Speechopaedia

Bhavana Agarwal- Speech language pathologist & Audiologist

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About me

I am Bhavana Agarwal, Speech language pathologist and Audiologist from India. I’ve had experience in this field for more than 6 years. I am a neurodiversity affirming speech language pathologist/therapist.

My most important goal is to create an awareness, acceptance, inclusion and help people with communication disorders.

I love learning things from people, especially from the ones who love talking about their experiences , it could be fellow ASLPs or parents.

I’ve worked with children and adults with communication disorders. I have assessed, diagnosed and treated various speech and language, voice, articulation, fluency disorders in children and adults. My areas of interest are treating speech and language delays, feeding issues, learning issues in children. I am more interested in learning more about GLP cases.

I exchange my knowledge @speechopaedia on the gram.

Blog

Stuttering- A verbal diversity

Introduction

Stuttering is a speech disorder where the person knows what to say, but cannot because of many factors, mainly- genetics, neurogenic causes, abnormalities in speech motor control.

What is a verbal diversity and why is stuttering a verbal diversity?

A few days ago, I met a friend—30year old—who stuttered since long time.

He introduced himself by saying- I stutter, la la la like th th th this” and this is how I talk.

I saw him being super comfortable while communicating with me.

That hit me! I questioned myself about my approach to treat “fluency”!

If you are doing something in your life and people say- it’s wrong, you need to fix it! how would you feel? It can impact the quality of your life throughout, with all the negativity induced.

Verbal diversity simply means that I support my client’s perspective of communication. I understand and accept it. My focus is on the comfort and confidence of my client when they’re communicating. This includes finding strategies to make their speech less effortful, rather than “fluent”. The focus is not on the person that hears, but the person who is speaking.

Verbal diversity is accepting stuttering as the diverse form of communication, it need not be changed. Because when you’re asked to change something you’ve been comfortable with, you’re creating a deeper negative impact.

We also talk about “Neurodiversity”, which says that changes in brain development, structure and function should be accepted as natural changes in human body. Neurodivergence includes Autism Spectrum, ADHD and dyslexia.

How can we SLPs change our perspective on speech therapy for stuttering?

During our college times, we were taught to take goals on improving fluency for stuttering- reducing repetition, prolongation, blocks. Nobody focused on improving the quality of life of the person with stuttering, the social aspects of stuttering.
Studies show that when improving fluency is taken as primary goal, secondary behaviours increased and stuttering would relapse in 95% of the clients.

A holistic approach - reducing secondary behaviours, core behaviours, counselling the caregivers, work/school environmental factors have to be focused.

Our main goal is not to “cure” stuttering but look at their perspective and provide them supporting strategies to effortlessly communicate.

Tips to model AAC at home

Let’s start!

Introduction-

AAC (Augmentative and Alternative Communication) means any form of language or communication used to augment or supplement spoken language or is used as an alternative to spoken language. It improves overall quality of life with dignity, inclusion.
There are varieties of low-tech and high-tech types of AAC.
* Low-tech aided AAC includes PECS( Picture Exchange Communication System), communication boards/charts etc.
* High-tech Aided AAC includes Speech generating devices, communication apps like Avaz, Proloquo2Go etc.

How can you model a child in AAC?
Modelling means pointing or pressing the pictures on AAC device as you say the word aloud. For the child to learn the word, you have to model it several times. For example- if your target word is EAT, show and point at the picture of EAT on the AAC device along with the gesture. Talk about different things related to the word EAT and point at it every time on AAC device.

What kind of words do I choose to start with?
There are two categories of vocabularies- core and fringe vocabulary. 80% of our language contains core words. Anything but nouns are core words. Example- conjunctions, prepositions, pronouns, adjectives etc. Fringe vocabulary includes names of fruits, vegetables, objects etc. Choose words that the child likes. Example- if the child likes food items like chips, pasta etc and if he like toys like train, aeroplane etc. Picking the words he likes act as communication motivator.

How many words should I model?
The length of utterance depends on the child’s level. If the child has just started, start with one word. If he’s consistent with one word, add one more word to the same set of words that he has learnt. Example- if he knows the word “ block”, add “red block” or “big block” etc. Then you can increase to phrase and sentence level.

What activities can I do to model AAC at home?
Everyday activities like brushing, bathing, meal time, playing, sleeping etc can be used to model words according to child’s level. Repeating the words as much as possible everyday will make the child understand imitate better. These routine activities will help the child imitate and for you to be consistent in modelling the same words everyday.

Finally, it’s important to understand that learning AAC needs patience and consistency. It takes time to be able for the child to understand and imitate the words. Do not rush. Let the child take the time to do so. In the process, even you might have doubts about it. Make sure to consult a Speech language therapist to help you out with anything.

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