Week 6, Blog 1

On Monday, I did everything I usually do. I pick the boys up at school at 2:15 but I always tend to get there forty five minutes early, not sure why...then we go home. Once we are home, they empty their backpacks and lunch boxes and figure out what they have for homework. Gus has a checklist he has to fill out everyday so he remembers do to all his homework and its almost easier to have everything written down in front of him. Sam, on the other hand, heads straight upstairs and is done with his homework in an hour. After Sam is done with his homework, he usually goes outside for an hour or reads or plays on the iPad. Gus often needs help with homework so he usually is in an hour and a half to two hours. It was Monday, so Sam had soccer at six, which meant dinner at 5:15 and out the door at 5:45. I know how to get to soccer usually, but I drove like we were going to Tae Kwon Do so we had to go the long way. These boys are so good with instructions that if someone stopped me and asked me for directions I think I could actually give street names! Sam and Gus have taught me so much.

Week 5, Blog 3

On Friday Sam went downtown with his friend Ben to get pizza and orange leaf. Earlier that day, I received a text from Sam and Gus' mom saying that she had talked to the boys about stranger danger because there is a level three sex offender back in town. This scared me because, although the boys know not to talk to strangers, they often forget things and with Sam and Ben downtown alone, I got very nervous. I was especially nervous when they were twenty minutes late coming home.

While Sam was downtown, Gus' tutor Krista came. They did stuff together for about an hour alone and then once Sam came home, they asked him to come and play a game with them. This game, which I don't remember the name of, is a really fun game for kids their age and even kids my age. There are different categories you can get by rolling the dice. One is sculpting something out of clay and having people guess, another is acting something out, then drawing something, and then their are riddles, pictures and things that you have to go and get. This game is really great for them because it helps exercise their imaginations and it's really fun.

After they finished the game, Krista left and the boys went outside for about half an hour. Once they came in, they washed their hands, got dressed for Tae Kwon Do and we left. At Tae Kwon Do, they do lots of stretches and great exercises that really work with every part of the body. I never realized how much strength Tae Kwon Do takes. About half way through, the boys mom came and I took off.

Week 5, Blog 2

Tuesday and today, I worked in isolation by myself cleaning out the cages and feeding the dogs. Four out of the six puppies were super shy so it was hard to lure them out of the cage long enough to clean it and get them back in. After, Katherine and I got put to work, sorting the education room. There was a ton of dog food, cat food, beds, toys and treats. Today, we also had to bring every dog from isolation outside for a walk. All the cages were full so it took about an hour to two hours to get every dog outside. Some of the dogs were teeny tiny puppies so we set up an x pen and brought them outside to play for a while in that. Our supervisor, Sunniva told us we had to be extra careful because since the puppies were so small, a hawk could come down and snatch them. It was a good two days of almost alone time working in isolation. It gave me a lot more responsibility.

Madeline: Week 5, Blog 1

Monday was just like every other day I had spent with Sam and Gus. I pick them up from school, and as always I get there 45 minutes early. On the drive home, Gus analyzes the traffic and asks how it was before I picked them up, we get home, the empty their backpacks and start their homework. Sam always goes upstairs to do his homework and is done in about an hour. Gus and I work on his homework together and get done in an hour to an hour and a half. He has a check list that his therapist Krista gives him so he can visualize what he has to do for the day/week. This helps him make sure he has done everything and stay on track. This also helps him not get stressed out and keeps his mind from wandering around. After he finishes study island and any written homework, I let him go outside with Sam for an hour while I clean up the house and make dinner. On Mondays, Sam has soccer at 6 so after they finish dinner, Sam gets ready for soccer and Gus reads. Gus records himself reading two pages so he can listen back to how he sounds and make sure he is reading the words right. AFter we dropped Sam at soccer we go back home and while I finish cleaning the dishes, Gus finishes his reading. The dad comes home around 6:30, and I go home.

Week 4, Blog 2

I officially don't have to ask Sam and Gus how to get back home from school or how to get to Tae Kwon Do!! I finally know how to get around Marblehead, maybe not like I know how to get around Essex and Manchester, but I'm pretty confident that if someone asked me how to get somewhere, I could tell them. Monday and today were normal days. I pick them up at 2:15, we go home, they do homework and then play outside. Except they have MCAS all week so the only homework they have is to read and do coin academy, an online math game. On Monday when they finished the very small amount of homework, they played outside for the two hours I was there. Today, they played outside for an hour, and then I had them come in and we brainstormed ideas of what they could make their mom for mothers day.
The first thing I thought of that I had seen someone do on youtube was make a pretend camera out of recycled soda cans. It was easy enough yet not to babyish for eleven years old to be making. The only problem was that we didn't have a glue gun. So that idea was out of the picture. Then I had seen something where you take water bottle and cut them into strips but keep the bottle together by not cutting the top off. After you cut the strips, you paint them different fun colors and then glue all of the bottles to a round wire to make a recycled water bottle flower wreathe. But of course they didn't have any water bottles, which I should not be complaining about because recycling is good.
The last thing I thought of, I had seen in a magazine. I had the boys trace their hand and part of their arm on brown paper and then cut the whole thing out. Then I had them water color a piece of white paper and make a pretty background. Once everything had dried, they glued the arm/hand to the background and glue fake flowers and leaves to the arm/hand and it looked like a pretty tree!!
I got to pay attention to the boys, let them think of ideas, let them be independent and they made a mothers day present for their mom!

Week 4, Blog 1

On Saturday, I worked 2:30 to 10 at night. That doesn't seem like appropriate SCORE times but it counts. Since it was Saturday, the boys didn't have anything to do that day. I decided to take them to see a movie and get dinner after. Once I got to their house, we had to quickly decide what movie time we were going to see because the earliest one was at four and we would have had to leave soon. One thing that I have noticed about Gus, the autistic twin, is that he is always focused one time, what time his parents are going to get home, what time he has an activity, how much time we have to get from one place to another. So when we decided to go to the earliest movie, I could tell Gus got worked up about the time but was clearly trying to hide it. We got to the movies with ten minutes to spare so we just sat in the theater watching the pre-previews. Gus likes to narrate things, so during the pre-previews and the previews, he would kind of narrate, kind of summarize each preview. After every preview, he would ask me when I think the movie will come out and if I will see it. During the actual movie, when something funny would happen, Sam would barely chuckle, trying to seem cool, and Gus would die laughing and flap his arms.

After the movie was over, Sam and Gus gave me directions back to Marblehead to Five Guys. The boys picked this out, because when they go here, or wherever they go, they always get the same things. The rest of the night was a breeze and they went to bed perfectly.

Week 3, Blog 3

Yesterday was just like every other day with Sam and Gus. I pick them up, we drive home, they do homework, play outside, eat dinner then their mom comes home. But a few things happened that made it a little different from every other day. When we pulled into the driveway I asked Sam to go unlock the door and open the garage so I could pull the car in. He took about five minutes to do this and I just thought he was having trouble with the door. Once the car was in the garage and they were getting their bags out of the back of my car, I noticed Sam had crumbs on his mouth. I asked what he had been eating and he said "nofing". I asked him again and he replied corn bread. We went inside and continued our day. I walked into the bathroom and noticed crumbs, clearly corn bread crumbs, all over the floor and toilet cover. I called Sam over and asked him why he ate it in the bathroom ad I could tell he was trying to make up a story as he went. I know he snuck the corn bread into the bathroom so I wouldn't see but he still won't come clean.

The difference between Sam and Gus is that when I ask Sam if he did something that he should't have, he lies and makes up a story to try and cover up  where as Gus is super apologetic and tells the truth right off the bat.

Week 3, Blog 2

My second day with Sam and Gus was way easier than my first day. Today, they walked to the corner and I picked them up. This gives them some independence and time together. I don't get how they are so good with directions but they are the reason I know how to get around Marblehead now. We got home and again they did their homework for an hour and a half and then we went outside. While they were still outside, I came in and made turkey burgers, green beans, cucumbers and broccoli. After we ate, they got ready for Tae Kwon Do and we took off. I never knew how intense TKD was, and am very proud to see that Sam and Gus get multiple compliments during it.

Week 3, Blog 1

My first day with Sam and Gus was a success!! I have known these boys since they were two so it makes everything a little bit easier. I drove to Marblehead and of course got lost on my first day. I quickly got back on track and went to the boys school and waited. And waited. And waited, until I saw Gus come running around the corner! He was smiling and ran up to me and gave me a huge hug and asked me how my day was! We got in the car and waited for Sam to come and then he was calling me. I pick up the phone and heard a very "cool" and "collected" Sam asking me where I was. After I explained it they gave me directions on how to get home and we made it in one piece!

They did their homework for the next hour and half and when they finished we went outside for an hour and played baseball and basketball. One thing I noticed about Sam and Gus playing sports is that while Sam just plays the sport, Gus narrates everything. He also, when he gets excited, flaps his hands and jumps up and down. They are both very sweet, outgoing boys and one word isn't going to change that. Im not sure if Sam knows his brother has autism, but he doesn't treat Gus any different. My first day was awesome with them.

Week 2, Blog 3

This was  my last FULL week of working at the animal shelter. On Thursday, I got to take four of the new puppies to the vet to be neutered/spayed. These puppies had come from Puerto Rico two days prior along with four other puppies and six kittens. After I came back from bringing the puppies to the vet, there was a lot of cleaning to do before the shelter was open to the public. After everything was cleaned up and the shelter had just opened, I hung out in the cat room and watched as quite a few people came in and out looking at the cats and kittens. Then, once I got back in the dog room there was a couple that wanted to play with some of the dogs outside to see how they acted together. I could tell that this couple really wanted to adopt a new dog but was torn between a few. Once back inside, a woman wanted to play with one of the puppies in the play area, so I brought all three of the tiny puppies to play with her. The one she wanted to adopt was acting up and and she decided on another puppy. The only problem was that none of them had reached a certain weight that they have to be in order to be neutered!

Week 2, Blog 2

Today, the first thing I did was go to Iso with one of the staff members Tom. The shelter had just gotten a new shipment of puppies and kittens the night before that were all down in Iso and needed new beds and food. To make sure that we don't get any germs from the animals in iso, we have to put on gowns and booties and gloves but since they didn't have any gowns we had to wear trash bags. The cleaning out of cages in iso is almost the same as cleaning out the cages of dogs who are adoptable. We have to move the puppies over so that we can fully get in and clean out the cage. These puppies cant have real bedding yet so we use full sheets of newspaper on the bottom then shredded newspaper to soak up anything and it is more comfortable than just regular newspaper.

Later on, Sunniva, my advisor, showed me these new toys that someone had heard of. If you cut a long rectangle out of a fleece blanket and cut small tassel like things out of the side and leave a small space in the middle, you can create a dog toy. By putting a water bottle inside and tying up all the tassels, it becomes a toy dogs can play with. I spent about half an hour making those and also spent an hour sorting a few huge boxes of small and large collars and a bunch of leashes. By organizing these, it will be easier for staff and volunteers to quickly grab a collar and a leash and take a dog out to play. I absolutely love volunteering at the animal shelter, and it is starting to steer me in a different direction for the future.

Week 2, Blog 1

My first day back from break wasn't what I thought it would be. For some reason I was expecting all the same dogs and cats to be there waiting for me to come back. A lot of the animals had been adopted, which is both happy and sad. Happy for them because they went to their homes and have a family now, but sad for me because I wont get to see them again. Although, I do love meeting new puppies. The first thing I had to do when I got to the shelter was help clean out the cages. One person has to bring the dog out, while someone else cleans out the cage. First, we have to the beds and toys out and put them in barrels to be brought down to the laundry. Then we have to make sure there is no pee or poop in the cage and then we take the hose and wash it out. They use a chemical, that is okay around animals, and use that on the cage and let sit for ten minutes. After that, we rinse it down, put new bedding and toys in and bring the dogs back in. Throughout the day, we feed them, and make sure their cages are clean and take them outside to play. I would say that it was a good day back.

Maddie Monagle Blog 2- 4/10/13

Yesterday, I met all the dogs down in isolation! These dogs had just come from Puerto Rico and had to be in isolation for forty eight hours before they could be moved up stairs to the regular cages. We had to help weigh them, but some of the dogs were to shy. There were two puppies that we had to take out and I put one down on the floor so I could clean out her crate. As soon as Kate, the woman that works there, came back in with the puppies brother, the little one on the floor had crawled under the crates. It took us a few minutes to get her out because she was so scared. It was important for us to get all the dogs weighed and labeled so that we could get them up to the cages so they would have the chance to be adopted.

Today, we were able to bring four dogs up from isolation. They aren't quite ready to be adopted yet because they still need to be neutered and spayed. Today was also the first day that I was there when the shelter was open. We had a few visitors come in looking for kittens but one cat finally got taken to her new home! There are so many great animals at this shelter so if anyone wants a new cat or dog, this is the place to go!!

Maddie Monagle, Blog 1- 4/8/13

My first day of SCORE was amazing. When I first got there they had me train with the cats first, so I would be able to handle the cats by myself. Then they showed me where everything goes and what to do with all the cat supplies. There were so many adorable cats, old and young, that I wanted to take home with me. One of my favorites is this seven month old cat named Marcelo. I would walk over to his cage and open the door and he would climb right up onto my shoulders. He also followed me around most of the time that I was in the cat room. The cat room has many, good sized cages that can be opened up to make a two floor room for each cat. The colony rooms are rooms where up to six cats can be put together so they have someone to socialize with.

After lunch, I helped walk two dogs, Bart and Bebe, who are both still puppies but are big puppies. The trails at the animal shelter provide a great opportunity for the dogs to run and spend time outside without being fenced in. The next hour or so I spent back in with the cats, until one of the women that works there came in and asked Katherine and I if we wanted to see something really cute.  I spent the rest of my day with Sassy and Rowdy, tiny chihuahua puppies. Then as I was signing out, I was asked to come help bring more puppies upstairs. These puppies had just arrived from being spayed and neutered, and are now ready to find there forever home. I am so excited to spend the next few weeks here, hopefully watching these dogs and cats finding homes.

Research Paper Outline

Question: How does autism effect the relationship between siblings

Thesis: Autism effects the family in different ways but the siblings are most effected.

I. What is Autism?

A. Autism is a complex disorder of brain development

1 have trouble relating to others

2 can't understand other peoples thoughts, feelings and needs

3 may have a limited number of interests and activities

B. 1 in 88 children are on the spectrum, symptoms 

1 communication- avoid eye contact, make noises but don't really talk, or parrot noises they hear, trouble communication with body language

2 relationships-act as if people around them don't effect them, don't seek love

3 interests-seem stuck on one activity, not interested in other things

4 senses-they are sensitive to taste, touch, smell, and sound

5 talents-more advanced in some areas: drawing, math, reading, memorization

C. Autism can be caused by older parents when the baby is conceived, sickness during the pregnancy, difficulties during birth like less flow of oxygen to the babies brain

1 the normal neurons in the brain are smaller than normal

2 short nerve fibers that affect signaling

II. How does it effect the family?

A. Different stages of dealing with autism

1 Shock

2 Sadness

3 Anger

4 Denial

5 loneliness 

III. How does Autism effect how the boys act together?

A. the one with autism is more vulnerable to be pushed around

B.  Observations

IV. What is different between the boys?

A. How they play

B. How they learn, read, write

C. How they act together and apart

Citations

Books:

Knight, Jeffrey. Salem Health Genetics and Inherited Conditions. Pasadena California: Salem Press, 1999.

Grandin,Temple, Izenberg, Neil. HUman Diseases and Conditions/Thinking in Pictures and Other Reports from My Life with Autism. New York: New York: Vintage Books , 1995.

Kahn,Ada, Fawcett, Jan. The Encyclopdeia of Mental Health. New York, New York: Library of Congress Cataloguing-in-Publication Data, 1993.

Periodicals:

Goehner, Amy Lennard. "Autistic Kids: The Sibling Problem." TIME, December 24, 2007. http://www.time.com/time/health/article/0,8599,1698128,00.html (accessed March 14, 2013).

AMY LENNARD, GOEHNER. "A Generation of Autism, Coming of Age." New York Times, 4 13, 2013. http://www.nytimes.com/ref/health/healthguide/esn-autism-reporters.html (accessed March 14, 2013).

http://www.time.com/time/health/article/0,8599,1698128,00.html

http://www.autismspeaks.org/what-autism

http://jenza20.hubpages.com/hub/How-autism-affects-siblings

New Labels

New Labels

Maddie McNamee SCORE Final Draft

Elementary Age Communication Disorders

The Diagnosis and Treatment Process

Throughout the past decade our society has become more aware and more accepting of handicaps, whether they be mental or physical. Due to this growing tolerance, treatments for these disorders have improved and are more widespread. Even in an age where the need for face-to-face communication is slowly declining, communication disorders is one of the areas where this is especially true. Many of these disorders can be effectively treated through therapy or medical intervention, and as diagnosis of these disorders becomes more prominent, the demand for therapy has grown. The professionals responsible for the therapy of communication disorders are Speech Language Pathologists. Speech Language Pathologists are people who have received a Clinical Competence Certification for Speech Language Pathology (CCC-SLP) and are capable in treating speech, language and swallowing disorders in individuals of all ages, from infants to the elderly. Of all these age groups, treatment for elementary age children has grown the most and has an overwhelming demand. However, due to the large spectrum of communication disorders in elementary age children, Speech Language Pathologists have broken up these disorders into three main brackets: Language Disorders, Speech Disorders, and Medical and Developmental Disorders. All variations of communication problems will fall under one of these umbrellas. In the last fifteen to twenty years there has been great progress made in the diagnosis and treatment process of these three main categories of school age language-based disorders. This progress has led to the prominence of Speech-Language Pathology as a profession, and the social awareness of these disorders in today’s society.

I.      Language Disorders

Even with the growing demand of Speech Language Pathologists, there is still a great confusion over the categorization of communication disorders, many of which fall into the category of Language Disorders. Language problems are much more complex and difficult to detect then Speech difficulties because everyone has difficulty communicating at one point or another. Language Disorders “involve the inability to choose words and form sentences and can be part of more general problem,” such as delayed development.[1] Language Disorders are either expressive, which involve having difficulty communicating one’s message or meaning to others, or receptive, which involve having trouble understanding or interpreting messages coming from others. However, Language Disorders are not only limited to spoken language but are also extended to written language.[2]      

One of the most common types of disorders under this umbrella is the category of Language Based Learning Disabilities. The American Speech and Hearing Association, otherwise known as ASHA, defines language-based learning disabilities as problems with age-appropriate reading, spelling, and/or writing. This disorder is not correlated with how bright a person may be; in fact, most people diagnosed with language-based learning disabilities have average to superior intelligence. The diagnosis process for this disorder is long, and involves many different opinions from professionals in all areas. A Speech Language Pathologist is part of a team consisting of the parents or caregivers and educational professionals (i.e., teacher(s), special educators, psychologists) that will assess a child before making the label permanent. The Speech Language Pathologist will evaluate spoken language, listening, and written language, as well as reading for children who have been identified by their teachers and parents as having difficulty. Standardized language tests are the most common and reliable method for answering the first diagnosis question. In order to decide if a child meets their age expectations a Speech Language Pathologist must have data on the child’s language performance. Once they have identified that there is in fact a language difficulty present they will follow the medical model and check for hearing acuity and neurological motor function. After all of these tests have been conducted a Speech Language Pathologist will meet with the rest of the diagnosis team and come to a conclusion as to whether a disorder exists, or the extent of the disorder present.[3]

Once a child is diagnosed with a language disorder, the goals of speech and language treatment for the child are to target the specific aspects of reading and writing that the child is missing. For example, if the child is able to read words but is unable to understand the details of what has been read, comprehension is addressed. This can be done through reading articles or stories and then asking the child questions on the information they have just read or heard. The questions asked are usually “WH” questions, or who, what, when, where, and why, questions that pertain to the story. This repetitive practice can teach the child the techniques they can use to help them understand what they are reading and eventually use them without the prompting from a Speech-Language Pathologist.

Selective Mutism is another common Language Disorder that is addressed by Speech Language Pathology during childhood. A child with Selective Mutism does not speak in certain situations, like at school, but speaks at other times, like at home or with friends. Selective Mutism often starts before a child is 5 years old, but is usually first noticed when the child starts school.[4] As with Language Based Learning Disabilties, a child will meet with a Speech Language Pathologist, who is collaborating with a pediatrician and a psychologist or psychiatrist, to diagnose the disorder. These professionals will work as a team with teachers, family, and the individual. The diagnosis process of Selective Mutism is similar to that of any other Language Disorder. A child will see a Speech Language Pathologist and go through a screening process that involves standardized testing. The data collected will be compared to the child’s age group to look for any deviations from the norm. The child’s hearing and neurological functioning will also be tested in order to see if there are any severe problems that explain the child’s failure to speak. The team of professionals will then discuss the data collected and arrive on a conclusion for diagnosis and treatment for the child.

Once a child is formally diagnosed with Selective Mutism, the type of intervention offered by a Speech Language Pathologist will differ depending on the needs of the child and his or her family. The child's treatment will use a combination of strategies, again depending on individual needs. The Speech Language Pathologist may create a behavioral treatment program, focusing on specific speech and language problems, and/or work in the child's classroom with teachers. The goals of treatment will usually be to target problems that are making the mute behavior worse, encourage communication and lessen anxiety about speaking, and help the child communicate with peers in a group by first using non-verbal methods (e.g., signals or cards) and gradually adding goals that lead to speech. The most common behavioral treatments for Selective Mutism are stimulus fading and shaping. Stimulus fading involves the child in a relaxed situation with someone they talk to freely, and then very gradually introduce a new person into the room. Most often this will be a child talking alone with their parent while the Speech Language Pathologist is slowly introduced. This introduction of the Speech Language Pathologist will allow the child to become comfortable with them, and feel able to work with the pathologist. The next tool used is shaping which is where a Speech Language Pathologists will use a structured approach to reinforce all efforts by the child to communicate, (e.g., gestures, mouthing or whispering) until audible speech is achieved. Such rewards may involve candy, stickers, a star chart, or any other incentive that encourages a child to speak.[5]

II.    Speech Disorders

In addition to Language Disorders, Speech Disorders are commonly present in children, and are the second category of elementary age Communication Disorders. Speech disorders refer to several conditions in which a person has problems creating or forming the speech sounds needed to communicate with others. Approximately “10-15% of pre-school age children and 6% of school-age children exhibit a Speech Disorder.”[6] The most common Speech Disorders involve incorrect production of sounds, impairments in the flow of speech due to disruption, and abnormal quality and pitch of speech. Speech disorders usually have their roots in oral-motor difficulties, although some involve language-processing problems.

One prominent Speech Disorder is Childhood Apraxia of Speech, which is a malady of the nervous system that affects the ability to sequence and say sounds, syllables and words. Children with Apraxia of speech have “great difficulty planning and producing the precise, highly refined and specific series of movements of the tongue, lips, jaw and palate that are necessary for intelligible speech.”[7] The assessment process for Childhood Apraxia of Speech is conducted using standardized tests and informal testing and observation, and parent/patient interview. Standardized tests do not directly diagnose Apraxia, but provide helpful information about a child’s communication and can help rule out other disorders. Thus, diagnosis for Childhood Apraxia of Speech is done more on an informal basis; however, this diagnosis process may take a very long time for children with this disorder because it is difficult to get sufficient speech samples for diagnosis. In the informal evaluation, a complete inventory of the sounds, syllable shapes, and words a child can make or attempts to make will be noted, as well as any “mistakes” the child makes when doing so. 

Once a child is diagnosed with Childhood Apraxia of Speech, they will meet regularly with a Speech Language pathologist to treat it.  Intervention for the child diagnosed with Apraxia often focuses on improving the planning, sequencing and coordination of motor movements for speech production.[8] Once a week meetings with a Speech Language Pathologist will not be enough for a child with this disorder because they need constant practice for articulation errors to be resolved. Many frequent half-hour sessions during the week is the best option versus longer less frequent meetings, because often the child is unable to focus for a long period of time. During these sessions a Pathologist will focus on putting together single sounds into words. While the child is talking, the Speech Language Pathologist may feel how the child moves from sound to sound, to do so they will “press or tap places around the face, such as the lips or under the neck, as the child is attempting to produce the word.”[9] By doing this the Pathologist will be able to correct how the child is forming words or sounds with their mouth so that they will be able to pronounce sounds better and provide clarity to their speech.

Another common type of Speech Disorders is Speech Sound Disorders, or articulation and phonological processing problems. Most children make some mistakes as they learn to say new words. A speech sound disorder occurs when mistakes continue past a certain age. Every sound has a different range of ages when the child should make the sound correctly. Speech sound disorders include problems with articulation, which is the precise movement of the tongue, lips and jaw in the production of speech, and phonological processes, which are the patterns in which speech sounds produce meaningful words. Out of a Speech Language Pathologist’s case load, about 80% of their patients are elementary age children with articulation of phonological processing problems.[10] These two disorders are diagnosed through the usage of standardized tests, and informal assessment where children are asked to name or describe certain pictures. However, a Speech Language Pathologist cannot simply diagnose these disorders through observation, they must also look to see how the child pronounces words, and examine the child’s mouth to see if there are any physical ailments affecting the child’s speech.[11]

After the child has been formally diagnosed with an articulation or phonological processing disorder, they will begin treatment with a Speech Language Pathologist. During therapy the Pathologist will provide treatment to improve articulation of individual sounds or reduce errors in production of sound patterns. According to Sarah Griffin CCC-SLP, to target a child’s problem areas, a Speech Language Pathologist will “first target a single sound (or set of sounds)”, which will be worked on intensively for months, and then eventually move on to phrases, and finally conversation.[12] Sarah Griffin also discussed that games are often used in therapy to motivate a child, especially games that involve taking. Taking turns during a game will allow a Speech Language Pathologist to have the child practice the sound they are working on and capture the child’s attention. For example, the Pathologist may have the child say five words with the letter “r” between each turn.[13]  

One of the most prominent Speech Disorders is stuttering, which is a disruption in speech flow characterized by frequent repetitions of speech sounds, syllables, words and/or phrases, prolongations of speech sounds, and blocks (an individual’s inability to start a word). Approximately 5 percent of all children go through a period of stuttering that lasts six months or more. Three-quarters of those will recover by late childhood, leaving about 1% with a long-term problem. The best prevention tool for stuttering is early intervention. A child should be evaluated for a stutter if their stuttering lasts more than a few months. A stuttering assessment includes a measurement model where the Speech Language Pathologist takes a sample of the patient’s speech and determines what percentage of spoken syllables are stuttered. During an evaluation, a Pathologist will “note the number and types of speech disfluencies a person produces in various situations. [They] will also assess the ways in which the person reacts to and copes with disfluencies. The [Speech Language Pathologist] may also gather information about factors such as teasing that may make the problem worse.”[14] For young children, it is important to predict whether the stuttering is likely to continue. An evaluation will also consist of a series of tests, observations, and interviews designed to estimate the child's risk for continuing to stutter. A Speech Language Pathologist may also note certain risk factors like a family history of stuttering, stuttering that has continued for 6 months or longer, presence of other speech or language disorders, and strong fears or concerns about stuttering on the part of the child or the family.

            Most treatment programs for people who stutter are "behavioral." They are designed to teach the person specific skills or behaviors that lead to improved oral communication. Speech Language Pathologists will often attempt to cure stuttering by “working to reduce the anxiety a patient associates with the disorder.”[15] This may include changing a patient’s environment, helping them to feel less stressed, or changing the way a parent interacts with the patient. Another way patients are taught to manage their stutter is to teach them to control and/or monitor the rate at which they speak. Monitoring breathing with diaphragmatic breathing, speaking at a slower rate, or using shorter phrases than normal, can do this. Over time a patient will be able to speak at faster rates and use longer phrases, but this will take time and continued work with a Speech Language Pathologist.  

III.  Medical and Developmental Conditions

Medical and Developmental Conditions are more broad than the categories of Speech and Language Disorders. They can cover anything from a traumatic brain injury to Attention Deficit/Hyperactive Disorder (ADHD). Medical and Developmental Conditions, also called Pervasive Developmental Disorders (PDDs), refers to a group of developmental conditions that involve delayed or impaired communication and social skills, behaviors, and cognitive skills (learning). All Medical and Developmental Disorders are “rooted in a complex combination of genetics, individual brain wiring, and, to a much lesser extent, environmental factors.”[16]

One of the most well known Medical and Developmental Conditions is Attention Deficit/Hyperactive Disorder (ADHD). ADHD is a condition of the brain that affects a person's ability to pay attention, and is most common in school-age children. Symptoms of ADHD are present in all children at a young age, but what categorizes children with ADHD is the “intensity, the persistence, and the patterning of these symptoms.”[17] Specific speech and language patterns vary from child to child with ADHD. For example, some children with ADHD also have learning disabilities that affect their speech and language. Evaluation of each child's individual speech and language ability is critical to developing an appropriate treatment plan. The child’s doctor diagnoses ADHD, with input from the family and other professionals. These professionals include the following: Speech Language Pathologists (SLPs); regular, special education, and resource teachers; nurses; and psychologists. Assessments by a Speech Language Pathologist will include observing the interactions of the patient with peers and authority figures in the classroom setting, and during formal testing. In addition the Speech Language Pathologist interviews parents/caregivers about speech and language development, and assessing social communication. A Pathologist will also formally evaluate speech and language skills, such as fluency, speech articulation, understanding and use of grammar, understanding and use of vocabulary, and awareness of speech sounds.

Speech and language intervention for the person with ADHD is always individualized, as each person has different needs. For most cases a Speech Language Pathologist will work with a child with ADHD on following directions and processing information. Most often this is done through reading a story or article and having the child answer questions on the story’s content. Children with ADHD also need to learn how to use language socially to communicate. That includes knowing how to hold a conversation, thinking about what the other person in a conversation understands and believes, and tuning in to the meta-linguistic signals of the other person, such as facial expression, tone of voice and body language. It is important to help them remember that communication is as much nonverbal as it is verbal. A Speech Language Pathologist will help a child with ADHD work on all of these behaviors.[18]

Autism is another disorder that is characterized as a Medical and Developmental Condition. Autism is a developmental disability that causes problems with social skills and communication. Autism can be mild or severe; it is different for every person, which is why it is categorized as a spectrum disorder. Children with autism may have problems with communication, social skills, and reacting to the world around them. However, not all behaviors will exist in every child. The child’s doctor, or another professional with experience in working with children with autism, should make an Autism diagnosis. There is no known cure for autism. In some cases, medications and dietary restrictions may help control symptoms, and intervention should begin when the child is young. In addition to a medical diagnosis, an evaluation by a Speech Language Pathologist should be completed to determine social skill and communication needs. This evaluation will include a standardized test as well informal observation, which is intended to “find out how the [patient] uses speech in a more natural setting.”[19] Along with test scores and a language sample, the Speech Language Pathologist will also make observations or notes about the child’s vocal tone and other fluency problems if they are present. In the case of a nonverbal child, a Speech Language Pathologist will look for other forms of functional communication including gestures, sign language, pictures, or augmentative communication devices.

Almost anyone diagnosed with an autism spectrum disorder will be recommended for speech therapy. This may seem odd, as many autistic people are either non-verbal (at the lower end of the spectrum) or extremely verbal (at the upper end of the spectrum). But even very verbal people with Asperger Syndrome are likely to misuse and misunderstand language on a regular basis. And even non-verbal people can certainly develop communication skills, and may even develop spoken language skills over time.[20] For a child with autism, a Speech Language Pathologist will work mostly on conversation skills and concept skills, as well as pronunciation and articulation. A Pathologist will teach a child with autism that knowing how to make statements is not the same thing as carrying on conversations. Speech therapists may work on back-and-forth exchange, sometimes known as "joint attention." Even the smallest of exchanges will help the child over time. A Speech Language Pathologist will also work on concept skills, which are a person's ability to state abstract concepts and to understand them. Autistic people often have a tough time with ideas like "few," "justice," and "liberty." Speech therapists may work on building concept skills by discussing different scenarios with the child.

The prevalence of all of three of these umbrellas of communication disorders, Speech, Language, and Medical and Developmental, has grown within the last decade and this is largely due to the diagnosis and treatment strategies discussed above. Even as little as five years ago, professionals were unable to identify many communication disorders in children because they were seen as ever changing; now thanks to the newfound awareness of these disorders as well as the availability of treatment, more children are getting the treatment and attention that they need. As Speech Language Pathology becomes more progressive, diagnosing and treating all different types of disorders is more and more possible. As these techniques grow and change, the demand for Speech Language Pathologists increases as well. Speech Language Pathology is expected to grow faster than average through the year 2014. Employment of Speech Language Pathologists in educational services for elementary and secondary school, now that federal law guarantees special education and related services to children with disabilities. Greater awareness of the importance of early intervention in speech, language, swallowing and hearing disorders has increased this employment. The number of Speech Language Pathologists in private practice will also rise due to the growing demand for them in hospitals, schools, and nursing facilities. Due to the upward demand of these jobs and the acceptance of Communications Disorders in today’s society, Speech Language Pathology will be a field that continues to grow, because even as the need for Pathologists levels off, there will always be a need to replace those who leave the occupation. This growth and demand will encourage Pathologists to look for new, unprecedented approaches to both treatment and diagnosis of Communication Disorders.

Works Cited

Allstetter, William D. "Pathology." Speech and Hearing. New York: Chelsea House, 1991. 77-            85. Print.

American Speech-Language-Hearing Association | ASHA. Web. 01 Dec. 2011.             <http://www.asha.org/>.

Blanken, Gerhard. "Definition and Diagnosis of Language Development Disorders." Linguistic             Disorders and Pathologies: An International Handbook. Berlin: Walter De Gruyter,             1993. 574-75. Print.

"Conditions Co-existing with ADHD." ::) ADHD, Attention Deficit Hyperactivity Disorder,             Hyperactive Child, Speech Delay, Reading Difficulty (::. Web. 10 May 2012.             <http://www.childsupport.in/html/adhd_add.html>.

Griffin, Sarah. "SCORE Interview 1." Interview by Madeline R. McNamee. 9 Apr. 2012. Print.

Hoch, Daniel B. "Language Disorder - Children: MedlinePlus Medical Encyclopedia." U.S             National Library of Medicine. Ed. David Zieve. U.S. National Library of Medicine, 29             June 2010. Web. 08 May 2012.             <http://www.nlm.nih.gov/medlineplus/ency/article/001545.htm>.

Kamhi, Alan G. "Treatment Decisions for Children With Speech–Sound Disorders." Language,             Speech, and Hearing Services in Schools 37 (2006): 271-79. Print.

MacAleer-Hamaguchi, Particia. Childhood Speech, Language, and Listening Problems: What             Every Parent Should Know. 3rd ed. New York [etc.: John Wiley & Sons, 1995. 110-13.             Print.

McNamee, Madeline R. "Maddie McNamee SCORE Week 1, Post 1." Web log post. SCORE.             Blogger, 9 Apr. 2012. Web. 9 May 2012. <http://scorehornets.blogspot.com/>.

Paul, Rhea. Language Disorders from Infancy through Adolescence: Assessment & Intervention.             St. Louis: Mosby, 2007. Print.

Schneiderman, Carl R., and Robert E. Potter. Speech-language Pathology: A Simplified Guide to             Structures, Functions, and Clinical Implications. San Diego: Academic, 2002. Print.

"Selective Mutism." Selective Mutism. American Speech and Hearing Association. Web. 08 May             2012. <http://www.asha.org/public/speech/disorders/SelectiveMutism.htm>.

Siri, Ken, and Tony Lyons. "Speech-Language Therapy." Cutting-edge Therapies for Autism,             2010-2011. New York, NY: Skyhorse Pub., 2010. 357-68. Print.

"Speech Therapy for Autism: The Basics." About.com Autism Spectrum Disorders. Web. 10             May 2012. <http://autism.about.com/od/whatisautism/a/SLP.htm>.

"Stuttering." Stuttering. American Speech and Hearing Association. Web. 10 May 2012.             <http://www.asha.org/public/speech/disorders/stuttering.htm>.

Waltz, Mitzi. Autistic Spectrum Disorders: Understanding the Diagnosis and Getting Help.             Beijing: O'Reilly, 2002. Print.

Waltz, Mitzi. Pervasive Developmental Disorders: Diagnosis, Options and Answers. Arlington,             TX: Future Horizons, 1999. 1-3. Print.

Wender, Paul H. "Characteristics of Children with Attention-Deficit Hyperactive Disorder."             ADHD: Attention-deficit Hyperactivity Disorder in Children and Adults. Oxford: Oxford             UP, 2000. 9-33. Print.

"What Is Childhood Apraxia of Speech?" Http://www.apraxia-kids.org. Apraxia-KIDS. Web. 09             May 2012. <http://www.apraxia-kids.org/site/apps/nlnet/content.aspx?c=chKMI0PIIsE>.

Williams, A. Lynn. "Setting the Stage." Speech Disorders: Resource Guide for Preschool             Children. Australia: Thomson/Delmar Learning, 2003. 1-3. Print.

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[1] Allstetter, William D. "Pathology." Speech and Hearing. New York: Chelsea House, 1991. 77-85. Print.

[2] Paul, Rhea. Language Disorders from Infancy through Adolescence: Assessment & Intervention. St. Louis:             Mosby, 2007. Print.

[3] Blanken, Gerhard. "Definition and Diagnosis of Language Development Disorders." Linguistic Disorders and             Pathologies: An International Handbook. Berlin: Walter De Gruyter, 1993. 574-75. Print.

[4] "Selective Mutism." Selective Mutism. American Speech and Hearing Association. Web. 08 May 2012.             <http://www.asha.org/public/speech/disorders/SelectiveMutism.htm>.

[5] "Selective Mutism." Selective Mutism. American Speech and Hearing Association. Web. 08 May 2012.             <http://www.asha.org/public/speech/disorders/SelectiveMutism.htm>.

[6] Williams, A. Lynn. "Setting the Stage." Speech Disorders: Resource Guide for Preschool Children. Australia:             Thomson/Delmar Learning, 2003. 1-3. Print.

[7] "What Is Childhood Apraxia of Speech?" Http://www.apraxia-kids.org. Apraxia-KIDS. Web. 09 May 2012.             <http://www.apraxia-kids.org/site/apps/nlnet/content.aspx?c=chKMI0PIIsE>.

[8] "Childhood Apraxia of Speech." « Everhear.com. Web. 09 Mar. 2012.                   <http://www.everhear.com/speech/specialized-areas/childhood-apraxia-of-                  speech/>.

[9] MacAleer-Hamaguchi, Particia. Childhood Speech, Language, and Listening Problems: What Every Parent             Should Know. 3rd ed. New York [etc.: John Wiley & Sons, 1995. 110-13. Print.

[10] Allstetter, William D. "Pathology." Speech and Hearing. New York: Chelsea House, 1991. 77-85. Print.

[11] MacAleer-Hamaguchi, Particia. Childhood Speech, Language, and Listening Problems: What Every Parent             Should Know. 3rd ed. New York [etc.: John Wiley & Sons, 1995. 110-13. Print.

[12] Griffin, Sarah. "SCORE Interview 1." Interview by Madeline R. McNamee. 9 Apr. 2012. Print.

[13] McNamee, Madeline R. "Maddie McNamee SCORE Week 1, Post 1." Web log post. SCORE. Blogger, 9 Apr.             2012. Web. 9 May 2012. <http://scorehornets.blogspot.com/>.

[14] "Stuttering." Stuttering. American Speech and Hearing Association. Web. 10 May 2012.             <http://www.asha.org/public/speech/disorders/stuttering.htm>.

[15] Allstetter, William D. "Pathology." Speech and Hearing. New York: Chelsea House, 1991. 77-85. Print.

[16] Waltz, Mitzi. Pervasive Developmental Disorders: Diagnosis, Options and Answers. Arlington, TX: Future             Horizons, 1999. 1-3. Print.

[17] Wender, Paul H. "Characteristics of Children with Attention-Deficit Hyperactive Disorder." ADHD: Attention-            deficit Hyperactivity Disorder in Children and Adults. Oxford: Oxford UP, 2000. 9-33. Print.

[18] "Conditions Co-existing with ADHD." ::) ADHD, Attention Deficit Hyperactivity Disorder, Hyperactive Child,             Speech Delay, Reading Difficulty (::. Web. 10 May 2012.             <http://www.childsupport.in/html/adhd_add.html>.

[19] Waltz, Mitzi. Autistic Spectrum Disorders: Understanding the Diagnosis and Getting Help. Beijing: O'Reilly,             2002. Print.

[20] "Speech Therapy for Autism: The Basics." About.com Autism Spectrum Disorders. Web. 10 May 2012.             <http://autism.about.com/od/whatisautism/a/SLP.htm>.