Speech

Children’s Services : Speech

Articulation

An articulation disorder involves problems making sounds. Sounds can be substituted, left off, added or changed. These errors may make it hard for people to understand you.

Young children often make speech errors. For instance, many young children sound like they are making a “w” sound for an “r” sound (e.g., “wabbit” for “rabbit”) or may leave sounds out of words, such as “nana” for “banana.” The child may have an articulation disorder if these errors continue past the expected age.

Not all sound substitutions and omissions are speech errors. Instead, they may be related to a feature of a dialect or accent. For example, speakers of African American Vernacular English (AAVE) may use a “d” sound for a “th” sound (e.g., “dis” for “this”). This is not a speech sound disorder, but rather one of the phonological features of AAVE.

    Our Treatment Program:

  • Evaluation, interpretation, and recommendations by a certified speech-language pathologist
  • Customized treatment programs based on individual needs
  • Indivudually scheduled therapy sessions

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Childhood Apraxia of Speech

A definition for childhood apraxia of speech, taken from the American Speech and Hearing Association is:   Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.

    Our Treatment Program:

  • Evaluation, interpretation, and recommendations by a certified speech-language pathologist
  • Customized treatment programs based on individual needs
  • Individually scheduled therapy sessions

Links:

Fluency and Stuttering

Fluency is a speech language pathology term that means the smoothness or flow with which sounds, syllables, words and phrases are joined together when speaking quickly.[ Fluency disorders is used as a collective term for cluttering and stuttering. Both disorders have breaks in the fluidity of speech, and both have the fluency breakdown of repetition of parts of speech. Fluency disorders are most often complex in nature and they tend to occur more often in boys than in girls.

    Our Treatment Program:

  • Evaluation, interpretation, and recommendations by a certified speech-language pathologist
  • Customized treatment programs based on individual needs
  • Indivudually scheduled therapy sessions

Links:

Tongue Thrust

Simply stated, it is an abnormal swallow pattern of pushing the tongue against the teeth between and while swallowing. Speech problems frequently occur with a tongue thrust due to the way the tongue is positioned and carried in the mouth. The most common speech problem is a frontal lisp that will affect the correct production of the /s/ and /z/ sounds and can affect other speech sounds that, while not obviously mispronounced, are produced in a way that will make speech sound “sloppy”. In order to correct the speech problems, the tongue thrust will have to be corrected. It is not possible to correct speech without correcting the position and carriage of the tongue in the mouth.

    Tongue Thrust Facts:

  • Children and adults swallow approximately 2,000 times per day.
  • Incorrect swallowing can exert 6 pounds of pressure against the teeth and jaw.
  • As many as 67% to 95% of children between the ages of 5 to 8 years old exhibit tongue thrust behavior that may be associated with orthodontia and/or speech problems.
  • Types of tongue thrust vary.
  • Tongue thrusting can prevent braces from effectively positioning the teeth.
  • Up to 80% of orthodontic patients have some form of tongue thrust.

Our Treatment Program:

The most effective type of therapy for tongue thrust utilizes techniques that re-educate muscles used for swallowing by changing the swallow pattern. This method is taught and monitored by a certified speech pathologist trained in the diagnosis and treatment of tongue thrust. The Swain Center offers the Progressive Tongue Thrust Therapy Program (PTTTP) that corrects tongue thrust over a period of four months.*

    Each level targets the tongue movements associated with:

  • Chewing
  • Swallowing
  • Integrating chewing with swallowing
  • Oral posture at rest

*The success of the program is based on commitment and motivation of the child, parent, orthodontist and speech pathologist.

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Cleft Lip & Palate

Cleft lip and cleft palate comprise the most common birth defect in the United States. One of every 600 newborns is affected by cleft lip and/or cleft palate.

A cleft lip is a separation of the two sides of the lip. The separation often includes the bones of the upper jaw and/or upper gum. A cleft palate is an opening in the roof of the mouth in which the two sides of the palate did not fuse, or join together, as the unborn baby was developing. Cleft lip and cleft palate can occur on one side (unilateral cleft lip and/or palate), or on both sides (bilateral cleft lip and/or palate). Because the lip and the palate develop separately, it is possible for the child to have a cleft lip, a cleft palate, or both cleft lip and cleft palate.

Cleft lip and cleft palate are congenital defects, or birth defects, which occur very early in pregnancy. There are many causes of cleft lip and palate. Problems with genes passed down from one or both parents, drugs, viruses, or other toxins can all cause these birth defects. Cleft lip and palate may occur along with other syndromes or birth defects. Risk factors include a family history of cleft lip or palate and other birth defects. The majority of clefts appear to be due to a combination of genetics and environmental factors. The risks of recurrence of a cleft condition are dependent upon many factors, including the number of affected persons in the family, the closeness of affected relatives, the race and sex of all affected persons, and the severity of the clefts.

A child born with a cleft frequently requires several different types of services, e.g., surgery, dental/orthodontic care, and speech therapy, all of which need to be provided in a coordinated manner over a period of years. This coordinated care is provided by interdisciplinary cleft palate/craniofacial teams comprised of professionals from a variety of health care disciplines who work together on the child’s total rehabilitation.

    Our Treatment Program:

  • Evaluation, interpretation, and recommendations by a certified speech-language pathologist
  • Customized treatment programs based on individual needs
  • Individually scheduled therapy sessions

Links:

Phonology

Phonology is viewed as the subfield of linguistics that deals with the sound systems of languages. Phonology describes the way sounds function within a given language or across languages to encode meaning.

A phonological process disorder involves patterns of sound errors. For example, substituting all sounds made in the back of the mouth like “k” and “g” for those in the front of the mouth like “t” and “d” (e.g., saying “tup” for “cup” or “das” for “gas”). Another rule of speech is that some words start with two consonants, such as broken or spoon. When children don’t follow this rule and say only one of the sounds (“boken” for broken or “poon” for spoon), it is more difficult for the listener to understand the child. While it is common for young children learning speech to leave one of the sounds out of the word, it is not expected as a child gets older. If a child continues to demonstrate such cluster reduction, he or she may have a phonological process disorder.

    Our Treatment Program:

  • Evaluation, interpretation, and recommendations by a certified speech-language pathologist
  • Customized treatment programs based on individual needs
  • Individually scheduled therapy sessions

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Motor Speech Disorders

Motor speech disorders can result from stroke, traumatic brain injury, and neurological or neuromuscular disease. A motor speech disorder is characterized by a weakness, slowness and/or incoordination of the oral speech mechanism and can affect a person’s speech, voice, and breath support for communication and swallowing.

The terms dysarthria and apraxia are terms that describe the type of motor speech disorder. The nature and extent of the motor speech disorder will vary depending on the cause. Proper assessment and diagnosis will facilitate effective and efficient treatment.

The Swain Center protocol has been established to provide assessment treatment to patients with motor speech disorders. Following an initial evaluation, treatment recommendations will be discussed and a comprehensive report will be sent to the referring physician. Insurance companies may cover treatment.

    Our Treatment Program Includes:

  • An initial evaluation assessing speech, voice, respiratory support and swallowing
  • Intensive therapy program based on evidenced based research
  • Clinically supervised structured supplemental home program
  • Group maintenance program following therapy
  • Collaboration with medical professionals as needed

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Swallowing Disorders

Swallowing difficulty, or dysphagia, presents itself in a variety of ways and occurs for a number of reasons. Swallowing disorders are usually related to neurologic disorders or dysfunctions. They may occur after a stroke, traumatic brain injury, neurological diseases, surgery or serious illness.

Swallowing disorders can pose safety and health risks and must be identified and treated. Sometimes a problem with swallowing can go unrecognized or undiagnosed and result in aspiration. Aspiration can occur when food or liquid enters a patient’s airway. This type of event is commonly referred to as food or liquid “going down the wrong pipe.” When this happens pneumonia may result. Additional problems can include choking which can be life threatening. In order to minimize health and safety risks changes in a person’s diet may be recommended.

    Our Treatment Program:

  • Evaluation, interpretation and recommendations by a speech-language pathologist
  • Collaboration with physicians and radiology professionals regarding imaging studies
  • Development of an individualized therapy plan to improve swallowing function
  • Implementation of specific swallowing techniques to improve skills (e.g. Masako, Mendelsohn, etc)
  • Use of oral-motor exercises to improve muscle strength to support swallowing rehabilitation
  • Consultation with a dietician for development of an appropriate diet and meal planning

Very often patients with post-surgical dysphagia or swallowing problems after stroke do recover their swallowing ability and return to a normal diet.

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Autism Spectrum Disorders

Autism is a complex developmental disability that causes problems with social interaction and communication.  Symptoms usually start before age three and can cause delays or problems in many different skills that develop from infancy to adulthood. Different people with autism can have very different symptoms.  Health care providers think of autism as a “spectrum” disorder, a group of disorders with similar features.  One person may have mild symptoms, while another may have serious symptoms.  But they both have an autism spectrum disorder.

Currently, the autism spectrum disorder category includes:

  • Autistic disorder (also called “classic” autism)
  • Asperger syndrome
  • Pervasive Developmental Disorder Not Otherwise Specified (or atypical autism)

In some cases, health care providers use a broader term, pervasive developmental disorder, to describe autism.  This category includes the autism spectrum disorders above, plus Childhood Disintegrative Disorder and Rett Syndrome.

    Our Treatment Program:

  • Evaluation, interpretation, and recommendations by a certified speech-language pathologist
  • Customized treatment programs based on individual needs
  • Indivudually scheduled therapy sessions

We do not participate in IEPs, Due Process Hearings or Fair Hearings. If you require follow up information beyond the evaluation report, you may request a letter of support for additional information that you may need for your child.