In a recent parent-teacher conference, maybe the teacher expressed concern that
your child could 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 find out if your child is having problems. Speech-language therapy is
the treatment for most kids with speech and/or language disorders.
Speech Disorders, Language Disorders, and Feeding Disorders
A speech disorder refers to a problem with the actual production of sounds. A language
disorder refers to a problem understanding or putting words together to communicate
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
Fluency disorders: problems such as stuttering,
in which the flow of speech is interrupted by abnormal stoppages, partial-word repetitions
("b-b-boy"), or prolonging sounds and syllables (sssssnake).
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.
Language disorders can be either receptive or expressive:
Receptive disorders: difficulties understanding or processing
Expressive disorders: difficulty putting words together, limited
vocabulary, or inability to use language in a socially appropriate way.
Cognitive-communication disorders: difficulty with communication
skills that involve memory, attention, perception, organization, regulation, and problem
Dysphagia/oral feeding disorders are disorders in the way someone
eats or drinks, including problems with chewing, swallowing, coughing, gagging, and
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
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.
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
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 vocabulary
and grammar and use repetition exercises to build language skills.
Articulation therapy: Articulation, or sound production, exercises
involve having the therapist model correct sounds and syllables in words and sentences
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 may use a
variety of oral exercises — including facial massage and various tongue,
lip, and jaw exercises — to strengthen the muscles of the mouth for eating,
drinking, and swallowing. The SLP may also introduce 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, but
not limited to:
cognitive (intellectual, thinking) or other developmental delays
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
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 an ASHA-accredited supervised
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
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