Speech Therapy - Best Private Hospital in Dubai Al Mankhool | IMH Dubai


“Avoidance increases fear and therefore stuttering, and it must be reduced” – Dr. Charles Van Riper

When speech is interrupted by frequent repetition like le- le- let me talk, prolongation like llllllet me talk, excessive fillings, stoppages like umm ah or sometimes no sound but a visible struggle to talk, it is called Stuttering or Stammering.
Stuttering prevents you from speaking freely and this disturbance while talking may be accompanied by rapid eye blinking, avoidance of eye contact, shivering of lips, jerks in the jaws or other such bodily or facial struggles. Certain situations such as speaking to a stranger, group of people, talking on the phone tend to make stuttering more severe.

The exact and precise mechanism that causes stuttering is not well understood. Stuttering tends to run in families. Children with other speech and language problems or developmental delays are more likely to stutter. Studies have shown that people who stutter process speech and language slightly differently than those who do not stutter. Sometimes even high expectations, stressful lifestyles can also contribute to stuttering.

Stuttering affects males four times more than females across all ages but occurs most frequently in children between 2 to 7 years of age whose speech and language are developing. According to the Stuttering Foundation, approximately 5 percent of all children go through a phase of stuttering that lasts six months or more. Most of them will recover by late childhood, leaving about 1% with a long-term problem.

If you think your child is stuttering and if the stuttering persists for three to six months or more, it’s advisable to seek help from a speech and language therapist who specializes in treating stuttering.

Currently, the available cure for stuttering is through speech therapy approach. There are varieties of successful approaches to treating children and adults with stuttering. The earlier the treatment, the better the outcome. Speech therapy will help prevent childhood stuttering from becoming a lifelong problem.

Let’s teach the baby in the womb

Do you believe that babies can learn even before birth? Yes, they can

Latest research has revealed that babies can be stimulated while they are still in the womb by methods such as talking and singing and that it tends to boost their visual, language and motor development. Prenatal stimulation provides a safe environment for your baby before as well as after birth which is key for long term success.

Your fetus experiences many sensations; hearing being the fastest developing sensation.baby Towards the end of the second trimester, your baby starts to hear. The mother’s voice is well perceived while background sounds such as the mother’s heartbeat, breathing, pumping of blood, gurgles of the stomach, and air filling the lungs are heard internally. Your unborn baby can also hear muffled noises and music coming from outside.

How do we initiate communication with the baby?

Your baby is the one who initiates communication. Encourage him/her to kick; whenever he/she kicks, touch the opposite side (merely the place where the head is) and say, “Kick baby kick. Kick-kick-kick”. Keep your tone of voice enthusiastic, entertaining and patient. This can be repeated several times and eventually the baby will learn to kick a point on the abdomen in response to the mother touching that spot and saying, “Kick, baby, kick here’’.

Play relaxing music to the baby; can be nursery rhymes too. Although your baby is well protected inside the womb, make sure not to place high volume headphones directly on the baby bump. It’s wise not to play music too loudly and frequently to your baby. You can sing nursery rhymes to your baby when he/she is awake; caressing your baby bump.

Who’s my pretty baby
Who’s my pretty little baby
You’re my, my pretty little baby
Hey Hey pretty babe
Hey Hey pretty baby
Ho Ho pretty little baby

When you speak, sing or play music to your baby in the womb, her/his heart beat may increase and your baby may move more. mother Mothers are welcome to be creative in their own way to stimulate the baby and repeat the same after the birth. You may find a wiggly and alert response from your newborn to what they heard regularly in the womb.

Read small stories to the baby. This will make the baby comfortable while in the womb. The same voices and stories will then comfort the baby after birth, which comes in handy on nights when the baby is fussy and doesn’t want to sleep. The mother’s voice is heard best by the baby in the womb. Teaching parents how to talk to their unborn baby forms love and trust, and provides a strong supportive background for the child to grow and learn. Continuation of same story rhymes and songs are essential to incite the desired response from the baby. Development of speech and language skills is an ongoing process and prenatal stimulation definitely forms the strong baseline for long term success.

About the Author: Ms. Hiranthi Karunarathna is a Speech Therapist at International Modern Hospital with 4 years of clinical experience in Speech Language Pathology. She specializes in stuttering, autism spectrum disorders & other childhood communication disorders. Her experience includes both pediatric& adult rehabilitation care.


“Wanting to be free. Wanting to be me. Trying to make people see. And accept the real me.” – Scott Lentine

Over the past decade a growing autistic pride movement has been pushing the idea that people with autism awarenessautism are not disabled, they just think differently with multiple abilities.According to the history of human evolution, it is likely our ancestors would have had autism without been noticed. Latest research concludes autism has a long evolutionary history. Incidence and prevalence of autism has dramatically increased over the past few years.

On March 27, 2014, the Centers for Disease Control and Prevention (CDC) released new data on the prevalence of autism in the United States. This surveillance study identified 1 in 68 children (1 in 42 boys and 1 in 189 girls) as having autism spectrum disorder (ASD). In the UAE, the prevalence is estimated at 1 in 50 children.

People with autism traits may not necessarily want to be accepted or best tolerated but they need to be respected for their unique skills. According to Penny Spikins, senior lecturer in the archaeology of human origins, at the University of York a significant diversity or a variation between people positively impact on successful human evolution and people who are gifted with special skills play an important role in their social group.

Many people with autism have exceptional memory skills like recalling information they read weeks ago, procedures followed in experiments and pattern identification. They often outperform others in auditory, visual, smell and taste related skills. They are also gifted with enhanced understanding of natural systems such as animal behaviors. Individuals with autism perform better on non verbal tests of intelligence than verbal.autism’s hidden giftThe incorporation of their gifted skills into a community would play a vital role in the development of specialists in our community. A study done in 2005 about an elderly reindeer herder from Siberia revealed a detailed memory of the parentage, medical history and character of each one of his 2,600 animals.

His vital knowledge would have made a significant contribution to management and survival of his herd of animals. This grandfather was more comfortable in the company of the reindeers than of humans, but was much respected and had a wife and son and grandchildren.

This example has given the various differences among people with autism and how they have been integrated for the development of specialists in the society.

The most important fact is to emphasize the strengths and weaknesses of people with autism. Though the past studies have concentrated mainly on deficits in autism, the field is now taking a broader and deeper view of the disorder.

We are all in the right era to start thinking of autism as an advantage and how to utilize this advantage for the well-being of the society.

Autism TreatmentsThe right environment for people with autism for making sophisticated contributions to the society is the need of the hour. In many instances, people with autism need opportunities and support more than they need treatment.
The major focus of the rehabilitation team is to identify the strength and weakness of the child with autism. For instance, if a child has minimal verbal ability, then you probably want to find a visual route to help him. Your intervention should target the deficits, while working with the strengths.

About the Author: Ms. Hiranthi Karunarathna is a Speech Therapist at International Modern Hospital with 4 years of clinical experience in Speech Language Pathology. She specializes in stuttering, autism spectrum disorders & other childhood communication disorders. Her experience includes both pediatric & adult rehabilitation care.

Children in Kindergarten

Keep in mind, every child is unique and some will speak very early, some will be late. Children will reach speech milestone in different ways and times. Inborn ability to learn language, other skills they learn, amount of input they get, and your response to their communication are the key factors which speed up or slow down the development of speech & language skills.

Bear in mind , the language spoken at home & cultural norms can influence the way that we communicate.

As always, if you have any questions or concerns about the child’s speech or language skills, please contact a speech-language pathologist.

What should I expect my child’s speech and language development by the end of kindergarten?

What does (s) he understand?

  • (s)he follows 2 step directions. For eg. Go to granny’s room and bring her mug. Glue the picture and press down.

  • (s)he understands a simple age appropriate stories read loud.

What does (s) he speak?

    • His/her speech is clear. can be understood by strangers.
    • (s)he can answer simple “wh” questions(what, where, who, Why for an extent)
      What did you eat for breakfast?….Who got you this bag?
    • (s)he can retell the story you read aloud to him/her.
    • (s)he is really interested in telling the events happened in class and in the play ground.

You observe: your child actively participates, initiates conversation and enjoys it.

Reading & Writing Skills

  • The child knows to use a book(e.g. reading form left to right and top to bottom in English)
  • Tries to read letter by letter.
  • Can identify rhyme words( cat & bat, mat & pat)
  • Can understand big (capital) and small (simple) letters. Some words can be matched with the pictures. It is obvious to see the child imitate reading by talking about the picture (s)he sees.

  • Can copy down his/her name, may jumble big and small letters. Tries writing down, but often ends up unclear.

Development in social skills

  • Social skills are how the child learn to express his emotion, understand others emotions feelings & facial expressions

  • Good social skills provide them ability to solve problem & conflicts occur in the playground, class room. Obey simple rules, Follow instructions, Build good interaction with other children and adults. Participate in common activities. Uses words thank you, please to adjust with a new environment, Ask for help and help others too, Demonstrate good discipline and self control. Respect others and value him/herself.

How to help the child?

  • Let the child feel reading is very important and fun, provide him/her with interesting, favorite small story books. Read the story aloud. Have an interesting conversation with the book and the story. Encourage him to tell you what would be the story or picture. More involvement with books encourages reading.

  • Explore the opportunities to have a wealthy conversation with the child .sing songs, do some games while bathing, cooking with the child.

  • Emphasize the concepts of yesterday, today and tomorrow.

How to help my toddler (between 4-5 years of age)?

What does (s)he understand?

  • He or she now hears and understands nearly everything that is said at home or at pre-school or day care.

  • Your child’s ability to hear properly all the time should not be in doubt. If you are in doubt about your child’s hearing, see an audiologist. If you are in doubt about language comprehension, see a speech-language pathologist / speech and language therapist.

What does (s) he speak?

  • Your preschooler will speak more clearly and will use even more words, often in more complex sentences of aboutHow To Help My Toddler six words or more for examples. Mom went to the supermarket but I couldn’t go with her. We visited grand ma since she was sick.

  • You’ll be able to understand what (s) he’s saying all the time.

  • His/her pragmatic skills are really good that he can stick to a topic of his/her imagination and talk.

  • You probably experience that they have difficulties with certain sounds such as /r/,/th/, and /v/.(s)he admires the gathering of peers.

How can I help my child?

  • Give full attention to your child when (s) he is speaking. Let him/her feel that you’re always attentive to him/her speech. Praise and encourage him/her after speaking.

  • Before you speak to your child be sure to get his/her full attention. Don’t accelerate your speaking. Pause; allow him to respond to what you have said. Repeat, if (s) he hasn’t understood.

  • This is the best periods to work on lexical items in categories such as vegetables, fruits, animals, shapes, vehicles, house hold items, food items and so on. Build on your child’s vocabulary when you teach the categorization .for an e.g.: What can we see on the road? We can see car, bus, these are called Vehicles, Car is a vehicle, bus is another kind of vehicle. So what is the train?How can I help my child?

  • Teach your child other concepts using the items categories. Make him sort out what are same and different.

  • (s)he is ready to sort items into categories on subtle differences such as vehicles into what goes in the water/air, cloths into women/men/children ware, house hold items into wooden/electronic appliances, hot and cold beverages. The child will learn multiples concept with sorting items.

  • Move to odd man out!!!! Ask the child what is different? Why it doesn’t belong in the given category. Let him explain why the item doesn’t’ belong.

  • Pretend that you don’t know how to play the game, follow his/her instruction to play. Do mistakes and allow him/her to correct you. Your child would value him/herself and (s) he will try to communicate more and more.

  • Give him/her two steps commands such as take your shoes off and keep on the rack. Take home work out and keep the bag on your table.

  • Make him/her involve in works like making juice, baking cake, painting, cleaning the floor and ask him/her how to make orange juice .Help him to explain steps. When playing with doctor set, cars, vegetable market ask them how did they give medicines? how did they shop? Write down, draw their steps as (s) he tells it. Your child will attempt to narrate stories and soon will build up interest to write letters.

  • Expand monologue to role play dialogues. Act different roles with the child. Explore new scenarios of acting, express new verbs, adjectives and how to combine them to a sentences.

  • Find the most interesting story with your child. Read, enact the story, make him actively participate in the story. Ask him/her WH questions (who, what, when, where, why) help him to predict what will happen next in the story.

  • Encourage your child to ask for explanation of new words (s) he heard.

  • Use pictures, story books, real situation to teach him/her spatial relationships (first, middle, last, left right) opposites (up and down, big and little, heavy and light) Use real life examples as much as possible.

  • Do guessing game with him. Give clues, and description about what is (s)he going to eat Where are they going, eg. your favorite with milk expecting the answer “chocos”

  • Make your child involve in plans and discussion at home . Get his/her suggestion in making list f or shopping, birthday celebrations, and festivals. What do you want to buy from the supermarket?

Your correct guidance would not only help in communication skills but also would improve the social and cognitive behavior of the child.

How to help my toddler (between 3-4 years of age)?

What does (s) he understand?help my toddler

  • His or her complexity of understanding keeps extending. He / She now understands simple WHO? WHAT? And WHERE? Questions and hears you when you call from another room.
  • This is the crucial age where hearing difficulties may become evident. If you are in a doubt of his/her hearing, it’s wise to consult an audiologist.

how to help my toddlerWhat does (s) he speak?

  • (S)he talks about many things to you, what happened in preschools, what type of play they did, how is teacher to him/her, what are his/her friends, what funny, and new (s)he experiences, and also his imaginations.
  • His/her sentences are becoming longer and longer as (s) he combines four, five or more words. His /her speech is usually clear and fluent and easily understood by the strangers most of the time.
  • They become very loud and unstoppable.

How can I help my child?

  • Mix categories e.g. mix animals with picture of baby, cookies, ice cream. And make the child to sort them out and show what doesn’t belong to the category. Tell him/her that he is correct baby doesn’t belong to cat, dog, category because baby is not an animal.
  • Draw, glue a car without wheels, favorite cartoon with a mistake, glue a dog in driving seat and talk about how silly the pictures and encourage him/her to talk about what is missing, and what is correct.
  • Act out typical scenarios with the child like going to doctor with the pet, teacher and student, acting like the mother at home, cooking food, making baby dress up, superman. Allow her/him to guide you in acting. Be the student and let your child teach a lesson. Ask the child questions; make him repeat if you have not understood completely.
  • Expand the child’s vocabulary by acting, storytelling, singing, filling the blanks. Talk about new games, new ideas you and your child can do and have fun.How can I help my child?
  • Find out a simple and interesting story book read line by line, ask simple WH questions (what, Where, Who, Why).Talk about favorite part in the story, in the cartoon. This is the best time to talk about favorite things with the child talk about his/her favorite game, food, rhymes and tell him/her also your choices.
  • Bring your family album to the bed. Talk about the photo and ask the child can you remember this photo. Help him to explain what happened.
  • Do silly mistakes in game, apologize for your mistakes, and ask his/her help to play correctly.

Leave interesting books and materials lying around for your child to explore.

How to help my toddler (between 2-3 years of age)?

What does the toddler understand?

  • By now (s)he will understand two steps commands take your shoe off and keep on rack.how to help toddler
  • And also understand opposites like hot/cold, stop/go, nice/ugly.(s)he hears ringing of the telephone , door bell and may become excited, get you to answer or tries to answer themselves

What does (s)he speak?

  • Your toddler’s vocabulary is going to explode. They seem to have a word for almost everything. Their sentence contains of one, two or three words.
  • Speech is probably not very clear, but family members can easily understand them.
  • Your toddler loves to hold your attention of what they hear and see.
  • They may draw your attention to something by naming it, for an example, Bus, Candy, Big, Hot, Wow, see.

How can I help my child?

  • Children learn by imitating adults. Use clear, simple words & sentences what is easy to imitate .Show your interest to their speech. When the child says doggie!!! ; Expand his/her word, Oh yes it’s a doggie, Doggie is running. Doggie says bow bow. It is black. Does Anny love doggie?
  • Have his/her help to arrange cloths, toys, food at home. These are what Anny eats put all into this bucket. Foods are here. We will put Anny cloths in this bucket. Teach the child basic function, features and class of objects with examples.Help toddler
  • Encourage the child to increase the length of speech. Which puzzle do you want? Try to give him/her open ended questions than close ended. For e.g. rather than asking Do you want rice? Do you want bread? Ask would you like to eat rice or bread? This will simply limit Yes & No answers.
  • Reinforce the child effectively .Positive reinforcement is the key for the successful communication. How good Anny speaks, Thank you Anny, mommy understood.
  • Introduce books, picture books, games & activities to expand your child’s vocabulary. Use colorful picture books and name object with the child. And describe the object using a simple sentence. Create the situation to use newly learned words in context. E.g. his is an Apple. Anny eats apple./ Apple is red
  • Have the child have the habit of collecting pictures from magazines, books. Help him/her to glue then paste or write the name under each object.


How to help my toddler (between 1-2 years of age)?

What does the toddler understand?

  • Her his receptive vocabulary is increasing day by day
  • The child points to pictures in a book when you name them, and also (s)he points to a few body parts when asked(nose, eyes, tummy, head).
  • She or He follows simple commands like push the chair, don’t touch, it’s hot, wash hands and understand simple questions (where is daddy, what is your frock, who is bunny).
  • Their interest shift from singing songs or say rhymes to simple story telling.
  • Your toddler now likes to listen to simple stories over songs.
  • This is the stage where you become exhausted with repeating the same story, game, rhymes many many times. But (s)he wants to listen the same again & again.

What does the toddler speak?

  • His/her expressive vocabulary keep increasing.,(s)he accumulating more and more words as each month passes.

  • (S)he can even combine 2 words and questions like mama ball, what is that, give me chocos, more chips, all gone, doggie ,daddy poo(car).

How to help my toddler?

Talk to the child while doing household things, going out or performing any activity. For an example Baby is going to bathe, run the tap. Water is coming ( put toys in the tub)Duckie is swimming, push push dickiee. Second example. I see a doggie, Doggie is running. It’s a big dog, Doggie says bow wow .Keep your language grammatically correct and easy to imitate. Talk about present activities what the child What does the toddler understand?sees around him/her. Use rhymes such as jonny jonny yes papa. Encourage the child to say hahahahaa/aaaaaa with you. Associate the object with sound e,g introduce the clock to the child, t-t-t-t-t clock, ding- dong- ding-dong .pi pi pi pi daddy car. Make him listen to the sounds of objects and create a sound associated with the object. mow mow mow mow cow. Use the sound like p-p-p-p-, m-m-m-m-, b-b-b-b-b, brooo-brooo, grrrr- ggrr while bathing, playing with toys, pampering him/her. These sounds will help him to learn better in preschool and kindergarten. Expand on words what the child says, for an example, if (s)he says car or sound likes car. Expand on words saying oh! yes it is a CAR, Biiig CAR, Big red CAR! Show the child big colorful picture book with large pictures. Name them, read aloud and talk about the picture. Wait your child to explore the picture, Ask him/her what is this and you answer. Make him/her point to picture Repeat the same several days. You would be surprised one day hearing(s)he names the picture.


What is stuttering? 

Stuttering is a communication disorder in which the  smooth continuous flow of speech is broken by repetitions (I- I -I want), prolongations (lllllet  me go), or abnormal stoppages (no sound silence pauses) of sounds and syllables . There may also be unusual facial and body movements associated with the effort to speak. Stuttering is also called to as stammering. But if you talk effort fully, with multiples disruptions that should be taken into consideration.stutter-2

What causes stuttering? 

There are four factors most likely to contribute to the development of stuttering:

Genetics (approximately 60% of those who stutter have a family member who does also);

Child development (children with other speech and language problems or developmental delays are more likely to stutter);

Neurophysiology (recent neurological research has shown that people who stutter process speech and language slightly differently than those who do not stutter);

and family atmosphere  (high expectations and fast-paced lifestyles can contribute to stuttering).

What is the ratio of males to females who stutter?

Males are affected four times more than females.

I think my child is beginning to stutter.

Should I wait or seek help? It is best to seek ways that you, the parents. How can I help him/her as soon as possible? If the stuttering persists beyond three to six months or is particularly severe, you may want to seek help from a speech-language pathologist who specializes in stuttering right away.

Can stuttering be treated?

Yes, of course there are a variety of successful approaches for treating both children and adults. In general, the earlier, the better……

Shot of a little boy talking to a psychologist

I read about a new cure for stuttering. Is there such a thing? 

There are no instant miracle or treatment cures for stuttering. However, a specialist in stuttering can help not only children but also teenagers, young adults and even older adults make significant progress toward fluency.

Language Problem or Late Talking?

 Our parents are smart. They are really concern about their child talk and how he / she communicate. They also listen to his or her peers who are at same age and may compare what older brothers and sisters did at the same age. This is how our parents mentally compare their child’s performance with other children. They immediately create an impression of whether the child is developing speech & language at normal rate or not.

st3If parents feel that development is slow, they check their impression with the other parents, relatives, and their pediatrician. You probably get an answer such as Oh!! Don’t worry, he / she will outgrow it. Look at my child she was so quiet and now she is a chatter box, give him/her time.

But…… suppose he / she doesn’t? Even after giving adequate time. 

st2You would feel guilty waiting and then finding out that I should have acted earlier. Waiting is so hard, why we have to be frustrated at last . We want the best for our child. What’s a parent to do?

But……. You’re not sure of what to do.

st1It’s hard to say the exact age when they hit speech and language milestones. It varies a lot on factors such as the child’s inborn ability to learn language, other skills the child is learning, the amount speech and language input he/she gets. and how others respond to his/her communication attempts .

Do you praise him/her? Listen to him/her carefully?

These factors can slow down or accelerate the speed of speech and language development of our children. Be aware of the certain factors that may increase the risk of late-talking child in the 18 to 30 month old age range even with normal intelligence.

The sooner The Better

If you are concerned about your child’s speech and language development, you should see a speech-language pathologist. The speech-language pathologist may suggest on early intervention program with follow up sessions. It’s important to have formal therapy sessions in case of severe problems.

Do you really want to wait for him/her to outgrow???Don’t leave a chance which leads you to feel guilty that I would have done with everything I could