Home When to Take Your Child to the SLP Taking Your Child to the SLP The services that speech-language pathologists provide are not just limited to the pronunciation of sounds and stuttering. Speech pathologists can help children express ideas, communicate in ways other than speaking, organize thought, pay attention, and even learn to accept a broader range of foods. You may not realize that many of the most common childhood disabilities are helped by speech pathology, even ones that are not traditionally thought of as speech and language disorders. This guide will take you through disorders for which speech, language, or communication issues are a component and offer resources that you can use to educate yourself on how speech therapy can help your child. What condition are you interested in learning more about? ADHD Apraxia Autism Brain Injury (Dysarthria/Apraxia) Cerebral Palsy Down Syndrome Feeding and Swallowing Disorders Language Disorders Learning Disabilities Selective Mutism Stuttering Tongue Thrusting Getting a Diagnosis Where Speech Therapy Takes Place ADHD A speech pathologist can help with the learning and social needs that often affect a child with ADHD. According to ASHA, SLPs can help with executive function so that your child can plan better and organize his or her thoughts. They can also work on attention and other social skills. School SLPs can work with your child and her teachers in the classroom to make sure she is best setup for success. Making sure a child sits in the front of the room or keeps checklists of assignments can help keep them focused and on track- an SLP often takes on the role of identifying and implementing these changes. Signs of ADHD ASHA notes that the following may be signs of ADHD: Attentiveness- Children with ADHD have trouble paying attention and may have difficulty listening, concentrating, focusing, planning, and learning new things. Hyperactivity- May have trouble doing one task for a long period of time, fidgit, and frequently try to multitask Impulsiveness Further Reading American Speech-Language-Hearing Association (ASHA) Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) ADDitude Magazine Apraxia ASHA describes Apraxia as a difficulty speaking due to motor skill issues, where messages do not effectively get from the brain to the mouth. Children with apraxia know exactly what they want to say and are just not able to say it. With childhood apraxia, treatment is a necessary means to improvement and often involves 3-5 weekly sessions with an SLP, where your child will learn how to make the proper movements to speak. Physical, visual, and other sensory cues can help your child learn the movements involved in individual sounds so that they can gain the ability to to make those sounds. Signs of Apraxia According to ASHA, a child with apraxia may: Not babble as an infant Delay first words Pause between words Says words in different way Only says a few sounds Have trouble eating Further Reading ASHA Apraxia Kids The Cherab Foundation Autism Speech-language pathologists can work with autistic students on social and communication skills by helping them understand gestures, pay attention to others, ask questions, initiate conversation, and more. Speech pathologists will help with reading and writing as well as speaking. With more severe cases of autism, the SLP can teach you and your child to use augmentative and alternative communication (AAC) that can open up his ability to express himself. SLPs can even help your child become comfortable with a wider range of food options, as his senses may often limit what tastes or feels comfortable to eat. Some professors are researching novel interventions that can better fit the needs of autistic children, such as Dr. Angela Losardo’s study on theatre as an intervention. Signs of Autism Mentioned by ASHA Include Social Skills- Trouble with joint attention, playing with others, and understanding the feelings of others Communication- Trouble having conversations, using and understanding words or gestures, and reading and writing. Tantrums Limited food preferences Spinning, rocking, and flapping of the arms Few interests or significant focus on few topics Sensitivity to some sounds Further Reading ASHA Autism Speaks Parents’ Wishlist Brain Damage and Injury: Dysarthria and Aphasia Dysarthria ASHA defines Dysarthria is a weakness of the muscles used to speak that makes speaking difficult. It is caused by brain damage which is why it can often happen in children who have other brain injury related speech issues such as aphasia. Speech pathologists can work with your child to slow speech, amplify voice, strengthen mouth muscles, and speak clearer. In more severe cases, the SLP can educate you and your child on how to use AAC. ASHA’s Signs of Dysarthria Fast, slow, slurred, or soft speech Difficulty moving mouth and tongue Robotic, breathy, or stuffy sounding voice Aphasia Aphasia affects attention, memory, and language depending on what part of the brain has damage (ASHA). Speech pathologists can help with each of these aspects so that your child can better understand, speak, read, and write. SLPs can help improve language and assist in finding ways to work around the aphasia. You may have a child that could benefit from AAC, which your SLP will help with as well. Signs of Aphasia ASHA notes the following signs of aphasia: Using the wrong word or not being able to think of a work at all Switching sounds Difficulty with whole sentences Made up words Trouble understanding others and jokes, especially in noisy situations or when speech is fast Trouble reading, spelling, or doing math Further Reading ASHA’s Aphasia and Dysarthria Pages Brain Injury Association of America Aphasia.org Cerebral Palsy Children with cerebral palsy can have a variety of speech issues, including aphasia, fluency issues, swallowing issues, dysarthria, articulation disorders, and voice disorders (ASHA). Language and communication can also be affected by cerebral palsy. These specific issues vary by case and are further broken down throughout this guide. An SLP can work on each of these issues. They can introduce AAC so that they can better communicate if verbal communication is limited. If the ability to swallow is limited, the SLP can also help your child with her dysphasia. Signs of Cerebral Palsy Cerebral Palsy Guide outlines signs of cerebral palsy, which fall in the following categories: Physical difficulties Missing cognitive, social, and emotional developmental milestones This diagnosis is typically given very early, up to several months old Further Reading Cerebral Palsy Guide Cerebral Palsy Group United Cerebral Palsy Cerebral Palsy Guidance Down Syndrome According to the National Down Syndrome Society, the fluctuating hearing loss that many young children with Down syndrome experience can impact speech and communication at a young age. The muscles that contribute to speaking are also weaker in these children. Because of this, most children with Down syndrome qualify for government sponsored early intervention speech and language services. Many children with Down syndrome are actually ready to communicate before they can speak, so AAC can help them communicate as speech continues to develop. If you have a adolescent child with Down syndrome, SLPs can help with grammar, verb use, pragmatics and oral motor skills, which are common areas of difficulty. Diagnosis of Down syndrome typically occurs during pregnancy. Further Reading National Down Syndrome Society Down Syndrome Aim High Resource Center Feeding and Swallowing Disorders ASHA notes that difficulty feeding and swallowing as a child can result in malnutrition, aversion to food, regurgitation, gastrointestinal issues, dehydration, and more. If your child has difficulty eating or swallowing, an SLP or doctor can diagnose the issue and help the child according to his or her needs. These disorders vary tremendously- from mild swallowing issues to needing a feeding tube to eat. Signs of Feeding or Swallowing Disorder Mentioned by ASHA Include Vomiting Only taking small amounts of food Breathing difficulty Back arching Coughing and choking Difficulty swallowing and chewing Gagging Crying when it is time to eat Refusing certain foods Inability to keep saliva or food in mouth Further Reading ASHA Cincinnati Children’s Hospital Language Disorders According to ASHA, Language disorders can be receptive and/or expressive (trouble understanding what others are saying or trouble expressing one’s own ideas). If your child has a language disorder, a speech pathologist can work with him to improve understanding of what others are trying to communicate as well as his own ability to express himself through speech, reading, and writing. Treatment delivery will vary greatly from patient to patient, as cases can differ in many ways. Language disorders are a common facet of many other disabilities, including autism, ADHD, and developmental disabilities. Signs of Language Disorders There are many possible signs, depending on the language disorder. ASHA has done a great job of compiling them. Further Reading Center for Speech and Language Disorders ASHA Learning Disabilities According to the Learning Disabilities Association of America learning disabilities can affect reading, writing, spelling, math, and even planning and organization. These disabilities include dyslexia, dysgraphia, and auditory processing disorder. Speech pathologists diagnose learning disabilities and treat them in a way that fits the child’s needs. SLPs will use many activities to help your child with a learning disability. Example activities include answering questions verbally or in writing after hearing a story, matching letters and sounds, and even taking a child through the steps of using a book. Signs of Learning Disability (ASHA) Trouble learning new words, the alphabet, and numbers Trouble learning songs Use of vague words Understanding reading, questions, and directions Remembering details, numbers, or directions Knowing left from right Trouble understanding the sounds letters make Mixing up letters when writing or numbers when doing math Telling time Further Reading ASHA Learning Disabilities Association of America Selective Mutism It is stated by ASHA that children who will not talk at certain times may have selective mutism due to shyness and anxiety. SLPs can work with your child to make them more comfortable speaking in those situations where they are unable to speak. By slowly introducing new speaking situations to the child and offering positive reinforcement, the SLP will get the child out of their comfort zone and speaking in more situations. SLPs will work with your child in the situations that cause them discomfort to help them at the point where their selective mutism is affecting him most. Signs of Selective Mutism (ASHA) Consistently not speaking in certain situations for more than one month, even though she has the language skills to do so. Selective Mutism Resources ASHA SelectiveMutism.org Stuttering Speech pathologists can help stutterers in a variety of ways. One way is by improving the stuttering itself by reducing or even eliminating its occurrence. Equally as important is helping your child with his or her emotional response to stuttering- it is important that he or she learns not to develop negative feelings about the stutter. Stuttering can affect your child’s willingness to engage in conversation and can even influence avoidance of certain words.As your child approaches adolescence, she become more aware of her stuttering and become more likely to try to hide it. SLPs typically help patients this age work on their fluency and also minimize avoidance of stuttering. Older children may even learn tactics to handle bullying and educate their peers on stuttering through their SLP. Signs of Stuttering, According to ASHA Syllable repetition Prolonged sound Pauses Struggle to say words Speaking and social avoidance Movement of extremities of nodding of head Stuttering Resources for Parents ASHA Prompt Institute The Stuttering Foundation Tongue Thrust (Orofacial Myofunctional Disorder) OMD is defined by ASHA as having a tongue that goes more forward than it should. This affects eating, speaking, and even placement of teeth as they appear. Food may not stay in a child’s mouth as easily and using a straw can be tricky. Making certain sounds can be difficult, especially “sh”, “ch”, “z”, “s”, and “j”. SLPs can help your child with each of these issues by teaching her to be more aware of her mouth movements, adapting chewing and swallowing, and working to clarify speech. Signs of Tongue Thrust (ASHA) Issues with the above sounds Tongue sticks out speaking Trouble eating Out of place teeth Tongue Thrust Resources for Parents ASHA Cincinnati Children’s Hospital Orofacialmyology.com Where Can I Get a Diagnosis for my Child? Depending on the condition, diagnoses can come from SLPs, doctors, dentists, and other professionals. If you have a suspicion that your child has one of these disorders, you should seek a professional opinion as soon as possible so that treatment can begin right away if needed. While SLPs can test for many of these conditions, ASHA says that you should consult a doctor if your child shows signs of the following1 Conditions related to brain damage or injury (apraxia, dysarthria, and aphasia) should be seen by a doctor first. ADHD should be diagnosed by a doctor. OMD may be tested by an SLP first, but can also be diagnosed by a doctor, dentist, or orthodontist. Selective mutism can be tested by an SLP, but a doctor may be able to prescribe helpful medication that cannot be prescribed by an SLP. Children should be tested for autism by a knowledgeable professional such as a neurologist, pediatrician, physical or occupational therapist, developmental specialist, or other. Sometimes, an SLP will be the first to notice that a patient of theirs has autism, or a child suspected of having autism will be taken to an SLP first for social and communication skills testing. If you need to find an SLP, ASHA has a database of professionals that is easy to use. 1 Not taking into account down syndrome or cerebral palsy, which are typically diagnosed early on. Return to footnote reference Where Will my Child’s Speech Therapy Take Place? If your child has one of these disorders or disabilities, there are many therapy options available. Depending on the condition and its severity, you may choose to take advantage of speech services at your child’s school, or even in your own home. You will receive recommendations for next steps when you receive a diagnosis, but here are some common settings where speech therapy takes place: School: Most schools have one or several speech pathologists on staff that can work with your child. They may work with them one on one or in group sessions with other students in the school. These SLPs will work closely with you and the teachers, to make sure that your child’s learning environment sets them up for success. Private Practice: Many speech pathologists have their own practices. You can find them by asking around or doing a google search for SLPs around town and reading reviews. These SLPs can work with your child outside of school hours. Private practice SLPs may have specialties that closely fit your child’s needs. Home: Younger children sometimes benefit from receiving speech therapy at home because it is an environment they already feel comfortable in. If your child is receiving early intervention services, these will often happen at home too. No matter where your child’s speech sessions take place, remember that your participation is also key to their success! Work with your child’s speech therapist to determine if there is anything you can do to help your child outside of speech sessions. If your child’s SLP gives you instructions, take them seriously- the more you can do for your child, the sooner improvements will take place.