Happy Fifth Anniversary Asheville Speech! 
   How did Asheville Speech Associates grow so quickly?  We have 15 dedicated speech/language therapists who enjoy helping people improve their communication skills.  We have expanded our office space and Marilou, our Office Manager, is very pleased.
   We watched J.H. advance from not speaking at all at age 2 to "jabbering" in phrases.  S.K., age 3 1/2, had ear infections in her earlier years and her speech was unintelligible.  We helped her speech become intelligible so she would be ready to talk to her kindergarten peers.  It was really fun watching B.J.'s "buck" teeth return to a more normal position once he learned to eliminate his tongue thrust.  Mr. H. had a stroke and could not produce single words.  We are happy to report that he is now speaking in sentences and learning how to spell again!  Then there was R.W.  He was autistic and mimicked what he heard on TV.  How exciting when he learned how to interact with his family and friends, answering questions and expressing his needs.
   These are just some of the samples of progress that we get to share with our clients.  Some children are receiving speech therapy in school and, due to large caseloads, the school therapists often must provide group therapy.  If you feel that your child could benefit from more individual speech therapy, call us and we can discuss possible supplemental speech therapy.
   Asheville Speech Associates continues to expand.  We are now in Henderson, Buncombe, Madison and Haywood counties.
   We would like to thank our referring doctors and agencies for their continued support and faith in our ability to rehabilitate those with communication disorders.

Stuttering: A Family Issue

Characteristics of the Various Levels of Stuttering

Normal Dysfluency (ages 1 - 6)

• 10 or less dysfluencies per 100 words
• worse when child is excited or competing to be heard
• usually whole word and phrase repetitions
• associated with rapid language development
• may be affected by environmental stresses (moving, divorce, new sibling)
• no secondary behaviors
• child is unaware of dysfluencies

Borderline Stuttering (ages 1 - 6)

• more than 10 dysfluencies per 100 words
• prolonged sounds are present
• few secondary behaviors (increased tension)
• child may be surprised by dysfluencies but not embarrassed or angered
• caused by combination of heredity and environmental factors

Beginning Stuttering (ages 2-8)

• repetitions are rapid and irregular
• increased tension causes a pitch rise
• more prolongations
• uses fillers and starters (uh, um, etc.)
• child is aware of stuttering
• no fear, anticipation or negative self image
• child is annoyed, frustrated, embarrassed, and feels helpless while stuttering
• visible muscle tension when stuttering

Intermediate Stuttering (ages 6-13)

• blocks are most frequent behavior
• more tension in the lips and tongue
• more secondary behaviors
• avoids words, situations and environments
• beginning to have negative self image and displays uneasiness when speaking to others

Examples of Behaviors

- Part-word repetition: "do-doggy"
- Single-syllable word repetition: "I-I want juice."
- Multisyllabic word repetition: "Puppy-Puppy ran away."
- Phrase repetition: "I want a-I want a lollipop."
- Interjection: "He went to the-uh-park."
- Revision: "I lost my-Where's Mommy?"
- Prolongation: "I'm sssssseven years old."

Observable Behaviors
(Danger Signs)
Block:  obstruction of the airflow for speech (attempting to speak, no sound is heard)
Pitch rise: a rise in pitch and/or loudness when trying to speak
Tension: mental, emotional, or physical strain, which interferes with speech
Tremor:  the small muscles around the mouth and jaw tremble or vibrate when stuck on words
Avoidance Behaviors: postponing a word, unusual number or length of pauses, substituting words or noises
Escape Behaviors: head nod, eye blinks, body jerks, grimaces, hand/foot tapping, etc.
Struggle Behaviors: tension, noises added to words, pitch changes
 

YOU CAN HELP YOUR CHILD BY:

• Provide the child with adequate time to respond to questions and/or express wants and needs.
• Use simpler language when speaking to the child.
• Use a slower rate of speech when talking to the child.
• Reduce the number of questions asked by approximately 50%.
• Reduce the excitement level of activities.
• Plan silent periods during play activities.
• Avoid "show and tell" display speech.
• Develop better listening skills:  listen to what they are saying - not how they are saying it.
• Avoid criticism of child's speech.
• Pause before speaking or responding to  questions.
• Try to eliminate situations that create tension for your child.
• Avoid calling attention to the child's dysfluency, as this may decrease speaking confidence.

   Parents should take time every day to spend solely with the child modeling simpler, more relaxed speech during conversation.  If possible, observe conditions under which your child does his/her most fluent and most dysfluent speaking and attempt to alter the environment to fit the child's most fluent speaking times.  Most importantly, let your child know that you will always love him/her and that he/she can always count on your support.

Pamela, Are You Listening?

   Here are some activities that will help to sharpen your preschooler&rsquos listening skills.  They are easy to play and fun to share!

Give Me a Rhyme!
   Introduce your child to a group of rhyming words (star, car; toy, boy; cat, hat).  Then say a word and ask your child to respond with a rhyming word.  Then let your child turn the tables.  Have him/her say a word and you supply the rhyme.

Follow My Directions
   Have your child listen carefully as you give him/her a direction.  For example, say "put your hand on your head."  Gradually make the direction more complicated ("Put your hand on your head and smile.") to increase the fun and challenge.

Picture Book Questions
   Share a story with your child.  Help to sharpen his/her skills by asking questions about the story as you read along.  For example, "What is the name of the dog in the story?" "Where did the dog run away to?" "What is the name of the boy in the story?"

From The Mailbox
Dear TLC:
   My son is in the first grade.  He was referred for a speech evaluation last August.  He was evaluated recently and placed as a &ldquospeech only&rdquo child, meaning that he only needed speech therapy.  It is November 22 and therapy still has not begun.  What are my options other than having it provided through the school system?
Concerned Mom

Dear Concerned:
   Asheville Speech Associates can provide speech therapy for children who are in school.  We provide speech therapy on a year round basis - during the summer, holidays, etc.  We move with the child, if needed, to be sure that there is minimal interruption of services.  We can see your child at home, after school, at our office, or if the school allows, we can go to his school.  Please feel free to call for a consultation.  Good luck.