Episode 56 – All About Early Intervention: Speech and Language Development
As parents, we’ve all heard at some point that each child is unique and will reach milestones at their own pace. Because of this, we might second guess ourselves when we feel that something is going on that warrants further investigation.
Today I am speaking with Jenae Dunlop, a children’s Speech and Language Pathologist from Canada. Jenae is passionate about educating parents on the importance of early intervention, and letting them know that it’s ok to seek help if a delay is suspected.
This week on the All About Audiology podcast:
- 1:41 – As a child, Jenae struggled with speech and language delays. Parent implemented intervention, as well as speech and language therapy from an early age, helped her to overcome these struggles.
- 7:38 – If, as a parent, your concerns are being dismissed by other parents or medical professionals, listen to your instinct and keep investigating. Don’t take no for an answer!
- 12:02 – Children are naturally motivated to communicate. Therefore, if you find that an older sibling is doing most of the talking for your child, it could be because they are struggling to communicate on their own.
- 13:34 – When communicating with your child, try the “Waiting Strategy”. Make a comment, then count to 10 in your head. This gives your child a chance to respond, without feeling overwhelmed.
- 16:40 – Another strategy worth trying is to slowly offer bits of food or toys to your child, and then wait for them to ask or show you that they want more. This is known as “Communication Temptation.”
- 17:59 – Depending on your location and eligibility, it may be possible for your child to receive services at little to no cost. Just remember that even if your child doesn’t qualify for free services, you can still access help.
- 20:18 – Some parents worry that exposure to more than one language at home is to blame for the delays their children are experiencing. Research shows, however, that exposure to 2 or more languages is positive for the developing brain.
- 25:32 – The “Combination Approach” gives children the choice of either signing to communicate, or referring to a picture. This will not have a detrimental effect on a child’s verbal development, in fact, it will help facilitate it.
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Listen Next/Related Episodes
- Episode 19 – All About Speech Therapy
- Episode 41 – All About Deaf Plus and Rare Disorders – with guest Madeline Cheney
Next time on All About Audiology:
Episode 57 – All About Educational Audiology – with guest Dr. Tina Childress
Welcome back to the All About Audiology podcast. I’m your host, Dr. Lilach Saperstein and today we’re going to be talking about the importance of early intervention. And if you ever come across a question, you’re a parent, and you’re saying, ‘Hey, my kid does this, or my kid doesn’t do this yet. Should I be worried?’ You know, parents have those questions about pretty much every topic in the development of their child. And it’s an important thing to listen to that question and that intuition. So today, we’re going to be speaking with a speech language pathologist who really focuses on this exact piece of education to say, when you have a question, should you seek help? Yes.
Let’s hear more from Jenae Dunlop.
Dr. Lilach Saperstein: “Jenae, welcome to the show. I’m so excited to have you.”
Jenae Dunlop: “Thank you. I’m so excited to be here.”
LS: “So, you’re a speech language pathologist in Canada?”
JD: “Mm hmm.”
LS: “And who is your population that you work with?”
JD: “I work with children, ages two to twelve, and their families. I just started a private practice, actually. And I am passionate about teaching parents and educating so that, you know, if they’re wondering about their children’s milestones, getting them services as soon as they might need them, and working with families to individualize those services so that it works for the family, for the parents, teaching them strategies.”
LS: “Awesome. What was your interest? How did you, you know, did you always want to be an SLP? Was this something that happened in grad school?”
JD: “So, I actually have a personal story. When I was really young, I struggled myself with severe speech and language delays, so much so that I could not be understood at all, even by family. And it created a lot of frustration to say the least. I had full out temper tantrums, didn’t matter if we were at home or in public. One day, you know, we were at Zollars, a department store and I’m screaming out, ‘I want pintins, I want pintins.’ And my mom’s like, ‘I have no idea what you’re talking about’. And my brother translated, ‘Mom, she wants the pink shoes.’
And luckily, I didn’t always have that much trouble communicating because it was very frustrating for everybody. I was so fortunate that my mom and dad put me in speech therapy at the young age of two and a half years old. And my mom was also very, very instrumental in helping me at home, which was amazing. So, I’m also a strong believer in parent implemented intervention. So, I think I just I feel like I have this unique empathy and compassion for the children and the families I work with, because I have that personal experience of how frustrating it is not to communicate.”
LS: “Yeah. So, you remember being two and a half years old?”
JD: “I actually don’t. This story is filled in with bits and pieces by, you know, what my parents have told me. And I remember little pieces of it for sure. I don’t remember all of it. It’s actually interesting how language does impact memory. So, there are a lot of gaps I feel like where I don’t remember things that maybe other people would remember.”
LS: “Well, memory in itself is a whole complicated can of worms of what we remember, what gets stored, how memories can be false memories. Anyway, that’s so interesting that you had the experience of being in speech therapy, and that you had a good experience that you remember it fondly, and like it helped you. So, how long were you in speech therapy for? Do you remember?”
JD: “Well, I remember in kindergarten, actually, I started not wanting it anymore, because I felt very self conscious that I was being pulled out. At that time, it wasn’t going into the classroom. It was like the speech therapist would knock on the door and say, I’m here to grab so and so. And so, I started getting really kind of feeling self conscious about that and telling my mom, I don’t want to go to speech. I don’t want to. But what was cool is that I actually started speech and drama lessons because my brother was taking them. And so, that gave me another avenue actually to work on speech and kind of build on what I had already been doing with the SLP.”
LS: “Hmm, that’s very interesting. Because we talk a lot about, you know, children who have hearing loss and incorporating dance class or rhythm and learning an instrument, like different modalities of getting to that without it being officially auditory verbal therapy or auditory rehabilitation. So, that’s great. You were doing like drama and speech and it’s informal. Everyone’s doing the same thing. You’re not being pulled out. That’s great.”
JD: “Exactly. Yeah.”
LS: “So, tell me more about what happened when you were in school age, when you were in high school, like did you just finish with it basically, or what?”
JD: “Well, I do believe, it was the case for me too, where early intervention does set you up for success later on. So, I did actually have struggles with reading comprehension in school, which interestingly, it is linked often, statistically, it is linked to kids who have those speech delays. So, I did find that, but I had a lot of support at school. And I did, you know, I think with that, like family support, too, I ended up graduating ultimately with a master’s degree. So, it’s one of those kind of rags to riches story, I guess. It is kind of cool because I think it can give people hope that no matter how much your child is struggling when they’re little, if they do have that early intervention and they have continued support, even if it’s literacy as they go throughout school, that they really can achieve success still. So, I try to impart that hope to the people that I work with that, you know, it doesn’t matter how bad things can get. It can be a big grieving process for parents really, when their kids are young and wondering, what is going to happen?”
LS: “Yeah, everybody wants the crystal ball to just know that everything will work out for their kid. But that’s not how life works. But you can kind of do a lot of things when they’re young, and get them the help that they need to help set them up, like you said. That’s so nice. I think it’s kind of this double edged sword that, on one part, we’re saying, ‘Hey, zero to three (years old) is super critical, we must get in during that time.’ But also, there is room for intervention and catch up and support. Otherwise, we wouldn’t have all of the things that we do, all the services from audiology, to speech and all the other therapeutic interventions.
So, I wonder if you can share a little bit about some of those common, the most common questions, common myths that parents of young children have. And I’d say even more so, during the year 2020, which is like, interrupted schooling and interrupted services so that there isn’t like, you know, the teacher who says, ‘Hey, I noticed something during class’, or anything that’s consistent. It’s like, you’re home, but you’re not, but you’re in, but you’re out. I feel like there’s a lot. You’re not going to go to every appointment, unless it’s crucial. So, there’s just less eyes on your kids these days. I think it’s an important element of this lovely year.”
JD: “Absolutely. Yeah, I think there are a lot of concerns that parents have that sometimes, unfortunately, I find, in my experience with parents, I hear, oh, so and so, another friend of mine said, ‘Oh, don’t worry,’ or, you know, even a professional is saying, ‘Oh, don’t worry, your child will catch up or it’s not a big deal’. But when I do an evaluation, I actually find, maybe there actually is something here we could be working with. So, I think a big piece in this is for parents, if they look into it or if they have a concern, not to just say, ‘Oh, you know, it’s okay, they’ll catch up.’ But to actually look further into it in case there is something more going on.
And I think an example of this that I have just goes to show the power of the parent being the advocate. I had a parent recently who got in touch with me and she, her daughter, had been in speech since she was really little. She was working on her “S” for years and years. And she still to this day is lisping, and she’s been discharged two different times from speech. And it’s like, ‘Why is she still lisping? I don’t understand what’s going on.’ Well, after evaluating her, I realized that she had a myofunctional disorder. So, that has to do with the muscles of her tongue and her jaw, like there is something more going on than just an articulation disorder until I was able to appropriately refer and say, ‘All the articulation therapy in the world isn’t going to help your daughter. The reason she still has this speech pattern is because there’s something else going on.’
So, it was just so eye opening for me that this parent, she didn’t take no for an answer. She had another SLP discharge her daughter saying, ‘oh, you’re good to go.’ And this parent is saying ‘no, I feel something more is going on. So, I’m going to follow up with this’ and now they are getting what they need. So, I would say, yeah, it is a unique time, our kids are at home or at school or a bit of both or whatever they are. But I think to keep investigating when you do have a gut feeling as a parent is a really important thing.”
LS: “Yeah, with this expression “Wait and see”, you need to put a time limit on that waiting, say like, okay, let’s see how this goes for three months, but not for the next two years. If you’re gonna do “wait and see” then you need to, I don’t know, put a reminder in your calendar that’s going to alarm you and say, Hey, remember, we were worried about that? Has anything changed?”
JD: “Yes, exactly. And to trust yourself as a parent, like, no, you’re not the professional, but you as a parent have a really strong sense. You’ve had other children, and you’ve seen other children, and you have life experience. So, to trust that gut feeling.”
LS: “I know, that’s the funny thing. It’s like, we don’t want to compare children as an emotional thing. You know, everyone is different and unique. Everyone’s on their own path. And we do have normal bell curve of like, some kids are a little quicker, some kids take their time. But then you have those extremes at the ends of the bell curve that might need that bit of support. And also, like you mentioned that sometimes it’s not a delay of like, they’ll get there when they get there. But it’s actually a disorder or something that needs intervention. And knowing the difference is kind of why we all went to many years of school.
And parents, I think you and I really respect the gut, and intuition, you know your kid more than anyone else knows your kid.”
LS: “You spend the most time with them. And you also, you know, generally have a lot in common with them. So, you can kind of pick up on the things that other people might not realize. But other times, it does kind of come from someone outside. Because also, the flip side of that is that you know them so well, you might not notice things that someone from the outside might notice.”
LS: “We work together. That’s the cool thing.”
JD: “Yes. I think that’s the beauty of you know, even during these unique times in our world, there’s other professionals, or there’s teachers or assistance or what have you. And so, to take into account that whole kind of collaborative approach is still really important, as much as possible.”
LS: “Yeah. So important! So, what are the other, specifically for speech, what are some of the other common concerns?”
JD: “Yeah, I would say one of the really common ones that I hear parents say is, ‘Oh, my little two year old, they’re not really talking very much yet. But you know, that’s just because their older siblings do all the talking for them. So, that’s why they’re not talking.’ And my response to that is, ‘Well, why are they doing all the talking for them? There could be something more going on that it’s not just that simple.’ Kids by nature are really, really motivated to communicate, I mean, communication is such a foundational skill if you think about getting what you want, and what you need in a day. And so, if a child is not really doing much of that, there could be something more. And so I just encourage parents not to just put it to, ‘oh, the older sibling is just taking over.’ I mean, even in my own personal experience, my brother did do a lot of translating for me, but that is because I did actually have a speech sound disorder. And so, he was helping me but it’s because I really couldn’t communicate.”
LS: “Yeah. And then that ties in to the parent coaching of how to help the parent. For example, I just saw this post about how every single time that you turn on or off the light, say, “on and off”, and if the light is off, don’t do anything. Just wait. They have to ask you (to turn the light on), you know, or to make those situations where you’re going to try to get them to say what they want or you know, hold that candy until they say candy.”
JD: “Absolutely, yes.”
LS: “But you know, there’s definitely still a balance there. Because you don’t want to get it to the frustration.”
JD: “That’s one of the big things I’m passionate about working on, are those strategies like the waiting strategy, you know. You make a comment, and you wait, even if you have to count to 10 in your head, because it’s so hard to wait sometimes. But it’s amazing the power of waiting for your child to say something or even gesture something rather than just jumping in with another question. As parents and as teachers, we can sometimes ask so many questions, in even just a minute, and it just overwhelms the child. So, kind of slowing down and waiting, commenting and waiting. And like you say modeling those words of just very simple language on, off. And then waiting is really powerful.”
LS: “Yeah. I also know that so much of the modeling, it’s really kind of a mindset shift from asking children questions that they need to answer instead of just like constantly being a fountain of speech just narrating. From an auditory perspective, we want so much auditory input to go in, especially children with hearing loss, we want them to be getting as much as input, statistical information, you know, 30 million words, let’s go.
So, you know, the old story about the difference between two different parents in the grocery store. One parent has the kid in the stroller and they’re just like doing their shopping. So, the kid is looking around and getting all the input, maybe they are getting it visually and different things, but there isn’t a lot of interaction. And another parent might be like, here’s the milk. Let’s get the milk. Milk comes from a cow. Let’s put the milk in our cart. And already that was another 25 words, just (talking about) every item. I mean, maybe your milk comes from almonds, but you see my point. And that’s a whole other conversation. So, just doing a lot of talking.
But sometimes, that’s against the parents’ nature. So, what would you say to someone who’s like, I don’t want to do that. That’s not how I talk?”
JD: “I mean, yeah, with some parents, the reality is, life is busy. And yeah, it’s not their nature. So, I would just say, can we make this goal more achievable by even thinking of one specific time during the day that it feels a little bit more doable? So, like maybe in the grocery store, it’s kind of chaotic, especially during COVID. Grocery shopping is not so fun. What if we could choose maybe a bedtime routine, where you know, when we’re brushing teeth, or reading a storybook together? Could that be a time that we do it? So, I would just try and really meet them where they’re at to really make that feel more doable for them.
And also, there are different strategies too that might be more conducive to certain parents styles of communication. So, I think the strategy of, you kind of mentioned this before, but we call it a communication temptation, where you’re kind of offering something very motivating, like a toy or a food that the child loves. You’re offering it bit by bit, and you’re waiting for that child to show or to ask that they want more. Maybe that’s something that the parent feels more comfortable with, because they do still interact with their child. I mean, on a day to day basis, they will be giving their child food or toys or what have you. So, that involves less talking, per se, but it’s still a very effective strategy.”
LS: “Awesome. And I think there’s so much value in getting help, getting guidance, getting support from someone who has that training, or has that experience. And I think it’s hard for parents, because it’s almost like you can talk to anyone or, or you can read blogs from every SLP in the world with different approaches and different strategies. And it’s like, Well, which one is right for me? There’s a lot of power in that.
And also, the other thing I wanted to mention was that sometimes whatever country you live in might have a system where children are eligible for services that are either very low cost or free, depending on if they qualify. And it’s really important to know that just because someone doesn’t qualify, as in it’s not bad enough to get the services from your government, doesn’t mean they can’t still get help.”
JD: “Absolutely. I think that’s something I love about going private now is that it doesn’t matter. I don’t have to worry about what does this child technically qualify for? If the parent wants support, I want to give them that support and make that as accessible as possible.”
LS: “Right. Although, then you come into the question of access, because it’s private. But I still, you know, would recommend that people even look into it, because even just doing the assessment outside of, “Is the motivation for the assessment is that will we give you free services or not?” But if you get an assessment from someone who’s outside that system, well, some could argue that then the motivation might be, “Do I want you as my client or not?” But you know, hopefully, there’s ethics involved all around, what should I say?”
JD: “I’m actually offering free assessments through September. And the purpose for that is I want to give, this is back to school time, and I want to give parents that opportunity to see where their child is at. Maybe they’ll be totally within average range, and they’ll be just really reassured, or maybe their child will come up with a delay. And they do not have to come to me for therapy just because I did that assessment. So, I want to kind of just give them that. The power is in the information and say, this is where your child came out and you can decide what you’re going to do with that.”
LS: “Wow, that’s amazing. Unfortunately, I don’t know if this is gonna go live before December.”
JD: “Hilarious.” Haha.
LS: “That’s very kind. I think, if anything, people should take with that to say, like, reach out to the local speech therapist wherever you are, and say this is what’s going on. They’ll answer your email. They’ll answer your call. People in this profession are generally helpers and service givers. So, take that to know that there’s really awesome people doing great things.
Were there any others? Did you have any other myths (that people misunderstand about speech pathology)?”
JD: “I think this is a good opportunity to me just because it does come up quite often regardless of where you live, is bilingualism. So, children who are exposed to more than one language in the home, whether that be right from birth, or you know, sequentially, one language after the other. Either way, you get a lot of parents saying, ‘Oh, is my child delayed because they are bilingual? Or is bilingualism causing the delay, should we say?’ To that, absolutely not! Research shows over and over again, these things are not linked. And in fact, exposure to two or more languages is really, really positive for the developing brain. That being said, there are sometimes children who have diagnosed language delays who are exposed to more than one language. However, they would have had a language delay regardless of being exposed to those two languages.
So, the other question parents ask is, ‘Okay, we do speak two languages in the home, they do have a language delay, should we only be speaking English to them instead of the other language?’ And to that, I say, “No!” I say, keep exposing them to both languages, and they will in time, with the right intervention, they probably will catch up. Having that input of both languages, even from a cultural perspective, is really, really important. We don’t want to deprive them of that other language. So, I feel very strongly about talking about that piece, because it comes up quite often and is a misconception.”
LS: “Yeah. With language, more is more.”
LS: “What about the one parent, one language idea?”
JD: “Yes. So, that’s another kind of belief. Is it going to be simpler for the child if say one parent speaks, well I’m in Canada, so let’s use the example. One parent will always speak French and one parent will always speak English? That again, that’s kind of a myth that that will help your child per se, learn those languages, you don’t need to be consistent between one parent only speaking one language. Language development is, well research shows it is more fluid. So, you know, both parents switching back and forth between both languages should not be a problem.
And in fact, research also shows how it can be really helpful for a child, particularly a child with a language delay, if a parent speaks very simply, kind of like what we were saying before with the on/off, when you model language in a simple way. So, if a parent for example, models on/off in English, very simply with few words, and then they immediately translate and model that same on/off in French, and they strategically are modeling both of those things kind of back to back, that is actually a strategy to use with bilingual parents to help those children start to learn. This is on in this language, and this is on in that language, and it will actually help that child.”
LS: “On Instagram, one of my favorite, super awesome people and accounts is Claudia, who is a bilingual SLP. And her account is Laleo, so it’s like a lot of Spanish and English and just bilingualism. I get a lot of information and ideas from her account. She talks about how sometimes you do an assessment on a child who speaks and is exposed to two languages and you might actually under estimate their language competency. Because the tester only knows the one language but maybe they’re making these different sounds that actually are words or can be counted as words, but the tester doesn’t know that language. So, it’s also a good idea to find a bilingual SLP if you can for the languages that you’re exposed to.
And the second thing on this topic is, we talk about this a lot is, the bilingual bimodal, bicultural, deaf children who are also exposed to auditory input in whatever spoken language is there in their country or in their home. And also sign language. This is not an either/or proposition. There really can be an exposure to both signed and spoken languages in the same way that you could have exposure to two spoken languages that would not be to the detriment of the development of either of those languages. In fact, it would probably be better.
And we talked about this, I’m just linking people to other episodes because I know sometimes, you can’t listen to everything. But maybe it’s of interest to you if you care about this topic. Madeline Cheney, who was on the podcast a while back, shared about her son, Kimball. And how, by introducing the sign, something clicked for him. He was like, oh, if I make this sign, then that means something. And then actually, from there, he actually started to speak. So, then they had this combination approach. And yeah, you could hear more about her story during her episode. She made this so helpful to know, and to just hit some of these big misconceptions with speech, where maybe some people just think, oh, speech therapists only work with stutters and that’s the whole thing. And that is not the case.”
JD: “Yes, yes. I’m so glad you bring up that combination perspective. I’m actually currently working with a little two year old and his verbal language is very limited right now. And so, we are actually using pictures as one of our modalities, which has been very powerful for him. So if, for example, even the picture of more, we can also use the sign more, which is very exciting. So, that actually gives him the choice. He can choose, depending on the situation, is he going to refer to a picture? Is he going to sign that word, but it is just so empowering for him when he can’t yet say that word “more”. I’m definitely a strong believer. I see the positive effects in combining those. And that’s kind of another myth that parents will sometimes bring up or a misconception where, oh, if we introduce sign or we introduced pictures, is that going to stunt my child’s verbal development? That is absolutely not the case! In fact, it facilitates the verbal development.”
LS: “Amazing. Yeah, definitely. So true! That’s what happens when we have these podcasts. It’s kind of like, yep, I agree. I agree. Excellent. And then an echo chamber of people who agree with each other. Yeah, these are really important topics to me. And I’m really glad that you came on the show to share them with us. Jenae, if people want to find you or follow you, where can they do that?”
JD: “Yes. So my website is www.communicationstation.ca. And I’m also on Instagram, @communication_station_speech. My Facebook is kind of long, but maybe just link it in the show notes because the link is long. So, thank you so much.”
LS: “We will do that. Thank you, Jenae. I really appreciate you coming on the show and sharing your expertise and busting some of those myths about speech language pathology.”
Another episode of interest for our listeners would be the All About Speech Therapy episode from way back in season one with Mary Louise Nichols. And on that show, we talked a lot about medical SLPs and how speech language pathology is actually much wider of a field. So, for any communication disorder students or anyone interested in speech, that’s a great episode. Go check it out.