Brooklyn Letters has just added Telepractice Speech Therapy to our catalog of services. This is an excellent option for those who require flexible scheduling and want access to high-quality speech language therapy services from the convenience of their computers.

We’ve outlined the entire process here. Please contact us should you require more details.

In adjusting the eligibility criteria for speech only children in Early Intervention, the New York State Health Department frequently stated that “late talkers were a variation of normal development.” The more stringent eligibility was intended to decrease services to “late talkers” because it believed that these children would catch up to their peers over time. The following information reflects research and resources compiled by Michelle MacRoy-Higgins, Ph.D., CCC-SLP, Assistant Professor, Communication Sciences Program, Hunter College-CUNY, who has researched the topic of late talkers and presented at the 2010 ASHA convention on the topic.

Who are Late Talkers?
The late talkers reflect 15% of the toddler population and are identified around two years of age when children produce fewer than 50 words and do not combine words. The late talker also has normal hearing, cognitive, sensory and motor development. A typical child at two years of age would be using over 300 words and putting together 2-4 word sentences.

Why Late Talkers are Not a Variation of Normal Language Development
Language characteristics of the late talkers are not reflective of typical language development in the areas of:

1. Word learning
• Receptive language (understanding): Late talkers do not learn (point to) new words as accurately as their peers. (Ellis Weismer & Evans, 2002; MacRoy-Higgins, Schwartz, Shafer & Marton, 2009)
• Productive language (expressive vocabulary): Once late talkers say words, they are slow to add more words to their vocabularies; they do not systematically add words to their vocabularies as observed in typically developing toddlers (MacRoy-Higgins et al., 2009).

2. Phonology (sounds)
The sounds in the words that they do say show delays and disordered patterns. For instance, late talkers produce atypical sound errors, atypical sound patterns and show little change in development over time as compared to language-matched peers (Williams & Elbert, 2003)

3. Morphology/syntax (grammar and word combinations)
Once late talkers begin to combine words they show delayed and disordered patterns. For instance, late talkers produce more errors than their language-matched peers (Thal et al., 2004)

4. Social skills
At risk for social/behavioral disorders. Late talkers are less social than their peers; quality of parent-child relationships in late talkers is judged to be more stressful than parent-child relationships in typically developing toddlers (Irwin, Carter & Briggs-Gowan, 2002)

Are there Long-Term Implications for Late Talkers?
The research has indicated that late bloomers show improvement in language skills but that they perform significantly poorer than their peers in reading/literacy, syntax and morphology (word combinations/sentences and grammar) and vocabulary deficits are observed through 17 years of age.
Toddlers with Specific Language Impairment (SLI) demonstrate significant difficulties with all aspect of language (understanding, expression and literacy/reading).

Why is it Important to Provide Speech and Language Services to Late Talkers?
Approximately one-half of toddlers who are late talkers will be labeled as having Specific Language Impairment in preschool/elementary school. Those that show improvement (late bloomers) continue to perform poorer than their peers in language and literacy skills throughout elementary and secondary school.

Late talkers are not a variation of normal development because at age two they show disordered patterns of
• Vocabulary acquisition (understanding and naming)
• Phonology (sound system)
• Grammar
• Social skills

Why is Early Intervention so Important for Late Talkers?
An early foundation in oral language skills is paramount for the development of literacy and reading skills. Late talking toddlers are at significant risk for academic difficulties and therefore would benefit from language intervention as early as their language disorder is identified.

Is Language Intervention for Late Talkers Effective?
Language intervention for late talkers is effective. Late talkers receiving intervention by a Speech-Language Pathologist over a short period of time showed improved language skills (vocabulary, production of sentences, speech sound production) as compared with late talkers who did not receive intervention (Robertson & Weismer, 1999), and these results suggest that if untreated, late talkers will not improve their language at the same rate as their typically developing peers, with the significant risk of lifelong language difficulties impacting academic achievement, reading and literacy.

References
Ellis Weismer S., & Evans, J.L. (2002). The Role of Processing Limitations in Early Identification of Specific Language Impairment. Topics in Language Disorders, 22(3), 15-29.

Irwin, J.R., Carter, A.S., & Briggs-Gowan, M.J. (2002). The Social-Emotional Development of ‘Late-Talking’ Toddlers.Journal of the American Academy of Child & Adolescent Psychiatry. 41(11), 1324-1233.

Leonard, L.B. (2000). Children with Specific Language Impairment. Cambridge, MA: MIT Press.

MacRoy-Higgins, M. Schwartz R.G., Shafer, V.L., & Marton, K. (2009). Word learning and phonological representations in children who are late talkers. (Doctoral Dissertation), Graduate Center, CUNY, New York, NY.

Rescorla, L. (1989). The Language Development Survey: A screening tool for delayed language in toddlers. Journal of Speech and Hearing Disorders, 54, 587-599. 22.

Rescorla, L. (2009). Age 17 Language and Reading Outcomes in Late-Talking Toddlers: Support for a Dimensional Perspective on Language Delay. Journal of Speech, Language, and Hearing Research. 52, 16–30.

Robertson S.B. & Ellis Weismer, S. (1999). Effects of Treatment on Linguistic and Social Skills in Toddlers With Delayed Language Development. Journal of Speech, Language, Hearing Research. 42, 1234-1248.

Thal, D.J., Reilly, J., Seibert, L., Jeffries, R., & Fenson, J. (2004). Language Development in children at risk for language impairment: Cross-population comparisons. Brain and Language, 88, 167-179.

Williams, A.L., & Elbert, M. (2003). A Prospective Longitudinal Study of Phonological Development in Late Talkers. Language, Speech and Hearing Services in Schools, 34, 138-153.

Dr. Michelle MacRoy-Higgins has worked as a Speech-Language Pathologist for nearly 15 years. In addition to being a private practitioner, Michelle is an Assistant Professor in the Communication Sciences program at Hunter College (CUNY) and teaches graduate students in the areas of language development, language, phonological, articulation, motor speech and swallowing disorders in children. Michelle has worked clinically in a variety of settings including home-based, preschool, elementary school and private practice clinics; and has enjoyed working with a variety of children presenting with language, phonological, articulation, and feeding disorders ranging in age from birth through adolescents. Michelle’s clinical and research expertise is with children who are late talkers. She enjoys working with children and their families to develop individualized and evidenced-based treatment, while having fun and encouraging communication success.

Minimize the problem:
• As much as possible, do not encourage your kids to side with you over their other parent. Empathize with them, help them problem solve if it feels appropriate. But remember, your child does not have the option of divorce from their parent. They need to find ways to deal with their other parent in a way that will work for them for the rest of their lives. Therefore, do not allow your children to polarize the two of you in this way. Neither you nor your ex are perfect and your child needs to learn how to have the best possible relationship with both of you that they can. Sometimes it helps to stop for a minute and remember that there was a reason you married this person in the first place, and no matter how far away that seems at this point, your children are still hanging onto those positive qualities. It is in their best interest to have as close of a bond with both of you as possible, despite whatever long list of imperfections have now presented themselves in your ex. If you don’t feel that you can be a somewhat neutral source of support for your child when it comes to issues with their other parent, find them someone else to talk to.
• Do not vent your own frustrations about your ex to your child. There are many other appropriate people to discuss your own ongoing feelings of anger and frustration about your ex with. Your child is not one of those people.
• Although you may be angry at your ex, DO find ways to be on the same team. You owe it to your children to maintain communication with your ex in some way, shape, or form, and maintain consistent rules and expectations for your kids at both houses. If you cannot communicate on the phone without fighting, try texting or emailing. If you still cannot communicate, seek help. Therapy is a great way to show children that even though you no longer live under one roof, you are all still a family and are willing to do what it takes to make the family work in a way that benefits the children without getting back together.

*Remember that you don’t have to be alone and out of social resources to seek professional help. Sometimes a therapist can be a great non-biased ear for you, your ex, and your children to vent to during this difficult time.

Susannah Gersten is a Brooklyn based psychotherapist with experience in mental health as well as community based counseling services in Park Slope, making her invaluable in building relationships with the schools and other services in the area. In her private practice, Susannah offers play therapy with young children as well as behavior management, behavior plans and other techniques that involve both children and their family. She also offers couples and family psychotherapy, in order to help the parents and family address any underlying concerns in the family system. She runs an equine assisted psychotherapy group for middle-school aged children out of Kensington stables to address anxiety, shyness and depression.

I am starting up my equine assisted psychotherapy program again in the coming months with small groups of 6-7 year olds based around feeling identification and empathy building. The sessions will include 15 minutes of grooming, a 30 minute therapeutic riding lesson, and a 30
minute office session on a separate day. The program will last 10 weeks: Riding will be on Monday afternoons at Kensington Stables and office sessions on either Wednesday or Thursday afternoons in Park Slope.

For those who are not aware, EAP is used to enhance office work with the use of horses. The therapeutic riding is excellent in helping with sensory integration, management of anxiety, and awareness of one’s body and feelings in the moment. This group will include those inherent aspects of therapeutic riding, but will have a specific focus on the feeling and empathy end. The riding is taught by an instructor from GALLOPnyc – www.gallopnyc.org – and the psychotherapeutic aspect is led by me, a licensed clinical social worker. If you are interested in the group for your child, please email me at susannah@brooklynlearning.com or call (718) 360-8531 to learn more.

Please note: Safety is of the highest priority – children must have adequate impulse control in order to be safe around the horses.

Susannah Gersten was born and raised in Brooklyn and specializes in working with young children and new parents. She obtained her undergraduate degree from Vassar College and her Master’s in Social Work from the Smith College School for Social Work. She has experience in mental health as well as community-based counseling services in Park Slope, making her invaluable in building relationships with the schools and other services in the area. In her private practice, Susannah offers play therapy with young children as well as behavior management, behavior plans and other techniques that involve both the child and their family. She also offers couples and family psychotherapy in order to help the parents and family address any underlying concerns in the family system. If parents desire, Susannah is happy to be in communication with guidance counselors, teachers and others at the child’s school. Outside of the office, She runs an equine assisted psychotherapy group with middle-school aged and younger children to address anxiety, shyness and depression. This group is especially indicated for children who have not responded to traditional therapy in the past. She has run this program for three years in conjunction with GallopNYC which works out of Kensington stables.

Join Brooklyn Letter’s pediatric experts Dr. Lindsay Whitman (pediatric neuropsychologist ages 4-18), Jo-Ann Kalb (NY State Certified Teacher & reading interventionist for children ages 5 to 10), and Craig Selinger (speech language therapist for babies to pre-adolescence) for a parent-friendly collaborative discussion on dyslexia (reading disorder). They will debunk common myths, provide up-to-date information on dyslexia, and review the process that should be undertaken to diagnose dyslexia. Finally, practical strategies to use with students (age 5-10) to help their reading development will be provided.

The discussion will take place in Park Slope. Cheese and wine will be provided.

When: Monday October 24th, 6:45pm-8:15 pm.
Lecture 6:45-7:45pm and Q & A 7:45-8:15pm.

Where: 435 15th St. #1 between 8th Ave and Prospect Park West in Park Slope, Brooklyn. One block from the F and G subway- 15th St. stop
Cost: $15 per person. No refund, unless event is canceled. Spots limited to 12 people.

Interested?
Email Craig at craig@brooklynlearning.com to RSVP. Once confirmed, please mail a check for $15, written out to Craig Selinger, and mail it to 435 15th St. #1, Brooklyn, NY 11215