9/10/2018


How Much Is Too Much Screen Time?


 I think one of the hardest things about being a parent is the constant feeling like someone is judging you. Too much sugar in your kid’s diet. Not enough time with them. Too much time with them. Not enough time spent in the woods. Too much screen time.

Most of these boil down to parenting style with no good or bad decisions. That last one, though, screen time, is one that a lot of people struggle with at a visceral level. What you need to understand, however, is why professionals are recommending limiting screen time. 

First, let’s talk about what constitutes as “screen time.” This includes TV, tablet games and videos, Netflix and other streaming services on devices, movies, Skype and other video chatting, and even those few respite moments of watching YouTube in the grocery store check out line (read: I’m a mom and I understand that need for Baby Shark).  

The American Academy of Pediatrics (AAP) has put out new recommendations on media and how infants, toddlers, and children interact and learn from screen time. The current research shows that children as young as 15 months can begin to learn new words from touch screen apps. Toddlers 24 months can learn new words from video chatting and from interactive games. However, toddlers learn from real-life play and social interaction. This means that what they watch on TV, they cannot relay into real life on their own. However, these toddlers can benefit from having a caretaker watch TV and play apps with them, discuss what they are watching, and reteach the content. Let me repeat: screen time can be good if an adult is helping the child digest the content.

Preschool media (think Sesame Street, Super Why) can be good for 3-5 year olds to teach a variety of academic skills (ex: letter recognition, site word reading, numbers), social/developmental needs (ex: social expectations, resilience, “grit”, impulse control), and childhood health needs (ex: obesity prevention, teaching to not fear health professionals). On a personal note, I would seriously fight anyone to say Daniel Tiger’s Neighborhood is the best show on TV right now! Some apps may also help with these skills; however, parents need to keep in mind that they need to be able to monitor the screen time and interact with their child to carryover these skills.

For older children and teenagers, screen time is obviously used in school as a learning aid. When was the last time you even saw a real-life encyclopedia? Social media platforms can also help to build friendships and even allow teens to make new friends they may never had to chance to meet based on personal interests.

So, if screen time can be so beneficial, why do we keep hearing about how bad it is? The answer lies in how much time our children are using media. The concern that the AAP presents is that screen time can affect time spent sleeping, mealtimes, and playing time. Real-life, 3D play time is so important to children as this helps them build not only fine motor skills (ex: playdoh, water tables), but also fine motor skills, social skills, and cognitive skills.

 So, with all of this information, let’s look at the AAP’s recommendations for screen time based on age:

For children younger than 18 months, avoid use of screen media other than video-chatting. Parents of children 18 to 24 months of age who want to introduce digital media should choose high-quality programming, and watch it with their children to help them understand what they're seeing.
For children ages 2 to 5 years, limit screen use to 1 hour per day of high-quality programs. Parents should co-view media with children to help them understand what they are seeing and apply it to the world around them.
For children ages 6 and older, place consistent limits on the time spent using media, and the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health. 
Designate media-free times together, such as dinner or driving, as well as media-free locations at home, such as bedrooms.
Have ongoing communication about online citizenship and safety, including treating others with respect online and offline.

(https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/american-academy-of-pediatrics-announces-new-recommendations-for-childrens-media-use.aspx)

If you are reading these recommendations and freaking out a little (like I did!), let’s remember that these are guidelines and should also be looked as an average. If you let your child watch a 2 hour movie, no one will storm into your house and tell you that you are a bad parent. What you can do is ask some questions to get a discussion going with your child about the movie. What was your favorite part? Who was your favorite character? How do you think the character felt when they had to do something hard? Etc.

Another thing you can do is set “no screen time” times (or days even). In my personal family, we try not to do any screen time when we have all been away from the house for school/daycare and work and we need some family time. This is hard not only for my 3 year old at times who JUST WANTS A LITTLE TV AND TO SEE HER FAVORITE DANIEL TIGER AND HIS SISTER MARGARET, but also for me if I want to wash the dishes or, you know, think for 5 minutes. What I do instead to get us all in a better mind space about no screens is I will put on a favorite playlist and dance with the kids while I wash dishes. I bring some toys into the kitchen and talk with them while using those special mom eyes-in-the-back-of-my-head. Or, I strap my one year old on my back and take them for a walk.

Now, let’s say that you are reading these guidelines and thinking that there is absolutely no way that you can cut down the screen time in your house that much. Or let’s say that even with limiting screen time, you are concerned that your child isn’t talking as much or as clearly as their peers. This is an area in which a professional such as a speech pathologist can help you. Not only can we perform a complementary speech, language, and hearing screening for your child here at Rehabilitation Specialists, but we can also give you techniques in which to engage your child more in social and language activities throughout the day.

Please, again, do not take this post as me trying to shame you in any way. Again, I get it.  I just wanted to write this in case there were any parents out there who may have needed more information on current guidelines and why they are so limiting, especially looking at our information-driven society. So, relax, take stock in how you can engage your child with their screen time and in real life, and contact us if you have any other questions or concerns. Until next time!

 

Kathleen

More information:

https://blog.asha.org/2018/02/26/help-families-find-a-screen-time-balance/

9/4/2018


What is an SLP?

When I was in college, a big ice-breaker amongst the academic crowd in social situations was, “What is your major?” Being young and having the people in my class understanding my lingo, I typically answered, “SLP” which was, 90% of the time, quickly followed up with, “Oh. What is that?” Whether you have heard the terms Speech Therapist, Speech Teacher, Communication Therapist, or another term, our technical title and degree is that of a Speech and Language Pathologist, commonly abbreviated SLP. An SLP is a highly-qualified professional who works to evaluate and treat individuals of all ages to work on speech skills, language skills, social skills, fluency/stuttering, voice, alternative and assistive communication pathways, swallowing and feeding skills, and deafness/hearing rehabilitation. As one of my professors in grad school liked to say, “We deal with the lungs up.”

Many times, a person in a social setting will tell me, “My brother had speech therapy as a kid! I couldn’t say my /R/.” While I am thrilled they actually have an idea of what I do, it is so much more than just being the “/R/ teacher.” In a single day, I could help to feed an adult with severe cerebral palsy, evaluate the voice quality of someone who has had a stroke, treat a young person with childhood apraxia of speech, teach conventional grammar to a preschooler, work on lipreading with someone who has cochlear implants and can’t hear the “noisy sounds”, help a teenager be able to get their idea for their assignment into a cohesive paragraph, and then work on the /R/ sound with a school-aged child.

As a young graduate student, I honestly wasn’t even familiar with all the aspects of the scope of practice of my chosen profession. It is a lot! Typically, however, most SLPs will get most of their training and specialization in a few areas within the field, which is important in choosing an SLP for yourself or a loved one. In my own practice, I have been very fortunate to be in several different settings and working with clients with a wide range of disabilities, allowing me to work with all of the above disorders and issues. I have the unique opportunity to be a “Jack-of-all-trades” working in a private practice clinic. That being said, even I have my strengths and specializations, such as language and literacy, working with several clients with Apraxia, and a strength in school setting paperwork, such as Individualized Education Plans (IEPs). When looking for an SLP, it may be a good idea to get a sense of their experience and plan for therapy.

As I mentioned, I work in a private practice as an SLP, working in both the outpatient setting and in contracted positions, both long-term and short-term with Rehab Specialists. Some other places an SLP could work include school settings (both public and private), hospital settings, skilled nursing facilities, adult training facility, rehabilitation clinics, universities, and early intervention going into people’s homes to train them in communication for children birth to 3. As you can see, we are diverse in this field.

Another aspects of SLPs which can be confusing for people not familiar with the field are all of those letters after our names. I sign my name Kathleen Dames, M.S. CCC-SLP. The M.S. after my name stands for “Master of Science.” This is significant because SLPs must have a master’s level education to become eligible for state licensure to practice. Some universities offer Master of Art degrees for speech-language pathology, so you may also see M.A. after some SLP’s signatures. The CCC after my name stands for “Certificate of Clinical Competence.” This means that after I graduated with my master’s degree, I worked a clinical fellowship year as an SLP with a certified SLP as my advisor. After having monthly observations and someone to continue to learn under, the American Speech-Language-Hearing Association granted me my “Cs,” showing that I was certified to provide highly-qualified services. If an SLP is in their clinical fellowship year, they will typically sign their name with CF, indicating “Clinical Fellow”. Fear not, however; most CFs are wonderful, qualified SLPs working under supervision and are still able to provide quality therapy services. Lastly, I sign SLP at the end of my signature, and I hope I have explained well enough what that stands for in this blog entry!

I plan on writing more blog posts in the future explaining what each aspect of speech therapy entails and how exactly a speech therapist can help.  If you have any specific questions at this time, please leave a comment below and I hope to answer your questions in a timely manner. If you are an SLP reading this and you think I have forgotten something important, please add your input below! I am obviously speaking from personal experience.  Lastly, if you are considering a career as an SLP, please contact us here at the office to learn more, set up a meeting or observation with one of us, and to make a contact. Until next time!

 Kathleen

 

Additional Resources:

“What Is A Speech-Language Pathologist?” Handout

https://www.superduperinc.com/handouts/pdf/162%20SLPs.pdf

American Speech-Language-Hearing Association
www.asha.org

 


9/4/2018

Hello! Welcome to Our New Blog

As you can see from the title, Rehab Specialists will be hosting a blog where we will be posting information about speech and language therapy every Monday. This will generally serve to get information out to the public on what we do as Speech-Language Pathologists and how speech therapy can help you or your loved ones. We would also like to build this blog to serve as a space where caretakers can connect and where you can get your questions answered by professionals. The therapists in this office work with all populations in most settings within the Pittsburgh area. We hope to cover a variety of issues for professionals, parents, and clients and talk about disorders which may affect both children and adults. Please check back often and engage in these talks so we get a sense of what the people reading this blog may be interested in learning. The two main therapists who will be contributing to this blog include Kathleen Dames and Julie Stroup. Kathleen mainly works with pediatric populations in a variety of placements including schools, early intervention, consultation for learning institutions, and here in the office. Julie also works with children in those settings but she has a specialty with swallowing and alternative communication options for adults with severe physical and intellectual disabilities. Comment below with any thoughts, comments, or questions for us. Until next time!

Kathleen and Julie
 

9/17/18


5 Questions With David Ford: Teachers and Laryngitis

Hello there again!

With the beginning of the school year already upon us, I wanted to introduce our 5 Questions With series to you. This will be a series where we will be posting an interview with a specialist in the Speech-Language Pathology field to find out more about their specialty and to get 5 answers to important questions for you. I am very excited for our first guest who has grown immensely in the field of voice therapy since graduating from Duquesne University, where Julie and I both went for undergraduate and graduate studies. He worked at Oregon Health and Sciences University in their Northwest Clinic for Voice & Swallowing for his clinical fellowship year then moved back to Pittsburgh to work at Straka and McQuone, Inc. as their on-staff speech pathologist for voice and swallowing disorders. He is currently studying for his doctorate degree and working as a Research Assistant at Michigan State University. I am very proud to introduce David Ford, our friend, and a specialist in voice disorders.


K: Thank you so much David for taking some time out of your very busy schedule to answer some questions for us! As I mentioned above, this post is in dedication to the new school year and I wanted this interview to specifically focus on voice for teachers. Working in schools with teachers has really opened my eyes to their struggle with trying to not get laryngitis! Can you explain a little why teachers lose their voices so often and what causes laryngitis?

DF: There are a number of reasons why teachers are susceptible to voice problems such as laryngitis.  First and foremost, vocal demand placed upon teachers far exceeds that of the general public (in most cases).  It is not uncommon for teachers to speak continuously throughout the day, whether they are lecturing, answering questions, dealing with administrative issues, or chatting with other teachers.  In addition, classroom environments are not typically conducive to healthy voice practices.  Teachers are often forced to speak over excessive background noise or in the absence of voice amplification, which can strain the voice.  There are also occupational issues such as limited sick/vacation days and working in an environment, which can include sick children.  When choosing between having an extra day at the beach or a day to pamper the voice, you can guess which one prevails!

K: I have known several teachers who drink tea or use throat lozenges to help with their sore throats. Do those home-remedies work?

DF: While home remedies may reduce symptoms temporarily, they can often lead to more problems down the road.  For instance, hot tea and honey can have a soothing effect, but tea contains caffeine and honey contains high sugar content.  Caffeine is a diuretic, which can dehydrate throat and mouth tissues, compounding voice problems.  Sugary substances can increase mucus production causing excess throat clearing (a vocally traumatic behavior).  Hot herbal tea would have the soothing effect of the heat without the harmful additives.  Throat lozenges are OK, as long as they do not contain menthol (which has a drying effect) or topical anesthetic (e.g. benzocaine).  Typically, the best throat lozenges are the ones with very few ingredients, but a hard candy can have many of the same soothing effects of a lozenge without questionable medicated properties.

K: What are the most important things you would like teachers to know regarding their voice?

DF: I’ve heard teachers say things like, “Oh, it’s just my teaching voice…” or “By the end of the school year, my voice is trashed.”  This should not be the case.  Lasting hoarseness or voice changes (in the absence of a related medical condition) are NOT EVER “normal.”  If you experience these symptoms for longer than a week or two and they do not improve with rest, please consult an otolaryngologist (Ear, Nose, & Throat physician).  In any case, seek help from either your school’s SLP or a community-based SLP, who can provide strategies and techniques to prevent voice problems. 

K: What can teachers do to prevent losing their voice?

DF: There are many environmental adaptations that can be arranged, some more simply than others. 

1.       The use of voice amplification is essential.  Amplifying the voice requires less effort to produce voice, which can have a compounding effect across a day of teaching.  Some school districts are even required to provide teachers with amplification.  Some districts have sophisticated systems, but it may be as simple as purchasing a $30 personal voice amplifier on Amazon. 

2.       DRINK WATER!  While it may seem like a no brainer, it is surprising how many people forget or do not prioritize this need highly enough.  The daily recommended dose is 64 oz water/day (8 glasses/3.5 bottles).  That is for the general public, speaking for many hours a day will likely require more.  As you speak there is air passing through the vocal folds more frequently and so they can dehydrate more quickly.  It is essential to replenish the lost fluid with water. 

3.       MORE HYDRATION!  Running a humidifier in your classroom is generally a simple adaptation.  Even if your schools HVAC system supposedly has humidification, I still recommend having your own personal humidifier.

4.       Always support your voice with lots of air.  Voicing is a “pressure-driven” event and there should be VERY little muscle effort involved in voicing.  Seek help from your school SLP with using more efficient breath support and airflow when voicing.

K: What can teachers do if they very dreadfully end up with laryngitis?

DF: Consult an otolaryngologist (as described above).  They can determine if your voice problem is more “functional” in nature (caused by muscle strain based on how your voice is being used) or if it is a true case of laryngitis (an actual inflammation/redness of the tissues used for voicing).  The symptoms can be exactly the same, so it can be tricky to identify.  If it is more functional in nature, they would likely refer you to an SLP for strategies/techniques to improve your voice use.  If it is laryngitis, sometimes a steroid can be prescribed to help reduce inflammation/redness. 

Knowing that sometimes, situations are not always ideal…some strategies to get you by would be:

1.       Hydration with WATER!!! (Sounding like a broken record yet?)

2.       REST when you can.  I know this seems trivial, but when you are running on a teacher’s schedule, ANY amount of rest can go a long way.  So when you get those rare, planning periods, close your door (if possible) and rest your voice while you plan.  Complete vocal rest means no whispering or throat clearing too.   

 

I hope this information has helped all the teachers reading this. Even if you aren’t a teacher, I hope that you have learned a little more about laryngitis and what you can do to prevent it and treat it. I know that I personally get laryngitis at least once per year and I will be doing a little more practicing what I preach. If you have any questions or comments, please feel free to share below. If you feel you need professional consultation or help, please reach out to one of us here at Rehabilitation Specialists and we can either assist you ourselves or refer you to appropriate voice specialists in our area.

 

Kathleen

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Speech and Language Therapy