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The controversy surrounding the field of speech pathology

These include stuttering therapy methods to "educate the emotions" and methods involving visual and auditory imagery. Other methods, such as those involving exercises and drills, are still in common use. Today, the oral-motor therapies designed to exercise the speech musculature e.

That is, they have been criticized because they are not passing the historically new standards arising from evidence-based research e. Rather than making therapy choices based on research, these early school therapists were creating and choosing their approaches using their clinical logic and intuition.

Language, Speech, and Hearing Services in Schools, 41 2152-160. The application of evidence-based practice to oral motor treatment. Language, Speech, and Hearing Services in Schools, 39 3408-421. The correction of defective consonant sounds. The controversy surrounding the field of speech pathology exercises for speech clarity. Better speech and better reading. Oral Motor Therapies Best practice Principled, ethical therapy is about theoretically-defensible, evidence-based practice and the best possible outcome for each client.

That means there has to be as solid a scientific basis as possible, based on well-grounded theory and good quality research, for any approach, technique or "tool" to be used in therapy. Mouth exercises Exercises for the mouth, or what some Speech Language Pathologists Speech and Language Therapists call "oral motor exercises", "oral motor therapy", "oral placement therapy" or "oro-motor work", are, in some clinical settings, a prominent component of intervention for children with speech sound disorders.

The activities may include sucking thickened drinks through straws; blowing cotton balls, horns, whistles and windmills; chewing and mouthing plastic and rubber objects; licking peanut butter and other foods from around the mouth; and playing with "oral motor tools and toys".

It sound like these mouth exercises might be fun. Nothing wrong with that! Therapy should be fun! What is the evidence? So the thinking person, clinician or parent, has to wonder: Are oral motor exercises, implemented systematically, necessary or helpful in the treatment of speech disorders?

Is there scientific evidence to support the testimonials and claims of success with the oral motor therapies that appear in non peer reviewed literature and wherever the controversy surrounding the field of speech pathology associated publications, and tools and toys, are marketed and sold?

Is there a solid theoretical foundation for their use? And indeed what does the research literature say? The games and toys themselves have not been scientifically "evaluated", but the procedures that they are used for very often have. For instance, the empirically tested Minimal Pair Therapies are usually presented in the form of card games and activities with toys and musical instruments.

Terminological debate over language impairment in children: forward movement and sticking points

Therapy, play and fun Like the Minimal Pair Therapies other therapy aproaches and their procedures are presented to children in the form of play; for example games are incorporated into Cycles Therapy the Patterns Approach. This can sometimes involve highly structured play with rules. Board games, card games, puzzles, hide and seek and "I spy" type games, following the conventional rules, may cleverly incorporate a therapy goal or target.

For example, child, parent and therapist may play a board game with pictures of "therapy words" e.

  • Of course, we need to be sensitive to the fact that for many people labels have connotations that go far beyond a simple definition;
  • General goals for this group of children include stimulating more mature vocalization types and connecting these vocalizations to meanings that can be used to communicate consistently with persons in their environment;
  • Worldwide, research using molecular genetics and imaging techniques has only recently begun;
  • Wright 2014 , writing from a legal perspective, notes how confusion in terminology leads to many children being denied services by local authorities, with endless tribunal hearings arguing about whether a child does or does not have a particular type of disorder;
  • Given these diverse needs, it may be wise to consider whether a single term framed within a single system can in fact meet all these needs;
  • As in other areas of medicine, a treatment regimen documented to be both necessary and sufficient to normalize a disorder provides some measure of support for the validity of a diagnostic category-particularly to the degree that the treatment differs significantly from treatments used with one or more other disorders that closely resemble the target disorder.

By contrast, play can also sometimes appear to have little structure and few rules. Pretend tea parties, construction toy games, car races, and "free play" might be used as opportunities for adults to model target sounds, words or language structures e.

Let's take it as a "given" that practising non-speech movements sucking, blowing, chewing, biting, tongue waggles, etc will not impact on speech. But, sometimes, with very young or reluctant children who are cautious about participating verbally, the therapist will encourage "oral play", "experimenting with the articulators" and "exploratory sound play".

This is done as a sort of lead in to working on speech. What is more, it is often the only way "in" with reticent or apprehensive little children. This oral play is presented as a fun thing. The child is encouraged to watch, imitate, and gradually become a little braver and more co-operative.

Vocalisations are quickly added, and these vocalisations are turned into meaningful vocabulary as soon as possible, and at syllable level if possible, - even if the vocabulary is only "hi", "me", "no", "ta", "bye" and "boo! A passing phase As soon as the child is willing or able to talk in sessions, the oral play, having served its purpose, is reduced to almost nil if the controversy surrounding the field of speech pathology is still fun or phased out altogether.

Brief, low-key, fun, oral play as a communicative temptation, applied early in therapy is not the same as the systematic implementation of unnecessary, time-consuming and hierarchical non-speech oral motor therapies.

This sounds so obvious, but in order to improve speech you have to work with the child's speech. This means helping the child to hear and say sounds, syllables, words, and longer utterances. There are many evidence-based therapies for children's speech sound disorders that speech-language pathologists are uniquely qualified to administer.

But surely children with cleft palate benefit from OMEs! No, actually they do not. The overwhelming majority of children with cleft palate do not have muscle weakness or muscle tone problems, and even if they did, NS-OMT divorced from speech production activities would not be indicated Ruscello, 2004. Moreover, efficacy studies of intervention designed to improve velopharyngeal function for speech through nonspeech oral motor treatment have largely been unsuccessful Ruscello, 2004; Tomes, Kuehn and Peterson-Falzone, 2004.

The clinician and caregiver should avoid NS-OMT activities and treat compensatory speech errors by using task-specific speech therapy. Treating compensatory errors in the cleft palate population: Bowen, Children's speech sound disorders.

Do children Down syndrome need OMEs? No, it is the same story for all children with speech sound disorders. Oral Motor Exercises are unnecessary, innefective and time-wasting for any child with speech difficulties. Interestingly, "Mark has a knack for product development and package design.

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