I’m here to give you some tips and try to be patient with me because I’m super, super pregnant, as you can see and my brain is a bit everywhere.

What’s the first red flag? When a flag does not respond to his name that is a big red flag for us. As long as you’ve checked his hearing and we know that he can hear you, when a child doesn’t respond to his name, it is one of the big telltale signs of autism.

What is another red flag? Some kids start walking on their tippy toes and that’s normal development for children when they start working. They should start walking on their tippy toes after they have been walking for a while. If you’re child is already four, three and a half, four and still walking on their tippy toes that is a red flag.

What else is a red flag for us? Repetitive movements. What do we mean by that? Doing the same thing over and over and over again, like if they rock constantly, arm flapping, if they flap their arms that is also a very big flag for us. Some kids do get excited and you do want to like show your excitement but arm flapping is usually a telltale sign for autism.

One of the largest, largest red flags for kids who have autism is that they don’t communicate. If they have a speech and language delay they are not verbal, they are not vocal that’s also a big part of autism.

When a child has reduced eye contact so reduced eye contact is also major in communication. You want to be able to engage to the child, you want the child to be able to look at you, to have joined attention. What does that mean? That if we’re both doing, and he’s looking at what we are doing, he is paying attention at the activity. Kids that have no attention to a project, nothing really– they lack interest that is usually something that we need to look into.

Besides the fact, that kids have autism don’t speak, at least, at first, it’s read flag of course. With therapy they’ll gain the ability to speak and they’ll be on the right track. Besides the  fact that they don’t speak in the beginning, they actually don’t point and they also have no gestures and they have no desires to communicate, which is a big difference a child who is just between speech and language delay, they are trying and trying, they are trying to communicate and they can’t versus a child that might be autistic that doesn’t point, doesn’t have gestures, doesn’t have the desires to communicate.

Another red flag for kids with autism is echolalia, which is repeating. Instead of them, you tell them, “I want cookie.” They will repeat, “I want cookie. I want cookie.” But it’s not functional and it’s become echolalic. Echolalic it is a red flag for kids who are autistic.

These are just some few little things. Some kids flip the lights on and off or they have repetitive behaviors, such as lining up their toys, they don’t like being touched, they don’t like to be dirty, they don’t smile back, like if a child with autism, where you think he may have autism doesn’t respond back when you smile, when you laugh, like it lacks that gaze of imitating your movement, that’s also a red flag.

There’s a bunch of little things that could be but in order to be diagnosed with autism, you don’t have to this one of these characteristics that we’ve discussed have a whole bunch, it’s a whole checklist, it’s a whole process. What would you do if you think that your child might be at risk you need to talk to your pediatrician abut it. Then you need to make a neurologist appointment and then the neurologist would further discuss with you if there were a test need to be done. Sometimes they do EEGS, sometimes they do different blood tests and they will guide you in the right direction.

Once you go to the neurologist. You will know they will send you the recommended therapy, which is usually speech therapy, feeding therapy if your child is not eating or doesn’t like certain textures, they might be referre you to OT and then series of other kinds of therapies. If he doesn’t behave, if he doesn’t follow directions, he might need behavior therapy.

It all kinds of depends after you go to the neurologist. The best thing that you could is to keep an open mind that everybody involved wants the best thing for your child. We all want your child to get better. We are not here to discriminate against your child. A lot of parents freak out because they don’t want to talk about it and They are in denial about it, but the best thing you can do for your child is to get help as soon as possible.

With that said, if you need anything you can contact us at Miami Speech institute. Thanks!

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Let’s first discuss the difference between speech and language and the relation with articulation disorders.
Speech is everything has to do with articulation, pronunciation, your diction, the motor component of your mouth, your articulators, your lip, your tongue, your teeth, all these things have to do with speech. It’s not the same thing as language.
Language is divided into two components:
1. Expressive language, which is verbal production. What you put out, what you say and what comes out of your mouth.
2. Receptive, which means what you understand, what means to you, what, you translate and what you comprehend.
Those are two different components of language versus speech. Speech is diction, pronunciation; language is receptive and expressive language.
When it comes to a lot of parents they always want to do speech eval and they really mean a language eval but in terms we are considered speech and language pathologists but a lot of people just treat it as the same thing but it’s actually not.

We are going to talk about articulation disorders, what are they?

An articulation disorder is when your child cannot pronunciate certain sounds. They can’t say the “R” They can’t say the “S” They can’t say the “L.” They can’t make clusters of a word, like syllables so those kinds of things are considered articulation disorders. There are some arituclation kinds of milestones that your child goes through from the time that they start speaking to about 4 or 5.
For example, the word “dog.” A lot of kids instead of using the “D” in the front of dog, they might say, “gog” because it’s easier to say the “G” sound in both places in the front and in the back than to actually make a new sound such as “dog.” This is a developmental process that every child goes through and they out grow and they out grow to the next process and the next process and the next process so these kind of things, which are phonetic milestones, these things are normal.
If you notice your child doing these things at 2 ½ it’s normal. Now if your child is doing this and they’re 5 then that’s a red flag. When you’re child is starting off these kinds of processes are considered to be within normal limits.
Articulation disorder is more precise for a child who cannot say one certain sound. They cannot say the “R” and they glide it. For example, instead of saying “rabbit” and they say “wabbit” and it’s constant. It’s every “R” at every time, in every place so it’s “wabbit” and instead of being car it’s “corw” it’s “w” at the end and if the “R” is in the middle of the world, it’s a “W” in the middle of the word. They replace the “R” for the “W” all the time, no questions ask.
Articulation disorders is usually are “Rs” which we call it gliding in our lingo so are the “Ls.” If you can’t “Ls” either, it’s considered it to be a glide because you substitute the “W” for the “L.”
There’s also a very, very popular one, which is the lisp. What is a frontal lips? It’s when you cannot say the letter “S.”
There is a frontal “S” which is “S.” The air comes through the middle if you blow out, you feel it on the front. But there is also a lateral lisp where the “S,” where kids go… and the air escapes everywhere on the sides, laterally of your face. There’s frontal lisp and a lateral lisp. It’s still, you can’t do the letter “S” correctly, you can pronounce the letter “S” correctly so we consider this to be an articulation disorder.
What can you do?
You want to talk to your pediatrician about it, especially if your child is over the age of about 4 or 5. Most of these are sounds, should be done— all these processes should be done, should be corrected, should have been outgrown about the time they’re —it depends on certain sounds but I would say, most of them about the time that they’re 3 ½ .
By about 5 years old your child should be able to say the letter “R,” say the later “L,” say the letter “S” and pretty much articulate everything really precise.
The “TH” is one of those sounds extend a little bit later, let’s say 5 ½. Even some books even until six years old. The just sound to such as in treasure and things like that, that one takes also takes a little bit longer but all other sounds, by the time your child is about let’s say safely, we would want a nice rounded number, I would say about 4, 3 ½ or 4.
By four they should speak perfect. 80% of your language is acquired when you’re four years old. The only thing you acquire as you grow is 20% of vocabulary words, fancy words. At 80% you should know pretty much how to speak perfectly. If you’re child at 4 year sold speaks and you don’t think it’s a good enough amount and they’re not pronunciating things, then you should definitely call pediatrician because you will need an evaluation if your insurance covers it and you do want the presentation to say speech evaluation.

Evaluation in articulation disorders

child at party

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When babies start talking?

If your child is 12 months, 12 – 13 months they should be saying their first words already which should be Mama, Papa, Dada, something along those lines. After that, your child will start acquiring more words. So how can we stimulate this child in order to help them say the words a little bit quicker?

Four most effective speech therapy exercises to help babies start talking.

Here in therapy we do a few things. The first thing I recommend that you guys buy puzzles (Watch video for detailed information). These wooden puzzles are great because they talk and manipulate them easily. They are wood. They are easy to put. They are easy to take away. You can find several different puzzles; there are also these kinds of puzzles. I recommend personally anything that makes sounds. So environmental sounds such as a bus, a fire truck, or an animal puzzle to start. After that, you can pick other things, other objects that maybe don’t make noise but I would like the puzzles at first for your baby to be able to make noise.

They have puzzles that actually make the noise for you such as this one but this one is not working or you can imitate the noise such as a cat does meow, a horse neigh brrr, or you can buy one if you ought to saying the neigh, and that comes with the sounds. So let’s begin.

What do you do after you have the puzzle? Well you can buy it at Ross or on the internet wherever you’d like, they sell them everywhere. Melissa and Dog are usually my favourite ones. So what do you do? First, you’re going to pick the most basic animals. Don’t pick the fish. Fish is difficult. Pick the dog and the cat. So you’re going to start with three. So first I would pick the dog, the cat, and maybe the horse. So I’m going to take three and I’m going to flash it at my child, at my patient, and I’m just going to say the noise. I’m going to go woof-woof and I’m going to try for my patient to imitate the noise back.

I’m not going to tell him it’s the dog. I’m just going to label this as woof-woof. I’m going to do the same with the cat and with the horse. Now, I’ll go over this with my child a few times during the day and I only use these three to begin. I’m not going to incorporate the rest. I don’t want to confuse him. So I’m going to go over this.

Once my child starts imitating the noise back to me, it doesn’t have to be perfect. It can be an approximation. Once they start imitating it back to me, I will add another animal. So I can add the bird, the frog, etc. So we want the child to be able to imitate it back. Once they have it perfect and then when we say perfect it’s not an approximation, it’s not kind of like a dog, it’s woof-woof, exactly how you taught it, then I would add the environmental noises.

The environmental noises include, let me show you, they include the choo-choo train, so choo-choo; a fire truck wowowoo, a bus, a car, a police car, a plane. So you’re going to incorporate environmental noises after the animal noises. First the animal, then the environmental noises. You could do either or but I like this order better.

Once they imitate it perfectly then you can start adding the word. You’re going to go back to the three animals you picked and you’re going to tell them woof-woof, dog. You’re going to add the label to the sound. You’re going to do the same with the cat, the same with the horse. So then like that, your child is going to now imitating the word. It might be an approximation at first but eventually here she will say it correctly.

I will try this. This would be my first exercise for a child. That’s not really speaking and they should add first words to the vocabulary. This is how we start. This is how we’d start here in therapy. So that’s one exercise.

Now, the second exercise that we do here in therapy are first word cards. These cards you can also get at Marshals at Ross on the internet, wherever you want. I want this first word cards because, I’m going to show you. For example, first they are big they are easy to manipulate. They are easy to grab. Second, you can touch them. They are furry. We like that, kids like that. So this is a cat and you could touch it, you could show it.

The first thing I would do is obviously do the sounds. If they imitate the sounds I do the word, and we’re going to flash these cards. Like I said, I don’t like to overwhelm my patients with a lot. I would not use all these cards. I would pick a few, maybe five cards and I would put the big things that I have at home. So for example, we can pick shoes, if you have a cat which I do, keys is something your child sees every day, they see it opening the door, closing the door, getting in the car.

Parents are impressed by the fact that their child knows what keys are. Well, yes, they’ve been watching you open doors for a really long time. So usually keys is a really good pick. Apple, and then you can pick another one. Baby so they can identify themselves. So I would pick five of these cards to start with and I would have the child point at what I want.

For example, this is the way that it should be done or the way that it’s done here in therapy. So I would ask my child which one are shoes, this one or this one? We don’t want to put a whole bunch of cards. We want it to be a field of two cards. We want our child to reach for shoes. If he doesn’t, if he doesn’t reach for the shoes, we want to flash the shoes in front. Cover the cat in the back and we want to show him the shoes. This is the correct way to kind of get the child to understand that these are shoes. You will do the same, apple and baby. So which one is the baby? You know, we want them to kind of reach for it and we want to facilitate it. We don’t need them exactly to come and grab it. You want to facilitate it. If they pick the wrong one, you flash the correct one in the front and do it again. Baby.

I will do a combination of this, a combination of the cards. This is for them to identify. This is for him or her to label. So identify, label. So this is receptive language and this is expressive language. We want to kind of stimulate the child in both expressive and auditory. This would be my second activity that I would do.

My third exercise that I like to do is my monkey. You can pick a toy, you can pick a baby, whatever doll you want. So you want to show your child three basic verbs. Verbs come in at two years old but we can still show him so he has the concept of what it is. They’re not going to say the verb but at least they understand what the verb mean.

I want to show him, drink. We don’t want to say drinking. Drinking is difficult, it’s progressive. It’s in the future, it’s what we’re doing now. We just want to say basic. Drink. So monkey drinks. We want to show the monkey drinks. We want to show the monkey sleeps because it’s something we do every day. So the monkey sleeps.

We also want to show the monkey eats. So let’s say the monkey eats bread. We want to show, hmmm, the monkey eats. I like to pick sleep, eat, and drink because these three verbs are we do all the time that kids will know. It’s not something out of the routine.

I would also show and incorporate the three verbs. I would incorporate the noises, the cards, and the three verbs.

The last exercise I would do with my patient would be a set of food. These foods are fun. They have soft foods and they have hard foods. It’s up to you in preference. You know, the smaller your child, softer. The older your child, harder, anyhow.

I have the soft pineapple. Pineapple would be really difficult. I will not pick three or five items to show the child pineapple. It would not be one of them. It’s a difficult word to say. It’s not something we eat every day. But we want to pick something basic so I would definitely pick bread because if you’re Spanish you eat break and bang, it’s easy to say. I don’t think this is bread. Actually, this is a potato, sorry. This is the bread.

We would pick something basic such as bread. I would also pick, you can buy any of these fruits and I have a shopping card. You can buy any of these fruits at any store. I think these were bought at Target. There’s chicken, there’s cheese, banana is a good one, and I’ll explain why. I would pick another one maybe something that your child eats, eggs. Is there anything else I would put? Look, and a cookie.

The idea is for you to pick again three to five items. Don’t overwhelm the child with so many options and so many things. We just want to show him the basic. So let’s see. So I would still do the same thing that I did before. I will show him, hmmm, banana. We put it here and cheese. Then, I would ask them to please pick the banana. You want them to reach for the banana. You would ask the same thing as you did with the cards, banana and cheese. You would ask them, which one is the banana. But this is different than the cards and I’ll explain why.

It seems to a lot of people that it’s the same exercise but it’s not. This is flat. This is a card. It’s flat, it’s two dimensional. This is something more concrete. I mean, it’s not real banana, a real cheese but it’s something more tangible that you can grab. So it’s not the same exercise even though that it kind of look like it is. So you want to do the same thing. You want to put it out and you want them to pick the banana versus the cheese or whatever it is that you asked for. Banana is a good fruit to pick because it starts with the letter B. B words are easy so when it comes to a baby or a child that’s between a 12 to 15 or 16 months, we want to pick words that are easy. So anything that starts with a B, an M, a P are easy words. So banana will be one. Pan, if you speak Spanish would be another one, that would be easy. Cookie is another one that would be easy because the K sound is also easy, cookie.

This would be by fourth exercise. I would go over with my child. We would identify all of them and then we will try imitating the word and then we would try labelling them. If you would do this kind of exercises, maybe once a day or so for a few weeks you would see the improvement and you would see that the child will start to get more stimulated and wanted to speak more and wanted to express himself or herself better.

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The first step is how to find a speech pathologist in Miami. My suggestion is once you go to the pediatrician and you are presented with a prescription or a referral, you should call your insurance company and see if they cover speech therapy. If you’re insurance covers speech therapy, you should ask, how many visits, what’s your deductible and then you should ask for a provider in their network.

Once you got all that information and you have a list of speech pathologists, then you can start calling around a few therapists in Miami and pick which center is the best for you in terms of location, quality, reviews, things that are important to you.

Once you’ve selected the center, how to select the best speech therapist that fits your needs. Not all speech therapists are made equal. I mean, we all do have master’s degrees but most of us do have the CCC certification, which means we have been clinically certified by the speech association called ASHA that governs over speech pathologists.

Best Speech Pathologists for Speech Therapy in Miami

Not all SOPs have their license or have their CCCs Certification. It is important that you find out, if you’re SOP that would be treating your child has the certification, which means they’re clinically competent.

Second you should always ask what’s their expertise. Is their expertise treating kid with autism? Is their expertise treating stuttering? are they a pediatric SOP? We are not all built the same and we all do have different skills and techniques, maybe they have different skills or if they have different jobs.

For example, I really love to treat kids with stuttering. It is my specialty. I have other SOPs that might specialize in autism, speech delay, apraxia and an array other sorts of disorders. You do want to ask the SOP that will be treating your child. What’s their skill, if they’re CCC, how long have they been working, etc.

Another question that you should ask, not all speech therapists have good chemistry with every single patient. You have to fill out your speech language pathologists and see if you think it would be a good fit. Some kids need a lot of structure. Some kids need to be kind the more creative.

You do want to pick what you feel is best for your child. You as a parent would now, what would benefit your child better.

Best Speech Therapy Centers in Miami

Once you have chosen your speech pathologists, the best steps that you can take at the at that point is to make an appointment, you always need an evaluation. Evaluations are only completed once every six months. If you go and get an evaluation at a center then you realize you didn’t like the center, you don’t need to complete another one when you go to the next center, you just take the evaluation with you. It last six months, and every six months it expires and you need to complete a new one.

Once you’ve done an evaluation with the speech pathologist that you have chosen, you do want to find the bet speech pathologist for your child, as well as the best speech center in Miami that you can find. You do want the evaluation to be explained to you. The evaluation is going to have recommendations that you say, how many times your child should be seen. The speech center that you are attending to should obey the rules or the amount of visits that you were awarded.

Once you start your child in therapy, you should be a good, easy going experience. The therapist should always come out and explain to you how your child did, they should tell you what they worked on and you should get a plan or a home program so you can help your child along once your home.

If you guys have any questions, or if you guys have any questions for me, you can call me. I’ll be glad to help.

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Stammering is when you have involuntary pauses. So to us in stuttering, we call those blocks. In stuttering, there’s many different ways that you could stutter. You could stutter by repeating initial syllable words, sentences, phrases. You can also stutter by elongating the words such as instead of cookie, making it coo-ookie.

You can also stutter her by having blocks, which means there’s no airflow and coming out. The airflow stops, which is the same thing as stammering. I guess we can say that stammering is one of the ways that you could stutter.

Another difference between stammering and stuttering and stammering is used in British dialect and stuttering is used here in North America. It’s kind of the same and kind of not, it depends who you’re speaking to.

What causes stuttering?

Stuttering has many different causes, it depends what kind of stuttering. There is neurogenic stuttering, which occurs to patients that have suffered a brain injury or suffer from a brain debilitating disease such as Parkinson’s, Alzheimer’s, Dementia. Neurogenic stuttering is usually for adult or I guess for a child who has suffered a brain trauma.

There’s also developmental stuttering, which occurs to children between the ages of two to five. It has to do with the myelination of the brain and using the right hemisphere versus the left hemisphere when using language. It also has to do with the way your language develops and a lot of environmental factors and genetic factors that go along with development as a child.

There’s also psychogenic stuttering, which occurs to patients who have suffered a psychological trauma and they’re psychologically have been predisposed to stuttering. That’s a different kind of stuttering as well.

Is stuttering hereditary?

It has been proven that stuttering is genetically based. There are certain chromosomes that have been pinpointed to produce stuttering. it does have to do a lot with the genes, but it also has to do a lot with your temperament, what kind of person you are, you’re sensitive. It has to do a lot with your environment, how you grew up, where you grew up and what kind of environmental factors. It’s a mix between your genes, your environment, and your temperament. Not just hereditary but doesn’t mean that it’s not hereditary.

If your child has early signs of stuttering, you should definitely keep an eye on. The signs that you should look for are, for example, repetitions; children’s start stuttering by repeating syllables.

If your child all of a sudden starts repeating, you know, “I, I, I,” more than two units at a time, so it’s not just “I,I” it has to be “I,I,I.” Three plus that is a red flag for stuttering. If your child kind of has a block after it. It’s like I want, you know, a cookie that is something to look for. If your child is making the vowels are the words longer. So, “I want a cookie.”

These kinds of things are not things that we considered within normal limits for kids. If your child starts to do that, um, you should definitely keep an eye on it. If your child is between the ages of two to five, they might start and it might fade off. It’s spontaneously they will recover from it. But if you see that it’s been going on for a while and it’s kind of getting worse as it goes along, then it’s definitely something that you have to look into.

A lot of kids stutter on the word “I,” they stutter on pronouns, they stutter on articles. Most of the times they don’t start our own content words. They probably won’t start around verbs. They won’t stutter on adjectives, they’ll stutter in pronouns, like I said.

You have to kind of keep an eye out, write down a sheet of paper, what they stutter. When they stutter is also really important as your child’s stutter in the morning, does your child’s Stutter at night? Does your child’s stutter when they’re excited, when they’re telling a story? These are all things that we look for because most kids start stuttering when they’re excited and they’re in a rush to speak. They don’t stutter when they’re calm, when it’s a peaceful environment. These are kind of the things you should look for. This is what we look for when we evaluate a child who stutters.

How do you look for help from a speech therapist?

The first thing you should do is talk to your pediatrician about it and asks for a prescription for an evaluation. Once you come in for an evaluation, we do run a series of tests. Most of the times we do the SSI-4, which is an index for stuttering, where we take a sample of how long your child stutters for. How many seconds does he actually repeat the word? We take a sample and how many times they repeat the word, so on the frequency. We also take a sample on the any physical movements or any physical concomitants that go along with the stuttering such as blinking or head nodding or stomping or any of those things is also something to look for.

If your child’s stuttering and they do faces or they kind of make a gesture that’s something to keep an eye on. I’m stuttering is diagnosed after we give the test and we see that the frequency is too high or the duration is too long. What do we consider normal is 93% of your speech should be fluent and 7% of your speech can be deployed. If it’s over the 93% percent, you know, if it’s under the 93% then that’s an issue. If your child is stuttering on 10% of his conversation, then we consider that to be stuttering.

Developmental stuttering

Developmental stuttering, it occurs only in children from the ages of two to five. As quick as it comes in, as quick as it can go away. Depending on, you know, several environmental factors that, you know, go along with the stuttering. If your child is developing sort of a stutter, my suggestion is that you start speaking really, really slow, that you don’t give your child, tasks that are taxing on the brain. A lot of parents think it’s cute to tell their kids to see a really difficult word or really long sentence or something that’s really taxing on the brain and that actually creates a lot of stress for the child and it produces–sometimes it can create for the child to be diffluent, which in turn can produce more disfluency. We don’t encourage for parents to make their kids kind of show off in a way where they’re sounding really, really smart because it can actually be detrimental for their language development. So that’s something that I always tell parents not to do. I always suggest that parents don’t stress out the kid.

Don’t kind of wake them up in a rush. Don’t make them eat their breakfast, dinner rush, don’t rush them. Rushing a child can also produce disfluencies. You kind of want to be grounded and peaceful and go slow.

They are different types of stuttering. There’s repetitions, which is when you repeat either syllables, you repeat word are you repeat phrases and the repetitions are more than three units, which is more than three times. That’s one way of stuttering, which is the most common way, which is the first way people start to stutter.

Then there are prolongations, which is when you make the words really, really long. That’s usually the second step to stuttering and then there’s blocks, which is when there’s no air airflow and nothing comes out and you’re kind of stuffed which is like, you know, and they try to push through for the word, but it doesn’t come out, which that’s also what people call stammering. Those are the different types of stuttering. Like I said a little while ago.

Red Flags in stuttering

Kids acquire the most amount of language from the year of 2-5 years old. At that point, the brain is tacks learning s many different vocabulary words and doing so many different skills, learning so many new things.

Language is the big, big part of your brain being stress out from the years of 2 to 5. Sometimes developmental stuttering occurs from the ages of 2 to 5 and this is all characterized because your brain is doing so many different function that stuttering may occur.

What is developmental stuttering?

Occurs in children from 2 to 5 and most of these kids start to stutter by repeating words. They would either repeat a syllable such as “I,” or they can repeat a phrase, “I like cookies.” They could repeat a word, “I like, I like, I like cookies” or two words. Usually, kids who starts to stutter repeat units of two. Once they repeat the word twice, it’s considered a form of stuttering.

There’s an also different form of stuttering, there’s prolongations, which is elongating a word so you could say, “I— like cookies.” That’s a form of stuttering. The last form of stuttering is called “blocks” which is blocking the air from your vocal chords to be able to produce a sound such as, “I like cookies.” These are the three basic core behaviors under the umbrella of what we call “stuttering.” Can spontaneously recover by itself, it depends on many factors. Usually, the kids who got cured by themselves are usually females. It’s hereditary. The genes actually have their recovery factors. There’s many different ways and factors that could help you recover by itself. 75% of the kids who have developmental stuttering have spontaneous recovery. Most of the kids who stutter are boys. It is a predominantly male disorder. There are four boys to every one girl who stutters.

When you have a child that you think is stuttering, the best thing to do is to get the child to a speech therapist as soon as possible. A lot of the times, stuttering has to do with self-esteem so if the child is not aware of doing it, it can actually be beneficial to be able to make it better. Once the child starts to notice that there’s something wrong in his speech pattern and people are making fun of him, stuttering can become worst.

What can you do as a parent if you see that your child is stuttering?

First thing to do is take them to a speech pathologist and there’s different tips on what to do at home. The best tips I recommend if you think your child might be stuttering is to talk really, really slow at the house. Include a lot of pauses in every word that you say, use a pause. Do not interrupt your kids when they’re speaking. Do not speak for your kids, do not rush your kids and try really hard to not make your kids feel that they’re being pressured. They are being looked at and that they’re speeches are under some sort of malfunction.

What can you do at home to reduce stuttering?

You have to talk slow. I know it sounds kind of silly and it sounds like something super common, like it’s not a big deal but it’s a huge deal. Your speech, your rate of speech should be slow for a patient who starting to stutter. Also, you want to take away environmental factors that can create stress. If your child is not a morning person or it takes longer, you know, a plan for a longer time so your child can move slowly. You know, don’t try to rush. Also, if your child is a talkative child, don’t cut them off. Don’t ask too many questions. Be patient and don’t interrupt them and the most important things that you can do is give your child positive feedback.

Don’t make the child feel self-conscious that they’re stuttering. Don’t stress them out telling them to start over, do it again. You know, you don’t want to do that. You don’t want the kids to feel not good enough, especially in their language abilities because that will create more and more disfluencies in the future.

The exercises you could do at home, like I said, are all the same things. You know, talk slow. You want to talk to your child in a slow speech rate. What do we consider to be so about 110 words per minute is considered to be slow. From 120 to 160 is considered to be conversational speech and anything over 160 words per minute is way too fast. I know that’s probably pretty technical and nobody’s goanna sit with a stopwatch but just try to speak really, really slow. If you think you’re speaking so you’re speaking slow.

Kids are really, really good on noticing when something is wrong. They want to please their parents and most of the kids who stutter always feel the pressure to please them. The number one tip would be is to make sure that your kid feels comfortable and that you’re not giving your kids a hard task so they don’t feel that they have a lot of pressure.

If you’re looking for any other information about stuttering, you can contact us. My name is Patricia Ruiz. I’m a Speech-Language Pathologist from Miami Speech Institute. We do help a lot of kids with stuttering. I do know a lot of tips and a lot of different tricks and techniques that we can do to help out the kids.

4 exercises to improve stuttering.

When you speak, do you constantly and involuntarily repeat certain letters or sounds? If you do, you likely have a stutter.

The practical effect of a stutter is that it reduces one’s ability to communicate with clarity and without interruption. This may, in turn, lower confidence in one’s ability to speak, or create insecurities about speaking.

If I’ve described a situation you can relate to, this blog is for you.

There are 4 exercises you can perform to reduce your stuttering and improve your speech. They’re simple and can be completed by anyone with a stutter, anywhere.

The first and most important step is a method of breathing known as diaphragmatic breathing, or deep breathing.

Diaphragmatic or deep breathing, and shallow or chest breathing

Deep breathing is performed by contracting one’s diaphragm. The diaphragm is a horizontally – placed muscle located between the thoracic and abdominal cavities.

People normally utilize a method of breathing known as shallow breathing, or chest breathing. Chest breathing is performed by drawing breath into the lungs by contracting one’s intercostal muscles instead of the diaphragm.

If you stutter, chances are you breathe shallowly. You’ll want to breathe deeply instead. To do it, “breathe” from your stomach and “fill” it with oxygen. Then, exhale to make your stomach as flat as possible. This is diaphragmatic breathing. Its benefits are that:

• It calms your nervous system, thereby making you feel more relaxed.
• You can enunciate more words, since you have more oxygen with which to do so.
• You stutter less, because when you speak while diaphragmatically breathing, you do so while exhaling.

Shallow breathing, on the other hand, has opposite effects: it puts your nervous system on the fritz and can result in or be symptomatic of hyperventilation; you enunciate less words since you have less oxygen with which to do so; and it either does nothing for or worsens stuttering.

I previously brought up speaking while exhaling as you breathe diaphragmatically. I’d like to discuss that technique in greater detail, as it is the second exercise I recommend.

Speaking on the exhale (while diaphragmatically breathing)

To effectively speak while exhaling, you:

• Breathing while contracting one’s diaphragm (as opposed to one’s chest).
• Exhale carefully (not necessarily slowly).
• Speak while exhaling.

For example, if you want to say, “I like cookies,” you would breathe in and contract your diaphragm, exhale, then say, “I like cookies.”

Don’t stop speaking to exhale. Speak while exhaling. If done correctly, you’ll eventually stutter less because you’ll have air coursing through your vocal chords, which will make them vibrate. The vibrations will in turn diminish the involuntariness of your stutter.

Think about it: if, again, you said, “I like cookies,” and did so repeatedly by stopping your breathing to speak, you would likely begin stuttering. You may say, “Ah… I like cookies.” The “Ah…” signifies you having to take a break and ‘catch your breath’ because you are restricting the flow of oxygen into your lungs to speak. To avoid this, it bears repeating that you should speak while exhaling.

The next exercise incorporates diaphragmatic breathing and speaking while exhaling, at the same time. As such, it is more complicated than the first 2 exercises and does not work for everyone. For those it works for, however, it helps with conquering stuttering significantly. The exercise is called pacing.

Pacing while speaking

Pacing involves accompanying your speech with gestures.
• You can tap your foot or snap your fingers to give yourself a rhythm to speak with.
• As you speak, you break up the syllables of the words you use, almost as if you were counting them.
• For example: “Apple. Banana.” If you break up the syllables, you get, “Ap-ple.” Ba-na-na.”
• Pacing poses a challenge because it is thorough. To do it properly, you must pay attention to your rhythm and maintain it.

Some people dislike pacing because they dislike the way it makes them sound; it forces them to speak deliberately and slowly, and it gives an unnatural spin to speech. Nevertheless, you should at least give pacing a try to ascertain whether it is good for you.

Light context

The fourth and final exercise is called “light context.” This is a phrase used to describe syllables and words that ‘expend’ a lot of oxygen to enunciate. Such words typically start with the letters ‘P,’ ‘M’ and ‘T’, like “patty,” “Mom” and “tomato.”

These are words which you must stop breathing to pronounce; where you have to purse your lips, tighten your tongue and speak them. This means that people who stutter will find such words difficult to pronounce because they must stop breathing to say them.

To perform the exercise of light context:

• Consider a word which emphasizes the “Puh” sound, like “Patty.”
• Remove the emphasis in your own pronunciation of such words. Lighten your lips; don’t smack them excessively, as that will agitate your stutter.

When to perform these exercises

All 4 of these exercises have 1 thing in common: they can be performed first thing in the morning, and last thing in the night – time. Personally, I recommend my patients perform these exercises for 2 – 3 minutes in the morning, before getting out of bed. I advise them to fill their diaphragms (not their chests) with oxygen and making it flat before exhaling. For a visual, I also advise my patient to lay flat on an even surface, place a book on their stomachs and try to breathe diaphragmatically. These directions can be repeated at night, just before going to sleep.

These are the 4 exercises I would suggest for those seeking to decrease their stutter. If those with stutters dedicate themselves to performing them as I have directed, I am confident that, with time, their fluency will improve, and they will feel better about speaking.

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Patricia Ruiz, Executive Director at Miami Speech Institute, invited to America TV in Miami to address bilingualism.

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What is normal?  It is normal for kids to acquire language from the years of two to four years old.  A bilingual child may acquire language at a slower rate than a monolingual child, however, the rate of language acquirement is not an indicator of speech delay.  Monolingual children may acquire words faster due to the fact that there is only one language.  However, bilingual children have a faster way of transferring language from one situation to another and they also know double the vocabulary words.  They know the words in both languages and they can distinguish which language to speak to which parent.

Recommendations for bilingual children

• Continue to speak both languages in the home. There is not good evidence that shows that you should only speak one language, in fact, research suggests that this should not be the case.
• Each parent should always speak in the same language to the child. For example, if the mom speaks Spanish and the father speaks English, then the mom should always speak Spanish to the child and the father always speak English. Switching between languages from parent to parent is not recommended.
• Code switching is normal and is not considered speech delay. This is like using “Spanglish”–filling in a word in a different language than the language one is speaking.  This may occur if the child can’t remember the word in the language they are speaking or they want to use the word in another language because it expresses what they are trying to say in a better format.  Code switching is not considered to be a speech delay and is a naturally occurring phenomenon in bilingual children.  Adults also commonly code switch and it’s an accepted way of speaking.

Is it normal for bilingual children to experience speech delays?

Bilingual children can experience speech delays just like any other child.  But just because your child is bilingual does not mean they will have speech delays.  There is a distinction being having a speech delay and being bilingual. However, do not ignore a speech delay attributing this to the child being bilingual.

Speech delay can be defined as the child not expressing himself or herself correctly with a certain number of counted words by a given age.  Being bilingual doesn’t mean that children speak less but they may acquire words at a slower rate.

What is normal for a bilingual child?

Bilingual children usually acquire the same amount of words except they acquire these in two formats in two different languages.  They are usually able to be more cognitively adept to switching between languages and it has been proven that most children that can switch from language to language have better cognitive abilities for certain skills in their adult lives.   Bilingual children know double the amount of words and double the grammar that they need to know to express themselves so being bilingual is definitely a plus and we discourage speaking only one language in the house.

What is not normal for bilingual children?

Bilingual children should not have a deficit in vocabulary words.  They should say the same amount of utterances at the same age as monolingual children.  For example, a two year old should be able to put two words together, whether they are bilingual or not, even if one word is in one language and the other word is in another language – this is considered within normal limits.

At Miami Speech Institute we would like to ask you to share our video. Join us, call us and subscribe.  Talk to your friends and family and doctors.  If you have any questions regarding bilingualism or speech delays we would be glad to help you.  Thank you for watching.

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Baby speech developmental milestones. When to worry?

So, what should you look for? A twelve-month-old baby should say at least one word, besides “Mama” and “Papa”, then the next word, such as animal names and things like that. What is an inappropriate sign, for example: Your baby should respond to his name when he is being called. He should be able to have eye-contact with a parent, for at least one minute. He should be able to engage in a play routine, with other children or with parents themselves. If you notice that your child has poor eye contact or poor eye gaze, he is not babbling as he should, he’s not saying “Mama” or “Papa” or “Tata” or any of those kind of words, that go with the vocal “a”. You should talk to your pediatrician about it because this could be a red flag.
So, once you’ve realized that your baby is twelve months, and he’s talking appropriately as he should, we should move on to one or two years old, which is when they start acquiring language, and then to two to three years old. Two to three-year old’s is the most important part of language communication. It’s when children acquire the most words – they can acquire from 50 to 500 words at the age of two. They learn how to add words, add nouns, add verbs, add proverbs. So, from two to three it is the most crucial time for children to develop language. If you notice, or you have concerns, you’re probably right. If you are concerned about your child’s speech, there probably is something wrong. So please don’t wait till they’re three or four, because somebody tells you that they started talking late. The most important part is from two to three.
Now, what are the red flags in speech delays from two to three, for children? If your child is not putting two words together, such as a verb and a noun, like “Mommy eats” “Mommy Sleep”, that is not appropriate. If they are putting two words together that are just nouns, it’s not appropriate. It has to be a verb and a noun, and then adding on from there. They should do two to three word utterances or phrases. They should have eye contact. They should be able to play with other kids. In such instances, such as autism, there are some very immediate red flags when it comes to language, for kids hat are about two years old.

Autistic children, for the most part, don’t have any eye contact. They do not respond to their name. They are compulsive about doing certain things. They have echolalia, which most parents think is okay, because you’re repeating words, but they are not being used functionally. Words need to be used functionally. They need to call their Mom “Mom”. They need to use words in a communication. No gestures, and no physical pointing. We want kids to use the words appropriately. So, autistic kids most of the time, repeat words, which is called echolalia. They will have physical directions, so they will take their parents to point to the things they want. They’ll use gestures. They won’t respond to their name. They’ll flip the light switches on and off. They might start walking on their tippy-toes. There are very interesting characteristics for kids with autism. So, if you see any of it, it doesn’t mean that he has, or she has, autism. It just means that it might be a red flag.

These are important things related to speech delays, that you should definitely talk to your pediatrician about, and get a referral for a speech and language evaluation, because we know that autism is, the majority is, a social pragmatic disorder. It’s a communication barrier. So, the most important person in that equation for autism, is a speech language pathologist. So, besides autism, that is a very common disorder now a days, it’s getting more prevalent, especially in boys.

Language disorders

There are other disorders, such as a language disorder. So, let me first explain, what is a language disorder? So, communication is separated into three areas. There’s speech. There’s language. There’s pragmatics.
Speech is your articulation. Are you intelligible? Your pronunciation. Are your sounds perfect when you say the “s” sound, the “r” sound. That, we talk about as being speech impediments. Speech impediments are pronunciation mistakes, so if you have a lisp, if you can’t say the letter “r”. Or you talk too fast. You talk too slow. You don’t pause in the right places. Those kinds of disorders are considered to be speech related. Now, language disorders, there are two kinds of language disorders. There’s receptive language disorders, which are; do you comprehend? Do you comprehend the language that is being spoken to you? Can you identify things? Are you receptively understanding and listening to what is being said to you? So, that is considered a receptive language delay, and then there is the expressive language delay, which is what you say. Not exactly if you are pronouncing those sounds correctly, but are you grammatically correct? Are your sentences correct? Is your verbal production, that you’re putting out, correct? So, there are many different aspects of different speech, language, receptive, expressive, disorders, delays, and then of course there’s pragmatic delays. Your social skills. Do you greet people when you walk through the door? Do you say “hi”? Are you socially acceptable? Do you give people personal space? Do you wait for people to answer questions? All these things are social language, which us as humans, separates us from animals, that we’re socially able to have a social language without words. So, speech language pathologists also take care of pragmatic skills. Are you socially, appropriate when you meet other people? Do you have good eye contact? Do you not look down? All these things are the things you have to take notice of when you have kids, and see if there’s a red flag.

When and how to look for a Referral to Speech Therapy

Once you’ve identified, or you’ve thought to yourself, okay, maybe there’s a red flag, maybe my son or daughter is not exactly on point, what should you do? My recommendation is that, you call your pediatrician, and you request a speech language pathology referral. So, most of us work with insurances. You need to make sure that your pediatrician gives you a referral, so you’re able to contact a speech language pathologist, so that they can evaluate your child. Most pediatricians would tell you that, they’ll ask you why, and you’ll just state your concerns and that should be enough. Your concerns should be enough for a referral. Once you have a referral in your hand, you should contact your insurance company, and make sure that your policy does cover speech therapy, and where, and have them provide you a provider that’s in their network, so it could be easier for you to contact somebody. Then once you contact the correct provider from your plan, a speech pathologist should be able to evaluate your son. They’re going to give them a formal assessment depending on what the prescription says, so it is important that you explain to the pediatrician, what your concern is. Is it a pronunciation concern, is it that he doesn’t listen, or is it that he doesn’t speak in many words? Like, you need to be specific, because we will conduct assessments based on what your prescription says, and then once you get to the therapist you should be in good hands.
So, I want to thank you guys for tuning in and I also want to ask you to share my video online if you liked it. If it was helpful. If you could please subscribe to my channel. I would like to keep coming on and sharing different tips and advices and things to do. So, if you also want to reach me, my email is miamispeechinstitute@gmail.com or simply call me.

Patricia Ruiz, Executive Director at Miami Speech Institute, identifies the Red flags in Speech and Language for a Child. Speech delays, Autism and most common speech and language disorders are addressed.

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