Speech Therapist In East Delhi

Children with Neurodevelopmental disorders suffer from various types of communication disorders which includes deficits in language as well as speech.

Language disorders: Difficulty in the acquisition and use of language.

Speech sound disorders: lack of phonological awareness of sounds.

Fluency disorders: Disturbance in normal fluency

Pragmatic communication disorders: severe deficits in social communication and interaction.

A common long-term goal for speech language therapy in children with Neurodevelopmental disorders is to establish effective communication skills.

Depending on the speech-language characteristics the short-term goals of spech therapy could be as follows:

If the child has Motor speech disorder (mainly Dysarthria) due to impairments in coordination of phonation, respiration, resonance and articulation the following techniques can be used.

Oro motor and Proprioreceptive: Neuromuscular facilitation (PNF) exercises of the oral cavity can be used to improve oral-facial muscle tone and coordination of articulators for improving speech intelligibility/ clarity as well as improving oral sensory awareness, reduce drooling and solve the problem of tongue thrust

This can be achieved through various exercises

Oromotor exercises include, massaging the cheek muscles and muscles around the lips with the help of fingers. Whereas, PNF exercises include massaging the inner oral cavity which include the inner cheek muscles and tongue with a finger brush/ vibrator brush (Z vibe) and also improve oral sensory awareness.

Blowing Exercises - Blowing candles, paper bits, bubbles and whistle to train the facial muscles to produce certain sounds and to improve residual lung volume capacity/ breath support and breath control.

Breathing Exercises - Facilitate abdominal breathing by doing inhalation and exhalation exercise to strengthen the diaphragmatic muscles and improve breath support for speaking longer phrases.

Jaw exercises - Use of chewy tubes {knob shaped, P and Q (XT)) to improve jaw mobilization and eating foods that require extra chewing, like apples and carrots, to strengthen jaw muscles; practicing opening and shutting their mouth using only the jaw muscles while someone else holds their chin.

Lip Exercises - Using a lollipop, squeezing their lips around it to increase strength and lip closure, pursing their lips to kiss a lollipop to improve lip extension.

Tongue Exercises - Strengthening the tongue bysticking it out and pushingit against a tongue depressor/ ice cream stick/ spoon for seconds at a time.

Articulation/speech sound disorders:

To improve articulation skills of the child through Articulation Therapy , a mirror and phonetic placement technique is used i.e. use of flash cards and word lists to help focus on specific sounds and encouraging children to make sounds while looking in the mirror to help them understand how to place their tongue at specific positions in the oral cavity to produce specific sounds.

Language disorder:

If the child is suffering from language or communication disorder, then the following could be the short term goals of language therapy.

Toimprove receptive and expressive language skills:

In younger children, the main thing to be done is to provide them with intensive stimulation during their early years. This will help the child to improve their receptive vocabulary and encourage use of verbal mode for communication.

Language and Word Association using flashcards/ puzzle pieces of word pairs e.g. toothbrush- toothpaste, comb-hair, shoes-socks, etc and putting together puzzle pieces.

To improve receptive vocabulary/identification of the following categories:

Common objects (Items of food, clothing, furniture, kitchen objects)

Lexical categories (fruits, animals, vegetables and vehicles)

Verbs (sitting, eating, drinking, etc)

Adjectives (clean, dirty, big, small, tall, etc)

Prepositions (up, down, beside, front, between, etc)

Adverbs (fast, slow, etc) and all other grammatical forms.

This can be done using flashcards. Expose the child to the pictures holding at our eye level and then keep 2 pictures in front of the child and ask him to pick up one picture from set of two pictures.

To improve expressive language skills of the child:

Use of vocal play sounds i.e. animal sounds (dog says "bow bow", etc) and vehicle sounds (car horn: peep —peep, etc) to encourage the child to speak and use verbal mode to communicate > Improve verbal speech imitation skills of the child i.e. ability to repeat sounds/ words after you.

Encourage the child to speak names of family members: Prepare a small familv album (1 picture on each page) and encourage the child to imitate the names of family members after you.

All the above grammatical forms mentioned in the receptive language vocabulary needs to be taught to the child to name it verbally using flashcards or picture books/ albums. Show the picture to the child and ask him to "name the item/ object in the picture". First allow the child to imitate after you later on you can ask the child to say it on his own.

Once the child learns to repeat and spontaneously say 1 word to express himself then gradually the "Mean length of utterance (MLU)" can be increased to 2 word phrases up to 4 to 5 word phrases and complex sentences.

Higher language abilities i.e. picture description skills, story retelling , story generation and conversational speech can be improved using more of visual learning through picture description charts, short story sequence cards, etc.

A speech and language therapist plays an important role in the developmental of children with neurological disorders. They make it possible for these children to communicate their needs appropriately. They also help in improving their breathing and swallowing which manages the associated complications.