Speech Pathology

Speech pathologists are university trained to assess, diagnose and treat communication disorders.

Speech pathology services cover the whole life span from premature babies to the elderly and address an extensive range of specialised areas of communication including; speech sounds, receptive and expressive language, literacy, fluency (stuttering), voice and social skills. Speech pathologists can also assist those with eating (fussy feeders) and swallowing difficulties.

A referral for speech pathology services is not necessary.

Speech pathologists can assess and address the following areas of clinical practice:

Speech Sounds

(articulation)

Receptive Language

(understanding language)

Expressive Language

(using language)

Literacy Skills

(reading, writing, spelling)

Fluency

(stuttering)

Play & Social skills

(pragmatics)

Voice

(quality & use)

Feeding & Swallowing

(fussy feeders)

Speech Sounds

(articulation)

Speech sounds are the sounds we produce when we speak. We use our tongue, teeth, lips, jaw and vocal cords to make the sounds. Children develop various speech sounds at different ages and will often make age-appropriate errors. A speech sound delay is present when children continue to make errors past the expected ages.

Your child may have difficulty with speech sounds if they; sound unclear or slushy, they change one sound for another sound, they leave sounds out of words, family and friends have difficulty understanding them or your child becomes frustrated when they are not able to be understood by others.
Speech sound errors may affect your child’s literacy development which includes their; reading, writing and spelling abilities. Speech sound errors can also interfere with a child’s ability to communicate their needs, wants and ideas leading to frustration, difficulty forming and maintaining friendships and decreased confidence.
A number of factors can contribute to speech sound difficulties including; having a family history of speech sound difficulties, frequent ear infections with hearing loss, structural abnormalities of the head, face or neck (e.g. cleft lip and palate) or having English as a second language. Developmental disorders such as autism or genetic syndromes such as Down syndrome can also result in speech sound difficulties.
A speech pathologist can assess your child’s speech sound skills and identify any non-age-appropriate errors that are being made. A therapy plan can then be created to address the sound errors. The speech pathologist can provide parents/carers with knowledge of age-appropriate speech sounds, strategies and tips on how to make and teach certain speech sounds and how to best assist their child to practise the new skills at home between therapy sessions.

How well words can be understood by parents

How well words can be understood by unfamiliar people

Reference:
Flipsen, P., Jr. (2006). Measuring the intelligibility of conversational speech in children. Clinical Linguistics & Phonetics. 20(4), 202-312.

Reference:
McLeod, S. & Crowe, K. (2018). Children’s consonant acquisition in 27 languages: A cross-linguistic review. American Journal of Speech-Language Pathology. Available from: https://ajslp.pubs.asha.org/article.asxp?articleid=2701897

Receptive Language

(understanding)

Receptive language is the ability to listen to, comprehend and process information that has been heard, read or seen. It includes concepts such as the; location, size, shape, colour, function and parts an item is made up of, and gaining information and meaning from the surrounding environment. A receptive language delay is present when children develop these skills at a slower rate than is expected for their age.

Your child may have difficulties with receptive language if they; have trouble following instructions, have difficulty answering questions (responds with unusual answers or repeats your question), have difficulty comprehending stories, struggle to pay attention or become easily frustrated.

Receptive language difficulties within the preschool/school environment can greatly impact on a child’s ability to fully access the curriculum and to interact appropriately with their peers. It can also contribute to attention difficulties as the child finds it difficult to maintain their focus on tasks they do not understand.

A number of factors can contribute to receptive language difficulties including; having a family history of receptive language difficulties, having limited exposure to language in the day-to-day environment, hearing impairment, vision impairment, attention disorders, developmental disorders such as autism or genetic syndromes such as Down syndrome.
A speech pathologist can assess your child’s receptive language skills and identify whether their skills fall within the expected range for their age. A therapy plan can then be created to address their difficulties. The speech pathologist can provide parents/carers with knowledge of age-appropriate receptive language skills, how to develop and support their child’s receptive language skills and strategies and tips on how to best assist their child to practise the new skills at home between therapy sessions.

See the ‘Understanding’ sections of the Communication Milestones Poster from Speech Pathology Australia (SPA).

Source: Speech Pathology Australia, 2020

Expressive language

(using language)

Expressive language is the ability to use words to build sentences, use the correct vocabulary and grammar, use gestures and body language and writing to communicate messages to others in a way that can be understood by the listener/reader/watcher. An expressive language delay is present when children develop these skills at a slower rate than is expected for their age.
Your child may have difficulties with expressive language if they; are not yet using single words at 1 year of age, have a limited vocabulary, have difficulty naming objects/items, use short sentences, have trouble forming meaningful sentences, use incorrect grammar, have difficulty telling or writing down their ideas/stories or becomes frustrated when they are not able to be understood by others.
Expressive language difficulties within the preschool/school environment can greatly impact on a child’s ability to fully access the curriculum and to interact appropriately with their peers. A child may have difficulty getting their wants, needs and ideas across to others leading to frustration and withdrawal from classroom activities and social interactions. Expressive language difficulties can also impact upon a child’s ability to produce written work.
A number of factors can contribute to expressive language difficulties including; having receptive language difficulties, having a family history of expressive language difficulties, having limited exposure to language in the day-to-day environment, hearing impairment, attention disorders, developmental disorders such as autism or genetic syndromes such as Down syndrome.
A speech pathologist can assess your child’s expressive language skills and identify whether their skills fall within the expected range for their age. A therapy plan can then be created to address their difficulties. The speech pathologist can provide parents/carers with knowledge of which age-appropriate expressive language skills, strategies and tips on how to develop and support their child’s expressive language skills and how to best assist their child to practise the new skills at home between therapy sessions.

See the ‘Speaking’ sections of the Communication Milestones Poster from Speech Pathology Australia (SPA).

Source: Speech Pathology Australia, 2020

Literacy Skills

(reading, writing, spelling)

Literacy refers to the ability to read, write and spell. It includes the phonological awareness skills of; letter and sound knowledge, rhyming, counting syllables and manipulating sounds. These skills are not naturally acquired, they need to be explicitly taught. Children can experience difficulties with literacy (specific learning disorder) without having any other areas of academic difficulty however, the ability to read and write impacts upon other subjects like solving word problems in maths or recording experiment results in science.
Your child may have difficulty with literacy skills if they; guess words based on the first letter, skip over unknown words, dislike reading and writing, forget spelling words easily, are not understanding or remembering what they have read or if writing is slow and tiring for them.
Difficulties with literacy can affect a child’s success in all subject areas leading to reduced self-confidence and a generally negative experience at school. Children may avoid certain activities and begin to fall further behind their peers leading to social exclusion and isolation. Future job prospects also become limited if literacy difficulties are left untreated.
The specific cause of literacy problems are variable. Some children struggle with literacy as a result of underlying speech and language difficulties. Children can experience literacy difficulties without having any other intellectual or learning disabilities. If children have not been exposed to books and other written content within their home environment they will have difficulty mastering literacy skills at school. Having a family history of literacy difficulties also puts children at a greater risk of struggling with literacy.
A speech pathologist can assess your child’s literacy skills and identify whether their skills fall within the expected range for their age. A therapy plan can then be created to address their difficulties. The speech pathologist can provide parents/carers with the knowledge of age-appropriate literacy skills, strategies and tips on how to teach letter names/sounds, letter combinations and spelling rules and how to best assist their child to practise the new skills at home between therapy sessions.

References:
Johnson, K.L, & Roseman, B.A. (2003). The source for phonological awareness. East Moline, IL: Linguisystems, Inc.
Paul, R. (2007). Language disorders from infancy through adolescence: Assessment & intervention (3rd ed.). St. Louis: Mosby, Inc.
Simpson, S. & Andreassen, M. (2008). Hierarchy of phonological awareness tasks. Retrieved from http://www.phonologicalawareness.org

Fluency

(stuttering)

Fluency refers to the flow and rhythm of speech. All children experience disruptions to the flow and rhythm of their speech as they develop their language skills which is completely normal. It is when the disruptions continue to impact the flow and rhythm of their speech for a period of time or when a child finds it difficult to communicate due to the disruptions that it becomes a problem.

Your child may have difficulties with fluency if they; repeat sounds, parts of words, whole words or sentences, struggle to get their words out or appear to be stuck (blocking), stretch out sounds in their words (prolongation), become frustrated when speaking or even avoid situations where they have to speak. Other non-speech characteristics of stuttering to be aware of include; facial grimace (scrunching up of the face when trying to speak), exaggerated or excessive eye blinking, head nodding or the tapping of a foot or leg when trying to speak.
If left untreated, a stutter can impact upon a child’s self-confidence, their willingness to participate in classroom activities, the avoidance of social situations and can increase stress and frustration.
The exact cause of stuttering is unknown. It is thought to be a problem with the brain activity related to speech production. Stuttering is not usually caused or triggered by an event, person, experience or anxiety however, these can exacerbate stuttering behaviours. Research indicates that there is a genetic link to stuttering meaning a child is more at risk of developing a stutter if there is a family history of stuttering.

A speech pathologist can assess your child’s fluency and identify whether there are ongoing fluency problems. A therapy plan can then be created to address their difficulties. The speech pathologist can provide parents/carers with strategies and tips on how to identify stutters, how to address moments of stuttering, how to record the severity of the stuttering and how to provide parent-directed therapy at home between speech pathology sessions.

Play & Social Skills

(pragmatics)

Play allows children to explore their world and develop the skills of; attention, concentration and language. Babies and children go through numerous stages of play as they develop including; unoccupied play, solitary play, spectator play, parallel play, associate play and cooperative play. Social skills or social language refers to the speech, body language/gestures and facial expressions we use to communicate with others. Our social skills assist us to identify the feelings and emotions of ourselves and others, initiate and maintain conversations and friendships, to interact appropriately depending on who we are talking to and to understand the more abstract rules of communication (puns, metaphors, inferences).
Your child may have difficulties with play and/or social skills if they have trouble interacting appropriately with others including; difficulty in taking turns, the inability to see and understand other peoples’ points of view and/or feelings, avoiding eye contact, difficulties making and keeping friendships and difficulty understanding jokes or puns.
Difficulties with play and/or social skills can lead to exclusion and isolation from peers as solid friendships are unable to be made and maintained without appropriate interactions.
The specific cause of play and social skills difficulties are unknown however, they are often accompanied by other conditions such as; autism, attention deficit disorders or other general language disorders.

A speech pathologist can assess your child’s play and/or social skills (with the assistance of parents/carers and teachers/educators) and identify any areas that require assistance. A therapy plan can then be created to address the difficulties. The speech pathologist can provide parents/carers with information regarding age-appropriate play and social skills and strategies and tips on how to best assist their child to practise their play and social skills at home/preschool/school between therapy sessions.

Voice

(quality & use)

Our voice is the sound we can hear when the vocal folds (or cords) come together and vibrate as air passes through them when we breathe out. We use our voice to speak and sing. Our voices can give information to others about our emotions, our personality and our physical and emotional health.

Your child may have difficulties with their voice if their voice sounds; hoarse, husky, strained, shaky or nasal, if they have difficulty projecting their voice, if the pitch of their voice sounds particularly high or low compared to others’ of the same age, they have the need to cough/clear the throat during and after talking or regularly lose their voice.
Difficulties with the voice can greatly affect a child’s ability to communicate effectively and can decrease self-confidence. Children may be reluctant to participate in classroom activities or social situations due to vocal difficulties.
A number of factors can contribute to voice disorders including; laryngitis, reflux, trauma to the vocal folds (from intubation or chemical exposure), overuse of the voice including excessive yelling or throat clearing, Parkinson’s disease, multiple sclerosis, stress, anxiety or depression.

A speech pathologist can assess your child’s voice and identify whether any problems are present. A therapy plan can then be created to address their vocal quality. The speech pathologist can provide parents/carers with knowledge on how to keep their child’s voice healthy, vocal exercises and strategies and tips on how to best assist their child to practise using a healthy voice at home between therapy sessions.

Feeding & Swallowing

(fussy feeders)

Feeding and swallowing are complex processes involving numerous muscles of the face and neck that we learn to master as we develop. Babies first learn to suck in order to get their nutrients and then move onto chewing and swallowing solid foods. Most children will have ‘fussy’ stages of eating/drinking however, if these stages continue over a long period of time they can compromise the child’s health.
Your child may have trouble with feeding and/or swallowing if they have difficulty; feeding from the breast or bottle, transitioning to solid foods, chewing, if they cough or gag when eating or drinking, if they avoid certain foods based on texture, temperature or colour, if they dribble excessively when eating and drinking or display anxiety at meal times.
Feeding and swallowing difficulties can limit the nutritional content a child is receiving which impacts on their overall growth and development. If a child has difficulty coordinating their chewing and swallowing, food and drink can enter their airway leading to aspiration (food/drink entering the lungs) and possible infection. Feeding difficulties can also lead to lengthy and challenging mealtimes.
A number of factors can impact on feeding and swallowing including; premature birth, heart defects or damage to the brain (e.g. cerebral palsy). Abnormalities in the structure of the head, face or neck may also contribute to difficulties with feeding or swallowing (e.g. cleft lip and palate).
A speech pathologist can assess your child’s feeding or swallowing to identify any difficulties and/or aversions. A therapy plan can then be created to address their difficulties. The speech pathologist can provide parents/carers with strategies and tips on how to best assist their child in strengthening facial and neck muscles involved in feeding and to explore and accept new foods.

Creating Confidence Through Communication

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