sound practice in action
Posted by Glynnis Dubois on August 21, 2014 12:08 AM
As a speech-language pathologist who provides auditory-verbal therapy and a Kinderdance instructor, I have a strong belief in the importance of music and movement to support listening, speech, and language development in preschool children. I also like to incorporate early literacy skills into my Kinderdance classes and love to watch the children have fun while at the same time learning so many new skills- it flows so naturally from music! Learning to listen to the beat of the music can then be transferred into the beat of a rhyme or the syllables in a name. Adding fun rhymes to the warm-up part of class helps to build memory skills, introduce words that rhyme as well as new vocabulary and even the opportunity to practice articulation! Imagine how beneficial these activities would be for children with hearing loss…
Taking these ideas into an auditory-verbal (AV) session might seem a bit daunting if you have never thought about it before — I think that we all have our favourite songs for therapy sessions, but adding just a bit of movement opens up a whole new aspect of learning and mind-body awareness.
During my sessions I like to begin with a song (or two) to get the children in the mood for listening. I use the same songs for a number of sessions with my little ones so that they get used to the routine as well as the pattern and gestures of the songs. We sit on the mat stretching our legs out wide and facing each other to sing the “Itsy Bitsy Spider”, and make the most of stretching to complete all of the gestures. I find that this engages the children and they really get into the singing and hand movements. Because they must coordinate both mouth and body, I find that they don’t have time to even think of not joining in! After a few sessions, they know what to expect and as soon as they come in will go to the mat to begin – it is a fun and relaxing way to start therapy.
Another way that I like to use music and rhythm is with tapping sticks. This is fun to do alone or with marching to stress the beat of a nursery rhyme. Not only do the children love to march and tap, they begin to ‘feel’ the words and relate them to a rhythm that then reinforces the words that they are hearing.
They will sometimes learn bits and pieces of the words and it all comes out as a very disjointed rhyme but the bits are filled in as we continue to practice each week! I also use sticks to tap ‘high’ and ‘low’ parts of a song, using the sticks to indicate high notes as ‘tapping up’ and low notes as ‘tapping down’. This helps the children to pay attention to intonation by practicing listening carefully for the changes in the music- they need to pay close attention to when the notes go up and when they come down in order to know where to tap their sticks. It is quite a challenging exercise for them but they have a good time practicing and always love to be actively engaged in the songs. Involving the body as a whole engages the mind and adds to the sensory input for memory and motor skill development.
Many researchers have looked at the impact of music on the developing mind- we have all heard about the Mozart Effect. You may have also heard about the enhanced listening skills that musicians have….these remind us how important it is to ensure that we are engaging the whole child in our therapy sessions; adding movement and songs stimulates both sides of the brain, adding language skills and memory to any activity. When the whole body is involved, studies have shown that better learning occurs! This is such a wonderful opportunity for children with hearing loss to also develop listening skills that will support their ability to discriminate – research tells us that trained musicians can distinguish between individual notes within an orchestral piece of music; that is to say that they can ‘pull out’ one ‘voice’ within the piece – this carries over into their daily lives as they are also able to distinguish one person’s voice in a room full of speakers- a challenge for children with hearing loss.
Using music is such a fun and active way to help develop this skill that doesn’t seem like therapy at all (and is even fun for the therapist!)
Using shakers and sticks to tap out the rhythms of songs and rhymes while marching around the room, clapping to the beat of a favourite song while sitting on a mat on the floor or just closing your eyes and listening for the drum (or violins, or flute….) in a favourite piece of music all add a new dimension to the experience….one I hope you will consider when planning your next therapy session!
Wearing two (or more) hats!
Having been a paediatric nurse for over thirty years, I always felt that I had a good idea of how children grow and develop. Once I became a Speech-Language Pathologist, I added a new dimension to my assessment skills — how DO children learn speech and language? This has been a wonderful journey; one filled with challenges and the search for fun and interesting ways to encourage an area that I had for so long completely taken for granted. When I chose to make Auditory-Verbal Therapy (AVT) my area of interest, I decided that I would incorporate my other ‘hats’ into the bargain. When I am assessing a child my nursing hat slips on and I look at the general growth and development, how the child moves, social skills and even if there are any issues around eating! As a feeding therapist (yet another hat to be discussed in an upcoming blog!) I understand how the development of chewing and feeding skills are prerequisites for the development of speech. This was not apparent to me before becoming a Speech-Language Pathologist, but I can truly appreciate it now!
As is the case for all of us as therapists, many of the children who come for AVT also have medical challenges. It becomes a bit of a dilemma to fully understand what obstacles are present. This is where my nursing background is once again a definite benefit! Having the inside scoop, so to speak, helps me to plan my sessions and parent teaching in a way that is able to incorporate the whole child. Being able to appreciate what kinds of things might be interfering with the development of speech and language or their ability to listen gives me insight into how best to support them during this journey of AVT. It is always such a pleasure to be able to explain to parents how development is based on a building block system…it’s a matter of balance and support….you can’t skip a step without your whole tower falling down!
I have had a number of children come to me for AVT who also have other ‘challenges’ that have not been noticed. One little kiddie did not seem to be progressing in any of her development and her parents were quite concerned. After discussing her health history, it became clear that there were a few things that needed to be cleared up before we were going to make any progress with AVT! Because she had had some very serious issues with reflux, her attention after feeds was definitely not on listening and interacting! She seemed to be uninterested in her surroundings – so much so that her parents thought that there was a cognitive issue. After discussing the impact of reflux on attention to the outside world and the difficulty for the toddler in separating the discomfort inside from the activities on the outside – no matter how fun and exciting they were – it became clear that a discussion with the toddler’s medical team was in order otherwise we would not be able to make any headway with therapy. I also spoke with the child’s feeding therapist and Mum about feeding times related to therapy and we managed to find a window of good time to engage her when she was more comfortable. As time went by and her medications were changed, she outgrew the reflux and is now very engaged in therapy and progressing nicely. It was a real challenge to try to figure out what the issue was and then how best to help, but it all paid off in the end!
So you can see how as therapists, we must make it our business to ask the questions…not that we need to know the answers… but that we are looking at the whole child and what might be influencing progress….that we are aware of what other supports or services might be of benefit to the child or family and we remember that we are part of a team who can all help to build a supportive, positive environment for the children we see. This, then, allows us to support the families along their journey and help to ensure that the children have the opportunity to be the best they can be!
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