Screening
Early identification of speech-language delay or disorders can prevent
frustration of children and their significant others due to difficulty
in communication. It can also help prevent later academic and social
difficulties
which are often due to weak basic language skills. A screening is a
brief assessment of speech and language abilities in order to determine
if the individual requires a comprehensive speech-language evaluation.
This service is typically provided when the parent or client is
uncertain whether an evaluation is necessary and would like to seek a
professional opinion. Often doctors or teachers will suggest a
screening if they are concerned. In the United States, it is mandatory
that all children entering kindergarten (typically 5 year olds) receive
a screening.
Evaluation
A speech-language evaluation takes an in-depth look at the
individual's speech-language abilities. The therapist uses a
combination of interviewing parent or client and if appropriate other
professionals (teacher, doctor, psychologist, other therapists),
standardized tests and other non-standard
approaches such as story-telling, conversation, or play situations to
assess these skills. A comprehensive evaluation involves formally
evaluating the following speech-language abilities as appropriate:
- Intelligibility (articulation, motor speech development,
phonology)
- Language abilities (Receptive (understanding) and Expressive
(speaking) skills)
- Voice quality
- Fluency
In order to rule hearing difficulties out as a reason for
speech-language difficulties, a hearing screening by the doctor or test
by an audiologist is coupled with a speech-language evaluation. A
report is written by the SLP addressing the in-depth findings of the
evaluation and stating recommendations. If therapy is recommended,
suggested Long-term goals and short-term objectives will also be
provided. After this report is written, the information is shared with
the parents or client and questions and concerns are addressed.
Therapy
When parents or client are in agreement, therapy guided by written
goals and objectives is provided. Goals and objectives are consistently
reevaluated and adjusted as the client makes progress. Written progress
reports are provided after the recommended therapy program has ended,
but verbal progress is communicated after each session.
I believe in working through a child's strengths to build up their
weaknesses. I believe therapy should be fun and motivating for a
child. If it is appropriate, co-treatment with other therapists
(e.g. occupational therapists, physical therapists) involved with the
child is possible. The family is an essential part of the therapy
process with children.
Home practice is expected and parents should have knowledge
of their child's ability, their goals and how to facilitate their
progress at home. Progress is dependent upon practice at home and in
the child's every day life. How this goal is achieved depends upon
whether it is best for the child to work alone with the therapist or
with the family present. This will be discussed with the family at the
beginning of therapy.
Typical skills addressed include:
- Receptive/Expressive Language (e.g. ability to follow directions,
answer questions, understand stories and written text/ability to name
objects, form sentences, tell a story, hold a conversation, write in a
cohesive manner).
- Pragmatics and social skills (e.g. ability to use language
appropriately in different social situations)
- Motor-speech control (e.g. child has low intelligibility due to
motor
control or coordination difficulties of speech organs)
- Articulation (e.g. Lisp, /r/, /l/, /s/ distortion or
substitutions, increase ability to be understood)
- Phonological skills (e.g. child displays pattern of speech
errors,
e.g. fronting t,d sounds for k,g sounds)
- Auditory Development (e.g. Child has difficulty hearing or
processing speech sounds or speech).
- Augmentative Communication (e.g. child is nonverbal and would
benefit
from alternative forms of communication such as picture communication
symbols)
Common speech-language problems of
children treated by Speech-Language
Pathologists:
- Apraxia of speech
- Articulation or phonological disorder
- Dysarthria (slurred speech)
- Fluency disorders (stuttering)
- Language delay or disorder
- Language-learning disabilities (reading and writing)
- Nonverbal communication needs (augmentative/alternative devices)
- Social skill impairments
- Speech, language, or reading difficulties associated with deafness
- Voice or resonance disorders (including those common with cleft
palate)
Tutoring
Tutoring services in English for subjects which are language-based
(e.g. reading, writing, language arts, social studies, history) are
also available for children who would benefit from extra help with
school work. Please contact Elizabeth for questions and further
information.
Consultation/Collaboration
Services
Consultation to and collaboration with the school or other
professionals can be offered on an as-needed or as-requested basis.
Often teachers or other professionals are interested in how they can
facilitate the child's speech-language improvement. Consultation can be
provided in this case. Sometimes a child does not need direct therapy,
but would benefit from strategies which can be used in the home or
classroom. In this case, consultation of the SLP with the parents
or other professionals is a possibility.
