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In this comprehensive discussion, we will dive into the world of aphasia and its effects on children. From understanding what aphasia is and how it manifests in young individuals to exploring various treatment options and ways parents can offer vital support. We will cover a range of essential topics regarding the effects of aphasia on children and how your donation can make a difference. Additionally, we've highlighted donation programs that play a crucial role in enhancing the lives of children with aphasia, demonstrating how contributions can make a meaningful impact. By addressing the challenges, interventions, and avenues for assistance, we aim to provide a comprehensive resource for anyone seeking insights into how to navigate and improve the lives of children living with aphasia. What is Aphasia? Aphasia is a communication disorder that affects a person's ability to understand, produce, and/or use language. It typically results from damage to the brain's language centers, often caused by a stroke, brain injury, or other neurological conditions such as brain tumors or degenerative diseases like Alzheimer's disease. People with aphasia may experience difficulties in various aspects of language, including: Speaking: They might have trouble forming coherent sentences, finding the right words, or producing fluent speech. Understanding: Difficulty comprehending spoken or written language, which can range from mild to severe. Reading: Challenges in recognizing and understanding written words or sentences. Writing: Difficulty expressing thoughts in writing, including spelling and grammar errors. It's important to note that aphasia doesn't affect intelligence or cognitive abilities. People with aphasia often retain their knowledge and skills in areas other than language. The severity and specific manifestations of aphasia can vary widely from person to person, and there are different types of aphasia, each with its own characteristics. Treatment for aphasia typically involves speech and language therapy, which aims to help individuals improve their language skills, regain communication abilities, and find alternative ways to communicate. The effectiveness of treatment can vary based on factors such as the underlying cause of aphasia, the severity of the condition, and the individual's overall health. Can Someone Be Born with Aphasia? Aphasia is typically acquired as a result of brain injury or damage to the areas of the brain responsible for language. It is not usually present from birth. However, there are certain conditions that can affect language development early in life and might be mistaken for a congenital form of aphasia. These conditions include: Developmental Aphasia: In some cases, children may exhibit language delays or difficulties in the absence of any clear neurological injury. This is sometimes referred to as developmental aphasia or specific language impairment. While it may appear similar to acquired aphasia, the underlying causes and mechanisms can differ. Neurodevelopmental Disorders: Certain neurodevelopmental disorders, such as autism spectrum disorder or intellectual disabilities, can impact language development and communication skills from an early age. These conditions are not aphasia, but they can affect language acquisition and use. Congenital Brain Anomalies: Rare congenital brain anomalies or malformations could potentially affect language areas of the brain and lead to language difficulties. However, these cases are quite uncommon. Genetic Factors: Genetic factors can influence language development. Some genetic conditions might contribute to language difficulties, but they may not strictly align with the characteristics of acquired aphasia. It's important to differentiate between true congenital aphasia and other conditions that may affect language development. Congenital aphasia, where an individual is born with a well-defined language impairment due to brain injury or damage, is extremely rare. Most cases of aphasia occur later in life due to factors like stroke, head injury, brain tumors, or other neurological conditions. If you suspect language difficulties in a child, it's important to consult with a pediatrician or a speech-language pathologist to determine the underlying cause and appropriate interventions. How Does Aphasia Affect Children? Aphasia can also affect children, although it may manifest differently compared to adults due to the developmental stage of their language skills. Children with aphasia may experience challenges in language development, communication, and social interactions. The impact of aphasia on children can vary widely based on factors such as the cause of aphasia, the age at which it occurs, and the specific areas of language affected. Here are some ways in which aphasia can affect children: Delayed Language Development: Children with aphasia may exhibit delays in reaching language milestones, such as speaking their first words or forming sentences. They might struggle to acquire vocabulary and use correct grammar. Limited Vocabulary: Children with aphasia may have a smaller vocabulary compared to their peers. They may find it difficult to find and use the right words to express themselves. Difficulty Expressing Themselves: Children with aphasia might struggle to express their thoughts and ideas clearly. Their speech may be less fluent, and they might omit words or use simpler language. Understanding Language: Similar to adults, children with aphasia may have difficulty understanding spoken or written language. They might struggle to follow instructions, comprehend stories, or respond appropriately to conversations. Reading and Writing Challenges: Aphasia can also impact a child's ability to read and write. They may have trouble recognizing and understanding written words, and their writing might contain errors in spelling, grammar, and syntax. Social and Communication Difficulties: Aphasia can affect a child's ability to interact with peers and adults. They may find it challenging to initiate and sustain conversations, which can lead to social isolation and frustration. Academic Performance: Aphasia may impact a child's academic performance, particularly in subjects that heavily rely on language skills, such as reading, writing, and verbal communication. Emotional and Behavioral Effects: Children with aphasia may experience emotional and behavioral changes due to the frustration and difficulties they face in communicating. They might become more withdrawn, exhibit signs of frustration, or develop low self-esteem. Early intervention is crucial for children with aphasia. Speech and language therapy can help address these challenges and support the child's language development, communication skills, and overall well-being. The specific therapy approach will depend on the child's individual needs and the type and severity of aphasia they are experiencing. Parental involvement and support are also essential components of successful intervention for children with aphasia. What are the Treatment Options for Kids with Aphasia? Treatment options for children with aphasia are aimed at enhancing their language skills, communication abilities, and overall well-being. The approach to treatment varies based on factors such as the child's age, the underlying cause and type of aphasia, and the severity of the condition. The primary method is speech and language therapy, where speech-language pathologists (SLPs) work individually or in groups with children to target specific language goals, addressing aspects such as vocabulary, grammar, sentence structure, speech fluency, and communication strategies. For children with more severe speech difficulties, augmentative and alternative communication (AAC) systems provide alternative means of expression through symbols, pictures, or text. Early intervention is crucial, with therapy often involving play-based activities that integrate seamlessly into the child's daily routines. Active involvement of parents and family members is essential, as SLPs collaborate with them to implement strategies at home that support language development. Group therapy sessions offer opportunities for social interaction and skill practice, while cognitive rehabilitation and school-based support can also be incorporated if relevant. The integration of technology, social skills training, and ongoing monitoring ensure a comprehensive and personalized approach to treatment, tailored to each child's unique strengths, needs, and goals, with the ultimate aim of fostering improved communication and overall development. How Can Non-Profit Programs Help Kids with Aphasia? Nonprofit programs such as The California Scottish Rite Foundation play a vital role in supporting children with aphasia by offering a comprehensive range of services and resources tailored to their unique needs. One of the primary ways these programs assist kids with aphasia is by providing access to speech and language therapy, which is essential for improving language skills and communication abilities. Financial assistance and scholarships are often available to ensure that children from all backgrounds can access necessary therapies and treatments. These organizations also facilitate support groups and peer mentoring, creating spaces where children with aphasia can connect, share experiences, and receive emotional support. Nonprofits develop educational materials and resources designed to aid language development, and they may offer technology and communication tools such as augmentative and alternative communication (AAC) devices. Some programs will assist through camps, workshops, and retreats, children with aphasia can engage in immersive environments that promote skill practice and self-confidence. These programs also advocate for awareness and policy changes, fund research initiatives, provide parent and family support, facilitate social integration, and offer scholarships and academic assistance. Conclusion: In our closing remarks, we will find that our exploration into the impact of aphasia on children has unveiled the intricate challenges awaiting young individuals and their families. The revelation will be that aphasia touches upon various facets of language development, communication, and social interactions. However, the potential for significant progress will become evident through dedicated early intervention and unwavering support. The diverse array of treatment options, ranging from advanced speech therapy techniques to innovative technologies and comprehensive educational aid, will underscore the critical nature of a holistic and personalized approach, tailored meticulously to meet the distinct needs of each child. As parents emerge as primary advocates and nurturing caregivers, their indispensable role in nurturing their child's language skills and overall well-being will become increasingly clear. Moreover, the landscape of the future will be adorned with donation programs and purpose-driven organizations singularly focused on uplifting children with aphasia, underscoring the collective and collaborative efforts aimed at enriching their lives through targeted therapy, abundant resources, and immersive community involvement. We hope that our contributions at California Scottish Rite Foundation to these transformative initiatives will serve as a testament to our commitment to shaping a brighter tomorrow for children with aphasia, empowering them to conquer challenges and flourish on their unique communication odyssey. As we converge knowledge, empathy, and proactive measures, a world will unfold where the voice of every child resonates, understood, and cherished.

When it comes to supporting children with Specific Language Impairment (SLI), families often play a vital role in their journey towards improved language development and overall well-being. Recognizing the importance of early intervention and the need for resources, several donation programs and organizations have emerged to support children with SLI and their families. These programs offer a range of services, including financial aid, educational resources, advocacy, and community support. To learn more about SLI and how families can help their children at home who might struggle with this disorder, read on for more info. What is Specific Language Impairment? Specific Language Impairment (SLI), also known as Developmental Language Disorder (DLD), is a condition characterized by difficulties in language development and use. It is diagnosed when a child's language skills are significantly delayed or impaired compared to their overall cognitive abilities and other developmental milestones. Children with SLI typically have trouble with various aspects of language, including grammar, vocabulary, sentence structure, and understanding or producing complex language. These difficulties often persist into adulthood, although they can vary in severity and impact from person to person. SLI is considered a specific impairment because it primarily affects language skills while other cognitive abilities, such as intelligence, are relatively preserved. The exact causes of SLI are not fully understood, but genetic and environmental factors are believed to play a role. It is important to note that SLI is not caused by hearing loss, intellectual disability, or other known neurological conditions. Early identification and intervention are crucial for children with SLI. Speech and language therapy, individualized education plans, and targeted interventions can help improve language skills, communication abilities, and overall quality of life for individuals with SLI. What are The Most Common Symptoms of Specific Language Impairment? The symptoms of Specific Language Impairment (SLI) can vary from person to person, but there are some common signs and difficulties that individuals with SLI may experience. These include: Delayed Language Development: Children with SLI often exhibit delayed language milestones. They may start speaking later than their peers, have a limited vocabulary, or struggle with forming sentences and using appropriate grammar. Difficulty Understanding Language: Individuals with SLI may have difficulty understanding spoken language, especially complex or abstract concepts. They may struggle to follow instructions, comprehend complex sentences, or understand figurative language. Expressive Language Difficulties: People with SLI often have challenges expressing their thoughts and ideas effectively. They may struggle with word-finding difficulties, have limited vocabulary, produce grammatically incorrect sentences, or have trouble organizing their thoughts. Poor Articulation: Some individuals with SLI may have difficulties with speech sound production, leading to unclear or unintelligible speech. This can make it harder for others to understand them. Trouble with Phonological Awareness: Phonological awareness refers to the ability to recognize and manipulate sounds within words. Individuals with SLI may struggle with phonological awareness skills, which can affect their reading and spelling abilities. Challenges with Pragmatic Language: Pragmatic language refers to the social use of language, including understanding and using appropriate communication in different social situations. People with SLI may have difficulties with turn-taking, maintaining conversations, understanding nonverbal cues, or interpreting social contexts. Academic Difficulties: SLI can impact academic performance, particularly in areas that heavily rely on language skills, such as reading comprehension, written expression, and understanding complex instructions. What are Some Treatments for Specific Language Impairment? There are several treatments and interventions that can be beneficial for individuals with Specific Language Impairment (SLI). The specific approach may vary depending on the individual's age, severity of impairment, and specific language difficulties. Here are some common treatments: Speech and Language Therapy: This is the primary form of treatment for SLI. A speech-language pathologist (SLP) works with the individual to address specific language difficulties through structured therapy sessions. The therapy may focus on improving grammar, vocabulary, sentence structure, comprehension, and expressive language skills. Individualized Education Plan (IEP): For school-aged children, an IEP can be developed in collaboration with teachers, parents, and SLPs. It outlines specific goals, accommodations, and strategies to support the child's language development in an educational setting. Parent and Caregiver Training: Parents and caregivers play a vital role in supporting a child's language development. Training programs can help parents learn strategies and techniques to facilitate language skills at home and in daily interactions. Augmentative and Alternative Communication (AAC): In cases where verbal communication is challenging, AAC systems such as sign language, picture-based communication boards, or electronic devices can be introduced to enhance communication abilities. Social Skills Training: SLI can impact social interactions and pragmatic language skills. Social skills training programs can help individuals with SLI understand and navigate social situations, interpret nonverbal cues, and develop appropriate communication skills. Peer Interaction Programs: Group interventions that involve interaction with peers can provide opportunities for practicing language skills in a social setting. These programs focus on improving conversational abilities, turn-taking, and overall social communication. Early Intervention: Early identification and intervention are crucial for SLI. Starting therapy as early as possible can help minimize the impact of language difficulties and promote better language outcomes in the long term. It's important to note that each individual with SLI is unique, and the treatment approach should be tailored to their specific needs. A multidisciplinary team, including speech-language pathologists, educators, psychologists, and parents, can collaborate to develop an individualized treatment plan. How Can Families Help Their Children Who Have Specific Language Impairment? Families play a crucial role in supporting children with Specific Language Impairment (SLI). Here are some ways families can help their children: Early Intervention: Seek early assessment and intervention if you suspect your child may have language difficulties. The earlier the intervention, the better the outcomes. Work with professionals, such as speech-language pathologists (SLPs), to develop an appropriate treatment plan. Communication and Language Enrichment: Create a language-rich environment at home. Engage in regular conversations with your child, read books together, and provide opportunities for them to express themselves. Encourage active listening and respond to their communication attempts with patience and support. Follow Recommendations from Professionals: Collaborate with SLPs and other professionals involved in your child's care. Follow their recommendations for therapy activities, strategies, and techniques to support your child's language development. Use Visual Supports: Visual aids, such as pictures, charts, or schedules, can assist children with SLI in understanding and organizing information. Visual supports can enhance comprehension, vocabulary development, and communication skills. Model Language: Be a good language model for your child. Use clear and correct language, model proper grammar, expand on their sentences, and introduce new vocabulary words in everyday conversations. Encourage them to ask questions and engage in meaningful discussions. Encourage Practice: Provide opportunities for your child to practice their language skills. This can be through play, storytelling, role-playing, or engaging in activities that promote communication and language use. Read Together: Reading is an excellent way to support language development. Read age-appropriate books with your child, ask questions about the story, and discuss the characters and events. This helps develop vocabulary, comprehension, and narrative skills. Foster Social Interaction: Encourage your child to engage in social interactions with peers, siblings, and other family members. Facilitate playdates, encourage turn-taking, and provide opportunities for cooperative activities that involve communication and social skills. Advocate for Support: Be an advocate for your child's needs in educational settings. Work with teachers, school administrators, and special education professionals to develop an Individualized Education Plan (IEP) or other accommodations that address their language difficulties. Seek Support Networks: Connect with support groups, online forums, or organizations that specialize in SLI. These communities can provide valuable resources, guidance, and emotional support for both you and your child. What Donation Programs Are There for Children with SLI? Various donation programs and organizations, like the California Scottish Rite Foundation, exist to support children with Specific Language Impairment (SLI) and their families. These programs aim to provide resources, financial assistance, and advocacy for individuals with SLI. Nonprofit organizations focused on speech and language disorders, such as the American Speech-Language-Hearing Association (ASHA) and the Childhood Apraxia of Speech Association of North America (CASANA), offer support programs and financial aid for therapy services. Local support groups provide emotional support, organize fundraising events, and raise awareness for SLI. Educational institutions, including schools and universities with speech and language pathology departments, may offer scholarships, grants, or financial assistance to families in need. Research and advocacy organizations dedicated to SLI also accept donations to fund research projects, awareness campaigns, and educational initiatives. Additionally, online crowdfunding platforms like GoFundMe, Kickstarter, or Indiegogo can be used by families to raise funds for therapy expenses, specialized resources, or assistive technology. Exploring these avenues and reaching out to specific organizations or programs can provide families with information about available donation opportunities. Families can also consider contacting local community foundations, corporate social responsibility programs, or local businesses that may be interested in supporting children with SLI. Conclusion: In conclusion, the availability of donation programs and organizations dedicated to supporting children with Specific Language Impairment (SLI) is a testament to the collective effort to address the unique needs of these individuals and their families. Nonprofit organizations, local support groups, educational institutions, and research and advocacy organizations all contribute to the holistic support and empowerment of children with SLI. These initiatives offer financial aid, resources, advocacy, and community networks, allowing families to access crucial services for their children's language development. Furthermore, online crowdfunding platforms provide an avenue for individuals and communities to contribute and make a difference in the lives of children with SLI. By harnessing these resources and support systems, families can navigate the challenges of SLI more effectively, ensuring their children receive the necessary interventions, education, and opportunities for growth. With ongoing dedication, collaboration, and generosity, these donation programs contribute significantly to improving the lives of children with SLI, fostering their language skills, and enhancing their overall well-being.

Pure alexia, also known as letter-by-letter reading or agnosia for written language, is a type of acquired reading disorder that affects an individual's ability to read written words. It is typically caused by damage to the left occipital lobe, particularly the visual word form area (VWFA) or the left posterior fusiform gyrus, which are responsible for recognizing whole words. People with pure alexia experience difficulty in recognizing words as a whole, instead relying on a painstaking and time-consuming process of identifying individual letters or groups of letters within words. They may need to spell out each word letter by letter, often using their finger to point at each letter, in order to comprehend the text. This approach can lead to slow and laborious reading. Despite their impairment in reading, individuals with pure alexia typically have intact language skills and can comprehend spoken language without difficulty. They may also have no trouble with writing, although they might experience some difficulty in word retrieval or spelling due to their reliance on letter-by-letter reading. Treatment for pure alexia primarily involves strategies to improve reading efficiency. This can include training in letter grouping, using visual aids or devices to facilitate word recognition, and practicing reading strategies that promote whole-word recognition rather than letter-by-letter reading. However, it's important to note that pure alexia can be a challenging condition to treat, and the level of improvement may vary from person to person. But how does this disorder affect children? Let's read on to learn more. How Does Pure Alexia Affect Children? Pure alexia can have a significant impact on children's reading abilities and overall academic performance. When children develop pure alexia, typically as a result of brain injury or neurological conditions, their reading skills are profoundly affected. Here are some ways pure alexia can impact children: Reading Difficulties: Children with pure alexia struggle with reading due to their inability to recognize whole words. They rely on a letter-by-letter reading approach, which significantly slows down their reading speed and comprehension. This can lead to frustration, difficulty keeping up with academic tasks, and lower reading achievement compared to their peers. Academic Challenges: Reading difficulties can have a ripple effect on other academic areas. Children with pure alexia may experience challenges in subjects that heavily rely on reading, such as language arts, social studies, and science. They may struggle with assignments, tests, and understanding written instructions. Writing and Spelling: While pure alexia primarily affects reading, it can also impact writing and spelling skills to some extent. Children may experience difficulty in word retrieval, accurately spelling words, and organizing their written work. However, it's important to note that not all children with pure alexia have impairments in writing and spelling. Emotional and Social Effects: The challenges associated with pure alexia can lead to emotional and social consequences for children. They may feel frustrated, discouraged, or self-conscious about their reading difficulties, especially when they notice their peers reading effortlessly. These feelings can impact their self-esteem and motivation to engage in reading-related activities or participate in classroom discussions. Educational Support: Children with pure alexia often require specialized educational support to address their reading difficulties. This may involve individualized instruction, interventions targeting reading strategies and compensatory techniques, and assistive technology tools to enhance reading efficiency. It's important for parents, teachers, and professionals to work together to provide appropriate support, accommodations, and interventions tailored to the child's specific needs. Early identification and intervention can play a crucial role in helping children with pure alexia overcome reading challenges and achieve academic success. Why is Early Intervention Important with Pure Alexia? Early intervention is important for children with pure alexia for several reasons. Firstly, during early childhood, the brain is highly plastic, meaning it can reorganize and establish new neural connections more easily. Intervening early increases the chances of developing alternative neural pathways for reading. As children grow older, the brain's plasticity decreases, making it harder to rewire reading processes. Secondly, pure alexia significantly affects reading skills, which are crucial for academic success. Early intervention helps children acquire effective reading strategies, improve reading speed, and enhance comprehension. By addressing reading difficulties early, children have a better chance of catching up with their peers and achieving grade-level reading proficiency. Moreover, reading difficulties can cause frustration, low self-esteem, and reduced motivation in children. Early intervention provides strategies and support to overcome these challenges, reducing emotional and psychological impacts. By addressing pure alexia early, children can develop a positive attitude towards reading and maintain confidence and interest in learning. Additionally, early intervention helps prevent secondary issues such as academic underachievement, social isolation, and poor self-image. By providing early support and accommodations, these issues can be minimized or prevented. Children with pure alexia can succeed academically, actively participate in social and educational activities, and promote their overall well-being. Lastly, early intervention maximizes learning opportunities for children with pure alexia. It ensures they receive appropriate educational support tailored to their specific needs, such as specialized instruction and assistive technology. By identifying and addressing reading difficulties early, children can fully engage in the learning process and benefit from educational resources and interventions. Parents, caregivers, and educators should remain vigilant for signs of reading difficulties in children and seek early assessment and intervention if pure alexia or any other reading disorder is suspected. Implementing appropriate interventions as early as possible increases the potential for positive outcomes and improved reading abilities in children with pure alexia. What Types of Donation Programs are There for Children with Pure Alexia? There are several donation programs and organizations that support children with pure alexia and other reading disorders. While specific programs may vary depending on your location, here are some common types of donation programs that aim to assist children with pure alexia: Nonprofit Organizations: There are nonprofit organizations such as the California Scottish Rite Foundation, dedicated to supporting children with reading disorders. These organizations often provide resources, educational materials, and funding for research and intervention programs. They may also offer scholarships or grants to help families access specialized services or therapies. Assistive Technology Programs: Many donation programs focus on providing assistive technology devices and software that can aid children with pure alexia in their reading and learning. These programs aim to make such technology accessible to those who may not have the financial means to purchase it themselves. This includes devices like text-to-speech software, e-readers, and other adaptive tools. Tutoring and Intervention Services: Some donation programs may fund or provide scholarships for tutoring or specialized intervention services for children with pure alexia. These programs help ensure that children receive the necessary support and instruction to improve their reading skills. They may cover the costs of tutoring sessions, diagnostic assessments, or individualized educational plans. Book and Reading Material Donations: Donations of books, reading materials, and educational resources can greatly benefit children with pure alexia. Programs that collect and distribute such materials aim to increase access to diverse reading materials and promote literacy among children with reading disorders. These initiatives often collaborate with schools, libraries, and community centers. Awareness and Advocacy Campaigns: Donation programs focused on raising awareness about pure alexia and reading disorders may allocate funds towards educational campaigns, public outreach, and advocacy efforts. These initiatives aim to promote understanding, reduce stigma, and improve support systems for children with pure alexia. It's important to research and identify specific donation programs or organizations in your region that align with your interests and goals. They may have different focuses or offer various types of support. Contacting local educational institutions, reading centers, or disability advocacy groups can help you discover donation programs available in your community. Conclusion In conclusion, pure alexia is a distinct reading disorder characterized by difficulties in recognizing whole words and a reliance on a letter-by-letter reading approach. It differs from other reading disorders, such as dyslexia, in terms of word recognition, visual processing, intact language skills, cause and onset, and treatment approaches. Early intervention is crucial for children with pure alexia, as it capitalizes on the brain's plasticity, promotes academic progress, supports emotional well-being, prevents secondary issues, and maximizes learning opportunities. Donation programs and organizations play a vital role in providing resources, assistive technology, tutoring services, and awareness campaigns to support children with pure alexia. By recognizing and addressing pure alexia early, we can help children overcome reading challenges and empower them to achieve their full potential in literacy and education.

If you have noticed your child using vocal fry, you may be worried that it is a sign of a larger speech disorder. Or, perhaps, someone like a teacher or childcare provider has made you aware of your child using vocal fry, and you don’t even know where to begin. Vocal fry is a low register tone produced by a person’s vocal cords. Some people use it intentionally others do not. It does not harm a person physically, but it can become a habit and has societal implications. So, let’s explore reasons children use vocal fry and whether or not that can be a sign of a speech disorder. What is Vocal Fry? Glottal fry or vocal fry is when a person uses a lower pitch when speaking. This is the lowest vocal register a person can make and usually comes with a raspy sound. It often occurs at the end of a sentence when a person doesn’t have enough breath to sustain the entire speech. Vocal fry can be used intentionally and unintentionally. According to the National Institution on Deafness and Other Communication Disorders, voice is produced when air flows into the lungs and through the vocal folds at high speeds. When we breathe, the air pressure increases in the larynx until the vocal folds blow apart. But, during voice production, much like a stringed instrument, the vocal cords will vibrate, generating sound. A child will then use their nose, mouth, lips, and tongue to shape the sounds and produce the words they communicate with. The vocal register includes the range of sounds a person can make with their voice. There are several types of vocal registers, which include vocal fry, falsetto, modal, and whistle register. A modal vocal register is considered normal. When a child is using vocal fry, they are relaxing their vocal cords without changing the amount of air pressure they are using. This generates slower vibrations and a lower tone. Vocal fry is characterized by a low, creaky voice sound quality. Some people think it sounds like bacon sizzling in a pan. It also is characterized as being raspy. The qualities of jitter and shimmer, which are the pitch and volume of the voice, change in the production of vocal fry based on the gender of the person. Some people think the sound of vocal fry is cool. Many celebrities have a vocal fry that has gotten a lot of notice recently. Other people think it is annoying and offputting and just want people to use their normal voices. Ultimately, it means that your child isn’t using their breath in a way that sustains the entire sentence. Is Vocal Fry Harmful To Your Child’s Voice? In general, vocal fry is not physically harmful to children. It can, however, be a sign of an underlying condition. If it is not done intentionally, your child may have respiratory issues that are making it difficult for them to produce enough air to sustain their voice. Or, it could be a result of a neurological condition that makes it difficult for them to use their vocal cords correctly. Vocal fry can also be a sign of a voice disorder or be a learned habit. If vocal fry is used intentionally by your child, there could be some side effects, although it is rare. Since your vocal cords vibrate chaotically when using vocal fry, a child who overuses this speech sound can be more susceptible to scarring and nodules on their vocal folds. Usually, this is not a cause for concern. The main avenue where vocal fry may become harmful is in a child’s social life. Voice affects your life in many other ways than just physically. People and society perceive others based on how they use their voices. Vocal fry can negatively impact the way others perceive your child. Recently, vocal fry has become a fad. Spurred on by the popularity of celebrities such as Kim Kardashian, Britney Spears, and Zooey Deschanel, vocal fry is a voice register that some young people use intentionally to make themselves sound more interesting. (This trend is not to be confused with uptalk, which is a way of speaking that ends everything as if you are asking a question.) Some children may mimic the hoarseness of these celebrities to sound more trendy. Specifically, young adult women tend to use vocal fry more for the sound of it than others. Unfortunately, female voices, in society, can be negatively assessed if they do not meet certain criteria. In a study by Long Island University in Brookville, New York, two-thirds of college-aged women in the study used vocal fry. This unpublished study suggests that women were more likely to use vocal fry in everyday speaking situations. However, this prevalence has led to some unforeseen backlash. Young women, in particular, are perceived as less educated and less hirable in the workplace with the use of vocal fry. These female speakers are perceived as less competent by many bosses. Although this is a perception by the public, it can affect a person’s job prospects. Although job prospects may not be foremost on the mind of parents to a younger child, the way they choose to speak can affect a child’s confidence, how others react to their child, and how others view their child. If they are using vocal fry intentionally, they may get into the habit of using it which could have future consequences. What Causes Vocal Fry? People have different voices because everyone’s vocal tract is different. Vocal folds have different shapes and sizes. A person who naturally has a vocal fry register generally has thicker vocal cords that don’t close as tightly. These thicker cords may also vibrate more slowly than others. This is what produces that raspy sound. Vocal fry can also be a learned habit. Children may use vocal fry intentionally to give their voice a sound quality they like. Once a child uses this vocal register over and over, it is hard for them to not use it. So, they have to get retrained on how to speak if they want to break the habit. The American English language has more vocal fry to it than many other languages. If your child has learned American English as a second language, their vocal fry may be a result of that. However, sometimes vocal fry has an underlying cause. If vocal fry is part of a voice disorder, it is often one of many symptoms. If your child’s vocal fry is accompanied by vocal fatigue and throat pain, they may have something else going on. It is important to note that children who choose to use vocal fry can turn it on and off, whereas children with an underlying illness cannot. Is Vocal Fry a Symptom of a Voice Disorder? According to the American Speech-Language-Hearing Association, voice disorders are characterized by a change in how the voice sounds. Voices disorders can be caused by structural issues such as changes in the tissues of the vocal folds or physical changes in the larynx. They can also be caused by neurogenic factors such as vocal fold paralysis, spasmodic dysphonia, or vocal tremor. Vocal fatigue, muscle tension dysphonia or aphonia, diplophonia, and ventricle phonation are also functional causes of voice disorders. Your child could be using vocal fry as a result of any of those. Some children cannot sustain the breath needed to complete a line of speech because they are not able to use their breath effectively. Others have poor posture for structural reasons they cannot sustain their airflow. If your child’s vocal fry is accompanied by other symptoms, they likely have a voice disorder. Symptoms that indicate a voice disorder include the following: Rough, breathy, or strained vocal quality Abnormal pitch, loudness, or resonance Aphonia Phonation breaks Asthenia Gurling, wet voice sound pulsed, shrill, or tremulous voice Decreased vocal endurance Running out of breath quickly Differences in voice quality at different parts of the day Increased vocal effort Throat or laryngeal pain If your child is experiencing these symptoms, it is important to seek out your pediatrician for further evaluation. How is Vocal Fry Diagnosed and Treated? If you are concerned about your child using vocal fry, or you have noticed vocal fry associated with other symptoms, it is time to get your child evaluated by a professional. First, take your child to their pediatrician to make sure no physical problems are causing the vocal fry. Temporary vocal fry may be the result of an upper respiratory illness that is making it difficult for your child to breathe. Based on your pediatrician’s evaluation, your child may be sent to an ears, nose, and throat doctor (ENT) to help clear the airway for better airflow. The ENT will further evaluate your child and decide on a course of action for any physical obstructions that may be causing your child’s vocal fry. After your child has been evaluated for physical causes of vocal fry, you may want to see if your child is using this method of speaking to sound more trendy. This may be a faze and your child might outgrow the vocal fry. Or, sometimes children are unaware of their speech patterns. Making your child aware of the way they speak can go a long way. If you point out that they speak this way, they may make a more conscientious effort to change it. However, if the vocal fry persists, it may be time to seek out a speech-language pathologist (SLP). How Can a Speech Therapist Help? A speech-language pathologist is a trained professional who can evaluate your child’s vocal fry. Once you set up a speech therapy appointment, the SLP will evaluate your child’s speech. They can tell you if the vocal fry is due to an underlying vocal disorder and come up with a treatment plan to help your child use their airflow more effectively. SLPs are trained in speech-language pathology to be able to help children practice techniques to improve their voice quality. In voice therapy, your child will learn to use their posture to improve their airflow. They will also practice voice strength. The more your child works with the SLP the stronger their voice and communication skills will become. Other strategies that you can use to support your child while they are in speech therapy are to make sure your child stays hydrated and remind them to take breaths when speaking. Sometimes children get overexcited when speaking and don’t take care of their voice. It is also important to support your child throughout this whole process, as it can hurt their self-esteem to have speaking difficulties. Let them know that no matter what is going on, you have their back. Use any tips or techniques that the SLP recommends to reinforce their learning at home. How to Find a Speech Language Pathologist? If you aren’t sure how to get started setting up an appointment with a speech therapist, the California Scottish Rite Foundation can help. If you are worried speech therapy may not be covered by your insurance, we offer free speech, language, education, and literacy programs to help your child be successful. Our trained SLPs will teach your child strategies to become more confident and improve their communication skills. Rite Care clinics are located conveniently throughout the state of California, serving communities in 17 locations. We also partner with local universities throughout the state to train and foster skilled speech pathologists who can diagnose and treat a large range of speech, language, learning, and voice disorders. It’s easy to get started and can make a world of difference in your child’s life. Conclusion Vocal fry may be a trendy way of speaking for young women, but it can affect them in the workplace. It can also be a symptom of a larger voice disorder. If you are ready to get your child evaluated for a voice disorder, reach out to a speech-language pathologist. They can give your child a complete diagnosis and give them strategies to help improve the way they communicate.

You may worry that your child with hypernasality will suffer speech development setbacks. Or, perhaps, you are unsure of how this resonance disorder affects your child’s speech skills, in general. These are normal concerns. As you learn more about the disorder and seek help from professionals, you will be able to help your child navigate this condition better. We will explore the definition, causes, effects on speech development, and treatment options for children diagnosed with hypernasality. What is Hypernasality? Hypernasality, also referred to as velopharyngeal insufficiency (VPI) is a resonance disorder where the speech sound comes out nasally. Resonance is the sound that is generated by the vocal cords. It provides the quality of sound and is important in making the sounds for vowels and voiced consonants. A person’s resonance is affected by the length and volume of the pharynx, the size and shape of the oral cavity, and the structure of the nasal cavity. People produce resonance by controlling their airflow through their nose and mouth. To do this, they use a valve called the velopharyngeal sphincter (or valve). During breathing, this valve stays open. When you speak, it is closed by the soft palate (aka velum or roof of the mouth). Several structures must work together to create the opening and closing of this valve, such as the soft palate, lateral pharyngeal walls, and the posterior pharyngeal wall (the back wall of the swallowing passage). If any of these physical structures are affected, it causes a velopharyngeal dysfunction, which can lead to communication disorders. The velopharyngeal valve is essential in pronouncing certain consonants correctly, such as the phonemes p, b, s, and k. In children with hypernasality, there is an abnormal flow of air and vibration during speech. The pronunciation of high vowel sounds, such as u and I, becomes difficult to make and more nasal sounding. Children with this resonance disorder may sound like they are talking through their noses. It is important to note that some languages are more nasal than others and that people learning a second language may make more nasal sounds than others. Also, the letter sounds in this article are based on the English language. For a proper diagnosis of a child who is learning English as a second language or who speaks a different language, a speech and language pathologist can make a culturally sensitive assessment. Symptoms of Hypernasality The signs of hypernasality include the following according to the American Speech-Language-Hearing Association: High vowels sound nasally (especially the U and I sounds) Excessive nasal resonance (replacing an l or r sound with a w or y sound) Nasal cognates for certain consonants (e.g. the n sound for the d sound or the m sound for the b sound) Hypernasality is one of many resonance disorders that are characterized by irregular oral sound energy or nasal airflow errors. Others include hyponasality (which is the lack of nasal sounds due to a blockage, cul-de-sac resonance (where sound is trapped in the nasal, oral, or pharyngeal cavity), and mixed resonance (where all or some of the other resonance disorders are present together). Hypernasality and hyponasality are commonly mistaken for one another. The key difference is that hypernasality is when the resonance of sounds is incredibly nasal. Whereas, with hyponasality, the sounds are not nasal enough. What Causes Hypernasality? The main three causes of hypernasality are cleft lip or palate, physical abnormalities, or learned behaviors. Genetic or structural anomalies in the ears, nose, and throat physiology can lead to velopharyngeal incompetence. The primary cause of this condition is having cleft palate surgery (palatoplasty), according to Dr. Joseph Haddad, Jr. and Dr. Micahel G. Stewart of New York Presbyterian. Children with repaired cleft palates form scar tissue on the palate, causing it to not function properly. Children have difficulty with velopharyngeal closure (closing off the back of their nose) to make speech sounds. Up to 40% of patients who have previously had cleft palate surgery experience hypernasality, even after repair to the palette. Other craniofacial abnormalities can cause hypernasal speech, including the following: Cleft lip Irregular adenoids Adenoid atrophy Enlarged tonsils Post-tonsillectomy or post-adenoidectomy Deep pharynx Velar hypoplasia or dysplasia Tissue deficit (from a tumor shrinking after radiation) Some of these conditions will require surgery to correct the abnormality. Genetic factors also play a role in developing hypernasality. These genetic syndromes cause structural anomalies that can increase the likelihood of your child speaking nasally: DiGeorge syndrome CHARGE syndrome Treacher Collins syndrome Nager syndrome BOR syndrome Turner syndrome Beckwith-Wiedemann syndrome Stickler syndrome Kabuki syndrome, Optize B/BBB syndrome Jacobsen syndrome Robin sequence Besides physiological causes for hypernasality, children can have this resonance disorder due to neurogenic causes. These include traumatic brain injury, stroke, cerebral palsy, apraxia, neuromuscular disease, neurofibromatosis, Prader-Willi syndrome, myotonic dystrophy, and nemaline myopathy. Hypernasality is also frequently a speech outcome in children who are deaf or have significant hearing loss. Children can also develop hypernasality as a learned behavior. They may have trouble with the articulation of certain sounds and keywords. Their compensatory behavior is to produce nasal sounds instead. In these cases, there is no problem with the velopharyngeal function, rather it is a misarticulation behavior that can be corrected through behavioral speech therapy. How Does Hypernasality Affect Speech Development? Socially, children with hypernasality can sometimes be perceived as less intelligent and less attractive than their normal-speaking peers. This can affect a child’s friendships and self-esteem. If a child has hypernasality into their adolescent and adult years, it can affect their social relationships. Academically, children with hypernasality, especially due to a corrected cleft palate, may have delayed speaking. Most children begin saying a few words by 12 months of age, such as “mama” or “dada.” However, children with hypernasality may start to speak later than their peers with normal speech. Parents usually begin to notice a difference in the resonance of sounds their children are making by age 3 or 4 years old. Children with hypernasality often have trouble with reading and writing, as well. However, this is not always the case. If your child also has a learning disorder or hearing impairment may be at a higher risk of having difficulties with these tasks. Hypernasality in children is usually characterized by the following developmental challenges. Your child may have an inability to produce certain sounds. They also may have trouble using their tongue and lips correctly to form sounds. Your child may also exhibit compensatory errors. For example, children may have errors using their glottis( or the part of the larynx with the vocal cords between them). Glottal stops (which are like grunts) can be used as an oral replacement for sounds your child cannot produce properly. The Glottis fricative is another compensatory error where the air is forced through the glottis to produce the h sound. Other articulation errors include pharyngeal plosives, which are when the base of the tongue hits the back of the pharyngeal wall to substitute velar sounds (k, g). A pharyngeal fricative is when the base of the tongue tries to act as the pharyngeal wall. This results in nasal air emission escaping between the base of the tongue and the pharyngeal wall. A posterior nasal fricative is when the back of the tongue hits against the velum and releases a loud, bubbling sound. Finally, a nasal sniff is when a child forces the sound through the nose to create the s sound. The above-mentioned compensatory errors can make speaking very difficult for your child, especially when peers and others judge them for the ways that they speak. Seeking Treatment In order to treat a child with hypernasality properly, several factors have to be considered. Your child may be treated by a combination of clinicians that may include a pediatrician, ENT (Ears, Nose, and Throat doctor), and a Speech-Language Pathologist (SLP). You can seek out a pediatric doctor with your initial concerns. The pediatrician will informally evaluate your child’s speech and decide on whether your child’s speech is concerning or developmentally appropriate. Then, if the doctor feels there is some form of obstruction or structural issue, they may refer your child to specialists which include a SLP or ENT. Doctors may also use a nasometer to calculate a nasalance score. This will help measure the ratio of nasal and oral amplitudes expressed by your child. If they suspect a physiological factor, they may suggest surgery. Pharyngeal flap or sphincter pharyngoplasty may help with velopharyngeal dysfunction. This will not completely fix the problem. Your child will still need speech therapy before and after the procedure. In cases where the hypernasality cannot be corrected with surgery, severity metrics are determined by speech intelligibility. Usually, these determinations are made by a speech pathologist. An SLP evaluates your child’s speech and language development. The SLP will interview your child. They need conversational speech samples to effectively diagnose your child. Single-word identification isn’t enough to determine the condition. Once the SLP makes the diagnosis, they can create a treatment plan for your child’s speech disorder. Many cases of hypernasality see a significant difference with speech therapy. Speech-language pathology focuses on intervening with young children to address weaknesses and increase strengths. They also create activities that help demonstrate correct speech usage. As well as give children the strategies to overcome articulation errors. Children of at least 3 years of age tend to have better results with speech therapy, even those with severe hypernasality. As many as 43% of these children improved and were developmentally similar to their normal speech peers by the time they were 6 years of age with these interventions. If you are looking for an affordable way to get your child speech therapy services, The California Scottish Rite Foundation can help. We offer speech, language, and learning programs for children free of charge. We are located throughout California at our 17 locations. We partner with speech and language pathologists in both private facilities and universities to ensure a large breadth of services can be offered to your child. This means your child gets the best quality of care at no cost to you. Speech therapy can go a long way in making sure your child is able to meet their speech development goals. Ways Speech Therapists Help Children With Hypernasality Speech-Language Pathologists have a number of strategies they use to assist your child in developing their speech. One example is using a mirror to show your child the path of their airflow. By doing this, they are teaching your child to be more aware of how they form speech. Understanding this lets them adjust and monitor their own airflow. SLPs also show children how to identify the differences between oral and nasal production. Identifying these differences allows the child to control these processes more consciously. Speech therapists can also teach your child to understand how pitch and volume change the sounds they make. Learning how to adjust their pitch and volume can reduce their nasality. It can give them more control over the sounds they make, as well. In speech therapy, children will begin to understand how to identify speech sounds in other people, which encourages them to replicate these sounds themselves. Speech therapy does not cure hypernasality. SLPs simply teach your child ways to better use the parts of their lips, tongue, and airflow to reduce their nasality. These strategies are less effective in children with physical obstructions or abnormalities. Yet, they do still help. Some children will continue to have hypernasality until adulthood, while others may overcome it after a few years. Conclusion Although hypernasality does affect a child’s speech development, most of this can be corrected with proper treatment. This may be a combination of surgery and speech therapy OR it can involve speech therapy alone. Continue to provide your child with plenty of speaking opportunities. Hypernasality can be treated and your child can make progress. Time and patience as well as providing support will go a long way. Your speech-language pathologist will recommend strategies to practice at home to help your child get back on track with their speech and language development.

If your child has difficulties articulating certain sounds in words, especially if they are school-aged, you may wonder if your child has an articulation disorder. Perhaps, even a pediatrician or teacher has suggested you seek additional evaluation. As a parent, it can be scary to face the prospect of a speech sound disorder diagnosis. Yet, there are many resources available to support and treat children who have difficulty producing sounds. Articulation disorder is one of many speech sound disorders diagnosed in children. We will dive into a thorough explanation of the definition, causes, symptoms, diagnosis, and treatment options for children with articulation disorder. What is Articulation Disorder in Children? Articulation disorder is part of a family of disorders labeled as Speech Sound Disorders. These include a wide variety of difficulties people may have in producing sounds common in speech. According to American Speech-Language-Hearing Association (ASHA), “articulation disorders focus on errors (e.g., distortions and substitutions) in the production of individual speech sounds.” Also known as functional speech disorder and articulation delay, articulation disorder, more specifically, is when a child has difficulty with sound production. They may also produce certain sounds incorrectly. For example, he or she may use the “f” sound instead of the “th” sound. Children with this disorder struggle to get their lips, tongue, teeth, lungs, and palate to coordinate to produce the needed sounds. The National Institute on Deafness and Other Communication Disorders explains that the difficulty in motor control is because of the “imprecise placement, timing, pressure, speed, or flow of movement” of these body parts. This leads to the child swapping out sounds for ones they can produce. It can also cause them to have distorted speech. This disorder is often confused with phonological disorder. These two disorders are difficult to distinguish many times and children can have both simultaneously. Children with an articulation disorder are unable to produce the sound in isolation or as part of a word. Articulation disorders are about the motor functions associated with producing sounds. In contrast, with a phonological disorder, children can produce the sounds, they just have difficulties putting them together correctly. Articulation disorder can affect a child’s self-esteem. Sometimes other children may make fun of a child who has difficulties making sounds correctly. It can also be associated with learning difficulties, troubles in reading, writing, and listening, and can be paired with other language and speech disorders. What are The Causes of Articulation Disorders in Children? Articulation disorders in children usually have no known cause. However, certain factors can make a child more at risk of developing an articulation disorder. Alternately, adults who develop speech sound disorders usually do so after traumatic brain injury. Males have a higher incidence of speech sound disorders than females. It is unknown why this is the case. Children with a family history of speech sound disorders are also more likely to have difficulties with speech themselves. Pregnancy complications, pre-term deliveries, and low birth weight are also associated with speech sound disorders. Stanford Medicine also lists some of the following as possible risks: Hearing loss Genetic disorders like Down Syndrome Developmental disorders, such as autism Nervous system disorders like cerebral palsy Frequent ear infections Cleft lip or palate Too much thumb-sucking or pacifier use Parents with low education levels Lack of learning support at home These are simply risks of articulation disorders, not the actual causes. The true cause is unknown in articulation disorders. Symptoms of Articulation Disorder in Children To determine for certain that your child has an articulation disorder, it is important to get your child evaluated by a speech-language pathologist (SLP). Children can be screened for this disorder and many other language, speech, and learning disorders with a speech-language assessment. Yet, common symptoms of articulation disorder involve specific speech sound errors. If you are hearing these articulation errors consistently and your child is 4 or older, you may want to get him or her evaluated: Distortions: A child uses different sounds or changes a typical sound in words. A lisp is an example of a distortion Substitutions: A child replaces particular sounds for one the child can produce more easily. Consonant sounds can be especially difficult. For example, he or she may use the “th” sound for “s.” Another example is using “wabbit” instead of “rabbit.” Omissions: This is when a child leaves out a sound in a word. This could be at the beginning, middle, or end of a word. (e.g. “ca” instead of “cat”). Syllable-level errors: The weaker syllables in words are deleted. (e.g. “elphant” instead of “elephant” Additions: Extra sounds are added to words (e.g. “buhbaby” instead of “baby”) It is important to note that not all substitutions and omissions are speech errors. Some may be a part of a speaker’s dialect. A dialect is a regional way of using language. They can vary greatly across any given language. They have different patterns and compositions. This is another reason it is important to have a speech-language pathologist evaluate any child suspected to have a speech sound disorder to help distinguish between regional differences and actual difficulties with speech. Also, some sound errors are common as a child is developing speech. Children can produce different letter sounds at different ages. Typically, by 6 years old, most children without speech issues can say almost all of the speech sounds. The following is a list of sounds children are typically able to produce by age: 2-3 years old: P, B, D, M, N, H, W; a child is about 15% intelligible at age 3. 3-4 years old: T, K, G, NG, F, Y; a child is about 50% intelligible at age 4. 4-5 years old: V, S, Z, SH, CH, J, L; a child is about 75% intelligible at age 5. 5-6 years old: voiced TH, ZH, R; a child is about 80% intelligible by age 6. 6-7 years old: voiceless TH; a child is about 90% intelligible at age 7. Remember that different children develop differently. This is merely a guide and not necessarily any hard and fast rule. If you think your child isn’t developing speech at the correct rate, it is important to get your child evaluated. What is Involved in Screening for Articulation Disorder in Children? If you suspect your child has a speech sound disorder, you can begin by taking your child to a pediatric healthcare provider. This professional will informally evaluate a child for errors in speech and physical barriers. If the professional believes your child may need a more comprehensive assessment, they will refer you to a speech-language pathologist. A speech-language pathologist will perform a more comprehensive assessment to decide whether your child has a delay in speech development. Some errors may be due to typical developmentally appropriate patterns in young children or the result of regional dialects or accents. This more comprehensive assessment will use formal and informal assessment tools to evaluate any body structure impairments, deficits, conditions, limitations, social, and/or environmental factors that may play into the child’s speech issues. The assessment will include an oral examination to check the structures in the mouth for any obstructions, such as cleft palate, that may be causing a physical barrier to speech. A hearing test will also be performed to check for any auditory conditions. A speech-sound assessment will be used to determine the severity of the child’s articulation disorder. And a phonological processing assessment will be given to assess how the child processes spoken language. They will also be tested on their spoken and written language skills since children with speech sound disorders often develop difficulties with language development. It is completely normal to see children with speech problems also diagnosed with language disorders. Then, a diagnosis and a recommendation for treatment will be given to the child’s caregiver. Often this diagnosis also comes with a severity rating. Severity is judged by the SLP based on the impact the disorder has on the child’s ability to communicate. The scale for severity is usually given using a number rating. More severe cases will have extensive omissions and many substitutions, whereas milder cases will only have a few of these. The severity determines the length and approach of the treatment plan. Treatment Options for Articulation Disorder in Children Once a diagnosis has been made, a treatment plan can be put into action. If physical barriers are preventing your child from creating the appropriate sounds, they will be referred to a medical professional who can suggest treatment for their physical condition. However, the most common treatment option is speech therapy. A speech therapist can provide your child with articulation therapy based on the child’s individual needs. In a speech therapy session, your child will learn to notice their sound errors and correct the sounds. They will practice the sounds they have difficulty with and learn how to correctly produce those sounds. They will learn how to move their muscles, lips, and tongues to produce the needed sounds. Practice does make perfect, so the SLP will also spend time having the child practice words and sounds over and over until he or she gets them right. They will also provide the caregiver with strategies and activities you can try to work on the sounds at home. Speech therapy can go a long way in building your child’s confidence back, as they become more successful in producing sounds that were once difficult for them. If other developmental delays or disorders are diagnosed along with the articulation disorder, there may be other strategies and treatments suggested alongside speech therapy. These could include interventions at school. Ways to Support Your Child At Home One of the best ways to support a child with an articulation disorder is to make sure he or she makes it to all their appointments, including health and speech therapy appointments. It is important to keep an open line of communication between yourself and your child’s healthcare providers to let them know any concerns you may have. If your child is in school, make sure to let the school know. Advocate for additional support for your child at the school level. According to the severity of the case, your child may need special services or interventions to help Practice the strategies your child is learning with the SLP at home to continually reinforce that development. The more your child practices, the better he or she will become. Your child may need more reassurance during this time, too. They will be having to do a lot of new and different things that may be scary and/or frustrating. If you think any of the symptoms become more severe, make sure you contact your child’s healthcare provider as soon as possible. Finding a Speech-Language Pathologist Seeking out a professional in speech-language pathology doesn’t have to be difficult, The California Scottish Rite Foundation can help connect you with a skilled SLP. We are partnered with many practitioners throughout California. Our SLPs can provide your child with the speech, learning, and language help that he or she needs to be more confident in social situations and more successful in academics. We not only provide services at locations across California, but we also partner with universities and private practices to offer a greater breadth of services to children. And, the best part is that these services are offered free of charge, making it easier for you to get your child the services he or she needs. Conclusion An articulation disorder doesn’t have to be scary. Knowing what it is, the symptoms to look out for, the risks of developing it, and the treatment options can give you peace of mind. You can take this knowledge to help you find a treatment plan that is best for your child. This will give your child the tools to be successful and confident. The earlier a speech disorder is treated, the better. So, if you are still worried your child may have an articulation disorder, make sure to get him or her evaluated by a Speech-Language Pathologist sooner rather than later.

Social Pragmatic Communication Disorder (SCD) affects between 7-11% of eighth graders. This condition affects a child’s conversation skills. It’s harder for children with SCD to make friends and maintain close relationships. Their difficulties with social situations can lead to mental health issues and feelings of isolation. As a caregiver, you want to advocate for your child to make sure that he or she receives the best education and the best opportunities at improving their social skills possible. Below, we will dive into what SCD is, how the diagnosis has changed in recent years, and how this disorder affects children’s daily lives. Then, we will discuss ways you can advocate for your child and give them the preparation they need to be successful in every aspect of life. What is Social Pragmatic Communication Disorder? Social Pragmatic Communication Disorder, according to the American Psychiatric Association, “Is characterized by a persistent difficulty with verbal and nonverbal communication that cannot be explained by low cognitive ability.” Most of the difficulties have to do with social interaction, social understanding, pragmatics, and language processing. The disorder can encompass all or a mixture of these difficulties. Children with this disorder have trouble with typical social behaviors such as eye contact, facial expressions, and body language. They struggle with pragmatic language, which is the when how, and why of communication. The expectations for these behaviors can vary greatly between families, cultures, and even individuals. So, a trained clinician must evaluate a child for this condition. One who can discern between actual social barriers versus cultural differences. According to the American Speech-Language-Hearing Association (ASHA), the symptoms of this disorder are the following: Inappropriate greetings Having trouble changing the style of speaking based on setting or person Difficulties telling or understanding stories Trouble initiating or entering a conversation Trouble keeping up a topic during conversation Inability to take turns, respond appropriately, or provide the right information in conversations Difficulty rephrasing when misunderstood Uses inappropriate verbal and nonverbal signals during interactions Has difficulties interpreting verbal and non-verbal cues from others Does not understand figurative or ambiguous language Has trouble making inferences Difficulty forming and maintaining relationships Males are more likely to be diagnosed with this developmental disability. Also, people with schizophrenia, who were born preterm, and people with developmental language disorders were at a higher risk of developing SCD. Children who had the following conditions were also more likely to have language pragmatic difficulties: Aphasia attention-deficit/hyperactivity disorder (ADHD) Autism spectrum disorder (ASD) Cerebral palsy Down syndrome Fetal alcohol syndrome Traumatic brain injuries This disorder is caused by a disruption in the language centers of the brain, but the exact reason those centers are disrupted is unknown. These symptoms may not be obvious during early childhood. Social communication skills become most apparent in school-age children. It takes time for people to notice social communication problems, so many children will not get a diagnosis until they are adolescents. Social Pragmatic Communication Disorder vs. Autism Spectrum Disorder The diagnosis of social communication disorder can oftentimes be confused with autism spectrum disorder (ASD). The two share several of the same symptoms. For years, they were classified under the same umbrella of terms. Yet, the main difference is that children with autism have trouble with social skills and exhibit repetitive behaviors such as repeated body movements, obsessive fixations, or repeating sounds, etc. Whereas, children with SCD do not have these repetitive actions. A professional diagnosis will help determine whether your child has a social communication disorder or if they are autistic. What has changed about Social Pragmatic Communication Disorder in Recent Years? Recently, Social Pragmatic Communication Disorder (SCD) was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This means that SCD is no longer simply treated as a speech disorder. Its addition to the DSM-5 represents new treatment options in the realm of psychiatry. The reason for this change is that many children with SCD have normal phonological processing, vocabulary, and higher-order grammatical skills, which places them on the outside of many of the speech-language treatments. Another reason for this change, according to Amoretti, Lalumera, and Serpico in an article for History and Philosophy of the Life Sciences, was the change in the definition of Autism Spectrum Disorder. Previously, SPD would have been grouped in with autism, but the diagnostic criteria for autism have changed. How Does Social Pragmatic Communication Disorder ASffect a Child’s Daily Life? SCD can make it difficult for your child to develop friendships and maintain effective communication with peers. Oftentimes, they will have inappropriate responses in conversation which can end up isolating them from their peers. Their inability to change their style of communication with different people can make it difficult for them to maintain close relationships with others. Others may see their inappropriate responses as rude or unfeeling when they just don’t understand what is appropriate in certain contexts. They may also have trouble understanding jokes. They also may not complete instructions that are only implied rather than explicitly stated. Their stories may go on too long or meander in an unconventional way, which can make them hard to understand or follow. They can also struggle with the use of written language, which can make school difficult for them. Especially, since many children diagnosed with SCD are also diagnosed with other language disorders. Children with social communication disorders are smart and can learn. They just need to practice communication skills to improve their interactions. However, many times people think that since these children say the wrong thing or don’t interact in a typical way in social situations that they are “weird” or intentionally acting callous. Children with SCD take things very literally. They do not understand the social norms expected of them in the classroom, peer-to-peer interactions, and other social situations. Since this disorder is often mistaken for ASD, the stigmas associated with it also affect children with SCD. With time and proper treatment, these kids can thrive in social situations. Many of the social skills they lack can be taught in speech therapy. Ways to Advocate for a Child With Social Pragmatic Communication Disorder As a caregiver, advocacy for your child in school and other social situations is essential. They may need extra support and patience to be able to achieve at the same level as their peers. The following tips are ways to ensure your child has the best opportunities possible. #1 Get Your Child Evaluated for SCD The first step in advocating for your child is to make sure they are properly diagnosed. If you suspect your child is struggling with pragmatic language impairments, let your child’s pediatrician know. They can evaluate your child informally. Then, if they suspect SCD, they can refer you to a Speech-Language Pathologist (SLP). Once you get an SLP, they can do a thorough evaluation of your child to determine how they use and understand pragmatic language. If your child gets diagnosed with a social communication disorder, they will recommend a treatment plan that is individualized to your child’s specific needs. This will involve a combination of interventions between the SLP, parent, and teacher. A clinician will offer one-on-one language therapy to help teach and practice interactions in a social setting. Early intervention makes a world of difference. In speech therapy, your child will get help building their language skills to succeed in social contexts. SLP's often use role-playing during their sessions to help their child practice social skills as if they were in a real setting. This will teach your child the ways to interact with his or her peers. They will also give your child a toolbox of strategies to help with communication problems. Speech therapists are trained to provide children with SCD with the knowledge they need to tackle social situations. #2 Inform the School If your child has received a diagnosis of SCD, it is important to let your child’s teacher know. This will help the teacher understand that your child may need accommodations. The teacher may even be able to give you more insight into how your child interacts with peers. Your SLP may even request an interview or statement from the teacher. Also, once the diagnosis is made, your child may need special education services, especially if their condition is paired with learning disabilities. An Individualized Learning Plan (IEP) or 504 plan may be needed. These plans are ways for you to ensure your child’s special learning needs are being taken into consideration by the school. Schools can assist with speech-language pathology services and communication intervention. These plans also give your child accommodations in the classroom to make them more successful. Contacting your school and keeping open communication with them will make sure that your child is getting the best available resources. #3 Practice at Home There are several ways you can support your child with SCD at home. You can read books with them and take turns communicating about the book to practice a conversation-like setting. This will also help your child to understand the structure of stories. Make sure to practice taking turns. Also, try to get your child to consider what the different characters must be thinking and why. Play games with your child. This will help them practice turn-taking. You can practice dialogue while playing games and even ask open-ended questions. If your child is having trouble communicating themselves, they could use props, toys, or pictures to show you what they mean when they can’t find the right words. More than anything, just give your child the affection, time, and patience they need. Your stability and care will go a long way in helping them to be successful. They are so much more than their SCD, and sometimes they need a reminder that their other interests and accomplishments matter, too. #4 Give Your Child Opportunities to Practice Social Skills Invite similarly aged children over for a playdate. Start with only one child, at first. Let your child practice interacting with them. Guide them, as needed. As your child becomes better at interacting with one peer, introduce another. Try inviting the children out to different settings such as your home, the other child’s home, or the playground. This will give your child the opportunity to practice their social skills with people their age. Eventually, you should be able to allow your child to interact with a small group of children. This will help them to learn how to deal with different situations that may arise. #5 Get Augmentative and Alternative Communication (AAC) If your child is younger, they may not be able to find the right words or even know the right words to communicate with others. AAC can give children another way to communicate. There are several options. These include the following: Pointing at pictures Drawings Gestures Technology devices Sign language AAC can give a child with communication difficulties the ability to get their ideas and thoughts across, which goes a long way in making them able to interact in social situations. Many children will learn to lean less on AACs as they get older, but others rely on them throughout their lifetime. These communication alternatives are a great way to boost confidence in your child with small successes and give them a way to make their needs and wants known. Conclusion There are many ways to advocate for your child with Social Pragmatic Communication Disorder. With regular speech therapy, additional support at school, practice at home, practice with peers, and Augmentative and Alternative Communication, your child can learn to function well in social situations. If you are looking to get a speech-language pathologist, it is easy with the California Scottish Rite Foundation. With locations throughout California, you can get free speech, language, and learning programs to support your child and give them the confidence they need to succeed. We partner with private providers as well as universities to offer a large range of services for every individual need.

A child with a fluency disorder can feel a lack of confidence, negative emotions toward themselves, and anxiety about speaking. As a caregiver, it can be painful to watch your child struggle emotionally and socially. With early intervention and extra care taken to support your child’s emotional needs, there is hope for a brighter future. Let’s explore the emotional toll a fluency disorder can take on a child and discover some tips for helping your child cope. What is Fluency Disorder? A fluency disorder is when a person has difficulties speaking fluidly. The person may have trouble with the rate, rhythm, and fluency of speech. This may be in the form of stuttering (when a person says a word part or whole word more than once. This is sometimes called stammering, as well) or cluttering (when a person speaks fast and jams words together). Oftentimes, a person who has a fluency disorder also struggles with physical tension, speaking avoidance, and secondary mannerisms. Secondary stuttering behaviors include eye blinking, head nodding, tightening of the jaw, and other behaviors used by the child to People use secondary stuttering behaviors to try to get the words out. These behaviors are a natural response to feeling “stuck” when speaking. However, they can make the stuttering pattern tense, painful, and full of struggle. According to American Speech-Language-Hearing Association (ASHA), children with fluency disorder will have the following symptoms: Repetitions of sounds or words Prolongations of consonants Blocking (inaudible fixations or unable to start a sound) Physical struggle while producing words Deleting syllables or word endings Excessive disfluencies or revisions (filling sentences with lots of “uhs”) Atypical pauses Rapid speech or irregular speech rate Unusual prosody (This is usually similar to the speech sound of children with autism) Childhood-onset fluency disorders affect around 5-10% of preschoolers. This communication disorder is caused by both genetic and neurophysiological factors. Children with autism, attention-deficit/hyperactivity disorder, seizures, and learning disorders are at a higher risk of developing a fluency disorder. Environmental factors can make the disfluency worse. Boys and children with a family history of stuttering are at a higher risk of developing fluency disorders. Young children may have developmental stuttering. This is when a child’s language skills aren’t developed enough to communicate what they want to say. Most children outgrow this type of stuttering. How Does Fluency Disorder Affect a Child’s Everyday Life? The emotional toll of fluency disorders can impact your child’s everyday life from their habits at school to how they act at home. Children with fluency disorder can suffer secondary effects. Dr. Sander and Dr. Osborne explain in their 2019 publication in American Family Physician that children with fluency disorder often deal with negative self-perception, negative perception by others, anxiety, and depression. Early childhood intervention for children with fluency disorders is essential. With early intervention, children can receive speech therapy to help develop techniques to overcome their impairment and eliminate secondary behaviors that may be getting in the way. Children with early intervention may avoid the risk of developing social anxiety, impaired social skills, maladaptive compensatory behaviors, and negative attitudes toward communication. Yet, even with early intervention, childhood stuttering may persist into adulthood. Depression Children with fluency disorders are at risk of developing depression. They can begin to associate their self-worth with the ability to communicate. They may begin to feel sad and hopeless. If you notice your child is showing the following symptoms, according to the CDC, you may want to seek out professional help for your child: Feeling sad, hopeless, or irritable most of the time Not enjoying fun things Eating more or less than usual Sleeping more or less than usual Acting tired and restless a lot of the time Difficulty paying attention Feeling worthless, guilty, or useless Evidence of self-injury Depression can sometimes be hard to spot. Young people aren’t always willing to talk about these difficult feelings, especially if they have a language disorder. It is also even more difficult with especially young children who are unable to fully express their emotions in words. So, if you have any suspicions that your child may be dealing with this condition, get them evaluated by a healthcare professional. Anxiety Another risk with a speech disorder is for your child to become overwhelmed with the pressure to speak correctly. School and other places where there are speaking situations can be hard for a child who has fluency problems. Your child may even begin to avoid social situations or speaking altogether. They may also get bullied by other children for the way they speak or inadvertently treated differently for their struggles in speaking fluently. They may feel constant rejection and humiliation. Your child may develop social anxiety due to the pressures of speaking fluently. Signs of social anxiety include the following: Blushing Fast heartbeat Trembling Sweating Upset stomach Trouble catching breath Dizziness or lightheadedness Feeling your mind is blank Muscle tension Young children often show social anxiety through temper tantrums, clinging to caregivers, and refusing to speak in social situations. If your child shows signs of social anxiety disorder, it is important to contact your healthcare provider to get your child evaluated by a behavior and mental health specialist. A clinician will be able to offer you the support and strategies your child needs to overcome these mental health conditions. Tips to Help Children with Fluency Disorder Cope As a caregiver, you want to give your child the best quality of life possible. So, you want to support your child in any way you can, especially if you notice them harboring negative feelings. The following tips can help support your child through the emotional toll of living with a fluency disorder. #1 Listen To Your Child It is important for family members and you to show your child support. When your child speaks to you, maintain natural eye contact. This will let them know you are listening and paying attention to their words. Be patient. It may feel quicker or easier to speak for your child or complete their sentence or word. However, this can undermine all the hard work your child is doing. It is also essential to set aside a time of day when there are minimum distractions so you can focus on your child’s conversation. This will give you to speak one on one with your child about things that are important to him or her. Giving them this time to speak to you openly regularly will make them more comfortable with talking to you about any feelings of low self-esteem they may have. It lets them have an outlet for their emotions and a low-stakes environment for your child to practice fluent speech. #2 Model Slower Speaking This may seem like an odd suggestion, but if you speak slowly, your child usually mirrors that behavior. This helps decrease stuttering. You don’t have to alter the way you speak to your child. You are simply showing them it is ok to take your time when speaking. Once again, modeling this behavior is great practice for your child. It allows them to become comfortable with slowing down speech before using that skill in real social situations. #3 Create a Calm Environment No matter your child’s stuttering severity, an anxious or fast-paced atmosphere will exacerbate the fluency disruptions. Stuttering increases when your child is stressed. It is best to provide a calm environment at home where your child feels comfortable speaking as they are. This isn’t the case always out in social situations or, for school-aged children, in the classroom setting. Often there are a lot of stimuli that encourage fast, hurried speech in these situations. Yet, if their home is a calm place, this will go a long way in helping them manage their feelings. If the home is their calm and safe space, they will feel more comfortable talking to you about what’s going on in the rest of their lives. #4 Focus on the Child as a Whole Person It’s easy to want to help your child fit in. But, focusing on their stuttering can make them more self-conscious. Also, be mindful of situations in which your child may feel pressured to speak. This can increase those feelings of anxiety in your child. Make sure to praise them for all their hard work, especially when they try a new speaking situation. Remember that there is so much more to your child than their speaking issue. They can be a great artist or play sports like a pro. Try to focus on the whole child, letting them know that there is so much of them to love and care about. This will show them that they are more than their stuttering, as well. #5 Seek Out Support There are support groups both online and in person for people with speech fluency disorders. It can be good for families of children with a stutter to get together. This can help normalize the condition and allow you to lean on others. It also gives your child a friend with similar hurdles to overcome. Support groups are also great for offering advice and other coping tips. Seeing how others cope with negative feelings can help you develop new strategies for your family. Getting Treatment One of the best ways to support the emotional and physical needs of a child with a fluency disorder is to make sure to get them the evidence-based treatment they need. First, you will need to get your child evaluated by a speech-language pathologist (SLP). This evaluation will determine whether your child’s fluency disorder is caused by developmental or neurophysiological factors, which influence the treatment approach. Next, the SLP will determine how severe the case is. Then, the clinician can recommend the best treatment plan for your child. There are a few different ways to improve speech fluency in your child. These treatment options include the following: Speech therapy: Speech therapy is a regular meeting with an SLP that teaches your child to slow down, notice patterns, and speak more deliberately. With time, natural speech patterns can be achieved in many children. Electronic devices: Some electronic devices are available for children with speech fluency disorders. They work to enhance fluency through delayed auditory feedback, which makes a child speak slower. There are other types of devices. These can be worn during daily activities but should be recommended by your SLP Cognitive behavioral therapy: Your child may need to participate in a type of psychotherapy called cognitive behavioral therapy. This will help identify and change the ways of thinking that make stuttering behaviors worse. This can also help to resolve stress, anxiety, and issues with self-esteem. Parent-child interaction: Many of the tips mentioned in the section above help with this. A key part of helping your child cope with the emotional toll of stuttering is to offer support and guidance at home. Practicing speaking at home also helps your child become more fluent. Your child may use some or all of these approaches, based on your child’s individual needs. Part of the treatment will focus on providing your child with strategies for speaking more fluently, another part will focus on reducing the secondary mannerisms children use to try to overcome the “stuck” feeling they have when stuttering. They will learn to replace these behaviors with strategies that work to help the child speak more fluently. Conclusion There is a lot of support available for children with fluency disorders. Getting a diagnosis and treatment plan with a speech-language pathologist, as well as offering your child support at home or with a mental health specialist can ease the emotional toll your child suffers. If you are looking for a speech-language pathologist to assist your child in becoming more fluent in their speech, RiteCare Clinics offer free services to California residents in 17 locations across the state. Our trained professionals will provide your child with strategies to help increase your child’s fluency. Ritecare Clinics assists children by providing childhood speech-language, literacy, and education programs to improve communication and confidence.

Language is an essential part of our everyday lives. It helps us communicate our thoughts, feelings, and desires. But for some children, speaking correctly can be a challenge. Phonological disorders are incredibly common in children and can significantly impact their ability to communicate effectively. In this blog post, we will discuss the importance of early intervention in addressing phonological disorders in children. What Are Examples of Phonological Disorders? Phonological disorders are a type of speech disorder that affects a person's ability to understand and use sounds within words. These disorders can be mild or severe, and they can affect a person's speech production, language development, and communication skills. There are a few types of speech sound disorders to be aware of. The good news is that most are fairly easy for clinicians to diagnose based on listening to abnormalities in speech patterns and phonological errors - and there are plenty of potential treatments to improve a child's speech, too. Let's take a closer look at some of the most common developmental phonological disorders. 1. Articulation Disorders Articulation disorders are the most common types of phonological disorders, usually affecting children. This disorder occurs when a child has difficulty producing sounds or making specific sounds in words. The symptoms of this disorder include distortions of sounds, repetition of syllables, omitting sounds, and adding different sounds or consonants in words (usually either final consonant deletion or initial consonant deletion). 2. Phonemic Awareness Disorders Phonemic awareness disorders occur when a child cannot differentiate between the sounds produced in words. Children that suffer from this disorder usually struggle with phonological processes such as blending, segmenting, or manipulating sounds in words, which may lead to reading and writing difficulties in the future. Phonemic awareness disorders are treated by teaching children phonological awareness skills, such as recognizing sounds in words or breaking sounds into separate phonemes. 3. Childhood Apraxia of Speech Apraxia of speech (AOS) is a neurological condition whereby a person has difficulty coordinating their oral muscles to produce speech sounds. People with this type of speech delay may struggle to plan and coordinate the movements required for speech, leading to inconsistent speech output with distorted or slurred sounds. Speech therapy can help treat AOS by building muscle memory and giving a structured approach for better speech production. 4. Phonological Delay Phonological delay refers to the development of speech sounds in a child that is slower than in typically developing children. While every child develops speech sounds at their own pace, a phonological delay refers to children who are significantly behind in their speech sound development. This may result in difficulty with language development, making it difficult to understand or produce spoken language. 5. Dysarthria Dysarthria refers to a physical condition that affects the part of the brain responsible for speech production, which might affect the nerves and muscles associated with speaking. These disabilities can affect a person's volume, tone, and phonetic pronunciation of words, which can make it challenging for others to understand them. Treatment for this disorder includes specialized exercises to help strengthen muscles involved with speech, such as the jaw, lips, and tongue. What Causes Phonological Disorders? There are a few potential causes for phonological disorders, and often, these various causes work together in tandem, rather than just being one overarching root cause. This can sometimes make it tough to diagnose or treat a phonological disorder, but the good news is that there are many evidence-based treatments for these speech problems and communication disorders, and understanding potential causes can help clinicians treat the speech issues a bit better. Here are some of the most common causes: Family History: Research has shown that genetic factors play a role in the development of phonological disorders. Children with a family history of speech and language difficulties are at an increased risk of developing phonological disorders. Thus, it is important for parents to inform their child's speech-language pathologist of any family history of speech and language difficulties so appropriate intervention can be provided. Environmental Factors: Environmental factors, such as exposure to toxins or infections during pregnancy, can also contribute to the development of phonological disorders. For instance, exposure to lead during pregnancy or early childhood has been linked to speech and language delays. Moreover, children exposed to chronic ear infections have an increased likelihood of experiencing speech and language difficulties. Social Factors: Children who grow up in homes with limited opportunities or resources may struggle with phonological disorders. These children may not have enough chances to socialize with others or access a rich language environment. Children who experience trauma or neglect may also have affected speech and language developmental processes. Biological Neurological Factors: Phonological disorders can result from various biological and neurological factors that influence the brain's ability to process auditory information. For instance, children with hearing loss may struggle with processing and articulating speech sounds, eventually experiencing a delay in language development. For example, children with dyslexia or attention deficit hyperactivity disorder(ADHD) are at an increased risk of developing phonological disorders. A neurological disorder can also result from a brain injury or stroke, affecting an individual's ability to produce, process, and comprehend speech sounds. Other biomedical factors that trigger phonological disorders and their resulting speech sound errors in young children include cleft palate or cleft lip, Down syndrome, cerebral palsy, and others. In such situations, it is crucial to diagnose the problem early, followed by various therapies to help the child develop speech and language. Developmental Factors: Phonological disorders can also result from developmental factors, such as delayed phonological development or language impairment. Children develop speech sounds at different rates, but phonological development typically follows a predictable sequence. If a child deviates from this sequence or experiences delays, it can result in a phonological disorder. Tone of Voice and Speech Modeling: Phonological disorders may also occur when children are exposed to poor tone of voice and speech models. Children have an innate ability to mimic sounds and language models that they encounter in their environment. For instance, ESL children who grow up in households with strong accents may have difficulty articulating speech sounds, leading to a phonological disorder. Socioeconomic Factors: Research has also shown that socioeconomic factors, such as poverty or low parental education, can increase the risk of children experiencing speech and language delays. Children from lower socioeconomic backgrounds are less likely to have access to quality healthcare and early intervention services, such as speech therapy, which can negatively affect their speech and language development. How Are Phonological Disorders Diagnosed? If you suspect that your little one is having trouble with speech, you're not alone. Parents all over the world notice their kids stutter, have trouble pronouncing certain sounds or struggle with reading and writing. But how do you know when it's nothing to worry about or if it's something more serious - that is if your child has a phonological disorder? If you're concerned about your child's speech intelligibility at all, you need to talk to a pediatric doctor first, who will likely refer you to speech-language pathology services. To diagnose a phonological disorder, a speech-language pathologist (SLP) will evaluate your child's speech in various contexts while examining their ability to understand and use language. During the assessment, the SLP will look for patterns in the errors your child makes and determine if they're typical of a phonological disorder. The SLP will also ask your child to say various words and sounds while examining their fluency, tone, and pitch. The SLP will also evaluate your child's receptive and expressive language skills, which include language comprehension, vocabulary, and syntax. The assessment may include standardized tests that measure your child's ability to follow instructions, repeat phrases, and match sounds to letters. Based on the findings from these tests, the SLP will determine if your child's speech difficulty is related to a phonological disorder or another issue. How Are Phonological Disorders Treated? Once the assessment is completed, the therapist will create a treatment plan that is tailored to the child's specific needs and goals. The type of treatment, duration, and frequency will depend on the severity of the phonological disorder, the age of the child, and the child's motivation and ability to engage in therapy. One of the most common approaches for treating phonological disorders is speech sound therapy. This therapy involves working on the specific sounds that are causing difficulties through repetition, practice, and feedback from the therapist. Another approach is phonological awareness therapy, which focuses on helping the child to recognize and manipulate the sounds and patterns of language. This approach can be particularly helpful for children with more severe phonological disorders. In some cases, a combination of therapies may be used, depending on the child's needs. For example, a therapist may combine speech sound therapy with phonological awareness therapy to ensure that the child is building a strong foundation for effective communication. They'll work closely with the child based on the errors and the known cause of the speech issues. It's not a one-size-fits-all approach. For some kids, working on consonant sounds might be the goal, but for others, improving overall speech intelligibility might be the goal. It is important to note that phonological disorders are not always cured completely, and ongoing support may be needed to maintain progress. This support may include regular check-ins with the therapist or home practice tasks to reinforce the skills learned in therapy. In some cases, follow-up therapy sessions may be necessary to monitor progress and make adjustments to the treatment plan as needed. Parents and caregivers can also play an important role in maintaining progress by reinforcing the concepts and strategies learned in therapy in the child's everyday communication and language development. This can include praising the child for using correct sounds and patterns and providing corrective feedback when needed. The Importance of Early Intervention for Phonological Disorders Now that you know about the potential treatments for phonological disorders in children, you might be curious about the role that early intervention plays. The short answer - a big one. Here are five ways early intervention is key in helping children overcome phonological disorders. Early Intervention Improves Language Development: Phonological disorders can have a significant impact on a child's ability to develop language. If these disorders go untreated, they can lead to further struggles with reading, writing, and social interactions. Early intervention can help children develop their language skills by addressing phonological difficulties through therapy and other interventions. Children who receive early intervention have more opportunities to practice and refine their language skills, increasing their chances of success in school and beyond. Early Intervention Supports Emotional and Behavioral Health: Phonological disorders can also have a negative impact on a child's emotional and behavioral health. Struggling with language can lead to frustration, low self-esteem, and social isolation. Early intervention can help children develop their language skills and reduce the emotional and behavioral challenges associated with phonological disorders. Children who receive intervention early on are more likely to feel confident and successful in their language abilities, leading to increased social connections and overall happiness. Early Intervention Reduces the Need for Special Education Services: Phonological disorders can lead to difficulties with reading, which can result in children being classified as having a learning disability. Early intervention can reduce the need for special education services by addressing phonological difficulties before they become more significant problems. By addressing these challenges early on, children can develop necessary language skills, reducing the likelihood of requiring more intensive interventions in the future. Early intervention can ultimately save children time, frustration, and stress associated with special education needs. Early Intervention Enhances Academic Success: Phonological disorders often lead to difficulties with reading, writing, and other academic tasks. Early intervention can help children develop their language skills, leading to better outcomes in all academic areas. Children who receive early intervention often have improved grades, higher graduation rates, and increased opportunities for post-secondary education. Early intervention can set children on a path towards academic success and increase their chances of achieving their goals. Early Intervention Supports Family Communication: Phonological disorders can be a challenge for families, with many feeling overwhelmed and unsure of how to support their child's language development. Early intervention can help families better understand their child's phonological challenges and how to support their language development at home. By providing strategies and resources early on, families can play a crucial role in their child's language success, leading to better communication and stronger bonds between family members. Treating Phonological Disorders: Addressing Language Disorders from an Early Age Early intervention is crucial in managing phonological disorders in children. Children who receive early treatment are more likely to overcome these disorders and make more significant progress than those who do not. These disorders can be challenging and frustrating for children and their families, but early intervention can play a crucial role in helping these children overcome their challenges and improve their speech. By understanding the causes and symptoms of phonological disorders, parents and caregivers can work alongside speech therapists to support children in their speech development journey. If you want to support the cause further, consider donating to an organization that works specifically toward increasing awareness and providing treatment for kids with phonological disorders, like the California Scottish Rite Foundation. After all, all children deserve a chance to communicate effectively - and early intervention can make all the difference in their lives.

It can be unsettling to see a child suffering from Selective Mutism. You probably aren’t sure how to help them or where to turn. This condition can interrupt daily life for this child, causing them to suffer in school and routine social situations. Yet, there’s hope. There are several strategies you can try with a child with selective mutism to help them manage this anxiety disorder. Let’s explore these strategies and a step-by-step guide for how to implement them in the child’s daily life. What is Selective Mutism? This complex anxiety disorder is sometimes difficult to diagnose. With selected mutism, the child does not choose when they speak and when they do not. The failure to speak is also not about the child’s knowledge of the language. Instead, the child repeatedly shows a failure to speak in specific social situations. There may be certain people the child is more comfortable speaking around. There may also be certain situations in which the child speaks freely. Yet, he or she becomes selectively mute in other situations or the same situation around different people. The variables differ from child to child. This anxiety disorder is often diagnosed between the ages of 3 to 6, around the time that school begins. However, selective mutism is not limited to school settings. Children may exhibit symptoms of this disorder around extended family members or in community settings. Along with not being able to speak, they may have a “deer in the headlights” look, which is characterized by a lack of facial expressions and sometimes difficulty making eye contact. According to the American Speech-Language-Hearing Association (ASHA), the cause of the condition is complex. It can often be attributed to a combination of the following: Genetics social phobia separation anxiety obsessive-compulsive disorder Parenting style Delays in speech or fine motor skills Shy temperament Overactive autonomic nervous system A Speech-Language Pathologist is essential in the diagnosis of selective mutism. They assess and differentiate it from other disorders such as autism spectrum disorder, schizophrenia, etc. Strategies for Helping Children with Selective Mutism On your journey to help your child with selective mutism break the silence, caregivers can try the following strategies. To truly treat the condition, a speech pathologist is necessary, but these tips will give you some ways to help reinforce what the speech therapist is working on with your child. Avoid Negative Reinforcement Well-intentioned people try to speak for the child with selective mutism in situations where they are unable to speak. However, this behavior works to negatively reinforce the child’s non-speaking behaviors. The University of Central Florida explains that negative reinforcement is when “[s]omething is removed to increase the likelihood of a behavior.” In the case of speaking for the child, you are removing their need to speak, so they continue to not speak in that situation. Although it may seem natural, especially as a parent or caregiver, to swoop in a rescue a child struggling to speak, they need to try to do it on their own. Give them plenty of time to speak. They need time to process questions and formulate an answer the way they can. This may seem like forever to you, but it is necessary in helping them to communicate in difficult situations. If they still can’t speak, try giving them alternative ways of communicating like writing down their answer on a notepad or whiteboard. If they are pre-literate, consider teaching them or asking them to use gestures, pictures, or other forms of non-verbal communication. Acknowledge Their Strengths When your child is struggling to communicate in certain scenarios, it can be easy to focus on that behavior rather than all the ways they are doing well. Even if your child is still not managing to speak in social situations, they may be trying to participate in these situations non-verbally. Observe your child’s behaviors closely, and praise them for their efforts. Be mindful of the types of praise you offer in public and in private. Non-verbal behaviors can be praised in public like you would with any other child. Praise for speaking more should be done in private to avoid embarrassing the child. Social interaction is especially hard for children with selective mutism, so any progress toward communicating with others is worthy of praise. These children may struggle with low self-esteem, so reminding them of what they do well and their hard work can go a long way. Don’t limit your praise to their speaking, though. There is so much your child can do! They may be great at art or sports or writing or any number of things. They still want praise for these activities, too. The child needs to know that they are more than their weaknesses and that they can accomplish great things, even if they have trouble speaking. Understand the Nature of the Condition As a caregiver, it’s important to realize that your child’s silence is not a choice. It is a social anxiety disorder. Mute children want to have play dates and interact in social settings, but they have social anxiety that is preventing them from speaking. They also won’t likely have a pattern of behavior that you can understand. They may speak perfectly fine to one aunt but remain silent with another. The people, places, and activities that cause your child anxiety may not make sense to you, but your child can’t help their response. So, even though offering your child a reward for speaking in certain situations, like a classroom setting, may seem like a way to motivate your child, it is counterproductive. Be Mindful About What You Say You may not realize it, but sometimes you can criticize a child with selective mutism unintentionally. Comparing your child’s speaking ability to siblings or comparing their speaking abilities from one instance to the next doesn’t seem to be harmful, but children usually perceive them as criticism. This criticism can discourage the child from speaking or affect their mental health. Additionally, questioning the child when they are struggling to speak can compound the issue. They are already having difficulties and the questions pressure the child further. You don’t even realize that the questions are becoming overwhelming, but your child simply can’t process the questions when they are already struggling to speak. Encourage Physical Activity Children with selective mutism still need to get out and exercise and interact with others. Plus, studies show that exercising can reduce anxiety in people experiencing symptoms. This will also give you a chance to bond with your child. Adolescents and young children alike will enjoy playing a sport or exercising with you. They could try organized sports, running, cardio, yoga, or even a dance party. Get your kid moving their body to help them manage their anxiety, especially after a difficult interaction. This can help boost your child’s mood and relieve some of the symptoms of anxiety. Make Mistakes Seem Less Scary Many people, not just children with selective mutism, have trouble overcoming mistakes. They may feel like a failure if they can’t speak correctly or say the wrong thing. However, they are learning opportunities and chances for your child to practice. Encourage your child to see each speaking opportunity as a learning experience and don’t punish or criticize your child for mistakes. As long as they are trying, that’s all that matters. This includes when children fail to say niceties like “please and thank you.” You may be worried others will perceive your child as rude, but they aren’t trying to be rude when they leave these out. Your child likely isn’t trying to be oppositional, they just struggle to say the words sometimes. They may even have trouble making eye contact. Let them know that they will get better with more practice and that you understand they are trying. Try to make talking in social situations seem like something exciting or gamelike, not a big hurdle to overcome. Your child takes a lot of cues based on the way you react to situations. If you are looking for more resources to navigate through this journey with your child, check out Selective Mutism Association’s website. Strategies for the Classroom The most common place where Selective Mutism interrupts your child’s daily life is in school. Often, the disorder becomes most apparent when a child enters elementary school, especially at the beginning of the school year. There are several ways to advocate for your child in the classroom. Teachers can also use these tips to help them to accommodate children with selective mutism in their classrooms. Get an IEP An Individual Education Plan (IEP), is a plan created by the special education department at your school in conjunction with you and the teachers to outline the strengths and weaknesses of your child and make appropriate learning goals. This plan gives your child an opportunity for special education services. It also provides them with legal protection against discrimination in the classroom. To be considered for an IEP, children must undergo an evaluation. Once they are determined eligible for an IEP, a plan is created by stakeholders and is implemented in the school environment. Small Group Work Whole group discussions can be a nightmare for some children with selective mutism. Small groups and pairs can be better for getting these children to speak up and answer questions in class. Try to identify other students in the classroom that the child feels comfortable speaking around to set them up for success. Caregivers can help their children by letting teachers know the particulars of their child’s dos and don’ts when it comes to speaking. Allow Alternatives Some assignments where speaking in front of the class can be difficult for kids with selective mutism. Allowing them to present these to a smaller group or the teacher alone can go a long way in helping the child complete the task. Parents can ask for this in the IEP meeting or let the teacher know ahead of time that there may be issues with presenting. Most teachers are willing to adapt the assignment for children with selective mutism. Getting Treatment In addition to the aforementioned strategies, it is important to get your child seen by a clinician. This disorder is categorized as an anxiety disorder, so it requires a behavioral approach. Behavioral therapists are trained in providing support to children with childhood anxiety disorders. Not only can they assess and diagnose the disorder, but they can also work in conjunction with behavioral therapists to treat Selective Mutism. Behavior therapy involves gradual exposure, contingency management, and stimulus fading. This treatment plan can work to get an anxious child to overcome their fear of speaking. Some children with Selective Mutism will also have delays in language development. In these cases, you’ll need to seek out a Speech-Language Pathologist (SLP) to assist the Behavioral therapist in working with the child. RiteCare Clinics can help connect you with a skilled SLP to get your child the treatment he or she needs. With locations in both North and South California, we can provide a variety of care to patients with speech, learning, and language disorders. These SLPs will provide your child with practice speaking in social situations and reinforce successful speaking experiences. These services are offered free of charge. A combination of these two treatment programs can give your child the ability to increase their verbal responses. Conclusion: As a concerned caregiver, you want to provide your child who has selective mutism with the best quality of life. There are several strategies you can try at home to encourage your child to speak more and give them the love and praise they need. You can also advocate for your child in the classroom to reinforce positive speaking behaviors. These strategies, paired with behavioral and/or speech-language therapy, will help your child overcome their fear of speaking. Breaking the silence of selective mutism is a journey you and your child will take together. Practice, perseverance, and patience are the keys to success.

As a parent of a child with apraxia of speech, you are concerned about how this language disorder will affect your child’s schooling. Verbal communication is found in every aspect of the classroom from answering the teacher’s questions to presenting projects. There are even exams that require students to verbally recite key concepts. To make sure your child gets the best education, you’ll need to advocate for your child with apraxia of speech from the very beginning of their educational journey. These tips will help you to navigate the education system as your child’s chief advocate. What is Apraxia of Speech? Apraxia of Speech (AOS) is a neurological disorder that interrupts the brain’s language-producing pathways. According to the American Speech-Language-Hearing Association (ASHA), it occurs in about 1 - 2 children per 1,000. There is a higher incidence in males versus females. Students who suffer from this impairment generally have a higher risk of other language, reading, and spelling disorders. Children with this language disorder will have the following symptoms: Makes inconsistent errors in speech Trouble with articulation Searching for the right sounds (a.k.a. babbling) Use incorrect tone, rhythm, or stresses These children generally understand language well, but they are unable to communicate effectively. There are two types: Acquired Apraxia of speech (which is usually the result of brain injury to certain parts of the brain) and Childhood Apraxia of Speech (which is also known as developmental apraxia of speech). Many with developmental apraxia have no brain damage or evidence of brain abnormalities. This language impairment can be difficult to diagnose. It often has similar symptoms to other language disorders, so it needs to be diagnosed by a speech-language pathologist (SLP). This is a motor-speech disorder, so it not only affects a child’s speech but also their fine motor skills. The National Institute on Deafness and Other Communication Disorders (NIDCD) explains that eye movement, coordinating multiple movements, responding to commands, making mouth movements (dysarthria), and making precise leg and arm movements may be difficult for apraxia kids. This disorder is treatable and your child can make a lot of progress in their speech development, but they will never outgrow it. How Does Apraxia of Speech Affect Schooling? As you can imagine, being able to think of the answer to a question or the right word, but not being able to say it can be very frustrating for your child. They not only can’t think of words, though, but they also have difficulty with vowel sounds, leave out consonant sounds at the beginning or end of words, struggle with longer and more complex words, and can even substitute incorrect words (aphasia). Children with apraxia of speech often have trouble in spelling, reading, writing, and even math. These children may have difficulties understanding instructions and being able to communicate a lack of understanding. They can also develop anxiety. This stems from their inability to speak clearly in social settings. Some children may avoid situations in which speaking is key. They may also suffer from bullying by other students. Tips for Navigating the Education System There are several ways you can advocate for your child in the education system. There are many ways to ensure your child is successful in school. Even before school begins, you can prepare for ways to make sure your child’s needs are met. #1 Get an IEP or 504 Plan The Individuals with Disabilities Education Act (IDEA) is a law guaranteeing free, public education for children with disabilities. As a part of this law, there are two types of plans available for children with disabilities. These plans are agreed on by the family members, teachers, and the child as a way to accommodate the disability. An Individualized Education Plan (IEP) is a plan created to support the student with accommodations and special education instruction to help them thrive in school. First, students are evaluated for their strengths and weaknesses. Then, the IEP is developed based on that information providing goals and the means to reach those goals. An IEP also protects children with disabilities from discrimination in the classroom. A 504 Plan is slightly different from an IEP. It is still a plan that provides teachers, parents, and children with goals and accommodations, but it is more about removing barriers in the classroom that keeps the student from learning with his or her peers. IEPs are more specific, regulated more closely, and provide special education services. In contrast, 504 plans are more generic, less regulated, and work to make the classroom more accessible for children with disabilities. Both services are free, so the choice depends on your child’s individual needs. Having these plans in place lets teachers know what your child needs to be successful. It also gives them scaffolding to help them achieve more. #2 Ask for Preferential Seating Even if you decide against an IEP or 504, you can ask for preferential seating in the classroom. But, note that IEPs and 504s ensure, legally, that your child gets this preferential seating. Preferential seating refers to placing the child in the best spot within the classroom for their success. Sometimes that means placing them close to the teacher. This can be beneficial for apraxia kids because the teacher can quietly lean in and give the student extra help without drawing attention or repeating instructions. This can also make it easier for a child to hear the instructions or see visual cues. #3 See if Your Child Needs Augmentative and Alternative Communication For children with apraxia of speech, communicating with others is hard. Severe cases may require assistive devices. But, all children with apraxia of speech can benefit from augmentative and alternative communication (AAC). AAC just refers to all communicating without using words. This is helpful for people who have language development issues. AACs can be used temporarily or throughout a child’s lifetime, based on the individual’s needs. Speech tablets are one example of these devices. Ipads or other tablets loaded with special speech apps. These help the child to communicate with others. They are easy to use and are often more cost-effective than other assistive technologies. Another option is to get a speech-generating device. These are computers that are catered specifically to a child’s speech sound disorders. These devices can even be used to help children learn speech sounds. These devices are more expensive and need to be developed specifically for the child. You can also go much more essential for your child if they are old enough to read and write. They can use pen and paper, spell a word by pointing to letters, or using a whiteboard to communicate with others. Drawing pictures, using facial expressions and gestures, and pointing to photographs can be good methods for pre-literate children. Children with apraxia of speech can also benefit from American Sign Language (ASL). Sign language can give children who have difficulties with speech production a way to communicate with those around them. This method is not recommended for children who may also have muscle weakness or issues with motor movements. #4 Have a Plan for Missed Class Time Since your child may need to miss class to go to special speech therapy sessions or attend doctor’s visits, you’ll need to make a plan for how your child will make up missed work. You can include this in your IEP or 504 plan. You can also speak to the teacher directly. There are ways to set up a system for getting missed work. There could be a special folder the student keeps with missing work. That way, he or she can quietly access the work when they come back to school. There are also many digital options available nowadays. You will need to work out this system with the teacher. In addition, due to lost class time, you may need to invest in a tutor. You will want to make sure to hire a tutor who is familiar with your child’s special needs and can work along with your child’s speech problems. #5 Alternative Assignments for Speaking Projects In the case of individual assignments, IEPs, and 504s help your child get the right alternatives while still performing a speaking assignment that is appropriate for their skill level. However, even if you do not have one of these plans, you can communicate with the teacher to ask them for an alternative for your child that allows them to communicate in a way that is more accessible to them. Alternative assignments don’t have to be obvious or disruptive. It could be as simple as asking if your child can present their verbal report individually to the teacher rather than in front of the class. #6 Enroll Your Child in Speech Therapy Sometimes it’s hard to know if your child needs speech therapy. Parents and children often find a way of communicating with each other even if there are speech distortions. You and your child probably have an expressive language all your own. That’s why it’s important to get your child evaluated by a Speech-Language Pathologist (SLP) if you even slightly suspect there may be speech deficits. Your child may need speech therapy if they have issues with language skills such as, processing or understanding sounds Blending sounds in the correct sequence Expressing themselves in the correct grammatical structure and order Using language in a meaningful way A speech therapist can help your child to develop clearer speech. They will work on getting your child to move their muscles correctly to produce sounds. They will also emphasize practice and slowing down speech to help make communication more clear. In severe cases, they may also help guide children to use Augmentative and Alternative Communication (AAC). Where Can You Find a Speech Therapist? For free-of-charge speech, language, and literacy across the state of California, check out California Scottish Rite Foundation. We partner with universities, private practices, and donors who support Ritecare Childhood Language Centers of California. Our organization has served over 2,300 students each year who struggle with language, speech, and learning disorders. The Ritecare Childhood Language Centers of California provide evaluation and treatment to children. There are 4 locations in Southern California and 2 in Northern California. We are also partnered with the following universities: California State University Long Beach California State University Los Angeles Chapman University in Orange County University of the Pacific in Stockton This partnership helps to expand our services offering a wider breadth. It also allows aspiring graduate students to get hands-on experience in this field. Our foundation also partners with several private practices to fully round out the services we can provide to children with language, speech, and learning disorders. These individual practices also provide aspiring speech therapists to participate in internships that grow the future of speech pathology experts. We currently partner with Sunrise A Speech Pathology Corp in Fresno, Speech-Language Learning Associates, Inc. in Sacramento, and Speech Goals in Burlingame, Oakland, and San Francisco. Here at Scottish Rite, our goal is to “help children communicate.” We are dedicated to making access to these services available to children no matter the race, creed, or family’s ability to pay. If you are looking to get your child evaluated for speech therapy, you can communicate with any of our locations for more information. Final Thoughts A child with apraxia of speech can benefit from a parent who knows how to advocate for them in the education system. There are several steps you can take to ensure your child has the best quality of education. Get your child an IEP or 504 plan to protect them legally and to set up a plan for them to be successful in the classroom. Talk to your child’s teacher about ways you can adapt their classroom interactions with preferential seating, alternative assignments, and a missing work plan. Your child may also need Augmentative and Alternative Communication (AAC) to help them communicate with those around them. They also may need speech therapy. With these tools in your toolbelt, your child is sure to succeed in school.

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