Children's Speech Pathology
What is Speech Therapy (Speech Language Pathology)?
Speech Therapy is a health profession that falls under the area of Human Communication Sciences. Speech therapy, is the diagnosis, management and treatment of individuals who are unable to communicate effectively or who have difficulty with feeding and swallowing.
Speech Language Pathologists (SLPs) assess speech, language, cognitive-communication, and oral/feeding/swallowing skills to identify types of communication problems (articulation; fluency; voice; receptive and expressive language disorders, etc.) and the best way to treat them.
What is speech and language?
Speech and language are similar but slightly different concepts.
What is speech?
When speech pathologists refer to the term speech they are referring to three things: articulation/phonological skills, speech fluency and voice. They look at a child’s ability to:
- Physically produce the individual sounds and sound patterns of his/her language (Articulation).
- Produce speech with appropriate rhythm, and free of Stuttering behavior.
- Produce speech with an appropriate vocal quality for his/her age and sex.
What is language?
While speech involves the physical motor ability to talk, language is a symbolic, rule governed system used to convey a message. In English, the symbols can be words, either spoken or written. We also have gestural symbols, like shrugging our shoulders to indicate “I don’t know” or waving to indicate “Bye Bye” or the raising of our eye brows to indicate that we are surprised by something.
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).
Some of these “rule” systems that govern a language can include syntax, semantics, phonology, morphology, and pragmatics. You can more about language in my post "What is Language."
When someone has trouble understanding other people (receptive language), or explaining thoughts, ideas and feelings (expressive language), that is a language disorder.
When someone cannot produce speech sounds correctly or fluently, or has voice problems, that is a speech disorder.
Who needs speech therapy?
A broad range of clients can receive speech pathology services. Clients may include children who fail to develop normal communication or people who acquire communication disabilities as a result of disease, injury or a stroke. Speech pathologists also assist a variety of clients with feeding or swallowing problems.
Speech disorders and language disorders
A speech disorder refers to a problem with the actual production of sounds, whereas a language disorder refers to a difficulty understanding or putting words together to communicate ideas.
Speech disorders include:
- Articulation disorders: difficulties producing sounds in syllables or saying words incorrectly to the point that listeners can'tunderstand what's being said.
- Fluency disorders: problems such as stuttering, in which the flow of speech is interrupted by abnormal stoppages, repetitions (st-st-stuttering), or prolonging sounds and syllables (ssssstuttering).
- Resonance or voice disorders: problems with the pitch, volume, or quality of the voice that distract listeners from what's being said. These types of disorders may also cause pain or discomfort for a child when speaking.
- Dysphagia/oral feeding disorders: these include difficulties with drooling, eating, and swallowing.
Language disorders can be either receptive or expressive:
- Receptive disorders: difficulties understanding or processing language.
- Expressive disorders: difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.
Although problems in speech and language differ, they often overlap. A child with a language problem may be able to pronounce words well but be unable to put more than two words together. Another child's speech may be difficult to understand, but he or she may use words and phrases to express ideas. And another child may speak well but have difficulty following directions.
What do they do at speech therapy?
In speech-language therapy, an SLP will work with a child one-on-one, in a small group, or directly in a classroom to overcome difficulties involved with a specific disorder.
Therapists use a variety of strategies, including:
- Language intervention activities: The SLP will interact with a child by playing and talking, using pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct pronunciation and use repetition exercises to build speech and language skills.
- Articulation therapy: Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables for a child, often during play activities. The level of play is age-appropriate and related to the child's specific needs. The SLP will physically show the child how to make certain sounds, such as the "r" sound, and may demonstrate how to move the tongue to produce specific sounds.
- Oral-motor/feeding and swallowing therapy: The SLP will use a variety of oral exercises — including facial massage and various tongue, lip, and jaw exercises — to strengthen the muscles of the mouth. The SLP also may work with different food textures and temperatures to increase a child's oral awareness during eating and swallowing.
When is therapy needed?
Kids might need speech-language therapy for a variety of reasons, including:
- hearing impairments
- cognitive (intellectual, thinking) or other developmental delays
- weak oral muscles
- excessive drooling
- chronic hoarseness of voice
- birth defects such as cleft lip or cleft palate
- motor planning problems
- respiratory problems (breathing disorders)
- feeding and swallowing disorders
- traumatic brain injury
Therapy should begin as soon as possible. Children enrolled in therapy early (before they're 5 years old) tend to have better outcomes than those who begin therapy later.
This does not mean that older kids can't make progress in therapy; they may progress at a slower rate because they often have learned patterns that need to be changed.
What can you do?
Speech-language experts agree that parental involvement is crucial to the success of a child's progress in speech or language therapy.
Parents are an extremely important part of their child's therapy program and help determine whether it is a success. Kids who complete the program quickest and with the longest-lasting results are those whose parents have been involved.
Ask the therapist for suggestions on how you can help your child. For instance, it's important to help your child do the at-home stimulation activities that the SLP suggests to ensure continued progress and carry-over of newly learned skills.
The process of overcoming a speech or language disorder can take some time and effort, so it's important that all family members be patient and understanding with the child.