Normal Speech Sound Development

June 4, 2013

One of the most commonly asked questions of a speech-language pathologist is “Are my child’s sound errors normal?”

If your child is unable to say certain sounds or cannot be understood by others, you may want to take them for a speech evaluation.  A speech-language pathologist would be able to answer your questions and determine whether your child’s sound errors are developmental (appropriate errors based on the child’s age) or non-developmental (not age-appropriate and would need intervention).  A speech-language pathologist would evaluate your child and use “speech sound norms” or “sound acquisition norms” to determine which errors are developmentally appropriate and which errors are not.

Results of a speech evaluation may help ease parent’s worries about their child’s intelligibility.  Speech sound norms give useful information about which sounds are typically developed in the first 2-3 years, which ones are not developed until 4-5 years, and which ones may not be fully developed until 6-7 years.  A commonly misproduced sound is /r/.  When setting expectations for their child’s speech, it is important for parents to know that the /r/ sound is not typically mastered by most children until age 5 or 6. Although, some children may master the sound as early as 3 or 4.

Below is a link to a chart that is used by speech-language pathologists as a guideline to help determine which sound errors are appropriate and which are not.  Please don’t hesitate to take your child to be evaluated if you have any concerns.

Speech Sound Chart


– Michelle Morgado, M.S. CCC-SLP


Information taken from:



Literacy Series Post #4: Fast ForWord

March 26, 2013

Fast ForWord
A critical first step in CSLOT’s literacy program is Fast ForWord, from Scientific Learning, Inc. Fast ForWord is a computer-based program that that takes your child through a series of age-appropriate, highly motivating computer games, building skills necessary for learning to read. Many speech- and language-impaired children have difficulty with the auditory perceptual task of discriminating between speech sounds. To remediate these foundational discrimination problems, the Fast ForWord software slows down speech so the brain has more time to perceive the acoustic differences between the speech sounds. Playing the games at home for 8-12 weeks, supported by weekly parent consultations with CSLOT’s Fast ForWord specialist, your child will learn to discriminate speech sounds, and as he progresses, the software gradually returns to natural sounding speech.

Fast ForWord Language v2

The Language series develops listening accuracy, phonological awareness, and language structures and moves elementary students who are reading below grade level toward grade level reading skills.

Fast ForWord Language to Reading v2

The Language to Reading series emphasizes the link between spoken and written language to guide young students to become proficient grade level readers.

For more information about Fast ForWord, please visit the Fast ForWord page on our website by clicking here.

Literacy Series Post 2: Phonological Awareness

February 25, 2013

Phonological Awareness

What is Phonological Awareness?

  • Awareness of sounds in a language
  • Awareness of rhymes
  • Awareness that sentences can be broken down into words, syllables, and sounds
  • Ability to talk about, reflect upon, and manipulate sounds
  • Understanding the relationship between written and spoken language

Phonological awareness consists of skills that typically develop gradually and sequentially through the late preschool period.  They are developed with direct training and exposure. Phonological awareness is a key component of learning to read.

What are Phonological Awareness skills?

•    Detecting rhyme and alliteration (use of similar consonants)
•    Identifying rhymes and words that start/end with the same sounds
•    Segmenting words into smaller units, such as syllables and sounds, by counting them
•    Blending separated sounds into words
•    Understanding that words are made up of sounds represented by symbols or letters
•    Manipulating sounds in words by adding, deleting, or substituting

If your child has a speech sound disorder and is 4 or older and not displaying these skills, visit our appointment page to set up an evaluation for your child with one of our SLP’s. 


Social-Pragmatic Skills and Autism Spectrum Disorders

December 17, 2012

Social pragmatic skills help individuals engage in social interaction with others. Many of us grasped the unwritten rules that govern our behavior in the social environment early on in our lives. However, individuals with Autism Spectrum Disorder (ASD) have difficulties learning these rules. In fact, social-pragmatics is often considered a core challenge for these children. The “hidden” social expectations can make social interaction a confusing experience. Therefore, many professionals and parents may want to help children with ASD develop a variety of skills that fall within the social-pragmatic realm. Nonetheless, before we start, we need to first sort out important conversational skills and find ways to assess children’s performance.

Social pragmatic skills involve not only one’s ability to communicate intent, but also knowledge of discourse management, register variation, presupposition, and other social skills. Discourse Management involves managing the conversation to keep it flowing and effective. Conversation partners need to agree on turn allocation, which involves identifying turn-taking opportunities and limiting one’s talking to one’s turn. They stay on the topic unless there is a signal by a communication partner that he/she is going to change the topic. Knowledge of topic maintenance includes knowing how to smoothly switch to a new topic. When conversation breakdown occurs, one needs to recognize it and use subsequent repair strategies such as repeat, rephrase, or adding information to aid communication. Register variation includes politeness/social role recognition, as people change their word choices, sentence forms, vocal tone and gestures/body posture to adjust to social roles in various discourse patterns. Presupposition, or perspective-taking, involves making assumptions about what other people know. People learn to understand everyone has different thoughts, feelings, and experiences, and take this into account during the conversation. Paralinguistics refers to the use of prosody, gaze, gestures, and physical proximity to show interest in the interaction, convey different layers of meanings and monitor the nonverbal communication of the partner. Social behaviors involve use of facial expressions, conventional gestures, and social actions that are expected in one’s culture, such as dressing appropriately for an occasion, offering to share something, assisting someone who needs help, patiently waiting for a turn in a game, etc.

Children with ASD may be able to fluently express their intention, but they often face difficulties in their social interaction with lack of proficiency of more than one skill listed above.

Assessing pragmatic skills can be a challenge since conversations are dynamic, and there is no easy way to measure one’s performance via standard tests. Formal assessment which involves static, often pictured situations can be used to establish a starting point, but information collected through observation, interview, and check lists helps us to detect if the individual lacks the knowledge to manage such conversations or is merely experiencing a performance issue. If needed, specific situations can be created to probe particular skills. Information from more than one source is necessary to establish goals and priorities for intervention.

Several key components need to be considered as we develop an individualized treatment program for children with ASD. These include the child’s knowledge about social communication, his/her ability to apply social knowledge in various situations, the cognitive/emotional cost to the child, the need to find right strategies to specific challenges, the co-occurring elements in the planning/implementation stages of social interaction, plans to generalize learned skills, self-monitoring skills that promote independence and flexibility, etc. Interventionists should also consider what skills are easiest/most important to teach, which skills can be paired together, and which skills will make the biggest impact in terms of improving social interaction. Many tools and programs have been developed for improving social interaction in this population. For example, social groups and social stories help children with ASD to experience different social roles and social situations, expand their knowledge of social skills, give them examples of strategies they can use, and offer them opportunities to practice social-pragmatic skills in a low-stress environment. While the SLP may lead intervention, family members and school teachers can also provide additional learning opportunities throughout the day to help children monitor their newly learned skills.

Information taken from:

– Chloe Chenjie Gu, MA., Speech-Language Pathology Intern

– Kristina Elliott, MA, CCC-SLP

Holiday Fun – Keeping Up our Skills While Trying Some New Ones

November 19, 2012

It’s officially the holiday season and thus begins the hunt for activities to keep our children engaged and learning while having fun during time away from their regular activities. While holiday breaks from school are a time for relaxing, it’s also a time for children to explore activities that they may not be exposed to in school as well as keep up some skills while on break (i.e. handwriting).

Ideas for fine motor activities:

1)      Make macaroni beads: paint and string to make necklaces or garlands to decorate the patio

2)      Make pasta art: use cooked or uncooked painted pasta to create fun scene and pictures

3)      Make sensory pictures: use materials that you can find outside (i.e. flowers, leaves, grass, sand) to make pictures and stories

4)      Write stories: find great story starters and ideas from Handwriting Without Tears ©

5)      Outdoor drawing: use sidewalk chalk to make outlines of the children’s body, make colorful scenes or just practice shapes on the sidewalk


Ideas for gross motor activities:

1)      Make forts: use pillows, blankets and furniture (inside or outside) to create hideaways and forts to kids to play in

2)      Create obstacle courses: use rocks, furniture and toys to create outdoor obstacle courses that children can climb over, under, and through

3)      Play outside! Remember all those games you played as a kid? Tag, Follow the leader, Simon Says are great games to play outdoors

4)      Animal Races: crawl like a crab, waddle like a duck, jump like a frog, slither like a snake


Ideas for sensory activities:

1)      Water sensory table: this is a great opportunity to play outside with a tub, bucket or pool of water. Splash, swim or watch animals dive.

2)      Sensory cooking: have children help with making cookies and let them squish it through their fingers. Or make Jell-o and let them try out different textures.

3)      Make bouncing bubbles and entertain children for hours

4)      Make coffee can stilts: let children decorate as animal feet or with their favorite colors

5)      Make elephant toothpaste

6)      Make ice cream in a bag: work on strength, attention and have a great treat too!


Above all else, have fun! Children with sensory processing difficulties may be hesitant to try out activities at first, allow them time to explore and multiple opportunities to try!


-Larissa Ksar, MS, OTR/L

Early Intervention

November 1, 2012

Early intervention refers to services for children with developmental delays. These services help a child develop functional life skills. In some situations, the therapy a child receives at an early age enables that child to reach developmental milestones on target or close to target. Early intervention can relate to a child’s:

  • Physical development a child’s ability to move, see and hear
  • Language and speech development a child’s ability to talk and communicate
  • Social and emotional development a child’s ability to play, interact and relate to others
  • Adaptive development a child’s ability to handle self-care functions, such as feeding and dressing
  • Cognitive development a child’s ability to think and learn

All parents and caregivers, no matter how busy, want to provide their children with the most stimulating environment for learning and using language. A trip to the supermarket, taking a car ride, playing outside, or doing everyday activities at home provide great opportunities for developing speech and language skills. There are always opportunities to maximize communication and encourage interactions, which are both language-rich and fun! Below are different daily routines with examples of ways we can maximize communication.

Bath Time

  1. Blow bubbles in the water. Talk about the size (big bubbles), speed (slow, fast), etc. as you play.
  2. Practice following simple directions like “kick”, “splash”, and “scrub.”
  3. Let your child tell you which body part to wash or give your child a choice, “Do you want me to wash your arm or leg?.”
  4. Talk about what the bath toys are doing (e.g., going up, down, hiding under, in/out of water, jump off the tub, etc.).
  5. Sing songs in the bath (e.g., “Row row row your boat”, “It’s raining it’s pouring”, etc.).
  6. Use bath toys to hide under a washrag. Allow your child to find the toys and explore hide & seek games.
  7. Talk about bathtime concepts (e.g., water temperature, washing speed, vocabulary related to the bath, etc.).


Eichten, P. (2000). Help me talk: A parents guide to speech and language stimulation techniques for children 1 to 3 years (2nd ed). Richmond, VA: PI Communication Materials, Inc.

Katey Sellers, MA, CCC-SLP

Social-Pragmatic Skills and Autism Spectrum Disorders

March 21, 2012

What are Social-pragmatic Skills?

Children with ASD have deficits in social and communicative functioning, as well as restricted/repetitive interests. According to Gresham and Elliot (1984) “social skills are socially acceptable learned behaviors that enable a person to interact effectively with others and avoid socially unacceptable responses.” It is important to recognize that the word “learned” means that social skills can definitely be taught to individuals who do not automatically learn these skills (Cardon, 2011). Social skills are learned behaviors and typical developing children can learn these skills easily; however, children with social-pragmatic impairments typically require more prompting and instructions. Martin and McDonald (2003) describe pragmatics as behaviors that encompass social, emotional, and communicative aspects of social interaction.

Six Categories of Social Impairment: (Cardon, 2011)

1. Nonverbal communication

– Difficulty recognizing other people’s body language including facial expressions

2. Social initiation

– Rarely initiate conversation with others due to fear, anxiety, or apathy

– Initiate conversation frequently but appropriately

3. Reciprocity and terminating interactions

-Social Reciprocity: engage in one-way interactions

-Termination Interactions: not able to read cues that signal the end of conversation

4. Social cognition

– Difficulty with social problem solving

– May not understand the unwritten rules of social behavior

– May not understand other people’s view points

– Difficulty with joint attention (i.e. eye contact)

5. Behaviors associated with perspective taking and self-awareness

– Perspective Taking: difficulty understanding someone else’s feelings (Theory of Mind); failure to consider the

interests of others

– Self-awareness: difficulty evaluating one’s own behavior

6. Social anxiety and social withdrawal

– Fear of social or performance situations where embarrassment may occur; may prefer structured activities over

unstructured ones

 Therapy for Children with Social-pragmatic Impairments:

Speech-Language Pathologists work with children with social-pragmatic impairments. Social-pragmatic skills require peers, and social groups are a great way to teach children these skills. Children with ASD and other social-pragmatic impairments greatly benefit from these groups and learn social interaction skills. Strong social interaction skills mean: more meaningful relationships, greater happiness and self-esteem, greater social acceptance, greater desire to participate in social situations, and less anxiety (Cardon, 2011).

 -Sanaz Amini, BA, Speech -Pathology Intern  &  Kristina Elliott, MA, CCC-SLP