How are parents involved in evaluation and speech therapy?

During the evaluation process, we gather developmental history via a parent/caregiver interview to guide the initial assessment, write treatment goals and develop home programs. During speech therapy the clinician and parent determine the optimal approaches for the child. Clinicians provide feedback following each session. A Home Program, including suggested activities and other recommendations is provided regularly as a part of the process. 

What is Speech Pathology and what is a Speech-Language Pathologist?

Speech-Language Pathologists diagnose and provide treatment for children and adults with a variety of speech-language, communication, cognitive and feeding-swallowing issues.

What kinds of speech and language disorders affect children?

Speech and language disorders can affect the way children talk, understand, analyze or process information. Speech disorders include the clarity, voice quality and fluency of a child's spoken words. Language disorders include a child's ability to hold meaningful conversation, understand others, problem solve, read and comprehend & express thoughts through spoken or written words.

At what age should I seek out help for my child?

While there are developmental standards, every child will grow their skills at a different pace. If you are concerned whether your child is functioning at a level consistent with their peers, it is recommended you seek a speech-language or feeding evaluation. 

The early months of your baby's life are a critical period during which the development of strong social and communication skills, emotional growth and intelligence takes place. These skills serve as the foundation for which all other learning will be built upon as they grow older. For this reason, early intervention is of utmost importance.

What are the warning signs of a communication disorder in my young child?

Below are some common developmental warning signs separated by age range.Please note: this list is simply a general guideline and should not be construed as a comprehensive list. 

Birth to Six Months

  • Developmental or medical problems

  • Lack of response to sound

  • Lack of interest in speech

  • Limited eye contact

  • Feeding problems

  • Lack of any vocalizations

  • Difficulties with attachment

  • Lack of interest in socializing

Six to Twelve Months

  • Limited sound production, lack of variety or amount.

  • Groping or awkward movements when attempting to make or imitate sounds.

  • Oral-motor problems such as excessive drooling, trouble with solid foods, intolerance to touch in and around the mouth.

  • Lack of interest in sound-making toys, radios, TV, music, voices, etc.

  • Developmental or medical problems

  • Lack of response to sound

  • Lack of interest in speech

  • Limited eye contact

  • Feeding problems

  • Very limited vocalizations

  • Difficulties with attachment

  • Lack of interest in socializing

Twelve to Eighteen Months

  • Easily distractible

  • Does not understand any words or directions

  • Limited sound production, lack of variety or amount

  • Groping/awkward movements when attempting to make or imitate sounds

  • Oral-motor problems such as excessive drooling, trouble with solid foods, intolerance to touch in and around the mouth

  • Lack of interest in sound-making toys, radios, TV, music, voices, etc.

Eighteen to Twenty-four Months

  • Communication without words at times

  • No interest in imitation

  • Will not play games

  • No jargon

  • Grunting and pointing as primary means of communication

  • Easily distractible

  • Does not understand any words or directions

  • Limited sound production, lack of variety or amount

  • Groping movements when attempting to make or imitate sounds

  • Oral-motor problems such as excessive drooling, trouble with solid foods, intolerance to touch in and around the mouth

  • Lack of interest in sounds-making toys, radios, TV, music, voices, etc.

Two to Three Year Olds

  • Not combining words

  • Must be told and retold to carry out simple directions (outside of non-compliance)

  • Using only nouns

  • Poor eye contact

  • No rapid increase in number of words understood and used

  • Does not tolerate sitting for listening activity/looking at books, etc.

Three to Four Year Olds

  • Not speaking in full sentences

  • Not using "I" to refer to self

  • Cannot relate experiences, even in simple telegraph sentences

What is a receptive language disorder?

Receptive language includes the skills involved in understanding language. Receptive language disorders are difficulties in the ability to attend to, process, comprehend and/or retain spoken language.

Is my child showing signs of a receptive language disorder?

Some early signs and symptoms of a receptive language disorder include:

  • Difficulty following directions

  • Repeating back words or phrases either immediately or at a later time (known as "echolalia")

  • Difficulty answering questions appropriately

  • Use of jargon while talking

  • Difficulty attending to spoken language

  • Inappropriate and/or off topic responses to questions

What can I do at home to help my child's expressive and receptive language?

Your child's Speech-Language Pathologist will develop a Home Program with specific activities and suggestions that you may incorporate into daily routines at home.

Is my child showing signs of Autism?

Signs of autism may begin to be detected as early as 12 months of age. Symptoms of autism can occur in isolation or in combination with other conditions. National Autism Association has compiled some early indicators of autism spectrum disorder which include:

  • Delayed development of the ability to draw the attention of parents and others to objects and events

  • Little or no use of pointing to encourage another person to look at what (s)he sees (i.e., "joint attention")

  • Little or no attempt to gain attention by bringing or showing toys/objects to others

  • Little or no eye contact

  • Participates in repetitive patterns of activities

  • Aloofness and indifference to other people

  • Lack of understanding that language is a tool for conveying information

  • Tendency to select for enjoyment trivial aspects of things in the environment (e.g., attending to a wheel on a toy car and not the whole car for imaginative play)

  • Odd responses to sensory stimuli, such as hypersensitivity to sound, fascination with visual stimuli, dislike of gentle touch but enjoyment of firm pressure

  • Uses senses of taste and smell rather than hearing and vision

  • Poor coordination including clumsiness, odd gait and posture

  • Over or under activity

  • Abnormalities of mood, such as excitement and misery

  • Abnormalities of eating, drinking, and sleeping

More Signs of Autism Spectrum Disorder:

  • Flicking fingers, objects, pieces of string, etc.

  • Watching things that spin

  • Tapping and scratching on surfaces

  • Inspecting, walking along and tracing lines and angles

  • Feeling special textures

  • Rocking, especially standing up and jumping from back foot to front foot

  • Tapping, scratching or otherwise manipulating parts of the body

  • Repetitive head banging or self injury

  • Teeth grinding

  • Repetitive grunting, screaming or other noises

  • Arranging objects in a line

  • Intense attachment to particular objects for no apparent reason

  • A fascination with regular repeated patterns of objects, sounds

What is a Social Pragmatic Language Disorder?

Children with social pragmatic difficulties demonstrate deficits in social and/or cognitive functioning. Diagnostic terms include: Asperger Syndrome, hyperlexia, High Functioning Autism, Semantic-Pragmatic Disorder, Pervasive Developmental Disorders NOS and Non-Verbal Learning Disabilities.

Is my child showing signs of a social-pragmatic language disorder?

Persons with social-pragmatic deficits have significant difficulties in their ability to effectively communicate and problem solve. Some signs and symptoms may include:

  • Difficulties with personal problem solving

  • Literal/concrete understanding of language

  • Difficulty engaging in conversational exchange

  • Difficulty with active listening, including participating through observation of the context and making logical connections

  • Aggressive language

  • Decreased interest in other children

  • Difficulty with abstract and inferential language

  • Lack of eye contact

  • Difficulty interpreting nonverbal language

  • Difficulty with adequately expressing feelings

Is my child's "stuttering" normal?

Non-fluent speech is typical between the ages of two and six years. It is typical for non-fluent speech to last up to six months, improve and then return. Any child who is demonstrating any "struggle behaviors" (e.g., facial/bodily tension, breathing disruptions, blocks, grimacing) should be referred to a speech-language pathologist. For more information on stuttering, please visit: www.nsastutter.org.

What is an articulation disorder?

Articulation is the production of speech sounds. An articulation disorder occurs when a child does not make speech sounds correctly due to incorrect placement or movement of the lips, tongue, velum and/or pharynx. It is important to recognize that there are differences in the age at which children produce specific speech sounds in all words and phrases. Mastering specific speech sounds may take place over the course of several years.

What is a phonological disorder?

Phonology refers to the speech sound system of language. A phonological disorder occurs when a child is not using speech-sound patterns appropriately. A child whose sound structures vary from the speech typical for their stage of development, or who produce unusual simplifications of sound combinations, may be demonstrating a phonological disorder.

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