Auditory Language Processing in Children with Sensory Processing

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Kelli Murdock Eickelberg, MA-CCC
Speech-Language Pathologist
==================================
7701 SW Cirrus Dr, Suite 32-D
Beaverton, Oregon 97008
(503)520-5030 (503)520.5090FAX
KelliEickelbergSLP@hotmail.com
www.KelliEickelbergSLP.com
Improving Language Processing
for Children with Sensory
Processing Disorders
Development of Language Processing
Birth to 6 Months
• Response to voice and sound
• Often quieted by familiar friendly voice
• Attends readily to speaking voice
• Responds to own voice
• Responds to angry vocal tones by crying or becoming
agitated
• Responds to pleasant tones by cooing and calming or
smiling and laughing
• Responds to noise and voice by turning toward the
source of the sound
Development of Language Processing
6 to 12 months
• Listens with increased intentness to new words
• Responds to a specific person by showing affect
on face and with body language (8 months)
• Understands “no” and own name
• Responds to “bye bye” (9 months)
• Nods head “yes” or shakes head “no” to some
questions (10 months)
• Follows simple instructions (11 or 12 months)
Four Key
Non-Verbal Elements
to Listening
1. ATTENTION SHIFTING
• STOP
• LOOK
• LISTEN
• STOP (sign + get your voice and
body calm)
• LOOK (get down to your child’s
level + sign)
• LISTEN (sign)
• THINK (sign/gesture)
Language Used with the Child
• “STOP, quiet body”
• “LOOK at me with your eyes”
• “LISTEN, with your ears”
• “THINK, with your brain”
2. SOUND ASSOCIATION
and LOCALIZATION
Sound Association and Localization
• Identifying what makes a sound and from
where the sound comes.
GAMES TO PLAY:
• “What do you hear?”: while taking a
walk outside or in your own home (i.e.,
footsteps, dishwasher, car engine, fire
engine, bird, echo, bathwater running,
toilet flushing, doorbell, etc.)
• Exploring sound makers (i.e., horns,
whistles, musical instruments, pots and
pans, etc.)
• Have a sibling or another parent go into
another room with items that make sound
and see if your child can listen for the
sound and find the person and the sound
maker.
• When listening to music in the car, see if
your child can pick out the different
instruments that they hear.
• Matching an object to a sound made (i.e.,
shake some keys under the table, then place 23 items, including the keys, on the table and see
if your child can pick the object that made the
sound they heard).
• Tap out a beat on a box, drum or ball (start
with 2-3 taps and increase as your child is able)
and see if the child can imitate the beat. For
example; tap…tap.tap or tap.tap…tap
• Exploring high and low notes on a recorder,
slide whistle, piano, etc.
• PBS Daniel Tigers Neighborhood: Trolley and
Bathroom games
www.pbskids.org/daniel/games
• Maisy’s Playhouse: Train Game
and Exploring each room
(order on www.amazon.com)
• Earobics, Step 1: Clown Game
(order on www.amazon.com)
• Thinking Things Collection 1: Several
games promote listening. www.edmark.com
• “Hear the World” game
• “Listening Lotto” game
3. Thinking with Your Eyes
• The importance of looking at what you
are thinking about.
• Your eyes tell you what your ears don’t
hear.
GAMES TO PLAY:
• Place 2 large items on a bare table and tell the child to
guess which toy you are thinking about by watching
your eyes. Take turns with looking and guessing. Once
successful with this, expand to 3 items spaced apart and
smaller items. When this is successful you can begin
having the child look at items or people within a room.
• Using big blocks, instruct the child that you are going to
tell them how to build a tower without using any words.
They will need to use their eyes to read your face and
body language. Then use thumbs up/down, head
nods/shakes, and facial expressions to let them know if
they have chosen the right block, placed it in the right
place, or placed it the correct way.
4. Listening With Your Whole Body
We listen with our entire body…
• Our eyes are for looking
• Our ears are for listening
• Our mouth stays quiet when listening
• Our body stays quiet when listening
• Our hands and feet stay quiet when listening
• Our brain thinks about what it sees, hears, knows, guesses
• (Adapted from Michelle Garcia Winner’s “Thinking About You Thinking
About Me”)
Key Linguistic (Verbal) Elements to
Listening at Home and in the
Classroom
• Get down to your child’s level both physically
and with the level of the language that you
use.
• Encouraging your child to “stop, look, listen,
and think” about what is being said.
• Give directions slowly so that the child has
adequate processing time.
• Present information in as many modalities as
possible (i.e., visual, auditory, tactile, gestural)
• Don’t be wordy. Be succinct and to the point.
Think through your directions before you begin
speaking.
• Build vocabulary. The larger a child’s
vocabulary the less effort he/she has to exert
when trying to comprehend what is being said.
Teach vocabulary via context (as it happens)
and stories. Talk about objects, people,
emotions and activities happening around
your child or in a book. Talk about what you
are doing and what your child is doing. Use
language that is rich and varied.
When teaching early Vocabulary, focus on:
• Objects/Nouns: people, places and things that the
child encounters often.
• Descriptors/Adjectives: colors, sizes, shapes,
temperature, speed, quantity, age, condition, etc.
• Possession: “mine, yours, Mom’s, Dad’s,” etc.
• Actions/Verbs: focus on actions that happen
everyday in the child’s life.
• Locations/Prepositions: “in, out, on, under, in
front, in back/behind, beside/next to, above,
below, on top, on bottom
• Notice: “I see____, I hear____, I smell____, It
feels____.”
• Teach synonyms, antonyms, multiple
meanings (i.e., “park” the noun and “park” the
verb) and figurative language/idioms (i.e., It’s
raining cats and dogs really means it’s raining
hard) and jokes/riddles for cognitive flexibility
as well as to activate the frontal lobe for better
learning.
• Recap longer directions by highlighting the key
components (1-2-3, First-Then-Last, Mark steps
on your fingers).
• Let the child know that you want him/her to
try first, but can ask for clarification or a
repeat if he/she is not successful (this teaches
the child to be an active listener and not
always rely on repetition).
• Visualization: help the child learn how to
visualize him/herself performing the
activity/task by first drawing cartoons of the
steps involved in the task/activity. The drawing
can be done by the adult at first in order to
give the child the idea, then transfer the act of
drawing to them for greater memory.
First get your coat then your shoes
and last meet me at the back door.
Games that help with Following Directions.
• Animal Scramble
• Green Eggs and Ham Speedy Diner
• Cranium Hullabaloo
• Cat In the Hat, I Can Do That
• Hyper Dash
Computer games that help with Following
Directions.
• PBS Between the Lions: Messy Attic (Games)
www.pbskids.org/lions
• Thinking Things Collection 1:
Fribbles
www.edmark.com
• Hearbuilder: Following Directions
www.superduperinc.com
• In the classroom, the child should be
positioned where he/she can see the teacher
the most and also beside a student that can
model the correct tasks.
• Teach the child to “watch what is happening
around him/her” in order to know what he/she
needs to do. We use our ability to look around
and listen to our environment to know what
behavior is expected of us.
• Talk with teachers about writing key words,
quick drawings, or picture symbols for
directions on the board or on a paper near or
on the child’s desk as a memory jogger.
Specific
General
_X_ Book out
___ Math page 10
___ Page 10
___ Science page 15
___ # 1,3,5,7,9
___ Reading page 23
___ Turn in page
___ Talk with teacher
EXECUTIVE FUNCTIONING
Described as the “Conductor” that helps us to
orchestrate what we think, feel and do with all
that goes on around us.
1. SELF REGULATION
• Being able to self-regulate helps you to be
prepared for learning. Sensory Integration
therapy is important in helping the child learn
how to sense and respond to the needs of his/her
own body.
• Self-regulation is also being able to understand
other’s body signals (nonverbal communication),
mediate emotions (his/her own and others) and
sustain attention.
“The Incredible 5-Point Scale”
By: Kari Dunn Buron and Mitzi Curtis
• Self-regulation can be enhanced by beginning
a learning session or new experience with a
joke or riddle. This activates the frontal lobe
which is the “rationale brain”.
(www.ducksters.com/jokesforkids).
• If the child is not regulated then the subcortex
or the “reactive brain” is in gear and learning
is much more difficult.
• SLEEP!!!: A tired brain is a perseverative brain
(gets stuck) and that is not conducive to
learning.
2. Awareness and Forethought
• This brings us back to “stop, look, listen and
think”
• “You Are a Social Detective” by Michelle
Garcia Winner and Pamela Crooke is a great
place to begin teaching kids about reading
their environment for clues.
www.socialthinking.com
• STOP and read the room/situation! Look around,
what is happening?
S= Space, Where am I? What does that mean?
T= Time (of day), Is it a routine time or non-routine
time?
O= Objects, What supplies do I need?
P= People, Read the people: faces, bodies, mood,
what they are saying.
(Created by Sarah Ward, MS,CCC-SLP)
• THINK-DECIDE-ACT: teach the child to think
about what is happening around him, decide
what he/she needs to do based on what he/she
has observed, then get the supplies that you need
and get going.
• You can also teach forethought via use of
literature. When reading stories, stop
periodically and ask the child what he/she
thinks might happen next. Help the child to
use what he/she has already learned from the
story along with past experiences/stories that
he/she has had/read to make a “smart guess.”
• You can also teach forethought with pictures:
Before:?
Now:
Next: ?
3. Organization, Prioritizing, and
Beginning an Activity
• Help the child learn how to keep his/her room
clean and helping them to organize play/work
spaces. Give items a consistent place to go.
• Daily routines where possible! Routines early
in childhood help kids pay attention to: space,
time, objects and people. These observations
then transfer to school routines by helping kids
stop and read the room. Familiar routines help
kids predict what new routines will look like
and how to problem-solve new sequences.
• Visual schedules with frequent reviews help
children to anticipate what will be happening next.
Schedules help to reduce anxiety which triggers the
“reactive brain” and impedes learning.
1.Car
2. Store
3. Brother
4. Home
• Teach the language to sequencing (First, next, last,
etc.)
• To-Do lists that can be marked-off are helpful
for organization and planning. Lists for chores,
parts of an activity/task, or directions to a
longer-term project can help the child to stay
focused and organized.
Making a Jack-O-Lantern
1. Write name on back of pumpkin
2. Glue eyes
3. Glue nose
4. Glue mouth
5. Glue stem
• Story Grammar Marker: (a.k.a. Braidy) a
visual/tactile tool to help kids remember the
parts to a story. Designed to help with
organization of story retell and writing.
www.mindwingconcepts.com
• Break familiar and novel activities into “Get
Ready, Do, Done” with estimates of the
amount of time that each step will take. This
helps the child learn how to break down tasks
into more “doable” parts and teaches them
about time management (provided by: Sarah
Ward, MS,CCC-SLP).
7:15 to 7:16
7:16 to 7:21
Brushing Teeth
Approx. 7:20
7:21 to 7:24
1. Get toothbrush out.
2. Get toothpaste out
1. Put the toothpaste on the
toothbrush.
2. Put the toothbrush in my mouth.
3. Clean my teeth.
4. Put water in a cup and take a small
sip.
5.Swish the water in my mouth.
6. Spit out the water and toothpaste.
1.Rinse my mouth.
2. Put toothbrush away.
3. Put cap on toothpaste
4. Put toothpaste away.
5. Throw cup away.
• Break long assignments/projects into parts
and provide a timeline for when each part
should be done. Reassure the child that they
may need more or less time for some parts
than originally planned and that they may
have to make adjustments.
Provided by: Sarah Ward, MS,CCC-SLP
• Visual Mediators: helpful for teaching the
child how to visualize items needed or
steps to an activity. For example: photos
of the child’s backpack with all the items
needed most days organized into
“feature” groups or photos of the child
performing a daily routine that helps
them visualize themselves performing
each step.
4. WORKING MEMORY
• “…a brain system that provides temporary
storage and manipulation of the information
necessary for such complex cognitive tasks as
language comprehension, learning, and
reasoning.” (www.pubmed.com)
• Working memory leads to long-term memory
storage, helps build relationships between
ideas and assists with problem-solving.
Steps in Memory Storage Process
Stimulus
Sensory Register
Working Memory
Active Processing
Long Term Memory
(“Source, Processing Disorders” by Gail J. Richard, 2001)
WAYS TO ENHANCE WORKING
MEMORY
• Rich experiences and a variety of experiences
allow the child to map new information onto
those old memories.
• Pre-learning information so that when the
student hears it in class, he/she can more
successfully process because it is not novel
material. When you know that your student will
be learning about a specific theme/topic (ask the
child’s teacher to give you these a little bit ahead
of time) you can go to the internet and look up
pictures, stories, information about the topic.
Games to help with working memory:
• Earobics, Step 1: Clown game
Child identifies environmental noises,
but they increase in the number presented.
• Earobics, Step 2: Fireman game
Child will need to know his/her numbers
(order both on www.amazon.com)
• Give the child numbers to remember and repeat
back. Start with two numbers and work up. You
also can give words to remember and repeat back.
Help the child learn how to parse the numbers
together (“1,3,5”=1,3…5). Help the child learn how
to make connections with the words to form an
image (“boy, dog, banana”= the boy saw the dog
that was eating a banana).
Use acronyms, silly phrases or cartooning
to help the child remember information.
(For grades 5+, I recommend BrainCogs computer
game at www.fablevision.com.)
• Acronyms highlight the first letter of each
item that the child needs to remember
and puts each beginning letter into a word
or nonsense word that can cue the child’s
memory (i.e., STOP= Space, Time, Objects,
People).
• Silly phrases also highlight the first letter
of a word or words that a child needs to
remember but instead puts them into a
catchy, often silly phrase (i.e., On Old
Olympus' Towering Top, A Finn And
German Viewed Some Hops for the
cranial nerves).
• Cartooning helps the child to sequence events and
add necessary details that help the student visualize
the information.
• Rehearsal of information is helpful for
retention. Have the student tell you
what he knows about the subject
and/or have the student pretend to be a
reporter and report about the topic
from notes that he/she has taken.
Kelli Murdock Eickelberg, MA-CCC
Speech-Language Pathologist
==================================
7701 SW Cirrus Dr, Suite 32-D
Beaverton, Oregon 97008
(503)520-5030 (503)520.5090FAX
KelliEickelbergSLP@hotmail.com
www.KelliEickelbergSLP.com
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