Speech-Language-Swallowing Therapy
Evaluation and treatment of delays and disorders in the areas of articulation (speech sound development) and Language (using words to communicate), as well as oral motor disorders that affect feeding and swallowing.
Speech-Language Therapy
Your child may need speech therapy if he or she has difficulty pronouncing sounds in words (speech/articulation) or has difficulty using words to communicate (language). Because the muscles and structures used for speech (lips, tongue, teeth, palate and throat) are also used in eating, a speech therapists (SLP) may also be needed to address feeding and swallowing difficulties (dysphagia).
Children who have developmental delays or special needs often need help to improve their language, speech, and communication skills. Children who cannot express their wants and needs can become frustrated and turn to inappropriate behaviors (hitting, biting, crying, throwing objects, temper tantrums, etc.). A speech-language pathologist (SLP) can help a child to become a successful communicator by working on:
Articulation: An SLP can help your child learn to produce sounds correctly so he or she can be clearly understood by others. Articulation problems can arise from muscle incoordination or structural (i.e. cleft palate) problem in the lips, tongue, and palate. Articulation difficulties can also be caused by motor planning and sequencing problem (apraxia of speech). In this case, the speech muscles do not get the proper signal from the brain to produce speech and do not work in the correct order. Articulation difficulties can be very frustrating for the child because they know exactly what they want to say. They just cannot say it.
Language: The SLP can help your child learn how to produce (expressive language) and understand (receptive language) spoken language. Language consists of vocabulary, grammar and sentence structure, and pragmatics. Pragmatics is the way that language is used. It includes the unspoken rules of language such as taking turns in a conversation, eye contact, and social interaction. Children with autism have difficulty with using language in a social context. Children who are typically developing are able to learn these unspoken rules easily. Children who have delays or developmental disabilities, however, often have a more difficulty learning the rules of language and how to use them.
Hearing Impairment: Because hearing is part of learning how to speak, children with hearing loss often have speech and language delays. In the past, sign language was the primary option for a hearing impaired person. However, with the advancement of hearing technology (hearing aids and cochlear implants), children with hearing impairment can learn to listen and speak with auditory-verbal therapy provided by a speech-language pathologist. “The Earlier, the Better” is the motto for successful communication for children with hearing impairment.
Stuttering: While it is normal for preschoolers who are acquiring language to repeat some words and syllables, atypical dysfluencies (stuttering) are disruptions in speech that make a child struggle to speak smoothly. Stuttering can range from mild to severe and can include part- and whole-word repetitions, sound repetitions, and silent “blocks”. Secondary characteristics can include eye blinking, lip tremors, tongue clicking, arm/hand flapping, avoidance behaviors, etc. Fluency techniques are taught by a speech-language pathologist to help the child speak more smoothly. For severe cases of stuttering in children over the age of 7, the child may also benefit from an assistive device called a SpeechEasy paired with traditional therapy.
Voice disorders: Children who have frequent laryngitis or hoarseness may be using vocally abusive behaviors such as yelling, talking too loud, or talking at a pitch that is not appropriate for their voice. These behaviors can damage the vocal chords causing vocal chord nodules or other voice disorders. The SLP can help the child learn to speak with good vocal hygiene through various strategies and behavior modifications.
Augmentative and Alternative Communication: For children that are unable to talk, the SLP can assist in finding an alternative means of communication that will work best for the child and family. (ie. sign language, assistive communication devices, etc.) The SLP works with an Occupational and a Physical Therapist, when needed, to be sure the child has the fine motor and visual skills and appropriate seating and positioning for use of the assistive device.
Having a child with a communication delay or disorder can be frustrating for the child and for the parent. A speech-language pathologist can help you increase your child’s communication skills and provide environmental adaptations to help facilitate successful communication. There are many things that parents and family members can do to help children grow and learn; your speech-language pathologist will help teach you what you can do to help your child acquire the skills that he or she needs. Working together can help your child succeed in communicating. If you are unsure about the rate your child is developing speech and language skills, you should contact your pediatrician or a certified speech-language pathologist to assess your child’s abilities.
Speech-Language Pathologist
Because the muscles and structures used for speech (lips, tongue, teeth, palate and throat) are also used in eating, a speech-language pathologist (SLP) may be needed to address feeding and swallowing difficulties (dysphagia). SLPs have specialty training in the assessment and treatment of dysphagia, and understand the anatomy and physiology of the swallowing mechanism. Feeding problems can be structural, functional, medical or behavioral/emotional.
Structural feeding problems such as a cleft palate or lip, or tracheoesphageal fistula (hole between the airway and the esophagus) can make eating very difficult for the child. Functional feeding problems such as weak suck reflex in premature babies or weak oral muscle tone can keep the baby or child from getting adequate nutrition. These children may have difficulty managing food, may be at risk for choking, and may aspirate food or liquid into the airway. Medical feeding problems such as gastroesphageal reflux can cause pain or discomfort after eating. In this case, the child may refuse to eat to avoid the pain. Once the reflux is resolved with the use of medication, the child may continue to have negative association with eating which leads to behavioral feeding problems.
Many children who have negative experiences around feeding due to structural, functional, or medical difficulties, will often develop behavioral feeding problems. Children who have undergone several medical procedures and surgeries from birth can become very defensive when a parent tries to feed them. Spoons, cups, and food appear threatening to these children. These children refuse anything offered by mouth and often do not mouth toys as young babies and children typically do.
For children who have been tube-fed from very early on due to medical/nutritional reasons, transitioning from tube feeding to feeding by mouth can take some time. These children have not been able to experience the tastes and textures of food in their mouths. Because of this, they can also be very defensive about trying foods and liquids. For children who are tube-fed, getting a speech-language pathologist involved from the beginning is key. The SLP can assist the parent or caregiver in providing oral stimulation along with each tube feeding. Providing oral stimulation and allowing experimentation with foods during the tube feeding will help the child to associate the feeling of satiation and fullness with oral stimulation. This will help to prevent the defensiveness that will occur if the child never experiences oral stimulation as typical feeders do.
All feeding problems should first be addressed by your child’s physician. Once the structural, functional and medical aspects of the feeding problem have been addressed, the Speech-Language Pathologist will work with the team of professionals treating your child to help your child become a functional, oral feeder. These professionals may include an occupational therapist, nutritionist, gastroenterologist, behavioral psychologist or other medical professional.
If your child has feeding and swallowing difficulties, a Speech-Language Pathologist can help to make meal time fun and functional for your child and your family.
