Pediatric Speech Therapy Process

AAC is short for Augmentative and Alternative Communication. Your child may use a communication device, system, or tool to replace or support their natural speech. These tools support children who have difficulties communicating using speech. This can range from sign language, pictures, communication boards, or a high-tech communication device.  

An articulation disorder is the distortion, substitution, or omission of a speech sound. When children cannot produce speech sounds within the typical developmental range, they can be difficult to understand. A child may have difficulty producing one or many sounds such as /k/, /s/, /r/ in isolation or when they put these sounds into words or sentences. 

The child knows what she or he wants to say, but her/his brain has difficulty coordinating the muscle movements necessary to say those words. Signs of motor speech disorder might be a baby that does not coo or babble. A toddler may only have a few sounds and/or demonstrates difficulty combining sounds. A child may make inconsistent errors,  they seem to understand language better than they can use language, and may have difficulty imitating longer words or phrases. 

A phonological process disorder is a form of speech disorder in which there is difficulty organizing the patterns of sounds in the brain, resulting in an inability to correctly form the sounds of words.  For example, this results in a child who may delete one or more sounds at the beginning of words (like “at” instead of “bat”). The child usually can produce the target sounds however uses them in the wrong place within the word or omits them from the word. 

Stuttering is characterized by speech behaviors that may consist of tense, effortful articulations that inhibit the natural flow of speech and may be associated with negative thoughts or feelings about talking. Stuttering affects individuals of all ages but typically begins in early childhood, usually between the ages of two and five (probability of recovery decreases sharply with age). There is no single cause of stuttering. 

Receptive language delay means that a child has trouble understanding language. This covers a wide variety of language skills and the child may have trouble with all of those skills, or just one or two. The child may have difficulty following directions, understanding questions, learning new concepts or vocabulary words, following time/spatial concepts, and having difficulty understanding feelings. 

Expressive language, is most simply the “output” of language, how a child expresses their wants and needs. Expressive language delay means that a child is having trouble using language in some way, shape, or form. This may mean the child has difficulty putting words together to form sentences, using the correct vocabulary word, sequencing information together in a logical manner. Children with expressive language disorder have difficulty conveying or expressing information in speech, writing, sign language, or gesture. These are usually “late” talkers. 

Voice disorder occurs when voice quality, pitch, and loudness differ or are inappropriate for an individual's age, gender, cultural background, or geographic location.  Children can develop voice problems from overusing their voices or from medical conditions. Less often, children may be born with a voice disorder. Voice problems can include vocal nodules, vocal cord dysfunction, vocal strain, or vocal cord paralysis. 

It is a disorder of the auditory (hearing) system that disrupts the way that an individual’s brain understands what they are hearing. It is not a form of hearing loss, despite showing difficulty with hearing-related tasks. A child with an auditory processing disorder can hear sounds, but their brain interprets these sounds atypically. Some of the most frequently reported symptoms of APD include: difficulty following multi-step directions that are presented verbally, without visual cues, difficulty reading, spelling, and/or writing when compared to their peers (performs consistently below grade level), and/or trouble following abstract thoughts or ideas.

A social communication disorder is a condition that makes it hard to talk with other people or use language in social situations. Children may have difficulty following the “rules” of spoken communication. This may be seen as a child takes over conversations, often interrupts, or says things that are off-topic or unrelated. Social communication disorders make it hard to connect with family members, people at school, sports/activities, or social settings. 

 The oral-motor aspect of eating involves how the mouth muscles function. This can be how strong the muscles are, coordination of motor movements, and range of motion for bolus manipulation. The oral-sensory aspect of eating involves how the mouth perceives sensory information such as the taste, temperature, and texture of food. Some children may be hypersensitive to oral stimuli, causing them to gag or have other strong reactions to certain types of food. Some children may be hypersensitive (under-responsive). The child may not feel food in their mouths and overstuff their mouths with food. Addressing feeding problems may be important for preventing or eliminating nutritional concerns, growth concerns including failure to thrive, unsafe swallowing which may lead to aspiration pneumonia, and future poor eating habits/attitudes.