This pamphlet was compiled by the Department of Speech and Language Services with a twofold purpose. As professionals in the field of speech and language pathology, we feel a strong commitment to the community. We are eager to share information which would be useful to parents of young children who will be attending our schools in the near future. These are the children whose development is occurring at its most rapid pace and, if offered meaningful and appropriate stimulation, will blossom into highly effective and articulate communicators. One of our objectives, therefore, is to offer some useful information regarding: developmental stages, as they relate to speech and language; simple techniques and materials to encourage maximum growth at each of these developmental levels; and typical speech and language disorders. The Department of Speech and Language Services functions as an effective and integral part of each of the schools. Our second objective is to familiarize the Yorktown community with the broad scope of services we provide and how these services interrelate with those offered by the other professionals on the educational continuum.
We hope you, as parents and educators, find this pamphlet informative as well as a useful resource to which you refer on numerous occasions. We encourage you to contact us with any questions you may have regarding speech and language development or any of our programs in Yorktown schools.
The exquisitely complex human activity known as talking has its beginning in the first few weeks of an infant's life. The tiny potential talker spends many of his first days screaming, howling, coughing, sighing, gasping and belching. But, before long, he hopefully adjusts to his new routine in his new world. His needs are readily cared for. He is bathed and changed and fed; he is loved and cuddled and talked to. He also launches into the first of many stages of vocal activity. He begins to babble. This is a period of sound making that occurs when the child is happy and content and it appears to be a pleasurable experience for the child. He utters a variety of cooing and gooing sounds, he makes throaty gurgling noises, and he blows bubbles. In short, he seems to be making these sounds mostly because they feel good to him; he receives some sort of pleasure from the sensations in his mouth and throat. Mothers report that their infants utter many different kinds of sounds and tape recordings that have been made of baby babbling show that the sound variety is impossible to transcribe phonetically. Some of their sound variations and pitch inflections do not actually occur in the language that they will eventually speak. This type of random vocalization continues until about the fifth or sixth month when gradually a higher level of babbling becomes evident. There is repetition of consonant and vowel syllables which the child may repeat for several days only to be suddenly dropped and replaced by a new and more interesting combination of sounds. From the scientific standpoint, it is felt that the child now is becoming aware of the sound that he is producing. He likes the sound and is stimulated to repeat it because of the satisfactory auditory feedback. During this period of time the infant begins to receive and improve on another type of feedback - attention getting. He has learned that vocalization is a very potent force in controlling his environment. He receives attention from mother by screaming, by laughing, by babbling and by all other means of vocalization that he has learned to this point.
Accompanying the development of vocal skills is the child's facility for comprehending the communication activity of his parents. For example, a baby soon learns to respond to the outstretched arms of his mother; he is able to react to adult gestures and grimaces and to soothing tones and scolding tones. Prior to the time when he utters his first word, he probably will have a comprehension vocabulary of more than a dozen words.
Before he uses his first real word, however, the infant must go through another stage of pre-word activity known as the imitation or echoing stage. This stage is typified by the child's growing awareness of the sounds in his environment and his ability to imitate them. In certain instances these imitations are merely repetitions of sounds in his own repertoire that his parents repeat back to him. He is showing an acoustic awareness of a sound that is made by someone else and he shows a mature skill in being able to duplicate it. During this stage the baby enjoys the back and forth sound games that his parent plays with him.
The baby says "da-da-da," the mother repeats it back to him, and so on. It is this type of vocal activity with another person that brings our infant to the threshold of meaningful speech. It prepares him for an activity that is more complicated than walking. Some time between 12 and 18 months, the child will utter his first meaningful word. With this first word as a foundation and because of the attention that resulted from it, other words will be forthcoming. The child finds that his needs are more quickly fulfilled when he uses the verbal symbol for the desired activity or object. There still is an overlap of echoing behavior and meaningless jargon during the period of word acquisition up to about 18 months. Beyond that time, however, there is a spurt in vocabulary development and more and more of his verbal activity usually consists of meaningful communication.
By the time a child has reached his second birthday, his vocabulary has developed sufficiently to allow him to begin to put together some two-word phrases. He says such things as, "Go bye-bye," "Daddy car," "Hi mommy," and "Me milk." He may have a vocabulary of 200 to 300 words, enabling him to ask for most of the things he desires. He names most of the familiar objects around the house and he can recognize and identify familiar pictures.
At two-and-a-half, the child may be able to do the following kinds of language activities. He is able to tell his first name but it is rare that he can give both first and last names. He has progressed to the point where he is able to ask for things by using some sort of connected phrase such as "give me," "May I?" or "Can I?" Most two and a half year olds can express a limitation or an inability to perform a task by saying "no," "I can't,' or "I can't do that," but they are almost entirely unable to give a reason for their limitation. They do not have sufficient language or experience to give reasons and this is why so many two and a half and three year old children say "because" or "because I can't," when a difficult task is given to them. Approximately a year later, however, they seem to be able to give a fairly adequate reason such as, "I'm too little," or "I can't reach it."
The two and a half year old youngster is capable of telling his age ("I two"), following commands that involve an object and a place to put the object ("put the cup on the table"), and his memory ability has advanced to the point where he is able to repeat a sequence of two words ("go bye-bye").
By the time the child reaches four years of age a great deal of maturation in language has taken place. He has developed a large vocabulary; he is able to put words together in sentences; he is quite capable of talking about things that have happened, that are happening now, and that are going to happen in the future. In general, the thoughts of the four year old are expressed in complete and well-organized sentences. He will continue to have grammatical errors but he seems to have mastered most of the complexities of the language.
From four years on there continues to be expansion of vocabulary and refinement of language usage. The influence of the child's environment begins to show in the degree of complexity of expression and precise pattern of language will be well established by the time the child reaches seven or eight years of age.
The development of speech is a process that is complicated and uniquely human. Speech follows an orderly developmental pattern that starts with babbling and ends with meaningful expression.
When the speech pathologist interviews the parents of a child who has been referred for an evaluation, it is necessary to obtain information about the child's developmental milestones.
Some parents, for example, will state that their child used some single words at eight or nine months. Although this may occur in rare instances, what they really heard was their child making repetitive sounds such as "ma-ma" or "da-da," but these sounds merely were a part of the babbling activities in the child's pre-language experience. In other words, the child had not yet progressed to the point that those particular sound combinations were used meaningfully to consistently signify his parents. This is what is meant by a word. The verbal (word) symbols are used consistently by the child and they are likewise understood and reacted to by his parents. The symbols may not be articulated accurately - the child may say "baba" for bottle but he uses that combination consistently to mean, "I want my bottle." The child may not succeed in getting his bottle in another home but in his own environment he is successful. If the child continues to use these inaccurate words as he gets older, however, then it is a problem which must be evaluated and course of treatment decided upon.
What has been happening during the first couple of years, therefore, is the development of what we call "Language." We are interested in how well the child articulates and pronounces his words but we are equally interested in how well the child uses these words to express meaning. A speech therapy session deals not only with improvement of articulatory skills but also with improvement of sentence length and sentence organization. In certain treatment sessions it is necessary also to train children to understand the language of others. It is obvious that if we must develop the ability to use language, we must first of all develop the ability to understand it. The type of children who are seen for therapy have these very problems - difficulty in not only expressing meaning with words but in understanding the words used by others.
There are many physical skills that a human being achieves throughout his lifetime. Following his birth he performs many automatic and reflexive activities but soon he lifts his head, rolls over, sits up, crawls, stands and walks. There are hundreds of physical, neurological and physiological activities that must occur to enable an individual to say a word. Consider, for example, only what the tongue does during the production of the word "train". The tip of the tongue elevates and touches the gum ridge above the upper front teeth and is released quickly in an explosive manner and immediately curls up and back to form the "r"; from that position the tongue drops down to a somewhat neutral position with the back of the tongue somewhat elevated and then the tip again goes up and forward to make contact with the front gum ridge to form the "n". It must be kept in mind that while the tongue makes these movements, many other activities are occurring; the breathing muscles are supplying air, the vocal cords emit puffs of air that give voice, our hearing mechanism monitors the correctness of the utterance, and there are other muscular activities in the throat and face to assist in word production. This, of course, is a simplified description of a complicated process but nevertheless indicates the tremendous skill and coordination that are required to make these maneuvers.
What can happen to speech, then, if something goes wrong in the complex communication chain? Here are only a few possibilities:
One can imagine what can happen to speech if more than one disorder occurs somewhere along the communication chain.
Between the ages of 18 months and 6 years, at least 80% of all children go through one or more very normal periods of what speech-language pathologists call developmental non-fluency. The child's speech suddenly becomes very noticeable because of some or all of the following behaviors: repeated sounds, syllables and words; "stretched out" sounds; many hesitations and pauses; and "filler" words like "and, uh, um." The amount of nonfluent speech and the length of the nonfluent period(s) will vary greatly with each child. In general, nonfluency occurs more frequently, is more pronounced and usually lasts longer in boys than in girls. The nonfluent period may last from one week to six or eight months, and may appear several times during the preschool years. Nonfluent speech periods may occur so briefly and to such a mild degree that they won't be noticed by parents or teachers. On the other hand, the child's speech may, for a time, be so alarmingly nonfluent that communication becomes impossible. The nonfluent speech may only be an infrequent pause or an occasional repeated word ("I fell down and I cried"). Another child may suddenly "get stuck" in the middle of a sentence and say the same word or word-part over and over ("I was go go go go go going home"). A third child may add "filler" words ("mommy, ah, um, um, um, um, do you know where my sock is?"). Still another child might add physical movements like swinging his arms over his head or jumping as he is talking. Finally, some children will combine all these behaviors into their particular "brand" of developmental nonfluency.
Nonfluency in preschoolers is a normal stage in communication development. However, it can be alarming or even frightening to parents. Some children, especially boys, are from time to time so dysfluent that the production of every word is a struggle. These children may have such difficulty talking that occasionally they will drop the particular topic and walk away in disgust. Parents may also feel very alone because they don't know any other preschool children who are having such "trouble" talking. By comparing their child's speech with the little girl or boy next door, who of course is talking perfectly, the parents may come to the inaccurate conclusion that their child has a problem.
A very common feeling among parents of a temporarily nonfluent preschooler is to wonder if the child will ever "talk right" or if he'll always have great difficulty speaking. For parents, who naturally want the best for their child, the thought of such a handicap can cause great anxiety. To help reduce these feelings parents must remember and believe that developmental nonfluency is a stage in normal behavior and will appear and disappear like other stages if left alone.
Parents and other adults must also make sure that the preschool child realizes there is nothing wrong with the way he is talking (when he is nonfluent). At no time should any one give the child such advice as "slow down, start over, take a deep breath, stop stuttering," or the ever-popular "think what you're going to say before you say it." These suggestions, no matter how well meant, will only cause the child to begin paying undue attention to his normally-developing, temporarily nonfluent speech. There is evidence to suggest that the speech problem known as stuttering can sometimes result from too much attention paid to developmental nonfluency.
A word also needs to be said about other people in the child's environment such as day care providers, grandparents, and siblings. It is the parent's responsibility, after recognizing that preschool nonfluency is normal behavior, to train other people to react without emotion to the child's speech. Demand that they respond to what the child says, not to how he says it. If necessary, remind them of the research which suggests that the communication problem called stuttering can sometimes result from too much attention paid to developmental nonfluency. A very effective teaching technique for children (sisters, brothers, friends) is simply to show by example how you wish other people to respond when your child is nonfluent. Let people know by your listening and lack of negative reaction that what they are hearing from your child is normal behavior.
OTHER THINGS TO DO:
The following are indicators that a speech-language pathologist should be contacted.
By age 2½ years:
The child does not appear to understand
The child does not use words
The child uses mostly vowel sounds when he talks (“-a—y” for “daddy”).
By age 3 years:
The child does not put words together (says “cookie" instead of
“want cookie”).
The child cannot talk meaningfully about people, places, or activities
The child omits many beginning sounds (“ants” for “pants”).
Speech is not readily understandable.
By age 4 years:
The child's speech is not easily understood
There are many substitutions and/or omissions of speech sounds (“tandy"
for “candy,” “ha”- for “hat”).
Sentence structure is noticeably faulty.
The child is embarrassed or frustrated by his speech.
What is Indirect Language Stimulation?
The purpose of the several techniques collectively labeled Indirect Language Stimulation is to give a language-developing child words for the actions he does and for the objects he sees and to expand his short verbal utterances without demanding an immediate response. I.L.S. includes the following types of utterances.
Self Talk:
Describe out loud to your child what you are seeing, hearing and doing as you do it, e.g.; "wash the dish, dry the spoon, I put the plate away." Use short, simple sentences and let your child know there are words to describe all sorts of activities and feelings. Give him words for what he sees you doing.
Parallel Talk (child centered):
Describe out loud to your child what he is seeing, hearing, thinking and doing as he does it, e.g.: "You're throwing the ball; In goes the car; Johnny has a rock; Push the bike; You're pushing the bike." Give him words to describe the action he does or the thing he sees.
Description (object centered)
A labeling or explaining phrase or statement, e.g.; "That's a big ball; There's mommy; That dog is a poodle; It's hot; The pillow is soft; The water is cold; There's a fire truck."
Repetition (imitation)
Repeat exactly what your child says but use correct articulation. For example, the child says "widdle wed wabbit," and you say, "little red rabbit."
Expansion
Repeat your child's "baby sentences" the way an adult would have said them. This shows him you understand and, at the same time, gives him a good model. You are revising and completing the child's speech. For example, the child says "doggy run" and you say, "Yes, the doggy is running."
Certain toys can be valuable vehicles for language stimulation. Perhaps the most useful toy is a CD or tape player. A word of caution in selecting them: avoid CD’s or tapes which put distorted language and speech in the mouths of the characters such as Porky Pig, Daffy Duck, or Tweetie Pie. Rather, select clearly articulated, easily understood stories, songs or nursery rhymes. These tapes can provide the child with excellent speech and language models and help them develop their memory span for stories, songs and rhymes. Some tapes promote gross motor activities such as "The Hokey Pokey." Such activities may help the child develop his coordination and ability to follow directions.
A tape recorder or any toy which incorporates a tape recorder can serve several purposes. When playing with the child the parent or older sibling can record language sample models. The child can also record his own utterances which can be played back, giving him a chance to develop his self-awareness of how he sounds. This allows the child to begin to make some comparisons between the way he sounds and the way others sound.
For those children who are still at the sound and/or syllable level there are toys that make sounds which provide models such as "popping, growling, mooing, barking, meowing, etc." These are fun and always at hand. Most of the sounds that these toys make are early developmental consonants and vowel combinations. (Mattel "See and Say")
Miniature objects and animals can be used in playing with most children. These toys can be handled, named and used in creative play. (Fisher Price play sets - e.g. "Hospital," "Gas Station," "Farm," etc.). Activities using these toys can help develop a child's vocabulary, concept formation, and general knowledge.
This list is by no means a complete one. Many items could be added but, hopefully, it will provide a few ideas for things to do at home besides drills.
Ways to Prevent Communication Disorders
Learning to listen efficiently and to understand language requires much help in many cases. Yet many parents and others typically become more excited about the baby's first step than they do about the first word, which is a far more complex and difficult accomplishment. For this reason communication skills are left to develop with little or no help on the assumption that these skills develop automatically. Fortunately, many children do develop such skills with little help but many others need a great deal of assistance. For all children the processes of learning to understand and use speech and language would be much more efficient if those around them, especially parents, understood how and what order language and speech skills develop and gave the necessary help to the child. If this were the case, a great many speech and language disorders could be prevented.
Kindergarten Scanning Program - D.I.A.L. -R
In the spring of each year, following kindergarten registration, Mohansic and French Hill Schools conduct a scanning program for all incoming kindergarten children. The scanning instrument, Developmental Indicators for the Assessment of Learning (D.I.A.L.-R) was adopted in 1987 for the purpose of obtaining a very general picture of the development of certain skills, as well as highlight the need for further evaluation in those few children with possible learning concerns. The D.I.A.L-R screens children for:
The goal of the D.I.A.L.-R is to identify:
The speech/language pathologist is a permanent member of the scanning team whose responsibility it is to conduct the portion of the scanning relating to communication skills, as described previously.
Programmed Speech Improvement System
The Programmed Speech Improvement System (PSIS) is a program on the elementary school level (Grades 1 and 2). The program provides speech services for children who have mild to moderate functional articulation disorders including sound substitutions, distortions, or omissions. It is not intended for children who have severe communication disorders.
PSIS may incorporate pre-recorded tapes and a playback system and is run by trained aides under the direct supervision of the building speech and language pathologist. The speech and language pathologist screens and identifies those children who are to participate in the program. Children are seen for PSIS sessions in small groups two times per week.
The program is arranged in three sequential phases. Phase I, Auditory Identification and Discrimination, is the auditory or listening portion of the program. It concentrates on teaching the child to identify his sound, contrast it with other sounds, discriminate it from other sounds and finally to identify the sound in words and phrases. The Production Phase, Phase II, is the portion of the program which teaches correct production of the misarticulated sound. This is done in small steps: producing the sound in isolation; in nonsense syllables; and then in words. Phase III, Stabilization is begun when the child can produce the sound correctly in the contexts mentioned previously. This is considered the "carryover" stage where the child practices using his newly acquired sound in a variety of words, phrases, sentences and conversational speech.
Following successful completion of all three phases, the speech and language pathologist determines if the child is using his newly learned sound habitually. If correct sound production is consistent, the child is dismissed.
Rosner Perceptual Skills Curriculum
Auditory - Motor
The Perceptual Skills Curriculum is an organized method for testing and teaching children the basic abilities - the readiness skills - assumed by the primary grade reading, writing, spelling and arithmetic programs.
The auditory-motor component of the Perceptual Skills Curriculum focuses on the basic abilities used in analyzing and organizing acoustical patterns, with special emphasis on verbal sounds - skills that are directly related to primary reading and, to a somewhat lesser extent, spelling.
Levels A and B objectives use music, clapping, and other non-verbal acoustical stimuli. Levels C, D and E focus on syllables, first as one-syllable words (Level C), and later as sub-components of multi-syllable words (Levels D and E). Levels F, G, and H are concerned with single phonemes, as they occur at the beginning, end, and within a word; and finally, as part of a consonant blend.
The program is administered to all kindergarten children as part of their regular kindergarten curriculum and is conducted by highly trained teacher aides. The speech/language pathologist serves as a consultant to this program.
Evaluation Content and Procedures
When a youngster is referred for a speech and language evaluation, his/her parents are notified. After parental consent has been obtained, the speech and language pathologist uses a variety of tests, both formal and informal, to evaluate the child's functioning in the following areas:
Receptive Language
In assessing a child's understanding or processing of language the speech and language pathologist tests his/her vocabulary or understanding of individual word meanings and for words in connected speech. This may be thought of as concept formation or the ability to process information from the environment. Memory and discrimination (visual and auditory) play a significant role, as well, and the speech and language pathologist assesses these areas in order to determine the child's most efficient learning mode.
Expressive Language
In assessing how the child is using spoken and written language to express himself/herself, the speech and language pathologist analyzes his/her vocabulary, syntax (word order usage), morphology (grammar), sentence complexity, and word retrieval ability. The child's ability to organize and sequence thoughts into verbal output is also assessed. Informal language usage is analyzed for appropriateness and amount of information conveyed (pragmatics). The child's ability to focus on a subject and change communication styles to suit the situation plays an integral part as well.
Intelligibility
Speech sound production is assessed in isolation and connected discourse.
Voice
Quality, pitch and intensity of the voice are examined.
Fluency
The speech and language pathologist determines whether repetitions, stretched out sounds, hesitations, and pauses are present in the child's speech as well as any secondary symptoms such as excessive body movement, blinking, etc.
Oral-Peripheral Exam
The oral-peripheral examination involves evaluation of the structure and function of the teeth, lips, tongue, jaw, soft palate, and hard palate. Often, deviations of these structures may cause or contribute to articulation or voice disorders.
Vision and Hearing
Information about recent screenings of vision and hearing is obtained. If indicated, additional hearing screening may be done by either the school nurse or the speech and language pathologist.
Behavioral Observations
Personality or emotional factors, as they affect speech or language functioning, are also assessed. Symptoms of early language disability may be manifested in inappropriate social interaction.
The length and time necessary to evaluate a child varies greatly from one child to another. It is dependent upon age, attention span, work pace and the depth and degree of testing that the speech and language pathologist feels is necessary to obtain the most accurate representation of the child's abilities. It is usually completed in two or three sessions and results are then shared with the parents and appropriate school personnel. These may include any or all of the following: classroom teacher(s), instructional assistants, school psychologist, principal, et al. Recommendations are made regarding: the appropriateness of speech/language therapy - frequency and focus; curricular and instructional needs or adjustments; referral to other specialists within the school setting, (reading specialist, psychologist, learning disabilities teacher), referral to outside sources for further assessment in other areas (e.g., A child whose voice is unusually hoarse may be referred to an ear, nose and throat physician. A child whose hearing is in question may be referred to an audiologist for a complete audiological evaluation.) *
Typical Speech, Language and Hearing Disorders
The following is a list of various disorders that may inhibit a youngster's communicative abilities.
A communication disorder as defined by the American Speech, Hearing and Language Association is "an impairment in the ability to receive, conceptualize, or transmit information represented by a symbol system. This impairment may be mild to severe in nature. It may exist in any combination of three areas of language functioning. It may be the primary disability or one that results from other physical or mentally handicapping conditions.
A. A Speech Disorder is an impairment of voice, articulation, or fluency.
B. A Language Disorder is the impairment or deviant development of comprehension, processing and/or use of a spoken, written, and/or other symbol system. The disorder may involve the form, content or function of language. Form of language would involve sound systems and their rules (phonology), grammar rules (morphology), rules governing word order (syntax). Content of language would involve semantics, or the system that patterns intent and meanings of words. The function of language would relate to the efficient use of language in communication which may be expressed motorically, vocally, or verbally (pragmatics).
C. A Hearing Disorder is altered auditory sensitivity or acuity which may be caused by damage to the auditory systems. A disorder of hearing may impede the development, comprehension, production, or maintenance of language and/or speech. Hearing disorders are classified according to difficulties in detection and perception of auditory information.
"Deafness" is defined as a hearing disorder that impedes individual's ability to receive auditory information to such a degree that other avenues of sensory input must be utilized (speech reading, total communication).
"Hard-of-hearing" is defined as a hearing disorder, whether fluctuating or permanent, which impedes an individual's ability to receive auditory information. In this case, the hard-of-hearing individual relies on the auditory channel as the primary source of sensory input and may only partially utilize other sensory modalities.
On occasion, a parent may be advised by the district speech and language pathologist to take his/her child to an outside agency. The speech and language pathologist may feel that the youngster should be seen by an audiologist, otorhinolaryngologist (ear, nose, and throat physician), orthodontist, etc. Opinions from these specialists may rule out any medical origins of existing speech and/or language difficulties or simply provide additional information about the child's functioning. Information obtained from professionals in outside agencies is generally shared with other school personnel who are in contact with the child on a day-to-day basis. These outside referrals are at the expense of the parents.
Committee on Special Education
A "student with a disability" is one who has been unable to satisfactorily achieve the learning objectives which have been established for all children enrolled in the public schools in New York State without the provision of special education programs or other services. Such children are educationally disabled if their failure to achieve is primarily the result of visual, hearing, motor or speech disabilities, mental retardation, emotional disturbance, autism, or learning disability.
Speech, language or hearing difficulties may be related to one of these disabilities as a secondary factor or may be the primary reason for failure to achieve educationally.
If a parent or school personnel suspect that a student's communication disabilities are severe enough to qualify as a disability under the state and federal guidelines, then steps can be taken to have that youngster evaluated by the Committee on Special Education.
The evaluation packet would include a psychoeducational, a physical examination report, a social history, a speech/language evaluation, and any other pertinent information. This information is presented to the Committee on Special Education which determines if the student is eligible for special education program/services. The CSE recommends the appropriate classification.
Once a child is classified, an Individualized Education Plan (IEP) is developed. The IEP lists the specific program, services, goals and objectives. The IEP is reviewed at least annually.
The purpose of the Instructional Support Team is to deal with student related problems which have not been resolved at the teacher level. The Instructional Support Team meets weekly and is composed of any or all of the following personnel: principal, teacher(s), guidance counselor, school psychologist, speech and language pathologist, reading consultant, nurse, special education teacher.
The team screens referrals and may recommend classroom adaptations and modifications in an Instructional Support Plan. The Instructional Support Plan assists teachers in differentiating instruction for students with different learning styles/needs. The team may also suggest further diagnostic testing.
The Speech and Language Department
The Speech and Language Department of the Yorktown Central School District consists of the speech and language pathologists from all of the schools, one of whom serves as coordinator and one of whom serves as a member of the District Committee on Special Education in addition to her school duties.
Although based primarily in one school, each speech and language pathologist may also provide services to any other district school.
Departmental meetings are held on a monthly basis, at which time individual and group concerns are shared and discussed, projects are planned, therapy materials are critiqued and shared, and general professional "give and take" occurs. These monthly meetings enable our professional staff to keep abreast of what is current in the field by sharing our individual experiences in continuing education, exposure to recently published literature and participation in the professional associations available on a local level.
The speech and language department ensures consistency in the delivery of services throughout the district and provides a vehicle for effective communication with central administration as well as the general Yorktown community.
We wish to express our gratitude to the staff of the Portland Center for Hearing and Speech (Portland, Oregon) for permitting our reproduction of selected portions of their publication, HEARSAY - Special Speech Edition.