Speech Therapy Session – March 14, 2016

Apologies for the long gap in posting! It’s been busy over here at Casa TAG (T, A, and my husband, G :))!

T had a fun speech therapy session yesterday! We mostly focused on teaching T to respond to a few different commands. Here’s what we worked on:

  1. Responding to “wait” and “go!” – T looooves banging on drums. Yesterday, T’s speech therapist showed us how to encourage T to start banging, and then we’d say “WAIT!” Once we told him to wait, if he kept banging, we’d move the drum slightly out of reach or cover it up. Then, after a pause, we’d say “Go!” and let him start banging again. Although at first T was not happy about the “wait!” part of this game, I think by the end of the session, he may have been starting to get the idea – by the end, when we said “wait!” he’d stop banging on his own and look up at us!
  2. Responding to “come!” – We tried to teach T to come toward us when we said “come” or “come here.” T’s speech therapist showed us how to do this by saying “come here!” while trying to entice him with a fun toy. We tried with a bunch of different toys, but T didn’t seem to find any of them compelling enough to come over. However, we repeated this while holding a shoe, T’s current favorite love, and he did race over for that.

Although we are just getting started with this, I think teaching T to understand and respond to different commands could teach him new words, and could be really useful to us!


Speech Therapy Session – February 29, 2016

We had a fun leap-day speech therapy session yesterday! One fun thing we did was play musical instruments. T’s speech therapist had a little musical piano that would play a song if you pushed a button. T’s speech therapist passed out a bunch of little instruments – egg shakers, maracas, a drum, and bells – and, once the music began, we’d all play our instruments along with the music from the piano. T’s favorites were the egg shakers and the drum. I think he’s starting to understand rhythm better – a couple times, it seemed like he found the beat of the music and was shaking or banging in time. One of the things I’ve done since T was super little is patting his body in time to music to help him feel the beat, so maybe some of that is coming together for him!

T’s speech therapist also went over some of our goals for T over the next 6 months or so. She is planning to work with him (and help us work with him at home!) on developing some simple vocabulary. In particular, she wants to work with him on the directives “give me the …” and “show me the …” She also talked about how we can use those to build up some simple vocabulary like animal names, body parts, etc. For today, T was more interested in looking inside the trash can than in practicing “give me the …”, but we’ll get there!

Playing With Bubbles

One of my favorite things about T’s speech therapy sessions is that we learn new ways to interact and play with T, including playing with toys we already have at home. At our very first speech therapy session (when T was only 4 months old!), T’s speech therapist showed us ways to play with T while playing with bubbles.

T’s speech therapist’s eventual goal was to get T to produce “ba” and “pa” sounds. However, when we first started, our initial goal was just to reward T for producing any sounds at all. So, we’d count to 3, and then wait for T to say something (anything!), and reward him by blowing bubbles. To be honest, it took about a month or a month and a half for T (until he was 6ish months old) to be interested in the bubbles – I think he had trouble visually focusing on them at first. After that, he started to really love looking at the bubbles floating around, and especially loved when we caught one on the bubble wand and brought it to him to pop. He soon got the hang of “asking” for bubbles (he’d mostly say “da!” or “ga!”).

After that, we started trying to make the game a little harder for T. First, a little background – one of the things T’s speech therapist has talked to us about is pairing consonants that are similar but different in some context so that T can hear the two consonants together and try to hear the difference. An example of this (that we use in our bubble games) are “ba” and “pa” sounds. “Ba” and “pa” are really similar in that both are bilabial consonants – meaning they are formed with the lips pressed together (if you look in a mirror while making “ba” and “pa” sounds, you’ll notice that they visually look really similar!). However, “ba” and “pa” differ from each other in a parameter called “voice-onset time.” In the case of “ba” and “pa,” voice-onset time refers to the amount of time between when the lips are opened and when vibration of the vocal folds begins. The time is much shorter for “ba” than for “pa,” and you can hear it in how “pa” has sort of a more explosive attack than “ba.”

Anyway, we’ve been trying to get T to hear and produce “ba” and “pa” sounds using bubbles. Now that T is a bit older, we count to 3, and try to wait for him to make a “ba” sound (and if he is reluctant, we’ll say “ba-ba-ba-BUBBLES!”). Then, we’ll show him how to pop the bubbles, while saying “Pa-Pa-Pa-POP!”). T has become somewhat consistent in saying “ba” to get us to blow bubbles, and he is working on the “pa” sound – we’ve heard him say this a few times in the context of popping bubbles, which is exciting!

Speech Therapy Session – February 12, 2016

T (almost 9 months!) had a blast at speech therapy today! We played a game where we rolled a ball back and forth – I sat with T and we rolled the ball to his speech therapist, who rolled it back to us. After we received the ball, we’d tap on it (well, I tapped; T pounded!) while saying “ba-ba-BALL!” and then we’d roll it the speech therapist, emphasizing the word “ROLL!” T got lots of practice hearing the contrast between the vowels “ahhh” and “ohhh,” and he also got to practice turn-taking by having to wait for the ball to come back to him. T is usually pretty patient about turn-taking, but he was SO EXCITED about the big red ball that he kept trying to race across the room to get the ball back. So, this was good practice for him!

And, something exciting happened! We’ve been working hard for the past few weeks on drawing T’s attention to the sound “shhhh.” For example, today at speech therapy, we were playing with a toy piano that plays a song when you push a button; when the song stopped, we’d say “SHHHHH!!! It’s quiet!! the music stopped!” and we would really emphasize the “SHHH” sound with gestures. We’ve been doing this sort of thing for a few weeks now, with music, and by pairing the “shhhh” sound with hiding during peekaboo. And today, for the first time, T produced the “shhh” sound! When the music on the toy stopped, T said “shhh.” We were all really excited – “shhh” is one of the more difficult Ling sounds to produce, since it requires careful mouth positioning, and it’s a bit difficult to hear, since it’s a relatively high-frequency sound that is also sort of soft. T’s speech therapist was excited, and said that all of our peekaboo practice was paying off. I didn’t mention that I’ve been privately working on “shhhh” sounds with T at home by singing and dancing to Taylor Swift’s “Shake It Off” – sometimes, T will start grinning at me when I sing “SHHHHHHHake it off” to him 🙂 (Go ahead and judge my taste in music – in the words of T-Swift – “haters gonna hate hate hate hate hate!”)

Ear Mold Impressions and Speech Therapy Session – February 8, 2016

Ear Mold Impressions

Now that T’s ears are ear wax free, T was ready to get new ear mold impressions made!

T wears behind-the-ear (BTE) hearing aids (common in children, because they’re so durable) As shown in the picture below, the ear mold is a clear piece that fits snugly in the ear. There is a tube that connects the ear mold to the processor (which sits behind the ear), and a clear protrusion from the ear mold that goes into the ear canal. Sound is routed from a loudspeaker on the processor through the tube connecting the processor to the ear mold, and the sound then goes through the ear mold protrustion into the ear canal. The case of the processor also has a microphone, which receives sounds, processes the sounds, and determines how to amplify the sound (based on the person’s audiogram).


The ear molds are supposed to fit super snugly within the ear – and the fit is really important! Properly fitting ear molds are more comfortable, and they also produce less feedback. In T’s case, snugly fitting ear molds stay in his ear much better, too. In order to get the proper, snug fit, ear mold impressions are made of each ear to make a cast of the exact shape and size of the ear

Deciding when to get new ear mold impressions seems like a bit of an art! (In our case, T’s amazing audiologist usually just tells us when to schedule the appointment!) There’s a few ways to tell that a child has outgrown their ear molds. First, the ear molds can visually look too small – there can be gapping between the ear mold and the skin of the ear. Another way to tell is if the ear mold is inserted in the child’s ear but you hear feedback – this occurs because the protrusion of the ear mold isn’t totally isolated from the microphone on the processor (because the ear mold is too small and the protrusion isn’t fitting snugly into the ear canal), causing feedback between the microphone and the ear mold speaker. However, we tend to get new ear molds for T every 6-8 weeks or so, even if his current set of ear molds aren’t obviously too small. This is because it takes 2 weeks for the new ear molds to arrive after an ear mold impression is made, and if we waited to do the ear mold impressions until a current pair was obviously too small, they’d REALLY be too small once the new set arrived! But, since babies tend to grow in spurts, I think it’s always a bit of a guessing game to get the timing right!

So, T got new ear mold impressions made this afternoon! The audiologist first stuck a little ball with a thread attached in his ear so that the ball was where his ear canal is. She then filled around the ball and thread with a pink paste that hardens – the ball/thread kept the pink paste from going too deep into the ear canal. Once the pink paste set, the audiologist took the cast out, and it was ready to be sent out to make an ear mold exactly the shape and size of T’s ear. T had both ears done, and although he was a bit impatient with needing to hold still, we were done in about 15 minutes! His new ear molds should arrive in about 2 weeks.

Speech Therapy Session

After getting his ear mold impressions made, T had a speech therapy session. We started by playing with a pop-up farm animal toy – there were 4 animals (a cow, a pig, a horse, and a chicken) that were “hidden” in a box with a lid. Each had a corresponding knob, and when the knob was turned, the animal would pop out. We first contrasted the words “open” and “close” by saying “OOOOPEN!” while turning the knob and “CLOOOSE” when shutting the lid and saying “bye-bye!” to the animal, emphasizing the “o” sounds in “open” and “close.”

When T tired of that game, we opened a book of animals and asked T to point to different animals (“where’s the horse?”) – T isn’t yet able to identify animals and point to them, but we’re working on it! I often don’t think to ask T to show me where items are or to give me objects, just because I don’t think he’s capable of this task yet. But, today was a good reminder that I can still ask him these things, and he’ll learn in the process – there’s no need to wait to start asking him until I’m sure he can do it!




Speech Therapy Session – February 1, 2016

We started today with working on identifying Ling sounds. Today, T was able to pick out the toys paired with “mmm,” “ooo,” and “ahh”! When the speech therapist said “can you show me mmmm?”, T was able to point to the corresponding ice cream toy out of 4 or 5 toys in a bin (and did similarly for the “oooo” ghost toy and the “ahhhh” airplane toy). I was so surprised he remembered these pairings, since we don’t have these toys at home and so aren’t able to practice this at home. I think it’s possible he identified them by chance, but I do think he’s getting the hang of this each time we try!

One really interesting thing we learned about today from T’s speech therapist was about “prosodic bootstrapping.” (Note: I am not a speech therapist, and really don’t know much about linguistics, so the explanation below is just to the best of my understanding!)

Prosody relates to the larger parts of speech than vowels and consonants, like syllables, words and phrases. Prosody gives us information about speech like the speaker’s mood, whether a sentence is a question or a statement, whether a sentence is said sarcastically, etc. Prosody also helps indicate a language’s underlying grammar. For example, prosody can indicate clause boundaries within a phrase or sentence. Consider the sentence “he walked the dog.” – In English, it would be unlikely to insert a pause between “the” and “dog,” because that splits the phrase “the dog.” The locations and durations of pauses within phrases are one example of prosodic information. Other auditory cues used to convey prosody include: loudness or stress (e.g., which parts of a word or clause we emphasize), frequency or pitch of the voice and how it changes (e.g., in English, pitch tends to rise as we ask a question), and duration and timing of pauses (e.g., to mark clause boundaries, as mentioned above).

Bootstrapping refers to way in which infants naturally acquire their native language, just by hearing it around them and spoken to them. In particular, bootstrapping refers to the idea that infants use innate statistical learning abilities to learn small bits of information about language and build on these small bits to build up their understanding of their native language. A particular example of this is how infants use statistical learning to identify word boundaries (see [1]) – in English, the letter combination “st” is fairly common (as in “sting”), but the combination “gb” is not. Just by hearing streams of speech, infants learn that “st” is common, but “gb” is not, and this knowledge helps them segment words within a stream of speech. Take the example of the stream of speech “stingingbee” – this can be broken into the words “stinging” and “bee,” and “gbee” not likely to be a word, because in English, “gb” is not a common combination.

So, “prosodic bootstrapping” is how infants learn to use the auditory cues that indicate prosody to learn about the intent of speech (is it a question? said angrily or sarcastically?) or the underlying grammar (which are the clauses that are grouped together). One really cool thing is that newborn infants cry with a prosody that is similar to their native language (see [2]), which may indicate that they are learning prosody of their native language heard in the womb! I hope to learn more about how infants (particularly those with hearing loss) learn to use prosody information, and will hopefully write more about this as I learn more.

So, to get back to T and our speech therapy session – T’s speech therapist asked if we had noticed him babbling with different prosody – for example, “ba da ga ba?” or babbling with excitement versus irritation. We have definitely noticed that when he’s ready to get up for the day in the morning (or, at 2 am in his case!), he will start off babbling happily, and then his voice gets more and more insistent and agitated until we finally get him up. Also, he seems more likely to respond vocally to us when we ask him a question (with a rising tone at the end of the question) than when we make a statement and then pause, which indicates that he is picking up on the auditory cues that indicate questions versus statements. We will definitely be paying more attention to this now that we talked about this today!


[1] Saffran, Jenny (1996). “Word Segmentation: The Role of Distributional Cues”. Journal of Memory and Language 35 (4): 606–621.
[2] Cross, Ian (2009). “Communicative Development: Neonate Crying Reflects Patterns of Native-Language Speech”. Current Biology19: R1078–R1079.


Speech Therapy Session – January 25, 2016

We started today by repeating some of the games we played last session where we paired toys with different Ling sounds, and asked T to identify the toy paired with a particular sound.  Today, he was a bit more interested in trying to pull himself up to stand; we tried to entice him with the toys for a few minutes, then moved on 🙂

One thing we have been working on since T first started speech therapy is the concept of turn-taking. Conversation naturally involves taking turns; for example, knowing that when one person pauses, it’s the other person’s turn to say something. One way we have worked on this that T LOVES is by taking turns banging on stuff (like a drum). One of us will bang on the drum, then give T a turn, and we go back and forth. He has really started to get the hang of turn-taking, and will wait for his turn to bang.

The other concept that drum-banging is helping to reinforce with T is the concept of segmentation – for example, that “bang” is one word and “bang bang” is two words. When it’s our turn to drum, we will bang either once, twice, or three times, and then encourage T to bang the same number of times when it’s his turn to drum. T is definitely getting the hang of segmentation, as he will bang a similar number of times, although it’s clear that he prefers banging many times to banging just once! 🙂 I learned a bit about how infants learn to segment word boundaries (for example, if you hear the stream of speech “iateanicecreamconebutitmelted,” you learn that “melted” is a word, and “itmelted” is not a word) in grad school – and it’s SO COOL – I hope to write more about this soon!

We finished up with a fun couple of rounds of peekaboo, where we tried to encourage T to make sounds like “boo!” before we pulled a sheet away from our faces.  He definitely made a few “ba ba” sounds, and he definitely had a blast! Peekaboo is always a favorite with him!