SpeakOut_Feb2014_electronic

SPA looks back on the highlights from 2013

• Successful Branch lobbying campaign in Western Australia, resulting in 11 new positions created (March) • Despite active lobbying (1) , cessation of registration of speech pathologists in Queensland (May) • SPA membership voted in a new constitution (2) , marking a new era for the Association (June) • Fellowships awarded to Sue Horton (3) and Dr Amanda Scott (4) , and Recognition of Service Award to Jade Cartwright (5) (June) • Sea Change: Synthesize, Evaluate, Act! National Conference on the Gold Coast, attended by 755 delegates (6) and featuring • Launch of online Member Communities, including growth in number of communities available to members (June) (10) • New suite of fact sheets launched, including new speech, AAC and stuttering sheets, as well as in Easy English (June) (11) • Launch of the Speech Pathology in Youth Custodial Education (SPyce) report, to over 100 attendees from the education, health and government sectors (August) (12) • #SPWeek 2013 Start the Conversation one of our most successful ever (August) (13) • Chris Stone (14) retired as President after three years in the role, and Professor Deb Theodoros (15) began her term (September) eminent speakers such as Dr Rosemary Martino (7) , Dr Tiffany Hogan (8) and Professor Sharynne McLeod (9) (June)

1 From left, Meredith Kilminster, Gaenor Dixon, Gail Mulcair and Petrea Cornwell outside the QLD Parliament.

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Communication impairment inAustralia

Stuttering

What isaSpeechPathologist?

What iscommunication? Communication involves speaking,hearing, listening,understanding, social skills, reading,writing and using voice. What iscommunication impairment? Peoplewhohavedifficultycommunicatingmay require assistancewith: Speech: involves saying the sounds inwords so thatpeople canunderstandwhat is being said.For example,a childwhodoesn’t saywordsclearlyoranadultwho slurs their speech after anaccident. Language: involves theexchangeof ideasusingwords,usually in spokenorwritten form. Forexample, a childwhohas troubleunderstandingand following instructionsoran adultwho can’t find the rightwords aftera stroke. Literacy: involves reading,understandingwhat is read and communicating inwritten form. SocialCommunication: ishowwe communicateand involves interpreting the contextofa conversation,understandingnon-verbal information and the social rulesof communication thatareneeded todevelopa relationshipwith anotherperson. Voice: using the vocal cordsor voicebox toproduce speech.Forexample,apersonwho frequently loses their voiceor apersonwhohashad surgery for throatcancer. Fluency: commonly known as stuttering.Thisproblem isusuallyfirstnoticedwhena child starts putting sentences togetherbut can continue into adulthood.

Augmentative and Alternative Communication

AugmentativeandAlternativeCommunication is also calledAAC.

Communication problems inAustralia

AAC areways to communicatewhen a person ●can not speak ●is hard to understand ●finds it hard to understand other people. Peoplemay usemanyways to communicate. For example, ●objects ●picture boards or books

Communication impairment ismore common than you think...

Stuttering isaspeechdisorder thatcauses interruptions in the rhythmorflowofspeech. These interruptionsmay include

13,000Australiansuse electroniccommunicationaids togettheirmessageacross impairmentaresixtimesmore likelytohaveareadingproblem thanchildrenwithout 46%ofyoungAustralianoffenders havealanguageimpairment Thereisahighcorrelation betweencommunication difficultiesandpoormentalhealth Threeinevery1,000newborns havehearingloss,whichwithout interventioncanaffecttheir speech,languageandliteracy. Indigenouschildrenhavethree timesmorehearingproblems thannon-Indigenouschildren

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•Childrenwithautism,Down Syndrome,andCerebralPalsy

Speechpathologists study,diagnoseand treatcommunicationdisorders, includingdifficulties with speech, language, swallowing,fluency and voice. Theyworkwithpeoplewhohavedifficultycommunicatingbecauseofdevelopmentaldelays, stroke,brain injuries, learningdisability, intellectualdisability,cerebralpalsy,dementiaand hearing loss, aswellasotherproblems thatcan affect speechand language.

Communication problems are problemswith ●speaking

repeated sounds ( c-c-can ), syllables ( da-da-daddy ),words ( and-and-and ) orphrases ( Iwant-Iwant-Iwant ). Repetitionsmighthappenonce ( b-ball, can-can )ormultiple times ( I-I-I-I-Iwant, m-m-m-m-m-m-mummy ).Stuttering mayalso includeprolongations, where soundsorpartsof theword are stretchedout ( caaaaan Igo )and blocks.Blocksareoften silentandare seenwhen it looks like theperson is stuck, trying to speakwithno sound comingout.Thereareoften secondary behaviourswhichaccompany stuttering. Thesemaybe verbaland includegrunts, smallnon-speech sounds, fillerwords

oftenbegintheirlifewitha communicationimpairment 20%offouryearoldchildren havedifficultyunderstandingor usinglanguage 14%of15yearoldshaveonly basicliteracyskills 28%ofteacherstaketimeoff workeachyearbecauseof voiceproblems •Atleast30%ofpeoplepost-stroke sufferlossoflanguage(aphasia) • 85%ofthosewithParkinson’s diseasehavevoice,speechand/ orswallowingdifficulties

tobecausedbydifferences inbrain activity related to speechproduction. Thismeans that stuttering isnotusually causedor triggeredbyanevent,person, experience, stressoranxiety.Some people inheritapredisposition to stutter. Whodoesstutteringaffect? Stuttering can affect children, adolescents and adults.Around1% of thepopulation experiences stuttering

•Childrenwithalanguage

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●hearing ●listening ●understanding ●social skills ●reading ●writing ●using voice.

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Peoplewhoexperiencedifficulties swallowing food anddrink safelycanalsobehelpedby a speechpathologist.

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(puttingwords together andbeing understood)or receptive language (understanding instructions and meanings).Speechpathologists alsoworkwithAugmentative and AlternativeCommunication (AAC), devices that helppeoplewho find itdifficult to speak orwrite to communicatemore easily.This can include ‘unaided systems’ like signing andgesturesor ‘aided systems’ likepicture charts,books and special computersordevices.

Augmentativeand AlternativeCommunication

at any given time and asmany as 5% across a life time.Stuttering usually starts in early childhood, oftenby the age of three. Itmay start gradually overdays,week ormonths, or it canbe sudden, over hours or a day.Stutteringmay change in typeor frequency over time. Itmaydecrease or seem togo away forperiods of time. TheSoundofSpeech:0 to3 years Theagesand stgesofchildren’s speechdevelopment

Using assessment tools, speech pathologists are able todiagnose eachperson’s specificproblem and devise a treatmentplan thatbest suits their needs. Speechpathologists are specialists might visit a speechpathologist to help them understand and find the rightwords to use after a stroke, while a childmight need treatment to help their expressive language whoworkwithpeople across their entire lifespan.An adult

• Helping yourbaby to talk

●spelling boards ●speech devices ●computers ●mobile phones ●computer tablets.

( um/er )orpauses.Theycanalsobe non-verbal likegrimacing,blinkingor bodymovements. Theexactcauseof stuttering is unknown.Speechdisordersare thought

Language is fundamental to yourbaby’sdevelopment.Everybaby learns to speakby listening,playingwith sounds and talking toothers. Babiesbegin to learn from themoment theyareborn –first receptive language skills (understandingwhat theyhear), thenexpressive language skills (speaking). You canhelpdevelopboth kindsof language skillsby talking,watching, listening,playingand sharingbookswith yourbaby.

Recent research inAustralia indicates that8.5%of3 yearold childrenexperience stuttering. Learning to speak isa crucialpar of achild’sdevelopmentand themost intensiveperiod of speechand languagedevelopmenthappens in thefirst three yearsof life. Even though children vary in theirdevelopmentof speech and language, thereare certain ‘milestones’ that canbe identifiedasa roughguide tonormaldevelopment.Typically, these skillsmustbe reachedat certainagesbeforemore complex skills canbe learned.These milestoneshelp speechpathologistsdetermine ifachildmayneed extrahelp to learn to speak oruse language.

What can cause communicationproblems? There are lots of causes.For example, ●brain disorders from birth, like autism, Down syndrome and cerebral palsy ●medical problems, like cleft palate and lumps on the vocal cords ●hearing impairment ●diseases, likeAlzheimer’s and Parkinson’sDisease ●brain damage from accident or illness.

Talking •

•Watchyourbabyandcopytheir actionsandsounds.Showthem newactionsandactivities •Choosegamesandtoys appropriatetoyourbaby’sage thatencourageexploration, problemsolvingandinteraction betweenyouandyourbaby. • Fingergames,softdollsand stuffedtoys,balls,blocksand activityboardsallhelptodevelop yourbaby’sfingersandhands, aswellaslisteningandlearning skills •Buildarepertoireofsongsand rhymes.Singingthesamewords overandoveragainwillhelpyour babylearnlanguageandrhythm languageandthinkingskills,preparing childrenforlearningtoreadandwrite. •Readtoandwithyourbabyfrom birth–makebookspartofyour dailyroutine •Choosebookswithlarge,bright Sharebooks Earlyreadingpromotesgood pictures.Babieslovepicturesof otherbabiesandphotosoftheir family Pointtoandnameobjects,animals orpeople–eventuallyyourbaby willrespond

Talktoyourbabyoften,speaking slowly,clearlyandsimply Emphasisewordsfortheobjects mostcommonlyusedinyour baby’sworld •Useavarietyofwordstodescribe whatishappeningaroundyou,not justthenamesofthings •Repeatwords–yourbabywill begintounderstandthemeaning ofthemiftheyhearthemoften Imitatethesoundsyourbaby makesorsaythewordthey maybetryingtouse •Commentonthesoundsyou heartodrawyourbaby’sattention tothesound Taketurnswhenyoutalkand play,pausingtolistenandspeak justlikeyouwouldinanadult conversation • • Playing •Babieslearnabouttalkingand listeningthroughplay,soit’s importanttosetasidetimetoplay withyourbabyeachday •Createopportunitiesforyourbaby toplaywithotherchildrenby joiningaplaygrouportoylibrary, •

Babies:0-1 year During their first year, childrendevelop the ability to hear and recognise the soundsof theirparents’ language.They experimentwith soundsbybabbling (e.g. “baba”, “babamada”), and over time, theirbabblingbegins to soundmore andmore like realwords. What canmostbabiesdo? •Between0-3monthsbabies communicateby crying, cooing, smiling, and making eye contact •Between3-6monthsbabies communicateby crying, cooing, smiling, making eye contact,pointing,blowing raspberries and laughing •Between6-9monthsbabies communicatebybabbling, using sounds madewith the lips (e.g.b andm) in sequences like “baba” and later “bamada” •Between 9-12monthsbabies communicatebybabbling, usingmore sounds (e.g.d,m, n, h,w, t) • Around12monthsbabiesbegin to usewords Whatdomanybabies still finddifficult? Babies can’t saywords the sameway as adultsdo andoften simplifywords (e.g.biscuitbecomes “bi”). Howcanparentshelp? Childrenwhodo notprogress through this stageof “playingwith sounds” are at riskof speechdifficulties later.Parents can helpby talking to their infants and responding to any attemptsby their infants to communicate (e.g.by copying theirbabbling). For information about helping yourbaby to talk, see the “ Helping yourbaby to talk” fact sheet.

What is aSpeech Pathologist?

What isAAC? AugmentativeandAlternativeCommunication (AAC) isany typeofcommunicationstrategy forpeople witha rangeofconditionswhohavesignificantdifficultiesspeaking.

Whymightsomeoneneed to useAAC? If aperson is not able speak theymay need a variety ofdifferent types ofAAC systems to communicate. Somepeople also needAAC systems and strategies to understand another person’smessage. Peoplewho havedifficulties speaking often needboth high technology sytems, low technology systems and unaided AACdepending onwhere they are and withwhom they are communicating. OneAAC systemor strategymay notbe sufficient tomeet all of their needs, all of the time.

Thereare twomain types ofAAC –aidedAACand unaidedAAC. AidedAAC is any external item used to aid communication (e.g. object symbols, communicationboards,books, key-ringmini-cards,wallets, speech generatingdevice, computer,mobile phone, tablet).AidedAAC includesboth high technology systems and low/light technology systems. UnaidedAAC refers to communication techniques thatdo not require the use of an external aid.That is, theperson useswhatever is available to them, generally theirownbody.Examples of unaidedAAC include using eye contact, facial expression,body language,gestures andmanual sign.

Speech pathologistsworkwith peoplewith ●communication problems ●swallowing problems.

Speech pathologists ●study ●assess ●work out the problem

Helping yourbaby to talk

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orspendingtimewithpeople whoalsohaveyoungchildren

●give advice ●give therapy ●find the right tools for you.

Speechpathologyand Indigenouschildren

Speechpathology in mentalhealth services

TheSoundofSpeech: preschooland schoolagedchildren Theagesand stagesofchildren’s speech development

Babies start learningwhen they are born.

Babies understandwhat they hear first. Next babies learn to speak. Babies learn to speak by ●listening ●playingwith sounds and ●talking to others.

Communicationproblems include problemswith ●speech ●language ●swallowing ●stuttering ●voice.

Mentalhealth Mentalhealth is related topromotionofwell-beingandprevention, treatment and rehabilitation ofpeople affectedbymentalhealthdisorders.Mentalhealthdisordersaffect aperson’s social, emotional and/orbehavioural functioningand canbe influencedby anumberof individual and environmental factors includingbiological,psychologicaland social factors. Communication impairment Communicationdisordersmay involvedifficulties inoneormoreof the following: •Speechproduction •Understandingwhatotherpeople are saying • Formulating ideas intowords to talk toor respond toothers •Having the social skills required to interactappropriatelywithothers across the lifespan ina varietyof situations

Learning to speak is a crucialpartof achild’sdevelopment andprogressmade in thepreschool andearly school years is crucial tomastering the rulesof language. Even thoughchildrenvary in theirdevelopmentofspeechand language, therearecertain ‘milestones’ thatcanbe identifiedasa roughguide tonormaldevelopment.Typically, theseskillsmustbe reachedatcertainagesbeforemorecomplexskillscanbe learned.Thesemilestoneshelpspeech pathologistsdeterminewhethera childmayneedextrahelp to learn to speakoruse language.

Preschool children: 3 to 5 years Preschool children start to usemuch longer sentences, yet their speech should stillbe understoodby unfamiliarpeople (outsideof the family) about75% of the time.By5 years of age, anyone (including unfamiliar listeners) shouldbe able to understand the child’s speech in conversation 95-100% of the time. What canmost childrendo? • By4 years, children can saymost sounds correctly (e.g.,m, n, h,w,p,b, t,d, k,g, ng, f, y, s, z, ch, j, sh, l).They can usemany consonant clusters, which are combinationsof twoormore sounds (e.g., tw, sp, gl).Children may use clusters at the start (e.g.,blue)or endofwords (e.g., hand).Also, childrenwill saymost vowel sounds inwords correctly (e.g., ay, oh, ee). • Between 4-5 years,preschool children start todevelop skills thatwillbe important for learning to read andwrite (called “pre-literacy skills”).They become aware that spokenwords can rhyme (e.g., cat –bat), and canbe broken into syllables/beats (e.g., am-bu-lance). Whatdomany children still finddifficult? • Some sounds are later todevelop and childrenmay still havedifficultywith them at this age. For instance,preschool children commonly havedifficulty with “r” (e.g., saying “wed” for red), “v” (e.g., saying “berry” for very), and “th” (e.g., saying “fank you” for thank you) • Some children are stilldeveloping the ability to use consonant clusters (e.g., scribble and strawberry),or to say all the sounds correctly in longerwords (e.g., caterpillar and spaghetti).Some childrenmay stillproduce “s” as “th” (e.g., a lisp) Whatcanparentsdo tohelp? Ifparentsareconcernedabout theirchild’sspeechdevelopment, theyareadvised to have theirchild’shearingcheckedbyanaudiologistashearing is important in learning how tosaysoundscorrectly.Also,parentscan visitaspeechpathologist ifconcerned about theirchild’sspeechdevelopment. Inparticular,a visit to thespeechpathologist is recommended ifchildrencannotbeunderstood, if theyare frustratedwithattempts tocommunicate, if theirspeechappears veryeffortful, if theyareusing very few words,or if theyarenotusingsoundsat thestartofwords (e.g.,saying “ish” for fish).

What can youdowith yourbaby? Ideas for talking ●Always talk to your baby

Communication impairmentcan impact onaperson’sability toparticipate in schoolandeducation,getand keepa joband socialisewith their family, friends andcommunity.This limits theway they form friendshipsand relationshipsas wellasaffecting thedevelopmentof

Adultsandchildrenwith speechand language impairmentsaremore likely tohavementalhealthproblems than thosewithout.There isalsoa strong linkbetweenaperson’scommunication skillsand theirmentalhealth status. The roleof speechpathologists inmentalhealth Speechpathologistsaim to improvea person’scommunicationandswallowing skillsso theycan function ineveryday life.Thegoalofspeechpathology intervention is to improveaperson’s ability to functionphysically,sociallyand mentallyathome, in theclassroom, in theworkplace, insocialsituationsand in mentalhealth treatmentprograms. Speechpathologistsarean important

–slowly –clearly –with simplewords.

•2.4%oftheAustralianpopulation(455,000)isIndigenous •Morethan50%oftheIndigenouspopulationliveinremoteareas •84%ofIndigenouspeoplelivinginremoteareasdonotspeakAustralianEnglishathome •21%ofIndigenousAustraliansdon’tuseAustralianEnglish

appropriatecommunication skills. Communication andmental healthdisorders Communicationdisordersoftenco- occur in individualswithmentalhealth issues,wit hsomepeopleexperiencing mentalhealthproblems related to pre-existingcommunicationconditions (e.g. they feeldepressedoranxious about theircommunicationdifficulties). Communicationand/orswallowing difficultiescanalsobepartofaperson’s mentalhealthdisorder (e.g.disordered speechand lan guagecanbe features ofschizophrenia,andswallowing difficultiesaspartofdementia). Swallowingdisorders inmentalhealth oftenoccurasasideeffectofmedication orasa resultofsubstanceabuseor acquiredbrain injury.

English’ andmanypeoplewho hear it spokenwrongly assume it tobe “pidgin English”. In fact,most Indigenous children in remote areas know three or four complex languages anddialects and it’s these they’ve grown upwith, not standardAustralianEnglish. AboriginalEnglish varies across Australia,butdiffers toStandard AustralianEnglish in its sound system, grammar, story structure and in the way it’s used –words often have differentmeanings and take into account the rich linguistic heritage of Indigenous culture. It is important that speechpathology services aredelivered from the

Indigenouschildren have a higher risk of health and otherproblems thanotherAustralian children.They are twice as likely tobebornwith lowbirthweightwhich can lead to communicationdifficulties. Indigenous children have extremely high rates of middle eardisease (around 70% of all children in remote communities),which can lead to conductive hearing loss. Hearing loss from early in life can affect thedevelopment of listening, speech and language skills, aswell as literacy development. AboriginalEnglish 80%of IndigenousAustralians speak ‘Kriol’ or adialect of ‘Aboriginal

partof thementalhealth team that assessespeoplewithmentalhealth issues,as they identifycommunication difficultiesanddevelopappropriate treatment targets.Aspartofamental health team, speechpathologistsplay an important role indiagnosingcertain mentalhealthconditions, likedementia, schizophrenia,autism spectrum

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SPyce Report launch: (L–R) Brendan Murray, Robyn Stephen, Ian Lanyon, Laura Caire, Christine Lyons, Gail Mulcair, Pamela Snow and Christina Wilson. 12

• Five authors awarded in the 10th anniversary SPA Book of the Year Awards (October) (16)

10 Speak Out February 2014

Speech Pathology Australia