Being an SLP is hard work.  It’s paperwork, meetings, tough clients, data, evaluations, therapy, materials, parents, teachers, therapists, and more paperwork.  It’s easy to get bogged down by the copious negatives.  Sometimes your SLP Soul needs a little pick-me-up… a little “Chicken Soup”!  This blog hop is the perfect place to be reminded of the amazing occupation we are in and all of the wonderful and funny things that happen in therapy.

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First Words

For most children, first words are uttered around 12 months of age.  It’s an exciting time for families.  However, for many other children, first words don’t come until much later or in an unexpected way.  I have been very lucky to witness first words with a few of my clients and it has been an incredible experience each time.

First, you should know that I didn’t decide to become a Speech-Language Pathologist to rid the world of articulation delays or because I had once needed Speech Therapy.  I originally wanted to teach Gifted Education and was on the path to doing just that when a High School assignment changed my life.  I decided to become a Speech-Language Pathologist after observing a child with Cerebral Palsy utilize an AAC device in her speech session.  I was immediately hooked.  I thought that it was incredible that a child, who if born only 30-40 years earlier may have been placed in segregated schooling or living placement and thought to be “feeble-minded”, was using this device to articulate her incredibly clear thoughts to her SLP during their session.  I have had a love of AAC since that day.

For the first few years of my career, I worked with children with severe delays and disorders including Cerebral Palsy, Down Syndrome, Autism, and other genetic disorders within the school setting.  Many of my students had yet to say their first “meaningful” word.  (Though, as many SLPs and families who know children with these delays/disorders can attest, they communicate in many other meaningful ways.)  I had a particular student whose parents feared that he may never be able to communicate in a way that was understandable by others.  They had very limited resources and were unsure of the best path to pursue for their child’s communication.  We tried several lower tech devices for this child and he was able to utilize them to request basic needs but seemed uninterested in the devices on most occasions as he was fairly independent and able to use gestures or other means to get his needs met the majority of the time.  Because we suspected that his cognition was at a high enough level, we discussed utilizing a higher tech AAC device for the student.  We were able to secure a trial device through the state’s program and I took it home with me to program it with the basic starters for the next day.

When I arrived to work the next day, device in tow, I couldn’t wait for my session.  Though I was uncertain of how much we would accomplish, I was so excited to see what this student could do and what he had to say.  As we entered my office for his session, the student walked over to the device (powered off) and sat immediately.  He looked at it, searched for the power button, and then turned the device on.  Immediately he began exploring the symbols and moving through pages and pages of words simply pressing them to hear what they said.  Some of the symbols must have caught his attention because he would press them multiple times before moving on.  Finally, after we had gone through the majority of the pages with our exploration, we returned to the home page and cleared the sentence (which was of course an enormous run-on of nearly every word that was programmed on the device).  I paused and looked at my student who was sitting fairly quietly at the table.  It looked like he was just processing the mini computer that sat in front of him.  Then, he slowly lifted his finger up to the device and in only a few seconds used it to say “Hi, water go yes” before stopping to reach back to touch the door handle of my office.  We stood up and walked to the water fountain, got a drink, and returned.  It was his first request using more than one symbol and was so incredibly meaningful.  And it was just the beginning for him.

I would love to say that all AAC trials go like this.  They rarely do – there are many tossed iPads and rarely used devices placed in closets until “needed”.  But this student was different.  For him, the device was a way to unlock “our” language for his use.  He was quickly able to map his device that was purchased for him and could move through the device with incredible speed and use multiple word sentences within a matter of months after receiving it.  He still utilizes AAC to communicate as he has never “spoken” with his physical voice.  However, he has become very successful in communicating with his device, now an iPad, and I often think about his “first words” in my office that day.

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We’re so excited that you’ve joined our hop!  In addition to getting some Chicken Soup for your SLP Soul, we’ve gathered a few prizes for those who check out each post.  Below are the prizes that will be raffled.  You will also want to jot down the number below – you’ll need it on the final post to enter the raffle.

If you’re just beginning the hop, feel free to head back to the “First Blog” by following the link below.  If you’re ready to head to the “Next Blog”, simply click on that image and enjoy the next stop!  Thanks for stopping by!

Welcome!  I hope you’re enjoying all of the amazing posts from the 18 participating SLPs in this “Happy to be an SLP Blog Hop”!  If this is your first stop, you should know a few things.  This blog hop is FULL of great information, ideas, and more!  Start at the first blog by clicking below and hop along.  Make sure to collect the letter from each blog post.  At the end of the hop, you’ll have a chance to enter that word/phrase to win several prizes including TpT Gift Certificates!  Make sure to read through the posts too… these SLPs have taken a lot of time to prepare quality material for you.  I hope you enjoy… and to start you off, here is an amazing video!

Now… on to my post:

Picky Eating vs Feeding Disorders

Many children that we encounter as Speech-Language Pathologists not only have developmental disorders/delays but also difficulties with foods, textures, etc.  When parents bring up concerns with their child’s eating habits many members of the child’s team may be involved including OT, Speech, Psychologist, and pediatrician.  Several factors go into determining if a child is displaying picky eating or a feeding disorder:

There are a few similarities between the two.  The difference is in the impact of the eating on the child’s health and family as well as length of time that it has continued.  Picky eating is transient while a feeding disorder is ongoing.

One of the largest populations of children that display feeding difficulties are children with Autism Spectrum Disorders (ASD).

As speech therapists, we are often involved in the management of feeding difficulties.  It may not be apparent if the behaviors are developmentally apropriate and will resolve on its own, or it is a problem which will lead to long-term difficulties.  SLPs and all care team members should listen to parents when they report a feeding problem. Focused feeding histories that includes length of the feeding problem, any time that the child was NPO for a prolonged period of time, and if the child received medical interventions in the past.  Additional assessments and management of feeding difficulties should include, according to  Marshall & Dodrill:

For SLPs, it is important to design therapy that is based on evidence, the child and family, and assessment.  Here are the top 10 Therapy Tips from Marshall & Dodrill’s 2011 ASHA Presentation:

1 – Be Predictable: Use visuals, prepare children with auditory information, use transition songs.

2 – Consider contributions of sensory sensitivities: Consult OT and use a “sensory warm-up” before treatment.

3 – Ensure child is in a posturally stable position: Ideal position is feet flat on floor, hips at 90 degrees, and table at elbow height.  Use sensory tools if necessary.

4 – Always work with hierarchies in mind: Establish routine, use “food chaining”, child must be processing sensory input for success.

5 – Consider contributions of motor skills deficits: Initiation and sequencing of the task.

6 – Be in tune with the child’s sensitivities and distress cues before you begin challenging them.

7 – Break “food jags”: Begin after several weeks of therapy, with warning you can make small but noticeable changes to familiar foods (shape, color, taste, texture).

8 – Move Slowly: Keep parents involved about speed of therapy because if you go too fast it may backfire.

9 – Provide parent education and support simultaneously: Educate parents about all child sensory, oral motor, and mealtime skills.  Encourage parents to make food and interaction with food part of their daily routine.

10 – Always consider generalization and be working on it.

Here are some other great ideas from McCormick & Markowitz:

MBSS may also be necessary depending on the difficulty that the child is demonstrating.

Childhood feeding difficulties can range from picky eating to feeding disorders.  It is often necessary to have a multidisciplinary approach for diagnosis and treatment.  If the SLP has an understanding of the complex nature of determining and treating a feeding disorder, they can better support and educate the family and child.  For more information, check out these great resources/sources utilized in this post:

“Picky Eater or Feeding Disorder” by Valerie McCormick & Goldie Markowitz

“Feeding and the child with ASD” by Jeanne Marshall & Dr. Pamela Dodrill

I hope this information has been helpful to you!

Don’t forget to enter the drawing for one of these great prizes:

Here is your letter for the drawing:

Now, you can return to the first post or hop along to the next!  Enjoy!!!

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