June 13, 2024
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June 13, 2024
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Linking Northern and Central NJ, Bronx, Manhattan, Westchester and CT

Q&A With Esti Schiff of The Therapy Place

Esti Schiff, MS, CCC-SLP has been working with children for over 17 years. Esti recently joined the team at The Therapy Place as director of the speech and language department. Esti’s vast and varied experience in the field of speech and language pathology allows her to provide our clients with the best in-class speech therapy services.

I always thought that speech therapists treat the /s/ or /r/ sounds, but I am starting to hear that they can do a lot more than that. Can you explain the different areas that fall under “speech therapy?”

The term SLP stands for Speech-Language Pathologist, which means that speech therapists can target issues that fall under both “speech” and “language.” “Speech” therapy helps children who have difficulty articulating one or more sounds (ex: s, r, l, sh etc.) or have difficulty with overall clarity. It also can help children who present with a voice disorder or who stutter. “Language” therapy helps children who have difficulty with receptive language skills (such as following directions, categorization and critical thinking skills), expressive language skills (such as telling a story and word retrieval), pragmatic language skills (such as picking up on social cues or flexible thinking) or executive functioning skills.

My son has difficulty following directions in class. Would this be something a speech therapist could help out with?

Yes, for sure! Sometimes a child has difficulty following directions because they are unable to hold information in their short term memory or they might have difficulty visualizing. During sessions, a therapist can work on teaching compensatory strategies that will help the child learn the process needed to follow directions. Some of these strategies include teaching them to repeat the information to themselves before following the direction in order to help store the information in their short term memory. Visualizing strategies are also helpful as they teach a child to “make a video” in their head of what they need to do; this helps turn the words into a picture, making it easier for them to process and remember.

My daughter has difficulty getting her words out; she seems to know what she wants to say but she has trouble getting it out. What can you do for her?

It sounds like she has difficulty with word retrieval. Word retrieval difficulties occur when a person knows and understands a particular word but cannot retrieve it and use it in speech. Speech therapy sessions can help a child with word retrieval difficulties by giving them strategies to help “find” the correct word. One way to help with this issue is by helping a child “organize” the information in their brain so that it will be easier to “find” the correct word when needed. This is done by teaching children categorization skills, to help make associations and link items that go together. Having a child list items by category and subcategory while linking connecting items together is very helpful for overall organization. Other strategies for retrieval include thinking of the first letter, thinking of a synonym or describing it to yourself to help pull up the actual word.

My son seems to “break down” when something doesn’t go exactly the way he expected it to. Could a speech therapist address this?

It sounds like your son has some difficulty with “flexible thinking,” which is an area that a speech therapist can address. A child who is a rigid thinker might have difficulty seeing things from others’ perspectives, thinking of multiple solutions to problems, or understanding that there are different ways of doing things. I like to show kids a rock and some putty. We discuss that when a brain is like a “rock” it is not able to bend to see things in a different way or problem solve, however when it is like “putty” it is very flexible and can stretch to go around a problem or stretch to see things from another perspective. Once the child understands this concept we engage in a variety of activities using this skill (ex: using picture scenes to see different people’s perspectives, coming up with multiple uses for an object, thinking of different solutions to the same problem). We can then work on carrying this skill into real life examples to help a child learn to be flexible in the moment.

Is there any way to help my daughter who has difficulty answering questions based on a story?

Many times a child has difficulty answering questions based on a story because they are not visualizing the information heard so they don’t really fully process the information and therefore they can’t answer questions. Teaching a child visualizing strategies can really help! The “Visualize and Verbalize” Program is a great tool to help teach a child the foundations of visualizing. Additionally, I like to teach a child how each of the “wh” question words are used (ex: the answer to a “who” question will be a person, “where” is a place etc.) using color coded cue cards. We practice asking/answering questions using the specific question words/cards to ensure that they really understand the skill. Once a child understands what type of information they are listening/looking out for, it makes it easier for them to answer correctly.

My son does not pick up on social cues and doesn’t always act appropriately in social situations. How would you go about helping him with this skill?

Many times kids struggle socially because they aren’t able to “read” a situation. Therapy sessions help teach a child to “think with their eyes” and learn to interpret gestures, facial expressions and body language. We teach children what to look out for using picture scenes (where is it, what important objects do you see, who are the people, what are they thinking). We focus a lot on figuring out emotions and cause and effects/triggers for the emotion. Once a child understands how to “think with their eyes” they will hopefully start to use this ability in real life situations and will start picking up on social cues.

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