How a Speech Pathologist Can Help
Speech pathologists often get the question “What is speech therapy exactly?” Unless you are in the healthcare field, it’s a profession not many people are familiar with. Speech therapists are trained to assess and treat speech and language disorders. Many people do not know that this can also entail feeding and swallowing disorders. Below are the various categories a speech pathologist may assess or target during an evaluation or therapy:
Language production is expressive language. It can be verbal (actually saying words) or nonverbal (gestures such as reaching). When it comes to infants, speech pathologists look to see if they can imitate motor actions (e.g. waving) and take turns producing sounds, cooing, and babbling. At around 12 months a child will begin saying single words, including names of familiar people, food, toys, objects, verbs, greetings (“hi”), rejection(“no”), and recurrence (“more”). As time goes on, children begin to join words to form short phrases and sentences. You should expect two-word phrases by two years of age: “Mommy up!” and “More juice.” As children mature, other components of language such as syntax (the order in which words are put in) and morphology (skills such as plurals and tense markers) will also develop. Expressive language skills allow children to request what is desired, ask for help, get other people’s attention, comment, ask questions, and more. If your child is having difficulty with any of these skills, it may be best to get an assessment—depending on his or her age—to rule out any possible speech and language issues.
Receptive skills involve understanding language. This includes following commands, pointing to pictures in books when asked to, pointing to the correct body part, and comprehending concepts such as prepositions, size, color, length, and quantity. Receptive language also involves answering yes/no, who, what, where, and when questions as well as more complex questions such as why and how. By understanding language, children can manipulate their environment, be a part of group activities, and function in a social setting such as a nursery school. A general rule of thumb is that a one year old should be able to follow basic one-step commands with gestures as necessary (“Give me” with an open hand cue), a two year old should be able to follow two-step commands (“Go get the book and bring it to mommy”), and so on. If you suspect any issues with language comprehension, feel free to get a speech and language evaluation.
Therapy focused on pragmatics deals with social skills. This category of language is often taken for granted because it involves simple skills such as responding to one’s name, eye contact, initiating play with someone appropriately, and greeting someone when they walk into a room. Higher level pragmatic skills include changing the manner in which you speak, introducing a topic, maintaining a conversation, solving communication breakdowns, and judging facial expressions. Appropriate pragmatic skills allow your child to create relationships and maintain friendships, which are important life skills.
Children learn language and develop cognitive skills through play. Stacking blocks, completing puzzles, and playing with cause and effect toys encourage problem-solving skills. Object permanence is also a very important skill to acquire—this is when your child searches for hidden objects. Parallel play (children playing next to each other) and pretend play also develop later on. You should observe whether your child is taking turns appropriately, using objects in the correct manner, and socializing with other children.
This is the way speech sounds are produced. It is common for children to change the way a consonant or vowel should be produced to make it easier to say—this is called phonological processes. Children may exhibit processes such as: sound substitutions (“kurkey” for “turkey”), omissions (“do” for “dog”), distortions (“thee” for “see”, which would be a lisp), and additions (“belue” for “blue”). Some errors can be age-appropriate while others are not—which an articulation assessment would determine.
When speaking we use our breath and the vibration of our vocal folds to produce sounds. Occasionally, issues arise when children use extremely loud voices or scream often. They are, in turn, abusing their vocal folds, which can cause pain or discomfort and lead to hoarseness. Other issues such as vocal fold paralysis, vocal fold nodules, or polyps can be possible and lead to voice issues.
This is basically the flow of speech. Many people use the word “stuttering” when their child’s speech is not fluent. The child may be hesitating, repeating words or parts of words/phrases/sentences, prolonging sounds, or “getting stuck”. Often the dysfluencies that children experience are normal, but it is important to consult a professional to make the appropriate determination.
Many families refer to their children as “picky eaters”. It is the job of a speech pathologist to determine if there are sensitivities to specific textures, colors, temperatures, and tastes and gradually introduce them to new foods. Speech pathologists also perform oral motor exams to determine if there are any mechanical issues such as difficulty chewing, pocketing of food in the cheeks, jaw sliding, drooling, and difficulty swallowing.
Keep in mind that all children develop at different rates, but there are standardized norms, which allow speech pathologists to determine if children as young as infants have delays. It is important for families to have their children assessed if they notice any warning signs of delays—the earlier the better!
Written By Gift of Gab Resources:
Debbie Shiwbalak, M.A., CCC-SLP, has a B.A. in speech pathology and is a graduate of Long Island University-CW Post Campus, where she received an M.A. in speech pathology in 2001. She holds a Certificate of Clinical Competence (CCC) from the American Speech Language Hearing Association (ASHA) and is licensed by the state of New York to practice speech-language pathology. Debbie has 13 years experience as a speech pathologist in the New York City area. She co-authored a chapter of Cutting Edge Therapies for Autism and presents at parent and professional workshops all over New York City.
Alpin Rezvani, M.A., CCC-SLP, graduated from New York University with an M.A. in speech-language pathology. She holds a certificate of clinical competence from the American Speech, Language, and Hearing Association (ASHA) and has New York licensure in Speech-Language Pathology. She has seven years of experience as a speech pathologist in the New York City area and was an adjunct instructor at New York University. She co-authored three chapters of Cutting Edge Therapies for Autism and presents at parent and professional workshops all over New York City.