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What is Speech Therapy?

The professionals who are educated to assess speech and language development and to treat speech and language disorders are called speech-language pathologists (sometimes informally referred to as speech therapists). Speech-language pathologists can also help people with swallowing disorders.

Does my child need Speech Therapy?

Complete FREE Developmental Checklist

  • Doesn't Smile or Interact with Others (Birth-3M)
  • Doesn't Babble (4-7 Months)
  • Makes Few Sounds (7-12 Months)
  • Does Not Use Gestures (Ex: Waiving, Pointing) (7-12 Months)
  • Says Only a Few Words (12-18 Months)
  • Doesn't Put Words Together to Form Sentences (1 1/2 - 3 Years)
  • Has Trouble Playing and Talking with Other Children (2 - 3 Years)
  • Has Problems with Early Reading and Writing Skills (Ex: May Not Show Interest in Books or Drawing) (2 1/2 - 3 Years)

  • Says p, b, m, and h incorrectly (1 - 2 Years)
  • Says k, g, t, f, d, and n incorrectly (2 - 3 Years)
  • Produces Speech That is Unclear Even to Familiar People (2 - 3 Years)
  • Struggles to say sounds or words (2½–3 years)
  • Repeats first sounds of words—"b-b-b-ball" for "ball" (2½–3 years)
  • Pauses a lot while talking (2½–3 years)
  • Stretches sounds out—"f-f-f-f-farm" for "farm"(2½–3 years)

Learn About the Areas of Speech

Sound Production

Sound Production 

This is the area most individuals think about when they think about speech. Speech sound production is how we use the motor movements needed to make a sound. For example, to make the “f” sound you must touch your top teeth on your bottom lip. If these movements do not occur, then the “f” sound would not sound correct. Speech sound production can also be impacted by a child’s phonological system. A child’s phonological system includes the skills necessary to use different sounds to make words. It also includes the natural process of speech development patterns that a toddler goes through. For example, it would be completely normal for a young toddler to say “da” for the word “dad”. This is called final consonant deletion. When a child gets older it could become increasingly difficult to understand their speech if some of their words did not have the final consonant.

What to look for?

  • Sounds are replaced by different sounds. Ex: The word “cat” sounds like “tat”
  • Syllables are missing. Ex: “Banana” sounds like “nana”
  • Sounds are missing Ex: “pan” sounds like “pa” or “top” sounds like “op”
Language

Language

The area of language includes how an individual understands spoken speech, how an individual puts words together for speech, and literacy. A child may have difficulty understanding what is being said to them. For example, they may have difficulty following directions or answering yes/no questions because they do not understand what was said. Speech therapy can work to improve these receptive language skills. On the other hand, a child may understand what was said to them but have difficulty forming phrases to respond. Some children have difficulty putting together sentences with noun, verbs, and adjectives. Vocabulary and sentence structure are also included in these expressive language skills. Children with language disorders sometimes also have difficulty with literacy, reading, and writing.


Language is made up of socially shared rules that include the following:
  • What words mean (e.g., "star" can refer to a bright object in the night sky or a celebrity)
  • How to make new words (e.g., friend, friendly, unfriendly)
  • How to put words together (e.g., "Peg walked to the new store" rather than "Peg walk store new")
  • What word combinations are best in what situations ("Would you mind moving your foot?" could quickly change to "Get off my foot, please!" if the first request did not produce results)

When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder.


What to look for?

  • Difficulty answering yes/no or “wh” questions
  • Difficulty following directions
  • Difficulty telling age appropriate stories
  • Difficulty combining words into age appropriate sentences
  • Difficulty with reading, writing, and spelling

Sign Language

Promoting Language Development Through Sign Language

Speech Pathologist answers common questions

by Taylor Wathen M.S. CF-SLP

Will my child still use verbal language if we teach them to use sign language?

It is a common misconception that teaching a child sign language will hinder their verbal language development. In fact, research shows the opposite effect. Children with language delays who are exposed to sign language are able to express themselves earlier than children who are using verbal language alone. Some studies also suggest sign language decreases frustration and therefore decreases temper tantrums in young children.

Goodwyn, S.W., Acredolo, L.P. & Brown, C.A. Impact of Symbolic Gesturing on Early Language Development. Journal of Nonverbal Behavior 24, 81–103 (2000).

Why is an SLP teaching my child to use sign language?

  • Presymbolic communication is communication without the use of a signs, words, or pictures. Presymbolic communication includes crying, laughing, reaching and pointing. Using sign language with your child introduces symbolic communication, the next step. This means your child is learning to use a symbol to convey information. Signs and words are both examples of symbolic communication. 
  •  Using sign language also introduces communicative intent.  This is the understanding that certain signs, words, or behaviors result in a specific response. For example, if I sign "eat" I get to eat.
  • Using sign language with your child can decrease frustration. Children who are unable to express their needs and wants often cry to express something is wrong. The caregiver must then guess what is upsetting the child. Teaching sign language gives them a way to convey these needs to their caregiver.
  •  Sign language increases social communication skills. It allows a child to communicate with their caregivers and peers. Sign language can be used to comment, request, and to share information. 
  • Sign language can also increase a child's length of utterance by combining two signs together before the child can combine two words.

Where do I begin?

Once your Speech-Language Pathologist and you have decided to begin using sign language with your child, you should work together to choose vocabulary that can generalize into multiple contexts. For example, I typically choose to teach the sign "more" early on. This sign can be used for more swinging, more food, more juice etc. It is important to work together with your SLP when choosing words that will be beneficial to the child. An SLP teaching your child the sign for "out" may not be the best choice if you stay inside most of the day. It is also important to choose words that are easy to duplicate before teaching more complex signs. Some signs I teach first are: more, eat, mom, dad,out, play, all done, drink, and help.

Do you have any tips on using sign language at home?

  • Teaching children a new skill  takes time. For example, a child is not going to learn to dress themselves over night. It takes time and a lot of reinforcement. Learning to use sign language is no different. It takes time, reinforcement, and many models for a child to learn to use sign language.
  • The child's sign may not look the exact same as when you do it. For example, when doing the sign for more you bring your fingers together. Some children instead bring their two hands together. It is acceptable for them to use close approximations of a sign.
  • If at all possible respond to every communication attempt. Everytime your child makes a request try to give them the requested object. This teaches cause and effect.
  • Some children may require hand over hand to imitate signs. It is important to discuss this with your SLP to ensure this is appropriate for your child.

Stuttering (Fluency)

Stuttering (Fluency)

Stuttering is when a child has difficulty with the flow of speech. They may repeat sounds, syllables, or full words when speaking. The child may pause during a word or insert um or uh frequently in speech. A child having difficulty with fluency may have a facial grimace when speaking or other indicators that they are struggling to speak.

What to look for?

  • Ex. The word baseball may sound like “b-b-b-baseball”
  • Sentences may sound like “I um like uh uh soccer practice.”
  • Facial grimace while speaking

Social Communication

Social Communication

To have effective communication you share a message with a communication partner. When you speak with a communication partner it will likely follow a pattern of speaking and listening. There are a set of rules established by a culture that everyone follows in order to communicate. When a child has difficulty understanding and following this pattern of rules then they may have difficulty with social communication or social skills. 

What to look for?

  • Difficulty staying on topic/ inappropriate topic for a given situation 
  • Difficulty starting or ending a conversation
  • Inappropriate conversational turn taking (interrupting frequently) 
  • Inappropriate volume 
  • Inappropriate conversation with teacher vs. peer
  • Difficulty understanding body language and emotions
Alternative and Augmentative Communication (AAC)

Alternative and Augmentative Communication (AAC)

Sometimes children have difficulty with verbal communication. When a child has difficulty with verbally producing language, they may need another method to communicate their thoughts, wants, needs, and ideas. A SLP can help a child and his/her family find an alternative way to communicate. Some examples include sign language, picture exchange system, or electronic “talking” devices. SLPs also help with augmentative communication. This means they establish a way to communicate that aids the child’s verbal speech. For example, if a child wants a soda they may say “want” and then use a picture of a soda to hand to their caregiver. 

What to look for? 

  • Your child may have a motor disorder that results in making the muscle movements necessary for speech challenging
  • Limited verbal speech 


Hearing/ Aural Rehabilitation

Hearing/ Aural Rehabilitation

If a child has hearing loss, or chronic otitis media (chronic ear infections), this can affect their speech and language development. Hearing the sounds in a child’s environment promotes speech and language growth. Aural rehabilitation can also assist a child who has recently received hearing aids or cochlear implants. SLP’s can complete hearing screenings. (However, full hearing evaluation would need to be completed by an audiologist.)

What to look for?

  • Hearing loss
  • Chronic otitis media (ear infections)
  • Difficulty with speech production due to hearing loss
Cognitive

Cognitive

SLP’s can assist children with cognitive communication disorders. These are language difficulties as a result of an underlying cognitive difficulty. Examples of things SLP’s could work on with your child include problem solving, attention, memory, orientation, executive functioning, planning, reasoning, and many more. 

What to look for?

  • Difficulty problem solving age appropriate situations
  • Short term or delayed memory difficulty
  • Difficulty telling stories with events in the correct order 
  • Difficulty providing a reason to “why” questions
Voice

Voice

Voice is the sound we produce when we speak. It is how we sound including pitch and tone. A child’s voice could sound harsh, hoarse, too quiet “lost voice”, or sound as if to much air is coming out of their nose. Children can have a voice disorder due to an organic cause or due to overuse and misuse. 

What to look for?

  • Loss of voice without apparent cause
  • Hoarse or harsh voice for more than a few days
  • When the child speaks does it sound nasally or as if air is coming out of the nose inappropriately?
  •  When the child speaks does their voice sound as if they have a stuffy nose (without present of sickness or sinus concerns)?
Swallowing and Feeding

Swallowing and Feeding

SLPs are also trained to evaluate and treat swallowing disorders. A swallowing disorder is when you have difficulty chewing or swallowing. Sometimes food “goes down the wrong way” and travels towards the airway and not the esophagus (food tube). SLPs can also work on feeding skills. Some children have difficulty with new foods or sensory feeding difficulties. 

What to look for?

  • Very limited diet
  • Your child may become very upset about trying to foods or refuse new foods.
  • Coughing with food
  • Coughing with liquids
  • It appears “food goes down the wrong way” frequently


Who benefits from Speech Therapy:

Diagnosis
Difficulty
Diagnosis
  • Achalasia
  • Aphasia (amnestic, global, nominal, semantic, syntactic)
  • Agnosia
  • Ankloglossia
  • Attention Deficit Disorder
  • Attention Deficit Hyperactivity Disorder
  • Aphasia
  • Aphonia
  • Apraxia
  • Autism Spectrum Disorder
  • Bell's Palsy
  • Central Auditory Processing Disorder
  • Cerebral Palsy
  • Cleft Lip or Palate
  • Concussion
  • Chronic Ear Infections
  • Congenital Malformation of the Musculoskeletal System
  • Congenital Malformation of the Respiratory System
  • Congenital Malformation of the Nervous System
  • Cognitive Communication Deficit
  • Desease of Vocal Cords
  • Dentofacial Anomalies
  • Developmental Disorder of Speech and Language
  • Down Syndrome
  • Dysarthria
  • Dyslalia
  • Dysphasia
  • Dysphasia
  • Dyspnea
  • Dysphonia
  • Dyslexia
  • Expressive Language Disorder
  • Facial Weakness
  • Feeding Difficulties
  • Fluency Disorder
  • Frontal Lobe and Executive Function Deficit
  • GERD/GER
  • Hearing Loss
  • Hemiplegia (right or lefts side)
  • Hyper/Hyponasality
  • Idioglossia
  • Intellectual Disabilities
  • Jaw Asymetry
  • Lalling 
  • Lisping
  • Macroglossia
  • Malocclusion
  • Mixed Receptive-Expressive Language Disorder
  • Muscular Dystrophy
  • Neurofibromatosis
  • Nodules of Vocal Cords
  • Paralysis of Vocal Cord and Larynx
  • Phonological Disorder
  • Polyp of Vocal Cord and Larynx
  • Speech and Language Delay Due to Hearing Loss
  • Slurred Speech
  • Symptoms and Signs Involving Speech and Voice
  • Swallowing Disorders
  • Tracheostomy
  • Traumatic Brain Injury 
  • Ventilator Dependence
  • Voice REsponance Disorders
  • Wernicke's
  • Zenker's Diverticulum
Difficulty
  • Attention 
  • Articulation
  • Augmentative Communication Device Training
  • Chewing
  • Communication
  • Coughing
  • Chronic Hoarseness
  • Delay in Words
  • Eye Contact
  • Gagging
  • Following Directions (preferred or non-preferred)
  • Food Refusal
  • Initiates and Carries out Conversation 
  • Intellectual thinking
  • Listening to Instructions
  • Limited Vocbulary
  • Literacy
  • Loudness of Voice
  • Matches Tone and Voice Level
  • Memory Concerns
  • Motor Planning
  • Organizing Environment 
  • Perception
  • Pre-Linguistics
  • Pragmatics
  • Problem Solving
  • Putting words together
  • Reading
  • Respritory Problems
  • Seeking Needed Verbal or Written Information
  • Self Regulation
  • Semantics
  • Sequencing Tasks 
  • Social Skills
  • Social Speech 
  • Sound Production
  • Sound Processing
  • Stuttering
  • Syntax
  • Swallowing / Eating Food or Fluid
  • Takes Turns
  • Vocal Hygiene
  • Voice Pitch, Volume, Quality
  • Weak Oral Motor Muscles