established our Teletherapy Department, consisting of two pediatric speech therapists who exclusively operate remotely.
"The same diagnoses and conditions that can be treated in our clinic can be treated effectively via teletherapy," said Haley Ott, FOCUS speech-language pathology assistant and director of the Teletherapy Department.
The process is similar to a Face Time call, except it's through a secure, HIPAA-compliant app.
"It's fairly simple from there," FOCUS SLP and TD department founder and executive director Emmi MacIntyre Ring explained. "We provide our clients with a meeting code, the client enters it into their device, and we pop up on their screen and utilize a variety of online platforms to target their therapy goals. It's an evidence-based and supported administration of therapy services that we've found to be extremely convenient and effective for our clients at FOCUS."
Some local schools contract with companies that strictly offer teletherapy services. However, only a small number of private therapy clinics offer it - for now.
In many regions - including Southwest Florida - the need for speech therapists is greater than the supply. The new Advanced Report on Telehealth and Telemedicine Market Analysis Forecast indicates that by 2026, the global market for all telemedicine is expected to exceed $185 million.
The cost for speech teletherapy is the same as an in-clinic visit, and it's covered in FOCUS' contract with Medicaid. We also extend this service to private pay clients, and are working to expand availability for patients in other insurance networks.
Therapists don't need any special training for telehealth services except for use of the app. If there are parent concerns about how attentive a child will be in online speech therapy, we encourage quiet observation of a session or two in the background. After the first few, though, kids usually make more progress when given space to connect one-on-one with their therapist - even from a distance.
Effectiveness of Teletherapy for Speech
Because telehealth is relatively new in the medical field, researchers are still gathering data and anecdotal evidence that will provide definitive proof of its effectiveness. Still, early impressions are that online speech therapy could be a game-changer for many kids who might otherwise be limited in the early intervention services they could receive.
One study found that kids receiving speech teletherapy outperformed control groups and national benchmarks in expressive and receptive language, social pragmatics and articulation skills.
Research published in the spring 2017 edition of the International Journal of Telerehabilitation concluded: "The evidence presented showed that telehealth is a promising service delivery method for delivering speech and language intervention services to school-age children. This alternative service delivery model has the potential to improve access to SLP services for children living in geographically remote areas, reducing travel time and alleviating the detrimental effects of communication difficulties on education, social participation and employment."
In other words: We KNOW that early speech and language communication skills are a strong indicator of a child's future success. The sooner we can treat speech and language deficits, the better off that child will be long-term. Online speech therapy is a way to extend the same services to kids who might have a difficult time to make it to the office everyday.
"The therapy we're offering isn't different - the mode of delivery is," explained Ott. "Many therapists believe that teletherapy is especially beneficial and a superior method for children in schools because it allows for a FULL session, without having to take time out of a session to transport students. More minutes means more progress."
It's also important to note that while screen time for young kids is generally frowned upon, teletherapy is different. While most television and online games deprive kids of key social interaction, the whole point of speech teletherapy is engaging them.
"Teletherapy is led and directed by a licensed, certified clinician, working specifically on therapy goals in a way that is tactical and motivating for each child and their needs," MacIntyre said.
Parent Feedback on FOCUS Online Speech Therapy Program
Parents come to FOCUS Fort Myers from all over Southwest Florida because we are one of the most trusted providers of speech, occupational, physical and ABA therapy in the region. But teletherapy is still fairly new, so it's understandable parents and even some providers would approach it with healthy skepticism. Ott said the primary concern initially is, "What if my child doesn't pay attention?"
"This is 100 percent understandable, and is a concern of ours as well," Ott said. "However, you can apply this question to your child in most situations - including at school and during in-clinic therapy sessions. In school, your child isn't paying attention ALL the time, and in-person therapy at FOCUS isn't always smooth-sailing either. Most children need frequent breaks in order to attend, and online speech therapy is no different."
Elliot Warford, 8, of Fort Myers, has been a speech teletherapy patient for several months now.
"We love teletherapy so much," his mother Crystal Warford said. "It's a more controlled, one-to-one session, as opposed to in the clinic, where there are sometimes distractions. He loves that Haley incorporates games, and he feels more in control when he gets to choose which games to play. And of course for us, it's convenient to be able to cook dinner while he's in therapy."
Teletherapy may not be an option for every child, but we also know for some kids, it can be every bit as effective as in-person sessions. Sometimes children are more engaged in teletherapy sessions than in-person sessions because they get access to functional screen time.
This service makes a big difference for working parents and families constantly ferrying back-and-forth to other appointments and commitments. It increases access to providers, allows for greater transparency (every session can be recorded) and children enjoy it.
"It's a great way to incorporate education with something they like and aid in increasing their development," Ott said.
Andrea Cappuccilli's daughter has been attending speech therapy, occupational therapy and physical therapy at FOCUS for the past several years. Recently, the 7-year-old started doing some of her FOCUS speech therapy sessions online from home.
"Our primary purpose for speech therapy is to work on voice and breathing exercises so that her respiratory system can get stronger," Cappuccilli explained. "Teletherapy at home gives her a solid chance of improving these skills, while allowing her to avoid exposure to illnesses like the flu or RSV that can easily put her in the hospital for weeks."
And her daughter loves it.
"She knows she's doing therapy, but being on a screen - which kids are already all about - makes it seem cool, and like it's on HER terms."
FOCUS offers pediatric speech therapy and online speech therapy for kids in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.
A Pilot Telerehabilitation Program: Delivering Early Intervention Services to Rural Families, Fall 2009, Jana Cason, International Journal of Telerehabilitation
While slime itself – slippery, gooey, smooshy, somewhere between liquid and solid – has a lot to offer in terms of sensory integration, the simple process of making it in a therapy session can give children a lot of practice in key skills we’re working to develop.
(And the lessons “stick” because, well – slime is cool!)
We encourage parents to try this – and other simple experiments – at home to get their kids talking!
Down syndrome, the most common chromosomal disorder in the world, affects 1 in every 700 children, or about 6,000 annually, a figure representing a 30 percent increase since the 1970s, according to the CDC.
Our Fort Myers speech therapists routinely treat children with Down syndrome, who frequently experience challenges to speech and language development. At minimum, speech is usually delayed, though many can be taught effective sign language to help with communication the first few years and beyond.
Most children with Down syndrome can benefit from speech therapy
Exact challenges and goals for speech therapy often vary depending the severity of certain physiological traits inherent in those with Down syndrome as well as whether they have co-occurring other conditions (to which they are prone) like hearing and vision problems, epilepsy and autism.
Our FOCUS Fort Myers speech therapists must admit: We were a little heartbroken upon learning there would be no more Sweethearts Conversation Candy Hearts this Valentine’s Day (MISS U!). In addition to the fact they can be used in a bunch of fun kids’ speech-language therapy exercises, we had a great idea for a special speech therapy line: TALK 2 ME. I LUV SPCH. WORD UP. LETS LINGO. I HEAR U. SLPZROCK. Not to worry, though – our speech therapists have other ways of making you talk…
In the spirit of spreading the love (despite being candy heart-less), our speech therapists are sharing some of our favorite positive affirmations for kids. Positive affirmations are the kind of declarations that go a step beyond praise and shine a light on something that is special and inherent in that child. Instead of simply, “Nice work!” we say, “You are a hard worker!” Instead of, “Good job on that one!” we say, “You are so brave to try new things.” Rather than just, “Cool picture!” we might say, “You have such a creative mind!”
Praise and compliments obviously are great too, but positive affirmation is more specific. It shines a light on something that is both inherent and special to that person. It acknowledges the challenge and validates the effort. Positive affirmation can help a child gain the confidence to keep going – even when it gets hard. Research shows that children who receive regular positive affirmations will believe, internalize and be motivated by it. In speech therapy, we often see them excel farther and faster.
The positive affirmation boost is backed by extensive research. One analysis published in the Annals of Behavioral Medicine found that children with cancer who practiced self-affirmation were overall more optimistic and coped better, achieved goals faster and ultimately had better health outcomes. Another study by psychology professors Carnegie Mellon University found that when people are under pressure, they can actually improve their ability to problem-solve by using positive self-affirmations. And a brain scan study published in the journal Social Cognitive and Affective Neuroscience established that people who practice self affirmation had higher activity levels in areas of the brain associated with reward.
Most any Fort Myers speech-language pathologist will tell you one of the first questions families of young children ask when inquiring whether certain missed milestones are cause for concern: “What if my child doesn’t respond to his name?”
It’s impossible to give a blanket answer because every child develops at a uniquely individual pace. (It’s also physicians – usually specialists – responsible for the actual diagnosis.) That said, a long-time speech-language pathologist will likely agree: If your child doesn’t respond to his name by the time they turn 1-year-old, it could indicate a developmental delay that requires action. You’ll want to alert your child’s primary care physician and discuss whether the concern warrants referrals for closer evaluation by specialists.
Responding to one’s name is a critical building block of functional communication. This wouldn’t be just a single instance when he couldn’t tear his attention from a riveting show or “selective hearing” in a moment of intense fun. This would be an issue that is consistent and noticeable (at least by you).
What Child’s Failure to Respond to Name Could Mean
Children learn speech and language through immersion. They closely watch your lips and hear the sounds while working to grasp the meaning. When there is a delay or disability that impedes that process, FOCUS Fort Myers speech therapists can help – but that doesn’t mean you should stop talking.
A recent study published in the Journal of Neuroscience reveals that when adults regularly engage young children in conversation, those kids will have stronger connections between the two developing regions of the brain known to be critical to language development.
This discovery held true even when researchers controlled for parental education and income, meaning engaging your children from a young age can help give them a language skills boost regardless of socioeconomic status.This is significant because many prior studies dating back to the early 1990s have established a so-called “word gap” when between children of disparate socioeconomic means. Those who grow up in lower-income households tend to have heard an estimated 30 million fewer words in their lives compared to classmates of more affluent means by the time they reach the ages of 4-6. Thusfar, it’s not been proven that the link is causal, but even if it were, this new research suggests to our pediatric Fort Myers speech therapists it can be overcome when parents devote the time to chatting their kids up at every opportunity.
Pediatric speech and language therapy is hard work – best achieved through fun-and-games.
Adults tend to disregard play as a silly childhood indulgence. However, consensus among speech therapists AND child development researchers is playtime is pivotal in speech-language progress – and overall development. In fact, almost all learning in those first five years occurs in play-based exploration. Further, these skills take root much faster when adults actively participate in child-led play.
FOCUS Fort Myers speech therapists have a treasure trove of toys, games, crafts and other fun things to encourage play, which directly spurs expressive and receptive language development. We’re also constantly on the lookout for new ideas. Sometimes we even make our own! Sometimes playful interest is captured in the simplest forms, like mushing food, making a paper bag rattle or blowing bubbles.
Speech therapists at FOCUS Fort Myers study for years – first in the classroom and then for the rest of our careers in practice at our clinic – learning ways to help children master key communication skills, from appropriate conversation to phonological awareness to comprehension. We use all sorts of tools to make that happen – including puppets, games, puzzles, swings, crafts – even a ball pit! But the most effective tool? Parents!
Parental engagement in helping carry over these same strategies with their child undeniably results in better, faster progress. (And the earlier we/ you get started, the better!)
We can cite countless examples that have us convinced, but it’s backed up by peer-reviewed research too.
Parental Involvement Helps Children Make Faster Speech Therapy Progress
The American Journal of Speech-Language Pathology followed the effects of parental involvement in language intervention on children between 1.5-to-5-years-old with language impairments that were both primary (language only) and secondary (accompanied by cognitive impairment or disability). Researchers reviewed 18 previous studies examining how well children did when speech therapists offered parents specific strategies to work with their kids outside the clinic setting.
When it comes to speech therapy, there are two general schools of thought: Early Intervention and Watch and Wait. Increasingly, doctors, specialists and teachers are on board with what our FOCUS Fort Myers speech therapists have been saying for years: Early intervention is key!
You may be familiar with the legend of Albert Einstein’s childhood speech delay leading to his parents’ concern he might not be bright. This purported speech delay of an unequivocal genius lends inspiration to many who struggle with similar issues. Unfortunately, it’s also given families of “late talkers” validation for the “Watch and Wait Approach” – which is typically not what we advise.
Until fairly recently, most pediatricians were content to let parents wait before seeking assistance with their children’s speech concerns, often not pressing for speech therapy until the child was school-age. That is changing – much to our enthusiasm! Clinicians are increasingly aware that speech impairments in children can lead to a greater likelihood of social struggles and reading problems. The younger the child, the more malleable their brains, and the better outcomes we have.