Low Tone: It is not just a speech thing

Toddler running during park strollOne of the consistent challenges I encounter in my practice is getting others on board with the idea that the child who is not verbally communicating his/her needs might benefit from other therapies.  I often hear that “my only concern is speech; he is not talking.” Many times that same child is running through the house, is not aware of my presence, or is playing with a preferred item for long periods of time without bringing me into his/her play.  I can tell you that as a speech pathologist my biggest concern in these cases is not speech.  It is about forming a relationship with that child, meeting the child where he/she is at, finding what motivates the child, and moving forward from there.  Last week we talked about low tone, food, and attention. This week we will think about auditory stimuli and using our voices to gain a child’s attention.

My primary background is Autism. What I have observed through the years is that many of my kiddos have low tone as well. Here are two great articles which discuss the prevalence of low tone in our kiddos on the Autism Spectrum but it looks as though more research is needed in this area.  When you couple low tone with low registration or a mix of both, this adds to the information that us as therapists need to look at with a child. These kids are not being “naughty”. If you get on board with the idea that your child or that some of the children on your caseload may have other areas to look at besides just speech, the better off the child will be in the long run and with his development.

In last week’s post we tapped into the idea of using food with some of our kiddos who have low tone. Some of the kiddos (not all) that I see who have low tone also have low registration.  And, let me add,  just because you have low tone, does not mean you cannot become “strong”.  What I have found is that many of my kiddos with low tone, followed by low registration respond less to auditory stimuli.  I cannot tell you how many times a parent has said, “My child does his own thing”.  “She does not listen very well”.  “He tunes me out”.  This may very well be the case, but often times I believe this child is not being obstinate.  They need help tuning into auditory information.  And, in my experience these kiddos respond better when there is more pitch or inflection in my voice.

close up of typewriter vintage retro styled , inscription teamwWhy talk about sensory processing? Why colloborate with our OTs?  Because, when it comes to taking in information and that includes auditory which in turn means language: it is our job. Many times my toughest job is educating and convincing a parent that we need an Occupational Therapist on our team. I need help as your child’s therapist. Granted, I have tools in my toolbox and many tricks that have worked, but for some of our kiddos they need more from someone who has a background in sensory integration.

My sister used to say, “Please don’t talk in your speech therapist voice”.  How many of you are nodding your heads now in understanding?  I will never forget one kiddo many moons ago that had not imitated a a sound or a word. He was over the age of 2 and had been diagnosed on the Autism Spectrum. His first word was “Oops” which he imitated after something was spilled. I had my best speech path voice on with an exaggerated inflection and increased volume.  I cannot tell you how many kiddos I have seen that their very first imitation of any sound or word was “ppssst”.  I am betting the novelty, the increased inflection, the changes in volume reverberate with these kiddos. Or, let a kiddo know that “no” is the answer by verbalizing “eh-eh” in a sing-songy fashion.  It is not meant to be mean, but meant to tap into their auditory system.  Using a “deeper” voice often does the trick too.

Think about our kiddos on the Autism Spectrum, Down Syndrome, or just low tone.  Many times these kiddos become hyper-focused on an activity. As a result it is difficult to gain his or her attention. Once again, if we have a better understanding of what this child needs we will experience better success in terms of speech, receptive language, interaction, etc. Low arousal: Increase the pitch and inflection to gain the child’s attention and to tune the child into you and what you are saying.  Many of our kiddos like the exaggerated voices, music, and voices with inflection.  On the other hand, some of these kiddos with low tone are shy and quiet and need the “tame”, soft-spoken voice.  It is a matter of reading the kiddo.

We also need to think about short, consistent prompts, commands, etc as I discussed in this post. This makes it easier for the kiddos to learn new skills.  Otherwise, given too much information I would venture to guess that child is hearing “wa-wa-wa” from Charlie Brown.  They will tune us out because it is too much.

I am the gal that needs caffeine in the morning to get going. I do not pop out of bed with a smile on my face.  It takes me longer to get going in the morning so coffee is my friend.  I like music that has a snazzy beat and rhythm and I am quick to change the station if the music does not gain my attention.  I am the person who loves to slink into my over-sized chair at the end of the day. And I love those atomic fire balls!  Low tone. Low registration.

Thank you for reading this week’s post! If you could relate to or use this information please consider following my blog and invite a friend! Be sure to grab a cup of coffee too!  Topics will include Low Tone, Apraxia, Autism, Food, Concrete Thinkers, Toy Selection.

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Luxurious drawing tools on a wooden table

  1. Lisa Allen

    Please everyone, stop calling children “kiddos.” It’s disrespectful, cloying and annoying.

  2. I couldn’t agree more with this post, thank you. My son was completely unaware i was in the room, focused on what he was doing at the time and did not seem to notice anyone walking in or out of the room. I am a huge advocate for Sensory Integration and the use of visual prompts/cues for “kiddo’s” like mine, they made a huge difference to all our lives!.

  4. Fantastic blog post. Many children with low tone are also breath holding for stability, which will affect their ability to attend, sit still, as well as produce speech. Work with your PTs also, help to get children’s inner cores active- it’s quality of movement and alignment not just “strengthening” that is important.

    • Thank you for reading my post and commenting Joni! I have two kids right now that tend to hold their breath also as well as have low tone. A two day sensory integration training I went to taught me to look for breath holding so thank you for validating the need for more disciplines to be involved with some of our kids.

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