The truth behind Ms Rachel and other virtual speech therapy programs as told by an early intervention, Speech Language Pathologist.
My honest opinion; you’re here for it aren’t you? "Teach your child to talk" programs, apps, digital flash cards, videos; they are possibly harming children. They could be especially damaging to the children watching them if they are being completed as the "sole" treatment for a suspected speech or language difficulty. In other words, if a child is watching "Learn To Talk With Ms Rachel" as it is marketed to parents, and parents believe that their child can learn to talk by watching it, it is likely harming their communiation development. Ms Rachel, Gemini and many other marketed “learn to talk" programs, apps and videos, are asynchronous (not live), and are not interactions between two human beings. The positive interaction is what teaches communication not the "flash cards". There are many great screen time options for children. Programs with real life faces, simple language, high repetition, enriching vocabulary and bright slow songs that are easy to follow along too are incredibly engaging and can be a positive time for children! I grew up with Mr. Rogers and Sesame Street, the programs available now have come a long way to supporting children's need to see faces and mouths up close, early communication signs, slow speech, and repetition. As a Speech Therapist myself, I too use songs, high repetition, and enriching vocabulary as a part of my speech therapy sessions, but let me be clear, that’s definitely NOT, all I do. The danger also comes from anything more than 1 hour of screens for children over two and any screens for children under 2 is detremental to communication, cognitive, motoric and social skills development. Read on to find out what "Ms Rachel", Gemini and other online "Speech Therapy" programs are missing and what I advise my clients to do if they choose to use these programs in their home so that they dont harm and can actually help a child's speech and langauge development.
What screen time programs marketed as “Speech Therapy” are missing:
1. Screens don’t provide a diagnosis:
First and foremost, the clients I work with are under the care and individualized guidance of a trained pediatric Speech Language Pathologist. Screens cannot evaluate a child’s speech language cognitive or oral function skills. The fine prints on these programs likely state that these programs are not to be used as a replacement for the guidance or evalaution from a licensed and trained speech language pathologists, SLP. SLP’s have the knowledge and skills necessary to identify if a child’s mouth, hearing, auditory processing, vocal characteristics and social communication skills are showing any signs of abnormality. Early intervention is hugely important and knowledge is power. To skip an evaluation, or to skip therapy in real time, with a Speech Language Pathologist can be seriously detrmintal to a child who needs the early intervention. Not receiving an evaluation or seeing a speech therapist when a parent is concerned, is like pulling the covers over our heads and hoping the sound was nothing. We might be right, the child may “just be behind” and “waiting and seeing” could work. In that case not paying for any program could be just as helpful as not watching any screens; and increasing face to face time and enjoyable interaction with people and other children too!
2. Screens don’t teach communication or social skills and they can harm language development and overall well being:
Screens can be highly stimulating and addictive and can increase anti-social behaviors. Recent research show a direct relationship to increased agrression, anxiety and emotional reactivity for children provided screens before 18 months of age, (Muppalla, Vuppalapati, Pulliahgaru, Sreenivasulu, 2023). Many children who develop screen addictions become anti-social and are at higher risk for depression. Screens can be a tool to teach social skills or vocabulary, but social skills must also be taught through real interactions with real people. Brown, 2011 reports that research still shows without a doubt that children under 2 should not be provided any screen time, an infant and toddlers time should be spent getting face to face positive interactions with real time people, with its only exception made for live video and or audio talking with people. Many potential adverse health and developmental effects exist for children using media before the age of 2. Research has shown that for chidlren older than 2 yeras of age there can be some educational benefit to watching high quality educational shows. Twenge and Campbell, 2018 conducted research that revealed anything more than 1 hour a day of screens for children ages 2-17 resulted in lower psychological well being including; less curiostiy, lower self-control, increased difficulty making friends, less emotional stability, incrased difficulty for parents to care for them, and inability to complete tasks. Therefore, instead of putting on Ms Rachel, parents and caregivers need to put the screen down, meet up with a friend and help their children learn to interact with eachother.
3. Screens don’t provide feedback:
My entire day at work as an speech therapist is spent providing feedback; real time, face to face in the moment feedback about my client’s communication attempts. “ba” may have meant the ball we played with, the bird they are pointing to outside or the bubble they just popped. This is the basis for speech and language: positive interaction= communication. Sometimes when I give feedback I’m wrong, but either way the child receives feedback as to whether the message they sent was received by me, their communication partner.
My biggest concern with online, recorded, video programs is “negative feedback” it is one of the first skills I teach my client’s caregivers to NOT do.
Negative feedback is telling a child they did well through facial expressions, comments or encouragement when in fact their production or attempt to say the word was not accurate or not what the child was trying to say. What the child hears with “negative feedback” is “yes! I said it right, okay I’ll say it again the same next time.” Instead, what they need to think is “bummer I tried to say bird but she didn’t hear me, I’ll keep trying to figure out how say it different next time so she can understand me.” Learn to talk programs provide negative feedback all the time and real time specific and helpful feedback can’t exist in these pre-recorded programs or apps.
Adults do this all the time too, half heartedly listening and say “uh huh, yeah sure”, or “good job!” when we really have no idea what a kiddo just said. I teach my client’s caregivers right away that if their child is struggling, we need to be specific with our feedback and “woo hoo!” the new! We also need to provide specific positive feedback if we want to provide encouragement we can say “wow, thanks for trying” or “I hear you trying to say that, keep trying!” or even “I heard you say “ca” yes! That is a caaaTT!” While saving the "yahoo!" for those new words and attempts and telling them specifically what we heard.
Online “Speech Programs”, videos and marketed software for “speech learning” provide negative feedback ALL THE TIME! Saying things as “great job!” having no idea what a child just said or did, or “way to go give yourself a hand”.
Instead, what children need is real time, specific, meaningful, in the moment, feedback that closes the circle of their message and lets them know how their message was or wasn't received by the listener! This is interaction, positive interaction = communication, screens cant do this.
4. Screens aren’t developed for the good of children:
Let’s face it, the good ol’ United States of America is a capitalistic driven economy. Technology, food, and so much more are and have been developed and marketed to make consumers believe the items is needed and will improve life. In many cases items such as screen programs are developed to explicitly addict consumers despite the adverse health effects. These programs are doing just that. To market and allow anyone to believe that increasing screen time useage will offer any benefits to a child without interaction from the parent and carry over learning is detremental to the health of every children who is watching it. Especially for the families particpating in the program believing it alone will improve their child's communication. Furthermore, these screens are marketed in a way that allows consumers to believe they may not need the skills and knowledge of a therapist. This is detrimental to the early communicaiton skills of children. Increasing screens could harm the outcome of children’s speech and language skills especially if not used under the care and guidance of a knowledgeable SLP, who I’ll be truthful SLP's like myself didn't go into this field to make money!
Simply stated these programs are great options for screens but please lets leave it as just that another form of, screens. Screen time if used less than 1 hour a day over the age of 2, can be a wonderful way for a child to pass their time without a parent or caregiver. In many instances watching along with a parent and interacting with them can make almost any screen time an educational experience! These screens are not a replacement to speech language evaluation or therapy and like any screen time offered their time should be limited; 0 hours for chidlren under 2, less than 1 hour children 2-17 is ideal and completely not our American standard. These "Speech Therapy" programs are developed and marketed to make parents feels a need to spend their time and their money on them. The developers are not offering them as an act to spread knowledge or skills they have been developed to make money. Please don’t hesitate to reach out to your doctor or local Scottish Rite Care Clinic if money is an issue there are many options for children to receive an evaluation for free or little cost to parents. These evaluations and individualized treatments are necessary for so many children to receive and develop communication, motor, visual, cognitive skills to the best of their ability.
Please use a child's precious cognitive explosion time wisely and limit their access to screens. Increase their face to face interaction with real time people who love and care for them during positive and meaningful every day routines and interactions.
References
Brown (2011) Media Use by Children Younger Than 2 Years. Pediatrics 128 (5): 1040-1045 retreived (9/26/24) https://publications.aap.org/pediatrics/article/128/5/1040/30928/Media-Use-by-Children-Younger-Than-2-Years
Muppalla, Vuppalapati, Pulliahgaru, Sreenivasulu (2023). Effects of Execessive Screen Time on Child Development: An Updated Review and Strategies for Management. Cureus, Published online 2023 June 18. doi 2023 Jun; 15(6): e40608. 10.7759/cureus.40608
Retreived: (9/26/24) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353947/#:~:text=The%20specific%20physiological%20mechanisms%20underlying,on%20their%20gender%20%5B19%5D.
Twenge and Campbell (2018) Associations between screen time and lower psychological well-being among chidlren and adolescents: Evidence from a population-based study. Preventive Medicine Reports 12: 271-283 Published online 2018 Oct. 18 retrieved (9/26/24) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214874/