Speech therapy is an intervention service that focuses on improving a child's speech and abilities to understand and express language, including nonverbal language. Speech therapists, or speech and language pathologists (SLPs), are the professionals who provide these services. Speech therapy includes two components: 1) coordinating the mouth to produce sounds to form words and sentences (to address articulation, fluency, and voice volume regulation); and 2) understanding and expressing language (to address the use of language through written, pictorial, body, and sign forms, and the use of language through alternative communication systems such as social media, computers, and iPads). In addition, the role of SLPs in treating swallowing disorders has broadened to include all aspects of feeding.
Some children may have excellent pronunciation and may even be early readers, but they may need speech therapy to improve "pragmatic" language, or the process of using verbal and body language appropriately in social situations for everyday purposes such as making requests, having conversations, and making friends. Other reasons children may need speech therapy include medical conditions such as a brain injury or infection that has affected their ability to communicate and an identifiable disability such as Down syndrome. Services often begin at a young age and continue as children enter school and start to communicate with written language.
An SLP may identify a language-based learning disability in students who struggle to read and express themselves in written work. "Language difficulties can have a major impact on a child's ability to write," says Kathy Oehler, a speech-language pathologist in Carmel, Indiana, and co-author of I Hate to Write. "In order to write, children must be able to put their ideas into words and organize those words into sentences. Also, language challenges make it hard for children to understand and follow directions. The SLP can help build these skills." To provide direct treatment, SLPs perform evaluations and consult with teachers to create language-rich classrooms. Therapy may be individual or include a small group of peers who face similar social and communication challenges. In either situation, the goal is to make language fun, develop friendships, and enable students to succeed in school.
"Speech and language pathologists not only assess and treat for articulation, language and cognitive difficulties, but some also focus on swallowing and feeding," says Melanie Potock, an SLP and author of Happy Mealtimes with Happy Kids. According to Potock, "It's not uncommon for children who have trouble talking to also have feeding challenges. While children with special needs may be the first to come to mind, it's not unusual for other kids to have both speech and feeding difficulties. Both speech and eating involve the fine motor aspects of moving the tongue, jaw, and lips in a coordinated fashion, and that's not always easy to do!"
The SLP might bring out some blow toys and whistles and have "blow the cotton ball" relay races to strengthen muscles used in speech and eating. Using crazy straws, a toothbrush that makes music, and blowing bubbles might also be fun strategies to help children tolerate different sensations in their mouths.
Speech and language pathologists work with children who have difficulty reading the cues from the social world, interpreting others, and using words and body language to communicate effectively and develop friendships. "The pragmatics part of communication and language deals with issues related to social communication; which includes, but is not limited to social language," say Michelle Garcia Winner, M.A., and Pamela J Crooke, Ph.D., SLPS and co-authors of Socially Curious and Curiously Social. According to the authors, "Attending to social information to process and respond to nonverbal cues provided by the context, people, and their language is difficult for students with social learning challenges -- autism spectrum disorders, non-verbal learning disability, speech language impairment, ADHD, etc." These students may benefit from a treatment philosophy called Social Thinking (socialthinking.com) that teaches about the relationship between how we think and behave and how others respond to us.
Children who, for a variety of reasons are unable to speak, need alternative communication methods. Early intervention and preschool SLPs teach children (and their parents) how pictures and simple sign language enable them to communicate their needs.
School-aged children may be able to use computers or iPads to communicate through text or a voice synthesizer. According to Lois Brady, author of Apps for Autism, touch screen technology such as the iPad has made it possible for students to communicate and meet their individual goals using the same super-cool device that their classmates use. Furthermore, speech therapists are able to use the same device to teach speech and language skills through engagement and motivation.
SLPs are readily available in public schools to evaluate and provide treatment. Parents may opt for private speech therapy offered in a clinical setting or have their child join a social skills training group. Ask the school guidance counselor or family physician to recommend a program with children of similar ages and developmental needs to your child's. The American Speech-Language-Hearing Association's (ASHA) website provides information about what ages children typically develop language skills. This information helps parents who suspect that their child has a language delay understand when to seek professional help. The ASHA site (Asha.org/proserv) also provides an online directory of programs that employ certified SLPs.
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