Our Speech Garden

Aphasia! Do you know what it is?

May 14, 2024 Melanie Shea, MS, CCC-SLP

Speech Language pathologists will often work with clients who have Aphasia. But what is Aphasia? Aphasia is a communication disorder that affects a person’s ability to produce and comprehend language. What distinguishes this from a standard language impairment is that it can be the result of brain damage, most often due to a stroke, head injury, or brain tumor. Aphasia can come on quickly (as in the case of a stroke) or it can be a slow onset (as in the case of a slowly growing tumor.) This will often predominately impact the left side of the brain, which is known as the language center.

Can children have Aphasia? Yes, they can, although it is more common in adults. Aphasia can be either acquired, meaning it develops after brain damage, or developmental, meaning it is present from birth or early childhood due to a brain abnormality.

As you would expect, an SLP would be tasked with helping the individual with aphasia communicate as effectively as possible. This may involve working on speaking, word finding, writing, reading, and/or understanding language. It may involve using a variety of techniques and tools, such as picture symbols, gestures, reference books, or electronic communication devices (i.e.Alternative Augmentative Communication Device or AAC). With the ultimate goal being communicating needs and wants.

There are several different types of aphasia, each with its own unique set of language difficulties. The type of aphasia someone has depends on the part of the brain that was damaged.

Broca’s aphasia- May have difficulty speaking, but their comprehension is relatively intact. This type of aphasia is caused by damage to the Broca’s area in the frontal lobe.

Wernicke’s aphasia- May have difficulty understanding language, but their ability to speak is largely intact. This type of aphasia is caused by damage to the Wernicke’s area in the temporal lobe.

Global aphasia– Which is a severe form of Aphasia that affects both production and comprehension.

Anomic aphasia– Which is characterized by difficulty finding the right words.

Recovery from aphasia can be a long and challenging process, but with the help of an SLP and other healthcare professionals, many people with aphasia can make significant progress and regain some or all of their language skills.

To see some examples of what the different types of aphasia can look like feel free to look through the videos below.

Broca’s Aphasia:
https://www.youtube.com/watch?v=IP8hkopObvs
https://www.youtube.com/watch?v=WE6woOFsxQA

Wernicke’s Aphasia:
https://www.youtube.com/watch?v=3oef68YabD0
https://www.youtube.com/watch?v=yIWDVb94yxQ

Global Aphasia:
https://www.youtube.com/watch?v=FUutVGeoG-k
https://www.youtube.com/watch?v=FiZudFy1ZVI

Anomic Aphasia
https://www.youtube.com/watch?v=5UH6xrzoSGg
https://www.youtube.com/watch?v=sUKmTo9U-gk

Neuro-Divergent Voices

May 8, 2024 Melanie Shea, MS, CCC-SLP

As a speech language pathologist, I often work with individuals who are neurodiverse. Neurodiversity refers to the natural variations in the way that the brain functions and processes information, which includes conditions such as autism, ADHD, dyslexia, anxiety and many others.

As a professional, I have learned the importance of listening to neurodivergent voices and valuing the unique perspectives and experiences of these individuals. Not only is this important for the well-being and empowerment of those individuals, but it also helps me as a practitioner to better serve and support my clients now and in the future. Its so important that we acknowledge we live in a unique time where we have a wave of neurodivergent voices who have first hand gone through a variety of therapies, schooling and social experiences. They can tell us, first hand, what worked, what didn’t and what hurt. What an incredible benefit to provide an entire community the opportunity to amplify their voices and utilize their experiences to help the children today.

Here are just a few reasons why it is important to listen to neurodivergent voices:

Neurodiversity is a natural part of human variation.

Just like there is diversity in ethnicity, gender, religion, race, etc., there is also diversity in the way that the brain functions. This diversity should be celebrated and respected, rather than discriminated against. By listening to neurodivergent voices, we can learn to appreciate and value the unique strengths and abilities that these individuals bring to the world.

Neurodivergent individuals have valuable insights and perspectives.

Many neurodivergent individuals have experienced firsthand the challenges and barriers that can come with living in a world that is not always accommodating to their needs. By listening to their voices, we can gain a deeper understanding of these challenges and work to create a more inclusive and supportive environment. Neurodivergent individuals may also have valuable insights and perspectives on how to better support and communicate with individuals with similar experiences.

Listening to neurodivergent voices can help to reduce stigma and discrimination.

Unfortunately, neurodivergent individuals often face stigma and discrimination due to misunderstandings and biases about their conditions. By actively seeking out and valuing the perspectives of neurodivergent individuals, we can help to reduce this stigma and create a more accepting and understanding society.

As a parent, it is important to remember that every child is unique and has their own strengths and challenges. By listening to and valuing the perspectives of your neurodivergent child, you can help to support their well-being and empowerment. This may involve advocating for their needs in school and other environments, seeking out resources and support, and creating a positive and inclusive home environment.

Here are a few ways that you can support your neurodivergent child and listen to their voices:

Create a safe and inclusive environment at home.

Your child should feel comfortable expressing themselves and sharing their thoughts and feelings with you. Encourage open communication and make sure that your child feels heard and respected.

Educate yourself about your child’s condition.

It is important to have a good understanding of your child’s condition and how it may impact their development and daily life. Seek out reputable resources and support from professionals, such as speech language pathologists and other specialists.

Advocate for your child’s needs in school and other environments.

Your child may need accommodations and support in order to succeed in school and other environments. It is important to communicate with your child’s teachers and other professionals to ensure that their needs are being met.

Encourage your child’s interests and strengths.

Every child has unique strengths and interests. Encourage your child to pursue their passions and support them in their endeavors. This can help to boost their confidence and sense of self-worth.

For our practice, we will always remember to listen to the voices who have had previous experiences, and try to build on that. We will always listen to our clients no matter their size and always remember every client is a unique individual. What works or feels right to one, may not be the same for the next and that is 100% okay!

If you have additional questions or concerns, please do not hesitate to reach out. Serving Tampa bay with English and Spanish direct services, and consultation/parent education everywhere else.

Difference between receptive language and expressive language

May 5, 2024 Melanie Shea, MS, CCC-SLP

One of the first things I explain to parents when I conduct a language evaluation is the difference between Receptive Language and Expressive Language. Do you know the difference between the two? Don’t worry, that’s the point of this blog, let’s dive in.

Expressive language refers to the language used for communication. It is the ability to physically express oneself. So put simply it is the individual’s ability to gather their thoughts and compile them into a cohesive message in the form of language. Expressive language skills involve the use of grammar, vocabulary, and sentence structure to convey meaning. This can include speaking, writing, and using sign language or other forms of communication. For example, a child might use expressive language when they say “I want a cookie” to request a cookie, or when they write a paragraph in an essay explaining a concept. A person with an expressive language impairment would have difficulty trying to communicate their wants and needs, potentially in any format.

Receptive language refers to the ability to understand and interpret language that is spoken or written. This includes the ability to follow directions, understand the meaning

Photo by Christina Morillo on Pexels.com

of words and sentences, and identify the main idea of a passage. For example, a child might use receptive language when they follow the instructions “Please pick up your toys and put them in the toy box” or when they read a passage and answer questions about its content. A person with an receptive language impairment may have difficulty simply understanding what is being said to them, either at a basic or complex level, or under certain parameters.

Its important to note that expressive and receptive language skills are closely related and will often develop together. However, one can be more impaired than the other. Typically the receptive language will develop prior to expressive (i.e. they understand more than they are initially able to communicate.) Ultimately, both are vital to effectively communicate.

Examples of expressive language skills include:
-Speaking in full sentences
-Using a wide range of vocabulary
-Using proper grammar and sentence structure
-Asking questions
-Making statements
-Making requests

Examples of receptive language skills include:
-Following directions
-Understanding the meaning of words and sentences
-Identifying the main idea of a passage
-Understanding the relationships between words (e.g., synonyms, antonyms)
-Understanding the meaning of nonverbal cues, such as facial expressions and tone of voice
-Understanding the meaning of idioms and figurative language

It’s important to realize impairments in expressive or receptive language can affect an individual’s social interactions, learning, and overall quality of life. If you are concerned an individual is having difficulty with expressive or receptive language, feel free to reach out with further questions, as they may benefit from direct Speech and Language services.

When do I seek help from an SLP?

April 29, 2024 Melanie Shea, MS, CCC-SLP

If you thought you were in the rat race before, it really climbs to another level when you become a parent. I have never experienced such a high level of constant criticism,

advice, pressure, doubt, excitement, fear, pride,… I mean you name it we experience it. And why? Because everyone has something to say about your child. The pediatrician is constantly reminding you about those milestones. Those mommies in the mommy groups can’t stop talking about all the “new skills” their babies have developed and how they are already working on that Harvard application. Those distant relatives you see every few years are letting you know… “in my day we did…. <Insert outdated practice here>” or “you worry to much” or my personal favorite “well uncle Clide didn’t speak until he was 5 and he turned out fine.” It is no wonder parents are constantly stressed out. Not to mention the notion of “know better, do better” but in the age of information, we know so much that it can be immensely overwhelming. As if keeping a tiny human alive and happy isn’t difficult enough. All the additional pressure from society surely doesn’t help.

Despite the unrealistic expectations placed upon parents at times (many times) there are moments where there’s a real reason to be concerned. When it comes to speech and language I want to ease some of your concerns and give you some basic guidelines. This way, when everyone is coming at you for one thing or another, you have your own frame of reference to work from.

Click on the links below for a free downloadable Milestone sheet:

12 Months: Speech and Language Milestones at 12 Months

Up to 2 Years Old: Speech and Language Milestones at 2 Years

Up to 3 Years Old: Speech and Language Milestones at 3 Years

Up to 4 Years Old: Speech and Language Milestones at 4 Years

Up to 5 Years Old: Speech and Language Milestones at 5 Years

And as always, if you are left with more questions than answers, reach out for a consultation. We provide serve to the Tampa Bay area, in both English and Spanish. And if you are further out, we can provide consultations.

What is an SLP?

April 22, 2024April 29, 2024 Melanie Shea, MS, CCC-SLP

So frequently when people find out I’m a Speech Language Pathologist I get one of three responses: (1) Oh so you work with /s/’s and /r/’s!, (2) You’re a what? Or (3) That awesome my <insert family/friend/self> had therapy and it made such a difference. But even those who have direct interaction with a Speech Language Pathologist, oftentimes don’t realize the scope of the profession. And if you really want to blow someone’s mind tell them you work in a hospital or are a medical SLP. Of course you’re here, so either you have some background knowledge, are looking for services, or just want to learn more. Regardless of what brought you here, I’m going to help you understand the “who, what, where, when, and why” of the SLP’s world.

Who:

One of the best parts of being a speech language pathologist, is the fact that our profession allows us to work with all stages of life from infants in the NICU, to grandparents at nursing homes or ALFs.

What:

The best way it was described to me as a student was: “An SLP works with everything from the neck up.” That means: Dysphagia (swallowing disorders) Voice (anything impacting vocal quality such as resonance, intensity, quality), Speech disorders (such as articulation, phonological, dysarthria), Fluency (stuttering), Aphasia (which is categorized as a result of portions of the brain being damage, impacting expressive language & receptive), Cognition (which includes memory, problem solving, sequencing, mental manipulation, numerical sense, etc.). Additionally, Language (which can be receptive vs expressive and is the way one perceives communication and their ability to effectively communicate wants, needs, and more) and the use of AAC (alternative augmentative communication) because communication is more than just verbal, so if we can aid someone in finding a manner to communicate that’s what we do.

Where:

SLP’s work virtually everywhere: At homes, daycares, schools, private clinics, in libraries or public locations, in hospitals, in skilled nursing facilities, and assisted living facilities. We can even come to you online. Therapists can come to you or you can come to them. There are even mobile dysphagia diagnostic trucks.

When:

Like mentioned above, there are no age requirements as to when you could use the services of an SLP. But rather, there are qualifying factors. As soon as you identify a concern (whether it is with your child’s development or your aging parent’s sustaining abilities) you should request a referral from your primary health care provider. Most insurance will cover the initial evaluation and many therapists will provide free screenings. Getting answers and early intervention is always the best option for aiding your loved one, in progressing or maintaining as much of their skills as possible.

Why:

This depends on each person. However, the purpose of our therapy is to improve quality of life, at any stage of life. We don’t often realize how much and how vital communication is and without it how isolated one can feel. Our job is to help bridge the gap as much as we can. It is no different with any other area in the field from dysphagia to fluency and cognition. Often most skills related to that area are implemented without thought, and it is not until you or someone you love has an impairment that you realize how vital and how complex it really is.

Hopefully, at this point you have a better understanding of everything your Speech Language Pathologist is educated and equipped to handle. But if I missed something, or you have additional questions please do not hesitate to reach out.

Early language Development: A few things to focus on.

April 15, 2024April 29, 2024 Melanie Shea, MS, CCC-SLP

Are you hoping to bump up your little one’s verbal skill, but don’t quite know what to do? Don’t worry we’ve got 3 easy tips to help.

Early language development is a critical aspect of a child’s overall development. It not only helps them communicate and express their needs and wants, but it also plays a role in their cognitive, social, and emotional development. As a parent, it’s natural to want to do everything you can to support your child’s language development. In this blog post, we will discuss some key areas that you should focus on and why they are important for early language development.

Let’s start with: functional language. This refers to the words and/or phrases that a child uses to communicate their basic needs, such as “drink,” “eat,” “sleep,” and “potty.” These words are essential for children to be able to express themselves and for caregivers to understand their needs. You also want to think of what is functional for your child and your family. For example if your family often goes outside and swings on a play set, you may want to add “out” and “swing”. If you have food in a closed pantry, you may want to add “open”. When talking about functional language you want to look at your child’s world and at its simplest form, what words would help them navigate their life while reducing frustration. Don’t be shy to share this with your therapist either; I always ask and welcome parents to add to our word list. Ultimately my job is to increase their communication, improve home life, and reduce frustration. And don’t forget how effective modeling and encouraging the use of functional language can be. You can achieved this by using it yourself and reinforcing its use when your child uses it.

Next we have: Nonverbal language, or body language: Communication is communication, it doesn’t matter the mode and we want to celebrate and encourage this. This includes gestures, facial expressions, and eye contact. Nonverbal language is a crucial way for children to communicate before they have developed verbal language skills. It’s important to pay attention to your child’s nonverbal cues and respond appropriately. For example, if your child points to something they want, it’s important to follow their gaze and provide them with what they are indicating they want. I have had parents worry that if they encourage non-verbal communication their child will never speak. And, while there are children who can be stubborn, more frequently what I have encountered is when we reduce the pressure of verbal communication and provide them access to the world, their verbal expression starts to come more naturally.

Photo by RDNE Stock project on Pexels.com

Our last point: Narrating actions and activities to your child. This is also an important aspect of language development. This means describing what you and your child are doing as you go about your daily routines. For example you might say, “We are getting ready to go outside. First, we are putting on our coats. Now, we are putting on our shoes. Let’s go!” This helps your child learn new words and understand the relationships between objects and actions. It also helps them develop their narrative skills, which are important for both oral and written language development.

So, if you want to continue bumping up your little one’s language skills you’re focusing on (1) Functional language, (2) Non-verbal language, and (3) Narrating. You can do it.

And remember if you aren’t sure and looking for some guidance or have concerns for your little one, feel free to reach out. We serve the Tampa Bay area in person and further virtually.

Being Bilingual & Language Impairments

April 12, 2024April 29, 2024 Melanie Shea, MS, CCC-SLP

“Is my child at risk of a language impairment because we speak two languages?“

As a bilingual speech language pathologist, I can’t tell you the amount of times I’ve had a parent come into my treatment room full of embarrassment and shame, as they ask “is this my fault?” No! Wanting to preserve your culture and foster the ability to communicate and connect with your child is not the cause of a language impairment. On the contrary, research shows duo-language learners have numerous neurological advantages.

One study found that bilingual children had better executive function, or the ability to plan, organize, and complete tasks, compared to monolingual children (Bialystok, 2001). Executive function is an important predictor of language development as it involves the ability to use language to solve problems and communicate effectively. Another study found that bilingual children had a more advanced theory of mind, or the ability to understand the thoughts and feelings of others, compared to monolingual children (Bialystok, 2006). Theory of mind is also an important predictor of language development as it involves the ability to use language to express and interpret others’ mental states. In addition to these cognitive benefits, being bilingual has also been found to have a protective effect against age-related cognitive decline (Bialystok, Craik, & Freedman, 2007). This means that bilingual individuals may be less likely to experience cognitive decline as they age, compared to monolingual individuals.

Given these neurological benefits, it is clear that being bilingual is not the cause of a language impairment. In fact, it is likely that any language impairment in a bilingual child would be due to other factors. However, the reality is this concept of being bilingual leading to impairments is a common misconception. As a speech language pathologist it is vital we continue to educate those around us of the benefits and we stop encouraging bilingual families from speaking their native language.

***It is also important to recognize that a language impairment would be visible in both languages, not just one.*** If a child is experiencing a language impairment, they may have difficulty producing and comprehending language in both languages.

If you are a bilingual Spanish speaker and you are worried about your child’s language development, feel free to reach out. If you are local to the Tampa Bay area we would be happy to meet with you in person. If you are a little farther we are happy to do a virtual meeting and provide as much guidance as possible.

Ultimately anyone can have a language impairment, but it’s not going to be caused by being bilingual. And if you are struggling with this currently as a parent, we are here to walk alongside you, support you, or point you in the right direction.

Why should we play with our kiddos?

March 8, 2023April 22, 2024 Melanie Shea, MS, CCC-SLP

Of course we choose to play with our kids to bring them joy, for engagement and connection, and because it can be downright fun to act like a kid again. But did you know that there is actually neurological research which supports increased learning through play? Let’s explore this a little deeper.

Let’s start with a hypothetical. Think about your job, hopefully you are in a job or career that you love (maybe for you it’s not your job but something you do outside of work,… a sport, a charity, a hobby, but it’s something you love). There are parts of that job you absolutely love and there are parts you do because you have to. Today we are going to pretend that job is engineering, this is where you thrive, particularly when you are designing. However, you also have to attend meetings, you have to give presentations so the stakeholders of the company are up to date with progress, you have to be a part of test groups and hear their commentary about your design. What we commonly see is the tasks you enjoy are the ones you find easier to complete. You feel focused and everything seems to move quickly. However, when doing tasks you don’t particularly enjoy, the day can drag, everything can feel like a bigger obstacle and even the small things can become a nuisance. Why is this?

When we experience something positive that brings us joy, there is a dopamine release in our brain. This dopamine release reinforces the pathway created by the activity, which is your brain saying, “hey this activity is pretty cool.” The more this neural pathway is reinforced with a dopamine release, the more fixed it becomes. The brain literally begins to forge new paths. This is (at a very basic level, because I am not a neuroscientist, just a neuro enthusiast) the concept of neuroplasticity.This is the brain’s ability to continue to re-map itself depending on what you put effort into.

Now this reinforcement can also happen in a negative way. Think back to when you were in school. Did you ever have that one subject that you just didn’t get. I did! For me math was always a struggle, I remember constantly having to work 2-3 times harder than my peers to understand and appropriately apply the concepts. The more failures I saw or perceived (for example: I took longer to finish the test, or I didn’t get the concepts as easily as my peers, which to me felt like failures), the ‘belief’ that I was not good at math continued to be reinforced. Eventually, I would (and sometimes still do) tell people math isn’t my thing. Because I struggled so much I began to believe math wasn’t my thing, instead of believing maybe I just needed to learn those concepts in a different way. This led to me wanting to avoid math and any career that involved it. I only realize later in life, it wasn’t the math that was the struggle, but rather the way I was learning it. Put simply it didn’t work for me. It doesn’t matter, my brain remapped itself to believe math was in fact the enemy.

So now let’s turn to our children. Their sweet little brains are just starting out, everything to them can feel big, because they have no frame of reference as they navigate and experience the world. Every aspect of their life is essentially learning. From socialization, to athletics, to academics,… their whole world is a series of lessons. But kids are curious, they are playful, and they are physical. They often learn through exploration. For some kids they will thrive in a very structured environment. While many thrive through play. When a child plays (whether that be with dolls, pretending to be a pirate, magna tiles or lining up their toys) they are feeling joy. When you join their little world that joy often grows exponentially (because in their world, at this point in time, you are the ultimate super star, relish this it doesn’t last forever). They feel joy from getting to do any activity they love and getting to connect with you. Now imagine finding a way to work in some academic concepts to that play. Color identification while lining up buses, going on a hunt for sight word while pretending to be pirate, learning about shapes or multistep directions while playing with magna-tiles, now we are chaining something they love with something that in a different context may not be as fun. This is where the concept of neurons that fire together wire together. We are building new pathways by chaining something we know they like with something new. Now this doesn’t mean they will like everything we expose them to if we expose it in this way. However, they will likely enjoy the process of learning it more and will retain more information because the manner in which they are gaining the information.

So next time you’re kiddo is having a hard time with a new concept see if you can come up with a fun playful way to try and learn it. And if creativity isn’t your thing there are tons of resources on youtube, pinterest, teacherpayteachers, instagram, tiktoc, you name it. Don’t be embarrassed to use your resources. Because at the end of the day all you are doing is helping your little one learn new concepts and making memories. That’s the best double whammy!

Below you’ll find some video that help with concepts of Neuroplasticity.

The Role of Dopamine in Motivation and Learning

REFERENCES

Siegel, Daniel J., and Tina P. Bryson. The Whole-Brain Child. Penguin Random House Publisher, 2011.

More References to come!

Open letter to Parents from your SLP

February 28, 2023 Melanie Shea, MS, CCC-SLP

Dear Parent or Guardian,

If you’re here, you are likely scared. Something doesn’t feel right and you’re here to try and find out what it might be. Maybe you already know what it is, or have your suspicions. But I want to remind you of something… your little one, regardless of diagnosis, is perfect. Your little one regardless of strengths and weaknesses is amazing. Your little one despite the expected milestones is a light and a beautiful gift to this world.

Thank you for sharing your little one with us. Our field, while 100% intended to help, but sometimes it bombards you with all the negatives: all the things your little “can’t” do, everything you have to do, all the literature you need to read and all the doctors/therapists/etc. you need to consult. Sometimes we become so focused on the “plan of action” we forget to take a step back and really relish the amazing little human we have before us.

But don’t worry, that is a job I take seriously. You probably don’t need me to remind you of how amazing your little one is, but it’s something I make a point to do often and when you need it I’ll happily remind you too. Don’t worry we will talk about the hard stuff, we’ll find what we need to work on and work hard on it. But we are also going to celebrate, and we will celebrate A LOT, every little and big success is a reason to celebrate.

We are officially a team, together parents and therapists are now team Kiddo and we will always raise your little one up. When working with me a diagnosis means little, it is simply a word linked to the symptoms we are identifying, it helps guide therapy and sometimes provides access to more therapy. However, ultimately for me it’s about your little one.

What do we need to work on to bring you and your little one more joy, more access to the world, more connections with you, peers, teachers, and/or family. We figure this out together. Your child is more than a diagnosis, they are more than standardized test scores, they are more than tests at school, they are more than bell curves. They are amazing and because we know they are amazing we focus on progress. Give that little one an extra squeeze for me and never let anyone make you feel like that little one by your side is anything less than a shining light. We are the ones who have the privileged to bask in their light so thank you!

Sincerely,
Our Speech Garden ❤