Keana was a
beautiful and charming girl and everything about her was perfect in the eyes of
her parents, Oliver and Valerie. When Keana was 2, according to Oliver and
Valerie, it was as if she was muted; nothing seemed to come out from her mouth.
‘Probably she’s just a late bloomer’, this was the thought of Oliver and
Valerie. At the age of pre-school (2 and a half years old), Keana could only
speak up to 4 words and some of these words were prompted. Once again, the same
thought had struck Oliver and Valeria that Keana was probably fine, anyhow she
was only 2 and a half years old hence it was excusable for her to speak less.
By Keana’s 4th birthday,
Oliver and Valerie noticed that her language was odd. Though she seemed to be
learning individual words and was using gestures, her language was very
tangential. Things just were not making sense and she would jump from one topic
to another so quickly no one could really follow her. There were also lots of
missing or distorted sounds in her words. Without context, or if Oliver and
Valeria were only 'half-listening', they did not know what she said.
‘Something was not right. This was not normal. Something was wrong with
Keana’s speech.’
Oliver and Valerie went to their general practitioner to gain advice on
such matter. But the doctor assured both of them that everything was fine. She
was just-starting-to or just-about-to reach all of her milestones of speech
development. Being not convinced, they went for another visit with Keana’s
clinical pediatrician to know more about her ‘problem’. The pediatrician
hypothesized that Keana was having difficulties with her speech and in order to
conduct a speech language evaluation and enhancement program, a licensed
psychologist who practices speech therapy would be required. Therefore, Oliver and Valerie were referred to
International Psychology Centre by Keana’s pediatrician, who was able to
recognize her speech issue.
Oliver and Valerie called
up ChildPsychTM, the Child Psychology division of the International
Psychology Centre to make an appointment for an initial assessment. To be able
to diagnose Keana’s speech issue, The Stanford-Binet Intelligence Scale, Fifth Edition
(SB5) had been employed and the test was administered by the panel of
psychologists in the International Psychology Centre to observe how Keana solved problems and why she made the errors she did.
The assessment had revealed that Keana
scored relatively poor in the verbal aspects of SB5 and with that diagnosis, it
was then concluded that Keana was suffering from the speech delay, a form of communication
disorder being characterized as maladaptive speech development. According to the Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition (DSM-5), an updated version of classification and diagnostic
tool for psychological disorders, this psychological disorder might
affect not only the ability to read and write, it would also have negative
impact on Keana’s attention,
and socialization.
A programme of child psychotherapy which
emphasized the speech and language enhancement was recommended for Keana. Speech
Therapy was the essence of this programme as it assessed
speech, language, cognitive-communication, and oral/feeding/swallowing skills
to identify types of communication problems (articulation; fluency; voice;
receptive and expressive language disorders, etc) and the best way to treat
them.
Dealing with Children
with Speech Delay; a Common Child Issue of New Era
Dr. Edward Chan, Principal Consultant
Child Psychologist of ChidPsychTM, followed up the session with
Speech Therapy therapeutic program. He began the session with a simple
ice-breaking session to enable him to build rapport with Keana. After that
session, he employed the Language Intervention Activity whereby he would
interact with Keana, by playing and talking, using pictures, book or any
ongoing events to enable the stimulation of Keana’s language development.
During the session, Dr. Edward would also model correct pronunciation and use
repetition exercises to build speech and language skills of Keana. In this
case, a 1-to-1 speech therapy session would be best to enable a speedy progress
of Keana’s speech development.
Most of the children suffering from speech delay lacked of the ability
to utilize oral-motor coordination. Seeing this was one of the issues Keana was
facing, Dr. Edward employed the model of Oral-motor/feeding and swallowing therapy. He would use a variety
of oral exercises including facial massage and various tongue, lip, and jaw
exercises to strengthen the muscles of the mouth. He too worked with different
food textures and temperatures to increase Keana’s oral awareness during eating
and swallowing.
In the following sessions, a specific
therapeutic program, Articulation Therapy was used in aiding Keana’s speech
development. In this Articulation stage or also known as the sound-production
stage, Dr. Edward would model correct sounds and syllables for a child, often during
play activities. The level of play was age-appropriate and related to the
child's specific needs and space for growth. He also physically showed Keana
how to make certain sounds, such as the "r" sound, and demonstrated
how to move the tongue to produce specific sounds. This stage required a
several sessions to follow to ensure Keana was able to master the skills for
articulating the correct sound of speech.
Being able to produce a correct word pronunciation was not the only main
focus of speech therapy. The motivation to articulate a speech was crucial and
it was seemed to be low in children with speech delay. They did not find
speaking rewarding and there was nothing that motivated them to speak. Hence,
seeing this as an issue to be tackled to aid Keana, Dr. Edward used behavioral
modification which mainly focused on the use of encouragement as the mean for
rewards. Children with the age of Keana were prone to accept encouragement and
with that, it could in turn boost their confidence and self-esteem which led to
the rise of their speech motivation.
After the therapeutic program, Keana was
able to talk like how a 4-year-old would. She did not only speak her only
6-word vocabulary, but rather a complete sentence. She would also ask
permission before she went for the loo. The joy and happiness in both Oliver
and Valerie were immeasurable the moment they saw Keana being able to speak and
socialize with other children without signing or pointing.
“The problem of speech delay is not the
pronunciation of words itself, but the motivation to articulate a speech. Once
we are able to help children to deal with the lack of speech motivation, they
will be able to understand and appreciate the value and importance of speech,”
said Dr WengLok Chan, Principal Consultant Child Psychologist of ChildPsych™,
Centre for Children and Adolescences Psychology.
This article is contributed by ChildPsych™, Centre
for Children and Adolescence Psychology of International Psychology Centre’s team of
psychologist and psychonutritional therapists. Contact them at the
International Psychology Centre Sdn Bhd, 11-1 Wisma Laxton, Jalan Desa, Taman
Desa Kuala Lumpur.
Call
03-27277434, e-mail child@psychology.com.my
or log on to http://www.psychology.com.my/
or https://www.facebook.com/pages/Child-Psychology-International-Psychology-Centre/1423663507845136
or http://chpsych.blogspot.com/
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