At Home Speech Therapy for Children and Adults in Northern NJ

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At Home Speech Therapy for Children and Adults in Northern NJ

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The Liberty Speech Associates blog discusses information pertaining to speech and language development, communication disorders in children and adults, accent modification, technology, and telepractice/teletherapy.  Comments and questions are welcome and encouraged!


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Is it Stuttering?

Posted on June 21, 2017 at 11:50 AM Comments comments (0)


Stuttering is a communication disorder, which impacts the fluency of one’s speech. It typically begins in childhood and continues throughout one’s life (this is referred to developmental stuttering). However, there are situations where someone could acquire stuttering (referred to as neurogenic stuttering) as the result of a brain tumor, stroke, or brain injury.


Prior to the age of 6, children can experience developmental disfluencies, which is often interpreted as stuttering. As children learn to talk, they may go through different stages of disfluency, repeating syllables, sounds, words, or phrases. In typically-developing children, these repetitions/disfluencies should occur less than 10% of the time. Additionally, the children should be essentially unaware of them. Children in this category will likely outgrow the disfluencies without intervention. In fact, according to ASHA, approximately 75% of preschoolers will eventually stop stuttering. Recovery typically occurs within months of beginning.



Although children may experience these developmental disfluencies and eventually outgrow them, there are children who may be at a higher risk of developing a stuttering disorder, which may continue into adulthood. A child is more likely to have a stuttering disorder versus developmental disfluencies in the following cases:

• He is male

• S/he has a family history of stuttering

• The stuttering persists for several months

• The moments of disfluency occur more than 10% of the time

• S/he is aware and upset by the stuttering and/or avoids speaking situations

• Stuttering consists of blocks and/or prolongations, in addition to repetitions



If you are unsure where your child may fall along the stuttering continuum or have general concerns about your child’s communication, it is best to contact your local speech-language pathologist (SLP) for a comprehensive speech and language evaluation. The SLP will be able to diagnose the stutter, as well as provide strategies and suggestions for improvement. As a parent the best thing you can do is not react negatively to the stutter/disfluency or tell your child to “slow down.” This can lead to stressful speaking situations for your child, which may cause the disfluencies to worsen.


For more information on stuttering, check out resources at The Stuttering Foundation and The American Speech-Language-Hearing Association.


Have questions about stuttering? Please leave a comment below!


About the Author:

Courtney Caruso is the owner of Liberty Speech Associates LLC and is a bilingual speech-language pathologist in Northern NJ. She works with children and adults in their homes so they can work on their skills in a natural environment where they are most comfortable.


Interested in speech or language therapy? Contact us at 201-658-4400 or [email protected]

Spanish-Influenced English: Spotlight on Semantics and Pragmatics

Posted on June 8, 2017 at 11:30 AM Comments comments (0)


Thanks for checking out my 3rd post of a three-part series on Spanish-Influenced English. Today’s post is Spotlight on Semantics and Pragmatics. If you haven’t had a chance to read posts 1 and 2, check them out now - Spanish-Influenced English: Spotlight on Pronunciation and Spanish-Influenced English: Spotlight on Morphosyntax.

To start, I’d like to give brief definitions of the terms “semantics” and “pragmatics.” Semantics refers to word meanings and vocabulary. Pragmatics refers to social language skills, such as making eye contact, using facial expressions, communicating with different gestures or body language. The purpose of today’s post is to discuss the semantic and pragmatic similarities and differences between Spanish and English and describe how the differences may impact a Spanish-speaker’s communication style or use of English. It should not be assumed that all second-language learners will present with the patterns described in this post.

Semantics

Both Spanish and English have vocabulary derived from Latin and, as such, there is shared terminology between the two languages. In some instances, there are words that are identical in spelling and meaning between English and Spanish (e.g., actor/actor; color/color), but the pronunciation varies, while in other instances there are words that are extremely similar (activity/actividad; independent/independiente) in both spelling and meaning. Words that are spelled the same or similarly and maintain the same meaning are referred to as cognates.


Cognates may make it easier to acquire English vocabulary; however, there are false cognates (words that appear to be the same, but aren’t) that can make it challenging to learn a second language. There are numerous false cognates between English and Spanish, including, but not limited to, library/librería (bookstore), assist/assistir (attend), and embarrassed/embarazada (pregnant).





Pragmatics

All cultures have unwritten rules of behaviors that are and are not considered socially acceptable. However, these rules are not the same between cultures, which makes it difficult for individuals emigrating from other countries to communicate with natives. The differences in our communication styles and pragmatic rules may lead to miscommunications and misunderstandings. Therefore, I will present some fundamental differences between our communication styles and those of Spanish-speakers so that we can better understand and communicate with one another.

In mainstream American culture, we place heavy importance on time, completing tasks, and getting down to business; we like to maintain a certain amount of personal space and do not like when someone approaches us too closely; we expect children to look at adults when speaking and consider it rude if they look down or away (Roseberry-McKibbin, 2002). Conversely, in Hispanic culture, it is customary to initiate business interactions with pleasantries and personal conversations, time constraints are less stringent; close proximity is frequently used when communicating with others; avoiding eye contact during communication with an adult is considered a sign of respect (Roseberry-McKibbin, 2002).



Although the aforementioned semantic and pragmatic characteristics are common between many English- and Spanish-speakers, it should not be assumed that all individuals have the same vocabulary knowledge, beliefs, or behaviors. This concludes my post on semantics and pragmatics in Spanish-Influenced English. I’d love to hear your cultural and linguistic experiences as an English language learner. Please leave me a comment below.

References:
Roseberry-McKibbin, C. (2002). Multicultural students with special language needs: Practical strategies for assessment and intervention (2nd ed.). Oceanside, CA: Academic Communication Associates, Inc.


About the Author:


Courtney Caruso is the owner of Liberty Speech Associates LLC and is a bilingual speech-language pathologist in Northern NJ. She works with children and adults in their homes so they can work on their skills in a natural environment where they are most comfortable.

Interested in speech or language therapy? Contact us at 201-658-4400 or [email protected] 

Spanish-Influenced English: Spotlight on Morphosyntax

Posted on May 27, 2017 at 6:00 PM Comments comments (0)

Today’s blog post, Spanish-Influenced English: Spotlight on Morphosyntax, is part 2 of a three-part series. Didn’t have a chance to read part 1? Check it out now - Spanish-Influenced English: Spotlight on Pronunciation.


I’d like to begin this post by explaining what is meant by “morphosyntax.” This term refers to the morphological and syntactic structure of language. Morphology refers to the study of words and their parts. Syntax refers to sentence structure and the rules governing the way in which we form sentences. The purpose of this post is to discuss the morphosyntactic similarities and differences between Spanish and English and describe how the differences may impact a Spanish-speaker’s production of English. It should not be assumed that all second-language learners will present with the patterns described in this post.




Spanish and English have comparable morphosyntactic structures. Typically, both languages follow a subject-verb-object (S-V-O) word order; however, this word order is not required in Spanish as it is in English (Anderson, 1995). Although both languages usually employ a S-V-O word order, there are significant differences between Spanish and English in areas, such as question formation, comparatives/superlatives, possessives, adjectives, gender, number, verb tense, negation, plurals, and articles (Goldstein, 2004; Roseberry-McKibbin, 2002). In Spanish, the following morphosyntactic rules apply (Goldstein, 2004; Roseberry-McKibbin, 2002):
  • Questions are identified by a speaker’s intonation rather than by word order, 
  • Comparatives and superlatives are signified by the word “más,” meaning “more,” 
  • Possessives are represented based on word order rather than an ’s, 
  • Adjectives follow nouns and agree in number and gender with the noun, 
  • Verbs are marked by number and tense, 
  • Negation is marked by the word “no,” 
  • Double negatives are acceptable, 
  • Plurals are represented throughout the noun phrase, 
  • Articles agree in number and gender with the noun. 

As a result of these differences, Spanish speakers learning English as a second language may make mistakes by employing the morphosyntactic rules of Spanish to their sentences in English. Examples of erred sentences that may be produced by a second-language learner are as follows:

  • You are angry?
  • His house is more big than our house.
  • That is the house of Jose.
  • I have three apples reds.
  • No do that!
  • I need three hundreds dollars.
  • I no want no cookies.



This concludes my post on morphosyntax in Spanish-Influenced English. Don’t forget to check back soon for the next post in this series. Also, please leave a comment if English is your second language to let me know what types of struggles (if any) you experience when speaking English.


References:

Anderson, R. T. (1995). Spanish morphological and syntactic development. In H. Kayser (Ed.), Bilingual speech-language pathology: An Hispanic focus (pp. 41-74). San Diego, CA: Singular Publishing Group, Inc.

Goldstein, B. A. (2004). Bilingual language development and disorders in Spanish-English speakers. Baltimore, MD: Paul H. Brookes Publishing Co., Inc.

Roseberry-McKibbin, C. (2002). Multicultural students with special language needs: Practical strategies for assessment and intervention (2nd ed.). Oceanside, CA: Academic Communication Associates, Inc.


About the Author

Courtney Caruso is the owner of Liberty Speech Associates LLC and is a bilingual speech-language pathologist in Northern NJ. She works with children and adults in their homes so they can work on their skills in a natural environment where they are most comfortable.


Interested in speech or language therapy or accent modification services? Contact us at 201-658-4400 or [email protected]

Spanish-Influenced English: Spotlight on Pronunciation

Posted on May 20, 2017 at 2:55 PM Comments comments (0)


Many of us can often discern when someone has an accent from another country, but may not know exactly what causes the accent. Because Spanish is the second most commonly spoken language in the U.S., this post will highlight the articulation and phonology of Spanish speakers. The purpose of this post is to describe common speech patterns of Spanish and how these patterns may affect a Spanish-speaker’s pronunciation of English words. It’s important to note, however, that this post serves to describe an overview of key differences between Spanish and English and is not a comprehensive list of all potential differences between the languages. Additionally, it should not be assumed that all second-language learners will present with the patterns described in this post. This post is the first of three in a series on Spanish-Influenced English, so be sure to check back to learn more about Spanish vocabulary, culture, and sentence structure.


The Spanish phonological system is smaller and more concise than that of English, containing fewer vowels and consonants. In Spanish, there are only 5 pure sounds: a, e, i, o, u, as well as some diphthongs (Salcedo, 2010) causing many second-language learners to make vowel substitutions. Common vowel substitutions include: /ɪ/ → [i], /æ/ → [ɛ], and /æ/ → [ɑ] (Roseberry-McKibbin, 2002).




The following consonants do not exist in Spanish: /ɹ/, /z/, /ð/, /dʒ/, /ʃ/, /ŋ/, and /ʒ/ (Goldstein, Fabiano, & Iglesias, 2004). Additionally, words cannot begin with s-clusters and can only end with the /s/, /n/, /ɾ/, /l/, and /d/ consonant phonemes (Goldstein, Fabiano, & Washington, 2005; Roseberry-McKibbin, 2002). /θ/ and /v/ also don’t exist in many Spanish dialects, but there are some that do utilize these sounds (American Speech-Language-Hearing Association, n.d.). The differences between the consonant phonemes of English and Spanish often result in the following sound substitutions: /v/ → [b], /ʃ/ → [tʃ], /dʒ/ → [j], and /θ/ → [d] (Roseberry-McKibbin, 2002).





Other characteristics of Spanish-Influenced English can include deleting final consonants, removing aspiration from stop consonants, and devoicing final consonants. The /t/, /d/, and /n/ phonemes may be dentalized, /r/ may be tapped or trilled, /s/ may be produced in a more anterior position, the schwa may be inserted before word initial consonant clusters and /h/ in the initial position of words may not be produced (Roseberry-McKibbin, 2002).


Another key impact on a Spanish speaker’s ability to pronounce English is stress pattern (Shoebottom, n.d.). Spanish is syllable-timed and English is stress-timed, which results in the stress, pitch, and rhythm of English sentences to be flattened when produced by a Spanish speaker. When stress patterns deviate from what we’re used to, a speaker may become unintelligible or difficult for us to understand (Shoebottom, n.d.).




This concludes my post on pronunciation in Spanish-Influenced English. Don’t forget to check back soon for the next post in this series. Also, please leave a comment if English is your second language to let me know what types of struggles (if any) you experience when pronouncing English.


References:
American Speech-Language-Hearing Association. (n.d.). Facts on Spanish phonology. Retrieved July 4, 2012, from http://www.asha.org/uploadedfiles/practice/multicultural/spanishphonemicinventory.pdf

Goldstein, B., Fabiano, L., & Iglesias, A. (2004). Spontaneous and imitated productions in Spanish-speaking children with phonological disorders. Language, Speech, and Hearing Services in Schools, 35, 5-15.

Goldstein, B. A., Fabiano, L., & Washington, P. S. (2005). Phonological skills in predominantly English-speaking, predominantly Spanish-speaking, and predominantly Spanish-English bilingual children. Language, Speech, and Hearing Services in Schools, 36, 201-218.

Roseberry-McKibbin, C. (2002). Multicultural students with special language needs: Practical strategies for assessment and intervention (2nd ed.). Oceanside, CA: Academic Communication Associates, Inc.

Salcedo, C. S. (2010). The phonological system of Spanish. Revista de Lingüistica y Lenguas Aplicadas, 5, 195-209.

Shoebottom, P. (n.d.). The differences between English and Spanish. Retrieved July 10, 2012, from the Frankfurt International School website: http://esl.fis.edu/grammar/langdiff/spanish.htm


About the Author:




Courtney Caruso is the owner of Liberty Speech Associates LLC and is a bilingual speech-language pathologist in Northern NJ. She works with children and adults in their homes so they can work on their skills in a natural environment where they are most comfortable.


Interested in speech or language therapy or accent modification services? Contact us at 201-658-4400 or [email protected]

Can't Get the Words Out? You Might Have Aphasia

Posted on May 10, 2017 at 4:55 PM Comments comments (0)


Aphasia is a communication disorder that is typically the result of a stroke or brain injury; however, there is also progressive form referred to as primary progressive aphasia, which is the result of degenerative diseases.


Aphasia is estimated to affect 1 in 250 people (NINDS, n.d.). Despite the high prevalence of the disorder, few people have heard the word (unless of course they have been diagnosed or have a family member that's been diagnosed). Like all disorders and disabilities, aphasia does not affect each person the same way or to the same degree. Location and size of the lesion can contribute to the type and severity of the aphasia. Regardless, though, all individuals with aphasia will have some difficulty with communication, which may affect any or all of the following skills: reading, writing, speaking, and understanding. Aphasia does not affect intelligence. This bears repeating...aphasia does not affect intelligence!





Although aphasia affects everyone differently, there is one common symptom experienced by all people with aphasia and that is difficulty retrieving familiar words. This difficulty is similar to that tip of the tongue feeling we all experience from time to time, except that a person with aphasia experiences it regularly. Continue reading below for more information on some of the most common types of aphasia and the associated symptoms.


Anomic – This type of aphasia is typically the mildest form in which the primary (or only) difficulty is retrieving words. A person with anomic aphasia usually speaks in complete and grammatical sentences, but often uses several words to describe one word (e.g., “that red fruit that you pick in the fall” for apple). This difficulty retrieving words is also evident during writing tasks. A person with anomic aphasia usually does not have significant comprehension or reading problems.


Broca’s – A person with Broca’s aphasia typically has difficulty producing complete and grammatically correct sentences and, as such, only uses 4 words or less in a phrase or sentence. The speech of a person with Broca’s is often referred to as “telegraphic.” Nouns are most commonly used in the person’s speech. These characteristics carry over into writing, as well. A person with Broca’s aphasia usually does not have significant comprehension or reading problems. This type of aphasia is sometimes referred to as “non-fluent” aphasia.





Global – This type of aphasia is typically the most severe. A person with this type of aphasia is rarely able to produce real or recognizable words and has significant difficulties understanding spoken and written words.


Wernicke’s – The chief difficulty for someone with Wernicke’s aphasia is comprehending written and spoken language; however, the same person can more easily produce fluent speech. Although the person’s speech is described as “fluent,” there is often a lot of jargon and made-up words. Speech productions may be irrelevant to the topic, as well. Writing may also be affected in this type of aphasia.


Do you know someone with aphasia? Do you yourself have aphasia? Please share your experiences below. 


About the Author:


Courtney Caruso is the owner of Liberty Speech Associates LLC and is a bilingual speech-language pathologist in Northern NJ. She works with children and adults in their homes so they can work on their skills in a natural environment where they are most comfortable.


Interested in speech or language therapy? Contact us at 201-658-4400 or [email protected].



Early Intervention: What It Is & What It Isn't

Posted on May 1, 2017 at 1:00 PM Comments comments (2)

Early Intervention, or EI for short, is a great program for young children and their families to receive related services, such as speech therapy, physical therapy and occupational therapy. In NJ, this program covers children from birth to age 3. Although it is a great program, there are a lot of misunderstandings about what EI is and isn't. These misunderstandings and misconceptions are perpetuated by families, EI service providers and healthcare professionals. My hope is that through this blog post families seeking EI services will understand what the experience entails (and what it doesn't).



What EI is:

bagless - If your child is receiving EI services, the therapist(s) should typically not be bringing in any of their own toys or special gadgets. As EI service providers, we're supposed to show you how to use what you've got to encourage communication, fine and gross motor skills, social-emotional development, and self-help skills.




family-centered - EI is about you as a family. There should be ongoing discussion between you and your therapist(s) about how EI services can best assist your child and your family doing day-to-day routine activities (e.g., food shopping, story time at the library). Goals and the types of services provided should be based on your family's needs and concerns. With EI being family-centered, family members/caregivers should be active participants in the therapy process. In fact, family members should be essentially driving and providing the services.  



What EI isn't:

free - It is a common misconception that EI is free and, unfortunately, in NJ this is not the case. The evaluations conducted by the Targeted Evaluation Team, as well as all meetings, are at no cost to the family. However, the actually services, such as speech therapy are at a cost. The cost is on a sliding scale based on your family's income. Your EI therapists are not privy to any of your income or billing information.




traditional therapy – As mentioned above, EI is based on a family-centered approach. If you are looking for traditional therapy, where your child works 1:1 with a particular service provider based on goals that the service provider deems fit, EI is probably not the best choice for you.




medically-based – Many times doctors will recommend that a child receive a certain number of hours of therapy (e.g., 2 hours per week of speech therapy) based on his/her medical condition or disability; however, because EI is not a medically-based or clinical program, these recommendations don’t hold much weight. As a family-centered model, the EI service providers are supposed to spend the least amount of time in the home necessary to show you different techniques that you can implement on a day-to-day basis.




a babysitting service - This may seem obvious, but you would be surprised at how many families want to leave their children with the EI service provider while they do chores, run errands, browse Facebook…I can’t stress enough that EI is about the family, not just the child, and as such you should be actively involved in the therapy sessions. If your service provider tells you to leave the room or you choose to leave the room because you have a lot to do, you are not receiving EI services in the manner they were intended and your child’s progress may be affected.




If you have or have had a child in the NJ Early Intervention System, I would love for you to leave me a comment with your experiences. If you live in another state, I would also love to hear what EI is like where you are. 


About the Author:



Courtney Caruso is the owner of Liberty Speech Associates LLC and is a bilingual speech-language pathologist in Northern NJ. She works with children and adults in their homes so they can work on their skills in a natural environment where they are most comfortable.


Interested in speech or language therapy? Contact us at 201-658-4400 or [email protected]


Ricurdari: Caring for someone with Alzheimer's and Dementia

Posted on April 22, 2017 at 7:25 PM Comments comments (0)

Guest Blog Post by Melissa J. Wells



I grew up only three blocks away from my Nonno’s house. My brother and I spent afternoons after school with him for years. Every day, he picked us up from school for lunchtime and made us a hot meal. We had to eat our pasta dish, some nuts and fruit. We watched the Price is Right with Bob Barker every day as part of our routine and when we were finished eating, we walked back to school together. In the summer time, there was no summer camp, or enrichment programs. Many days were spent with Nonno or his sister Gianna. The beauty of growing up in an immigrant family is that we were all we had so it was a small but very strong and tight family.


My nonno, Salvatore, was the only boy in his family with four sisters. He and his sister Gianna immigrated to this country from Sicily in the 50s. Gianna was already here with her husband Carmelo and two very young daughters. The other sisters, Angela, Maria, and Sara remained in Sicily. Salvatore was visiting and looking for temporary work when he met my grandmother, Jennie, a Sicilian - American woman. They were engaged and married immediately. Jennie was a graduate of the American Education system and spoke some proper Italian, the madrelingua Sicilian, and English. Salvatore worked two jobs – as a drill press operator and he owned his own business as a mason. Though I never met my grandmother who died at a young age of cancer, the story goes that she made it very clear to Salvatore that she was his wife, not his secretary and she brought him an English-Italian dictionary and he had to start learning English. In Sicily at the time, English was hard to come by, but now it is as commonplace in the schools as proper Italian and taught as a foreign language.




When you move forward in time, Salvatore has five grandchildren between his two daughters, myself being the oldest grandchild. Every spring and summer he worked in his garden once he retired. He was not a man of many words but that wasn’t due to lack of intelligence or any language barrier. He was the type to just sit back and listen to everyone else. Our favorite activity was people watching at the park. As far as I noticed, my grandfather spoke perfect English by the time we were all born, though still had his very strong accent which to this day we still mimic. He had an Italian newspaper every day to keep him up to date with current events in Italy and he watched American soap operas and news to keep up on his English. Summers in the basement where it was cooler or outside were spent with children playing and the adults laughing and yelling loudly between the three languages. At the end of the summer, he went back to Sicily to visit his other sisters and family and friends. We shopped for days and weeks looking for the best “Made in America” products to bring back to Sicily. The best shopping trip was finding the giant Hershey’s chocolate bar that he brought with him and on the first day of his trip, everyone sat together and he cut up the chocolate bar in the hot Sicilian night – a memory my cousins in Sicily still talk about to this day.




When I was old enough to begin to learn Italian in school, I remember asking Nonno for help and to my surprise, he said he could not. He understood Italian from the newspapers and news stories but he did not understand the grammar and vocabulary, nor was he confident in his English. He gave me the dictionary his wife gave him decades earlier. I studied Italian on weekends in middle school and throughout all four years of high school. I took honors accelerated Italian and was inducted into the Foreign Language honor society. I was excited for the day that my grandfather met my Italian teacher only to really understand them say to each other “buona” and pointing at me with smiles.




I left to live away at college at Rutgers University, which felt like a lifetime away. I graduated from Rutgers in the spring of 2007 with a double major degree in Psychology and Italian Studies. I studied abroad in Italy for a summer prior to graduation where I finally got to visit my cousins in Sicily. While I was visiting, I stayed at my cousin’s house where my great aunt Angela was also living. Angela had suffered from Alzheimer’s for over ten years. Most of her words were incomprehensible to me, a non-native speaker but from what I gathered from my cousins, it was mostly babble to them too. She had a personal aid that lived in the home and she didn’t get out much anymore. When I visited, she saw me and immediately asked about Turi, her brother without an introduction. While her short-term memory was completely gone, her long-term memory was still hanging on and her baby brother was in her mind – I must have had characteristics that reminded her of him. It was a hard scene to absorb, especially since I knew her fate because their sister Maria had developed and eventually passed of the same health complications.


In the time that I was away, my grandfather started to get very old. He became more and more forgetful. He voluntarily stopped driving, but only after he had hit the neighbor’s car with his 1984 Chevy Caprice. He began accusing my dad of stealing money. We were finding things in weird places such as deli meat in cabinets, money under the carpet and milk in the dishwasher. It almost seemed as though out of nowhere he began acting weird. For decades he went for walks to his sister’s house and suddenly he was getting lost in familiar places. One time a priest found him and another time a police officer. I don’t think the word “Alzheimer’s” was ever officially spoken, but the progression was noticeable and as a family we were familiar with the condition due to his two other sisters. He had diabetes for as long as I could remember and prostate issues that were getting worse because he forgot his medication or he was not managing his medicines properly. Sometimes when we’d ask him a question he forgot the words he wanted to use to answer them – regardless of language. It was always at the tip of his tongue.




I continued to study Italian at Rutgers for a Masters degree in the summer of 2007, immediately after graduation. This was partially as recommended by professors in the department, but also because I wanted to increase my fluency to help my Nonno. I was studying full time and even studied abroad again. The faster my fluency and language acquisition progressed, the faster the dementia progressed and the worse his became. He could not recognize his neighbors. Slowly he could not recognize family or friends. My brother Michael, his not so secret favorite grandchild he could not remember at times, despite regularly reciting names with pictures. He began to see hallucinations, which may have been a symptom related to the diabetes, more so than the dementia. We got puzzles for him. We brought him the Italian newspaper to read every day to keep his neurons firing. He was having more bad days than good, and very few moments of clarity when he broke down and cried because he was aware of what was happening. Eventually we noticed he read the newspaper the way a toddler reads – he sounded out the letters, but there was no comprehension or retention of the material. We left the same newspaper every day for months and he continued reading it as though it was a fresh paper. We could speak to him in English and on a good day he spoke to us half and half between languages or at least attempt to respond by pointing. He could recite Italian poetry and stories he learned in the 5th grade, but he couldn’t always tell what happened earlier that day. There was one time he found a photo of his 6th grade class and he was able to tell me who every person in the photo was and what they were doing; however he didn’t know who I was. When I could, I helped to cook him meals and go food shopping, as did his daughters, neither of who lived in town anymore but worked nearby. We took him to his sister’s house to sit with her and other friends for coffee and chats. I remember a time when he fell and hurt himself. A family friend and my uncle had to carry him out to the car to take him to the hospital. The nurses had given him so many drugs claiming that he was babbling incoherently, but when I saw him he was telling me that his head hurt in very clear Italian.


After that hospital stay, in what felt like the blink of an eye, his English had become non-existent, as though he never learned it to begin with and now we could only communicate with charades or Italian. There were only three people who also spoke both languages and could interpret for him: his sister Gianna, thankfully our family doctor and myself. I do not want to use the word burden to describe the relationship between my grandfather and me at any point in life, but at some point, I came to the realization that my Nonno was gone. The bubbly, silly and sweet man I grew up with was long gone and I only had his shell of a man left. He went through incredible mood swings that we had never experienced before. He was often irrational and lived in a time warp. There were many times at night I found him trying to escape “to go home.” We found ourselves giving him children’s Dimetapp to help him fall asleep because his sleep regulation was non-existent. He forgot who his own children were at this point. Thankfully, we did not live in his crazy time warp for long – he passed away peacefully over breakfast at the age of 85 in the spring of 2008, during my final exams for my very last Masters courses.




There are two major points to take away from this story. Alzheimer’s does not affect one person. It affects an entire family unit. It is not meant for the weak. As healthy individuals we often take for granted the ability to communicate but this disease robs us of that. The other point that I want to emphasize is the need to encourage bilingualism both leisurely as well as professionally. Alzheimer’s is a terrible disease, without a cure. There are some studies that show there are things one can do to test their memory and cognitively tease their brain to postpone it – one of which is becoming fluent in another language. The omega 3 fatty acids in foods common in the Mediterranean diet are also found to help postpone the onset of Alzheimer’s and dementia, but these will only delay the inevitable. I am not sure that speech pathology in this case would have increased the quality of life for my grandfather because the diseases seemed to have been triggered and spread so rapidly. Having more individuals who were bilingual though would have been helpful to my struggling family. Our first at home aid, Helen was Brazilian. She was able to communication through Portuguese, a language very similar to Italian to help keep my grandfather more comfortable. My own bilingualism was able to help my family at very personal and private times, especially after his death with handling some of the affairs such as his pension from his service in Italy.




Today I use my psychology and Italian degree as a teacher of both contents, to spread awareness of the terrible disease that shook my family and will continue to shake it for the next generation. I am also sharing the importance of learning new languages with anyone willing to learn so that if anyone finds themselves in my shoes some day, they have the skills and resources to help keep their family together and provide comfort for their sick family member through something as basic and simple as communication. I have cousins who are studying neurology and biomedical sciences as well as genetics in both Sicily and the United States. This is a disease that has had a negative impact on our family emotionally; however through science and additional research we hope to one day find a cure for this degenerative disease.


About the Author:



Melissa J. Wells is a graduate of Rutgers University with a B.A. in Psychology and Italian studies as well as an MA in Italian. She is currently pursuing an MS in Nutrition and Food Sciences from Montclair State University and has a certificate of Educational Leadership in Supervision from New Jersey City University. She’s an alumnus of Phi Sigma Iota, Foreign Language Honor society. She is currently a teacher of Italian, Psychology and AVID at the John E. Dwyer Technology Academy in Elizabeth, NJ and an alumni member of the Coccia Institute’s Amici della Cultura Italiana, the Italian Teachers Association of New Jersey as well as the Dante Society of America.

What is a Phonological Process?

Posted on April 14, 2017 at 1:50 PM Comments comments (1)



A “phonological process” is a fancy term used to describe speech patterns that many children experience as they learn to speak like an adult.  Although not all children will experience phonological processes, there are some processes that are rather common in typical speech development.


Below is a list of these common phonological processes and the age at which most children stop using them.





Affrication is when a fricative is substituted by an affricate, such as saying “chew” for shoe. Children typically eliminate this process by the age of 3.


Final Consonant Deletion is just as it sounds. Children delete the final consonant in words, so, for example, “ca” for cat. This process is typically eliminated by age 3.


Prevocalic Voicing is when a child voices a prevocalic consonant like “bink” for pink. This process is also usually eliminated by age 3.


Reduplication is the process of repeating one or more syllables of the target word. A common example of reduplication is saying “baba” for bottle. Children typically eliminate this process by age 3.


Word Final De-Voicing is when a voiced final consonant is produced as a voiceless consonant (e.g., “het” for head). This process if commonly gone by the age 3. Stopping is the process of producing a stop consonant in place of a fricative or affricate, such as “dis” for this. The age of elimination for this process depends on the particular sounds.


Fronting is when a posterior sound is substituted by an anterior sound (e.g., “doat” for goat). Children typically eliminate this process by 3½.


Unstressed Syllable Deletion is exactly as it sounds – an unstressed syllable is deleted, such as “tato” for potato. This process is typically eliminated by the age of 4.


Consonant Harmony is when one consonant takes on the features of another consonant (e.g., “beb” for bed). Children usually stop using this process by age 4.


Consonant Cluster Simplification is the process of simplifying a consonant cluster either by omitting one consonant in the cluster or substituting one phoneme for another in the cluster (e.g., “poon” for spoon). This process if usually eliminated by the age of 4.


Deaffrication is when an affricate is replaced by a fricative, such as “share” for chair. Children typically sound using this process by age 4. Gliding is when a liquid is substituted by a glide (e.g., “wing” for ring). This process can persist up until the age of 5.


References:

Bowen, C. (2011). Table 3: Elimination of Phonological Processes. Retrieved from http://www.speech-language-therapy.com/ on April 2, 2017.


Kent, R. (2004). Normal aspects of articulation. In Bernthal & Bankson (Eds.), Articulation and Phonological Disorders Fifth Edition. New York: Pearson.


Vihman, M. M. (2004). Later phonological development. In Bernthal & Bankson (Eds.), Articulation and Phonological Disorders Fifth Edition. New York: Pearson.


Do you have questions about your child’s speech development? Leave a comment below or contact us today.


About the Author:

Courtney Caruso is the owner of Liberty Speech Associates LLC and is a bilingual speech-language pathologist in Northern NJ. She works with children and adults in their homes so they can work on their skills in a natural environment where they are most comfortable. 


Interested in speech or language therapy? Contact us at 201-658-4400 or [email protected]


The SLP's Role in Autism Treatment

Posted on April 7, 2017 at 9:20 PM Comments comments (0)



Autism (AKA Autism Spectrum Disorder or ASD) is classified as a developmental disability. It impacts individuals differently, but those with ASD typically have difficulties with social skills and communication. Additionally, people with ASD may experience repetitive behaviors and be hypo or hypersensitive to different stimuli. ASD may co-occur with other conditions, such as apraxia. Because difficulties with social skills and communication are key symptoms of ASD, speech-language pathologists (SLP) play a crucial role in autism treatment.

Here is a list of some ways that SLPs can assist in autism treatment:
• Contribute to early identification
• Provide early intervention services using a family-centered approach
• Teach appropriate augmentative and alternative (AAC) techniques so that a person with ASD can more readily and functionally communicate with family members and the community at large
• Treat co-occurring conditions, such as motor speech disorders and feeding difficulties
• Ensure that a person with ASD has the necessary pre-linguistic skills to engage in successful communication

For additional information, check out Autism and SLPs and Autism.

About the Author:

Courtney Caruso is the owner of Liberty Speech Associates LLC and is a bilingual speech-language pathologist in Northern NJ. She works with children and adults in their homes so they can work on their skills in a natural environment where they are most comfortable.


Interested in speech or language therapy? Contact us at 201-658-4400 or [email protected]




Accent 101

Posted on April 1, 2017 at 7:20 PM Comments comments (0)

Often when we think of the word "accent," we think of the pronunciation of someone from a foreign country trying to speak English. Although foreign accents are a type of accent, someone monolingual born and raised in the US could also have one. We all like to believe that we don't have accents and that others do, but in reality, we all have accents.




According to Merriam-Webster, an accent is “a way of speaking typical of a particular group of people and especially of the natives or residents of a region.” Accents can be foreign, like described above, or regional. Regional accents are pronunciation differences based on the region where someone lives. A New Yorker saying "cawfee" or a Massachusettsan omitting his Rs in words like "park" and "car" are examples of regional accents.


Accents are a small piece in the bigger picture referred to as dialect. Some people use the terms accent and dialect synonymously while others haven’t heard the term dialect at all. A person’s dialect not only describes his accent, but also his vocabulary and sentence structure, which is a rule-based system used by a particular group. Although general categories are often made about people’s accents and dialects (e.g., a New York accent like I referenced above), assumptions should not be made solely based on where he lives or what country he is from as many factors can contribute to our speech and language characteristics. Additionally, some individuals choose to receive accent modification services to reduce or change their accent or dialect.


Be sure to check back soon to learn more about specific foreign and regional accents and dialects.


About the Author:



Courtney Caruso is the owner of Liberty Speech Associates LLC and is a bilingual speech-language pathologist in Northern NJ. She works with children and adults in their homes so they can work on their skills in a natural environment where they are most comfortable.

Interested in speech or language therapy or accent modification services? Contact us at 201-658-4400 or [email protected]


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