• Do Speech-Language Pathologists treat Dyslexia?
• What is a speech-language screening?
• What is a hearing screening?
• What if my 2 year old isn't talking?
• Do ear infections affect speech and language development?
• What does reading have to do with language?
• What is Occupational Therapy (OT)?
• What is Pediatric Occupational Therapy?
• What is Sensory Integration (SI)?
• How does an OT use SI treatment?
• What are some signs that my child may have a Sensory Processing Disorder (SPD)?
• Will my child "grow out" of these problems by himself?
• My preschooler is stuttering. Is this a problem?
• What are the signs of a "problem voice"?
• What is Auditory-Verbal Therapy?
• My child has trouble pronouncing some of his sounds? Should I be concerned?
• What are some "warning signs" that my child's articulation skills (speech sound productions) may be delayed or disordered?
• Can I help my child correct his sound errors?
• How long will therapy take to correct my child's articulation errors?
• My child has already gone through extensive testing with a psychologist. Why is another evaluation necessary at Abilities?

Frequently Asked Questions

Q: Do Speech-Language Pathologists treat Dyslexia?

A: Basically, Dyslexia is a language-based reading disorder. It begins as an auditory processing disorder in which a child with normal hearing is easily confused by the sounds of the language. This confusion carries over into the blending of sounds into syllables and then into words. The opposite process of breaking words into parts (syllables and sounds) is also affected. When printed letters are matched to the sounds, the confusion worsens. The weak auditory system leads to difficulty processing the meaning of spoken language. Vocabulary, grammar and sentence meanings are not acquired as expected. When we attempt to build the complex tasks of reading, spelling and comprehension on top of this unsteady foundation of auditory and oral language skills, dyslexia is often the result. Speech-language pathologists build the foundation for language and help transition language into reading and writing.

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Q: What is a speech-language screening?

A: A screening is a quick measure to determine if there is a communication problem which needs further evaluation or if communication skills are within the normal range for a person's age.

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Q: What is a hearing screening?

A: A hearing screening determines if hearing is within the normal range and often includes a measure, called impedance testing or tympanometry, to determine pressure behind the eardrum. This determines if your child has middle ear fluid.

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Q: What if my 2 year old isn't talking?

A: By 24 months of age, many children use 50 or more spoken words, which they may combine to form short phrases. This however, is not always the case. There is a great deal of variety in language development at this age, with some children using more spoken words and some using far less. Generally, 2 year olds communicate much of what they want through a combination of gestures, sounds or single words. If only for peace of mind, anyone concerned about their child's speech or language development should contact a licensed speech-language pathologist (SLP) certified by the American Speech and Hearing Association (ASHA). An SLP compares the child's language to that of other children his age. If there is cause for concern, communication intervention at a early age is crucial.

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Q: Do ear infections affect speech and language development?

A: When a child has a middle-ear infection, fluid accumulates in the middle ear. This fluid build up causes a temporary hearing loss. If these infections become frequent or if the fluid build up becomes a long standing problem without an active infection, these children have a higher incidence of speech and language disorders. If a child is having to deal with fluctuating hearing loss at the same time he or she is learning to speak, it makes sense that he or she may have some difficulty. Even a mild hearing loss, as little as 20dB, which would not be detected by a screening, can cause a child not to hear high-frequency sounds ( such as f,z,s,sh,ch), some word endings (such as the plural "s" and past tense "ed") and some word final consonants ( such as the t in cat). Small words within sentences ( such as "and" and "is") may also be missed. These effects become even more pronounced in noisy environments ( such as preschool classrooms during free play). Hearing screenings or evaluation are appropriate in cases of longstanding ear infections or whenever symptoms of hearing loss are observed by parents or other caregivers. If a child's speech is difficult to understand due to sound errors, a referral to a speech pathologist is appropriate. Remember, these children are at a higher risk for articulation disorders. If other speech or language concerns are observed, the speech pathologist should be consulted.

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Q: What does reading have to do with language?

A: Reading is a complex activity, which is highly dependent on our learning ability, experience with print, knowledge of the world and overall language ability. Learning to read begins during the preschool years as parents read to their children. It continues throughout life. Even as adults, we continue to refine our reading ability.

The child who is having difficulty reading or learning to read may not have a solid foundation in his/her language ability. A child's development of understanding language (receptive) or using language to express himself ( expressive) form the basis for leaning to read and write. This includes vocabulary, grammar, word and sentence meaning. The ability to comprehend spoken stories as well as to organize and formulate ideas in order to tell stories are also important aspects of language. Without a firm language foundation, a child may experience academic problems, especially in the areas of reading, spelling and writing.

Effective treatment methods are available. The first step is a reading-language evaluation conducted by a licensed and certified speech-language pathologist. This can determine the extent to which language and reading skills are delayed, as well as identify areas of strengths and weaknesses. A treatment plan can then be made to address the breakdowns between language, reading dynamics and comprehension. When reading and writing skills need a boost, look beyond the symptoms to a cause in order to promote improved language skills for a lifetime of reading success and enjoyment.

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Q: What is Occupational Therapy (OT)?

A: OT is a health and rehabilitation profession designed to help people regain and build skills that are important for health, well-being, security, and happiness. OT's work with people of all ages who, because of physical, developmental, social, or emotional deficits, need specialized assistance in learning skills to enable them to lead productive, independent, and satisfying lives. Through the use of therapeutic activities, OT's help individuals to engage and participate in life activities, or occupations.

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Q: What is Pediatric Occupational Therapy?

A: The primary occupation of children is play. Through play, children learn the foundation of skills necessary for success in school, among peers, and in activities of daily living. Play involves exploring/interacting with their environment, people, objects, and toys. As children grow older, they also take on the role of the student. As a student, the child is responsible for academic skills such as writing, drawing, cutting with scissors, and paying attention. If a child demonstrates weakness or inability in one or more of these areas, he/she could benefit from Occupational Therapy. Occupational Therapists are also trained to help children who have impaired self-care skills (dressing, eating, toileting), motor skills (fine or gross motor skills, balance, coordination), sensory integration concerns, etc.

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Q: What is Sensory Integration (SI)?

A: Every day we receive a great deal of information from our senses. We use this information to organize our behavior and to successfully interact with our environment. Our brains must organize this information so that we may function in everyday situations, such as the classroom, at home. On the playground, etc. Other than the common senses (sight, touch, taste, hearing) our bodies also receive input from our vestibular system (balance and movement) and proprioceptive system (muscle and joint sense). When the process of SI is disordered, problems in learning, motor development, or behavior may be observed.

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Q: How does an OT use SI treatment?

A: An OT utilizing an SI approach would focus on providing a controlled amount of sensory input during specific age-appropriate activities. The ultimate goal is to assist the child in participating in important daily life tasks and activities as independently as possible. To do this, the therapist designs an environment to enable the child to interact more effectively. The therapist encourages and assists the child in choosing activities that provide the appropriate amount of sensory input. The child is guided through activities that challenge his ability to respond appropriately to sensory input by making a successful, organized response. With SI treatment, the child is given as much control over therapy as he can handle, as long as the activity is therapeutic. AS a result, self-confidence is often the first change parents notice in their children after they begin therapy. The child becomes more in control of his life because he develops better control of his body as his nervous system functions more effectively.

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Q: What are some signs that my child may have a Sensory Processing Disorder (SPD)?

A: A few signs of Disordesr of Sensory Integration include:

• overly sensitive to touch, movement, sights, sounds
• easily distracted
• unusually high or low activity level
• impulsive, lacking in self-control
• under-reactive to touch, movement, sights, sounds
• social/emotional problems
• physical clumsiness or apparent carelessness
• difficulty transitioning from one situation to another
• speech, language, motor delays
• academic achievement delays

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Q: Will my child "grow out" of these problems by himself?

A: If a child has a Sensory Integrative problem, he will not "grow out of it." When the child presents with a Disorder of Sensory Integration, it is necessary to address these issues in all contexts of the child's life in order to assist that child with acquisition of essential developmental skills. If the child's problems are ignored, he will continue to struggle in all his efforts leading to poor skill development, frustration and low self-esteem. With practice and effort, he may learn "splinter skills" that compensate for poor sensory processing, covering up the problem. An example of a "splinter skill" is the ability to play a particular song on the piano without having the general ability to play the piano. When a child has to rely on his own resources, he may use these "splinter skills" for many of the tasks he performs daily; however, he will do so with increased effort. For children with Disorders of Sensory Integration, it is imperative that they receive consistent occupational therapy services in order to teach the brain how to work in a more integrated way.

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Q: My preschooler is stuttering. Is this a problem?

A: Some stuttering behavior is typical in preschoolers. These are usually referred to as linguistic non-fluencies. They usually occur when the child is trying to formulate their ideas into words and phrases and can't seem to get the words in order. Very often in conversation, a child loses their conversational turn if they pause and are quiet for a few seconds. Rather than have silence, a child will often repeat a phrase to "buy time" until they come up with the next phrase. These linguistic non-fluencies are a typical part of development. True stuttering has some marked characteristics that differentiate it from typical linguistic non-fluencies. The child will repeat one word or part of a word rather than an entire phrase. Also, the child may become blocked and though they seem to be pushing, they are unable to get a sound out. They may avoid eye-contact or become frustrated when they stutter. If you are concerned that your child may be truly stuttering, then an evaluation by a speech-language pathologist is recommended. There are techniques that can be used with young children to improve their fluency and reduce their frustration.

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Q: What are the signs of a "problem voice"?

A: A voice disorder is when the pitch, loudness, or quality of a person's voice calls attention to itself. The speaker may also experience discomfort or pain when speaking. If you or your child have hoarseness, vocal changes, or discomfort that lasts for more than 10 days in the absence of a cold or allergy, you should have an examination by a medical doctor. This examination may help you decide if you need further medical assistance. The most common cause of a voice disorder is the presence of vocal nodules, commonly caused by vocal misuse or abuse. Types of vocal misuses include talking too loudly or screaming, using a pitch that is unnatural, constant throat clearing or coughing. Many voice disorders can be remediated with the help of a speech-language pathologist. Some voice disorders will require the combined approach of medical or surgical treatment AND voice therapy conducted by a speech-language pathologist.

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Q: What is Auditory-Verbal Therapy?

A: The Auditory-Verbal Philosophy is for people who are deaf or hard of hearing and their families. The primary goal of Auditory-Verbal Therapy is for children who are deaf or hard of hearing to learn to listen and talk, attend their regular school and to become active, contributing, independent members of society. Auditory-Verbal Therapy sessions are conducted in a parent participation format so parents are given the goals, as well as, guidance and information on how to integrate the child's goals into their daily lives. For more information and a list of the guiding principles of Auditory-Verbal Therapy, please see the Auditory-Verbal section under therapies on this website.

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Q: My child has trouble pronouncing some of his sounds? Should I be concerned?

A: There is an expected developmental sequence to the development of correct sound productions. A baby's first words are usually limited to a few favorite consonant and vowel sounds, such as /p, b, m, n/. Rapid speech development occurs between 18-36 months, and sounds are mastered gradually during this time. By 3, your child should be well on the way to mastering most vowel sounds and these consonants: /n, m, p, h, f, w, t, k, d, g, b, ng/. Between the ages of 3 and 4, children begin correcting the /l, r, sh, ch, y, v, z, s, j, th/ sounds. Many of these sounds (such as r and th) will take several years to fully develop. Children will continue to use some "tricks" to simplify hard-to-pronounce words, but these should be used less and less. If your child is not mastering sounds at this general rate or if your child's articulation calls attention to itself, it would be best to talk with a speech pathologist about your concerns.

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Q: What are some "warning signs" that my child's articulation skills (speech sound productions) may be delayed or disordered?

A: In addition to the above listed stages of sound development, here are "warning signs" that your child's articulation skills may be delayed or disordered:

• Your child's speech calls attention to itself, so that other adults or children comment on his or her speech.
• You have to "interpret" your child's speech before other people can understand him or her.
• Your child shows frustration with his or her unsuccessful attempts to communicate. He may even "give up" when you do not understand his speech.
• When your child shows embarrassment about his or her speech.

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Q: Can I help my child correct his sound errors?

A: If you are concerned about your child's articulation skills, the best advice is to seek help from a speech pathologist. A speech pathologist is aware of appropriate speech development for children according to age expectations. Her training also equips her to determine if there are any underlying problems (such as oral-motor weaknesses) contributing to his articulation problems. Without appropriate techniques, you may increase your child's frustration and compound his errors. However, if it is determined that your child is having difficulty with his articulation skills that require speech therapy, the speech pathologist will show you ways to practice with your child at home. Your involvement with home practice will greatly enhance your child's progress in therapy.

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Q: How long will therapy take to correct my child's articulation errors?

A: This is an often-asked question, with no set answer. The duration of therapy varies from child to child, and depends on many variables. The severity of the articulation problems will have the biggest influence on the duration of therapy. Some children have a few errors with no oral motor weaknesses. These children usually complete therapy more quickly than others with more significant difficulties. Some children have multiple errors, errors that are more difficult to correct, and/or oral motor weaknesses. Therapy for these children will obviously be longer. Another variable is called "carry-over." Some children are able to quickly "carry-over" their corrected speech sounds into their everyday speech, whereas other children have a more difficult time with this task. A third variable is home involvement. Parents who are consistent with bringing their child to therapy and completing their home practice play an important role in "speeding up" therapy! So... to answer the question, how long will therapy take to correct MY child's articulation errors? It depends... Articulation therapy can be as quick as 6 months or as long as several years! After an evaluation and a brief period of therapy, your child's speech pathologist should be able to address this question more specifically.

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Q: My child has already gone through extensive testing with a psychologist. Why is another evaluation necessary at Abilities?

A: The evaluation that will be conducted at Abilities should not be considered "another" evaluation. Rather, it is a specialized extension, a more in-depth assessment of the areas of need that may have been identified as primary deficit areas by the psycho-educational evaluation. The information received from the psychologist may provide your therapist with invaluable information about your child's general intellectual ability, academic achievement, attention, and skill areas.

A speech-language evaluation will explore the child's awareness of language meaning, vocabulary, verbal concepts, and the "content" of communication. It will asses his or her ability to understand and express a variety of language structures, including sound-level variations, word choices, and sentence types, or the "form" of language. A speech-language evaluation will determine how your child interacts with his environment, or expresses his needs or ideas, or the "use" of language. The evaluation documents your child's current level of performance, identifies strengths and weaknesses, and provides critical information to assist us in recommending and planning the most appropriate course for intervention. IN addition, the evaluation will establish a baseline of performance by which we can measure your child's progress. Finally, the evaluation may result in a diagnosis that may affect determination of insurance benefits.

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