Speech Therapy Blog

Fine Motor Delay and Speech Delay Correlation

October 30, 2010
In my speech therapy practice, I often find that children with articulation delay or disorders often have difficulty with fine motor skills. 
 
Speech is the finest, fine motor skill we have.  Think about the intricacies required for saying the multisyllabic word “buttercup”.  To say this word, your lips come together for /b/.  Next, the tip of your tongue touches the area just behind your top front teeth for /t/.  Then, the back of your tongue spreads out for /r/, and immediately moves upwards for /k/.  Finally, your lips come back together for /p/.  The muscles of the mouth (jaw, lips and tongue) have to perform very specific movements so a word is produced with appropriate speech clarity.  Using words in sentences and conversation requires rapid and precise muscle movements.
 
The jaw, lips and tongue work most optimally when they have a strong and stable trunk to support them.  A child should sit upright with his or her feet supported, and the ankles, knees, hips and chin at right angles for optimal respiration, phonation, resonation and articulation.  When a child sits on the floor in a “W” shaped position, the knees are bent with one foot on each side of the child’s tushy, not allowing for an upright posture.  Children should be encouraged to sit on the floor with their legs straight out in front of them or in a criss-cross / Tailor-sit position.
 
Many children make predictable developmental sound substitutions as they are learning to talk.  Articulation errors may involve substituting one sound for another (“tar” for car), omitting a sound in a word (“boo” for blue), or distorting a sound.  Guidelines as to when individual speech sounds should appear can be found here.
 
A speech therapist can be helpful in improving your child’s speech clarity.  It is important for the therapist to understand why your child is having difficulty saying speech sounds.  For example, is the jaw unstable?  Does he or she not achieve adequate lip closure?  Does the tongue have a poor range of motion?  When oral motor therapy is used in conjunction with traditional articulation techniques (practicing individual speech sounds), excellent results are often achieved.
 
Thumbsucking, pacifier use, bottles and sippy cups should be avoided past age one for appropriate speech clarity, as long as nutrition is not compromised.  The non-dissociated movement that occurs while suckling does not allow for the muscles of the jaw, lips and tongue to work independently.  Suckling may lead to tongue thrusting. 
 
The jaw, lips and tongue have precise fine motor jobs.  Encouraging good speech habits can help the muscles of your child’s mouth work more efficiently.
 
Stephanie Sigal M.A. CCC-SLP is a speech language therapist practicing in children’s homes on the Upper East Sideof Manhattan.  Stephanie specializes in articulation and language delay and preparing children for Gifted and Talented Testing and The ERB’s for New York City private school kindergarten admissions.  To learn more about Stephanie, please visit her website sayandplayfamily or you may contact her at sayandplay@yahoo.com or 646-295-4473.
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Fine Motor Activities

January 30, 2010

Children with articulation delay often have fine motor delay.  At times, a consultation with an occupational therapist (OT) is necessary.  Other times children may simply need to be exposed to the types of activities listed below to encourage development of the hand muscles.  

Supervision is crucial for safety (many of these activities contain small parts) and to ensure that the fingers are used appropriately within each task.  If the fingers are not used appropriately,  your child is simply playing with the item and not developing their fingers / hand muscles.

Encourage the writing fingers (see picture above) to do the work during precise fine motor activities.  While holding a marker or crayon, encourage a proper grip (see picture at right).   


During writing and many other fine motor tasks, the writing fingers (thumb, pointer and middle fingers) are active, while the pinky and ring fingers stay tucked in, secure against the palm.


Proper use of the fingers lays the foundation for higher level fine motor skills like writing letters and tying shoes.

 
Some of these activities are great in the car or airplane.

Begin with these fine motor tasks:
  • Mr. Potato Head
  • Crayons – try coloring with small, broken crayons to encourage a better grip.
  • Pip-Squeaks Markers
  • Stickers – peel off stickers with pincer grasp and place them on a vertical surface (piece of paper taped to the wall).
  • Magnetic Sets
  • Wikki Stix
  • String large beads or dried pasta – make a noodle necklace!
  • Place coins in a bank – you can make a slit in a coffee cup top.
  • Playdoh, Silly Putty - break off small pieces and roll them into balls between the pads of the thumb and pointer finger.  Then, squish the small balls between the thumb and pointer finger.  You can also roll and squish between the thumb and middle finger, thumb and ring finger and thumb and pinky.  Place toothpicks or thin birthday candles into Playdoh and make a birthday cake!
  • Glue dry macaroni – make a collage
  • Scissor work – make sure the thumb stays facing upwards.  Begin with My First Fiskars and promptly transition to a kids blunt tip.
  • Magnadoodle
 
Later, try these activities:
 
  • Standard hole punchers or try challenging shape punchers
  • Lacing cards (or make your own with a hole puncher)
  • Clothes pins – pinch them onto the edge of a container or a dishcloth.  Alternate fingers (first squeeze with thumb and pointer, then thumb and middle finger, then thumb and ring finger and finally thumb and pinky).
  • Paper clips – connect colorful clips
  • Practice fasteners (buttons, snaps, buckles, zippers)
  • Eat with Farm or Fish sticks
  • Blunt tweezers – pick up small cotton balls and transfer them from one cup to another.
  • Unifix cubes 
  • Zoobs
  • Legos
  • Lite Brite – you may like the travel size
  • Small Pop Beads
  • Pick Up Sticks
  • Keychains like these are fun to connect.  I recommend purchasing them from a hardware store where they will have more resistance than from a therapy toy catalogue.
  • Theraputty – Choose a texture that will slightly challenge your child and then increase the resistance with a firmer texture.  Hide pennies inside and encourage your child to find them.
 
Please remember, these activities are only helpful for fine motor skills if they are completed using an appropriate grasp as mentioned above.  If you find the exercises are difficult for your child, a consultation with an occupational therapist may be appropriate.

My favorite Manhattan Occupational Therapist Lauren Stern has helped me compile these activities over the years.  She can be contacted at laurendstern@gmail.com or 516-298-4084.
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