What is Speech Therapy?

Many sticky notes with questions like who, what, when, where, how and why, and a question mark, all posted on an office noteboard to represent confusion in communincation

There is a large misconception about what speech therapy is all about.  Most people, upon hearing the term “speech therapy”, think of kids with lisps.  Although it is true that Speech Therapists (more accurately called Speech-Language Pathologists) work with children who have lisps, there’s a whole lot more to what we do.

What most people don’t realize is that speech development starts in infancy, and there are many steps along the way before a child is “speaking”.  At any point along that development, a problem may arise. We are here to help children overcome those hurdles.

As you can see from the title “Speech-Language Pathologist”, we not only focus on speech sounds, but also on language skills (communication skills). We look at how a child is “taking in” (understanding) all the new information he/she is receiving on a daily basis, as well as how he/she is using” that new information. Another aspect of speech therapy that people are mostly unaware of, is working with feeding and swallowing problems. Most of the skills and movements necessary for eating and swallowing are similar to movements necessary for speech, and are therefore inter-related.

So, speech therapy (speech-language therapy) is the process by which a Speech-Language Pathologist works with people (of any age) who have any type of difficulty in their speech and language skills, or feeding and swallowing skills,  and teach them strategies and techniques which will help them reach their potential.

How do I know if my child needs speech and language therapy?

As a general rule, children develop skills at their own pace, and not always “on schedule”.  Having said that, it is also important to be aware that for some children, they may need help getting to those skills (also known as milestones).  There is a common misconception that people often have, where people will say “Oh, they’ll outgrow it”. There may occasionally be times when this will turn out to be true, but why should you be constantly worrying about when it’s going to happen?  Furthermore, there are many pediatricians who hold by the theory of “let’s wait and see”.  However, there is an even more important idea to consider: “The earlier help is given, the better.”  Without going into specific details about each stage of speech and language development, a general guideline that you can follow is to determine whether or not your child is showing new skills every week.  These changes do not need to be large ones, but if you’re not seeing a progression from week to week, then that should at least raise a question in your mind.  Furthermore, don’t think that just because a child is an infant that they are too young for speech and language therapy…a child of any age is able to benefit from assistance in his speech and language development.  As a parent, you know your child best.  So, if there are issues that concern you, it is best to seek advice from your pediatrician and from a licensed Speech-Language Pathologist (also known as “speech therapist”). As the saying goes, “When in doubt, ask”.  So, don’t be afraid to ask for help or a professional’s opinion.

How do I get started?

The first step is to contact us by email at [email protected], or by phone at 201-880-6009, to discuss your concerns. The next step is to set up an appointment.  Before the appointment, you will need to fill out some paperwork, which provides us with important background information regarding your child’s birth history, their development, and your concerns. This information is vital input from you as a parent/guardian – you know your child best!  The paperwork can be emailed, mailed, or faxed to you. Once the forms are returned to us, your appointment will be confirmed by email or phone.

What happens during a speech and language evaluation?

All Speech-Language Pathologists (Speech Therapists) have their own styles of doing evaluations. So, this answer will be based on what we do at Horizon Speech Therapy Services.  Depending on the types of concerns you have, we will determine which type of speech and language evaluation will be administered.  However, there are several basic common aspects to all evaluations.  First, parents are asked to fill out a case history form, which contains some basic background information about the child (ie: pre- and post-natal history, health history, developmental milestones, etc.).  This information, in combination with the information gained from the evaluation, will help the therapist get a full picture of where the child’s strengths and weaknesses are.  The evaluation itself consists of formal and informal testing.  Formal testing refers to the use of standardized tests, the results of which, tell us where the child is performing in comparison to peers his age.  The informal testing is usually a combination of parent input, conversation with the child, or play with the child.  After the evaluation is completed, the therapist will be able to give you their impressions of your child’s speech and language development/skills, and determine whether therapy is recommended.  Yes, there are actually times when therapy will not be recommended.  The therapist may also recommend an evaluation or consultation with another professional (ie: A special type of doctor, another type of therapist, a school or county service, etc.)

There are so many names for types of speech problems. What do they mean?
Many sticky notes with questions like who, what, when, where, how and why, and a question mark, all posted on an office noteboard to represent confusion in communincation

Many sticky notes with questions like who, what, when, where, how and why, and a question mark, all posted on an office noteboard to represent confusion in communincation

As people become more aware of speech and language issues, a lot of terms are becoming commonplace, but many people are still confused as to what they all mean.  Here are some of the more common ones.  If there are others that you are specifically concerned about, please feel free to contact us by email or phone and we will be happy to answer your questions.

Articulation: This term refers to a child’s ability to produce speech sounds (consonants and vowels). As children learn to speak, they tend to follow a typical pattern for the development of speech sounds. A problem with articulation happens, when a child steers away from that typical pattern or when they stay at a certain stage longer than others their age.  There are also times when, for various reasons, a child just does not learn to form a sound correctly.  Often, the child will substitute a different sound in it’s place.  Other times, there will be a distorted version of the sound, or they may leave out that sound all together. There may also be a problem where going from single consonant-vowel-consonant combination (ex: “bed”) to a consonant blend (where two consonants are together – ie: “br” as is “bread”) becomes difficult or, when a child can produce the sounds on a single word level but then it “falls apart” when it is combined into phrases and sentences.

Stuttering: This term refers to a difficulty in producing sounds or words in a smooth, flowing manner.  It is usually characterized by hesitations before speaking, the repetition of sounds or words – usually at the beginning of a sentence, or sounds that are seemingly to be “stuck” and can’t come out for several seconds.

Receptive and Expressive Language: The term “Receptive Language” refers to a child’s ability to understand spoken language (ie: having a vocabulary of words they understand that are appropriate for their age, having skills to be able to follow directions, demonstrating thinking skills and memory skills, etc.). The term “Expressive Language” refers to their ability to use spoken language (ie: having a vocabulary of words spoken on a daily basis that is appropriate for their age, an ability to express their needs, wants, feelings and ideas, an ability to participate in a conversation, an ability to put a stream of words together to produce sentences and use grammatical forms, etc.).

Oral-Motor (Oral Placement) Disorders: This term refers to the problems where there is low muscle tone in and around the mouth, as well as poor coordination of the muscles and structures in and around the mouth (cheeks, lips, teeth/jaw, tongue), and poor motor planning for speech and feeding movements.   Oral-motor problems are often accompanied by feeding problems which parents may or may not be aware of.  For example, a child who is an extremely “picky” eater (ie: only eating certain textures or temperatures) would be more obvious to parents. A child who is not drinking properly from a straw (ie: using an immature suckling pattern) or not chewing properly (ex: using an immature munching pattern instead of a rotary chew) may not be so obvious to parents but would be recognized by our Speech-Language Pathologist  who specializes in oral motor disorders.

Apraxia: (Segments of this section have been copied from www.apraxia-kids.org) This term can be broken down into two basic sections: Oral apraxia and Verbal apraxia.  Oral Apraxia indicates that the child has difficulty with volitional control (doing an action on demand) for non-speech movements. For example: having difficulty sequencing movements for the command: “Show me how you kiss…Now smile…Now blow”. Verbal Apraxia indicates that the child has difficulty with volitional movement for the production of speech. This can be at the level of sounds, syllables, words, or even phrases (connected speech). The motor struggle is most typically seen with sound sequencing.  It has been reported that it is very rare (and fairly unheard of) for a child to have oral Apraxia without verbal Apraxia. What are the symptoms? Basically, the problem occurs when the child has toconsciously make a movement or sound; However he/she can make the same movements or sounds when they’re not focusing on it.  For example: the child may be playing happily and parents may hear sounds being made – almost without thought – “ma, ma, ba, ma, da”. However, when the parents attempt to get the child to use those sounds – “Say Ma-ma!”- the child is unable to do so. In many cases one can see the struggle on the child’s face. The child may move their lips as if searching for the right position to use. One minute he/she could do it (when not thinking about it or attempting the task) and the next minute it is an intense struggle (he/she is now aware of the request and are trying to will their mouths to make those movements = volitional control). This type of difficulty would be recognized by our Speech-Language Pathologist who specializes in Apraxia.

Sensory Integration / Processing Disorder:  This term is usually associated with occupational therapy, but is often inter-related with speech therapy.  It refers to the system in the body which controls our body’s response to sensory input. A sensory integration disorder would be when “the child’s central nervous system is inefficient at integrating, interpreting, analyzing, associating, and generally making use of sensory information” (Carol. Kranowitz, author of “The Out-Of-Sync Child”).  When infants develop, they often learn about their world through their mouth (putting toys and objects in their mouth).  This tendency to explore objects by mouth eventually becomes outgrown at a certain point.  However, for some children this behavior continues and they are frequently seen putting objects in their mouth.  This is usually due to the body’s craving to have sensation in the mouth, to fulfill a lack of sensation that the body is feeling. For more information about this topic please refer to the website: Sensory Processing Disorder Foundation.

Articles about Speech and Language Disorders:  Communication disorders can affect people of any age, race, gender, and ethnicity. Furthermore, just as people are different, so are the communication disorders which effect them.  However, there are some common threads or symptoms that run through each disorder. The following articles are presented with the intention that they may help clarify things for you or answer some questions that you may have.  These articles have been published by the American Speech-Language-Hearing Association to help parents, educators, physicians, and others, to gain more understanding about Speech and Language disorders: What Are They? Who Do They Effect? And, What Can Be Done About Them?

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