Speak_Out_June_2013

SPA online update and profile

SPA Twitter update Links to recent newsworthy articles tweeted and/or re-tweeted on our Twitter feed in April-May included:

• “How foetuses learn language” (9 May)

• Tasmanian member Holly Puckering on ABC Breakfast this morning speaking about Tounge Tie (18 April) • Gelada baboons calls may help to reveal more about the origins of human speech (9 April) • One in five kindy children are likely to struggle (4 April)

• A virtual speech pathologist is being developed in America. Any thoughts? (2 May) • A study of 900 pre-schoolers has found half of those with communication issues are neglected (29 April) • Friday afternoon food for thought: How the Brain Speaks Two Languages (25 April)

Join in the conversation and follow Speech Pathology Australia on Twitter: @SpeechPathAust

• Speech pathology is 12th best job in

2013 according to Wall St Journal (22 April)

Remember to join the discussion at the 2013 National Conference! #SPAConf2013

Speech Pathology Australia Facebook highlights from April to May included...

Communication impairment inAustralia

Stuttering

Thumbs up for a great effort!

What isaSpeechPathologist?

What iscommunication? Communication involves speaking,hearing, listening,understanding, social skills, reading,writingand using voice. What is communication impairment? Peoplewhohavedifficultycommunicatingmay require assistancewith: Speech: involves saying the sounds inwords so thatpeoplecanunderstandwhat is being said.For example, a childwhodoesn’t saywordsclearlyor anadultwho slurs their speech afteran accident. Language: involves theexchangeof ideasusingwords,usually in spokenorwritten form. For example,a childwhohas troubleunderstanding and following instructionsoranadultwhocan’t find the rightwords after a stroke. Literacy: involves reading,understandingwhat is read andcommunicating inwritten form. SocialCommunication: ishowwecommunicateand involves interpreting the contextof aconversation,understandingnon-verbal informationand the social rulesof communication thatareneeded todevelop a relationshipwithanotherperson. Voice: using the vocal cordsor voicebox toproduce speech.Forexample,apersonwho frequently loses their voiceorapersonwhohashad surgery for throatcancer. Fluency: commonly knownas stuttering.Thisproblem isusuallyfirstnoticedwhenachild starts putting sentences togetherbutcan continue intoadulthood.

Communication impairment ismorecommon 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,diagnose and treatcommunicationdisorders, includingdifficulties with speech, language, swallowing,fluencyand voice. Theyworkwithpeoplewhohavedifficultycommunicatingbecauseofdevelopmentaldelays, stroke,brain injuries, learningdisability, intellectualdisability,cerebralpalsy,dementiaand hearing loss,aswellasotherproblems that canaffect speechand language.

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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The Speech Pathology Australia Facebook site has now reached an impressive 2,816 followers at the time this issue of Speak Out went to print – this number

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Peoplewhoexperiencedifficulties swallowing foodanddrink 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 speakorwrite to communicatemore easily. This can include ‘unaided systems’ like signing and gesturesor ‘aided systems’ likepicture charts,books and special computers ordevices.

Augmentativeand AlternativeCommunication

at anygiven time and asmany as 5% across a life time.Stuttering usually starts in early childhood, oftenby the age of three. Itmay start graduallyoverdays,weekormonths, or it canbe sudden, over hours or a day.Stutteringmay change in type or frequencyover time. Itmaydecrease or seem to go away forperiods of time. TheSoundofSpeech:0 to3 years Theagesand stagesofchildren’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

( 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 soundsand talking toothers. Babiesbegin to learn from themoment theyareborn – first receptive language skills (understandingwhat theyhear), then expressive language skills (speaking). You canhelpdevelopboth kindsof language skillsby talking,watching, listening,playing and sharingbookswith yourbaby.

Recent research inAustralia indicates that8.5%of3 yearold childrenexperience stuttering. Learning to speak is a crucialparof a child’sdevelopmentand themost intensiveperiod of speechand languagedevelopmenthappens in the first three yearsof life. Even though children vary in theirdevelopmentof speech and language, thereare certain ‘milestones’ thatcanbe identifiedas a roughguide tonormaldevelopment.Typically, these skillsmustbe reachedatcertain agesbeforemorecomplex skillscanbe learned.These milestoneshelp speechpathologistsdetermine ifa childmayneed extrahelp to learn to speak oruse language.

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 sounds of theirparents’ language. They experimentwith soundsbybabbling (e.g. “baba”, “babamada”), andover time, theirbabblingbegins to soundmore andmore like realwords. What canmostbabiesdo? •Between 0-3monthsbabies communicateby crying, cooing, smiling, and making eye contact •Between 3-6monthsbabies 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) • Around 12monthsbabiesbegin to usewords Whatdomanybabies still finddifficult? Babies can’t saywords the sameway as adultsdo andoften simplifywords (e.g.biscuitbecomes “bi”). How canparentshelp? 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 isAAC? AugmentativeandAlternativeCommunication (AAC) isany typeofcommunicationstrategy forpeople witha rangeofconditionswhohavesignificantdifficultiesspeaking.

Whymightsomeoneneed to useAAC? If aperson is not able speak theymay need a variety ofdifferent typesofAAC 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 system or strategymay notbe sufficient tomeet all of their needs, allof 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 their ownbody.Examples of unaidedAAC include using eye contact, facial expression,body language,gestures andmanual sign.

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orspendingtimewithpeople whoalsohaveyoungchildren

Speechpathologyand Indigenouschildren

Speechpathology in mentalhealth services

TheSoundofSpeech: preschooland schoolagedchildren Theagesand stagesofchildren’s speech development

Mentalhealth Mentalhealth is related topromotionofwell-being andprevention, treatment and rehabilitation ofpeople affectedbymentalhealthdisorders.Mentalhealthdisorders affect aperson’s social, emotional and/orbehavioural functioning and canbe influencedbyanumberof 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 interactappropriatelywithothersacross the lifespan ina varietyof situations

Learning to speak is acrucialpartofa child’sdevelopmentandprogressmade in thepreschool and early school years is crucial tomastering the rulesof language. Even thoughchildrenvary in theirdevelopmentofspeechand language, therearecertain ‘milestones’ thatcanbe identifiedasa roughguide tonormaldevelopment.Typically, theseskillsmustbe reachedatcertainagesbeforemorecomplexskillscanbe learned.Thesemilestoneshelpspeech pathologistsdeterminewhetherachildmayneedextrahelp to learn to speakoruse language.

Preschoolchildren:3 to5 years Preschool children start to usemuch longer sentences, yet their speech should stillbe understoodby unfamiliarpeople (outsideof the family) about75%of the time.By 5 years of age, anyone (including unfamiliar listeners) shouldbe able to understand the child’s speech in conversation 95-100% of the time. What canmostchildrendo? • 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 combinations of 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). • Between4-5 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). Whatdomanychildren 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).

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 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

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

appropriatecommunication skills. Communicationandmental 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 threeor four complex languages anddialects and it’s these they’vegrown upwith, not standardAustralianEnglish. AboriginalEnglish varies across Australia,butdiffers toStandard AustralianEnglish in its sound system, grammar, story structure and in the way it’s used –wordsoften have differentmeanings and take into account the rich linguistic heritageof Indigenous culture. It is important that speechpathology services aredelivered from the

Indigenouschildren have a higher riskof health andotherproblems thanotherAustralian children.They are twice as likely tobebornwith lowbirthweightwhich can lead to communicationdifficulties. Indigenous children have extremely high ratesof 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 thedevelopmentof listening, speech and language skills, aswell as literacy development. AboriginalEnglish 80%of IndigenousAustralians speak ‘Kriol’or adialectof ‘Aboriginal

exceeds half of our total membership!

As a member you can help us spread the news about the important work of our profession by ‘ Liking ’ us on Facebook, and if you see an article, photo and/or link posted on our page that piques your interest, please feel free to ‘ like ’ this and share it with your colleagues and wider Facebook network – the more the merrier!

(Clockwise from top left) Our shelves at National Office began filling up quickly with 2013 Book of the Year contenders; we launched the new suite of fact sheets with much positive feedback received; SPA showed support for important initiatives such as World Autism Awareness Day (2 April) and World Voice Day (April 16).

Speak Out June 2013

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www.speechpathologyaustralia.org.au