Speech-Language Therapy
Speech therapy sessions always follow a detailed assessment. Usually, a speech therapy session lasts for 45-60 minutes. A range of specific goals will be developed as a part of your child’s therapy program. These goals are individually tailored for your child’s needs and will be explained to you in the first session of speech therapy. We have seen children progress faster and better when parents are actively involved in the intervention program. Parents will be empowered with various strategies to facilitate language learning throughout the day. Speech therapy sessions are usually done one-to-one in a structured setting. The child will be enrolled in a group (maximum 3 children) sessions if necessary. The frequency of speech therapy depends on the severity of the child’s problem and time availability. However, this decision is made jointly with the parents.
Read through the following speech and language disorders that are commonly seen among children. The information will help you to understand what speech-language pathologists do.
Speech-Language Disorders in Children
What is Autism?
Autism is a neuro-developmental disorder that affects children’s social, communication, and behavioural development. Autism begins in the early years of childhood and will last throughout a person’s life. What causes Autism is still not known, and researchers believe that genes and a child’s environment play a major role. Children with Autism have many challenges in their day-to-day life, starting from clearly expressing their needs to a conversation with another person. However, there is no proven medical treatment for Autism, but there are a number of evidence-based training methods to improve the child’s skills to participate actively in society. If a child gets involved in these training programs early, the progress will be better.
What are the signs and symptoms?
Not every child with Autism is alike. Some children show mild symptoms and some show severe autistic symptoms. Children start showing these symptoms as early as 18 months or sometimes earlier than that. The below list provides some commonly seen symptoms of a child with autism.
- Not showing interest in what is happening around them.
- Does not look at the other person’s eyes directly and tries to avoid eye contact.
- Prefers to be alone.
- Have trouble in playing toys appropriately or using objects correctly.
- Does not seem to listen when spoken.
- Restricted interest in people and toys.
- Have challenges in using gestures, words, facial expressions to communicate needs, wants, and desires.
- Unable to follow what another person is saying.
- Difficulties in identifying social cues during the conversation.
- Talk a few words or not talk at all
- Might repeat what others say.
- Use tantrums or any other behaviors to express instead of talking.
- Have trouble participating in play activities with another.
- Get upset when the routine is changed.
- More interest in playing with parts of objects. (eg. Wheels)
These are not only symptoms of autism and not very child shows all of these.
How is Autism diagnosed?
A team of professionals diagnoses autism. Sometimes they work together, and sometimes they test separately in their respective areas to provide information to reach a final diagnosis. The team might include paediatricians, child-psychiatrist, neurologist, developmental psychologist/behavioural therapist, speech-language pathologist, physical therapist/occupational therapist, and sometimes audiologist to test the child’s hearing.
Speech-language pathologists/therapists assess a child’s speech, language, and communication skills. They will talk to parents, caregivers, teachers, and observe the child in clinical and natural settings to gather information about speech-language development. They identify the communication strengths and need to plan out the communication intervention.
How does the speech-language pathologist work with a child with autism?
Speech-Language Pathologist/therapist work closely with parents, family, and teachers to facilitate communication in the home, school, and community. A number of evidence-based strategies and techniques are used to improve speech, language, and, social communication skills. Some of the skills speech pathologists work on include;
- Listening and attending to others in different settings.
- Taking turns, especially in conversation.
- Expanding interests like playing with toys, trying out different food.
- Understanding what others are saying and responding to them appropriately.
- Improving vocalization, imitating sounds and words, new vocabulary, grammatically correct sentences, clarity of speech, etc.
- Interacting with peers
- Use language appropriately to answer questions, initiate conversation, maintain a conversation, tell a story, etc.
- Improve knowledge of speech sounds to help in reading and writing skills.
Speech-Language pathologists also work with non-verbal and minimally verbal children to facilitate and augment their communication using alternative methods (AAC) such as Picture Exchange Communication System (PECS), picture charts and boards etc.
If you are concerned that your child might have Autism, do not delay to discuss it with your child’s doctor. If you are unsure what to do, call us and we will guide you through the process.
Preschool language disorders
Preschool age is generally considered as three to five years. During this period, children undergo important physical, cognitive, emotional, social, and language development. Age-appropriate language development is a sensitive indicator of a child’s later reading and writing abilities. So, your child must receive a strong linguistic foundation during their preschool period. However, not every child is developing these skills at the same rate. Some speak less, some may have difficulties making sentences, or some may have speech clarity issues. These problems must be identified, and necessary intervention is provided as early as possible to build strong foundational skills for later academic achievements.
Signs of language disorders.
Not all children develop language at the same rate. The most common language-related difficulties children manifest during this age is as below.
1. Difficulty in understanding language
- Unable to following directions.
- Not understanding what the teacher says in the class.
- Difficulties understand questions.
2. Difficulties in expressing
- A limited number of words
- Unable to name pictures and objects
- Use only single words or short sentences when talking to others
- Difficulties in answering questions
- Trouble in asking questions to get information
- Not knowing how to start a conversation
- Doesn’t refer to past
Other than understanding and expressing, the child may demonstrate trouble in;
- Holding the pencil
- Learning and remembering the alphabet and numbers
- Holding the book correctly
- Taking turns in group activities
Children can have problems in both understanding and expressing or either in any one domain. If you are concerned about your child’s language skills or if the teacher raises concerns about your child’s verbal participation in the classroom, meet a speech-language pathologist for initial language assessment.
Stammering/stuttering is the disruption of the normal flow of speech. Developmental stammering is common in early childhood between 2 – 5 years. Often children outgrow this type of dysfluencies, but many children continue stammering into school years. A well-planned speech therapy program can help children to manage their stuttering successfully.
Is it really stuttering?
Some dysfluencies during early childhood disappear in a short period of time. But some errors persist. As a parent, you need to be aware of what is real stammering and what is not. If your child has the below risk factors, we recommend you meet a speech-language therapist for help.
- Family history of stammering.
- Having dysfluencies for more than 6 months.
- Trying to avoid speaking certain words or situations.
- Prolong the first sound of the word (e.g., Ssssssssssssnake).
- Repeat the first sound or the syllable of the word (e.g., m-m-m-my, ma-ma-ma-my ).
- Having a block and not able to speak the word out.
- Secondary behaviours like blinking eyes while saying words, stomping feet, tapping hand while speaking.
- The onset of stammering after the age of 4
- Male gender
How can parents help young children to ease their speech?
- Slow down the rate of your speech.
- Listen to your child with interest without interrupting.
- Give undivided attention and acknowledge what your child says.
- Convince the child that you as a parent has plenty of time to listen to him. This is a better way than saying “speak slow”.
- Encourage other family members to take turns when talking. E.g., Not two members speaking at the same time.
- Try your best to have a pleasant and calm environment at home.
- Talk about the situations that your child is fearful of. Provide solutions to overcome the fear.
- Read stories together at a slow pace.
- Avoid too many questions.
- Wait till he/she finishes his speech completely before you start speaking.
- Repeat stammered words back to him/her at a slow rate.
- Do not speak on his/her behalf. Patiently listen till he finishes the sentence.
Speech sound development is a gradual process. It is common to see young children have trouble pronouncing words correctly. Children develop and master speech sounds at different age levels. By three years of age, children should be able to say p, b, m, n, h, w, t, d, k, and g in words. When they reach 4 years, children are able to say /f/, /y/ and /v/ sounds clearly in words. By 6 years, the master l, v, ch, sh, j and still make mistakes in /s/, /r/, /z/, /th/ sounds. In general, by the fourth birthday, children’s speech is 100% clear to their parents. It is important to keep in mind that every child has individual variations in their development.
Speech sound disorders involve difficulties or delays in developing age-appropriate speech.
- The structural or functional problem in speech mechanism (e.g., Cleft lip, Cleft palate)
- Associate with language disorders
- Difficulties in coordinating oral muscles to execute speech (e.g., Apraxia of Speech)
- Muscle weakness (e.g. dysarthria due to cerebral palsy).
- Hearing loss
If you notice that your child is having difficulties in saying sounds correctly, meet a speech-language pathologist for a comprehensive assessment. A well-planned speech therapy program can help your child to overcome speech difficulties.