Tag Archives: Language

What is Speech Therapy?

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:

Expressive Language
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.

Child psychologist with a little girlReceptive Language
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.

Dysphagia/Oral Feeding
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!

standard_Debs___AlpsWritten 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. 

When Does Literacy Begin?

We know children pick up language starting from birth—they hear our conversations, they repeat our words, and then words turn into sentences. But when does literacy really begin?

Literacy begins the first day you bring your baby home and starts with the process of language development. This is displayed through body language and signals your baby uses to communicate. To foster this communication further, parents should speak to their babies frequently as they interpret cues and focus on different kinds of communication.


In the last ten years, neuroscientists have done tremendous research on infant brain development and identified areas of the brain responsible for different functions. Here is a quick and easy overview:

Wernicke’s area: Located in the temporal lobe and plays a critical role in the ability to understand meaningful speech.

To develop this area, speak to your baby in whole language (use short complete sentences) and read to him or her daily, as reading helps develop listening skills, language skills, speech patterns, and memory. Age appropriate music with rhythm is another great way to develop of this area of the brain. Not only does music help with language, it also introduces other cultures and teaches infants how to follow directions—like the song “If You’re Happy and You Know It” (clap your hands!).


Broca’s area: Located in the frontal lobe of the brain and controls the production of spoken and written language.

Once your infant is mobile, place a bin of interactive picture books on the floor within reach, so your baby has the opportunity to expand his or her vocabulary. Make sure to interact with your baby while he or she flips through pages, but also give him or her time to play with books and toys alone.


Temporal lobe: Located above the ears and responsible for hearing, speech, and some learning and memory.

Infants and toddlers love repetition! This is because it’s how they start to understand what you’re saying and what words mean. To encourage temporal lobe development, repeat the words to a favorite song frequently over a period of time, and you’ll see that your child will start to know what comes next and develop important memory skills.

When babies are born their brains are 25% developed, and by the time they are five years old development is at 95%! So focusing on developing these three areas of the brain between birth and age three is crucial in order to avoid problems later on.

By Daseta Gray, an educator with over 20 years experience. She consults for Sabree Education Services. Read her previous posts here.

Straight Talk on Closing the “Word Gap” In Early Childhood

Straight Talk on Closing the “Word Gap” In Early Childhood

As politicians nationally emphasize the importance of PreK in preparing children for school success, there is a growing movement to focus on the first three years of life, and specifically on bridging what leaders call the “word gap.” This gap refers to the disparity in the number of words learned by children of different economic backgrounds by the time they enter kindergarten and across their lifetimes. It is a critical issue. Research shows that children who start kindergarten with fewer words are never able to catch up to their counterparts with larger vocabularies. Not surprisingly, parents and teachers can have a huge impact on children’s success by simply creating an evolving and engaging dialogue with the children during their first few years of life.

In March, The New York Times focused on the word gap when it published “Providence Talks” (http://www.nytimes.com/2014/03/26/us/trying-to-close-a-knowledge-gap-word-by-word.html), an article on an initiative spearheaded by Providence Mayor Angel Taveras. The program aims to grow children’s vocabularies from birth to four, particularly in families living in poverty. The process coaches parents so they actually use more words each day, measures word interactions by recording families at home, and ultimately gives children more word power for learning.

The Providence program’s aim is undeniably admirable. But as Claire Lerner, director of parenting resources at Zero To Three, the largest American advocacy organization for infants and toddlers, points out: the number of words children acquire will not by themselves create a “smart and successful” adult. She stresses, “We don’t want parents talking at babies…We want parents talking with babies.”
Lerner’s distinction between talking at and talking with babies reminds us that the dialogue itself, the interactive exchange between adult and child, is really what’s important. Children have a point of view from birth before there is any expressive language. Their gaze indicates engagement and wonder and opens up the door for back-and-forth communication. Parents can foster this communication in simple but important ways. For example, when your child notices a dog on the street, acknowledge this with words. “That’s a big dog. Do you see his black spots? Look at his feet. His nails are really long.” When we recognize a child’s fascination, we can model our own in return and become partners in observation, using language to present new words and ideas. The child’s interest lays the groundwork so next time they see a dog they’ll be able to retrieve those ideas. Some word interactions carry more weight than others.
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Providence Talks is just one of several initiatives underway across the United States aimed at growing vocabularies of very young children. To learn more you can visit:
Providence Talks at http://www.providencetalks.org/
Too Small to Fail at http://toosmall.org/mission
The Thirty Million Words Initiative at http://tmw.org/tmw-initiative/

Renee Bock is a dedicated early childhood educator, who is currently the Educational Director at Explore+Discover, a social learning center in Manhattan that is dedicated to setting the standard for infant and toddler care and education. Renee has more than a decade of experience in the field and holds a Master’s in Early Childhood Education from Bank Street College in New York. In her present position, she is helping Explore+Discover open the first of 27 New York City centers focused on children from 3 months to two years old. She can be reach at Renee@K3Learn.com.