Monday Live: How to Fix Wrong Speech Sounds with Delayed Children

Wrong sounds that are going on with your child. And I want to talk about, like, small kids first. Right. But anyways, all these tips and tricks and strategies and whatever, they all help with whatever kind of speech sound disorder your child is. All right? So first of all, let's define what is a speech sound disorder, all right? That speech sound disorder is part of communication disorder. Okay? And what that really means is speech sounds is the sounds that we make with our mouths, which becomes what we call speech. And speech is the sounds that we make that can communicate with other people. So it needs to be communicative, okay? It's not like if you do, like, a lip troll. Like. Like that. Sorry, it's too early for a lip troll. And those, like, lip trills by itself, is it a speech sound? It could be. It could be if your. If your language has that as a sound. All right? Registered inside. All right? So for instance, in Indonesian, the R is a tongue trill, right? Like. Like that. And there are different types of tongue trills. So my type of tongue trill actually sucks. Apparently mine is a little too back. The tongue, it should be at the front, which I don't know how to do yet. Right? And for French, you get a lot of, like, throat sounds. Like, if there's a R, you go, I don't know how to do it. I'm not going to embarrass myself here. So that's that. And if you think about it, those sounds are. It becomes part of your phonological system. And it's a crazy word. Just means by. It just means, what kind of sounds are you already accustomed to making? So, for instance, in Japan, when people see an R, they think of L. Just because in Japanese, there's no R, right? It's always L. So therefore, when they speak English, it's a very common mistake for them to actually do L for R. So if you've watched Lost in Translation, the movie, you know, when. When the Japanese woman says rip, she says lip. Okay? Another example is the English th. English, th is pretty bad. Pretty bad spoken kind of sound. So for Chinese people like myself, the th sound, like the. If you can hear it through the mic, usually becomes an F, because it just means that there's no th inside Chinese, like both Mandarin, Cantonese, Hokkien, whatever. We don't have th in it. So therefore, we substitute it with something else. All right? So that is one of the reasons why we want to talk about this. Now we know what is a speech sound, right? The speech sound is actually just the sounds we Use to communicate. Okay. As long as it exists inside your language, then it's something that you need to be able to say or else it's going to sound weird. Okay. It's going to be wrong. All right. If you are an English person, but you cannot do the th, all right? That's actually still fine because the th sound is like, it's going to extinct. If you look around, especially in different, like, ghetto communities or like second wave, second generation of like Americans or whatever, the th is becoming an F and a lot of neighborhoods apparently, and it's gonna be extinct in like 15 years, which I doubt, to be honest, because people nowadays like to be proper. Okay, so that's that. Once we got that out of the way, now we can talk about, like, how do we even start fixing your speech sounds? So if you're a child right now, there's some sounds in the pronunciation that are wrong according to your language. Right. Let's say that your child is in the Japanese trying to speak English. There's no accent involved. It's just purely. They don't know the sounds correctly. Yeah. Then this video is for you. All right? And if you haven't, you should go to agentsofspeech.com to check out those blog posts as well. I write them up. And also you should get on our emailing list. So whenever you see like a box to put on your email, you should do it. Because we're doing a lot of workshops and email subscribers, which is around 2000 people now. Hallelujah. You guys get like a discount for upcoming workshops. And one of the workshops that I'm thinking about is doing a toilet training, doing one for haircuts, again, doing one for disruptive behavior, doing one for speech sounds, so and so forth. So a bunch of live workshops and you get like, discount if you're an email subscriber. So let's get back real quick to fixing speech sound. So first of all, you have to identify what kind of speech sounds are missing. Okay. And usually what you would do is to pay a speech therapist like myself to do. Okay. We go through a test. Okay. And in. In Hong Kong, we use something like Hong Kong Cantonese articulation test, which I'm super familiar with. But in English, we use something called. I always get the name like gold. Let me just double check. Speech assessment. Yeah. So if you use any type of speech assessment in English, man, I am so bad that I forget all the names. Right? Okay. It's called Goldman Fristo. It's the one that is the most well known and well used in the western countries. And if you. If you're living somewhere out of that place, right, let's say that, like, you're in Indonesia, like a lot of people who are watching right now, like Lena and Agnes and stuff that are watching. And if you're watching on a replay, you're living somewhere else where you speak English, but it's not your official language in your country. Just be careful if the speech therapist actually norms your test, all right? What I mean by norm is that they compare your child to someone to like a scale. So they tell you, oh, it's like two standard deviations below or something. Or like, oh, they're at the whatever percentile or something. Those. You don't need to care, okay? Because basically they're comparing you to Americans or they're kind of comparing you to, like, English people. So don't. Don't care about the numbers if you're not living there, okay? If you're living in America, yeah, of course you would love to be compared to fellow, like, English people or like Canadians or something. But at this time and point, it's just stupid to compare with people who have a different cultural background than you, right? So if you do these tests, basically you come to me or you come to anyone who, who does speech articulation assessments. You will do assessment of speech test like that. Groan Fisto. Goldman, fisto. Like that, to see what sounds are missing. All right? Once the speech therapist knows what kind of sounds are missing, they will drill in to those particular sounds and see why it's happening. All right? And then most probably there are only a few reasons why that are like the top, top reasons. Number one is that they don't know how to make the sound by itself. Okay? And why do they not be able to, like, make the sounds by themselves motorically? It might be difficult. Okay? So for example, one of our clients, he used to not be able to do the L sound. And when we checked, it seems like the L does that. The tongue doesn't even go up. It doesn't even. It's not even able to go up. So therefore the L sound is out of the question because it's impossible. So the first thing we need to do is to fix the tongue for it to be able to go up. All right? So that's number one. And that's usually the case. And we call that like a very classical articulation, like, motoric kind of thing. And it's pretty easy to treat. All right? The second reason. The second reason of which is actually to do more of what we call phonological. That's a long word for basically knowing your sounds within a language. Okay. And when we say that, it means that if you ask them to do a minimal pair. And by the way, I've written a whole article about minimal pairs on my blog. Okay? So you can go to agentsofspeech.com, check it out. Oh, actually, it might be on mingfengslp.com so, you know, go there and check out. Just search on Google, like, minimal pairs, Ming phone or something, and you'll see exactly what I mean. But the short version here is like, so, for instance, your child cannot really say the words, the sounds, the S sound, and it becomes a T. Okay? So for instance, if he's supposed to say sew, as in like sewing something, but he says toe instead, then what you want to do is to put, like, two pictures. One is sewing, the other is like a toe, like your. Your feet, your toe. And then you want to put them side by side and ask them to identify if they can listen to the differences and the two things. This is a super easy test, and it also tells you what's going on. All right? So when you do that, you ask. Okay, which is. So this one, which is toe. This one. Good. And you have to be careful because you cannot do it. Like in. How to say you cannot do it in a structured, like, a predictable way. Because your child's gonna catch on because they're super smart, and they're gonna try to, like, guess which one. Because to them, if there's a problem, it sounds the same. All right. It sounds the same. All right. And this one we also use for sometimes treating accent reduction. Okay. If they cannot even know. What's this? What's the difference? Like, for instance, like a Japanese guy. I would try this on the chat. I don't know if it's. This is the way you actually do it, but I would try to see if they can actually hear the difference between the R and L. Okay? So that when the first step is identify, if they can identify it, then they can probably do something about it. If you cannot identify the wrong behavior, then it's impossible to actually do anything about it. So anytime, if you guys have questions about your child, put them in and I'll tell you, like, if this, what I'm about to say, is related to you. If not, then I'll answer your question. Okay? And if you want to, you can also, like, describe your kid. I'm here every Monday, Wednesday, Friday, 9, am sometimes a little late because I need to set up both the phone and the computer. Sometimes it just doesn't work. Right. But I'm here to hang out with you guys, and, you know, we've got a bunch of people watching on YouTube and a few more on. On Facebook, so I'm on both sides. And then. And then. Yeah. So if your child has a problem with distinguishing between the error sound and the correct sound, like a soul and a toe, and they cannot, like, hear the difference, then they have, like, what we call a phonological disorder. Right? Just the stupid long word for they can't understand differences in speech sounds. All right? And what I see the most is, for example, the L sound. The la, la, la, la, la, L sound. They turn it into ya sound, like, yeah, yeah, yeah, yeah, yeah, like a Y. And then they cannot see the difference between, like, L and a Y. So for instance, if they do like a, like, they will say yike. But then when you say yike, they think that you're saying, like. It sounds very complicated, but actually it just means that they're just confused, right? So at the end of the day, you have to check out if they have a problem there. So there. There are two reasons. Number one is they cannot physically do the sound by itself. Number two is that they cannot see the difference or hear the difference in different sounds. Okay? So number three reason is actually to do more with, like, coordination, right? Let's say your child can do S by its own, right? But then as. As. As far as, you know, okay, they can do the S. They can go, yeah, that means by its own. It's an isolation, like isolated S, when they can do that, but they cannot do it in the whole word. And that's a problem. That's a problem because they cannot actually sequence the S sound with the stuff behind. Let's say they wanted to say sorry, right? They want to say sorry to you, and you're teaching your kid how to say sorry, okay? Which is a very common thing to teach. And they can do the S sound by its own. But when they say the whole word sorry, they go tory, right? So that means they cannot really co. Articulate. That's the real word. But let's say that it's just unable to coordinate between, like, the hard sound and also the sound at the. At the back. All right, so what does it look like? All right, so this happens to everyone, by the way. Happens to me as well, because I lack the coordination, and I like the. The practice to do it. So I have all means of doing it. It's just that I haven't done it enough to actually be able to do it. So, for instance, if I do the trill R in Indonesian, like that, I can do it by itself. But if it's a long word with like three or five syllables, I'm going to screw it up. I'm not going to be able to do it. So, yeah, I always cannot do it. So that's something that is. That's something that you have to keep on training. So for me, how I would do it, how I train myself is I would start from like, and I'll add certain vowels behind until I get very, very, very, very good at it. And then I can make a whole word like. I don't know. I don't know any words to tell you about. Maybe you can give me some insights. Okay, so the third reason is coordination. Okay, we have a question. Lynn says, shall we show. Shall we try showing her some flashcards with letters that are missing? Or aren't we supposed to start it? Okay, so Lynn is actually my client. Just to give you guys a little more context. And when she's. What she says here is that, should we start doing, like, the traditional way? You know, this is how, like, traditional speech therapy is. If you're missing, like, a bunch of Rs, then you will do a bunch of flashcards like, this thick, and you go like. Like rabbits. I don't know. Radish. I can't think of R words. Right. So should we do that for her? For Lynn? Her kid is having something called apraxia speech. Right. And the situation here now is that she's missing some sounds. Right. And I would say that the answer is astounding. Yes, we should. We should. But the thing is, how far is she able to do those sounds coordinatedly? So let's say that the ones that we've been working on and the most pronounced problems are actually. Are actually the. What's that called? The S. The S sounds. The final S sounds. So if they do the final S sounds, can she actually do, like, ask is us like that? Right. So we're actually training voluntary speech. All right, I'm gonna confuse a whole bunch of people here, except for Lynn, because she knows what's going on. But you have to understand that for apraxia of speech, children. Actually, not even for children, because for her is more acquired meaning. She used to have speech sounds. She used to camp pronounce, and then she lost it. Right. So for those, we have to be very careful about Thinking, which one is voluntary? Which one? We're dealing with automatic speech. Okay? For apraxia of speech, right? The ones that I've seen in the hospital when I was, like, a student, the. The automatic speech can be very, very fast. All right? So let's say if we ask them to tell me a poem in Cantonese, once they start, they will say the whole thing in perfect articulation. But the thing is, if you tell them to say one particular word, they're going to have a problem and they start to find the correct word. So whilst we're always increasing the automatic speech for functional purposes, we're trying to make it as automatic as possible. Meaning you need to do it over and over and over and over and over and over and over and make it into, like, a really crazy habit so that they don't even need to think to grab that speech sound. That's one of the part of the goals. The other part is the missing sounds that it's voluntarily difficult to say. All right? And how we treat those is by making those motor plans for them. So, for instance, for Lynn's case and her child is that the S sound is missing. So sometimes when she's doing the automatic stuff, she's able to actually do the S sounds correctly. All right? So those ones that she just pulls out of her head without thinking, without bypassing that certain pathway in her head, she's able to do that. But then the other side, when she's trying hard to, like, say sounds she's not familiar with, that needs effort. Then how far is she with the S sound? Is she at, like, a V, a VC level or like a VVC or like a cvc? Right? So I'm confusing a whole load of people, especially on YouTube. I'm sorry, guys, but, you know, ask me a question. Like, you can ask for clarification, right? You can ask, oh, what's the cvc? Whatever, or I don't understand or something, just let me know, all right? So Lynn, yeah, you can. You can start doing that, but, you know, you need to keep it within that five or ten minutes, all right? And actually, the most important is, like, the variations within the speech sounds we're teaching her that are voluntary. Okay? So if you're able to give her, like, more different sounds for her to do, okay? There are. There's something that's very real for everyone who's left listening, especially for children who have certain, like, pronunciation, speech sound disorder stuff. All right? There's something real, really real, which is what we call fatigue. So if you do a certain sound for extended period of time, and you keep on doing it. That stuff's gonna be real hard. Okay. That stuff is gonna be really tiring for your kid. So you see them burn out really quickly. And, yeah, sometimes in the clinic, I can do one sound for the whole session, and. And sometimes that is the most effective thing to do. But it might not be the best thing to do at home. All right. Because you have to be able to give them enough breaks. So I hope that I answered your question. Yes, you can use flashcards with the letters missing. That's cool. But at the same time, you have to remember, Lynn, that we're not treating her reading. It's obvious that her reading pathway. The reading to the. So reading. There's like two. Two parts, right? Reading to the meaning. Reading to, like, the sounds. So reading to meaning is totally fine. The reading to sounds. There's some. Some stuff going on, all right? Especially because she cannot. How to say, she cannot spell that correctly when she's typing, then that really means that, you know, from the letters to the sounds, it's a little impaired. The rules are a little shaky. So don't do. Don't. If you're doing the flashcards, don't show him the. Don't show the letters. Just show the picture or something, all right? I hate it. To make her feel like she's doing the reading. Okay. If you need more explanation, just tell me, because I'm here for, like, a whole hour just to hang out with parents and stuff. All right, so where was I? Yeah, I was talking about reason number three is that they cannot really coordinate. So usually reason number one and number three happen together. So they cannot say the sounds nicely by itself in isolation. And then by the time we teach them to be able to do it, what happens is that they cannot put it next to different sounds. Let's say you just learned how to do, like, the th sound in English, which isn't hard to learn, to be honest. All you have to do is put your tongue between. Like, on top of your teeth in the middle, right? And you go like that. But the thing is, if you're. If you can do that by itself by isolation, but you cannot do it within a word like this, right? It means that you don't have enough practice, okay? And a lot of English speakers cannot do this. And it's nothing to be ashamed about. It's just never inside the sounds of your language, okay? And it's the same as, you know, some Westerner trying to learn Mandarin because There's tone inside the Mandarin, but they don't. They've just never done it before. But tones are a topic for a different day. I'm not like, a super expert in that as well. I'm still learning about it, so. Yeah. And especially now I'm over in Indo. There's not much. There's not much tone involved, and there's not stress involved as well, which is kind of cool, and it kind of sucks at the same time. Yeah. So Lynn, use the flashcard without the letters. Just let her see the pictures. Because pictures don't carry any type of phonetic information. Right. It doesn't carry any sounds. So don't use those, you know, like jolly phonetics. That kind of stuff. That's just gonna piss her off. All right. Yeah. So the number three is, like coordination. What is number four? Number four reason is like, more of what Lynn is going through right now. My client just now. And what it is, really is, you know, motor planning. Motor planning. So if there's a problem with motor planning. There's a problem with motor planning. Then you have to know if it's like, apraxia of speech or not. Okay. So this is a big topic because a lot of parents are saying. Are claiming that they're. That their kids have apraxis speech, especially those who are on the spectrum. Okay. So I was speaking to another client yesterday during our session, and she was like. And it's online, by the way. Don't think that I've started seeing clients already. I really don't want to, but I'm trying to. I'm trying to organize something. So if you're. If you're a client of mine and you're watching this on a replay now or whatever, then I might be telling you, asking you about, like, if you want to continue, but in, like, a safe way. I also want to collect questionnaires for everyone so that, you know, it's collect question everyone so that other parents can see what health conditions, what kind of, like, lifestyle you guys are doing, and just don't come if you don't want to. Right. So Agnes asked, does the same technique used for a kid with cleft palate? Yeah, that's actually like, the fifth thing I want to talk about after apraxia. But I'll skip ahead for cleft palate first and I'll talk about apraxia, because it does happen. Right. So cleft palate is kind of like a deformity inside, like, the mouth. Right. So what happens is that because of the structure is different Therefore, they cannot do certain sounds. Right. So first of all, you have to identify what type of cleft palate it is. There are, like, around four types, and I cannot remember it on top of my head. All right, but usually why we want to do this is to see how the structure is and how it actually affects speech. Okay. So most times, cleft palate, it will actually affect a few sounds that are more pronounced. Right? So for instance, whenever the tongue needs to touch the top part of your palate, then there's going to be a problem. How bad is the degree of cleft palate? Do you need to fix it? Do you need plastic surgery to fix it? Is it something out of the scope of speech therapy? So you have to know that first you have to identify what type, how severe. If a speech therapist has tried out methods to see if they can reach certain places inside their mouth and create the speech sounds, then you have to evaluate whether you would want to actually continue with the behavioral therapy, which is a speech. Speech behavior is, like, on the behavioral level. Right? And then what I'm suggesting, if the behavioral level doesn't work, meaning, like I'm telling you, I'm teaching you it doesn't work, then the next one is you seek medical help and you fix those structures using plastic surgery. All right? It sounds scary, but it's actually done everywhere. Okay, so for cleft palate kids, if their feeding is fine, then that's cool. That means there isn't an actual need to fix it on a biological level. But, you know, you have to go through the tests, like the articulation test I was talking about, to see which sounds are missing. All right? Usually it's the airy sounds I found. Right? It's like the Fs, the Ss, the Ths, the, the K. All that kind of airy sounds are kind of not as pronounced as other sounds. Okay. So the same techniques do work, do work, and you have to identify the sounds first and why it's not there and then give the appropriate cueing, the prompts and teaching of which. Okay, so, yeah, if you were to do a cleft palate case, it would be the same. Just that you have to evaluate the effectiveness of what I'm doing, what the therapist is doing already. Okay. Before you, like, that's the first thing you would think, is it going to be effective or not? If not, then why is it not effective? Is it because the structure is so impaired that there's nothing we can do or very little we can do? Or is it like, oh, the structure is enough, but it's going to take longer for us to get there. So you have to remember that a cleft palate person has a hole right inside their mouth. So it's going to take longer. They're going to compensate a lot to say the same sounds that we actually do. Okay. They have to compensate and that's up to like you and the therapist to figure out what's the best way to compensate for it. Like, it's not going to be 100% accurate for a few sounds, especially if you do it like if they talk fast. Right. So you have to think about what you're sacrificing with the therapist. Right. It's the same techniques, but at the same time the effectiveness of the techniques will be lower. Will be lower. And you have to think about whether it's worth it or not. Okay. That is all I'm going to say. Because every pilot is different because how it's like impaired is different, right. Some cases they have something called like a crypto. Cleft palate means like you don't even know that they had a cleft palate. You know, there's just a hole beneath the skin. Okay, I'm stop talking about cleft fat for a bit and go back to apraxia speech. So the reason why I want to talk about it more is because yesterday a client said to me, oh man, dude, I feel like a lot of people on the spectrum, a lot of kids on the spectrum have apraxia of speech. And, and that's actually like, that's astoundingly and backed by data that's not actually the case. And the reason why she thinks that is because she thinks that a non verbal ASD kid will. It should be apraxia. Right? But it's not really like that. It's not really like that doesn't mean that they have apraxia because they have an ability to say the speech that might be like, from like what I was talking about the first three reasons, right? It might be because they physically cannot do certain sounds. Right. Second of all, which is a very big one for ASD children, is that they cannot tell the sounds between different. They cannot tell sounds apart from each other because children who are language delayed or language disordered is a better word for it, they usually have a difficult time of like getting the speech sounds correct and listening to which is right, which is wrong. So if you are like that parent and getting asked by a lot of different parents just because your child has ASD or just because your child is suffering from apraxia of speech. And you think to yourself, hey, does this person's. Mom, should I say that? Oh, it might be apraxia of speech? No, we shouldn't. You shouldn't. You shouldn't do it because you're telling the parents something that they don't know. And second of all, if you say becomes kind of your responsibility, then, you know, like, they kind of come back and say, oh, then how to do. How to do. And the worst thing that can happen, right? The worst thing is that parents start to ask me or like, other parents about how to do certain things without knowing the whole picture, right? It's just not cool. You know, for instance, you might ask me, like, like, I, I own a Honda crv, right? Like, I drive one and you ask me, hey, how do you change the engine oil? But I only know how to tell you, for the Honda crv, I don't, I don't know about your Toyota. So of course, it's like, everyone knows, dude. You find the valve at the bottom, you unscrew it and you let the, you know, the engine oil to run dry. And after that you screw it back up and then you pour it back in. But I don't know which where it is for the Toyota and why you should do it and when you should do it, right? There's a manual for it. And I don't know the whole picture, so it's the same thing. It runs into, like, the risk of it, of that parents like to ask, oh, how should I do this? And give and ask very general questions to me. I've been getting a lot more questions nowadays, but thankfully I have more of my videos to point to. So if that's the case, then point them to some of my videos on YouTube or on Facebook so that they can do their own research and come to their own conclusions rather than asking these kind of things. So let's go back to apraxia of speech. Apraxia of speech just means basically apraxia in its own. Let me define it so that I don't screw it up. Apraxia, right? Apraxia just means, like a motor disorder that there's a specific damage to the brain which impairs motor planning. And what is motor planning? Is the ability to plan motor in a certain way, to do certain things. Okay? So for instance, if I see this thing here, this roller thing, I want to consciously do that and hold it. I need a plan in my brain to, like, put my hand forward and then, like, do that and then take it. Okay? So when you see a problem with motor planning, you see a difficulty in starting something. So for instance, if there's like apraxia within the limbs, as I remember correctly from my textbooks, okay, don't, like, don't quote me on this because I haven't been reading those kind of texts. I've only been reading about speech and language. Okay? But anyways, apraxia is like, when they want to start getting it, they have a bad time initiating, right? They like go, oh, man. Don't know where to put it. Like, that's the right word. Don't know where to put it, Right? All right, that's model planning. Okay? Motor executing. Motor executing is to do with something in the small brain, the cerebellum, right? So the difference between apraxia and ataxic, which you've never heard before, but I'm going to confuse you anyways, is that ataxic. They will overshoot, right? You see children with cerebral palsy, cp, right? They will go, like, overshoot and undershoot and miss and stuff. That's the motor execution. They planned it, but they can't do it, right? But apraxia is when they. You. You can't even plan it. You can do it, but you can't plan it, right? So that's why if it's automatic, they can do it. Because they didn't plan it at all. They can do it, right? So a very crazy hallmark for apraxia. We're not talking about speech, just in general, apraxia is that if when they drink, like from a cup, they just take it and drink it. No probs, no problem. But if you ask them to pick up the cup and drink it, it becomes voluntary. Now they become conscious and they have to think about it. It becomes a problem, right? So you tell them to, okay, drink from that black cup. And they're like, you can't do it. So that's. That's the problem. All right, There's. If it's automatic, if that thing is automatic, if they didn't even use the brain to plan for it, then they can most probably do it. All right? If they needed to plan for it or whatever, it will actually do harm. No, not do harm. They actually have a problem with starting, initiating. Okay? So a lot ask. Some people ask me what's the difference between dyspraxia and apraxia? So I'm gonna search online. Okay, so what it means, it just is because of the prefects, like this and a. Right. And usually this And a, like, if you talk about like apraxia or dyspraxia is used interchangeably. Right. So on. By definition, dyspraxia is like the partial loss of the ability. Right? Partial loss of ability. An apraxia is like the total loss or something. Yeah, complete loss. Which is kind of not true because nowadays people use apraxia even if there's a degree of apraxia. Right. So there's severe, there's like moderate, there's mild. So basically nowadays it's used interchangeably and no one really says dyspraxia anymore. Okay. For some reason, I don't know why don't ask me. I'm not the person who comes up with the stuff. Okay. So. And if they have like a smaller definition for it, then, you know, doesn't matter. It just means the same thing. It just means that they have problems with motor planning. Okay, so how do you treat motor planning problems? So you might ask me that. So in the first three reasons I talked about is more because of motoric coordination and also like if they have, what's that called, a good understanding of the sounds. Let's say those are all cool, right? Let's say those stuff is like totally fine with your kid. And all you have is apraxia, pure apraxia, which is not unheard of, but sometimes it comes with like different things. So when your child has difficulty reaching different parts of their mouth with a tongue, then that's actually what we call a comorbid thing that happens together. Right? It happens together. So usually it does happen together. And the reason why behind it also might not be of the, like the, the motoric thing. So there's two things I want to point to you to about, to increase your knowledge about this stuff so that, you know, if you're watching this, it means that you care a lot. And it means that other parents will actually come up to you and ask you instead of searching for themselves. And it happens to a bunch of my clients, right. Just because they love to ask me. It means that they're knowledgeable and they want to learn more. And therefore other parents are attracted to them and they ask them. All right, so let me tell you. So apraxia of speech is just apraxia of talking. Okay. Talking is a very intricate, very, very high level motoric skill. Okay. Let's say I have a cat here. They're not going to be able to talk, right? It takes a whole load of cognition. Like it needs to be smart. They need to be able to like know Language and everything. And then you can have speech. Okay? It's just impossible for a cat or dog to have some sort of speech. They can't do it. It's very intricate. Right? So therefore. So therefore, apraxis of speech is just in the lack of motor planning for a speech sound. Right? But there is a high chance. Not high chance. I don't know the chance. I don't want to say something that's wrong here. Right. But there is a chance that your child has oral apraxia as well. Okay? So what that means is that they actually have problems with initiating motor movements in the mouth, okay? So if you tell them to lick something, to lick something, they're like, it cannot start. They cannot start doing it. But if you just leave them alone, you give them ice cream, they're like. They're like licking away, all right? Because you didn't give an instruction. It's automatic to them. Okay? So there's two things. There's oral apraxia and speech. Approxia of speech. Okay? Okay. So if that's the case. That's the case. Then you have to. You cannot really. There's really no, not much point with treating oral apraxia. So sometimes if. If you go to a clinic and your child has oral apraxia and apraxive speech, both things, the first thing they do is to check. Yeah, you can check, but after checking for. For those type of movements, like oral motor movements, if your child has oral apraxia, there's not much point with treating oral apraxia. Okay, I'm confusing a whole load of people. You don't want to do this because what's the point of it? What's the point of treating oral apraxia just to make them be able to do, like, oral movements voluntarily. How often do they need to do oral movements voluntarily? You leave them alone, they can eat, they can drink. Then that's cool already. That's enough. You don't need to treat the oral apraxia to treat the apraxia of speech. That's something that a lot of people don't understand. And actually, just functionally and like, from textbooks, it says already, which I don't understand why this is the case sometimes. Okay, yes, and I am exactly talking about what you went through, Linh. And to be honest, this doesn't only happen in, like, developing countries. Now that I've been through it, I see that, you know, even, like, developed countries also have this problem, is that they see they need to treat oral apraxia. There's no Point in doing it. Okay? And it's the same for if your child has, like. What's that called? Has a problem with, like, creating speech sounds and the therapist is doing, like, stuff like putting your tongue outside of her mouth like this, like, all the tongue all the way to the nose or something. Sorry, that's my cat. Or like, the tongue all the way to, like, the left side or down below touching the chin. That's just stupid because, like, why would you even want to, like, treat that right? It doesn't turn into speech sounds. You. You never make a speech sound like that. You never make a speech sound with your tongue all the way to, like, touching a nose. Like, that's impossible. That's just crazy. So never do that. If you see someone who does that, that's still fine. But, you know, as long as they slowly decrease it to inside. But I don't see why they have to start there, right? So just be careful. If you see therapists do this to your child, okay? I'm not saying that it's bad. I'm not pooping on them. I'm just saying that you have to be careful if they do not. If they do not change to the speech sounds asap, okay? And this is something I'll segment later. I want to do a segue later towards something else. Okay? And yeah, apraxia is like that. There's two things deal with apraxia of speech. And when you deal with apraxia speech or any type of speech sound disorder, you always have to think about what are the sounds that are lacking what they already have. Okay? And if your child is really, really bad in terms of the intelligibility, meaning the sounds they cannot make, you have to make a set of words that are functional to them so they can use it. Saying it with speech, okay? That is understandable to you and immediate family so that they don't lose the interest in talking. All right? You have to teach a bunch of sounds that are very, very easy for them to say by themselves. And then they can use it every day. So that's more on a functional level. And the next, the other side is that you're trying to actually teach the basic stuff. Okay? So for apraxia of speech children. Children, okay, they have a difficulty with, like, syllable sequencing. This is. What is syllable sequencing? Let's say that they have to say chocolate. The longer the syllable is, the harder for them to say. They'll become like something. I don't know. I'm pretending. But there's a problem with sequencing between syllables, and they will chop it up like crazy. If you ask them to say chocolate, they'll say chop, cook, like that. So what you can do about it, what you can do about it is to ask them to sequence easy vowel sounds. Okay? If you are one of my clients, you might have done it before, and you might think, dude, this is so unfunctional. So usually what we do is like, we do like. And by the way, don't do this if you don't understand what's going on. For instance, I might just tell them to say ah, ah, ah three times, right? So it's. It's pretty easy. If you see a client who is so apraxic that they can't even do the same vowels three times, then, you know, this is the place where you start. You know, like, we're dealing with the low, the lowest level, the most fundamental skills that they need to do. Okay, So I might do one more, a whole video on this. But it's very tailor made. Okay? It cannot just tell you guys, oh, this is the stuff you need to do. This is the stuff you don't do. Whatever. It depends on the kid. All right? So I'm gonna stop here with apraxia. If you have any questions about apraxia, please leave them down below. I'm also learning about this stuff. Childhood apraxia of speech is not very well understood, okay? And the reason behind it is because adults, adult ones are much easier to understand because adults already have a full picture of, like, speech and language, right? When something happens to them, a piece of the puzzle is missing, and we're able to identify it. For children, the whole speech and language is still developing. So you don't know what's, what's, like, what's lacking, and therefore you don't know what to do about it. Okay? And therefore, it's rather hard to understand what's going on. All right? So don't be too discouraged if your therapist doesn't know enough, because it's fair enough that they don't know enough, okay? And even, like, for me, I don't have a whole, like 10 plus years of experience as a therapist, but I can tell you that this stuff, not a lot of people know, okay? Including myself. I need to learn more as I go and ask expert advice whenever I need to. And I hope that this is a mentality that you have as well, that you don't. Speaking for my colleagues, don't bash them if they don't know, because most of the time you have to ask someone who has been through that kind of stuff, right? That's why I've been through, like, toilet training many, many times. If you ask me about toilet training, I can tell you, like, what's the best way to do it, because I've done it. Most therapists, speech therapists especially, wouldn't know for sure. Okay. It's just because I know I've done it many times. Okay? So I want to last talk about sensory. Sensory is a very big thing. And. And making good sounds. So if right now your child is having, like, problems with sensory issues, then this is a huge thing, because sensory and motor, they come hand in hand. If you can't sense it, you can't really move it correctly, right? So a good analogy is like. A good analogy is something like, for instance, Okay, so let's say that, you know, you've been sleeping on your arm, right? And then for a long time, you've been. You've been sleeping on it, and it becomes numb. You know, like when you don't have enough blood towards your hands. And, yeah, for a few seconds, you feel like you can't. You cannot even raise your arm because there's not enough blood, and you cannot feel anything. So you put something in your hand. You can. You have this. Actually have the strength to grip it, but you cannot because you can't feel anything. Okay? So this is one example. Another example is, for instance, you know, you've been to the dentist and you're removing a wisdom tooth or something, and then you take anesthetics, anesthesia, I don't know the name for it. Like the painkillers. It's safer if I say it that way. The painkillers, it numbs your whole thing. And after you come out of the dentist, you start drooling and you can't even talk correctly, right? So that means it's not the muscles that are weakened, right? Or it's not your IQ or cognition that's weakened. The thing that is weakened is actually your sensory, right? Because your sensory has been pulled away. Therefore, when you do that, it means that. It means that you want to say it in a certain way, but your body, because it's lacking sensory, it can't do it normally. Okay? And this is the. This is exactly why your child has a hard time to understand, to learn how to do certain speech sounds when their sensory is, like, not complete. That's why it takes longer. All right? So when. When I say this, I. Hopefully you've. You've been through that dentist experience, and you know what's happening. Sensory is a big, big problem in terms of. In terms of speech, sounds, and why and how you actually treat it. I cannot tell you here, all right? It needs to be specific to your kid. It might be hyper or hyposensitive, meaning hyper, meaning too sensitive or not sensitive enough or sometimes it's a mix. And the mix stuff is pretty crazy because, like, one client of mine didn't have enough sensory somewhere and a very sensitive somewhere else right inside the mouth when it's, like, centimeters apart, you know? So to treat that, you really have to use, like, a sponge thing. I don't even know why it works, okay? But it works for some children. For some children, not everyone. And how you do it is like you use a brush. And I've taught many people. Like, I talk about a lot. Whilst I don't understand the scientific or the theoretical side of it is you get like, a. Like a brush from talk tools. It's called toothettes, or like, just any old brush that isn't too rough, or like a toothbrush that the 3D wants, and you just brush their mouths until they're normalized, Meaning, like, if they're too sensitive, then now they're okay. If they're not sensitive enough, you brush it enough, and then become a little more sensitive. I don't know why it works, man, but, you know, I've done it a few times where my clients were drooling, and I kept on brushing their mouths every day. I told their clients, told their moms and dads to do it, and it got a lot better. You know, they didn't drool anymore. But at this moment in time, I really don't know why. Okay? So put it in the comment section if you have this kind of problem and what you have tried and tell me what kind of stuff. Okay. And Lynn asks, what about Apraxia talk tools? Okay, so Apraxia, like, let's talk about talk tools first. Talk tools, if you haven't. If you don't know about my stance about talk tools, basically, I think they're cool, but they're misused. But the Prexia kit of talk tools is for kids who are having real difficulty in making even one single sound. All right? So for instance, they have, like. It's basically like a cue, like a prompt, right? And that's why it kind of works. So, for instance, let me get something. So let's say they have a card. The talk tools thing is like a card that's, like, triangular, right? And how they do it is like, for instance, The M sound they want to teach, they swipe that here and they go. And it's red, it's triangular. If you do a few times like that, it becomes a prompting tool for it. And that's because they even have a problem with doing the M sound. Okay, so it's going to work. It's going to be effective if you know how to build the prompt up, you know how to build the cues up. Okay, it's not going to work. If you just, like, you just think that, oh, this is going to work for the M, I'm just going to go do it. Oh, how come it doesn't work? It sucks. No, you have to build it up. You have to teach them that it's part of something. Okay. And Lynn asks, are there tools to help Q, O and. Okay, wow. You can actually type that on that IPA here. Lynn, that's crazy. Okay, so for. For those. They usually use, like, those. Like. What's that called? The tube thing? That plastic tube thing. Yeah, exactly. They would blow instead of making a sound, right? Yeah. Actually, I don't like tools to cue for vowels because, to be honest, vowels is more like a tongue thing more than the mouth shape thing. Obviously, the roundedness of your lips and the spreadness of your lips do help with making a sound. So let me give you an example, right? If you put something in a child's mouth, you literally cannot control what they do with it, man. So that's why it doesn't work. For instance, if you put like that. I don't even need to drop my jaw around my mouth that much when I say oh in a word, right? So let me think about a word with stop. I think, oh, that's a different vowel. But anyways, it's close enough. Okay, don't be nitpicky about my English transcription stuff. I'm not a linguist. Okay, so let's say that they're saying stop for, like, the. Oh, fine. It's really a different vowel. Okay, Saw. So there are very little sounds like that. Anyways, so let's say that we do. Right? I don't need to open my mouth that much. I don't need to round my mouth that much. What is the most important part is actually the tongue. So the talk tools are targeting children who cannot use. They cannot. They cannot actually, like, put the jaws down and make that mouth shape. All right, so how do I say this nicely? I demonstrate to you. If I say, oh, like that, look again. Oh, I'm not even rounding my. My lips, right? For God's sake. I don't. I'm not even moving my lips. Oh. And you can still hear the sound. So what's doing the most work is actually the tongue. And this is what we need to teach your child to do it. Because when they're at like a word level or a sentence level, you're not going to see them say something like, unless they're emphasizing every word or every sound that they say, they're not going to go like, all like that. Right. So if you put a tool inside their mouth, then it becomes like that. They're just going to blow it. Because it's very difficult for you to actually demonstrate. The best way to demonstrate is to do it together. So she has one, you have one, and you go like all together with that tool. But to be honest, I don't like using the talk tools stuff because it's just not. It's just not effective because you have to teach it first. And by the time I've taught using the tool, then might as well I just use my hands. Right. It's just the same thing. Okay. And Lynn says because she doesn't know how to put the tongue to produce the sounds. Yeah. So that we need to keep on doing. Right. That's why we do, like simultaneous productions. And once we've already found something that's effective in teaching her, we have to stick to it no matter what and don't try to use newer cues and prompts. I see a lot of parents go into this situation and the reason behind is that they're not happy with the speed of therapy and they try other things. And. Yes, I'm talking to you, Lynn. Yeah. Don't try more things. Right. Do not try more things because it will increase the speed. If it's already effective and it's helping the child, then just stick to it. Right. It's effective cue. You have to stick with it enough to become a very effective cue. So right now, for her, for this particular client of mine, what is working is that hand prompts are working very nicely. She can do it. She can prompt herself. This is like the holy grail of therapy. If a child can identify what's wrong and then prompt themselves with some sort of cue, then it means that I don't even need to be there. Like, I don't even need to do anything. Or the parents don't need to be there. They can even do therapy themselves. That's the holy grail for it. All right. Yeah. So I guess why Lynn is asking is because she wants other parents to actually know about it too. Yeah. So the reason why kids cannot use talk tools is because you have to build the queues, build it as a queuing system. Whereas a lot of parents think it's a plug and play thing. It really isn't. There's no plug and play and speech sounds. When you're teaching them something, they would think that, oh, if I put this here, their sounds will go this way. No, you have to pair it a thousand times until they know. Okay. And this is one I want to talk more about now since actually I'm already, like, quite long. Like, it's been quite a long time. But I see there are still people watching, so I'll still go on. All right, so what you. I want you guys to be careful of is when you're developing those cues to help your child no matter what, if it's like, like, if you want, you can watch the video about me talking about queuing. It's also a live video, is that, you know, if you do the ah, ee, oo, eh, o, and then you give a very exaggerated mouth shape, I guess. Ah, e. Oh, that's cool. But at the same time, you have to make sure that it's not too exaggerated. It's natural towards what you're doing. Okay. So you need to slowly decrease it. Slowly decrease it. So what I mean by that is like, this is why the tongue to produce the sounds is very important. They have to start to, like, make a connection between the sound and the tongue position. And how you do it is very meta. You cannot just teach them by telling them, oh, yeah, look, your tongue needs to be like 2cm behind your. The back of your front teeth. And then when you say it, the top two muscles need to tighten so that it becomes sharper. No, that doesn't work like that. Right. Everyone's tongue moves differently to get to that sound. Right. And this is what we call, like the principle of motor learning. Right. It's just you need to keep on doing it. There's feedback and feed forward. Don't want to get too academic. And I can't because I don't have enough. This kind of knowledge anyways is that you. If you play golf, you hit a ball, There's a thousand different ways you hit the ball. It's still going to go in the hole. Right. And the same with tongue. There's a thousand different ways that you can move your tongue. Like variations that you can still get the same vowel sound. And that's why we all have different sound profiles. When we say Something or different accents or something. That's why it's distinctive. That's why you hear Adele sing. You hear it sounds better than a normal dude. Okay? So there's a thousand different ways to do it. Oh, Janor's here. Hi, Janor. How are you? So don't go too exaggerated. So another one I see a lot is that when you're teaching the F sound, you go like, f. F. Do you. You never say that. You never do like that. All right? When you're talking, you do not say fast like that. You don't say that. You go fast. That's the F word, right? The F sound, you just put the lip towards here, and that's it. You don't go. Or like, if you're teaching, like, the ah sound, you don't. You don't go like ba like that. You just like ba. Right? It's just very small. So when you're giving cues, you're giving prompts, you're giving instructions. Don't overdo it. Okay? Whatever you put in the child's mouth or like, you show them, it's going to be exaggeration in the beginning, right? As Linh pointed out, if you use talk tools, some of them are actually exaggerations, especially if your child's mouth is very small. You know, if you put a very big old thing inside their mouth and they like that, that's exaggeration for all. I don't even go down that much because my tongue knows where to go. So what you actually need to teach is like to link the motor. The motor to the sound. And you do this by slowly doing it. Like, keep on doing it together, right? And to be honest, this is the slow way, but it makes sense. It's better than you using those tools being able to do it, but you need to take time to fade it away. Okay. If you don't fade out any cues and prompts and instructions, they're not going to be able to say it within a sentence. So I've seen people that, using talk tools or whatever, that they will use it in between inside a word. For instance, if they want to teach the M sound but they're losing it in the middle or at the end. For instance, if they say December, they will actually use, like, the card thing I was telling you about. There was a December like that or like, they give them as a cue. That's all cool as well. As long as you fade it out. All right, so hopefully in this live, you have understood a few reasons why we're doing Reasons why your child's speech sounds are incorrect and how to fix it by identifying what's going on. So it might be because that they're physically unable to get to those places. Number two is that they cannot. They cannot physically. They cannot know the difference between, like, a few SAMs. Right. Like, they cannot physically just understand between S and T, and they mix it all up. And number three is like, they have. I probably forgot about what I've talked about. So, you know, don't. You know, I'm trying to remember. I have some notes here, but, you know, I get. I talk pretty much. Yeah. So number three is like, I forgot what was our coordination of the sounds. So they can say it, but doesn't mean they can coordinate and say it in a whole word or sentence. Right. Number four is like motor planning. So specifically apraxia of speech, which, if you're interested, I can talk more about it. And number four is like, sensory problems. So if your child, they don't like it or they like it too much when you brush their teeth or they don't like certain textures or whatever, that might be a sensory issue. And you have to do things to desensitize them. Hopefully these four reasons to why your child has wrong speech sounds are clear. And the last thing I want to tell you guys before we get off is that babbling is very important. Babbling is super important as a sign of whether your child will speak or not. So there are two stages of babbling that we see in textbooks and, you know, scientifically proven, whatever. The first type of babbling is when they go like. It's the same word that keeps on happening. Okay. The next level is called reduplicated. And what it really actually just means is that there's a sequence of it. So instead of ba ba ba ba, they go ma ba mah ba mah ba, or like, beep beep beep boo bibu for like, ambulance. So those things are very helpful. Okay. If your child doesn't have these, then you might want to do more sound play with them. Right. So you might want to actually teach them to do things. Like when you play with them, just make stupid sounds and see if they actually help. And I know to know is watching this, I guess, on YouTube. I cannot see who's watching on YouTube. You know, like, I just see a number. And when you do this, it will help them with sequencing syllables. Okay. So it helps them. So for tinar, you're doing, like, the ah e that kind of stuff. If you teach him during, like, what's that called? Playing. And you do these stupid sounds as well. It's going to help him naturally without having to do the things we were doing on the table with, like, stupid cards. Okay. So that's all I wanted to talk about today. If you have any questions, anything in particular you want me to talk about in these Lives Live videos that I do every Monday, Wednesday and Friday, Just a time for us to hang out. Then, you know, tell me in the parents group, on Facebook, or if you're on, like, YouTube, just comment below. Or if you have the email you're a member of Agents of Speech, just send me an email and I'll get back to you and I'll think about what to talk about. Okay. And this is a good time that we connect and for me to answer questions directly. So the more you tell me about your kid, the better the advice and the better the input I can give you. All right? It's just as simple as that. If I know more, then I can share more about your kid. Okay. So that's probably it. If you haven't, you should go to agents of Speech.com checklist to grab a checklist if you're seeing me for the first time. Because the situation here is that there's no sort of slowing down in terms of the pandemic. So if you need to do it, you got to do it yourself for now. If you can trust your therapist, then go. Okay? And if you're a client of mine who is right now in Jakarta, then I'm also shouting out to you guys, I will be reaching out to you maybe in this week or the next week for you guys to. If you're interested in continuing therapy, I'll be giving out a questionnaire. And this questionnaire is open. The information is open. I won't be asking anything personal, but I want to know what type of activities you've been doing, how if you've been to traveling, anyone in your family is doing whatever. Just basic medical history for COVID 19 right now. And I will share with everyone. Everyone who is my client will be anomalously shared. Everyone will know what other clients who come to me are been into, have gotten themselves into or like, what have they been doing that might increase the risk. And then you can evaluate for yourself whether you want to come or not. Okay. And I will also evaluate whether you should come to me or I should take you as a client again, or whether we should continue with online therapy. So with that said, I hope everything is crystal clear. And if you're watching this. That's pretty cool. And thanks for hanging out. Thanks for your time. I know it's very precious. And I'll see you on Wednesday again, please do let me know. Comment, comment, comment. And like the videos. And let me know what kind of things you want me to talk about. Okay? Because that makes me a better therapist as well, you know? If I don't know, then I'll find my way to get to know. But it doesn't happen if you don't ask. Okay? So with that said, thank you so much. I will see you on Wednesday. Goodbye. Bye. Bye, guys.