In a recent parent-teacher conference, the teacher expressed concern that your child may have a problem with certain speech or language skills. Or perhaps while talking to your child, you noticed an occasional stutter.

Could your child have a problem? And if so, what should you do?

It's wise to intervene quickly. An evaluation by a certified speech-language pathologist can help determine if your child is having difficulties. Speech-language therapy is the treatment for most kids with speech and/or language disorders.

Speech Disorders and Language Disorders

A speech disorder refers to a problem with the actual production of sounds, whereas a language disorder refers to a difficulty understanding or putting words together to communicate ideas.

Speech disorders include:

• Articulation disorders: difficulties producing sounds in syllables or saying words incorrectly to the point that listeners can't understand what's being said.
• Fluency disorders: problems such as stuttering, in which the flow of speech is interrupted by abnormal stoppages, repetitions (st-st-stuttering), or prolonging sounds and syllables (ssssstuttering).
• Resonance or voice disorders: problems with the pitch, volume, or quality of the voice that distract listeners from what's being said. These types of disorders may also cause pain or discomfort for a child when speaking.
• Dysphagia/oral feeding disorders: these include difficulties with drooling, eating, and swallowing.

Language disorders can be either receptive or expressive:

• Receptive disorders: difficulties understanding or processing language.
• Expressive disorders: difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.

Specialists in Speech-Language Therapy

Speech-language pathologists (SLPs), often informally known as speech therapists, are professionals educated in the study of human communication, its development, and its disorders. They hold at least a master's degree and state certification/licensure in the field, and a certificate of clinical competency from the American Speech-Language-Hearing Association (ASHA).

SLPs assess speech, language, cognitive-communication, and oral/feeding/swallowing skills to identify types of communication problems (articulation; fluency; voice; receptive and expressive language disorders, etc.) and the best way to treat them.

Remediation

In speech-language therapy, an SLP will work with a child one-on-one, in a small group, or directly in a classroom to overcome difficulties involved with a specific disorder.

Therapists use a variety of strategies, including:

• Language intervention activities: The SLP will interact with a child by playing and talking, using pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct pronunciation and use repetition exercises to build speech and language skills.
• Articulation therapy: Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables for a child, often during play activities. The level of play is age-appropriate and related to the child's specific needs. The SLP will physically show the child how to make certain sounds, such as the "r" sound, and may demonstrate how to move the tongue to produce specific sounds.
• Oral-motor/feeding and swallowing therapy: The SLP will use a variety of oral exercises — including facial massage and various tongue, lip, and jaw exercises — to strengthen the muscles of the mouth. The SLP also may work with different food textures and temperatures to increase a child's oral awareness during eating and swallowing.

When Is Therapy Needed?

Kids might need speech-language therapy for a variety of reasons, including:

• hearing impairments
• cognitive (intellectual, thinking) or other developmental delays
• weak oral muscles
• excessive drooling
• chronic hoarseness
• birth defects such as cleft lip or cleft palate
• autism
• motor planning problems
• respiratory problems (breathing disorders)
• feeding and swallowing disorders
• traumatic brain injury

Therapy should begin as soon as possible. Children enrolled in therapy early (before they're 5 years old) tend to have better outcomes than those who begin therapy later.

This does not mean that older kids can't make progress in therapy; they may progress at a slower rate because they often have learned patterns that need to be changed.

Finding a Therapist

It's important to make sure that the speech-language therapist is certified by ASHA. That certification means the SLP has at least a master's degree in the field and has passed a national examination and successfully completed a supervised clinical fellowship.

Sometimes, speech assistants (who usually have a 2-year associate's or 4-year bachelor's degree) may assist with speech-language services under the supervision of ASHA-certified SLPs. Your child's SLP should be licensed in your state and have experience working with kids and your child's specific disorder.

You might find a specialist by asking your child's doctor or teacher for a referral or by checking local directories online or in your telephone book. State associations for speech-language pathology and audiology also maintain listings of licensed and certified therapists.

Helping Your Child

Speech-language experts agree that parental involvement is crucial to the success of a child's progress in speech or language therapy.

Parents are an extremely important part of their child's therapy program and help determine whether it is a success. Kids who complete the program quickest and with the longest-lasting results are those whose parents have been involved.

Ask the therapist for suggestions on how you can help your child. For instance, it's important to help your child do the at-home stimulation activities that the SLP suggests to ensure continued progress and carry-over of newly learned skills.

The process of overcoming a speech or language disorder can take some time and effort, so it's important that all family members be patient and understanding with the child.

Reviewed by: Amy Nelson, MA, CCC-SLP
Date reviewed: July 2011