Self-Calming and Emotional Regulation Tools for Children of all Ages

Due to a multitude of factors, many parents are struggling putting their children to bed at a reasonable time.  Children may feel anxiety, worry, and stress when the lights go dim and the room is quiet.  Daily struggles and challenges may race through their minds and it can be very difficult for our little angels to fall asleep peacefully, easily, and quickly.   I hope that the following resources can provide your child with more peace and calm during the day and especially at night time.  Many Blessings

Utube Resources

“Hot air balloon ride:  A Guided meditation for kids for sleep and dreaming.”

“Children’s Bedtime Story-Billy & Zac the Cat’s Fairground Adventure Relaxation/Kid’s story.”

“Children’s Bedtime Story-Billy & Zac the Cat go on a Rocket Ship to Space, stories for kids.”

“Kids Meditation Bedtime Story-Billy & Zac the Cat’s go to Candy land.”

“Breath meditation for kids.  Mindfulness for kids.”

“Guided Meditation for Children/Your Secret Treehouse/Relaxation for Kids.”

“Dragon Story time. Meditation for kids & tots.  (Sleep or rest time outs).”

“Magic bubbles.  Guided relaxation for children.  Meditation for kids/guided meditation for anxiety and worry.”

“Guided meditation for children.  Enchanted forest.”

“Bedtime-Guided meditations for Children.”

“Lilly and her Magical Unicorn Dreams-Children’s Bedtime.”

“Stunning Aquarium & The Best Relax Music-2 hours.”

“Guided Meditation for Sleep…Floating Among the Stars.”

“Dreaming of being a Dolphin-Children’s Relaxing Bedtime Meditation.”

“The Fairy & Leprechaun Spoken word Guided Meditation for Children For Sleep & Relaxing.”

“Martin the Octopus-Children’s Bedtime Story/Meditation.”

“Welcome to Cloudtopia-Children’s Bedtime Story/Meditation.”

“It’s cool to Be Different-Children’s Bedtime Story/Meditation.”

“The Magical Enchanted Tree-Children’s guided Meditation.”

“Teddy Bear Land-Children’s Bedtime Meditation.”

“Pet Heaven-Children’s Bedtime Story/Meditation.”

iPad Apps 

“Stop, breathe, think” Promotes compassion. Ages 10+

“Five minute escapes for meditation and relaxation” Ages 10+

“Drift away” Ages 9+

“Dreamy kid meditation app just for kids.” Ages 8+

“Well beyond meditation.” Ages 7+

“Breathing bubbles.” Relieving anxiety and worry.  Ages 5+

“Settle your glitter.”  An emotional regulation tool Ages 4+

“Breathe, think, do Sesame Street” Ages 3+

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Resources and Referrals for Families

The following resources and referrals are highly recommended by

Coastal Speech Therapy Inc.



Dr. Yu Pediatrician Phone: 949-548-7777 Address: 320 Superior Ave. Ste. 220 Newport Beach, CA 92663

Dr. Iravani Phone: 949-515-7337 Address: 1640 Newport Blvd. Suite 360 Costa Mesa, CA 92627

Ear Nose and Throat Doctor:

Head and Neck Associates of Orange County: Dr. Supance, MD., F.A.A.P., F.AC.S Pediatric Otolaryngology Head and Neck Surgery Phone: 949-364-4361 Address: 16300 Sand Canyon Ave., Suite 201 Irvine, CA 92618


Hear Now Abramson Audiology:  Maria K. Abramson, Au.D., CCC-A, FAAA                Phone: 949-495-3327 Address: 28985 Golden Lantern B-105 Laguna Niguel, CA 92677

Occupational Therapy:

Irvine Therapy Services, Inc.  Phone: 949-252-9946 Address: 16631 Noyes Avenue Irvine, CA 92606

Learning in Motion, Tara Mackenzie Phone: 214-288-4503 Email:

SKY Pediatric TherapyPhone 949-630-8290 1929 Address: Main Street Suite 103 Irvine, CA, 92614

Neuro-Developmental Testing:

Andrew McIntosh, M.D. Child Neurology Phone: 949-249-3780  Address: 30131 Town Center Drive, Suite 195 Laguna Niguel, CA 92677 Website:

The Center for Autism and Neuro-developmental Disorders Dr. Snyder,                       Phone: 949-267-0400 Address: 2500 Red Hill Ave. Suite 100 Santa Ana, CA 92705 Website:

Dr. Recor, Ph.D. Clinical and Forensic Psychologist Phone: 949-720-0167 Address: 101 Pacifica Suite 220 Irvine, CA 92618

Child Psychology:

Dr. Sarah L. Giokaris Licensed Psychologist Phone: 562-412-4191 Address: 1400 Quail, Ste. 265 Newport Beach, CA 92660

Cognitive Therapy Orange County  Lisa K. Phillips, Ph.D. Clinical Psychologist Phone: 949-675-0545 Address: 151 Kalmus Drive, Suite B220 Costa Mesa, CA 92626 Website:

Dr. Michelle Molina Ph.D. Phone: 949-253-4144 Address: 2102 Business Center Drive Suite 130 Irvine, CA 92612

Child Psychiatry:

Amada Isabel Almase, MD, Diplomate in Adult, Adolescent, and Child Psychiatry:  Phone: 949-892-7242 Address: 1400 Bristol Street North, Suite 250 Newport Beach, CA 92660

Dr. Rose Pitt MD. Child Psychiatrist Phone:  714-547-8609  Address: 14181 Yorba St. Tustin, CA 92780

Dr. Ester Park D.O., Phone: 949-258-3741 Address:  23141 Molton Pkwy. Suite 213 Laguna Hills, CA 92653

Vision Therapy:

Julie Berg Ryan, O.D., M.S.Ed Pediatric vision therapy Phone: 949-733-1400 Address: 2950 Barranca Pkwy. Suite 310 Irvine, CA 92604

ABA Therapy:

In STEPPS: Erin McNerney Ph.D Phone: 949-474-1493 Address: 18008 Sky Park Circle Suite 110 Irvine, CA 92614

Morning Star ABA Therapy: Amanda Dissmore, M.A., BCBA Phone: 714-552-1317 Website:

Creative Behavior Interventions: Dr. Denise Eckman Psy.D., BCBA-D Phone: 949-328-7688 Address: 3002 Dow Avenue #122 Tustin, CA 92780

Shine Learning Alliance: Kim Robertson Phone: 949-466-4324  Website:

Yoga and Play Gym for Special Needs:

We Rock the Spectrum Phone: 714-824-1238 Address: 23572 Moulton Pkwy Suite 102 Laguna Hills, CA Website:


Paul Eisenberg Educational Advocate Phone: 714-235-3319 Address: 52 Brisa Fresca, Rancho Santa Margarita, CA 92688

Barbara Frank Special Education Consultant Phone: 909-226-2289 Website:

Educational Therapists: 

Franklin Educational Services: Phone: 949-381-7488 Address: 1151 Dove St Suite 140 Newport Beach, CA 92660  Website:

Linda Larson: Educational Therapist Phone: 949-786-6359 Address: 4601 Sierra Tree lane Irvine, CA 92612

Catherine Messina: Educational Therapist Phone: 949-735-6766 Email:

Active 8 Learning Center: Anna Paton Phone: 949-251-0605 Address: 1000 Bristol Street Suite 18 Newport Beach, CA 92660

Cerebral Palsy:

Cerebral Palsy Guide Jenna Gehrdes Community Outreach:  Phone: 1-855-329-1008 Address: 3208 E. Colonial Dr. #241  Orlando, FL 32803

Cerebral Palsy Group, Alison Sanchez, Advocacy Director: Address:  400 Putnam Pike Suite J #242 Smithfield RI 02917

Feeding Therapy:

United Cerebral Palsy Foundation Phone: 949-333-6400 Address:  980 Roosevelt Ste 100 Irvine 92620


Marissa Kent Nutrition MS, RDN, CDE Phone: 949-378-1047 Address: 26461 Crown Valley Pkwy, Suite 100 Mission Viejo, CA 92691

Websites (866) 479-9025

Communicating with an Autistic Child: A Parent’s Guide with an autistic child (Helping children with sensory Processing Issues)

Autism Resources for Families

Sesame Street Autism Resources for Parents

Reduce the Noise: Help Loved Ones with Sensory Overload Enjoy Shopping

CDC Autism Links and Resources

Operation Autism for Military Families

Moving with Special Needs Kids

Academic Accommodation Resources

Home Modifications for Kids with Sensory Concerns

Temple Grandin’s Teaching Tips

Estate Planning for Parents of Kids with Autism

Parent Education Books


Ten Things Every Child With Autism Wishes you Knew: Author: Ellen Notbohm

An Early Start for Your Child with Autism: Author: Sally J. Rogers, PhD, Geraldine Dawson, PhD, Laurie A. Vismara, PhD

The Conscious Parent’s Guide to Autism: Author: Marci Lebowitz, OT

Parenting with Presence: Author: Susan Stiffelman, MFT

The Whole Brained Child:  Author: Daniel J. Siegel, Tina Payne Bryson

The Everything Parent’s Guide to Special Education: Author: Amanda Morin

Sensory Processing Disorders:

The Highly Sensitive Child:  Author: Elaine N. Aron, Ph.D.

The Out of Sync Child:  Author: Carol Stock Kranowitz

The Out of Sync Child Has Fun:  Activities for Kids with Sensory Processing Disorder: Author: Carol Stock Kranowitz

Zones of Regulation:  Author: Leah M. Kuypers

Raising Kids with Sensory Processing Disorders: Author: Whitney, Ph.D., OTR/L and Varleisha D. Gibbs, OTD, OTR/L

Executive Functioning Disorder:

The Impulsive, Disorganized Child: Author: James W. Forgan and Mary Anne Richey

The Highly Explosive Child:  Author: Ross Green

The Sensory Child Gets Organized: Author: Carolyn Dalgliesh

Children with Anxiety:

The Anxiety Cure for Kids: Author: Elizabeth DuPont Spencer, M.S.W., Robert L. DuPont, M.D., Caroline M. DuPont, M.D.

Helping Your Anxious Child: Author: Ronald M. Rapee, PH.D.

The Everything Parent’s Guide to Overcoming Childhood Anxiety: Author: Sherianna Boyle, MED, CAGS

Behavioral Problems:

The Defiant Child: A Parent’s Guide to Oppositional Defiant Disorder: Author: Dr. Douglas A. Riley

Setting Limits with your Strong-Willed Child: Author: Robert J. MacKenzie, Ed.D.

The Explosive Child: Author: Ross W. Green Ph.D.

Your Kid’s a Brat and It’s all your fault: Nip the attitude in the Bud-From Toddler to Tween: Author: Elaine Rose Glickman

Children’s Books

Anxiety and Worry:

What to do when you worry too much: A kid’s guide to overcoming anxiety                Author: Dawn Huebner

What to do when you grumble too much: A kid’s guide to overcoming negativity Author: Dawn Huebner

What to do When Bad Habits Take Hold: A Kid’s Guide to Overcoming Nail biting and more Author: Dawn Huebner

Stress can Really Get on Your Nerves: Authors: Elizabeth Verdick and Trevor Romain

What if…? Commonsense strategies for kids on worries, upsets, and scares                 Author: Sally Mumford

What to do when You’re Scared & Worried: A Guide for Kids: Author: James J. Crist

Be the Boss of Your Stress: Authors: Timothy Culbert, Rebecca Kajander

Get Organized without Losing it: Author: Janet S.


What to do when your Temper Flares: A kids Guide to Overcoming Problems with Anger Author: Dawn Huebner

How to Take the Grrr Out of Anger: Author: Marjorie Lisovskis

Survival Guide to Kids with Behavior Challenges: Author: Tom McIntyre PhD.


Speak up and Get Along! Author: Scott Cooper

Flexi Lexi Learns to be Flexible Author:  Molly B. Stuckey MA CCC SLP

FL #1This educational book is designed to teach children how to become more aware of their own thoughts, behavior, and language to improve their flexibility, cooperation, and emotional regulation.

Posted in ADHD, Anxiety, Apraxia, Articulation, Aspergers, Autism, Developmental Verbal Dyspraxia, Expressive Language, Group therapy, Pragmatics, Sensory Processing, Social Skills Therapy | Leave a comment

The Positive Effects of Therapy Dogs Utilized in Speech and Language Therapy


We are extremely excited and proud to announce that Coastal Speech Therapy now offers a trained therapy dog utilized during speech and language therapy sessions.  For years, therapy dogs have been utilized to reduce a child’s separation anxiety, improve rapport and trust with a therapist, and assist therapists in improving a child’s spontaneous, functional language. IMG_0546[1]IMG_0504[1] With the parent’s permission, we are now offering Buddy, our trained and certified Golden Retriever therapy dog to assist our therapists in providing the highest quality of speech and language therapy possible.



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Facilitating Flexible, Cooperative Language

Flexible LanguageIMG_3983[1]

Can we trade?

I changed my mind.

Ok, maybe next time.

Whatever, no big deal.

That’s a great idea!

Let’s compromise

Let’s work together

We did it together!

Do you mind if we…

Let’s try it again

First this…then that…

Let’s take turns

How about we try it this way?

This would be a good time to show flexibility.

First we’ll try it your way, and then we’ll try it my way.

It’s more fun to play together!

Tell me when you’re ready for more.



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Sensory Red Flags

When to refer to an Occupational Therapist

  • Poor Eye ContactDSCF0087
  • Difficulty Communicating
  • Picky Eater and/or chews on everything.
  • Breaks toys and crayons easily.
  • Poor fine motor skills.
  • Poor body awareness, frequently bumping into people and objects.
  • Clumsy, trips and falls easily, underdeveloped motor skills.
  • Hyper tonic; appears stiff and inflexible.
  • Avoids swings and playground activities.
  • Shows fear when feet are off the ground or head is tipped backward (bathing)
  • Walks on tip toes; toe walker
  • Jumps in place and is always moving.
  • Seems as if driven by a motor.
  • Unable to remain seated during structured activities (i.e., dinner time).
  • Very sensitive and hyper-aware of environment.
  • Seeks out excessive movement, touch, and hugs.
  • Difficulty with personal space boundaries (i.e., in people’s faces)
  • Overly sensitive to loud sounds such as vacuums and blenders.
  • Dislikes bathing, grooming, self-care, and/or haircuts.
  • Finds it hard to follow instructions, especially with multiple steps.
  • Needs more practice than other children to learn a new skill.
  • Difficulty listening, focusing, or concentrating during non-preferred tasks.
  • Becomes hyper focused on technology.


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Autism Spectrum Disorders

Red Flags to Look Out For….059

  •  Reduced receptive and expressive language.
  • Lack of eye contact
  • No response to name being called, it could be as if the child is not listening or appears to be deaf.
  • Flapping, rocking, or spinning especially when excited.
  • Repetitive movements with body parts or objects such as shaking a hand in front of his/her face or waving a pencil in front of his/her face.
  • Loss of speech after child has been talking.
  • Lack of pretend play skills.
  • Lack of interest or joint attention.
  • Echolalia- repeating words or phrases.
  • Difficulty with transition from one activity to the next.
  • Sensitive to sounds, tastes, and textures.
  • Difficulty with social interactions with others including initiating and maintaining conversations and play.
  • Preoccupation of objects or parts of objects.
  • Restricted interest in foods; “picky eaters”.
  • Prefers to engage in solitary play with repetitive actions.
  • Frequent tantrums.

Important information when interacting with children with ASD…From the perspective of the person living with ASD:

  • Eye contact can be over-stimulating for me. Just because I am not making eye contact with you does not mean I am not listening.
  • I thrive on routine and knowing what is going to happen ahead of time.
  • I might have a hard time transitioning from one place to the next so please be patient with me.
  • I like to play alone most of the time. You might need to try and engage me in playing or talking with you.
  • My interests may be narrowed to only a few things. Please try and introduce new toys and objects to me.
  • I have a hard time understanding figurative language and sarcasm. I am very literal, so you will have to explain what you mean.
  • I might communicate better with pictures or using sign language such as, “more” and “all done.”
  • If you see me rocking or flapping my hands, I am either excited or trying to make myself feel better. Try giving me a bear hug or deep squeezes.
  • Sometimes loud noises are too much for me and I will cover my ears. If you see me cover my ears, try to turn the volume down or walk out of the room with me.
  • I like to talk about things that I like. I might not let anyone talk about anything else and try to bring the conversation back to what I want to talk about. I need to be reminded to show interest in what other people want to talk about.
  • Holiday parties are really hard for me because I am out of my routine and it is very loud.

Children with autism may learn differently….

Children with autism benefit from learning through pictures. Teachers can have pictures of the steps to washing hands or the steps of a cutting and gluing activity posted for the student to look at as a reminder.  It is easier for students to learn through pictures because they are visual learners.  They also learn skills through modeling and repetition, rather than picking it up in the environment.  Applied Behavioral Analysis (ABA) is a very successful treatment approach combined with speech therapy.

Children with autism like to know what is going on…

Having a consistent routine and/or a visual schedule helps reduce stress and anxiety from not knowing what is going to come next.  Using a picture schedule of what is going to happen throughout the day or letting the child know a head of time (with several reminders given) will help alleviate some of the anxiety.  Using the language, “First-then” helps reduce anxiety of the unexpected.

Children with autism have social deficits…

Children with autism might have difficulty starting or ending a conversation or they might have trouble with taking turns in a conversation.  Sometimes they engage in one sided conversations where the child with autism is doing all of the talking about a preferred item or topic.  A personalized social story can be created to help teach the child how to interact in social situations.  The social story will be a short story that is about that child’s specific area of need. For example, the story could be about taking turns in conversation and giving the other person a chance to speak.  Your speech therapist can help you design this.

Some children with autism have sensory problems…

Some students with autism are sensitive to clothing items, loud noises, and food items.  Children with autism may rock back and forth, spin, or hit themselves seeking sensory stimulation.  Deep pressure such as squeezing, massaging, or deep hugs helps to relax the child and helps in calming and allowing the child to regroup.

Children with autism often have difficulty with initiating…

A child with autism may have trouble initiating play or requesting basic wants and needs (i.e., “I want __.”).  A child with autism might not notice that another person is in the room and therefore may not say greetings or farewells.

Parent Resources:

Here are resources to find out more information about Autism Spectrum Disorders :

  • –The materials exchange page has great handouts for teachers and parents to work on with students.
  • has great blogs that are supportive, informative, and helpful. There are blogs and many topics from people, family, and friends living with autism spectrum disorders.
  • has great handouts that are informative for parent and teachers, not only of children with autism but with other disabilities.


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Speech Therapy iPAD Apps


Early Childhood (0-3 YO) & Cause/Effect
Tiny Hands
Speech Pups
Peekaboo HD
Pepi Tree Lite
Duck Duck Moose
Pocket Pond
Laser Lights
Ooze App
Falling Stars
Dropophone App
Paint Sparkle
Monster Chorus


Any Age
Articulation Station
Flip Books (The Entire World of)
LinguiSystems: Vocalic R Shuffle


Elementary Age (1st– 5th Grade)
Model Me Kids: “Going Places”
APA: Magination Press: “The Grouchies”
“Breath, Think, Do” Sesame Street
“Emotions, Feelings, & Colors”
Speech with Milo: “Prepositions”
Speech with Milo: “Sequencing”
LinguiSystems “Buddy Bear: Associations”
Sorting 2
iSequences Lite
Learn with Boing: “Language!”
My PlayHome Lite
Super Duper
Sentence Builder
Endless Alphabet
Endless Word Play
Speech with Milo: Board Game Articulation
Webber Photo Articulation Castle
All About Sounds!
Phonics Studio
Toca Boca
Monkey Preschool “When I grow up”
Monkey Preschool “Lunchbox”
Hair Salon 2 Elementary


Adolescent Age
The Social Express
My Life Skills Box “Life & Social Skills Guide”
The Electric Company “Feel Electric”
Conversation Builder


Augmentative & Alternative Communication (AAC) Apps
TouchChat Lite
GoTalk Now Lite
Easy Speak
Lets Talk!
Picture Care Communication


Elementary Age (1st– 5th Grade)
Model Me Kids: “Going Places”
APA: Magination Press: “The Grouchies”
“Breath, Think, Do” Sesame Street
“Emotions, Feelings, & Colors”
Speech with Milo: “Prepositions”
Speech with Milo: “Sequencing”
LinguiSystems “Buddy Bear: Associations”
Sorting 2
iSequences Lite
Learn with Boing: “Language!”
My PlayHome Lite
Super Duper
Sentence Builder
Endless Alphabet
Endless Word Play
Speech with Milo: Board Game Articulation
Webber Photo Articulation Castle
All About Sounds!
Phonics Studio
Toca Boca
Monkey Preschool “When I grow up”
Monkey Preschool “Lunchbox”
Hair Salon 2 Elementary


Adolescent Age
The Social Express
My Life Skills Box “Life & Social Skills Guide”
The Electric Company “Feel Electric”
Conversation Builder


Augmentative & Alternative Communication (AAC) Apps
TouchChat Lite
GoTalk Now Lite
Easy Speak
Lets Talk!
Picture Care Communication


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Adolesent Social Skills Group Therapy

We feel that it is important to create a uniquely designed treatment plan with DSCF0042measurable goals so that we are able to target a child’s individual needs within the context of  social skills group therapy.  We create group placements based on a child’s age and developmental level.  The following skills are some areas that are addressed within the context of social skills group therapy.
Speech and Language Social Skills Goals:
  1.  Client will improve emotional vocabulary to describe feelings from stories and pictures in a more descriptive manner.
  2. Through role play, and sharing thoughts and feelings with others in group, client will openly contribute thoughts and ideas.
  3. Discussing the client’s “peak and pit” (high/low) during the day.
  4. Client will initiate, maintain, and take turns in conversations.
  5. Client will learn how to “Pass the question back” to continue the conversation without talking excessively about one’s own experiences and interests.
  6. Client will learn how to use “bridging statements” (i.e., “By the way”..”That reminds me of”)  to appropriately change subjects.
  7. Client will remember one detail from a previous conversation with a peer and ask a question related to the peer’s experience.
  8. Conversation starters and ice breakers are utilized to help facilitate novel topics.
  9. Client will improve perspective taking, inferencing, theory of mind, and reasoning skills by identifying how his/her behavior directly affects how other people feel.
  10. Client will learn the concept of “Bucket filling/dipping” to improve his cause/effect and perspective taking skills.
  11. Client will learn and utilize the “social fake theory.”  In society, we have a social responsibility to show interest, even if we are not very interested in the topic or activity.
  12. Recognizing and paying attention to nonverbal cues from others to determine what a peer might be thinking and feeling so that we can react to them appropriately.
  13. Identifying what different nonverbal, subtle physical cues mean in order to interpret and use facial expressions accurately.
  14. Understanding how our expected or unexpected behaviors can make other feel comfortable or uncomfortable and drives how people respond to us.
  15. Understanding that others may have a different perspectives, beliefs, opinions, ideas, and emotions, based on their own past experiences. We need to be respectful and sensitive to other’s perspectives.
  16. Understanding the importance of being flexible, calm, cooperative, and considerate.
  17. Client will improve internal local of control, frustration tolerance, impulse control, and emotional regulation which is the understanding that one’s behavior and actions have a direct effect on events and consequences in their life.
  18. Learning the “social filter theory.”  I can think and feel one way, but say something more appropriate to the situation, to prevent uncomfortable feelings.
  19. Good sportsmanship and learning how to react to winning, losing, playing fair, and deciding what to play and in what order.
  20. Rating problems on a 5 point scale and identifying reasonable reactions to small versus big problems.
  21. Identifying more than one solution to a problem and deciding how to prevent the problem from happening.
  22. Through role playing and videotaping, client will learn how to appropriately interrupt others when they are busy (hand on shoulder until acknowledgement is received).
  23. Client will understand the intentions behind their own behaviors and the behavior of others (accidental vs. purposeful behavior).
  24. When purposeful and hurtful comments are made and/or behavior is aggressive in nature, client will learn how to deal with bullies and self-advocate for themselves.
  25. Learning how to interpret and appropriately use idioms, sarcasm, jokes, humor, and puns.  Figurative language can be very confusing to understand and is often taken personally with children who are very literal.
  26. Client will learn how to join into an ongoing conversations and/or play.
  27. Client will learn the difference between formal and informal salutations.  The idea that verbal and nonverbal greetings can be different based on the age and familiarity of the person, and formality of the environment. For example, “Hey, what’s up?” “Hello, how are you?” When to use a handshake, high five, knuckles, or wave.


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Speech Sound Disorders- Articulation Disorders and Phonological Processing

Speech Sound Disorders

Q. What are speech sound disorders?

A. Most children make some mistakes as they learn to say new words. A speech sound IMG_0448disorder occurs when mistakes continue past a certain age. Every sound has a different range of ages when the child should make the sound correctly. Speech sound disorders include problems with articulation (making sounds) and phonological processes (sound patterns).

Q. What are some signs of a speech sound disorder?

A. An articulation disorder involves problems making sounds. Sounds can be substituted, deleted, added or changed. The development of speech sound acquisition varies with each child.  However, the following sounds are typically the earliest developing phonemes children acquire: “p, b, m, n, h, w, t, d, k, and g.”  These sounds should be clearly produced in conversation by 4.5 years of age.  Most children acquire later developing phonemes including: “f, v, r, l, s, and z” between the ages of 5-6.  The latest developing phonemes: “j, ch, sh, th” are typically developed between 6-7 years of age.  The ultimate goal is for your child to be approximately 100% intelligible, to an unfamiliar listener, given the context, by 6 years of age.  The child may have an articulation disorder if these errors continue past the expected age.  It is important for children to clearly articulate most sounds prior to entering Kindergarten, to prevent academic delays in reading, writing, and spelling.

Q. How will a Speech and Language Pathologist assess my child?

A. A speech-language pathologist (SLP) will listen to your child and use a formal articulation test to record sound errors. The SLP will tell you exactly what sounds your child is struggling with, in what position of the word (beginning, middle or ending), and what sound, if any, he is substituting it with.   The therapist will also determine if your child is stimulable for the correct sound.  A child is “stimulable” if he or she can say the sound in direct imitation of the therapist. An oral mechanism examination is also done to determine whether the muscles of the mouth are working properly and to ensure that she has good independent control of her lips, tongue and jaw, as well as good range of motion.  The SLP will also evaluate your child’s language development to determine overall communication functioning.  Whenever there is an articulation delay, it is always recommended to rule out a hearing impairment and/or fluid in the middle ear.

Q. What causes speech sound disorders?

A. Many speech sound disorders occur without a known cause. A child may not learn how to produce sounds correctly or may not learn the rules of speech sounds on his or her own. These children may have a problem with speech development, which does not always mean that they will simply outgrow it by themselves.   Children who experience frequent ear infections when they were young are at risk for speech sound disorders if the ear infections were accompanied by hearing loss.

Q.  What are some signs of a phonological disorder?

A. A phonological processing disorder involves patterns of sound errors that children use to simplify the sounds of speech.  While it is common for young children learning speech to leave one of the sounds out of the word, it is not expected as a child gets older.  Most phonological processing errors typically disappear by 3.0 years of age.  If they persist past 3.0 years of age and negatively affect intelligibility, therapy is typically recommended.  The following are common errors many children present with.

Pre-Vocalic Voicing: “Pig→big”

Word-Final de-voicing: “Pig→pick”

Final Consonant Deletion: “cat→ca”   This is the most common pattern that children present with.  The final consonant in a CVC word typically has less “stress” and therefore, is often difficult to hear in connected speech.  Since these sounds are difficult to hear, they are often deleted.

Fronting: “tite→kite,” “dod→dog.” The “t/k” and “d/g” phonemes are often substituted for each other because they share the same manner of articulation with different tongue placements.

Consonant Harmony: “gog→dog,” Due to consonant assimilation, which is the propensity for one consonant to take on similar characteristics of another consonant in the same word, many children confuse k/g for t/d, especially when they are presented in the same word.

Cluster reduction:  “cool→school”, “back→black”, and “boo→blue.” Blends can be very difficult for children to produce because each consonant is difficult to perceptually discriminate when adjacent to each other.

Syllable reduction: “nana→bannana.”  As words increase in length and complexity, children often omit one or more syllables.

Stopping: /p→f/, /t→s/, /d→th/.  Your child’s airflow is literally “stopped” and substituted with a plosive sound, typically the /t/, /d/, /p/ phonemes.

Gliding:  /w→r/ and /y→l/.   The /r/ sound is the most frequently produced phoneme in the English Language, making it an important phoneme to acquire for improved overall intelligibility.

Q. How can a Speech and Language Pathologist help my child?

A. Sound elicitation is the process we go through to teach the child how to say the targeted sound. For example, if your child cannot say the /th/ sound in imitation, your therapist will break down the process for him.   She might say, “Put your tongue between your teeth then blow.” After the sound is learned, then the sound(s) is practiced in isolation.

Isolation:  Practicing a sound in isolation means saying the sound all by itself without adding a vowel. For example, if you are practicing the /t/ sound you would practice saying /t/, /t/, /t/ multiple times in a row. When the child is 80% accurate producing the sound in isolation over three consecutive sessions, she is ready to move onto syllables.

Syllable Level:  Practicing sounds in syllables simply means adding each long and short vowel before, after, and in the middle of the target sound.

Word Level: At this point, your therapist has decided which position of the word she wants to target and will begin practicing words in the initial, medial or final position of the word. When your child is 80% accurate producing the target sound(s) in all positions at the word level, she will move on to the next step, which is using the word in sentences.

Sentence Level:  A great way to practice sounds in sentences is with a “rotating sentence”.  In a rotating sentence only one target word changes. For example, the sentence might say, “Put __ in pink purse.” Then the child rotates all the target words through the sentence. This is an especially great way to practice sentences for young children who can’t read yet.

Sounds in Stories:  For younger children, we prepare a story for them to practice using the sounds they have been practicing.  We try to include as many picture cues as possible so young children can retell the story without being able to read.

Conversation:  The biggest leap in progression occurs from the sentence to conversational speech level.  This last stage of therapy typically takes the longest amount of time, as the child is required to produce the sound(s) with automatic, habitual, overlearned, effortless productions without using any mental effort.

Q. What are different therapy approaches?

Core vocabulary approach: Focuses on whole-word production and is used for children with inconsistent speech sound production who may be resistant to more traditional therapy approaches. The words selected for practice are those that are used frequently in the child’s functional communication system.

Cycles approach: Targets phonological pattern errors and is designed for highly unintelligible children who have extensive omissions, some substitutions, and a restricted use of consonants.  During each cycle, one or more phonological patterns are targeted rather than specific sounds.

Distinctive feature therapy:  This approach is typically used for children who primarily substitute one sound for another. This approach uses minimal pair contrasts that compare the target sound with the error sound (chip/ship).

Metaphon therapy:  Designed to teach metaphonological awareness, the awareness of the phonological structure of language. For example, for problems with voicing, the concept of “noisy” (voiced) versus “quiet” (voiceless) are taught.

Oral-motor therapy:  Involves the use of oral-motor training prior to teaching sounds or as a supplement to speech sound instruction. The rationale behind this approach is that immature or deficient oral-motor control or strength may be causing poor articulation and that it is necessary to teach control of the articulators before working on correct production of sounds.

Speech perception training:  Recommended procedures include auditory bombardment and identification tasks in which the child identifies correct and incorrect versions of the target through inter-auditory discrimination (e.g., “rat versus wat”).

Q. What are some things I can do at home to help my child?

There are many fun ways for your child to practice sounds outside of therapy!

  • When you are driving, play the “Alliteration Game.” For example, if your child is targeting the phoneme /r/ in therapy, see who can come up with more words that either start or end with the /r/ sound.
  • When you’re in a store with your child, ask your child to find as many products that include their target sound(s). For example, if your child is working on clearly producing /s/ blends, he can find and say: “strawberries, spices, string cheese, snacks, and spaghetti.”
  • When your therapist provides you with pictures of the target sound(s), cut them out and tape the pictures above your child’s bed. Every night, turn out the lights, focus a flashlight on each picture, and model the correct production of the word. You can also play a scavenger hunt game, producing the sound(s) each time a picture is found.
  • Buy a child’s magazine and cut out all the pictures that contain the target sound(s). Make a collage of all the pictures and practice saying the sound.
  • When your child is brushing her teeth, practice the sound in isolation. Ask your child to see what’s happening to their lips, tongue, and jaw when they produce the sound correctly. The mirror provides excellent visual feedback.
  • Instead of saying comments such as: “What did you say?” or “Say that again” try repeating everything that you heard your child say, but omit the word(s) that were unclear. This will reduce your child’s frustration and improve their awareness of which sound(s) are mispronounced.
  • Feed your child’s speech cards to puppets after they have been said.
  • Once your child is aware of the correct production of a target sound, try saying a word incorrectly to see if your child corrects you.
  • When your child is at the “generalization stage” of therapy and expected to say the sound(s) correctly in conversational speech, model a faster rate of speech when practicing their speech homework.
  • If your child is learning to read, highlight the target sound in your books at home. This visual prompt will remind them to produce the sound correctly while reading.

Additional resources:,

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Developmental Verbal Dyspraxia (DVD) Also known as “Apraxia”

Developmental Verbal Dyspraxia (DVD)

 Developmental Verbal Dyspraxia (DVD) also known as “Apraxia” is the difficulty forming sounds into words.  It is a motor planning delay, characterized by difficulty carrying out movements that a person is physically able and willing to do such as vocalizing correctly and consistently.  The child has difficulty carrying out purposeful voluntary movement sequences for speech, in direct imitation, in the absence of weakness or paralysis of the speech muscles.  For example, the child may be able to babble on his/her own volitional accord, but unable to imitate babbling when asked to perform this task.

A child with DVD of speech often has difficulty sequencing the motor movements necessary for speech.  Research shows that there is a disconnection between the pre-frontal cortex (Broca’s area), which is responsible for motor planning and executive functioning and the primary articulators (lips, tongue, jaw). Your child can present with both Orofacial Apraxia and Verbal Apraxia as they are not mutually exclusive.

Orofacial Apraxia: The inability of a person to follow through on commands involving the face, tongue, jaw, and lip motions. These activities include coughing, licking the lips, whistling, and winking. It is the impaired ability to, on command, perform non-speech tasks like puffing out cheeks, clicking the tongue, or licking lips.  The child’s understanding of language is much better than the child’s expression of ideas. The child substitutes gestures and nonverbal communication for oral communication.

Verbal Apraxia: A condition involving difficulty coordinating mouth and speech movements.  A child with developmental apraxia may be unable to say certain words in imitation.  Or, the child may say a word correctly once, but be unable to do it again consistently.  The child usually understands what others say, but has trouble replying.  The child may move the muscles used for speech without making sounds. Typically, the child has more difficulty saying longer words and sentences. The following speech characteristics are typical for a child with Verbal Apraxia (DVD):

  • Extremely limited repertoire of consonant and vowel sounds.
  • Receptive language is typically much higher than expressive language.
  • The child can become easily frustrated because he knows what he wants to say, but has significant difficulty planning, sequencing, coordinating, and executing the sounds correctly for intelligible speech.
  • The child does not correctly use the sounds in some words that are produced in other words.
  • Consonant errors in conversational speech are highly variable.
  • The child typically presents with initial and final consonant deletion, cluster reduction, syllable omissions, and substitutions with no pattern to the errors
  • Progress is inconsistent, variable, and unpredictable.
  • The longer the word, phrase, or sentence, the more speech errors occur. As words increase in length and complexity (but, butter, butterfly), the child’s intelligibility significantly reduces.
  • A child with DVD often demonstrates significant difficulty producing multi-syllabic words such as: “hospital,” “spaghetti,” and “cantaloupe.”
  • While repetition of sounds in isolation may be adequate, connected speech is more unintelligible than one would expect on the basis of single-word articulation test results.

Most Frequently Asked Questions:

Q. How do I know that my child has DVD?

A:  There is not currently a standardized assessment tool to differentially diagnose DVD from a language delay for young children. A licensed speech and language pathologist will conduct multiple play based observations, an oral motor sensory evaluation, detailed language sampling, and a comprehensive parent interview to determine if your child presents with DVD.  For children seven years and older, the SLP can utilize The Jelm’s Analysis of Oral Motor Skills in Imitation and/or The Kauffman Speech Praxis test to validly determine the presence and severity of DVD.

Q:  How long will my child need therapy for?

A:  A child’s prognosis is typically dependent on the following factors: internal motivation, cognition, stimulability, attention, compliance, concomitant or associated disorders, consistency in attendance, and parental involvement.  Progress can often look irregular and variable.  However, with a highly trained therapist utilizing intensive, research based treatment programs such as PROMPT and The Kauffman program, prognosis s is typically good.  Progress is carefully monitored every session and a progress report is written at six months, to determine if the measurable goals are mastered or emerging.  The ultimate goal is to achieve functional, intelligible communication with familiar and unfamiliar adults and peers.

Q:  How much therapy will my child need if they have a diagnosis of DVD?

A: The most efficacious treatment program for a child with dyspraxia is increased frequency with reduced duration per session.  The recommended type, duration, and frequency of therapy for a child with a diagnosis of DVD is typically four times per week for 20-30 minute sessions each.

Q:  Where can I learn more information about DVD?

A.  For more information on DVD, please visit or



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