3 Signs Your Child Has An Articulation Disorder | Pediatric Therapy Tv

In today’s Webisode, a pediatric speech therapist discusses common red flags to look for in your child’s speech development.

Click here to read a blog that suggests articulation activities to practice at home

In this video you will learn:

  • When your child’s frustration with articulation means something more
  • How speech therapists check articulation based on age

Physical Activities to Get your Child Moving | Pediatric Therapy Tv

In today’s Webisode, a pediatric physical therapist will explain creative ways to help your child get up and get active!

In this video you will learn:

  • What indoor games are best for encouraging physical activity with your child
  • What outdoor activities increase muscular activity
  • What gaming system is best for enhancing your child’s activity

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV, where we provide experience and
innovation to maximize your child’s potential. Now you’re host, here’s

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host Robyn
Ackerman, and today I’m standing here with Leida Van Oss, a
pediatric physical therapist. Leida, can you tell us some
physical activities that we can use to get our children

Leida: Sure. When you want to get your kid moving and active, it’s
really important that it’s something that’s fun to them. So
if they’re really interested in doing board games, there
are a couple different board games you can do, such as
Hullabaloo or I Can Do That by Cat in the Hat or Twister.
If they like to go outdoors, then do something like a
sport, like swimming or soccer, or if there’s snow on the
ground, you can build forts or go sledding. But it’s really
important to pick something that they’re going to be
interested in so that they get really active.

If they really like video games, there are a lot of good active video
games you can do, especially with the new system, the
Kinect. Things like Just Dance or Dance, Dance Revolution
are all really good games that incorporate the video game
aspect with being really active.

Robyn: All right. Well, thank you so much for those tips, and thank
you to our viewers, and remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of
mind to your family with the best in educational
programming. To subscribe to our broadcast, read our blogs,
or learn more, visit our website at That’s

Up Up and Move Away with Kids!

Moving is already a stressful process without adding children into the moving day

Here is a list of life-saving tips that may help to ease both you and your children throughout the transition!

  • Before the move, start preparing the children by showing them books about moving to a new home. Show them pictures of the new city, the schools, the playground, the pool, etc. You should also discuss any feelings that the children may have regarding the move.
  • The day before the move, make sure the children have enough sleep.  Tired children will make the moving experience much more difficult for the entire family.
  • During the day of the move, have a backpack ready for each child that includes music, books, activities and additional batteries to keep them busy throughout the day.  Remember to pack snacks as well as the day will become quite busy. Hungry kids =cranky kids
  • Take a log of pictures of the entire experience, from packing and moving days to the first few weeks og living in the new house.  Make the experience very exciting!
  • Once you arrive at your new home, remember the needs of your children. You are bound to encounter issues that will most likely exhaust you. Consider hiring a babysitter for the first few days of the transition. An extra adult to have around will be able to give your children the attention they need while you are packing and unpacking.
  • Plan to take a day off from everything once you are finished with the move. This will allow the family to reconnect and recharge.

If your child is in therapy, ask your therapists for home program information so that you may continue the therapy on a daily basis.

Enjoy your new home!


What is Articulation Therapy

A child may have an articulation disorder if they are deleting sounds (e.g., saying “do” for “dog”), substituting sounds (e.g., “dat” for “cat”), adding girl in speech therapysounds (e.g., “balue” for “blue”) or distorting sounds (e.g., “thpoon” for “spoon”). In general, there is a range of typical speech-sound development. Most children are 90% intelligible to a wider range of communication partners by the age of four. If you are concerned about your child’s speech intelligibility or articulation, it is best to seek the advice of a licensed speech-language pathologist who will conduct a formal assessment. This formal assessment will involve looking at both speech and sound production and sound error patterns or distortions.

What Qualifies As An Articulation Disorder?

There are many factors that may contribute a child’s diagnosis of having an articulation disorder such as a medical diagnosis or illness (i.e., including neurological disorders, genetic syndromes and developmental disorders), the development and structure of the oral mechanism, exposure to adult language models and/or hearing loss. Some common articulation errors include substituting /w/ for /l/ or /r/, distortion of /s/ as /th/ with the tongue
protruding on the sides or out the front of the mouth and de-voicing, using a /k/ for /g/.  Once your child has been formally diagnosed with an articulation disorder, you may be wondering as to what articulation therapy will consist of?

What Is Articulation Therapy?

Initially, a speech-language pathologist will determine which sounds will be most beneficial to target in terms of generalizing to other sounds and overall speech intelligibility. The process of therapy will begin by teaching the sound or sounds in isolation. This isolation process will be able to teach the accurate production in terms of placement in the mouth and movement of the articulators. Once production of the sound is mastered, the speech pathologist will follow a hierarchy of more complex language targets to generalize the sound to words, phrases, sentences, and, eventually, conversational speech.  A hierarchy of speech levels includes mastering the production of the sound in that context at 80% accuracy or higher across a number of sessions.

A traditional speech therapy hierarchy may resemble the following:

  • Sounds in isolation
  • Sounds in words (i.e., all word positions: initial, medial and final)
  • Sounds in phrases
  • Sounds in sentences
  • Sounds in reading/writing
  • Sounds in spontaneous conversational speech

Articulation therapy involves significant repetition and targeting of the sounds in error. Although drills are often targeted, a speech pathologist will use a variety of methods to target sounds and keep your child motivated. Once the sound has been mastered at all levels of the hierarchy, it is likely to be remedied with minimal maintenance needed in order to support the best production.


Smartphone Technology and Language Development: Pros and Cons

iPads, iPhones and apps.  Today’s buzz is all about Smartphone technology and what “apps” will benefit development and academic skills in children.  Parents frequently request recommended apps to best address their child’s speech and language skills.  After all, we want to take advantage of the latest learning tools and most cutting edge technology to help our kids succeed.  However, use of Smartphone technology should be approached with caution.  Like all good things, moderation is key.

Here are a few important points to consider before integrating Smartphone children on phonestechnology into your child’s daily routine:

Pros: What are the positive benefits of Smartphone technology?

  • Smartphone apps provide excellent “drill” style activities to teach specific skill sets, such as vocabulary building, phonologic awareness, articulation skills, and learning new concepts.
  • Devices such as tablets, Smartphones and iPads expose children to modern day technology, improving their computer literacy and ability to navigate such tools.
  • Smartphone apps provide a fun and entertaining activity for children. This can be excellent choice for breaks from homework, rewards or car-rides.

Cons: What are the negative effects of Smartphone technology?

  • Smartphone apps promote passive learning and provide little opportunity for creativity, social interaction, problem-solving, sustained attention, ideation, and make-believe. All of these skills are foundational to development in children by promoting motor skills, language learning, problem-solving, and social skills.
  • While Smartphone apps may encourage children to talk or practice sounds, they do not encourage children talk to an actual person. Language is a reciprocal social system, intended for communication between people. It’s critical that children learn to communicate with others in a reciprocal context.
  • Smartphone apps do not promote the use of novel language.  A critical part of language development includes the ability to arrange words into combinations, building sentences to communicate their thoughts and ideas.
  • Smartphone applications offer little opportunity to learn social skills. Social skills include interpreting nonverbal cues, making eye-contact, initiating conversation, and responding to others.
  • When it comes to learning, practicing skills in context is critical. So even though Smartphones might teach children new skills, they do not offer opportunities for children to generalize these skills in a real-life context.

So what can parents do?

Here are a few practical steps as families navigate their child’s use of tablets, Smartphones and iPads:

  • Think moderation. Limit your child’s use of electronics, and set boundaries ahead of time so your child knows what to expect.
  • Encourage activities that encourage creativity, social interaction, problem solving, sustaining attention, ideation, and make-believe. A few good choices include blocks, dress-up, play-doh, books, pretend food, and baby dolls.
  • Spend face-to-face time with your child every day. Encourage your child to participate in play with you and encourage their use of their language, facial expressions, eye-contact, and engagement.

Love What You Read?  Click Here To Subscribe To Our Blogs Via Email!

The Benefits of Increasing Therapy Over the Summer

Summer is the time of the year when children engage in more free play and physical activity. Therefore, summer is the perfect time of the year to improve upon skills that children need in order to be active, successful, and independent children!Little girl jumping a rope

Here are some of the best reasons to consider starting therapy or increasing the number of therapy sessions for your child over the summer:

Maintain and improve skills for school – Since school is out for the summer, it is important that children do not lose the fine motor, problem-solving, planning, and organizational skills (and more) that are necessary to be productive students at school. Although summertime is a great time to provide opportunity for free play, it may create academic issues for your child once school starts back up if he or she does not engage in challenging tasks  during their 3 month break from school.

Practice physical activities, such as bike riding, climbing, and jumping rope – During the summer, children are often playing outside for hours on end. It may become noticeable that your child is not keeping up with their peers. Activities with which you may notice some difficulty are often when children have to coordinate their arms and legs, such as jumping jacks, climbing the jungle gym, and learning to ride a 2-wheeler. By participating in therapy over the summer, therapists can address these specific concerns in order to help your child stay up to speed with their friends while performing these activities.

More availability over the summer – Since your children are out of school for the summer, they may have a lot more time and availability during the day to participate in more therapy. Summer camp and extra-curricular activities often only take up part of the day, so there may be more times you are available to schedule therapy appointments. Furthermore, although camp and extra-curricular activities are great options for staying active, they do not necessarily offer the same therapeutic benefits as therapy.

Provides structure to their day– Oftentimes, summer can be a season of unstructured play time in which children can do anything they would like. Sometimes the choices are so overwhelming that this can often lead to hours of playing video games, watching TV, and other sedentary activities. Therapy can provide structure to your child’s day to make them feel like they are being productive by spending their time doing valuable tasks.

Opportunity for peer interaction outside of school – Once school is over for the summer, some children may only spend their time with the same friends every day. Therapy sessions can provide the opportunity to make more friends in the clinic and learn how to engage in social situations with other people.

These are just a few of the many benefits that therapy can provide to your child over the summer! By making your child more actively engaged in goal-directed activities, you are setting your child up to be productive students the following school year and active children during the summer!

Love What You Read?  Click Here To Subscribe To Our Blogs Via Email!

How Sign-Language Can Help Late Talkers

This hot topic issue has been in the press for some time now. What is the truth? Can the use of sign language really help your toddler start talking? The answer is… yes! Continue reading to discover the truth about late-talking toddlers and sign language.

How Sign-Language Can Help Late Talkers:

  • We learn to use language through three modes: gestures, oral language, and written language. Children develop these skills in that order. For instance, children will wave bye before they say “bye”, before they write it!child and sign language
  • An important developmental skill, symbolic function, is what helps children realize that one thing (gestural or verbal) represents another. For example, the word “pig” represents the pink animal on the farm. Just the same, putting your hands together to sign “more” represents the idea of receiving additional food, toys, turns, etc.
  • We establish symbolic function by using sign first, before verbal language. Why?
    • The physical ability to make a sign using large muscle groups is less complicated than the intricate coordination of our articulators (lips, tongue, teeth, etc) that we use to speak.
    • Sign also helps the child’s ability to learn imitation. Sign, a static, visual event is easier to process and store in long term memory than a fleeting auditory stimuli (e.g. spoken word).
  • Once the ability to imitate sign has been established, the child learns that he has control over his environment. He will continue to use sign (and eventually verbal language) to control his situation with more consistency.
  • *Research shows that children with expressive language delays learned more words across treatment conditions (and did so more quickly) when given sign and verbal models (at the same time) as opposed to verbal models alone.
  • It is important to note that signing requires joint-attention (the adult and child attend to an object at the same time) and eye contact from the child to be as successful as possible!

*Robertson, S. & Weiskerger, K. (2003). The effects of sign on the expressive vocabularies of two late talking toddlers, Poster presented at the Pennsylvania Speech-Language Hearing Association State Convention, Harrisburg, PA.

For more on baby sign language click here

Love What You Read?  Click Here To Subscribe To Our Blogs Via Email! 

Promoting Language in a Toddler with an Expressive Language Delay

My toddler was referred for speech/language therapy to address his expressive (what he says) language delay. What is the therapist going to do? How can I help? Below are common strategies used in therapy and at home to encourage “late-talkers” to start using verbal language.

Speech Strategies For Late Talkers:


The most important concept to remember when modeling language, is to model AT THE LEVEL EXPECTED of the child. We boy with megaphonedo not expect toddlers with an expressive language delay to speak in phrases or sentences. So, we must model the level of language we want them to use. Speak in one-word utterances. For example, rather than reading each word in a book, label items and actions one word at a time.


Pick a specified time each day to model language during play time with your child. Choose around ten words to focus on, so your child is exposed to a consistent vocabulary. These words should be paired with objects (e.g. ball, pig, nose), motions (e.g. up, hop), and requests (e.g. more).


Parents often encourage their toddlers to imitate their speech (e.g. say, “dada”). It may be just as important to imitate your child. Even if your child is babbling (e.g. “baba”, “badaba”) and not yet using true words, try imitating his babbles, inflection, and facial expressions. This will, in-turn, help him understand imitation, learn turn-taking, and promote joint-attention.


Teaching a child the power of communication often facilitates expressive language. In order to encourage children to use any form of communication, they need to have an experience that demonstrates this “power”. Therapists often begin by using sign language. For example, the parent blows bubbles. When the child wants more bubbles, he imitates (or independently uses) the sign for “more” and receives more bubbles. This teaches the child that using communication (sign or verbal) will accomplish a goal with much more ease than crying, pointing, or grunting! Hence, the power of communication!

Love What You Read?  Click Here To Subscribe To Our Blogs Via Email! 

How Long Will My Child Have To Be In Therapy

One of the most popular questions we hear as pediatric therapists is “how long will treatment take for my child”? Parents like to be able to visualize a plan of action and know that there is an end in sight. Parents want to make sure that their child is not only keeping up with same-aged peers, but fitting in with their peers, and succeeding across environments: at home, at school, and within the community.  As therapists, we completely understand this mindset and want to help parents to feel valued and heard.  And we want to work as a team to create appropriate goals and treatment ideas to help each child reach their greatest potential by working as a team.

How Pediatric Therapy Sessions Work:

  • Every child progresses differently, which is why each child has their own individualized set of goals and recommendations.  Similarly, one strategy may work quickly for one child and not at all for another. Therefore, treatment hourglassstrategies are unique to each child.
  • Consistency and follow through at home is extremely important, as a child is typically only in the clinic for 1-2 hours per week.  Whether it is 10 minutes or an hour, finding time to complete your child’s exercises each day makes a huge difference in their progress, skill sets, and success. For example: heavy work activities to help with self-regulation; theraputty to work on hand strength; practicing natural environment skills while at the playground; increasing turn-taking and initiation of conversation during mealtime.
  • Typically, therapists work with a client for at least 6 months, at which point a re-evaluation can occur to assess progress made since the initial evaluation and revise the goals and plans for the future. Therefore, a date for course completion can not be determined at the initial evaluation. The therapist will continue to assess progress throughout the child’s therapy sessions, and together with the parents will decide on a course completion date when appropriate. Overall, course completion is very case specific.
  • Treatment may be longer than anticipated to make sure that there is a smooth transition for the child, to make sure all goals have been met, to make sure the child will be successful moving forward (e.g. going into the next school year), and to make sure both the child and the family have the tools and resources to continue to make progress, rather than see regression.
  • Teamwork is huge. By collaborating with other professionals (e.g. teacher, coach, other therapists), the child will have several advocates working together towards one purpose- his success. Similarly, when everyone works together to meet the child’s wants and needs, there will be greater consistency and, therefore, greater success.

Love What You Read?  Click Here To Subscribe To Our Blogs Via Email!

Imagine Being a Parent of a Child with Apraxia of Speech (CAS)

Guest post By: Leslie Lindsay, R.N., B.S.N. and a mother

At two years old, Kate was a beautiful, energetic, and happy toddler. With the exception of one word-hi-Kate was as quiet as a mouse. We wondered if something was wrong. Even as a baby, Kate rarely babbled and cried; she was beautiful and unique with red hair and bright blue eyes. She was, in a word, apraxia“perfect.” So why were we worried? After all, she could understand everything we said, even the big words. And what was so wrong with having a quiet, happy toddler?

But there were times my heart would sink. Gaggles of women who had all been in the same childbirth class a year or so earlier met up for our summer book discussion. They were chattering about how their children were saying new words every day. One mother proudly shared, “Oh, Maddie said elephant yesterday at daycare. I hate that I missed it.” I pulled my lips into a tight line and let out a sigh. If only my baby could say, ‘mama’ I thought.

Fast-forward a year or so. We learn Kate has Childhood Apraxia of Speech (CAS). Characterized by a child’s inability to express themselves verbally, CAS is a complex neurologically-based motor speech disorder. It is serious and requires intense and frequent speech therapy by a licensed speech-language pathologist (SLP). Part of me was relieved: now we know what to call this “reason” for Kate’s lack of verbal communication. But another part of me was overwhelmed, nervous, and anxious: now what and why?

It was time for me to put on my proactive parenting cape (forget Supermom), this diagnosis called for a little more. I started gathering any and all information I could on the subject of CAS. I joined listservs and read old text books on the subject. I picked my SLP’s brain. I worked with my daughter at home, in the car, and everywhere in between. I enrolled her in the special education preschool. And she improved. Yet in the meantime, we dealt with so many quizzical looks, unwanted advice, and clueless peers.

Imagine going to the grocery store with your toddler. The clerk makes small talk with you and your child. Your child can’t answer when asked, “What’s your name, cutie?” Instead, she grunts and smiles. The clerk turns to you, perplexed as if to say, “doesn’t your kid know her name?”

Try taking your 4-year old to see Santa at the mall. He can’t tell the big man in red what he wants for Christmas, even though you know he’d love a new bike with training wheels. Instead, he makes a spinning gesture with his hands and goes vroom, vroom. Santa chuckles, “Oh, a toy car!” But you know that’s not it. So does your son.

What will you tell the kind, grandmotherly babysitter who tells you, “Oh, don’t worry. Some kids are just late-to-talk. She’ll catch up. Maybe you aren’t reading and singing to her enough? Do you go to mommy-and-me classes so she can interact with other kids?”

How will you know what your child wants when he just stands and points to the top of the shelf at the many items it could be? You ask, “Do you want the blocks? No. Do you want the farm book? Oh, I know…you want your car!” But, instead he breaks down in tears and walks away.

How does your heart break when you overhear her peers say, “Julia can’t talk. Let’s not ask her to play with us.”

What’s a parent to do?

  • Love and accept your child for who he is. Of course you didn’t ask for your child to have CAS. Neither did your child. Focus on finding the resources your child needs the most-a qualified SLP.
  • Talk to your child. Speak with her as though you expect an answer. Just because she can’t speak back in a way you understand, she understands you. Make your communication with her matter.
  • Provide opportunities for your child to absorb speech and language. Read to him, study the illustrations; illuminate the details. Point out everything you can about the environment. “Look at the birds. Do you see the blue birds? Beautiful blue birds. Can you say bird?”
  • Be patient with your child. Having a child with CAS takes time to remediate. It’s not over in a matter of a couple of speech therapy sessions. It can take years to get your child speaking at developmentally-appropriate levels. Talk with your SLP about ways to monitor progress. It’s all about baby steps.
  • Be patient with yourself. Take a deep breath or a give yourself a time-out when you find yourself losing patience. Allow yourself to do other things besides parent a child with CAS. It’s important for your mental health.
  • Allow your child to be a “regular” kid. This may mean “coaching” social play. You may have to introduce your child to a group of peers, “This is Max. He’s a fun kid, but he’s still working on his words. Can he play with you?”
  • Bite your tongue or educate-diplomatically, of course. When someone asks you about why your child isn’t talking like every other child, you can grin and bear it, or you can simply tell them, “Brooke has Childhood Apraxia of Speech. She sees an SLP each week. We’re working on it.” Most folks don’t need or want more details than that.

Soon, you’ll be hearing things like, “Mom, can I have twelve bucks?” like I did the other day when my daughter with apraxia came home from school one day and wanted to go to Disney on Ice. You’ll be hearing words and phrases like, “Whatever,” and “I didn’t do it.” But the most touching of all, is when you hear these precious words: “I love you, mom.” Imagine being a parent of a child with CAS.

About the Author:

Leslie LindsayLeslie Lindsay is a former staff R.N. in child and adolescent psychiatry at the Mayo Clinic. She is the author of “Speaking of Apraxia: A Parent’s Guide to Childhood Apraxia of Speech,” available from Woodbine House, Inc. in March 2012. This is the first-ever book written by parents for parents specifically on CAS. Leslie blogs daily on apraxia, parenting, child development and more at She lives in Chicagoland with her two daughters Kate and Kelly, her husband Jim, and a basset hound named Sally where she writes full-time. Feel free to contact her at

 Love What You Read?  Click Here To Subscribe To Our Blogs Via Email!