“Let’s Talk!”
Overview
Speech refers to the actual
production of the sounds that are contained within a language. A speech
disorder can severely affect intelligibility, making it very difficult for the
person with a speech disorder to make their needs and ideas known. The rules
that a person uses to say the right words and structure them into sentences and
questions is contained in our language. Different languages have different
rules for how it is structured, but all children throughout the world begin learning
the sounds, words and rules of their language as soon as they are born. Research has shown that the first 6 months
of life are crucial to a child’s development of speech and language skills
(National Institute on Deafness and other Communication Disorders [NIDCD],
2012; American Speech and Hearing Association, 2012). In the English language, children begin
saying a few simple words that are recognized by their parents around their
first birthday. By the time the child is 18 months old, a typical child can say
8 to 10 words that others can understand as well. Two year old children are
beginning to put two words together for phrases such as “more juice” and “big
dog” (NIDCD, 2012).
In the United States, 8 to 9% of
preschool children have a speech disorder and as high as 19% of preschool
children are diagnosed with a language disorder. If children are unable to hear
the sounds and rules of their language, they are unable to produce it. Three
children out of every 1000 children are born deaf or hard of hearing. Newborn
hearing screening is an important means of identifying babies with a hearing
impairment, but if they are not identified at birth, children with a hearing
loss typically are not identified until 1.5 to 3 years of age (NIDCD, 2012).
A language disorder known as
specific language impairment affects approximately 7% of children beginning
kindergarten and has been shown to be associated with concomitant reading
difficulties and other academic problems. By the time children enter first grade,
it is estimated that 5% have a noticeable speech disorder. In children with a
specific speech disorder known as a phonological disorder, 50-70% exhibit
difficulties in other academic areas throughout high school (NIDCD, 2012;
American Speech and Hearing Association, 2012).
It has been demonstrated that ongoing difficulties with speech,
language, and/or hearing can also negatively impact social, emotional and
vocational choices as the child grows into adulthood (NIDCD, 2012).
A study by Oller, Eilers, Neal, and
Schwartz (1999) found that a significant number of babies that exhibited
delayed babbling of syllables between 10 and 12 months of age also displayed
other signs of a speech, language, or hearing disorder. In the study,
researchers found that a 5 minute interview with parents could provide
important and relevant information for the researchers to reliably determine
the need for further testing or intervention needs with the child. This
provides significant implications in the importance of providing education to
parents so that they can be watchful of their children’s speech and language
milestones, and be an advocate for their child to receive early intervention
services if needed.
In Sweden, Miniscalo and her
colleagues (2007), found that children exhibiting delayed language skills at
2.5 years demonstrated impaired oral narrative skills at 7 to 8 years of
age. Since the 1970s, speech and language
screening has been part of the nationwide general health screening for children
from birth to 6 years of age. Children between 2.5 and 3.0 years of age undergo
the first language screening and approximately 6% of the children exhibit signs
of language and/or speech disorders and are referred to speech pathologists
(Miniscalco, C., Hagberg, B., Kadesjö, B., Westerlund, M., & Gillberg, C.,
2007).
Description of Intervention
This intervention is designed to
provide parents of young children the information they need to recognize the
signs and symptoms of possible speech, language and/or hearing problems exhibited
by their children. Bringing this to the attention of healthcare professionals
can assist in obtaining the evaluation and treatment needed to minimize the
effects of any deficits and provide support as children begin school.
Setting
South Hulen
Kindercare is the setting for this intervention. It will take place on Tuesday
evening, September 25th, at 5:00 p.m. and again at 7:00 p.m. This is the evening of the Back to School
Open House that the preschool hosts each year for parents to see their preschool
child’s classroom and talk to their teachers. The reason for providing the two
different times for the presentation is that the Open House is being held from
5:00 p.m. until 8:00 p.m. in an effort to be available to as many parents as
possible and accommodate their work schedules. The presentation will be held in
the preschool’s meeting room which can accommodate 50 people. There are padded
chairs for the parents to sit in but there are only two 6 foot tables. One
table will be placed at the front of the room and the other will be placed at
the back of the room. The chairs will be
setup in classroom style with six rows of eight chairs, four chairs on each
side, and the last two chairs in the last row. This arrangement of even numbers
allows couples to sit together if both parents are present. Following is an
example of the seating arrangement:
Time Required
The presentation will require
approximately 25 minutes. It takes place at the end of the parents’ work day
and the children will be in another room for childcare. Time is valuable and to require any more than
20-25 minutes may force parents to choose between coming to the presentation
and not coming at all. The timeline will be as follows:
Introduction
and passing out materials 3
minutes
Pre-assessment
of objectives 2
minutes
Presentation
of information re: children’s 14 minutes
speech and language development
Questions and Answers 4 minutes
Post-assessment of objectives 2 minutes
Materials Needed
Materials required for the
presentation include:
·
Laptop computer with PowerPoint presentation ,
all computer cords
·
Extension cord, gaff tape (for taping down the
extension cord)
·
Handouts for 100 people for both presentations
·
Copies of PowerPoint presentation as backup
·
Clip boards and pencils for 50 people
·
Flashdrive with presentation (backup)
·
Chairs for 50 people
·
1 basket to hold post-assessment questionnaires
·
Two 6-foot tables, one placed at the front of
the room for the computer and supplies; the other table will be placed at the
back of the room with extra handouts and the basket for the participants to
place the post-assessment questionnaires
Guiding Health
Education Model
This program differs from many
other health intervention programs in that the health behavior being addressed
is not an effort to change poor health choices of the parents themselves, but
rather to provide them the information they need to effectively screen their
children’s speech, language, and hearing skills. Parents, as the primary caregivers of their
children, are the most qualified observers and reporters of their children’s
health. While it may be very obvious when children are sick with an illness, it
is much more difficult to recognize what may be subtle signs of delayed speech
and language skills or a hearing impairment.
It is imperative that parents learn to recognize the signs and symptoms
of difficulties in their children’s speech and language skills in order to have
their children evaluated and to obtain intervention as soon as possible in
order to minimize the effects of the disorder.
The Diffusion of Innovations health model can be used to disseminate
this information to parents. The Diffusion of Innovations model focuses on
utilizing various channels to disseminate program information to individuals
(Oldenburg & Glanz, 2008). The
information provided in this presentation can be distributed in verbal and
written format, and does not require a high level of health literacy to
comprehend and apply the information. The
program can be systematically disseminated to maximize the number of recipients. It can also be adapted to target a different
audience such as pediatricians to enable them to assist the parents in the
screening of the child’s speech, language, and hearing skills.
In using
the Diffusion of Innovations model, the intervention program is evaluated with
key attributes that are considered to be vital in determining the likelihood
that an intervention program will be successfully disseminated. These
attributes include: relative advantage, compatibility, complexity,
trialability, and observability (Oldenburg & Glanz, 2008). This intervention program measures well
against these attributes which can be a good indicator of the potential success
of the diffusion process (Oldenburg & Glanz, 2008).
In
conjunction with the Diffusion of Innovations model, social marketing will be
used to guide the distribution of the program intervention. The principles of
social marketing which include focusing on the benefits of the program and
developing a strategic marketing plan to reach the intended audiences can be
easily applied to this program (Story, Saffitz,& Rimon, 2008). This program can be modified to include the
speech and language milestones of different languages so that it can be
presented in different communities. For example, in a suburban area that is
comprised primarily of Vietnamese residents, the program would be presented by
a Vietnamese speaker and the materials and handouts would be adapted to include
the milestones for the parents to screen for in their children. Because this intervention program addresses
the needs of children, has little cost, and is relatively easy to apply, social
marketing techniques can provide effective distribution of the program
intervention to a wide audience.
Program Intervention
Goal
The goal of
this program is to increase parents’ knowledge of normal speech and language
development in children.
Objectives
Process Objective: Three weeks before, and again two weeks
before the open house, brochures will be placed within the classrooms and the
common areas of the preschool announcing the presentation on the evening of the
open house.
Process Objective: Flyers reminding the parents about the
presentation will be placed in each child’s “cubby hole” two days before the
event and the day before the open house (not all children are in preschool
everyday; by passing out flyers on two consecutive days, chances are greater of
maximizing the number of parents that are reminded about the presentation).
Process Objective: As part of the post assessment, questions
pertaining to participants’ overall satisfaction with the program will be included.
Outcome Objective: Participants will demonstrate increased
knowledge of normal speech and language development by completing post
assessment questionnaires with an average of 80% accuracy (Cognitive objective)
Outcome Objective: Participants will demonstrate willingness to
complete a screening of their child’s speech, language, and hearing skills
(Affective objective)
Outcome objective: Participants will be able to name two
healthcare disciplines they can contact regarding their child’s speech,
language, and hearing skills (Cognitive objective)
Procedures
Introduction: Introduce self and
briefly describe role as a speech pathologist.
Pass out pre-assessment questionnaire and ask participants to complete.
Presentation: “Even
before children are born they are beginning to hear the sounds their mother
makes during her speech. As soon as children are born, they are listening to
the speech and language of the people around them. This requires the baby to
have sufficient hearing to be able to hear the different sounds. In the United
States, about 98% of babies are screened at birth for their hearing ability.
This is done by placing headphones on the baby and introducing sounds into the
earphones and then recording the baby’s brainwaves which indicates that the
sounds were heard. If the baby cannot hear the sounds, then the brainwaves will
not be recorded. This indicates that the baby is not hearing and requires
further testing.
By
the time a baby is 3 months old, he is beginning to make the sounds that he is
hearing around him. Children continue to imitate sounds and begin putting the
sounds together. At 1 year old, children are beginning to say a few single
words. As children grow, they continue
to add words to their vocabulary and by 2 years old, children should be able to
say between 200 and 300 words and are beginning to put 2 words together like ”more
juice” and “big dog”.
Let’s talk a minute about the
difference between speech and language. Speech refers to the actual production
of the sounds that are used in that particular language. English uses different
sounds than German or Japanese. Language is how words are used to be put into
sentences and questions to be used to express needs and ideas, and also refers
to the ability to understand what other people are saying. A child may have problems with their speech,
language, or both. It is estimated that
6% of preschoolers have a language disorder, and 9% of preschoolers present a
speech disorder.
You also need to continue to be
aware of your child’s hearing. Approximately 6 out of every 1000 babies are
born with a hearing loss. But even though a baby may be born with normal
hearing, certain illnesses and ear infections can prevent the child from
hearing sounds which can prevent them from producing speech. A rule of thumb is
that if a child has more than 5 ear infections in a year, then a trip to the
ENT (ear, nose, and throat) doctor may be needed to look at the option of placing
PE tubes to help prevent recurrent ear infections. The importance of this
information is to be aware that although your child’s hearing may be ok at one
time, if they become sick with certain illnesses, their ability to hear can be
compromised. Their hearing skills need to be constantly monitored.
A child’s speech and language skills
expand rapidly during the toddler years. Three year olds have a vocabulary of
about 1000 words, they are able to answer questions, follow 2-step directions, and
they are approximately 75% intelligible. When children are beginning kindergarten, they
are able to follow 3-step directions; they have a vocabulary of approximately 2500
words, are 100% intelligible, and can use language in pretend play.
As a parent, you know your child
better than anyone else. You are the perfect person to listen to your child’s
speech and language on a daily basis. On the handout, I have included the
milestones of normal speech and language development for you to use as you
screen your child’s speech and language skills. If your child does not appear
to be hearing you, or if are your concerned about your child’s speech or
language skills, you can talk to your pediatrician or contact a speech
pathologist. You can find speech
pathologists at your local school district or a hospital. If your child is found to have a speech or
language disorder, he or she can be seen by the speech pathologist in the
public schools beginning at the age of 3 years old.
Your child may be referred to an ENT
and an audiologist for further testing to find out if there is a problem with
your child’s hearing. Depending on the type of hearing loss, there are
different treatment options available. The main goal is to get help for your
child as early as possible. The older a
child is when a problem is identified and treatment is started, the more
difficult it is for the child to “catch up” with his peers. It is not unusual for a child to start
receiving speech or language treatment beginning at age 3, and be completely
caught up with other children by the time he starts kindergarten. However, children that do not receive treatment
fall further behind their peers and academic areas such as reading and writing
are affected.
So take 5 minutes and listen to your
child. And if you need to make a call, “Let’s talk!” “
Evaluation
To evaluate the outcome objectives,
the participants will be asked to complete the pre-assessment questionnaire
comprised of specific questions related to normal speech and language
development. Following the presentation,
the participants will be asked to complete the post-assessment questionnaire with
the same questions, as well as additional questions to assess the overall
effectiveness of the program. Questions on the pre-assessment tool include the
following:
1. How many words should a 2 year old be able to
say? _______________________
2. How intelligible is the speech of a 3 year
old child? _______________________
3.
When do children start putting words together to make sentences?
______________
4.
How many words does a typical 5 year old have in their vocabulary?
____________
5. Name two health care professionals that you
can contact if you are concerned about your child’s speech and language skills.
_____________________________ ______________________________
The
post-assessment tool will include the following questions:
1. How many words should a 2 year old be able to
say? _______________________
2. How intelligible is the speech of a 3 year
old child? _______________________
3.
When do children start putting words together to make sentences?
______________
4.
How many words does a typical 5 year old have in their vocabulary?
____________
5. Name two health care professionals that you
can contact if you are concerned about your child’s speech and language skills.
_____________________________ ______________________________
6.
Do you have more knowledge about your child’s speech and language skills
now than you did before the presentation?
YES or
NO
7. Do you believe you can now listen to your
child’s speech and determine if further testing of their speech and language
skills should be done? YES or
NO
8. Would you feel comfortable
contacting a speech pathologist if you had questions about your child’s speech,
language or hearing skills? YES or
NO
Anticipated Problems
and Solutions
The presentation is being
provided as part of the Back to School Open House. This means that many of the
parents will have their children with them. I will arrange with the preschool
to provide childcare during the 25 minute presentation, however, there will
still be parents that will have their children with them. I will provide some
coloring books and crayons, and some puzzles that the parents can use to help
entertain their child during the presentation
If the
computer fails, or the presentation will not work even with the backup, the
entire presentation can be done verbally and there will be printed copies of
the PowerPoint slides that can be handed out.
In case I
run out of handouts, I will take a ream of paper with me and ask permission of
the preschool to make extra copies. If that is not possible, I will have
participants write down their email address and I will email the handouts to
them. I will also have the flash drive
with the handouts on it and if any of the participants have a laptop computer
with them, I can open and save the file on their computer.
References
American Speech
and Hearing Association. (2012). Incidence and prevalence of communication
disorders and hearing loss in children-2008 edition. Retrieved from
www.asha.org/Research/reports/children/
Gilbert, G. G.,
Sawyer, R. G., & McNeill, E. B. (2011). Health
education: Creating strategies for school and community health. Sudbury,
MA: Jones and Bartlett Publishers
Lanza, J. R.
& Flahive, L. K. (2009). Communiction
milestones. East Moline, Illinois:
LinguiSystems.
Miniscalco, C.,
Hagberg, B., Kadesjö, Westerlund, M., & Gillberg, C. (2007). Narrative
skills, cognitive profiles and neuropsychiatric disorders in 7-8 year old children
with late developing language. International Journal of Language &
Communication Disorders, 42, 665-681. Doi:10.1080/13682820601084428
Oldenburg, B.
& Glanz, K. (2008). Diffusion of innovations. In K. Glanz, B. Rimer, &
K. Viswanath (Eds.), Health behavior and
health education: Theory, research, and practice (pp.313-333). San Francisco, CA: Jossey-Bass.
Oller, D. K.,
Eilers, R. E., Neal, A. R., & Schwartz, H. K. Precursors to speech in
infancy: the prediction of speech and language disorders. Journal of Communication Disorders, 32, 223-245.
Story, J.D.,
Saffitz, G. B., Rimon, J.G. (2008). Social marketing. In K. Glanz, B. Rimer,
& K. Viswanath (Eds.), Health
behavior and health education: Theory, research, and practice (pp.435-464). San Francisco, CA: Jossey-Bass.
Appendix A
Thank you for coming to the presentation, “Let’s Talk!”
Before we get started, please take a minute and answer the following questions.
1. How many words
should a 2 year old be able to say?
_______________________
2.
How intelligible is the speech of a 3 year old child? _______________________
3. When do children
start putting words together to make sentences? ______________
4. How many words
does a typical 5 year old have in their vocabulary? ____________
5. Name two health care professionals that you
can contact if you are concerned about your child’s speech and language skills.
_____________________________ ______________________________
(Pre-assessment questionnaire)
Appendix B
Thank you again for your participation in our presentation, “Let’s
Talk!” Please answer the following questions related to what you have learned.
1. How many words
should a 2 year old be able to say?
_______________________
2. How intelligible
is the speech of a 3 year old child?
_______________________
3. When do children
start putting words together to make sentences? ______________
4. How many words
does a typical 5 year old have in their vocabulary? ____________
5. Name two health
care professionals that you can contact if you are concerned about your child’s speech and language skills.
_____________________________ ______________________________
6. Do you have more
knowledge about your child’s speech and language skills now than you did before
the presentation? YES or NO
7. Do you believe you
can now listen to your child’s speech and determine if further testing of their
speech and language skills should be done?
YES or
NO
8. Would you feel comfortable contacting a speech
pathologist if you had questions about your child’s speech, language or hearing
skills? YES or NO
(Post-assessment questionnaire)
