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Speech and Language (Pathology) for Kids

The word ‘speech therapy’ may cause some parents to break into a cold sweat, but there is really nothing to feel frightened about at the thought of your child needing to attend speech therapy. Speech therapy is like a rite of passage for many children. Case in point, there are many children, who for one reason or another require a burst of therapy and later go on to enjoy optimal communication or learning outcomes. 

So then, what is speech therapy? Speech-language therapy is an allied health profession that deals with communication (speech, language, literacy) and swallowing disorders.

The term, ‘speech therapy’ or ‘speech pathology’ can often be misinterpreted to mean just ‘speech’, but in actual fact, as you will see below, speech therapists are concerned with more than just ‘speech’.

Speech therapists or better yet Speech- language therapists quite simply, work to improve outcomes (academic, social, literacy, etc.) as well as overall communication skills. Speech therapists can specialise in children and/or adults.They also work with adults to likewise, improve their communication (speaking skills, presentation skills, pronunciation, etc.) skills.

Communication is a broad term referring to the exchange of information. Communication encompasses your actual speech skills- how you articulate sounds in words or fluency of your speech, your language skills- the manner in which you use words (choice of words) when conveying a message, what is referred to as, expressive language skills and your understanding of what is said to you; referred to as receptive language skills. Communication also refers to reading and writing; otherwise known as literacy skills.

Therefore, the 4 broad categories contained in communication are: 

If you consider everything that is encompassed under the broad term, ‘communication’, then you start to get the sense that speech therapists do many things related to a person’s communication. In addition, each of the sub-categories of communication, also contain other further categories.

For example, when a child has a speech difficulty, they may be experiencing any one or more of the following speech issues; 

- Articulation (pronunciation of words) 
- Stuttering (or stammering) 
- Cluttering 

Pragmatic language skills is a sub-category of language skills and refers to the social language skills we use, i.e. what we say, how we say it and the accompanying non-verbal cues we use and their appropriateness in the situation. 

There are many causes of communication disorders. Some of the causes directly affect one or more of the broad categories of communication while some causes affect a speech and language structure, which in turn impacts directly on speech, language, literacy or swallowing skills.

For instance, if your child has a hearing loss, their speech and language would be affected because they will not be receiving optimal sound signal, which may affect their auditory processing skills. That is, their articulators may be perfectly fine, but they may still struggle to pronounce accurately and this is because when you have a hearing loss, you require therapy that targets your audition (listening skills) as listening may not come automatically for a child with any degree of hearing loss.

Simply put, auditory processing is what you do with what you hear. Auditory processing skills become a factor once a child who experienced any type of hearing loss, which has subsequently resolved or been managed (fitted with a hearing device).

That hopefully paints a picture of the broad scope of practice of speech therapists.

And let’s not forget swallowing difficulties (dysphagia) as another key area speech therapists focus on.

Common Causes of Communication Disorders

Thanks for your tips Lorna. I came across your content in December. I bought the late talkers bootcamp materials. I have seen quite a difference in my now 4year old daughter. We seem to have understimulated her for a long time plus alot of screen time by nannies. Now that I'm a SAHM for a while in a new country, I have been able to implement the tips. I'm not 100% perfect yet in the implementation (I'm sure you can relate the scenario with no nanny) but I am glad that we are not where we are. Blessings!🙋‍♀️🙋‍♀

WWK Says ;

"Thank you so very much, I shall put this into practice i have learned a lot . God bless"

Maureen says ;

The first visit to a speech therapist is referred to as an Initial Consultation or Speech and Language Evaluation/ Assessment. During this first visit, the speech therapist will evaluate your child and ask you a number of questions about what your concerns are. This is referred to as case-history taking. The speech therapist will also observe your child (their behaviour, their play skills, etc.) and will also get to interact with your child.

This first visit must be attended by a parent or caregiver who is familiar to the child and therefore able to answer questions about the child’s development and even their pregnancy or birth period.

The initial consultation may take up to 1 hour depending on how much information the speech therapist needs to collect and whether or not your child was co-operative.

Upon conclusion of this initial consultation, the speech therapist may provide you with a tentative diagnosis or idea of why your child is having difficulty with their communication. The speech therapist may also refer your child for further evaluations by other Specialists e.g. audiologist, neurologist, paediatrician, ENT, etc.

Many factors will determine whether or not the speech therapist will refer you to the aforementioned specialists. For example if your child is presenting with a limited repertoire of sounds, the speech therapist may refer your child for a hearing evaluation. There are many hearing assessments your child can undergo.

Other times particularly if the reason you have sought a speech and language evaluation is for an in-depth evaluation, but also if the speech therapist feels that an assessment more thorough than an informal assessment is indicated, you will be advised to consider a standardised assessment.

A standardised assessment is a norm-referenced assessment tool on a specific area of communication or learning, which has an established statistical reliability and validity. Due to its strict administration, it is considered an accurate way of determining a child’s skills and where their skills fall compared to other children their age in the norm referenced region. 

Standardised assessments are not popularly utilised in under-served countries as the tests would not have been standardised for the under-served populations.

Following an initial consultation, everything checking out, the speech therapist will advise on whether your child would benefit from speech therapy sessions and if so, how regularly.

Before speech therapy can commence, your child’s speech therapist will come up with specific areas to target in order to remediate your child’s communication difficulties.

Your Child’s First Speech Therapy Session

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Your child may require speech and language therapy if they are experiencing:
1. Speech difficulties
2. Language difficulties
3. Reading difficulties
4. Fluency disorders
5. Auditory processing difficulties
6. Swallowing or voice disorders.

I mentioned above that for many children, a burst of speech therapy seems to be a right of passage. Your child’s paediatrician (the good ones anyway) may recommend that your child is evaluated by a speech therapist if they are presenting with any unmet speech and/or language milestones.

These could be anything really…e.g. if your child is a late-talker, is mispronouncing specific sounds; perhaps because they were (still are) on their pacifiers, whether your child is stuttering (or stammering), has a medical or developmental diagnoses such as Autism, Cleft Palate, Down Syndrome, tongue-tie, you name it... 

Your child will mostly be better off by attending an initial evaluation by a speech therapist, if there are any concerns related to the achievement of their speech and language milestones. Consider this initial evaluation an opportunity to find out if those concerns are valid or not. Besides, any issue that is identified at the earliest instance is what research advocates as being ideal in ensuring those issues are fully resolved or resolved as best as possible.

In addition, this post can also guide you on whether your child may require speech therapy.

This period of early Identification of developmental anomalies or delays and making a start at mitigating them is referred to as early intervention

So back to right of passage, a way that can help parents lessen any anxiety they may have about their child attending speech therapy is by looking at speech therapy as a way of life. All my 3 children have undergone speech therapy and actually continue to by virtue of having their mom being a speech therapist.

I like to make the analogy of speech therapy being not unlike parenting or good quality teaching because speech therapists have been trained on various aspects of speech and language development; what is typical development versus what is atypical or disordered development. If you’re armed with this knowledge, it then becomes easier to first, identify when your own child’s development is off centre and second, what to do about it.

So, it is very possible to actually do a lot of your own child’s speech therapy from home. All you need is some instruction on how to determine what your child may be having difficulty with;

- Is it speech or is it language?
- Could your child be experiencing an pronunciation/articulation disorder or are they just displaying developmentally appropriate errors?
- Could they be having a stutter (or stammer)?
- Could they be having a reading disorder (dyslexia)?

Or, would it be prudent to in addition;
- Have their hearing tested?
- See a paediatric neurologist or even an occupational therapist?

Not knowing whether your child is presenting with normal communication delays or or specific developmental disorders can be worrisome to many parents and this can cause inaction.

To find out whether your child has achieved their speech and language developmental milestones, determine if they have the expected speech and language markers. 

One of the conditions that is the most alarming to parents is whether or not their child has Autism Spectrum Disorder.




Does my child need Speech Therapy?

Speech therapists specialise in different areas, therefore, all speech therapists don’t treat the same disorders!

If you decide to seek the services of a speech therapist for your child, make sure to find out whether they specialise in what your child is struggling with.

If you’re not sure, check out this downloadable, ‘Questions to Ask your Child’s Speech Therapist.’





Questions to Ask your Speech Therapist

Depending on the concern you have over your child’s communication, it can be possible to learn how to do speech therapy at home. For late-talkers, parents can repeat what they say to their child more often, speak slower and clearly and limit screens.

Speech therapy sessions can be costly and for many families, they may not be readily accessible. Families which reside in areas that are not well served by speech therapists may experience long wait periods or un-ideal therapy situations such as crowded group sessions.

In countries, which have a shortage of qualified speech therapists, like in Africa (often referred to as under-served countries), accessing speech therapy services can be a challenge or in most cases, not even possible.

To increase access to speech therapy, I developed an online course, Late-Talker’s Bootcamp 1.0/2.0 that aims to equip parents with the relevant tips to grow their late-talker’s language skills

Please visit this page to learn more about the Late-Talker’s Bootcamp course.


How can I do speech therapy at home?

LATE-TALKER'S BOOTCAMP COURSE

Access speech therapy from home using the Late-Talker's Bootcamp course.
The Late-Talker's Bootcamp is designed to teach parents how to grow their late-talker's speech and language from home.

The Late-Talker's Bootcamp 1.0 is designed to teach you what you should focus on if your child hasn't started talking or is saying less than 10 words as it is what will help bring your child's vocabulary to at least 50 words.

The Late-Talker's Bootcamp 2.0 is designed for parents with children who are already saying approx. 50 words and are ready for the next phase of language growth, i.e. combining words/ making sentences.

LEARN MORE

The Late-Talker’s Bootcamp 1.0/2.0 is ideal for parents with children aged 2 - 5 years who have not achieved their expected vocabulary or may have developed words, but may not be combining those words to make sentences.

In order to carry out speech therapy for your child at home, you will need to break down your child’s area of difficulty into smaller manageable chunks and set a priority list and goals for each (short and long-term goals). This is usually the most difficult part if you are not a trained speech therapist as all your child’s difficulties appear urgent. 

Knowing what to target and when to target is a crucial factor in speech therapy.

Depending on how severe your child’s difficulties are and the age at which speech therapy is sought, progress can be swift or measured. There are many factors that determine how quickly your child will make progress and from my 15+ years’ experience, these factors are summarised here.

In order for your child to realise fast progress from speech therapy;
- You should be empowered
- You should be consistent with your child’s speech therapy sessions (at home or at the clinic)
- You should be well supported
- You should have a conducive home environment
- You should offer your child many generalisation opportunities (how to practise what is being targeted in speech therapy in the child’s day to day activities)

For a further guide on how to jump-start your late-talker’s talking, see this post on the ‘4 Foolproof tips to expand your child's language

Hopefully, as this post has demonstrated, speech therapy is intervention that holds the key to improving your child’s overall communication outcomes.

Other resources:

Speech Therapy Totos Blog
ASHA
LinguiSystems Guide to Communication Milestones 2012 Edition
Mommy Speech Therapy 





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