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Sydney speech pathologists helping adults and children speak for themselves.

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The Banter way

30 things parents tell us they look for in excellent speech pathologists

David Kinnane · 8 December 2019 ·

We want parents to be informed about, and engaged in, what we do when we work with their child.

Research – and clinical experience – tells us that parents want to work with a speech pathologist who is:

  • right for them; and 
  • right for their child. 

This means we must impose high standards on ourselves, our team, and our professional colleagues.  

As part of our ongoing efforts to improve our services, we looked at peer-reviewed research and client feedback.  It highlighted 30 key themes for us to think about when:

  • selecting and training our speech pathologists; and
  • improving our services.

Related articles:

  • Why us?
  • Let’s cut to the chase: when should I seek help from a speech pathologist for my child?

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

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Celebrating staying small; plus a sale!

David Kinnane · 2 December 2019 ·

A few weeks ago, one of my clients – a successful entrepreneur – took me aside. “You should scale Banter Speech,” he said. “Open more branches. Franchise!”

He wasn’t the first person to give us that advice. From a business perspective, the suggestion made sense. We’ve invested a lot of time and energy over the years in training, building quality systems, and creating resources to help people with speech, language, stuttering, literacy and other communication challenges. With work, we could probably double or triple our size pretty quickly.

But, something about the idea didn’t sit right with me. 

Cut to yesterday. As I cleaned up my man cave, looking for our battered Christmas Tree box, I came across a classic: “A Pattern Language”, by Christopher Alexander and colleagues. It’s a book about planning ideal towns, buildings and services for people and communities. 

As I flicked through it (procrastinating), I came across this great quote:

“Services don’t work if they are too large. When they are large, their human qualities vanish; they become bureaucratic; red tape takes over.” 

If you are providing quality care to real people with challenges, there are big benefits to staying small:

“We have concluded that no service should have more than 12 persons total…the largest number of people that can sit down in a face-to-face discussion.”

So – although we are grateful for the support – we’re not looking to scale or franchise our clinic. We love our small, but talented team. Our independence. Our active relationships with our clients, their families and our local communities.

A Pattern Language with Francis, the Squishmallow

We revel in the absence of red tape and the freedom it gives us to try new things, to improve our client care, and to create useful resources. 


Speaking of resources, Teachers Pay Teachers is throwing a huge cyber sale on 2 and 3 December!

All of our 188 resources are discounted by up to 25%!

To inspire you, here are some of our most popular resources. But check out the terrific resources of other speech pathologists, too! 

Lidcombe Program Activities
Shop now!

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

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Why us? 11 reasons

David Kinnane · 28 September 2016 · Leave a Comment

 

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

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Let’s cut to the chase: when should I seek help from a speech pathologist for my child?

David Kinnane · 29 August 2016 · Leave a Comment

Speech pathologists help people with communication problems. But many of us are not very good at explaining what we do in Plain English:

  • We use too many long, pointless words.
  • We call ourselves different things in different countries.
  • We can’t agree on what to call some communication impairments.

And we’re not alone. Psychologists, doctors and psychiatrists use different words and phrases to talk about communication issues. It’s not always clear whether we’re all talking about the same thing.

This is a big problem: it’s confusing to people and families who need help.

There’s an urgent need for speech pathologists to give people better information about common communication impairments. In this article, we answer some questions about speech pathology and common communication problems.

We want to help you understand what we do and how we can help.

1. Are speech pathologists, speech therapists and speech-language pathologists the same thing?

Yes.

2. What do speech pathologists do?

Most speech pathologists help people with communication impairments. Some of us also help people with swallowing and feeding impairments.** An impairment is a disability.

3. What does “communication impairment” mean?

To survive and to take part in society, we need information: facts and knowledge. One way we get and pass on information is by communicating with others. Communication means sending information to, and receiving information from, others.

Some people have problems sending and/or receiving information. We call these problems communication impairments.

4. What are the most common communication impairments?

Developmental language disorders and speech sound disorders. They affect about 5-8% of pre-school children. If untreated, they can lead to lots of problems including with behaviour and social interaction, reading and writing, school and work success, and mental health.

(a) Are language and speech the same thing?

No.

One way we communicate with other people is through language. Language is understanding and using words and sentences to receive and to send information. We can do this by speaking and listening, reading and writing, or by sign-language. Language includes:

  • content: our knowledge of words (vocabulary) and meanings (semantics);
  • form: our knowledge of speech sounds (phonology), word forms – e.g. saying “cups” to tell people there is more than one cup, or “climbed” to tell people that the climbing happened in the past (morphology); and how to put sentences together properly (syntax); and
  • social use: how to use language appropriately in a given situation, e.g. when having a conversation, giving a speech or telling a story.

Speech means using our voices to make words and sentences. Speech involves both language skills and motor skills (using nerves, muscles and body parts to make speech sounds). For example, to say “banana” we need to coordinate our breath, vocal chords, lips, soft palate, jaw, tongue and teeth to articulate the three “beats” – ba-na-na – in a way that others can understand.

You can have good language skills, but impaired speech skills. For example, you might be able to write or sign fluently, but not be able to speak clearly.

(b) Developmental language disorders

These are problems understanding and/or using language to communicate with others.

Confusingly, speech pathologists and others can’t agree on a single name to call it. Different people in different places use different terms, e.g.

  • language delay;
  • language disorder;
  • specific language impairment;
  • language learning impairment; and
  • developmental dysphasia (or aphasia).

All these names have their pros and cons. In line with recent academic and professional efforts to reach agreement, we prefer the term “developmental language disorders”.

(c) Speech sound disorders

These are problems saying speech sounds correctly and being understood. If strangers can’t understand your child’s speech, they might have a speech sound disorder.

Speech sound disorders include:

  • not being able to say some sounds. You can read more about when children are expected to be able to say different consonants here;
  • developmental and unusual error patterns called “phonological processes”. You can read more about 10 common error patterns here; and
  • articulation problems, like lisps. You can read more about lisps here and here.

5. When should you see a speech pathologist about your child’s speech-language development?

When any of the following is true:

  • You are concerned about your child’s speech, language or communication skills development.
  • Your child is having behavioural or psychiatric problems.
  • Your child’s communication skills (listening and/or speaking) are well behind the skills of his or her peers.
  • Your child is between 1 and 2 years old and:
    • isn’t babbling;
    • is not responding to speech or other sounds; or
    • is making few attempts to communicate with you.
  • Your child is between 2 and 3 years of age and:
    • does not interact with you or others much;
    • has no or very few words (fewer than 50 words);
    • does not respond to spoken language; or
    • has their language development appear to stall or even go backwards.
  • Your child is between 3 and 4 years of age and:
    • speaks in two-word sentences at most;
    • does not understand simple commands (e.g. “Get your shoes”); or
    • is not easily understood by close relatives.
  • Your child is between 4 and 5 years of age and:
    • speaks in two-three word sentences at most;
    • does not understand spoken language;
    • is not understood by strangers; or
    • is not understood by close relatives at least half of the time.
  • Your child is older than 5 years and:
    • is not understood by strangers;
    • can’t tell or re-tell a coherent story;
    • can’t understand what is read to them or listened to;
    • has difficulty understanding, following or remembering spoken instructions;
    • talks a lot, but is very poor at engaging in conversation; or
    • interprets things very literally, often missing the point of what is meant.

Developmental Language Disorder Key Red Flags

6. How do speech pathologists assess communication impairments?

Speech pathologists should get their information from more than one place to make sure they understand the scope of the problem and its effects:

  • Client, parent, and teacher reports.
  • Observations: in the clinic and, if possible, out in the real world.
  • Standardised and other tests to probe areas of strength and challenge.
  • Language sampling.

Speech pathologists should look at two things when they assess people with language or speech problems:

  • the skills that are impaired; and
  • the effect of the person’s communication impairments on their participation in the real world.

These are different things. For some people, a minor impairment (e.g. a lisp) can have a big impact on their quality of life. For others, even a severe communication impairment may not cause many problems.

7. What communication skills do speech pathologists assess?

  • Language understanding – also called “receptive language”.
  • Language expression – also called “expressive language”.
  • Language content, form and use (see above).
  • Speech sounds: development of vowels and consonants, developmental error patterns and atypical error patterns.
  • Oro-motor skills (nerves, muscles and body parts of speech).
  • Fluency.
  • Intelligibility: can the person be understood by others?

Often, speech-language assessments are done in stages. We look for the big issues first, then zero in on specific problems.

8. Can children have both developmental language disorders and speech sound disorders?

Yes. We know that:

  • around 15% of 3 year olds have a speech sound issues; and
  • 50-75% of these children also have a developmental language disorder.

You can read more about this here.

9. What if my child speaks more than one language?

Speaking more than one language:

  • does not cause language learning impairments; and
  • is an advantage for many children.

At 30 months of age, children who have at least 60% exposure to English will usually have similar language skills to a native English speaker. Children need around 5-7 years exposure to a language to be fluent in it.

A true language impairment will affect all languages a child speaks.

You can read more about language impairments and children who speak more than one language here.

10. Can children with language disorders also have other issues?

Yes. Developmental language disorders and speech disorders frequently happen at the same time as other difficulties, including problems with:

  • working memory;
  • auditory processing;
  • attention, e.g. ADHD;
  • hearing problems;
  • behaviour, e.g. hitting, kicking, biting other children;
  • gross or fine motor impairments;
  • reading; and
  • general development.

In these cases, it can be a good idea for your child to be assessed by other relevant professionals as well as a speech pathologist, e.g.

  • a paediatrician for a developmental assessment;
  • an audiologist for hearing and auditory processing assessments;
  • an occupational therapist for sensory, gross and fine motor assessments; and
  • a psychologist for a cognitive or reading assessment.

Some children with developmental language disorders and speech sound disorders also have developmental disorders or life-long disabilities, e.g. some children with:

  • moderate-severe profound hearing loss (although this typically only affects oral language – not signing or speech – if the child is exposed to signing early in life);
  • intellectual disabilities;
  • Down Syndrome;
  • Klinefelter Syndrome; or
  • Autism Spectrum Disorder.

11. My child might be stuttering. Where can I find information about evidence-based treatments?

Stuttering is fairly common, and often starts between the ages of 2 and 3 years. There are some great treatments available for pre-schoolers. Stuttering gets harder to treat with age.

You can read more about stuttering and other fluency disorders here. We don’t think there is any link between developmental language disorders and stuttering. However, we know that 30-40% of children who stutter also have a speech sound disorder.

12. My child has voice problems. Should I be concerned?

Voice disorders are probably not picked up as often as they should be and can have a big impact on a child’s quality of life.

You can read more about voice disorders here.

Bottom line

Speech-language communication impairments:

  • are the most common of childhood disabilities;
  • are often not picked up early enough; and
  • can have serious effects on a child’s social, school and later work goals, participation and achievements.

Speech pathologists (myself included) need to do a better job telling the public about common childhood communication impairments. We need to:

  • agree on our terms;
  • cut out the jargon and speak in Plain English; and
  • give families:
    • quality information based on the latest research evidence; and
    •  practical guidance on when, where and how to seek help.

If you have any concerns about your child’s communication skills, please contact your local speech pathologist for a chat.

Principal sources:

  1. Bishop, D.V..M., Snowling, M.J., Thompson, P., & Greenhalgh, T. (2016). CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study. Identifying Language Impairments in Children. PLOS One, 11(7). Full text can be accessed here.
  2. Prelock, P.A., Hutchins, T., Glascoe, F.P. (2008). Speech-Language Impairment: How to identify the Most Common and Least Diagnosed Disability of Childhood. Medscape Journal of Medicine, 10(6), 136.

** People use many of the same nerves, muscles and body parts for both speech and swallowing. But they use them in very different ways. At Banter, we focus on speech and language and do not treat feeding or swallowing disorders. For people with swallowing or feeding needs, we are always more than happy to refer them on to speech pathologists with this expertise.

Image: http://tinyurl.com/zbtpfav

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

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Defrazzle and reconnect: tips for families to talk to each other to stimulate language development

David Kinnane · 12 October 2015 · Leave a Comment

The irony of spending time away from my family to write this post about increasing communication at home isn’t lost on me. Nor is the truth about how hard it is to do this stuff in practice!

I suspect our family is fairly typical for Sydney. Both parents work, juggling child-minding with help from family. Kids at different schools, with different sports and other activities. Homework. Volunteer work. Kids’ friends’ birthdays every second weekend – sometimes more than one. Visiting grandparents whenever we can. Weekends eaten up with chores we couldn’t squeeze into the week. Criss-crossing Sydney, always stuck in traffic. Always en route to or from somewhere.

Every now and then, when we discover a magical gap in our schedule, all we want to do is come home, switch on the TV, distract the kids with iPads and do nothing at all. Now, once in while, that’s perfectly fine.  But, too often, too easily, that once in a while becomes the norm, and we stop talking to each other about anything other than ‘disciplinary matters’ and the logistics of the next event in our overstuffed-calendar.

Why does it matter?

As we’ve previously said, children are hard-wired to learn language. They don’t need flashcards, educational apps or expensive training systems, and they don’t learn language efficiently from passively watching screens. Instead, the key in how children learn to talk is obvious, free and simple: talking with them. Conversation.

Talk contributes not just to language development, but to children’s expanding knowledge of the world and their willingness to talk to others. Studies show that children exposed to fewer words, and a higher percentage of negative statements (e.g. “No. Don’t do that, Stop that!”), tend to have lower vocabularies and IQ scores (e.g. Hart & Risely, 1999). In other words, the amount and quality of talking with your kids can have lasting impact on children’s language development – especially during their first three years when they are most dependent on you doing most of the conversational heavy-lifting.

So how can we do it in the real world?

Here are 8 ideas to kindle or rekindle real communication with your family. None is rocket science.  But they all take conscious thought and commitment to pull off:

1. Eat together: even if it’s just for 20 minutes and not every day.  Make it a priority.  Turn off your TV, phones and other devices.  Talk about daily events, share ups and downs.  Take it in turns.  Ask specific questions, not simply “how was your day today?”.  Studies show that families who eat together as a family have children who have fewer problems when those teenage years hit.

2. Host a monthly family games night: take it in turns to choose the board game.  Start with all those games you’ve received for kids’ birthdays and never used.

3. Set a weekly reading night: turn off the TV, turn on some music (traditional jazz is a big hit in my family), get everyone to sit in a room together (any room will do) and read anything they want for pleasure. Paper books only. No school texts or academic papers allowed.  Leave plenty of time to discuss what you’ve read and learned.

4. Choose a walk morning/night: take advantage of daylight saving to explore your local neighbourhood.  Take in the sights, sounds, smells, and textures all around you.  Discuss anything and everything – bugs, rocks, leaves, flowers, overgrown hedges, unpainted fences, poorly-crafted graffiti, roadworks, and whether Mrs Carruthers down the road is a witch or just misunderstood.

5. Family membership: whether it’s a local footy club or the Australian Symphony Orchestra, subscribe to something that will get you all out and about at least a few times a year.

6. Public transport day: choose a day a month – we always go for Sunday – and catch a train, bus and/or ferry to somewhere you’ve never been before.  Don’t over-research it.  Just go somewhere, then look around.

7. Family project: now, before you roll your eyes, it doesn’t have to be lame.  Nor does it have to be expensive. Design and plant a new garden bed. Cook a meal – everyone contributing ingredients.  Corral all those thousands of digital photos on your phones into a personal website or an album-gift for the relatives.

8. Kids’ choice play: as a Hanen-certified speech pathologist, I would be remiss if I didn’t recommend getting down on the floor to the kids’ eye level and following their lead as they choose and play a game of their choice.  Following a child’s lead is a powerful way to help him or her initiate interactions; and children are more likely to learn language talking about things of interest to them. Allow your children free play time – not everything has to have an educational purpose.

Principal source: Hirsh-Pasek, K. & Golinkoff, R.M., with Eyer, D (2003). Einstein Never Used Flash Cards: how our children really learn – and why they need to play more and memorise less. Rodale, New York, New York.

Related articles:

  • Defrazzling update: practising what we preach
  • Defrazzling: Family Project Time: The Local Council Pick-Up
  • Defrazzle: Stuck in a rut? Do something random!
  • Defrazzle: Ironfest (huzzah!)
  • Defrazzle time to improve your child’s behaviour and language skills
  • Speech pathology homework doesn’t have to be boring

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

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