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For parents, the anticipation of their child's first words is exciting. Will my baby say “Mom” or “Dad”? It is a special moment that will be remembered for a lifetime, marking a significant milestone in the child's development. However, some toddlers are slower to talk than other kids. It can be difficult and scary for parents to discover why their child isn’t speaking as early as other children their age. Late talking can signify a more serious problem, such as a language delay or developmental disorder. To help parents recognize the potential signs that their child may be a late talker, this article will discuss the signs to look out for, when to seek help, and how to support your child in their communication development. But first, what is late talking? What is a Late Talker? Late talkers, also known as late language learners (LLE), are children who delay their language development. This delay can manifest in various ways, including difficulty with producing or understanding speech sounds, forming sentences or phrases, and difficulty with expressing thoughts or ideas. Late talkers may also need help with social interaction and communication and understanding the meaning of words or sentences. In helping a late talker, it is essential to identify the underlying cause of the delay, which may include physical, cognitive, or neurological issues. Children late to talk may have a speech sound disorder (SLD), a learning disability, or some other cause. If your child is not talking by about age three, or if you have concerns about your child's speech, contact your pediatrician for an evaluation by a speech-language pathologist. Early intervention is the best way to help a late talker reach their full potential. If your child has a speech sound disorder, an SLP can provide the appropriate therapy and support to help them improve their speech abilities. How To Tell If Your Child Is A Late Talker More often than not, late talking is just a temporary stage and not a sign of a problem, but late talkers have been wrongly labeled as having autism. Almost all kids with autism are late talkers—but not all late talkers have autism. It is important to remember that late talking has many explanations and that the first word usually shows up around 12 months. However, there is a wide variation in when kids start to talk, and it is common to have first words before the first birthday or after the second. More than half the time, late talking is just a stage, and if you follow a group of 2- and 3-year-olds with language delays, as many as 60 percent will be speaking just fine a year or two later. Therefore, it is important not to panic but rather seek the advice of a professional to ensure that the child is on track with their language development. Identifying Late Talkers Identifying if your child is a late talker can be difficult as you may misdiagnose the issue. It requires careful monitoring and understanding of your child's development and awareness of the norms and expectations for language development. First, it is vital to understand the typical stages and milestones of language development. Generally, by the time a child is 18 months old, they should have a vocabulary of at least ten words and understand basic language concepts. By the time they are three, they should be actively expressing themselves and engaging in conversations. If your child is not demonstrating these milestones, it is essential to consult a professional. Here is what you can expect: 18 months - At this age, babies can typically say a few words such as "mama" and "dada." They can equally understand simple commands like "pick up the toy" and use a variety of words like nouns ("baby," "food"), verbs ("come," "go"), prepositions ("up," "down"), adjectives ("hot," "big"), and social words ("hey," "bye"). 24 months - At this stage, toddlers should be able to use around 50 spontaneous words and be able to combine two words to form meaningful phrases such as "doggie gone," "eat food," or "my hands." As you can see, the milestone starts at 18 months. Most late talkers say their first words after 12 months. This is understandable. Another critical indicator of late talking is if your child does not respond to their name. If they are not responding to their name or responding inconsistently, it could signify something more serious. You should also consider the context and environment in which your child speaks. If your child cannot engage in conversations in a stimulating, language-rich environment, that could signify a language delay. The signs and symptoms of Language and Learning Disorders (LLE) can vary widely as research is based mainly on parent reports to the American Speech-Language-Hearing Association (ASHA). Some of the signs and symptoms that may indicate the presence of LLE include: - Delayed or nonexistent babbling before the age of two - Fewer than 50 words by age two - Difficulties in connecting two words - Phonological differences compared to peers - Shorter and less grammatically correct words - Reduced communicative gestures - Poor understanding of words and delayed comprehension. Finally, look for any signs of developmental delay in other areas. If your child is having difficulty with gross motor skills, fine motor skills, or other tasks, it is essential to consider how this might impact their language development. The best way to determine if your child is a late talker is to consult a professional. They can provide a more detailed evaluation and make recommendations for further action. What Causes Late Talking in Children? A toddler between 18 and 30 months old who is not speaking as much or at all as expected but is otherwise developing normally may be classified as a late talker. Approximately 17.5 percent of children up to age 3 who are slower to develop speech may have a speech or language delay. Late talkers may be lagging behind on typical toddler speech milestones. However, they are still able to comprehend what they hear (known as receptive language), use body language to communicate (such as waving or pointing), or gradually learn new words. A late talker might have one or both of the following: Speech delay - a condition where a child has difficulty articulating words and expressing themselves clearly. This can make it difficult for other people to understand them, or Language delay - is a condition where a child has difficulty expressing thoughts, ideas, and feelings. Even though they may be able to say some words, they may only have a few words or be unable to put more than two words together. A Toddler's Late-Blooming Speech Might Be Attributed to the following: Birth Stats: Babies born underweight or before 37 weeks are at an increased risk of becoming late talkers as toddlers. Twinning: Twins are more likely to be late talkers than single births. Family History: Late talking tends to run in the family. It is hereditary. If a family member is a later talker, that may cause a toddler to talk late. Other Interests: Toddlers who develop early in other areas (like climbing and jumping) can take longer to master language because they are so busy concentrating on those skills. They may often be good at puzzles little “escape artists” figuring out how to get out of cribs or other places always trying to put things together Lack of Necessity: Children whose parents (or older siblings) are quick to anticipate their needs might take longer to speak up — because there is less need to. History of Hearing Loss or Ear Infections: Past infections or difficulty hearing can slow speech development. However, the above does not cover all the causes of late talking in children. Half of late talkers may have other issues hindering them. Among the possibilities are the following: An expressive language disorder This is a condition where a child has difficulty producing language properly. It may make them have challenges with pronunciation, word choice, and grammar. Children with ELD may be unable to produce words or sentences until they are much older, or they may only have a limited understanding of what has been said, leading to delays in communication skills. An intellectual disability Autism: Autism is a neurological disorder that results in impaired social skills, communication, and behavior. Late talking is only one of the signs of Autism. However, autism is not usually the case. Not all children with autism are late talkers. Some children with autism are late talkers, and some who talk on time. This is because every child is different, and the spectrum of autism is vast and diverse. A physical problem: Another cause of late talking can be a hearing problem or a neurological disorder (like epilepsy). A speech disorder: This is when a child finds it hard to pronounce words. A speech disorder affects the development of language skills. The child may have difficulty using the correct language to communicate their wants and needs, which can lead to frustration and difficulty with communication. This, in turn, can cause late talking. What Are The Outcomes Of Late Talking In Children? According to an ASHA study on Late Language Emergence, between 50 and 70% of late talkers can reach a normal language development level by late preschool and school age. However, the same study also states that late talkers are more likely to experience language and literacy difficulties in the future. Some of the outcomes listed by the study include: At age 5, children identified as late talkers had lower scores on complex language skills, such as narrating a simple story. At age seven, those same children had reduced performance when it came to general language ability and grammar. At ages eight and nine, these children displayed poorer performance in reading and spelling. At age 13, children identified as late talkers had lower scores on aggregate measures of vocabulary, grammar, verbal memory, and reading comprehension. At age 17, those who had been late talkers showed poorer scores on vocabulary/grammar and verbal memory factors. Other studies further support these findings. For example, researchers agree that late talkers who eventually "grow out of it" have been found to have weaknesses in some language and literacy skills, including vocabulary, grammar, phonology, reading, creating stories, writing, reading, and listening comprehension, which can persist until adolescence. Additionally, skills that rely on language, such as social, behavioral, and executive function skills (planning, organizing, paying attention, and controlling impulsive behavior), are weaker in these individuals. Furthermore, a study on children aged three to five showed that late talkers do not process speech as easily as their peers, indicating an immature or underdeveloped speech or language processing ability, affecting language and literacy development. When To Seek Help For A Late Talker? With the abundance of parenting information available, it is no surprise that different opinions exist when it comes to late talking. Many parents opt for the 'wait and see' approach, which experts often agree is not beneficial for the child. Early recognition and intervention are essential to prevent any language disabilities, as well as to ensure the child's social and academic readiness. If your child is exhibiting any of the risk factors mentioned in this article, it is important to seek the help of a speech-language pathologist to prevent any language disorders, such as Developmental Language Disorder, or as the research calls it, Language Impairment. Early intervention is key to supporting your child's development and ensuring their academic success. Help Children Speak Up To ensure that your late talking child has the best chance of thriving, it is essential to seek help from medical professionals. First, have their hearing evaluated by a pediatrician or an audiologist. This will let you know if your child is able to hear at the appropriate volumes and pitches and if they can detect differences in sounds. After this, you should consult a speech-language pathologist. During the session, the SLP will discuss your concerns, assess your child's ability to understand, speak, and use gestures, and identify the type of communication disorder they may have (if any) and the best way to treat it. Finding the right professionals and creating a custom program to suit your needs will provide your child with the support they need to thrive.

When children come to our Rite Care Centers, they interact with a speech-language pathologist. These speech-language pathologists will be the guide on their path to treating and overcoming their speech, language, and literacy impairments. But what does a speech-language pathologist do? In this article, we will go over their duties, licensing qualifications, and diagnoses and therapies they specialize in. What is a Speech-Language Pathologist? A speech-language pathologist (SLP), also known as a speech therapist, is a licensed professional specializing in the diagnosis and treatment of communication problems. SLPs work with people of all ages, from babies to the elderly. Since they are responsible for many different types of people and diagnoses, SLPs must have the ability to work in a variety of situations. They must be caring, compassionate, patient, resourceful, and able to create treatment plans that meet the needs of unique diagnoses. After all, each child is different and will need treatment specially tailored to their needs. To do this, the SLP must be able to listen well to the patient and interpret their behavior. This is not an easy task since most patients are struggling to communicate. Some SLPs have speech-language pathology assistants to help them with the heavy workload that often comes with this kind of career. Additionally, they will work closely with other therapists as part of an interdisciplinary team to create a unified, targeted treatment plan. This includes other disciplines like nursing, physical therapists, occupational therapists, and activity directors. WHERE DO SPEECH-LANGUAGE PATHOLOGISTS WORK? SLPs work in: Private practices Clinics Physicians' offices Hospitals Schools Colleges Universities Rehabilitation centers Long-term care facilities Residential healthcare facilities Rite Care Centers! Data from the U.S. Bureau of Labor Statistics says that 40% of SLPs work for state, local, or private educational facilities. Then, 24% work in physical, speech, auditory, or occupational therapists’ offices. Most are full-time workers, though part-time is also common. A speech-language pathologist's duties may vary depending on the setting they work in. Educational settings are the most common for SLPs. Those that work in schools have the objective of identifying disorders early. The aim is to hopefully implement preventative therapies that will lessen the impact of any communication issues on the children’s lives. If the SLP works in a medical setting, he or she will be focusing on introducing exercises that target fluency problems, help rehabilitate motor or cognitive functions, or assist the patient with finding new ways to communicate. Speech-language pathologists are not only hands-on. They also have to keep up with administrative work in order to comply with state, local, and federal standards. When they are not working with patients, they are writing reports, filling out progress logs, or doing research. There are some SLPs that like to be more behind the scenes by helping shape the curriculum of speech-language pathology. They focus on collecting data, designing large-scale treatment therapies, or advocating for educational reform. QUALIFICATIONS OF A SPEECH-LANGUAGE PATHOLOGIST For SLPs to work with children and adults in need, they must complete a rigorous education to obtain official certification. To become a speech therapist, one must have received the following education: Obtain a high school diploma or GED Complete a Bachelor’s degree in a Communication Sciences undergraduate degree program or a related field of study Complete coursework for a specialized graduate program, like a Master’s Degree in Speech-Language Pathology. The graduate school should be accredited by the Council on Academic Accreditation (CAA) in Audiology and Speech-Language Pathology Complete a clinical fellowship year (CFY) which typically lasts 36 weeks at a minimum of 35 hours a week. In order to practice during the CFY, the SLP must have a temporary state license for speech pathology Some states require aspiring SLPs to complete a Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP), administered through the American Speech-Language-Hearing Association (ASHA). Must pass the Subject Assessment in Speech-Language Pathology to earn the state licensure. However, there may be other requirements, depending on the state. What Does a Speech-Language Pathologist Do? While the duties of speech-language pathologists vary widely, there are three main overarching duties they are in charge of: evaluating, diagnosing, and providing treatment for their clients. Let’s explore each of these in detail. EVALUATE: Most patients will first need to be evaluated by the SLP. The evaluation will be primarily focused on the person’s communication or swallowing issues. It is best to see a speech-language pathologist when there is: Trouble communicating after illness or injury: Whether it be something like a stroke, a neurodegenerative disease, or a traumatic brain injury, there may have been damage done to the parts responsible for speech and language. This can cause the person to be unable to express wants and needs, have difficulty communicating in relationships, have difficulty learning in school, struggle with work, or be unable to complete daily tasks. Trouble eating after illness or injury: Some illnesses and injuries can cause loss of motor function in the muscles that help us eat. The patient may be at risk of accidentally inhaling food particles, which could lead to choking. Trouble feeding babies and toddlers: Young children with swallowing disorders will show signs of fussy mealtimes, congestion after eating, vomiting after eating, gagging while eating, or aversion to some textures or temperatures of food. A developmental delay in speech: If a child is not reaching the speech and language milestones and falling behind in communication skills, he or she may have a developmental delay. After seeing a pediatrician, the child will be referred to an SLP to evaluate the issue. The earlier the delay is realized, the quicker the child can get into therapy to improve the underlying speech or language disorder. DIAGNOSE: Next, the SLP will detect and diagnose the suspected problem and come up with a treatment plan. He or she will carry out that plan through sustained therapy sessions over time while tracking the progress the patient makes. SLPs are familiar with and can diagnose the following problems: Speech sound disorders: Also known as articulation or phonological disorders, these kinds of speech disorders involve difficulty with perception, motor production, or phonological representation of speech sounds and speech segments. Some examples include apraxia of speech, cleft palate, and dysarthria. Language disorders: Disorders that include difficulty getting meaning across through speech, writing, or even gestures. There are some disorders in which a child has difficulty with what is heard or read (receptive language disorder) or has difficulty getting across what he or she is thinking (expressive language disorder). The child may also have a mix of both (mixed receptive-expressive language disorder). Another language disorder, aphasia, often occurs as a result of a stroke and damages a part of the brain that controls language expression and comprehension. Literacy problems: Children who suffer from speech and language disorders also struggle with reading, writing, and spelling. This can include learning disabilities like dyslexia and hyperlexia. Fluency disorders: When a patient has trouble with the flow of their speech, it is thought to be a fluency disorder. This includes stuttering where the child may repeat sounds like d-d-d-doll, pause a lot, or overly rely on “um” or “uh”. Social communication issues: There are unwritten social rules governing our society that are taught to us by our family, friends, and community. These rules include things like taking turns, how close to stand to someone when in conversation, and how to talk to different people. However, some children and adults don’t learn these rules and will often have trouble fitting in socially. Notably, those with autism spectrum disorder struggle with this issue. Voice disorders: People whose voice quality, pitch, and loudness differ or are inappropriate for an individual’s age, gender, cultural background, or geographic location are said to have a voice disorder. They may sound hoarse or nasally, easily lose their voice, talk at a high volume, or are unable to make sounds. These can result from structural, neurogenic, or functional issues. Hearing impairment: Both children and adults suffer from hearing loss, which will have a huge effect on their communication. Although SLPs do not specialize in audiology, they can work with an audiologist to determine the level of hearing the child is capable of, then provide treatment to the child. Those with severe or profound hearing loss need to be exposed to other forms of language, such as sign language, so they do not lose the ability to learn language. Swallowing disorders: These disorders involve difficulty swallowing food or liquid. This can lead to poor nutrition, weight loss, and other very serious health issues. Dysphagia Cognitive-communication disorders: Those with these kinds of disorders typically suffered an injury to the brain from stroke, dementia, or head trauma. As a result, their memory, attention, reasoning, and organizational skills were affected. They may also have trouble speaking, listening, writing, or reading. PROVIDE TREATMENT: Speech pathologists are trained in a variety of therapies targeting a variety of disorders. They use their well-honed problem-solving skills to design treatment plans specially tailored to each patient’s unique needs. These therapies may include some of the following activities: Boosting kids’ phonological awareness by focusing on rhyming and identifying words’ beginning sounds Teaching children how to express more complex ideas by joining words like “and”, “but”, or “because” Teaching kids to understand inferences in text Interacting with children through talking and playing Using books, pictures, or other objects to help stimulate language development Teaching patients to speak clearly Modeling how to make certain sounds and syllables through age-appropriate play Teaching and overseeing exercises in which the patient strengthens the muscles that are used for speaking and/or swallowing Helping the patient learn to say and/or understand more words. The SLP may act them out, use them to tell stories, or play vocabulary games Helping patients improve their sentence structure to provide more clarity in communication Providing aided and unaided communication methods through augmentative and alternative communication (AAC) systems for those patients with severe language problems Teaching patients and their families or caregivers strategies on how to best deal with the patient’s condition at home Providing aural rehabilitation for those patients with hearing loss Using problem-solving, organization, and memory games to help improve cognitive communication Using conversational tactics to teach social communication. This may involve learning to pay attention to the other person’s tone of voice, body language, and emotions Teaching breathing exercises for better resonance Teaching exercises to help strengthen oral muscles Introducing the patient to speech therapy apps Introducing the patient to language development games and toys like flashcards and flip cards Giving homework in speech therapy workbooks Our SLPs Make a Difference in Children’s Lives Through our Rite Care Centers, your donations fund the work of many gifted speech-language pathologists all over California. These SLPs have the credentials, experience, and knowledge to make a difference in children’s lives. Additionally, your generous donations help fund SLPs in training through university partnerships and scholarships. And the money also goes toward our private partnerships with speech-language pathologist practices to help even more children in need. All of the money donated ends up giving struggling children the resources and tools necessary in order to overcome their speech, language, and literacy impairments. SLPs Evaluate, Diagnose, and Treat Children coming to speech therapy are often shy and uncertain of what is in store for them. But with the help of a well-educated and gifted speech-language pathologist, they soon discover the path to better communication. And thus, better lives. SLPs go through a rigorous Bachelor’s and Master’s education and clinical fellowship before being awarded their certification. Once certified, speech-language pathologists work in education or medical facilities to evaluate, diagnose, and treat their patients. Patients struggle with a variety of impairments, including speech sound disorders, language disorders, literacy problems, fluency disorders, and more. Depending on the disorder, speech therapy can last a few sessions, a few months, or even a few years. And since these are some of the most important formative years in a child’s life, the time is best spent with an educated, experienced SLP in a well-funded program.

The prevalence of speech sound disorders is evident: Approximately 10% to 15% of preschoolers and 6% of students are affected by them. Four out of five of those children will require treatment. If left untreated, these children may suffer academically. That’s why we are here to help. In this article, you will learn more about these speech sound disorders, and the kind of treatment we fund to help these kids to live happier and more successful lives. What Is a Speech Sound Disorder? Children are expected to hit certain milestones when it comes to their language development. If they are experiencing a speech delay, it could be indicative of a speech disorder. A speech sound disorder is a disorder in which speech sound production is not at the level of what is expected at the child's developmental stage and age. SPEECH SOUND MILESTONES Here are the typical speech sound milestones during children’s developmental years: By age 3: The child should be able to be understood at least half the time when they communicate By age 4 to 5: Most sounds are being pronounced correctly. Sounds they may still struggle with are “l”, “s”, “r”, “v”, or similar sounds. By age 7 to 8: The child should be able to pronounce harder sounds like those mentioned above. If the child continues to have issues after the expected age has passed, they may need to see a pediatric doctor who will refer them to a speech-language pathologist (SLP) to diagnose and treat a speech sound disorder. CATEGORIES OF SPEECH SOUND DISORDERS According to the American Speech-Language-Hearing Association (ASHA), speech sound disorders are communication disorders that can be either organic or functional. Organic speech sound disorders: These are either developmental disorders or acquired disorders. They can result from motor/neurological disorders, structural abnormalities, or sensory/perceptual disorders. Functional speech sound disorders: These have no known cause. They include disorders that involve the motor production of speech sounds and the inability to produce language. The disorders could fall under articulation disorders or phonological disorders. Articulation disorders center around errors in the production of individual speech sounds, while phonological disorders include errors beyond individual sounds. For example, phonological errors would include fronting, stopping, or deleting consonants. Because it can be difficult to discern between articulation and phonological disorders in a patient, oftentimes clinicians will refer to it simply as a speech sound disorder if the cause of the speech difficulties is unknown. Types of Speech Sound Disorders Children with functional or organic deficits make four kinds of errors in the acronym SODA. They are classified as: Substitutions: When one or more sounds are substituted for another. For example wabbit for rabbit or tow for cow. Omissions: Certain sounds aren’t produced and entire syllables may be deleted. For example fi' for fish or 'at for cat. Distortions: Sounds are changed slightly. Additions: An extra sound or sounds are added to the intended word. For example puh-lane for plane. The types of errors the child makes will determine which speech sound disorder he or she is suffering from. Let’s explore these disorders in greater detail. ARTICULATION DISORDER An articulation disorder occurs when the child cannot produce speech sounds correctly because of problems with placement, timing, speed, or pressure problems. It may also be a result of imprecise movements of the lips, throat, or tongue. With articulation disorders, it is common for sounds such as “r”, “l”, or “s” to be changed. Due to these predictable speech errors, close family members are usually able to understand the child. Symptoms: Common speech impairments within an articulation disorder include: Deltacism: Difficulty with producing the “d” sound Etacism: Difficulty with producing the “e” sound Gamacism: Difficulty with producing the “g” sound Hitism: Difficulty with producing the “h” sound Iotacism: Difficulty with producing the “j” sound Kapacism: Difficulty with producing the “k” sound Lambdacism: Difficulty with pronouncing “l” and similar sounds Rhotacism: Difficulty with producing “r” sounds Sigmatism or Lisp: Difficulty with producing “s”, “z”, and similar sounds Tetacism: Difficulty with producing the “t” sound Tetism: Replacing “s”, “k”, and similar sounds with “t”, and replacing “z” and similar sounds with “d” When a child is aware of their articulation issues, he or she might often be quiet or seem shy, get frustrated when speaking, or just stop saying some words completely. It is quite often the child will struggle with a lack of confidence and self-esteem. Children with a cleft lip or cleft palate may experience articulation errors such as glottal stops, nasal fricatives, pharyngeal fricatives, and mid-dorsum palatal stops. Causes: In most young children, there is no known cause for their articulation disorders. However, some articulation errors are known to be caused by things like: Brain injury Development or cognition issues (For example Down syndrome) Deafness or auditory impairment Physical disabilities that impact speech like cleft palate or cleft lip Any nerve disorder that affects the nerves associated with speech Treatment options: To treat articulation disorder, it is very helpful for the child to attend speech therapy sessions. Having regular appointments with an SLP will improve articulation errors. To treat articulation errors, SLPs will focus on: Figuring out the exact sounds your child has difficulty with Correcting the way he or she creates sounds to produce the right sound Teaching or re-learning ways to control the motor functions of speech. This can include how to shape the lips to express a particular sound Introducing exercises that strengthen the muscles involved in speech Giving you exercises for your child to practice sound formation at home PHONOLOGICAL DISORDER A phonological disorder, also known as a phonemic disorder, occurs when children find it difficult to sound out words correctly and struggle to recognize and process language patterns. As a result, these children will use phonological processes to simplify adult speech patterns. However, those with a phonological disorder will use these shortcuts longer than normal. Children with a phonological disorder may make mistakes when producing sounds and some sounds such as consonants may be omitted. Symptoms: If the child is suffering from speech intelligibility by age 3, this could be a sign of a phonological disorder. Is unable to pronounce most phonetic sounds correctly by age 4 or 5. Some exceptions can include these sounds: l, s, r, v, z, ch, sh, and th. Has difficulties forming longer sentences or understanding context Produces a certain sound correctly, but uses it in the wrong position or in the wrong word. For example, he or she may use the 'd' sound instead of the 'g' sound, and say 'doe' instead of 'go'. Makes mistakes with sounds in particular words, such as making the 'k' sound in 'kite' but will leave it out in other words. Lower self-confidence Causes: Phonological disorder is more prevalent in boys. However, the causes are mostly unknown. However, there are some risk factors associated with this disorder: Family history of speech-language disorders Hearing loss Developmental delays Genetic diseases Neurological disorders Treatment options: Work with an SLP to understand the phonological issues the child is having. He or she will present exercises for the child to teach them how to produce the correct sounds. The SLP will coach the child on how to move the jaw, lips, and tongue effectively to teach them how to use the correct muscles when pronouncing words Parents or caregivers can help the child with home exercises by mimicking the proper speech patterns. It helps if they focus on making the right movements, in the right context, with the right output of sound. CHILDHOOD APRAXIA OF SPEECH Apraxia of speech, or verbal apraxia, refers to the speech sound disorder in which brain damage has impaired a person’s motor skills that affect one’s ability to make speech sounds. The person often knows the words they want to say, but are simply physically unable to. Language problems like Aphasia can co-occur with speech disorders like apraxia of speech or dysarthria. These are all the results of brain damage. Aphasia is when the person is impaired in linguistic capabilities rather than motor skills used to speak. Apraxia of speech can also occur in children upon birth, though this is uncommon. It is called childhood apraxia of speech (CAS), or developmental verbal dyspraxia. Symptoms: These are some common symptoms of CAS: Difficulty pronouncing vowels Stressing the wrong part of the word Difficulty transitioning from a sound, syllable, or word to another Putting a pause between syllables Inconsistency in pronunciations; making different speech sound errors on the same word Difficulty pronouncing simple words Causes: In most cases of CAS, the causes are not known. However, there are a few known causes of CAS: Neurological impairment: This may be caused by infection, illness, or injury, during or after birth. Some genetic conditions can also cause neurological impairment associated with CAS. Autism: Apraxia related to autism can be very difficult to diagnose. Take a few sessions with your SLP before a conclusion is drawn. Genetic disorder: Many different complex disorders have CAS as a secondary characteristic. That being said, not all children with that particular genetic disorder will have CAS. One common genetic disorder associated with CAS is galactosemia. Treatment options: Speech therapy: Working with an SLP 3-5 times a week, in the beginning, can make a difference with CAS and language skills. Speech therapy may include speech drills, sound and movement exercises, speaking practice, vowel practice, and paced learning. Home practice: The SLP can give words or phrases for the child to practice at home, which can be done in a quick 5-minute session, twice a day. They can also get some practice in real-life situations by creating situations where it is appropriate for the child to say the word or phrase. Other communication alternatives: If the child has a severe case of CAS, it may be helpful to learn other communication methods, like sign language or natural gestures like pointing. However, as their speech gets better, these methods can be abandoned. DYSARTHRIA Dysarthria is a speech sound disorder characterized by muscle weakness or difficulty controlling them. Muscle weakness or loss of control occurs in the parts that are needed for speech including the face, lips, tongue, throat, or chest. The speech is often slurred or slowed, making it difficult to understand. Symptoms: Common symptoms of dysarthria speech problems include: Slurred, gurgly, monotonous, nasally, or breathy speech Mumbling A voice that is strained or hoarse Speaking too quickly or too slowly Very soft or quiet speech Difficulty moving tongue or mouth; may involve drooling Unable to speak in a regular rhythm due to hesitative speech Causes: The cause of dysarthria can be either developmental or acquired. Some common causes could be: Brain or head injury Brain tumor Cerebral palsy Lyme disease Muscular dystrophy Some medications including certain sedatives or seizure drugs Treatment options: When it comes to dysarthria, it is important to treat the underlying cause of the issue. If it was caused by prescription medications, change or discontinue the medications to relieve the issue. For those suffering from dysarthria that persists, it is a good idea to get treatment from an SLP. Depending on the child’s level of impairment, he or she will work with the child on: Slowing down the rate of speech Learning how to use more breath to raise voice volume Practicing mouth exercises to strengthen muscles Practicing lip and tongue exercises to strengthen muscles Enunciating words and sentences more clearly Introducing other communication methods including gestures, writing, or devices Children Need a Differential Diagnosis for Speech Sound Disorders Keep in mind that some children may be suffering from several speech sound disorders we’ve listed, along with other language impairments or learning disabilities. That is why they must see a specialist highly qualified in the field of speech-language pathology to receive a differential diagnosis and treatment plan. Luckily, our Rite Care Centers are staffed with educated and experienced SLPs to diagnose all of the above speech sound disorders. But they can’t do it without your help. Donate today!

Being unable to communicate is not the only painful expense of a speech impediment. Sometimes speech impediments can cause kids to be bullied, leaving them feeling ostracized from their peers. The degrading experience of being teased and bullied in itself can also cause many mental health problems like depression, anxiety, and long-term self-esteem issues. Meet Megan Megan was being teased by her classmates for her difficulty pronouncing the “r” sound. While this is one of the last sounds children can master, typically the “r” sound is learned by age 6 to 7. Megan is 9. Instead of “r”, children with this difficulty will often substitute with “w”. For example, it is common for them to pronounce “Little Red Riding Hood” as “Widdle Wed Widing Hood”. Although many of us find this cute, some kids on the playground can be very cruel to other children like Megan with this speech impediment. Why Is the “R” Sound So Difficult? There are plenty of reasons why children like Megan struggle with the dreaded “r”; it is one of the most challenging sounds in the English language! Difficulty pronouncing this sound is what is known as rhotacism, a speech impediment. It was found that 12.9% of preschool-age children struggle with rhotacism. But why exactly do so many children struggle with it? Here are a few reasons: Abstract motor movements: It is difficult to see the tongue when saying the “r” sound, unlike many other speech sounds. For instance, for “b”, “p”, and “m” sounds, children can see that the sounds are made with their lips closed. And “t”, “d”, and “n”, children can see that the tongue should rest behind the top front teeth when making the sound. But with “r”, children are unable to visualize the position of the lips, tongue, and jaw (the articulators). Different ways to make the “r” sound: There are a few different configurations for pronouncing “r”. There is the bunched “r” configuration where the tongue is bunched up with the tip down. The hump in the center of the tongue gently touches the hard palate. Then there is the retroflexed “r” where the tip of the tongue is facing upwards. These can be very complex for children to understand and learn! Not only one “r” sound: When “r” is surrounded by vowel sounds, the r will sound different. For instance, the “r” in “hair” has a different sound than the “r” in “iron”. Then there are times “r” will act like a vowel itself. This is evident in examples like “feather”, “learn”, and “fur”. Additionally, there are variations of the vocalic “r” that each requires different transitions from its preceding sound. For instance, “ar”, “ear”, “er”, “ire”, and “or” all require slightly different transitions from one articulation to another. Some children may be able to pronounce some of these “r” sounds, but not others. Children like Megan with “r” difficulties need to practice several different variations of the sound in different word positions to master the sound. This takes time and patience and is best done under the guidance of a speech-language pathologist. Megan progresses: Megan’s mother was dedicated to helping Megan conquer the sound after many futile attempts to help her daughter. Frustrated and unsure of how to help her daughter learn the sound, Megan’s mother reached out to one of our Rite Care Centers. Megan began attending weekly sessions in late November. She works with our highly qualified SLPs to incorporate these new sounds into her speech. Once she can produce a sound in isolation, our SLP will encourage her to use the sound in words and sentences. Eventually, the SLP will have her introduce the new sound in conversation. This is not an easy task since Megan is trying to produce sounds she has never produced before! But, Megan is already progressing with leaps and bounds and is responding well to our SLPs’ instructions. Megan gets introduced to new “r” words every session, as she continues to conquer the sound. Difficult but Not Impossible! The pressure to learn a new difficult sound may seem like an impossibility to some children. And with painful teasing coming from her classmates, Megan had an even more difficult journey. But with the help of our Rite Care Centers speech-language pathologists, Megan is slowly conquering that dreaded “r”. She exudes more confidence every day as she gets closer and closer to her goal. You see, it is difficult but not impossible! But it is only with the help of generous donations that these services are possible. We want to thank our donors for the funding that keeps our Rite Care Centers running. This enables children like Megan to conquer their debilitating speech and language impairments. You too can donate! It is easy, quick, and will make a world of difference in the life of a child.

Imagine being able to understand words but unable to express them yourself. Or imagine not even being able to understand the words in the first place! This can be very frustrating and isolating for a child. In this article, we will explore the types of language disorders that can cause these phenomena in children: receptive language disorder, expressive language disorder, and mixed receptive-expressive language disorder. What is Receptive-Expressive Language Disorder? Receptive language disorder, or language comprehension deficit, is when a child cannot understand what they hear or read. On the other hand, an expressive language disorder is when a child has trouble speaking, writing, and expressing their thoughts and feelings. When a child has both of these disorders, it is called mixed receptive-expressive language disorder or receptive-expressive language impairment (RELI). This means the child’s ability to both understand and produce speech is affected. Research shows that approximately 2% to 4% of five-year-olds suffer from mixed receptive-expressive language disorder. Symptoms A child affected by mixed receptive-expressive language disorder can exhibit some of the following symptoms: Giving the impression they aren’t listening when you speak to them Seem uninterested when books are read to them Trouble understanding the meaning of words Trouble understanding complicated sentences Has a hard time learning new words Difficulty answering questions Trouble identifying objects Difficulty understanding concepts and ideas Difficulty following long or complicated verbal instructions Difficulty finding the right word or using the wrong words Grammar mistakes Using short, simple sentences Mixing up past, present, and future tenses Struggling to add new vocabulary words Have trouble being clear with what they want to say Have trouble conveying a story or relaying information Difficulty starting or holding conversations Difficulty using and understanding others' gestures, facial expressions, and posture Have trouble asking questions Difficulty singing songs Children diagnosed with mixed receptive-expressive language disorder can suffer from these symptoms to any degree, with symptoms ranging from mild to severe. This type of disorder can have symptoms that vary among children; so it is important to note that while one child may exhibit certain symptoms, another may experience a whole other range of symptoms. For the disorder to be classified as mixed receptive-expressive language disorder, the symptoms should not be attributed to sensory deficits, neurological conditions, environmental deprivation, nonverbal intellectual deficits, or psychiatric impairments. Causes It is important to keep in mind that having this disorder does not necessarily have anything to do with intelligence. Some people are born with more skills than others, and the child simply is unable to communicate at the level of other kids his or her age. Research involving SPECT measurements of brain blood flow has found that these children do not exhibit left hemisphere activation in phonemic discrimination tasks. Phonemic discrimination refers to the process of differentiating between sounds that sound similar but have different frequencies, durations, and/or intensities. Associated with developmental disorders What causes a lack of left hemisphere activation in children? Well, most children with mixed-expressive language disorder are more likely to suffer from developmental disorders. If the child has a language disorder that does not seem to be caused by a physical disability, intellectual disability, or environmental factors, this can be considered a developmental language disorder (DLD). This term is used interchangeably with specific language impairment (SLI), language delay, expressive-receptive language disorder, or developmental dysphasia. DLD will typically run in the family and commonly occurs with other diagnoses like Attention Deficit Hyperactivity Disorder (ADHD) and other learning disorders. Possible contributing factors However, there are more possible contributing factors that could have led to the acquisition of the disorder. And sometimes the cause is not known or can come from a combination of factors. Here are the possible causes of this disorder in children: Seizures Stroke Traumatic head injury Family history The child has little practice hearing the language spoken in their daily life Aphasia: This is an acquired language disorder that happened due to brain injury, infection, tumors, or a degenerative brain disorder. Those with aphasia will have difficulty with language formulation. There are many types of aphasia and will have different issues depending on what part of the brain was affected. Developmental and cognitive disorders such as autism spectrum disorder or Down syndrome Hearing impairment or hearing loss Vision impairment Attention disorders Developmental issues beginning from birth Medical issues Finding the Right Diagnosis Unfortunately, language disorders are frequently misdiagnosed. Sometimes the child is mistaken as “lazy” or ill-behaved. As with any disorder, the proper treatment cannot start without the right diagnosis. It starts with the caregivers. Speech and language development follows a certain basic trajectory. Parents should be on the lookout for certain age-appropriate milestones when it comes to language. Experts provide a timeline that represents the most common times for children to start talking and understanding language. The timeline should always be represented as a range because there isn’t an exact age when children will start talking. After all, some children may experience a receptive language delay or expressive language delay and are simply found to be “late talkers”. They eventually grow to have no long-term language issues. Fortunately, they are able to catch up with other peers the child’s age, but they may simply have a limited vocabulary. Signs of Receptive and Expressive Language Disorders Parents, teachers, and physicians should be on the lookout for these early signs of a language disorder. Here are the most common warning signs the child may have an expressive language disorder: 1 year, 3 months: The child only has a vocabulary of fewer than three words. He or she will use mostly vowel sounds when vocalizing. 1 year, 6 months: The child doesn’t say “Mama”, or “Dada”, or call anyone by their name. 2 years: The child only has a vocabulary of fewer than 25 words. He or she doesn’t exclaim when delighted or surprised by something. 2 years, 6 months: The child does not use two-word sentences, for instance, will not combine a noun and a verb. He or she is often very hard to understand. 3 years: The child has a vocabulary of fewer than 200 words. He or she has trouble asking for objects by their names. When spoken to or asked a question, he or she will repeat the words that were spoken. Older than 3 years: The child’s speech varies from their peers. He or she will often use words wrong or use words that are related instead. And here are the warning signs the child may have a receptive language disorder: 1 year, 3 months: The child doesn’t acknowledge when their name is called. 1 year, 6 months: The child has difficulty following simple directions like “Pick up your toy.” 2 years: The child seems disinterested when being read to. 2 years, 6 months: The child doesn’t answer questions verbally, or even nod/shake their head in response to the question. 3 years: The child has difficulty following simple two-step directions like “Pick up your toy and put it in the toy box.” He or she may also have difficulty playing or participating in groups with others. The child may also forget the names of people he or she knows well or may confuse the name with a different one. Some early signals can be present in either of the two language disorders we’ve mentioned. Keep in mind children can suffer from the mixed receptive-expressive language disorder. Here are some possible early warning signs that can be present in young children with either receptive or expressive language disorder: The child was able to say one or two words at the normal developmental age but did not expand his or her vocabulary past that point. After 18 months old, the child will gesture or point instead of vocalizing with speech. The child does not attempt to imitate their parent’s sounds or words. Even though the child has an understanding of language when at home, he or she is unable to understand the language when out of the house. Parents should be aware that even though this list can help identify if the child has a communication disorder, only having one or two signs from this list doesn’t mean the child has the disorder. That is why they must visit a pediatric doctor, or speech-language pathologist (SLP), or attend a Rite Care Program to get an accurate diagnosis. We recommend an SLP who is certified by the American Speech-Language-Hearing Association (ASHA), which means that they adhere to rigid standards in the diagnosis and treatment of these issues. Treatment Options Early intervention is key. When a child is diagnosed with a receptive language disorder, expressive language disorder, or mixed receptive-expressive language disorder, he or she will need a treatment plan to overcome these language difficulties. The treatment options that are best for the child should be facilitated by a licensed SLP. Here are the most common options used by children suffering from these disorders: Speech-language therapy: Speech-language therapy can be done on a one-on-one basis or in a group format, depending on what your child needs. For speech therapy, especially to aid in articulation, it can be more effective to get sessions with a language therapist on an individual basis. A speech therapist can use playful methods to relax the child and enable them to open up and communicate. These methods could include toys, books, objects, or pictures that can help with receptive language skills, expressive language skills, and language development. They may also have activities to do or can practice asking and answering questions with the child. Home exercises: There are exercises that caregivers can do at home to encourage language growth in the child. The caregiver can practice naming items with the child, explain new concepts in different ways, play Simon says, or put together an obstacle course. Other options include playing the feely bag game with an emphasis on guessing the item, describing its characteristics, and answering questions about it. It is also beneficial to look at picture books with the child, ask them questions about the pictures, and help them guess what might happen next. Caregivers can also help improve communication skills by encouraging various ways of saying things. For example, the caregiver could come up with wacky or nonsensical ways to say things to get the child’s brain patterns going in different directions. This will encourage a different response from them, and hopefully more forms of expression. Language intervention programs: These are typically school-based programs that can focus on auditory skills as well as other language issues. Special education classes: In the US, if a child has a confirmed diagnosis of a speech and language disorder, they are eligible for special education classes. This is provided under the Individuals with Disabilities Act (IDEA). Teacher’s aide support: Those with severe impairment can benefit from the support of a teacher’s aide. Psychologist: If the child exhibits behavioral problems, it can be beneficial to schedule an appointment with a licensed child psychologist to help resolve these issues. When it comes to language disorders, there is no “one size fits all” model. How well the child progresses in treatment will depend on various factors, but it is evident that each child has his or her own unique set of challenges. These challenges must be dealt with on an ongoing consistent basis, through a process built on compassion and patience under the care of a licensed SLP. Some children can overcome these difficulties, while others may deal with lifelong symptoms. And even if these issues are resolved, children with early language delays are more at risk for having difficulties with things like phonological awareness, reading, and writing throughout their lives. Those with mixed receptive-expressive language disorder are likely to have long-term effects on language development, literacy, behavior, social development, and even mental health problems. It is our goal to set these children up with the highest success they can have on their journey. Providing Language Tools for Future Success Receptive language disorder is when a child has trouble comprehending language. Expressive language disorder is when a child has trouble communicating language. Mixed receptive-expressive language disorder is when both are present in the child. A child’s language ability is one of the most important tools for his or her future success. That is why here at the California Scottish Rite Foundation are dedicated to helping these children learn how to use these tools to ensure a better future. And we could surely use your help. Donate today!

If you think about it, reading difficulties are something that can impact a child’s entire life. Being unable to read makes learning difficult, which means the child is not equipped to thrive in the world. In this article, we will explore the cause of these reading and learning difficulties: dyslexia. We will take a look at the varieties of dyslexia and hone in on dysphoneidetic dyslexia, which can be the most challenging to treat. What is Dyslexia? Dyslexia is a learning disorder that can affect reading, writing, and spelling. This disorder can make it hard for someone to recognize words or decode language. It is also thought of as a reading disability because it can lead to reading comprehension deficits, delaying vocabulary skills, and overall knowledge that comes as a result of reading. Due to their learning disorder, dyslexics can struggle in a variety of areas, including: Handwriting Math Focus Attention Oral language Motor planning Coordination Organization Spatial perception Control of eye movements Orientation to time Some dyslexics will struggle in some of these areas, while others will struggle in others. There are several different ways to classify dyslexic types because there are many different variations of issues. Classifying Types of Dyslexia There are three common subtypes of dyslexia: Dyseidetic Dyslexia/Visual Dyslexia/Surface Dyslexia: This learning disorder occurs when the learner has trouble decoding and/or spelling words. This is due to problems remembering or revisualizing the word, especially eidetic words (also called irregular sight words). This issue is associated with the angular gyrus of the left parietal lobe in the brain. While the learner is good with auditory processing and understanding phonics, their main issues surround visual processing, word sequencing, whole word recognition, and memory synthesis. He or she may experience letter reversals when reading and dysgraphia, which affects writing abilities. Typically these students can read better than they can spell. Dysphonetic Dyslexia/Auditory Dyslexia: This learner will also have trouble decoding and/or spelling words. However, the reason he or she struggles is because there is lack of phonemic awareness. This means he or she has difficulty matching up symbols with their sound. This disorder is caused by dysfunction of Wernicke’s Area in the left temporal lobe of the brain. Unlike the visual dyslexic, the auditory dyslexic has no trouble with visual processing. Instead, he or she struggles with auditory processing and linking sounds with visual cues. Students typically learn words through memorization, and any unknown words will either be substituted or skipped as they read. Dysphoneidetic Dyslexia/Mixed Dyslexia/Double Deficit: When the learner struggles with both of the above, he or she is said to have dysphoneidetic or mixed dyslexia. This means he or she has trouble with both visual and auditory processing due to deficits in functioning in Wernicke’s Area and angular gyrus. The dysphoneidetic dyslexic will have weak visual-motor skills. Classification Through Syndromes Because of dyslexics' varying abilities, research was conducted on 113 children with dyslexia. The evidence allowed researchers to break down the variations into three syndrome classifications: Syndrome I: Language Disorder: These dyslexic learners will experience anomia, comprehension deficits, and confusion with speech and sound discrimination. Syndrome II: Articulatory and Graphomotor Discoordination: This syndrome is characterized by gross and fine motor coordination deficits, poor speech, and a lack of graphomotor coordination. Syndrome III: Visuospatial Perceptual Disorder: Dylexic children with this syndrome will experience poor visuospatial perception and will have trouble encoding and retrieving visual stimuli. Outside of this classification system is another term, known as stealth dyslexia. This refers to those dyslexic learners whose problems with reading, writing, and spelling were compensated by their skills in analysis and problem-solving. These learners are able to excel in their chosen fields. However, stealth dyslexics are often mistaken to be “lazy” or “careless”. This can cause the learner a sense of learned helplessness and affect their ability to achieve success. Categorizing dyslexia still is not perfect and the classifications may not always fit a child perfectly. That is why getting an individual diagnosis based on the child’s symptoms is the most optimal way to help them. The cognitive deficits can be laid out and examined, which allows a dedicated treatment plan to be created. So with that in mind, let’s explore how dysphoneidetic dyslexia specifically is diagnosed. Diagnosing Dysphoneidetic Dyslexia To be diagnosed correctly, a student must be formally assessed. A formal assessment will allow them to benefit from the special services offered at his or her school (public schools in the U.S.). In fact, parents are legally entitled to request an evaluation of their child from their school district if a suspected learning disability is at play. This assessment can be performed by an educational psychologist. Additionally, neurologists and other medical professionals can also provide a formal diagnosis if they have the right qualifications. Dyslexia can be assessed through a profile showing the child’s patterns of strengths and weaknesses. It will also focus on ruling out other possible causes of the symptoms like vision or hearing impairments. To differentiate between dysphoneidetic and other types of dyslexia, let’s look at the symptoms of this disorder in children. Dysphoneidetic Dyslexia in Children Dysphoneidetic dyslexia reading and spelling patterns will typically emerge during schooling, approximately Kindergarten to 3rd grade. Here are some symptoms of dyslexia that will often come up at that time: Difficulty with word recognition Difficulty with phonological skills Struggling with reading comprehension even if the child decodes well May have poor listening comprehension or oral vocabulary Struggling with fluency due to difficulty with word reading and language comprehension Difficulty remembering individual sounds or sound sequences Substitutions of sounds for others Difficulty retrieving letter sounds while analyzing a word. As the last letter of the word is recalled, the beginning of the word has been forgotten Trouble analyzing unknown words due to lack of knowledge regarding phonetic rules, as well as trouble sequencing sounds Guessing at unfamiliar words instead of using word-analysis skills. Let’s look at some examples of how a child with mixed dyslexia might read some words: “Corexs” instead of “correct” “Vilen” instead of “violin” “Musune” instead of “museum” “Mitear” instead of “material” . Causes of Dysphoneidetic Dyslexia When it comes to dyslexia, there are genetic factors that can cause the issue. If someone in the family has it, it can mean that the child is predisposed to developmental dyslexia. If a parent has it, the child has a 50% chance of having it. However, dyslexia is not always developmental; it can be acquired. Acquired dyslexia occurs due to an event, like an illness or head injury, that has caused brain damage and impairs brain function. The root factor causing dysphoneidetic dyslexia is deficits in the processes the brain uses to decipher words. Dyslexic brains rely more on Broca’s area in the frontal lobe. In contrast, strong readers rely on the Occipital and Temporal lobes for reading, which allows readers to recognize words quickly. However, Broca’s area is located in front of the cerebrum, which is not as effective. Learning deficits Unfortunately, deficits in one area can pile up to encompass difficulty learning in general. Learning is a stratified process. The first step needs to be mastered well enough in order to take the following steps. And it is important to follow the sequence so you won’t fall. If you aren’t able to do this, it ensures you won’t be able to reach subsequent steps on the ladder. You can’t add before you count, just like you can’t read before you master certain cognitive skills. Here are some of these following cognitive skills, among others: Phonological awareness: This term refers to a person’s awareness and the ability to work with the sound structure of language. It is centered around listening to words and sounds. Someone with keen phonological processing skills is able to distinguish things like rhymes, syllables, and individual phonemes in syllables. This key skill will set the child up to be able to decode, blend, and eventually read words. It begins to develop before formal schooling starts and continues to develop through third grade and later. Verbal short-term memory: When you are able to hold words or verbal items as “active” or available in your mind for a short period of time, this develops your verbal short-term memory. Unfortunately, children with dyslexia usually have reduced verbal short-term memory. It is also reduced in adults with a history of dyslexia. There are three parts that make up short-term memory, capacity, duration, and encoding. As you can imagine, if the child is unable to hold the information in his or her working memory for very long and it is not rehearsed, it will be lost in about 15 seconds. This presents a problem with not only reading, but learning anything in classroom lectures, and later on work training programs. Rapid automatized naming (RAN): How fast you are able to retrieve letters, numbers, colors, or object images from your long-term memory is called rapid naming. People with dyslexia tend to score low on RAN assessments compared to normal readers. This deficiency causes poor fluency. These students will have difficulty retrieving words, although oftentimes they can describe the words. Fortunately, RAN can be improved with high-interest tasks, topics, and games. This helps provide the child more motivation (which is necessary) for them to work on improving their RAN. Treatment Options Of the three types of dyslexia we’ve listed, dysphoneidetic dyslexia is the most severe form. Unfortunately, it can also be the most difficult kind of dyslexia to treat. These children require individualized therapy with a treatment plan suited to their needs. This could include things like: Special education or instructional intervention: Literacy programs like these in schools allow kids specific and direct instruction in reading. He or she may also benefit from a private reading specialist. Multisensory structured language education (MSLE): To help kids connect language to words, multisensory teaching employs the use of sight, sound, movement, and touch. This is considered the gold standard for helping kids with dyslexia learn to read. Teachers using this approach will use different senses to help the child; including sandpaper letters to learn phonics and spelling for example. He or she might learn syllables by tapping them out with their fingers. Therapy: Therapists and specialists can help children improve phonological awareness by teaching phonics and learning decoding. Some of these specialists work in schools, private settings, or Rite-Care Centers. Professionals that specialize in these types of therapy include psychologists, reading specialists, speech-language pathologists, and specially-trained teachers. It will have the most impact if the child is able to attend weekly sessions with the therapist. Treating co-occurring issues: Kids with dyslexia may also have ADHD, anxiety, or depression. Getting therapy and medication to help ease these issues will not directly help dyslexia, but it will help them feel more confident and comfortable while improving their dyslexia. Support at home: Parents can help children with dyslexia by reading with them, talking to them about dyslexia, and teaching them how to learn and think differently. This will help the children better understand the problem and what it means. A patient, supportive parent will help a dyslexic child thrive while learning and sets them up for a better chance of success later in life. Accommodations: The child can also benefit from accommodations in their classrooms to help them read and learn with less difficulty. Some of these accommodations include things like audiotapes of textbooks, peer reading groups, using a highlighter, no requirements to read aloud, alternatives to written assignments, designated note takers, or reduced written work. Children with Dyslexia Need Quality, Individual Interventions Sadly, dysphoneidetic dyslexia can pose lifelong challenges for a child. But with intensive intervention focused on their individual treatment from a quality facility like Rite Care, a student has the ability to excel beyond what he or she thought possible! And you can help them excel! Here at California Scottish Rite Foundation, we bring donations From generous people like you to help build the resources necessary to change these children’s lives. Donate today!

Language literacy in its many forms is fundamental for the childhood developmental process and children’s later success in life. Moreover, directives from the U.S. department of education show that children are expected to know how to write at younger and younger ages to keep up with classmates and peers around the United States. For this reason, childhood literacy programs can be a great help for both students that are struggling with literacy and those who do not struggle but have room for improvement In this article, we will discuss in general terms what a childhood literacy program is, and then we will go on to explain the 6 key components of a childhood literacy program. Upon reading this article, you will have a much better idea of what a childhood literacy program is and whether or not a childhood literacy program would be a good fit for your child or children. What Is a Childhood Literacy Program? A basic definition of a childhood literacy program is a program that aims to help children master a form or multiple forms of literacy skills through support and important resources. Of course, there are adult learning programs and adult education programs for adult literacy, as well as programs for all grade levels. However, this article will focus specifically on childhood literacy programs. Some childhood literacy programs partner with schools, training classroom teachers to better help their students achieve literacy goals. Others provide tutors for individuals or groups outside of the classroom, though these can still be partnered with schools. Some programs focus on helping young children with literacy disabilities through speech, reading, and writing therapy, often assisting children to succeed in life where they may have otherwise struggled to thrive in a world so dependent on speech, reading, and writing. For childhood literacy programs, researchers and practitioners have identified 6 key areas of literacy that cover what a child needs to achieve full literacy. These are sometimes referred to as the ‘Big Six,’ and they include phonological awareness, phonics, vocabulary, fluency, comprehension, and writing. In the following, we will talk about what each of these components means, why they are important for literacy, and how childhood literacy programs can help children master the ‘Big Six.’ Why Early Childhood and Childhood Literacy Matters When a child learns a love of reading at an early age, they will have greater general knowledge and expanded vocabulary. In addition, reading builds improved attention spans and better concentration skills. Literacy opens opportunities for academic success. This allows your child to pick up necessary knowledge and information by mastering effective literacy strategies. Moreover, self-confidence and independence become rooted in your child when they learn to read. It promotes maturity, increases discipline, and lays a basis for moral literacy. Satisfy their curiosity with explanations of how things work while exposing them to problem-solving techniques. Your child’s creativity and imagination will bloom, as well as their curiosity about people, places, and ideas. Finally, exposure to literacy at a young age leads to improved linguistic skills, a richer vocabulary, improved grammar, higher quality writing, better spelling, and more precise oral communication, ultimately carrying over to elementary school, middle school, high school, and beyond to professional development. Childhood Literacy Programs: The Six Key Components 1. Phonemic Awareness Phonemic awareness is the ability to hear that a spoken word is made up of a series of discrete sounds. This is not just important in English, but phonemic awareness is critical for any language that has an alphabetic writing system. Phonemic awareness is an important component of a good literacy program for a few reasons: (1) Teaching phonemic awareness allows for greater printed word recognition; (2) Teaching phonemic awareness teaches children to identify, understand, and manipulate sounds in spoken words; (3) Teaching phonemic awareness helps teachers recognize if students will have trouble with reading and spelling. Research from the National Reading Panel suggests that the more phonemic awareness a child has before school is a good determinant factor of how well that child will learn to read. The National Reading Panel also asserts that phonemic awareness is the precursor to phonics instruction. Phonemic awareness is a necessary component for phonics instruction to be effective because the students need to connect the units of the written word to the sounds in the spoken word. Phonemic awareness is also a vital component in a child’s success in learning how to read. The NRP suggests that including phonemic awareness is a necessary component in the process of teaching children how to read. The NRP states that those who promote the use of phonemic awareness believe that including phonemic awareness as a component in literacy programs may finally prevent the massive rehashing that English instruction goes through every five to ten years. 2. Phonics Instruction The next step for students is to learn phonics or the actual letter-sound correspondences. As these understandings fall into place, students can decode. Initially, they may recognize familiar words on sight, but gradually they should apply what they know about letter-sound correspondences to decode words as they read and to encode words as they write. Thus, besides learning letter-sound patterns, beginning readers must become fluent in decoding—the process of segmenting letter-sound patterns within words and blending them back together to access that word in their lexicon. According to Dorthey Strickland, a veritable powerhouse when it comes to writing about phonics instruction, strong teachers teach these skills explicitly with detailed explanations, modeling, and practice. In these ways, teachers demonstrate the utility of the sophisticated concepts and skills students are working on mastering. Students should also be encouraged to try the skills out themselves by reading simple text or writing on their own. This mixing of explicit instruction and practice activities strengthens students’ understanding and confidence as beginning literacy users. Students can also practice phonics skills by taking dictation from teachers; the resulting products give teachers valuable informal data about students’ understanding of letter-sound correspondences and letter formation. 3. Vocabulary Instruction Vocabulary can be defined as the knowledge of words and their meanings. The purpose of teaching vocabulary is for children to understand words and to use them to acquire and convey meaning. Vocabulary is an important component of a literacy program because the more words that a child knows and understands the more the child will comprehend when reading. Vocabulary is an important component in a successful literacy program because: (1) Vocabulary knowledge increases comprehension, which is vital to a child’s ability to do well in school; and (2) A greater vocabulary increases a child’s ability to read and write with fluency. A few ways to increase a child’s reading vocabulary is to have them learn high-frequency words and have them read from a wide range of sources of both fiction and non-fiction. 4. Fluency Practice in reading simple texts and reading their writing contributes to students’ development of fluency or reading smoothly with accuracy and expression. When students’ word identification becomes fast and accurate, they have freed up some “cognitive space” to draw on their broader knowledge of the language and comprehend what they are reading. Teachers model fluent reading when they read aloud to students, especially as they pause for punctuation or change their voice to show expressiveness. Teachers also model prosody, a component of fluency that is most prominent in reading poetry with inflection and rhythm. Prosody also refers to how the tone of voice and inflection conveys meaning in oral language—for example, the way one expresses sarcasm or irony. Teachers demonstrate prosody in their oral reading and can explicitly explain what they are doing as they read by asking how the change in inflection changes the meaning implied by the words on the page. As teachers help students become fluent readers, they need to reassure them that fluency means reading with comprehension, not merely saying the words as quickly as possible. Teachers model this distinction in their oral reading by pausing to question the meaning of words, the implications of word choice, or other aspects of the texts they are reading. It's important to recognize that fluency is critical to a student’s motivation to read. When students struggle to sound out letters and words, reading can become an exhausting task and students may begin to think of reading as a negative activity. Thus, much attention and hard work should be put into this stage. Here are some examples of ways to help increase fluency: 1. Modeled reading instruction: hearing teachers read connected to reading materials and poetry is one of the best ways to learn how fluent reading sounds. 2. Oral Reading: either students read together or they practice with a more experienced reader and echo what the experienced reader says. 3. Digital Software: Digital software can offer students a great resource for hearing fluent reading or facilitating fluency practice through instructional materials. 5. Comprehension Instruction Comprehension is the ultimate goal of learning to read. Even beginning readers benefit from instruction that introduces them to various strategies to help them understand different kinds of texts and their text structures. Part of beginning comprehension instruction is a teacher “externalizing” or modeling the comprehension strategies mature readers use automatically. The daily read-aloud period is ideal for this instruction—so long as teachers remember that merely reading aloud isn’t enough. Students need to be actively involved in asking and answering questions, making predictions or explaining characters’ motivations or other actions in what they are hearing. Comprehension instruction is most effective when teachers have access to high-quality children’s literature in various genres, representing different cultural backgrounds and experiences. One of the great advantages of introducing students to reading comprehension skills through independent reading is that the experience reinforces that the students can become successful readers. Some useful methods for comprehension instruction are as follows: 1. Using text structure: teachers can introduce students to the “clue words” used to show the structure of different types of texts; for example, the clue words both, alike, and different are often found in compare and contrast texts. 2. Engaging students in discussion: during read-alouds, teachers can periodically ask students to summarize what has happened and to predict what will happen. English language teachers should also ask higher-level questions, such as those addressing the motivations for characters’ actions. 3. Careful selection of texts: rich narratives with clear plots and character development and informational texts that are accurate and well-structured make comprehension instruction easier and make it easier for students to feel invested in improving their reading skills. 6. Writing Instruction Most young students will—if given opportunities—become writers. Initial efforts may be part drawing and part writing, with words spelled as students “hear” them while subvocalizing what they want to say. These early efforts also demonstrate young learners’ understanding of orthography and syntax, for example, that writing flows from left to right across a page. Gradually, students’ writing becomes more complex and expressive–their writing skills increase– especially if students receive explicit instruction on the writing process, that is, the recursive steps a writer uses to compose text. The steps in the writing process include initial planning, drafting, sharing with the teacher or peers to get feedback, revising per the feedback, editing for clarity and mechanics, and evaluating the final written product. As students learn to evaluate their own and others’ writing, they look for clarity of expression, thoroughness of ideas, and other features of good writing. As with reading, explicit writing instruction that draws on and builds students’ understanding of language will be most effective. Students benefit from instruction on handwriting, spelling, sentence structure, grammar, and other skills. Still, teachers also need to model writing for their students and point out the features of good writing during read-alouds and other instructional interactions. For example, pointing out how dialogue in a story is punctuated reinforces explicit instruction on using quotation marks in writing conversations. The *7th* Component of a Literacy Program This seventh component, though not on the list of topics covered in a literacy program, is just as important as the preceding six components mentioned. This seventh component is high-quality instruction. High-quality instruction is absolutely essential for many children to achieve literacy and go on to become well-equipped readers and writers. At the California Scottish Rite Foundation, we have for many years been dedicated to providing the highest quality literacy development education programs to children all over the United States, and in particular, California. Through our literacy programs and providers, students will move through the six key components, taught by highly trained and competent instructors and tutors specializing in developmental literacy. Moreover, our RiteCare Learning Centers across the state of California offer our services absolutely free of charge, because we believe that children deserve eligibility for the best education and empowerment no matter how much their parents are able to pay. Additionally, we have partnered with universities to support teacher training in literacy instruction, as well as speech-language pathology.

Childhood Apraxia of Speech (CAS) is a rare speech disorder occurring in approximately 0.1%-0.2% of children. Childhood apraxia of speech (CAS) is a neurological childhood (pediatric) speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (e.g. abnormal reflexes, abnormal tone). As such, apraxia of speech can present severe difficulties for children with the disorder. In this article, we will discuss what Childhood Apraxia of Speech is, what risk factors contribute to CAS, what symptoms may be present in a child with apraxia of speech, how CAS is diagnosed, and common treatment options for CAS. What is CAS? Childhood apraxia of speech is a type of speech and language disorder that is present at birth. A child with this condition has problems making sounds correctly and consistently. Apraxia is a problem with the motor coordination of speech, specifically a problem of the brain directing the movements of the mouth to produce intelligible speech. In this way, it's different from aphasia, which is a problem with the use of words. The speech centers of the brain help plan and coordinate what a child would like to say. These parts of the brain send complex signals to the speech muscles of the face, tongue, lips, and soft palate. Normally, all this signaling works smoothly, and a child can make all the sounds he or she needs. With childhood apraxia of speech, something in this process goes wrong. The speech muscles seem to work properly, and the child knows what he or she wants to say. However, the brain has trouble working with the muscles to create the movements needed for clear speech. CAS is also sometimes referred to as “developmental apraxia of speech” and “developmental verbal dyspraxia.” However, Childhood Apraxia of Speech is generally the preferred term for this disorder. It is important to note that CAS is truly a rare condition, and it occurs more often in boys than girls. Still, despite its rarity, this condition does affect a non-negligible amount of children, and there are a number of organizations that work with children with CAS and their parents to help these children overcome the difficulties of their disorder. Signs and Symptoms of CAS Currently, there are no validated diagnostic features that differentiate CAS from other childhood speech sound disorders. However, three segmental and suprasegmental features consistent with a deficit in the planning and programming of movements for speech have gained some consensus among those investigating CAS: 1. Inconsistent errors on consonants and vowels in repeated productions of syllables or words (for example, a child says the same word differently each time he tries to produce it). 2. Difficulty producing longer, more complex words and phrases. 3. Inappropriate intonation and stress in word/phrase production (for example, difficulty with the timing, rhythm, and flow of speech). It is important to note that none of these signs or symptoms are generally considered necessary or sufficient for determining whether or not a child has CAS. Moreover, the frequency of these and other signs may change depending on task complexity, the age of the child, and the severity of symptoms. Other researchers, such as Luzzini-Seigel (2017) have identified a number of other characteristics deemed to be present in many of those who have CAS, representing difficulty with the planning and programming movement gestures for speech. These include: 1. Late development of the child's first words and sounds. 2. A decreased sound inventory (for example, a lack of variety of consonant and vowel sounds expected at a certain age). 3. Multiple and/or unusual sound errors. 4. Vowel sound errors. 5. Excessive movements of the mouth or attempting to position the mouth for sound production. 6. Persistent or frequent regression in the number of words produced. 7. Differences in performance of automatic speech (such as "hello" and "thank you") versus voluntary speech. In most cases, voluntary speech is more affected by apraxia of speech. 8. Errors in the order of sound production in words (such as sounds omitted, switched, or added to words and within words). It is important to note that the presence of error patterns in the child's speech does not necessarily indicate a phonological problem rather than a motoric problem. Many patterns can have either linguistic or motoric bases. For example, a child may consistently reduce consonant clusters either because of a lack of understanding of the phonological rule or because of a motoric inability to sequence consonants. Moreover, The signs may vary with a child’s age. They also may be mild to severe. A child with a mild case of apraxia may only have trouble with a few speech sounds. A child with very severe apraxia may not be able to communicate very well with speech at all. Other Speech Disorders Commonly Confused with CAS Some speech sound disorders often get confused with CAS because some of the characteristics may overlap. These speech sound disorders include articulation disorders, phonological disorders and dysarthria. A child who has trouble learning how to make specific sounds, but doesn't have trouble planning or coordinating the movements to speak, may have an articulation or phonological disorder. Articulation and phonological disorders are more common than CAS. Articulation or phonological speech errors may include: 1. Substituting sounds, such as saying "fum" instead of "thumb," "wabbit" instead of "rabbit" or "tup" instead of "cup" 2. Leaving out (omitting) final consonants, such as saying "duh" instead of "duck" or "uh" instead of "up" 3. Stopping the airstream, such as saying "tun" instead of "sun" or "doo" instead of "zoo" 4. Simplifying sound combinations, such as saying "ting" instead of "string" or "fog" instead of "frog" Dysarthria is a motor speech disorder that is due to weakness, spasticity or inability to control the speech muscles. Making speech sounds is difficult because the speech muscles can't move as far, as quickly or as strongly as normal. People with dysarthria may also have a hoarse, soft or even strained voice, or slurred or slow speech. Dysarthria is often easier to identify than CAS. However, when dysarthria is caused by damage to certain areas of the brain that affect coordination, it can be difficult to determine the differences between CAS and dysarthria. What Are the Causes of Childhood Apraxia of Speech? Researchers don't yet understand what might cause childhood apraxia of speech. Some think that it is related to a child’s overall language development. Others think of it as a problem with the brain’s signals to the muscles needed for speech. Imaging tests have not found any real differences in brain structure in children with the condition. Childhood apraxia of speech may be a part of a larger disorder a child has, such as: 1. Cerebral palsy 2. Autism 3. Epilepsy 4. Galactosemia 5. Certain mitochondrial disorders 6. Neuromuscular disorders 7. Other intellectual disability The condition may run in families. Many children with the disorder have a family member with a communication disorder or a learning disability. Testing and Diagnosis for CAS An accurate diagnosis of childhood apraxia of speech requires a comprehensive speech and language evaluation by a speech-language pathologist (SLP). The SLP will evaluate your child's speech skills and expressive and receptive language abilities while gathering information from your family about how your child communicates at home and in other situations. It is important that the SLP evaluating your child has experience and expertise in diagnosing and working with childhood apraxia of speech so an accurate diagnosis can be made and other possible diagnoses are ruled out. For example, childhood apraxia of speech is often confused with a severe articulation disorder, since both diagnoses include poor speech intelligibility. Unfortunately, the approach taken to address an articulation disorder is vastly different from the approach for childhood apraxia of speech, and confusing the two could result in reduced therapy gains. An assessment for childhood apraxia of speech must include an evaluation of your child's expressive and receptive language abilities; many children with this disorder demonstrate deficits in their language skills. In addition, gaps between receptive and expressive language skills, word order confusion, and difficulty with word recall are common in children with apraxia of speech. A thorough assessment of your child's abilities is needed so therapy goals can be developed based on their individual needs. Treatment Approaches for CAS According to the American Speech-Language-Hearing Association (ASHA), there are a number of approaches that practitioners take for treating CAS. These include: 1. Motor programming approaches use fine motor learning principles, including the need for many repetitions of speech movements to help the child acquire skills to accurately, consistently, and automatically make sounds and sequences of sounds. These approaches: provide frequent and intensive practice of speech targets; focus on accurate speech movement; include external sensory input for speech production (e.g., auditory, visual, tactile, and cognitive cues); carefully consider the conditions of practice (e.g., random vs. blocked practice of targets); and provide appropriate types and schedules of feedback regarding performance. 2. Linguistic approaches for treating CAS emphasize linguistic and phonological components of speech as well as flexible, functional communication. These approaches focus on speech function. They target speech sounds and groups of sounds with similar patterns of error in an effort to help the child internalize phonological rules. It is important to note that linguistic approaches to CAS are intended as a complement to motoric approaches, not as a replacement for them. 3. Combination approaches use both motor programming and linguistic approaches. 4. Rhythmic (prosodic) approaches such as melodic intonation therapy, use intonation patterns (melody, rhythm, and stress) to improve functional speech production. Prosodic facilitation treatment methods use intonation patterns (melody, rhythm, and stress) to improve functional speech production. Melodic intonation therapy is a prosodic facilitation approach that uses singing, rhythmic speech, and rhythmic hand tapping to train functional phrases and sentences. Using these techniques, the clinician guides the individual through a gradual progression of steps that increase the length of utterances, decrease dependence on the clinician, and decrease reliance on intonation. 5. Augmentative and Alternative Communication (AAC) Approaches involve supplementing or replacing natural speech or writing with aided symbols (e.g., picture communication, line drawings, Blissymbols, speech-generating devices, and tangible objects) or unaided symbols (e.g., manual signs, gestures, and finger spelling), as well as sign language. Whereas aided symbols require some type of transmission device, the production of unaided symbols requires only body movements. How CASRF Helps and How You Can Too The California Scottish Rite Foundation (CASRF) is a nonprofit organization that is dedicated to helping children with speech and literacy disabilities and deficiencies overcome their obstacles and reach their goals. Helping children with CAS has long been a part of CASRF’s goals, and for years they have been partnering with individuals, universities, education centers, and more to provide services to children suffering from speech disorders like CAS. Moreover, they have made it their mission to provide these life-changing services free of charge, thanks to help from donors. If you think that your child may be suffering from CAS, then the CASRF is a great organization to reach out to. Moreover, if you would like to help with their cause of providing free treatment and speech therapy to children in need, then you, too, can donate to help make their mission possible. Key Points Concerning Childhood Apraxia of Speech CAS is a rare neurological speech disorder that affects the way that the brain communicates and directs mouth movements to produce clear and intelligible speech. Children suffering from CAS face a number of difficulties, and unfortunately, it is not a disorder that a child can simply “grow out of.” For this reason, it is important that children with CAS have access to treatments from Speech-Language Pathology specialists and/or other speech therapists, and it is important that parents of children with CAS have access to information and resources that can help them help their child struggling with CAS. The CASRF is an organization that has made it its mission to help children struggling with CASRF, but we hope that you can find many resources, support groups, and organizations that can help you and help your child during these trying times.

Non-profits use a range of fundraising strategies to increase revenue. There are peer-to-peer campaigns, special giving events, and often a holiday push for donations. But aside from these programs, there is one type of program that really stands out because it benefits both the employees of a corporation and non-profits: this method is called corporate matching or matching gift programs. Corporate matching gifts are a type of corporate philanthropy giving program that is set up by companies and corporations as an employee benefit. After an employee donates to a nonprofit, they can submit a matching gift request to their employer and the company will make an additional donation to that nonprofit. Out of all of the funding sources available to non-profits, corporate matching programs are truly some of the best for reaching revenue goals so non-profits can successfully carry out their missions. In this article, we will go into depth about the ins and outs of matching gift programs. Whether you are a manager at a corporation, an employee looking to do good, or a non-profit organization looking for sources of funding, the information in this article is sure to be instructive in how you can implement your own goals. Why do Companies Implement Matching Gift Programs? 65% of fortune 500 companies offer matching gift programs, and a ton of smaller businesses are following suit and offering the opportunity, too. This begs the question: why? Companies of all sizes match donations their employees make to nonprofits because it’s an easy, structured way for them to support good work in their communities. CSR, or corporate social responsibility, is an important factor in how the public perceives brands and companies these days. Corporate matching gifts are an efficient and straightforward way for companies to build relationships with charities. Why do Non-Profits often Overlook Corporate Matching Gifts? Nonprofits often struggle with receiving these gifts because so few donors know about their employer’s corporate philanthropy programs. Nonprofits also don’t always know who someone’s employer is or what their specific policy is. Communicating guidelines and instructions, especially on a wide scale, can be difficult, so nonprofits frequently choose to focus their efforts on traditional fundraising strategies. But just because there are typically some difficulties in getting funds from matching gift programs does not by any means mean that your non-profit should not look for matching gift opportunities. It can be a good idea for your non-profit to do research on what companies are doing matching gift programs and then engage in outreach among the employees to make them aware, not only of the matching gift program at their company (that they may not even be aware of) but also your non-profit, its mission, and why they should donate to your cause. Later in this article, we will discuss more in-depth the way your non-profit can increase revenue from matching-gift programs. What are the Major Elements of Matching Gift Programs? Every matching gift program is certainly unique to the company that implements the program, but each matching gift program will have a certain amount of similar elements that make a matching gift program what it is. These are as follows: Match ratio: The match ratio refers to the amount of money a company will pay in relation to the original donation made by the employee. A 1:1 ratio means that a company will donate the exact same amount. The match ratio can be anywhere from .5:1 to 3:1, though it is most commonly 1:1 or 2:1. Minimums and maximums: Matching gift programs will almost always specify a minimum and maximum amount for qualifying donations. If an employee donates less than the minimum, they are not eligible for a match. If they donate more, they are only eligible for as much as the specified maximum amount. Employee status: Sometimes the match ratio, or even an employee’s eligibility, depends on the employee’s status. For example, a part-time employee might be eligible for a 1:1 match, while a CEO of the same company qualifies for a 2:1 match. Often retired employees are eligible for matching gifts as well, though sometimes at a reduced ratio. Type of organization: Some companies will narrow their matching gift programs to organizations of a certain kind. For example, some companies will not donate to organizations with religious goals, though they are technically classified as a 501(c)(3). Deadlines: It is important to check your guidelines specifically for the deadline for requesting matching gifts. Some companies put their deadline at the end of the year, while some use Tax Day as their cutoff. These are the major components of any matching gift program. While it is important to know these elements (because you will see them time and again as you navigate the matching-gift terrain), it's also important to remember that each matching gift program is unique and will require that you research the specificities of each promising program you come across. What Non-Profits are Eligible for Matching Gifts Companies often place stipulations regarding which organizations are eligible to receive a match. However, a majority of companies will match donations to these types of organizations: Educational institutions: Colleges, universities, K-12 schools, educational foundations. Arts and cultural organizations: Aquariums, libraries, museums, etc. Community-based social services: Homeless shelters, animal shelters, low-income assistance, etc. Environmental organizations: Conservation efforts, wildlife preservation, recycling, etc. Healthcare organizations: Hospitals, substance abuse programs, medical research, etc. Other companies might restrict their nonprofit eligibility to nonprofits falling into one or multiple of the above categories. A few common restrictions include political organizations, sports teams, and religious organizations that lack a focus on community outreach. Prominent Gift Matching Programs As you and your non-profit continue to navigate opportunities for matching gifts, there are a few notable matching gift programs that you will be sure to want to pay attention to. The companies listed below have shown a deep commitment to matching gifts for long periods of time, and your non-profit would be sure to benefit from learning more about what makes these programs special. General Electric: GE Foundation created the concept of corporate matching gift programs in 1954. Through its matching gift program, General Electric empowers full-time and part-time employees to request matches from all sorts of organizations. They match at a 1:1 ratio for donations between $25 to $5,000. They also have a generous deadline for requesting a matching gift. Matches must be requested by April 15th of the year following the initial donation. The program isn’t limited to just U.S.-based nonprofits either; many UK-based organizations can get in on the action, too. Last year alone, they donated $16.8 million in matching gifts. BP: BP is unique in that it will match, in addition to personal donations, all money raised by an employee. So if a BP employee raises $5,000 in a peer-to-peer fundraiser, they can have that entire $5,000 matched. Microsoft: To date, Microsoft employees have donated more than $1 billion since 1983. This amount continues to rise with $221 million donated by Microsoft employees last year. Microsoft strives to maximize its corporate giving in October, when the company hosts over 300 activities, such as 5Ks and auctions, to raise funds for nonprofits. However, they offer their matching gift program year-round. Microsoft matches donations between $1 and $15,000 at a 1:1 ratio. Full-time employees, spouses, board members, and part-time employees are eligible to submit requests. Most nonprofits are eligible. As part of their commitment to empowering nonprofits worldwide, they also donate and discount the Microsoft Cloud for more than 165,000 organizations, which showcases their passion for supporting charitable causes. Apple: Apple Inc. has a match ratio of 2:1 for all employees! Plus, they offer volunteer grants of $50/hour, which is much higher than usual. Verizon: Under the Verizon Matching Incentive Program, the Verizon Foundation will match full-time and part-time employees’ donations to a wide range of nonprofit organizations. For every dollar an employee donates, the Verizon Foundation matches the gift at a 1:1 ratio for up to $1,000 to most nonprofits each year. If an employee donates to a college or university the matching gift limit is upped to $5,000 per employee per year to higher education institutions. The program is extended to retired employees. However, the company focuses strictly on scholarships and curriculum development with this extension, so they’ll only match retirees’ donations to higher education institutions. They also offer another type of matching gift through their Team Champions program. When teams of 10 or more Verizon employees collectively raise funds for a nonprofit or school, the company will match the funds raised up to $10,000 per team and event. As a direct result of this generosity, Verizon contributed an additional $8.5 million in matching gifts to schools and nonprofits in 2019. Soros Fund Management: Soros Fund Management ranks as having one of the most generous corporate giving programs out there. With an admirable 2:1 match ratio, employees can make a notable impact on any size donation from $25 to $100,000 per year. In other words, if they donated the full $100,000, the company would donate an additional $200,000, totaling to $300,000 for the cause. With this type of generosity comes a few stipulations. For instance, the program is limited to full-time employees. That way, they can continue funding the full amount of these requests. Others: There are a number of other companies with gift matching programs worth mentioning if not in-depth: Johnson & Johnson, CarMax, ExxonMobil, State Street Corporation, and Gap Corporation. How Your Non-Profit Can Collect Matching Gifts Though each program is unique, the steps for collecting matching gifts are actually quite uniform. The process consists of the following five steps: 1. An employee makes the initial donation: The first step is always that initial donation. There can be no matching gift without an initial gift to match. This is also why outreach to employees is so important. 2. Employee submits a matching gift request: This is the most crucial step in the process. A donor must take a few minutes to request the matching gift from their employer. A nonprofit organization or educational institution can not make that request, even when they know that a donor is eligible. 3. Employer checks donation eligibility: Often companies will have someone on staff who is dedicated to matching gifts. This person (or team) will make sure that a donation is within the specified minimum and maximum amounts, check the employee’s employment status and make sure that the organization itself is covered by the program guidelines. 4. Employer verifies donation: Once the donation is verified as match-eligible, the company will contact the nonprofit organization or educational institution to confirm the donation amount, date, and donor. 5. The organization collects the matching gift: The last stage, of course, is when the organization receives that matching gift from a company. How to Increase Matching Gift Revenue For Your Non-Profit The biggest hurdle to collecting matching gift revenue is a lack of donor awareness. Not only do donors not know if they are eligible for matching gift programs, but they also don’t even know what matching gifts are. A donor is more likely to submit a matching gift request if you can ease the process for them. Double the Donation has created a search tool that allows donors to search through an extensive matching gift database of more than 20,000 companies and subsidiaries to find if their employer offers matching gifts. Marketing matching gifts is the single most crucial action an organization can take toward increasing matching gift revenue. And with matching gift revenue basically being free money, it’s hard to come up with reasons not to take advantage of this. In short, your organization should mention matching gifts wherever you can. A matching gift search tool embedded or linked throughout your website and communications can be an incredible way to increase funding from matching gifts. Funding Your Non-Profit with Matching Gifts As we have talked about in this article, employee matching gift initiatives are a great way for non-profits to get sources of funding. The key is to identify matching gift companies and then conduct outreach to employees, informing them about your organization and their company's program for matching funds, and the ways employees can submit match requests. This may take some work, but the payoff for your non-profit will be well worth it. Of course, this does not mean that your non-profit should abandon other ways of fundraising, such as asking for individual donations.

About 5-10% of all children will go through a period of time where they stutter. Approximately 3 thirds of all children who stutter recover by adulthood, either by themselves or with the help of speech therapy. Still, stuttering is a prevalent problem in the world, with approximately 70 million people, or 1% of the world population, who struggle with stuttering. Unfortunately, stuttering can result in a number of challenges for children, and this is especially the case if early childhood stuttering continues into adulthood. In this article, we will focus on the causes of childhood stuttering, and we will explain some of the treatment options available to stuttering children. What is Stuttering? Stuttering, sometimes referred to as stammering or dysfluent speech, is a speech disorder characterized by repetition of sounds, syllables, or words; prolongation of sounds; and interruptions in speech known as blocks. An individual who stutters exactly knows what he or she would like to say but has trouble producing a normal flow of speech. These speech disruptions may be accompanied by struggle behaviors, such as rapid eye blinks or tremors of the lips. Symptoms of stuttering can vary significantly throughout a person’s day. In general, speaking before a group or talking on the telephone may make a person’s stuttering more severe, while singing, reading, or speaking in unison may temporarily reduce stuttering. Common Difficulties Often Experienced by Children with a Stutter 1. For most children, stuttering occurs over a number of activities at home, school, and in play. For some children, a stutter only occurs in specific situations, such as talking on the telephone or talking in front of groups. 2. A stutter can range from mild to very severe. The impact of stuttering on a child is highly individual such that a mild stutter may cause one child extreme frustration and/or anxiety while a more severe stutter in another child may not affect them at all. 3. The child may avoid situations where the stutter is worse or hide their stuttering by choosing words on which they are less likely to stutter. 4. The child may also rearrange their words and sentences to avoid a stutter. Sometimes they will pretend they have forgotten what to say or remain quiet. 5. Stuttering can have a great effect on a child’s confidence when speaking and may affect their social skills or how they relate to others. 6. School-age children will often report feeling embarrassed when they have to read out aloud or talk in front of the class. 7. Language delay or disorder. 8. Articulation difficulties. If left untreated, a child with a stutter may face a number of difficulties: 1. They may have trouble learning to talk and speak intelligibly and with clarity. 2. They may struggle with self-esteem and confidence when they realize that their speaking skills do not match that of their peers. 3. Unfortunately, children who stutter are at a higher risk for bullying when others become away from the child’s speaking difficulties. 4. They may experience social isolation, either self-imposed or externally imposed, when it becomes clear that they cannot cope in group situations or busy environments, impacting their ability to form and maintain friendships. 5. They may experience anxiety and stress in a variety of situations, ultimately leading to more difficulty in reaching their academic potential, regardless of their intelligence. 6. They may struggle with various forms of social communication, such as making eye contact, maintaining an appropriate distance when talking to someone, and taking turns in a conversation. 7. They may face problems with vocabulary acquisition whereby the child cannot clearly get their message across to others due to limited word knowledge. Different Types of Stuttering and Causes No one speaks all the time perfectly. Many people will experience speech disruptions at some point in their life. However, for most people, these speech disruptions are minor and do not greatly affect a person’s life. For people who stutter, these disruptions, or disfluencies, are more severe and are experienced more consistently. Researchers currently believe that stuttering is caused by a combination of factors, including genetics, language development, environment, as well as brain structure and function. Working together, these factors can influence the speech of a person who stutters. 1. Stuttering and Language Development Stuttering most often begins between the ages of two and eight, when children’s language abilities are rapidly expanding. Many children who stutter may know exactly what they want to say, but their motor pathways aren’t quite ready to get the words out. As children produce longer and more complex sentences, their brain experiences higher demand. This increased demand can affect the motor control necessary to produce speech. When motor pathways can’t keep up with language signals, stuttering can occur. While the rapid language development occurring in young children makes them more susceptible to disfluencies, all children develop differently. Some children who stutter have additional problems that may contribute to disfluencies, such as speech and language delays, ADHD, and learning disabilities. For developing children, a genetic disposition to stuttering combined with environmental factors may cause their disfluencies to increase over time and persist into adulthood. 2. Brain Activity in People Who Stutter While no one factor determines stuttering, the predominant theory suggests that a combination of genetics, language development, and the environment can influence the brain activity of people who stutter. The areas of the brain responsible for language may look and work differently in people who stutter. Findings from brain imaging studies indicate that there is more right hemisphere activity in adults who stutter, with less activity in the left hemisphere areas typically responsible for speech production. Some people who stutter have more difficulty processing auditory information and slower reaction times on sensory-motor tasks. In general, research has shown that the pathways in the brain responsible for language look and function differently when stuttering occurs. 3. Genetic Factors A family history of stuttering can demonstrate that stuttering runs in families and is influenced by genetic factors. Children who stutter, for example, often have relatives who stutter. Identical twins sharing the exact same genetic makeup have more similar patterns of stuttering than fraternal twins. We also know that stuttering affects males more than females and that females are less likely to continue stuttering as adults. Researchers haven’t pinpointed a specific gene that’s solely responsible for stuttering. However, it’s possible that if you carry certain genetic material, you may be more likely to stutter at certain years of age. 4. Emotions and the Environment As children become aware of their disfluencies, negative feelings related to speaking may increase tension and further affect their ability to communicate. Depending on their temperament, some children may experience more emotional arousal and anxiety when speaking than others. Emotional factors are difficult to measure, and cannot be considered the primary cause of stuttering. However, negative emotions may place an additional cognitive burden on children who stutter during a critical period of language development. 5. Acquired Stuttering Most people who stutter begin stuttering in childhood, during the developmental period in which they are learning to communicate. In rare cases, stuttering is the result of brain injury or severe psychological trauma. This form of stuttering, known as “acquired” stuttering, differs from developmental stuttering in both its causes and manifestations. Treatment Options for Childhood Stuttering 1. Indirect Treatment Mild stuttering may require indirect treatment if it doesn't resolve on its own or improve with parent counseling within about 6 weeks. This type of treatment encourages young children to speak more slowly. It may involve breathing exercises and other techniques that can help create a comfortable and relaxing environment in which the child's speech can improve or stuttering may go away naturally. Your child may have limited involvement with a speech-language pathologist (SLP), who evaluates and monitors progress while observing and interacting with your child. Treatment will also focus on how you can support your child at home. For example, you may be taught more ways to slow down your own speech and how to provide opportunities for quiet exchanges with your child, where speaking is optional. Some programs focus on continuing to learn creative ways to give your child positive reinforcement during periods of speech fluency. You will also be shown how to track your child's progress and keep detailed records. 2. Direct Treatment Direct treatment (speech therapy) tends to be used if your child's stuttering lasts (persists), gets worse, or is severe. It involves personal interaction between a speech-language pathologist (speech therapist) and the child who stutters. The main focus is to help keep the stuttering from getting worse. Working with a speech therapist can help your child master certain speech and language skills and feel better about his or her ability to speak. The therapist teaches your child: 1. How to form words, speak slowly, and relax even while stuttering. Your child can practice these exercises outside of instruction time. 2. How to manage the physical symptoms of stuttering, such as eye-blinking. 3. How to deal with the emotional difficulties that may result from speech problems. Role-playing and play-based activities are common ways to help your child learn how to apply these strategies. For example, your child may be asked to imagine different situations as he or she speaks and to role-play how others would react. Your child can practice responses and learn to anticipate and manage stressful situations. Also, a therapist may have your child practice speaking in different settings and with different people. For example, your child may start with speaking alone, then in front of a small family group, and then gradually work up to reading aloud in front of others, speaking on the telephone, and talking in front of a classroom. The therapist also often works with you and other family members. The therapist teaches the family some techniques for building an accepting and calm environment, which is important for improving your child's speech. This training is an extension of indirect treatment, where a calm environment is provided for speech to resolve naturally with little intervention. You also may be asked to keep detailed records of your child's progress by using specific techniques in the home setting. Stuttering usually improves gradually over a year or more with direct treatment. Some children may even lose all trace of speech problems. The success of treatment largely depends on: 1. The cause of the speech problem. 2. A child's strengths. 3. The therapist's abilities. 4. The amount of support from parents and family. Your child will need to practice his or her new skills after the therapy program has ended. Using the skills day after day will help your child continue to speak as smoothly as possible. Speech Therapy Resources There are many organizations that have made it their mission to help children with speech disabilities to find their voice and succeed in life. In California, the California Scottish Rite Foundation’s life-changing speech-language and literacy programs provide opportunities for children to improve their communication skills and self-confidence. Our RiteCare Childhood Language Programs offer best-in-class, individualized services that address the needs of developing children and their families. Funding from our donors and granting foundations facilitate the resources our Speech-Language Pathologists need to empower children with increased independence, decreased frustrations, and a pathway to academic success, at no cost to the families. Our donors are proud to give, knowing their contributions drastically improve thousands of children’s lives every year. Moving Past Stuttering Childhood stuttering is a problem faced by a large portion of children worldwide. In fact, the primary type of stuttering is ‘developmental stuttering’ which occurs in children. When a child stutters, they may face a number of difficulties, both socially, academically, and personally. children often become self-conscious and find much social interaction, as well as academic activities, challenging. If left untreated, stuttering can develop into a serious problem. This is why it is best to reach out to organizations and practitioners working in speech therapy to ensure that your child beats their stutter and can move forward in life, happy and confident.

It can be heartbreaking watching your child struggle with a stuttering problem. But it can be even more heart-wrenching watching them stuttering when stressed. When they are involved with lots of other kids or rushed to decide their choice at a fast food place, you may notice their stutter becomes more pronounced. In this article, we will address the problem of stuttering while anxious and stressed. We will discuss why it happens and how to help your child combat this painful issue. What is Stuttering? Stuttering, also called stammering, is a fluency disorder that disrupts the flow of speech. Those that stutter know what they are trying to say, but have trouble getting the words across in a fluent way. There are several kinds of stuttering. Let’s explore them. Developmental Stuttering About 3 million Americans stutter. Although all age groups can be affected by stuttering, children tend to experience it most often. About 5 to 10% of all young children will stutter at some period. Typically it starts between the ages of 2 and 6 as they are learning to speak because oftentimes both their speech and language abilities are not developed enough to express what they want to say. This is called developmental stuttering, the most common type of stuttering, and will typically last between 3 and 6 months. Boys are more likely to stutter than girls. However, about 75% of children who stutter can outgrow it. For the other 25%, stuttering can become a lifelong communication impairment. What causes a developmental stutter? Researchers are still studying the exact causes, but there may be several factors at play. There are several possible causes of stuttering during childhood development. They are: Abnormal speech motor skills: The child may have abnormal speech motor control, including around things like timing, sensory coordination, and motor coordination. Family history: The genetic trait may be inherited in the family line. Neurogenic Stuttering When a stutter is caused by signal problems between the brain and all the various speech mechanisms in our body, this is called neurogenic stuttering. When the brain is unable to coordinate with the brain regions involved with speaking, there is an inability to speak clearly and fluently. This is typically caused by a stroke or brain injury. This kind of stutter most often will manifest through speech that is slow, has pauses, or repetitive sounds. Psychogenic Stuttering Psychogenic stuttering is rare but was once believed to represent all stuttering. Today we know that this condition seems to occur in people who have been through severe emotional trauma or suffer from a psychiatric illness. Oftentimes those with a psychogenic stutter will rapidly repeat the initial sounds in words. Besides the three kinds of stuttering, it is also possible for speakers who do not stutter to experience the same kind of speech disfluency. A stutter can happen for non-stutterers when they feel nervous or pressured. Symptoms of Stuttering Symptoms of this speech disorder may vary throughout the day and in different situations. Here are some common signs and symptoms of stuttering to look out for: Repetitions of a syllable, sound, or word (example: “W-W-W-What”) Difficulty forming the initial sounds of a word, phrase, or sentence Prolonging a word or sounds in a word (example: “SSSend”) Brief pause within a word due to problematic syllables or words. Stopped or blocked speech occurs when the mouth is open but no words are coming out Talking slowly The face or upper body carries tension or tightness when speaking May include movement and facial tics while speaking Adding interjections if the next words are problematic (example: “um” or “like”) Afraid/anxious to talk Being out of breath while talking Difficulty communicating effectively May experience rapid blinking, lip or jaw tremors, head jerks, and/or clenching fists Those children with severe stuttering will have physical symptoms, including increased tension. They will often try to hide their impairment or talk less. Severe stuttering more often occurs in older children. It can even manifest after the child has only had a mild stutter for months or years. It may even appear out of nowhere with no previous speech problems. For severe stutterers, there are speech disfluencies in just about every phrase or sentence spoken. Here are some symptoms of advanced cases of stuttering: One-second or longer disfluencies Prolongations of sounds are common Silent blockages are common Eye blinks, eye closing, looking away, Tension around the mouth and face The rising pitch of the voice during repetitions and prolongations “Um,” “uh,” “well” and other interjections are used when a stutter is expected Fear of speaking; will seem anxious or guarded in situations where they must talk Severe stuttering is likely to persist into adulthood. This is especially the case if the child has already been stuttering for 18 months or more. But do not give up hope; children have been known to recover spontaneously. If you suspect your child has a chronic stutter, consider visiting your child’s healthcare provider for a proper diagnosis and treatment plan. You may notice that the stutter will get worse when the person experiences excitement, fatigue, stress, pressure, or self-consciousness. The stutter will likely come out in situations like public speaking or even talking on the phone with a stranger. But you will notice that the person may speak perfectly when talking to themselves or when singing or speaking in unison with others. Why Does a Stutter Worsen Under Stress? If your child suffers from a stutter, it is important to realize that this does not indicate any mental health issues are at play. It is a fact that anxiety does not cause stuttering. However, anxiety and stress can make a stutter worse or activate a stutter that was already there. You may have noticed that when a person is afraid their stutter will manifest, it makes them stutter even more. And this fear of stuttering can be very detrimental to a child’s ability or desire to socialize, and to have friendships, and can greatly affect the overall quality of life. The reason why stutters increase with stress is physiologically related. When we’re stressed, this has a negative response on our bodies. Our bodies secrete hormones and our muscles tighten; building up tension in the chest, shoulders, jaw, neck, tongue, or lips. The muscle movements that the brain directs to control speech tense up, which can aggravate the stutter that is already existing there. This causes a negative feedback loop. The child has a stutter, which causes anxiety, which then causes the stutter to become more pronounced. This cycle can be very frustrating, and you are likely to see your child withdrawing from social events and activities. Half of the adults who stutter also have social anxiety. Anxiety does not cause a stutter but stutters increase the odds someone will be diagnosed with an anxiety disorder. Having a stutter can make you 6-7 times more likely to have anxiety and 16 to 34 times more likely to be diagnosed with social anxiety. Not only are children likely to withdraw from social interaction more often, but they are also likely to experience bullying and being isolated by their peers. With more experiences like these that can negatively impact self-esteem, adolescents are likely to withdraw even more, and perhaps carry some of these social behaviors into adulthood. How to Combat Stuttering When Stressed There are things you or your child can do to end the negative feedback loop that causes endless cycles of stuttering and anxiety. We recommend trying the following to combat stuttering when stressed: Know the problem: When the person who stutters gets educated on their speech problem, it can make it seem less daunting. Understanding what the stutter is, why it is, and how to overcome it can be half the battle. Speech therapy: It is often best to attack the issue at its core. Luckily, stuttering itself is treatable, which will automatically alleviate the associated anxiety. Get in touch with a certified speech-language pathologist (SLP) to help treat your child’s stutter. A speech therapist can also address any stuttering-related issues, making an easier path to coping with the issue. Electronic fluency devices: An electronic fluency device delays or alters the sound of someone’s voice, creating an echo. These types of devices can also mimic your speech as if you are talking in unison with another person. Both of these ways have proven to improve speech fluency. Cognitive behavioral therapy (CBT): CBT can help alleviate social anxiety by identifying, neutralizing, and preventing self-defeating thoughts. It is also good for increasing self-esteem. Also, consider family therapy. This can help remove the stigma around the stutter. Each family member will be given their own set of supportive strategies to help deal with the child’s stutter. Relaxation exercises: Learning mindfulness and meditation practices can do wonders for relaxation. Also, learning to breathe deeply with breathing exercises is a great skill to master. One easy exercise to focus on when feeling anxiety is learning to exhale deeply. When we exhale, this is linked to the parasympathetic nervous system, the system that helps our bodies relax and calm down. Teach your child this deep exhalation exercise: Do this technique standing up, sitting down, or lying down. Before taking a deep breath, make a long thorough exhale in its place. Try to get all of the air out of your lungs, then allow your lungs to take a natural breath and inhale on their own. Then keep breathing, but make the exhale longer than the inhale. You can start by inhaling for four seconds, then exhaling for six. Keep doing this for 2 to 5 minutes, then realize how much more relaxed you are. Support groups: When you or your child are around other people who stutter, it can make it much less isolating. The problem will then seem less important, which will make it easier to deal with in the future. Find events that include children with similar speech problems. Create a relaxed environment: A person who stutters should have a comfort zone where they can relax around communication. If you are the child of the stutterer, be sure to never talk over him or her, be impatient when they are stuttering, or correct their speech. Instead, listen attentively so he or she does not feel that you are bored or annoyed. Practice communication: When someone avoids social settings, this can make the anxiety worse. Instead, actively seek out new opportunities to practice communication in a social situation through exposure therapy. The more practice, the easier and easier it will be. And much less terrifying. Also, be sure to set aside some quality time to talk to your child and allow him or her the opportunity to have a relaxed conversation without having to feel anxious. Bring up easy, fun topics that will interest your child, rather than difficult ones. Speak slowly, and your child will more than likely follow suit. Provide emotional support: You do not want your child to feel like a burden. Encourage him or her to talk about their feelings regarding stuttering. Knowing they have a listening ear will help them feel supported and less likely to hide their feelings, which can worsen their anxiety. Be positive as you listen, praising your child when you notice any small progress along the way. Ease the Anxiety that Comes With Stuttering Whether it be a developmental stutter, neurogenic, or psychogenic, having a stutter can cause a child to feel isolated from their peers. You must get professional help to help your child cope with their speech impairment. There are ways to learn to cope with both the stutter and the anxiety that can come with it. Although the stutter may not be curable, the anxiety can be dealt with. The earlier, the better. For more information on stuttering, or to get involved with our programs, contact us for more information here at the RiteCare Childhood Language Centers of California.

Along with language disorders, speech disorders can be particularly debilitating for children. Speech disorders can lead to learning disabilities and impact them throughout adulthood. It can also affect things like self-esteem and lead to depression. There are many types of speech disorders out there, but we will focus on some of the most common speech disorders in young children. With this information, we hope to serve as a guide stone to getting your child the treatment they need. Let’s take a look at common speech disorders in children. Stuttering Stuttering, or stammering, is a fluency disorder. It refers to the repetition of sounds, syllables, or words; sound prolongations; and blocks in which speech is interrupted. Certain words or sounds can make the stutter even more pronounced. Stuttering is fairly common; it can affect 5-10% of all children at some point. Symptoms Stuttering typically starts between the ages of 2 and 6. Many times, this period will last less than 6 months. People who stutter can have varying symptoms. Additionally, things like stress, frustration, or excitement can cause the stuttering to increase. Here are the most common symptoms and some physical symptoms that can accompany a stutter: Repeating words, syllables, or sounds Completely halting speech production Uneven speech rate Face and shoulder tension Quivering lips Clenched fists Jerky head movements A rapid succession of blinks If the stuttering lasts longer than 6 months, the child may need treatment. Boys are more likely to continue to stutter than girls, and those who start stuttering after the age of 3 ½ are more likely to continue. Causes There is no one cause of stuttering. But there are several possible causes. They are: Family history of stuttering Brain injury Emotional distress Emotional trauma Abnormal brain function Treatment Options If your child suffers from a stuttering problem, it can help to have support from you, other family members, and your child’s teacher to make a difference. Treatment may not completely eliminate the stutter, but it can help with things like improving speech fluency, developing effective communication, and participation in activities. Treatment options include: Speech therapy: A speech-language pathologist (SLP) can help the child slow down their speech and notice when the stutter occurs. Parent-child interaction: There are techniques you and your child can practice at home to help with stuttering. Talk with your child’s SLP to find the best approach that will work with your child’s issue. Cognitive behavioral therapy (CBT): CBT is a good way to help resolve stress, anxiety, or self-esteem-related issues associated with stuttering. Electronic fluency device: An electronic fluency device delays or alters the sound of someone’s voice which creates an echo. It can also mimic your speech as if you are talking in unison with another person. Both of these ways have proven to help those with stutters. Support group: Joining a support group with other children with similar problems can help your child feel less alone. Apraxia of Speech Apraxia of speech, or verbal apraxia, refers to the speech sound disorder in which brain damage has impaired a person’s motor skills that affect one’s ability to make speech sounds. The person often knows the words they want to say, but are simply physically unable to. Language problems like Aphasia can co-occur with speech disorders like apraxia of speech or dysarthria. These are all the results of brain damage. Aphasia is when the person is impaired in linguistic capabilities rather than motor skills used to speak. Apraxia of speech can also occur in children upon birth, though this is uncommon. It is called childhood apraxia of speech (CAS), or developmental verbal dyspraxia. Symptoms These are some common symptoms of CAS: Difficulty pronouncing vowels Stressing the wrong part of the word Difficulty transitioning from a sound, syllable, or word to another Putting a pause between syllables Inconsistency in pronunciations; making different errors on the same word Difficulty pronouncing simple words Causes In most cases of CAS, the causes are not known. However, there are a few known causes of CAS: Neurological impairment: This may be caused by infection, illness, or injury, during or after birth. Some genetic conditions can also cause neurological impairment associated with CAS. Autism: Apraxia related to autism can be very difficult to diagnose. Take a few sessions with your SLP before a conclusion is drawn. Genetic disorder: Many different complex disorders have CAS as a secondary characteristic. That being said, not all children with that particular genetic disorder will have CAS. One common genetic disorder associated with CAS is galactosemia. Treatment Options To help improve your child’s speech to be more clear, there are several treatment options to try. Treatment will involve learning how to plan the movements needed to say sounds and make the movements at the right time. Treatment options include: Speech therapy: Working with an SLP 3-5 times a week, in the beginning, can make a difference with CAS and language skills. As your child's speech improves, the sessions can be less often. It can be helpful to do either individual or group therapy sessions. Speech therapy may include speech drills, sound and movement exercises, speaking practice, vowel practice, and paced learning. Home practice: Your child’s SLP can give you some words or phrases for your child to practice at home. You can do a quick 5-minute session twice a day. They can also get some practice in real-life situations by creating situations where it is appropriate for your child to say the word or phrase. Other communication alternatives: If your child has a severe case of CAS, it may be helpful to learn other communication methods, like sign language or natural gestures like pointing. However, as their speech gets better, these methods can be abandoned. Dysarthria Dysarthria is a speech sound disorder characterized by muscle weakness or difficulty controlling them. Muscle weakness or loss of control occurs in the parts that are needed for speech including the face, lips, tongue, throat, or chest. The speech is often slurred or slowed, making it difficult to understand. Symptoms Common symptoms of dysarthria speech problems include: Slurred, gurgly, monotonous, nasally, or breathy speech Mumbling A voice that is strained or hoarse Speaking too quickly or too slowly Very soft or quiet speech Difficulty moving tongue or mouth; may involve drooling Unable to speak in a regular rhythm due to hesitative speech Causes The cause of dysarthria can be either developmental or acquired. Some common causes could be: Brain or head injury Brain tumor Cerebral palsy Lyme disease Muscular dystrophy Some medications including certain sedatives or seizure drugs Treatment Options When it comes to dysarthria, it is important to treat the underlying cause of the issue. If it was caused by prescription medications, change or discontinue the medications to relieve the issue. For those suffering from dysarthria that persists, it is a good idea to get treatment from an SLP. Depending on your child’s level of impairment, he or she will work with your child to: Slow down the rate of speech Learn how to use more breath to raise voice volume Practice mouth exercises to strengthen muscles Practice lip and tongue exercises to strengthen muscles Enunciate words and sentences more clearly Introduce other communication methods including gestures, writing, or devices Articulation Disorder Articulation disorder is a functional speech sound disorder that occurs when the speaker has trouble with the motor functions that are needed to make certain sounds. Their lips, tongue, teeth, palate, and lungs are unable to coordinate. This causes the person to produce speech sounds that are distorted, or they will swap out sounds for ones that can make. Symptoms A child suffering from an articulation disorder may be hard to understand. Here are some articulation errors he or she is likely making: Addition: This occurs when sounds or syllables are added that don’t belong. As an example, “puh-lay” instead of “play”. Distortion: This occurs when a sound is changed. It can often sound like a lisp. For example, when the “s” sounds like a “th”. Omission: Excluding certain sounds that he or she has difficulty with. For example, “leaving out the “sc” in “scratch”. Substitution: This occurs when one sound is substituted for another. For example, not being able to form the “th” sound in “those” and replacing an “f” instead. Behavioral issues: When a child is aware of their articulation issues, he or she might often be quiet or seem shy, get frustrated when speaking, or just stop saying some words completely. It is quite often the child will struggle with a lack of confidence and self-esteem. Causes In most children, there is no known cause for their articulation disorders. However, some articulation errors are known to be caused by things like: Brain injury Development or cognition issues Deafness or hearing impairment Physical disabilities that impact speech like cleft palate or cleft lip Any nerve disorder that affects the nerves associated with speech Treatment Options To treat articulation disorder, it is very helpful for your child to undergo speech therapy. Having regular appointments with an SLP will make an improvement with articulation errors. This is what your SLP will focus on: Figuring out the exact sounds your child has difficulty with Correcting the way he or she creates sounds to produce the right sound Teaching or re-learning ways to control the motor functions of speech. This can include how to shape the lips to express a particular sound. Introducing exercises that strengthen the muscles involved in speech Giving you exercises for your child to practice sound formation at home Voice Disorders Children are also susceptible to voice disorders. They are very common; about 5% of children may experience a chronic voice disorder. Voice disorder occurs when the speaker’s voice sounds noticeably different from others’ voices of the same age and sex. But thankfully, most voice disorders are harmless and often disappear on their own. However, this may require some treatment to overcome. Typical voice disorders include laryngitis, muscle tension dysphonia, neurological voice disorders, polyps, nodules, or cysts on the vocal cords. Symptoms Harsh or hoarse voices A voice that is too high or too low A voice that is too loud or too nasally Breathiness Raspiness Strained voice Loss of voice Causes Excessive shouting Excessively loud talking Making too many harsh sound effects when playing Infections like a cold or laryngitis which inflame the vocal cords Paralyzed vocal cords Growths on the vocal cords such as nodules, cysts, polyps Recurrent Respiratory Papillomatosis (rare) Tumors/cancers (extremely rare) Treatment Options Having a hoarse voice can be common in children. However, if it is a chronic issue, we recommend getting an assessment from an ENT and a speech pathologist from a voice clinic. It can also make a difference to pay more attention to taking care of your child’s voice. Be sure to make sure he or she is drinking plenty of liquids. It is also a good idea to have quiet time where your child rests their voice or is encouraged to speak softer. Try to make sure your child does not spend a lot of time in smoky, dusty, or polluted environments. It also is essential that they are free from stress and anxiety so they can speak more calmly. In rare cases, surgery may be necessary. Pay Attention to Milestones in Your Child’s Development To detect any possible communication disorders in your child, it is important to pay attention to the normal milestones in childhood development. If you notice a language delay or any other developmental delays, you may want to reach out to your pediatric healthcare provider to get a more conclusive diagnosis. He or she will recommend an SLP, preferably certified by American-Speech-Language-Hearing Association (ASHA). We are also here to help. Here at the RiteCare Childhood Language Centers of California, we’ve made a difference in childhood speech disorders for 60 years. Our certified SLPs perform free services to children in our community. And we will continue to make a difference in speech disorders like stuttering, CAS, dysarthria, articulation disorders, and voice disorders.