Pragmatics

by Michael (Speech Pathologist)

• A boy walks through the front door.
• Mother: Wipe your feet, please.
• He removes his muddy shoes and socks and carefully wipes his feet on the doormat.

• E.g: Dogs chase cats.
• Paraphrase: Domestic canines pursue domestic felines.

• E.g., Melissa: *What’s up with Terry [the cat]? He was running away like his tail was on fire. Did Rufus [the dog] have anything to do with it?”
• Matt: Dogs chase cats.

• Paraphrase: Yep, Rufus was chasing Terry and that’s why Terry was terrified.

Childhood defined by, and through, language

by Michael (Speech Pathologist)

I recently read a paper by Michael Gerard Plastow* and was lead to ponder the following question: if what is taken to constitute a child depends on historical and cultural contingencies, can language development provide us with a more solid, less transient foundation? A century ago, the terms “infant” and “child” were synonymous; whereas today there is a relatively-distinct, if arbitrarily-placed, distinction separating the two. Going back further than this, we see that the child virtually disappears from the art of the Middle Ages: replaced by figures resembling adult men and women in all but stature.

Part of the confusion about which cluster of ‘ages and stages’ belongs under the headings, ‘infant,’ ‘child,’ ‘adolescent,’ and ‘adult’ is surely owed to the less-than-perfect correlation between said ages and stages. Not everyone comes into possession of the same attainments, by the same ages, as everyone else, and so we are left with a quandary as to which metric (ages or stages) we should use to judge whither child or non.

Moreover, as the preceding quote from Freud illustrates, we flatter or diminish ourselves (depending on how one looks at it) to imagine that we ever leave the child behind. Here, another quote, this time by William Wordsworth: “The child is the father of the man.” Hence the man, or woman, is both his or her own father or mother, and yet still the child, even unto manhood or womanhood.

What, then, might we speculate that words are worth in settling this debate—in providing a more solid foundation upon which some kind of boundary wall, bidirectionally permeable as it may be, might be constructed? Let us start with etymology. ‘Infant’ comes into English by way of the French enfant (as in, Les Enfants Terribles), which has only the connotation of ‘child,’ but this in turn descends from the Latin infans, designating “one without speech.” Aha! Now we have it, yes, a distinction as clear as night and day to bound and separate ‘infant’ from ‘child’ or ‘adult.’

I have my doubts, however. You see, while I would not be much of a speech pathologist if I made light of such a momentous milestone as speech, but, on the other hand, what of all all the people who never come into possession of speech, or which lose its facility? Most assuredly these people are not infans—literal Latin interpretations aside. Nor does it sit well with me that the short period of time preceding which most children do come into possession of speech is followed by a much larger stretch of time over which all sorts of mighty accomplishments (and not only in the domain of speech and language) are made on the way to the moving goalposts of adulthood.

In speech pathology, we often speak of “adult language,” and hold this out as a kind of endpoint towards which (we hope) “child language,” in the particular instantiations of individual children themselves, is moving. These two classifications encompass a range of abilities too numerous to delve into here, but suffice it to say that what is generally being posited is that there is a tipping point at which the complexity of a child’s language, and the ways that they use it, are in some kind of parity with the complexity and usage of adult language in the aggregate. There are two obvious problems with this, at least if we entertain any hopes the movement between these categories to in turn substantiate our categories of ‘child’ and ‘adult.’ First, it assumes that this is progressive movement in which gain after gain occurs, and nothing is lost; second, it runs into the problem of circular reasoning, since we form our conception of what constitutes adult language by evaluating how adults use language—which of course requires that we already have a definition for the very thing we are seeking to define!

I fear, then, that I can do no better than Oedipus in answering the Sphinx’s riddle, and only respond with “wo/man” to “which creature walks on four legs in the morning, two legs in the afternoon, and three legs in the evening?”

* Plastow, Michael G. The Ages of the Child https://www.ecritique.net/volumes/Volume_10/fwdecritiquevol102015pdfs/6_Ecritique%2010.%20MichaelPlastowTheagesofthechild.pdf

Why do children speak?

By Michael Audas, Speech Pathologist

Have you ever asked yourself, “why do children start speaking?” It’s not a question that arises very often, as most of us take for granted that speaking is an all-but-inevitable occurrence in the development of a child that ‘just happens.’ To an extent, this is true: children are primed to learn language, and primed to speak, and this is why they begin babbling right from the crib.

But on the other hand, speaking, unlike breathing or digestion, is an entirely voluntary act: we can quite easily stop speaking without suffering any physical harm. Speaking has to be something we want to do in order for us to do it, so why do would we—and children—want speak? Here are two reasons: first, speaking is fun, and second, because someone is listening. It is this latter reason that I would like to focus on here.

We all want people listen, and we all want to be heard. This is, as I have just said, a big part of why we desire to speak in the first place. Perhaps, though, we might be somewhat saddened by reflecting on how seldom this actually occurs in our own lives and, by extension, the lives of children.

What, then, gets in the way of listening? It is usually not that someone is intentionally, or even negligently, oblivious to what we are saying. Rather, we all have a tendency to listen in a way that actually revolves a lot more around ourselves than it does the other person. When someone tells us a story from their personal history, the first thing we search for is a story of our own to match it. If we are successful in finding this match, we further believe that we have related to, and understood, the experience they are attempting to convey.

When we fail to relate to the other person’s story, we often come to the conclusion that we have not understood them or, worse, that they have not made themselves understood. In an effort to avoid this unpleasant conclusion, we can be wildly overzealous in attempting to assimilate someone’s story to our own; as a result, we become deaf to many of the unique features of the other’s story, and that person’s other-ness itself. We haven’t really listened to what makes them them.

If someone is not hearing our stories, with all of their idiosyncrasies and eccentricities—which are precisely the parts of the story which speak to who we are—our desire to continue communicating them may diminish. So how can we counteract this natural, but not always-ideal tendency, in our interactions with little storytellers?

If I were to propose that we attempt to ‘just listen,’ this might capture the essence of what is needed, but in a manner so vague as to not be useful. Instead, let me propose some specifics:

• Set aside a time and a place—preferably a quiet space—for some uninterrupted sharing time. Reading a book or engaging in some other activity that both of you enjoy can be a good way to break the ice.
• Exercise ‘hovering attention.’ This means leaving preconceptions and agendas at the door, and letting the child’s words percolate in your mind without being preoccupied immediately arriving at a particular interpretation.
• Ask your child to elaborate or explain things you don’t understand, rather than your first recourse being to attempt to make sense of what they have said for them.
• If your child is describing something that happened to them, ask them how that experience was for them, rather than telling them how it was for them, or might have been for you had you experienced the same.

Listening in this way is not easy. It runs counter to our inbuilt tendencies and long-cultivated habits. Nevertheless, I urge you to try, and see who you find!

Learning about self-regulation

by Michael, Speech Pathologist

When it comes to communicating, expressing how we feel can be one of the most intimidating challenges for us to grapple with. By the time we might feel the need to talk about our feelings, it is often because the intensity of those feelings has reached a critical point, and in that state we are quite vulnerable to what someone might say in response. It is no surprise, then, that children and adults alike tend to shrink from this challenge, and choose to remain silent instead.

Not sharing our emotions with others, however, can lead to some of our actions seeming quite mysterious to others. And while adults are usually quite good at inventing reasons to explain away their behaviours, children, especially very young children, find this much more difficult, and may simply forego offering any explanation at all. But whether one is inventing reasons or avoiding them altogether, neither strategy is likely to result in solving whatever problems led to those emotions in the first place.

This is exactly the situation that Leo and his classmates in the book, Classroom Chaos, find themselves in. It’s Leo’s first day at school, and he is feeling understandably nervous, but his father teaches him a special poem that helps him calm his troubling feelings:

—Sometimes I’ll feel happy,
—And sometimes I’ll feel sad.
—But sharing my feelings with others,
—Will always help me feel glad.

Reciting this poem to himself, Leo finds to talk about his nervousness with the significant people in his life, and they are able to help him work through those feelings. But more than this, Leo shares his poem with his classmates, and, throughout the day, they each start sharing their emotions and this leads to the resolution of many misunderstandings between them.

Classroom Chaos is a wonderful story about the power of speech and language to bridge the divide between our internal worlds, and the internal worlds of others. When we communicate with confidence, we give others the strength to do the same.

You can find a free copy of Classroom Chaos here.

What is stuttering?

by Michael, Speech Pathologist.

We may all think we have at least a rough idea of what stuttering is, but arriving at a precise definition of stuttering that differentiates those who stutter from those who do not is a deceptively complex endeavor. Why should this be? Let us look at the definition offered by the World Health Organization in 1977:

Disorders in the rhythm of speech, in which the individual knows precisely what he wishes to say, but at the time is unable to say it because of an involuntary, repetitive prolongation or cessation of a sound.

There are two glaring problems in this definition. The first is that the definition relies on behaviours that are not exclusive to people who stutter. Whether or you are someone who stutters, I am sure that you can recall many occasions when you were temporarily unable to say what you wanted to say due to “involuntary, repetitive prolongation or cessation of a sound.” So this definition in no way distinguishes between those two do and do not stutter, it merely describes interruptions to fluent speech, which are a universal phenomena.

But this definition suffers from an even more fatal flaw. It fails to acknowledge two hidden, but extremely important, facets of stuttering: covert stuttering behaviours, and the psycho-emotional concomitants of stuttering. If we use the visual metaphor of an iceberg, the stuttering behaviours captured in the World Health Organization’s definition represent only the visible ‘tip,’ of the iceberg, while the two facets just mentioned represent the vast bulk submerged beneath the water.

Covert stuttering behaviours are, as the name implies, behaviours which are an attempt on the part of the person who stutters to conceal, avoid, and prevent ‘stuttering moments’—or times when the repetitions and prolongations already mentioned occur. Behaviours of this sort range from substituting words or phrases associated with stuttering moments, to the avoidance of speech altogether. Some people who stutter may be so practiced in the utilisation of these behaviours that they may not be recognised by those who associate with them as someone who stutters.

It should not be underestimated, however, the toll that covert stuttering behaviours may take on the one who regularly employs them. Avoidance of speech, in particular, may have devastating consequences in the realms of professional and personal life. Anxiety (particularly social anxiety), depression, and other impacts on mental and social wellbeing may all ensue when stuttering functions to negatively alter one’s self-image and/or ability to function in social life without excessive levels of discomfort.

It might even be said, that it is the impact that stuttering has on the life of someone who stutters, rather than the subset of behaviours that might be said to comprise stuttering, which is the true grounds for differentiating someone who stutters from someone who does not. At the very least, this should be the primary consideration when evaluating the need for treatment.

Treatment

There are a large number of treatments available for both children and adolescents or adults who stutter. For children, the treatments supported by the most robust research evidence are:

• The Lidcombe Program
• The Westmead Program (also known as syllable-timed speech)

For adults, the approach demonstrated to most effectively reduce stuttering behaviours is the Camperdown Program. This approach is what is known as a “speak more fluently” approach, while there are other treatments which emphasise a “stutter more fluently” approach, in that they place a greater level of importance on the ‘submerged’ aspects of stuttering that we have already touched on, rather than on only reducing the incidence of overt stuttering behaviours.

The reason that different programs exists for children and adult or adolescent populations is that effective treatment in the early years can often result in a complete remission of stuttering behaviours (though of course not the elimination of typical dysfluencies). Past a certain stage of maturation, however, stuttering behaviours—covert and overt—become well enough entrenched that management, rather than remission, is what might reasonably be expected as an outcome of current treatment modalities.

No matter the age of the person seeking treatment, or what treatment he or she ends up selecting, it is vital that to the success of these treatments that they enjoy the support of their loved ones: both on an emotional level, but also as active participants in the intervention itself.

WHAT IS L I T E R A C Y   

By: Pauline, Speech Pathologist

What should my child be able to do at his/her age?              

• Understand that print carries a message
• Make attempts to read and write
• Identify familiar signs and labels
• Participate in rhyming games
• Pretend to read, either by remembering a story and by using the pictures to help them tell the story
• Name various letters of the alphabet and make some letter-sound matches
• Use upper- and lower-case letters interchangeably
• Know how to write a few letters and know the direction of writing on a page

How can I help my child at home?

• Most importantly, read with them! The benefits of shared reading cannot be stressed enough! While you are reading…
  • pause while reading to talk about the story and pictures
  • point to each word with your finger as you read
• Make books available for your child to read with you as well as explore on his/her own
• Make reading a fun, everyday activity and read with enthusiasm (beware of not making it a chore)
• Give your child many opportunities to see you reading because this will show your child how important reading is to everyday life (newspaper, labels, books)

Activities to support your child

Research has shown that the skills targeted in the following activities are foundational to the development of literacy skills.

Syllable Awareness (age 4-5) – identifying how many syllables are in words

Awareness of Sounds (age 5-6) – identifying beginning, middle and final sounds in words.

Sound Blending (age 5-6) – able to blend sounds in a word (for example, after hearing c-a-t said with the sounds isolated, your child says “cat”).

WAIT…WHAT?! with an EXPECTANT LOOK

By Pauline, Speech Pathologist

Since we started telehealth sessions, I often hear many parents providing the answers in the background.

Working with children with speech and language delays require substantial patience. This patience is WAITING a bit longer than usual.  Children benefit from waiting a little longer to allow them to process the information.  Increased wait times with expectant looks is a strong way to help a child respond to questions on his or her own.  After asking a question, don’t repeat right away, ask different questions, don’t answer for the child, tell the child what to say, comment such as “You know that!”.  It only delays the process or frustrates the child.  You are sending the message that he/she is taking way too much time to answer.  It’s also interrupts their thinking process and hinders their ability to be independent.

As speech pathologists, we want to know what the child is capable of doing on his/her own, what level the child is performing at, and what support, cues or strategies works best for the child to come up with his/her own response.

How much time is enough time?

After asking your child a question, count 5-10 seconds silently  in your head (1,2,3,4,5,6,7,8,9,10).  Yes, it may feel like a long time.

Pair the wait time with a visual cue:

-Point to the screen

-Point to your forehead (i.e., you are thinking about it)

-Place your hand on your chin in a thinking pose

Here are some things you can do while you wait:

-Take a drink of water

-organize the desk area

-repeat the question to yourself at least one time

-take a few deep breaths

If after waiting for 5-10 seconds, you do not get a response, you can:
— Repeat the question
— Rephrase the question
— Make the question less complex
— Give your child a forced choice (e.g., “Do you think it is —- or —–.”)
— Provide a sound cue (e.g., It starts with a ‘P’ sound)
— Provide a sentence completion cue (e.g., “You eat with a fork; You cut with a ——“?)

Consider the two scenarios below:

Scenario #1

Speech Pathologist: Laura, have you ever gone to the zoo? (waits with an expectant look silently counting 1,2,3,4,5,6,7,8,9,10 and pointing to forehead).

Laura: We saw tigers.

Speech Pathologist: Wow, I love tigers! (more wait time with an expectant look focusing on Laura with hand on forehead).

Laura: We saw zebras and giraffes too.

-In the above scenario, Laura was provided with more time and expectant look along with a visual cue pointing to forehead to formulate and come up with her own response about her visit to the zoo.  She was processing the information and going through her visit in her head and thought of the animals.  Given Laura more time allowed her to continue the conversation.

Scenario #2

Speech Pathologist: Laura, have you ever gone to the zoo? ( waiting with an expectant look silently counting 1,2,).

Parent: Laura, remember we went to the zoo on your birthday? ( Answers for Laura).

Laura: Looks at parent.

Parent: We went with grandma and you really liked the tigers (Laura is silent).

Parent: Do you remember? We saw zebras and giraffes too. (still answering for Laura)

Laura: (Talking to her parent) Yes.

In the above scenario, Laura left the conversation with the Speech Pathologist and turned her attention to her parent.

The Koala Who Can

A great book to help children cope with change

By Michael (Speech Pathologist)

Change can pose quite a challenge for children. Jacques Lacan, a French psychiatrist, argued that feelings of anxiety often arise when we do not know what is expected of us. New and unfamiliar situations present new expectations, and often these expectations are not only ‘unwritten,’ but also ‘unspoken.’ As adults, we typically have a wealth of experience with the world behind, so when we unexpectedly find ourselves in a new situation, we can draw upon our encounters with other, more-or-less similar situations to guide how we might act in order to meet the expectations that might accompany this new set of circumstances.

For children, however, many situations they will encounter are not only ‘new,’ but ‘radically new’: they don’t have the familiar landmarks they can use to orient themselves and find their bearings in whatever new territory they are attempting to navigate. There is nothing quite like kinder until you attend kinder for the first time, and school only resembles kinder to a small degree.

So how do children cope with the great deluge of situations to which they are subjected in those early years? Pragmatic language and social-inferencing skills are key here: if you can make inferences about social situations and gauge how people around you are reacting to things that you and others do, then this means you can learn-as-you-go and figure out how you should be acting to meet the expectations of the situation. Similarly, if you are able to communicate effectively with other people, you can deftly ask others around you to fill you in on what you should be doing, or perhaps even offer the right apologies or crack the right jokes that will serve to smooth over any unintentional blunders you might make during the period of adjustment.

When children aren’t quite so well-versed in these skills as their peers, then the introduction of even minor changes to a routine, activity, or what-have-you can occasion anxiety. It can be as if a sudden gust of wind has unmoored them, and they find themselves adrift in strange waters without the necessary navigation equipment chart their way back to the dock. From an outsider’s perspective, the change is minor, but that is because past experience and the ability to ‘check in’ with others through communication allows for the recognition that expectations really haven’t shifted all that much, I just need to do or stop doing this one thing now that the situation has changed.

Children who find change—especially of the expected and/or unwelcome variety—difficult to manage need multiple resources to draw upon when such changes do inevitably occur. At the outset, it is usually helpful to help children get a firm grasp on what change means, and the distinctions between welcome/unwelcome and unexpected/expected changes. Leading on from this, helping children to understand that even when unexpected and unwelcome changes do occur, it’s okay, because a) it probably won’t be as bad as they expected, and may even bring along new and exciting things that they will enjoy, and b) they cope with such changes by using one of the strategies they have learned.

The book I want to bring to your attention today (The Koala Who Can, written by Rachel Bright and illustrated by Jim Field) is all about understanding that change is okay, and that there might even be certain disadvantages to avoiding change (like missing out on something fun). It also communicates that there are other people who will support and help you through change, and that going on that journey together can actually strengthen your bonds with those people. Replete with the most wonderful illustrations, the book provides plenty of opportunities to discuss the emotions that the main character, a Koala named Kevin, is feeling at various points in the story. I would also, depending on your child’s age and development, consider discussion the particular features of the changes that Kevin either goes through or avoids: e.g., refusing to change by coming down out of the tree vs. the tree falling over near the end of the book and forcefully reuniting him with terra firma. Most of all though, the book does a wonderful job of representing the embracing of change as a very brave and praiseworthy act—and what child doesn’t want to be brave?

Sincere apologies

By Michael (Speech Pathologist)

Sincere apologies are often a tricky thing for young children to master. For one thing, it takes time for children to be able to mentally move beyond the bounds of their own perspectives, and begin to consider how other people might think and feel about things. Second, their vocabularies are still developing, and thus they lack the words necessary to offer a full apology that contains not only the words ‘I’m sorry,’ but also some statement about why and what for; along these same lines, a relative lack (compared to older children and adults) of social experience means that they may not have a great deal of familiarity with the different forms that an apology could or should take in different situations.

Ordinarily, these gaps in a child’s awareness and knowledge will be plugged by observing, and interacting with, people within the social environments which the child moves through. For children on the autism spectrum, however, such learning through observation often only occurs to an appreciable degree when the thing that they are learning about strongly corresponds to their interests. Thus a child may readily learn the letters of the alphabet after hearing them recited a handful of times, but never tune in to social interactions closely enough to recognise the how, when, and why of offering apologies.

Apologising is a skill, then, that may need to be explicitly taught. But while it is easy enough to teach most children to offer some variation of “I’m sorry” in at least some of the situations when an apology is called for, it is another thing entirely to teach the empathic response necessary for the formulation and demonstration of a sincere apology. What follows is an outline of some of the ways in which you might help your child develop this skill:
What happened?

Before a child can experience an empathic response to a situation, they need to understand the what of the situation itself. In order to guide this understanding, you can start by gently prompting your child with questions like:

Why is Steven mad?
What happened to Chloe that made her cry?
How do you think Negin felt when Robert pushed her?

It might also be helpful to explore your child’s own emotional responses, both to the incident under consideration, and also to the emotions they recognise in those involved in the situation.
What was my role?

Once your child understand what has happened, the next step is for them to recognise what role they played in how events transpired, and what is their share of the responsibility for how people felt as a result. It is very important that your questions be phrased and delivered in as-gentle a way as possible, so that they do not sound like recriminations—rather as genuine entreaties for reflection and learning. The sorts of questions you work through with your child might include:

Do you think that it made Susanna upset when you pushed in front of her?
How would you feel if someone threw your favourite toy over the fence?

The value of an apology

Your child is more likely to be motivated by, and invested in, an apology when they perceive that it will yield some benefit for all the parties involved. It is important that children learn how an apology not only makes people feel better, but that it also benefits the one offering an apology—either by avoiding negative consequences (e.g., some form of retaliation), or reaping positive benefits (making a new friend, or repairing/strengthening existing bonds of friendship). You could prompt your child to consider statements like:

Giving someone an apology is a way to show them respect. If we treat others with respect, they’re more likely to treat us with respect too.
Apologising to someone usually cheers them up, and sometimes it may even make you better friends.

Next time, we will delve into some ways you can work with your child on what to say in an apology, as well as how to say it.

Is my child a picky eater or a problem feeder?  We get asked this question a lot.  Here is an SOS feeding checklist.   Please check in with our dietitian Kim who is running SOS workshops and sessions in Term 3 and 4 for further information.