Treating Cluttered Speech in a Young Child

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Re: DeJa Vu

From: Lynne Shields
Date: 24 Apr 2010
Time: 09:41:10 -0500
Remote Name:


Hi Jonathan, Thanks for all of these good questions. I'll have a go at answering them, but let me know if I miss something! Our work with Claudia on eye contact and other social skills falls in the area of language known as 'pragmatics' or the social use of communication. It is common for SLPs to address issues such as eye contact, initiating and maintaining conversational turns, when to speak formally vs. informally, knowing how long is too long for a talking turn, how to tell a cohesive story, and many more skills that relate to communicating effectively with others. I guess you could call pragmatic language skills the 'rules of engagement'. Some of the skills, such as eye contact, are nonverbal, but they still relate to communication—those who do not use eye contact appropriately are often seen as not paying attention or not interested in what their speaking partner is saying. And, for her, it is an important skill in attending to feedback that her listener is not understanding what she says. Claudia very much wants to have friends, but socializing is difficult for her, since she lacks many of the social language skills. Her mom has told me that increasing her speech intelligibility has helped in that other kids in her class can now understand her and will respond to her comments and questions. She is spending more time with other children as a result of the social group that her resource teacher at school started this year, and through her participation in the after school social group, so we hope that she will develop friendships through these activities. You might check with child psychologists in your area to ask about social group therapy resources. Most larger communities do have them. There are quite a few options here in the St. Louis area. We have a wonderful resource that addresses social skills in a camp format here in our area; my oldest son attended summer camp and weekend retreats during the school year from the age of 9 through his graduation from high school, and it was quite helpful for him in gaining social skills. The camp is designed for kids with a wide range of issues such as autism, ADHD, low self-esteem, or everyday issues in getting along with family members. If you want information on the camp, please email me at and I'll send you the contact information. While most of the campers are local to Missouri/Illinois, kids come from all over the states to attend the camp sessions. We found it to be an extremely supportive environment and a really positive camp experience for our son. In terms of organization of thoughts, Claudia shows this in her difficulties in telling stories, explaining how to do something and well as in her conversational skills. This is an area that will eventually be addressed in her therapy, both social and speech/language therapies. Since she is young, we have not considered going to a device such as the Speech Easy at this point. Your final questions relate to self-advocacy, in dealing with teasing and other issues that may arise. As far as I know, Claudia has not been overtly teased (her mom doesn't report any teasing). Rather, she tends to be ostracized—not invited to play, ignored, etc. But, teasing may certainly become a problem for her. In our clinic, we work directly on teaching kids ways to deal with teasing when it occurs related to their speech and/or language disorder. We talk openly about how it feels to be teased, why kids tease, and brain storm ways to respond to teasing. Lots of role playing to practice various ways to respond (depending on the nature of the teasing) can help a child develop skills so that they have an arsenal of what I call 'snappy come backs' that allow them to respond to the teaser, and (within themselves) assign blame to the one who is teasing or bullying and not feel bad about themselves. It is a process that may take quite some time, but is very important, I believe. As a child gets to the later school years, learning to advocate for themselves with teachers is also an important skill to develop. It is empowering for older children to be able to talk with a teacher and let the teacher know what they need, and work with them to come up with solutions to problems. Once again, thanks for your good questions. I appreciate your kind comments and I'm so glad that you found Claudia's story helpful. Regards, Lynne

Last changed: 05/05/10