Dr. Jen: Thank you so much for agreeing to answer some questions for our One Sassy Doctor blog, it's wonderful to have you here! Please tell us a little bit about your background, specific interests in your field, and about what a typical day in the life of a speech pathologist is all about.
Ms. Anne Freilich. M.S., C.C.C. Licensed Speech Pathologist: My name is Anne Freilich. I have a Masters Degree in Speech and Language Pathology, hold a Certificate of Clinical Competence and am licensed by the New York State Department of Education. I have been in private practice since 1976 and in addition was a part of the clinical staff for the New York University and Long Island University Masters Programs in Speech and Language Pathology. I am also the mother of two sons, now 32 and 29. My private practice primarily is work with babies and young children on who are diagnosed as being on the “Autistic Spectrum” and those with fluctuating muscle tone who have problems swallowing liquids and appropriately chewing solids safely. My days are filled with fun and games with young children to promote age appropriate communication skills and safe and nourishing eating skills. In addition, I spend a good deal of my time training parents and care givers to develop their skill to continue the work I do with their children during the short amount of time I spend with them directly. This training piece is by far the most rewarding as it has a direct impact on a family's quality of life. Oftentimes, I find myself working with Occupational Therapists, Physical Therapists, Nutritionists and Pediatricians, as we all are working with this one baby/child and family, I have found that a coordinated approach is an effective way to make the most progress in the shortest amount of time.
Dr. Jen: So, here on the One Sassy Doctor blog, we talk a lot about healthy baby development. Could you comment on pacifier usage in terms of usage and the possible connection to speech development?
Freilich: Pacifiers are certainly an appropriate part of baby development. Newborn babies have a sucking reflex, and they find comfort in sucking at the breast, or on a nipple or a pacifier, however by around 6 months of age the pacifier is losing its purpose and is becoming a habit.
Dr. Jen: Another area I am curious to get your opinion on is the usage of sippy cups. I've heard from some speech pathologists that, in children with speech delay of various types, extended use of sippy cups is believed by some to be a problem. Could you tell us what your opinion is on this topic?
Freilich: Most “sippy cups” on the market today are structured in such a way as to require maladaptive oral postures for drinking. What that means, is the design does not encourage ideal development of the oral musculature and coordination. For a child developing appropriately, this is not an issue as children are quite adaptable. However, for children with developmental delays, this may become an issue because of challenges in figuring out how to “motorically” overcome the maladaptive posture. Specifically, children with some forms of developmental delay may need to learn how to obtain lip closure around the bottle or sippy cup spout, and also have to coordinate the tilt of the cup to adjust the flow of liquid. These tasks are more easily learned with an open cup. Given the spill and messy factor, however, moving to an open cup straight from the bottle isn’t practical. That is why I am so glad to have had access to the Sassy Grow Up Cup™, which looks and feels like an open cup and yet still requires sucking which is a mastered skill for most children by the time they are ready to be weaned from the breast or a bottle. We must remember that speech and language is an overlaid function of the oral system, so this system was designed to eat, drink and breathe. As babies develop, this system is also required to master the fine motor movements required to articulate sounds in a specific sequence to produce language.
Dr. Jen: As a speech pathologist, could you comment on ways parents can promote effective habits that promote healthy speech from a young age? Tell us all you know!
Freilich: There is not a simple answer to this question. First, there has been much research that provides parents with developmental milestones so you can “expect” when your child will sit, walk and speak at certain ages. It is important to stress, however, that there is a wide continuum of "normal" and not all children do all things at the same specified times. Second, I would like to suggest that parents serve as good communication models for their children. Children tend to imitate, so you might want to make sure that the language you use in front of your child is the language you want to hear him/her say. Waiting for your child to initiate and request is a good idea as opposed to presupposing his/her wants and needs. By being patient, you are providing a natural context for your child to use his/her repertoire of speech and language and practice the fine motor movements required to produce clear speech. Giving children choices (Do you want to wear your red shirt or blue shirt?) will not only serve to increase your child's vocabulary but also provide good "articulatory" and grammatical models for your child to imitate.
Ms. Anne Freilich. M.S., C.C.C. Licensed Speech Pathologist: My name is Anne Freilich. I have a Masters Degree in Speech and Language Pathology, hold a Certificate of Clinical Competence and am licensed by the New York State Department of Education. I have been in private practice since 1976 and in addition was a part of the clinical staff for the New York University and Long Island University Masters Programs in Speech and Language Pathology. I am also the mother of two sons, now 32 and 29. My private practice primarily is work with babies and young children on who are diagnosed as being on the “Autistic Spectrum” and those with fluctuating muscle tone who have problems swallowing liquids and appropriately chewing solids safely. My days are filled with fun and games with young children to promote age appropriate communication skills and safe and nourishing eating skills. In addition, I spend a good deal of my time training parents and care givers to develop their skill to continue the work I do with their children during the short amount of time I spend with them directly. This training piece is by far the most rewarding as it has a direct impact on a family's quality of life. Oftentimes, I find myself working with Occupational Therapists, Physical Therapists, Nutritionists and Pediatricians, as we all are working with this one baby/child and family, I have found that a coordinated approach is an effective way to make the most progress in the shortest amount of time.
Dr. Jen: So, here on the One Sassy Doctor blog, we talk a lot about healthy baby development. Could you comment on pacifier usage in terms of usage and the possible connection to speech development?
Freilich: Pacifiers are certainly an appropriate part of baby development. Newborn babies have a sucking reflex, and they find comfort in sucking at the breast, or on a nipple or a pacifier, however by around 6 months of age the pacifier is losing its purpose and is becoming a habit.
Dr. Jen: Another area I am curious to get your opinion on is the usage of sippy cups. I've heard from some speech pathologists that, in children with speech delay of various types, extended use of sippy cups is believed by some to be a problem. Could you tell us what your opinion is on this topic?
Freilich: Most “sippy cups” on the market today are structured in such a way as to require maladaptive oral postures for drinking. What that means, is the design does not encourage ideal development of the oral musculature and coordination. For a child developing appropriately, this is not an issue as children are quite adaptable. However, for children with developmental delays, this may become an issue because of challenges in figuring out how to “motorically” overcome the maladaptive posture. Specifically, children with some forms of developmental delay may need to learn how to obtain lip closure around the bottle or sippy cup spout, and also have to coordinate the tilt of the cup to adjust the flow of liquid. These tasks are more easily learned with an open cup. Given the spill and messy factor, however, moving to an open cup straight from the bottle isn’t practical. That is why I am so glad to have had access to the Sassy Grow Up Cup™, which looks and feels like an open cup and yet still requires sucking which is a mastered skill for most children by the time they are ready to be weaned from the breast or a bottle. We must remember that speech and language is an overlaid function of the oral system, so this system was designed to eat, drink and breathe. As babies develop, this system is also required to master the fine motor movements required to articulate sounds in a specific sequence to produce language.
Dr. Jen: As a speech pathologist, could you comment on ways parents can promote effective habits that promote healthy speech from a young age? Tell us all you know!
Freilich: There is not a simple answer to this question. First, there has been much research that provides parents with developmental milestones so you can “expect” when your child will sit, walk and speak at certain ages. It is important to stress, however, that there is a wide continuum of "normal" and not all children do all things at the same specified times. Second, I would like to suggest that parents serve as good communication models for their children. Children tend to imitate, so you might want to make sure that the language you use in front of your child is the language you want to hear him/her say. Waiting for your child to initiate and request is a good idea as opposed to presupposing his/her wants and needs. By being patient, you are providing a natural context for your child to use his/her repertoire of speech and language and practice the fine motor movements required to produce clear speech. Giving children choices (Do you want to wear your red shirt or blue shirt?) will not only serve to increase your child's vocabulary but also provide good "articulatory" and grammatical models for your child to imitate.
There are many ideas to promote effective speech and language skills; my best advice is to speak with your baby often. When my sons were very little, I spoke with them all of the time—as I changed diapers, fed and bathed them, and went for walks. I waited for them to produce some babble or vocalization, as if we were having a conversation. This gave them the pre-linguistic skills necessary to take turns in conversation.
