Could my Child benefit from speech therapy? by Sarah

Difficulties with speech-language development is nonbiased and may touch the lives of any family regardless of socio-economic status or cultural background.  Because of the diversity of issues that may be present, there is the potential for confusion in understanding how to remediate issues and when to begin intervention. 
 
How  could speech therapy  help  my  kid?   
Is my child too old or too young to benefit from speech  therapy?  
Why did my doctor refer my child for speech therapy?  
I have specific concerns about my child’s communication, is this something speech therapy can address?  
  
You are not alone: these are some questions that a speech therapist can answer during almost every evaluation. The goal of this post is not only to answer some questions, but to give parents and guardians an idea of what speech therapy is and how it may benefit your child. Specifically, what a pediatric speech therapist may treat, an example of an evaluation, and how to get started if you feel your child may benefit from speech therapy.  
 
Who do pediatric speech therapists treat?  
Pediatric clinics serve kids off all ages, from 0-18 years old.   
Isn’t 0-3 years old too young for therapy?  
Nope! Many children from the ages of 3 and under do very well in therapy. Younger children are  often more flexible in their communication and  learn new skills more quickly.   Therapy for our youngest clients is often play based intervention accompanied by a home-based program. 
Are speech therapists available during COVID19?   
Yes,  we are- In fact, speech therapy is considered an essential service and has remained available through-out the pandemic.  Our clinic follows CDC and state-based guidelines for PPE use and implement a cleaning protocol.  We ask anyone not feeling well to stay at home.  Most parents wait in their car during appointments; however, some exceptions can be made to accompany a child into a therapy room when depending on a child’s needs. In addition, we offer telehealth! This allows for treatment  at  home, and many kids love showing their therapist  their favorite  toys and activities. Telehealth can be offered on an ongoing basis, or on a weekly basis depending on what would serve our families best.  
What do pediatric speech therapists treat?  
Ah yes, the big question. The answer is... a lot.  Speech therapists assess, diagnose, and treat disorders related to  communication. Communication  encapsulates  a vast array of skills, which may include:  

• Articulation and Speech Sound Disorders- An area intervention that targets errors with specific speech sounds. As a child develops, we expect them to gradually master the sounds in their language and be intelligible to unfamiliar people.  Children with articulation errors may present as:  

• A young child who strangers can’t understand  

• An older child struggling with one or more sounds, such as /r/ and /l/  
• A child who can form sounds correctly, but uses them in the wrong place  

To help you decide if articulation therapy  would be beneficial, take a look at the  speech  sound  development chart  found  here.  It  shows  the ages that sounds are first acquired  and when most children typically master the sound.  

• Receptive Language- a person's ability to understand the language  being spoken to them. This is not a hearing disorder, and may persist despite having typical hearing.  Challenges in this area may manifest in a variety of different ways depending on your child’s age.  Examples may include:  

• An infant who does not respond to their name  

• A toddler  who may need the assistance of gestures to follow simple directions  
• Answering questions may be difficult, and include  off-topic information  
• Some children may struggle to follow conversations and not remember important details  

• Expressive Language- while receptive language is what a person understands, expressive language is what a person can produce in daily conversation.  Delays in this area may present as:   

• An infant who is a late talker  

• Reduced vocabulary size   
• Challenges constructing and organizing a narrative or story  
• Frequent grammar errors that are not consistent with those that peers make  

For more detailed information regarding both receptive and expressive language development,  here are some helpful resources:  

• For a simple chart that breaks down skills based on age, click  here  

• For more detailed information on language development for infants between the ages of 0-6 months-old, click  here  
• For a more in depth look at language and comparing skills acquired at the same age, try  this  page  

• Social Pragmatic Language- how a child uses their language to interact with their conversation partners. Even a child with a robust vocabulary and excellent receptive language may struggle to communicate in socially appropriate ways. Difficulties with pragmatic language may present as:  

• A child who does not  turn to look at  people talking  
• Some children struggle to maintain an appropriate  personal space  and eye contact.  Different cultures have different social rules  regarding these skills, but a child struggling with this skill will usually struggle in their home culture as well.  

• Children who interpret  everything literally, including figures of speech and sarcasm  
• Conversation may focus only on topics they are highly interested in or jump between topics without warning  

Social pragmatic challenges can manifest in a variety of ways. This is one of the most diverse groups of deficits in speech therapy, so feel free to reach out if you have any questions about this area of communication.  Below are some references to help determine  if this may be a challenge for your kid:  

• For more information about conversation and non-verbal communication, try  this  post  
• For children that can maintain conversation, take a look at  this  breakdown of conversational skills  

• This  chart is for children 0-3 years old, and also includes language milestones  

• Stuttering- this is a fluency disorder that typically manifests when your child is a toddler. Young children may attend speech therapy to eliminate a stutter, while older kids can learn techniques for reducing the impact of a stutter on daily communication.   

  

• Voice- if your child’s vocal quality recently changed (e.g., suddenly raspy, quiet, pitch breaking not associated with puberty), then a speech therapist  can help. After an ENT examines the structures for abnormalities or differences in vocal function, a speech therapist is needed to help with the following:  

• Education of vocal health  

• Teaching and practicing safe vocal techniques  
• Providing resources for tools to reduce vocal trauma  

  
What would an evaluation look like?  
  A  speech pathologist will determine if your child is demonstrating skills consistent with their peers.  Research has demonstrated trends of development that are considered “typical” for all age ranges. If your child falls in the average range  for their age, then speech therapy won’t be needed. However, if they are placed outside of the average, then therapy will be recommended. Testing may include but not limited to:  
  

• A parent interview and medical history  
• Standardized testing  to compare their skills to their peers  
• Observation while your child engages in structured play activities  or age-appropriate tasks to obtain a speech sample 

• Having your child tell a story  

  
Speech pathologists have a variety of tools at their disposal to assist with the evaluation process.  Through years of ongoing education and experience, speech therapists acquire many strategies to aid in the testing process and learn to gather information during naturally occurring interactions.  This data can be used and compared to developmental norms to establish clear baseline levels of skills. 
  
If I am interested in speech therapy for my child, what do I need to do?  
  
Talk to your child’s primary physician about your concerns and to get a referral for a speech evaluation. Many pediatricians check speech and language milestones for their patients and will inform you if they are not developing at age expectations. If you have specific concerns about your child’s communication, your doctor may recommend a screening. This is a shorter session with a speech therapist to determine if further testing is needed.  
  
What do I need to do to get ready for an evaluation?  
  
Most clinic settings have an intake packet that is used to help choose the best evaluation tools for your child. Questions that are included pertain to their birth, medical and family histories,  present level skills, and your child’s interests.  Most testing situations are best served when a family arrives 10 minutes prior to the scheduled appointment, to give the evaluating therapist a chance to review this information and adjust their session accordingly.  
  
 If you have any questions or are  interested in learning more, please reach out! We would be happy to speak with you to answer questions or help decide if speech therapy can benefit your family.  
  Stay safe, stay happy, and stay healthy everyone!  
  
Sarah Swanberg  
CCC-SLP  
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