By: Anne O’Dowd, Pediatric Speech-Language Pathologist, CF-SLP
What does Speech Therapy Include?
Perhaps your child or another child you know is referred to see a speech-language pathologist from their doctor. When you think about the areas a speech-language pathologist treats, it is easy to assume we work only in the areas of speech and language, as our title implies. This is a common misconception.
In fact, our field is much larger than our title offers it to be. To provide a better view of the areas we treat, below is an extensive list of our scope or service delivery areas. A speech pathologist can help a child in nine key development needs. Please note that this list is not exhaustive, not all service delivery areas are offered at Easterseals DuPage & Fox Valley, and individual speech-language pathologists can specialize in one or several areas. Areas in which we practice vary in development, some continuing to evolve (e.g., literacy) and others emerging.
Learn more about our speech services here.
Speech refers to the production of speech sounds, individually and in words. Children produce several typical speech errors that decrease over the first few years of life, resulting in adult-like speech. Intelligibility, how well an outside listener without context can understand an individual’s speech, is one quick tool we can use to measure speech development. Below are some examples of the service delivery areas we treat regarding speech:
- Articulation: errors in individual speech sounds
- Phonological: errors that follow rule-based, predictable patterns (e.g., phonological processes of stopping, final consonant deletion, or weak syllable deletion)
- Motor planning and execution: developmental or acquired disorders at a motor/neurological level characterized by difficulty producing consistent, predictable speech patterns
Language refers to expressing and comprehending words through multiple modalities, including speech, writing, reading, speech-generating devices, picture symbols, and gestures. We use language for various intents, including sharing ideas and ensuring our needs are met. Below are some examples of the service delivery areas we treat regarding language:
- Phonology: system of speech sounds and how we combine them to make meaningful words
- Morphology: use of word forms to create new words
- Syntax: combining words to create grammatically correct sentence structures
- Semantics: appropriate use and identification of word meanings
- Pragmatics: social aspects of communication and language use
- Literacy: spelling, reading, writing
- Prelinguistic communication: (e.g., intentionality, communicative signaling, joint attention)
- Paralinguistic communication: (e.g., body language, signs, gestures)
Fluency refers to the rhythm of our speech. Typical speech is characterized by occasional disfluent moments (e.g., pauses and repetitions), although a higher frequency of these may be a cause for concern. Below are some examples of the service delivery areas we treat regarding fluency:
- Stuttering: disfluencies in speech, including repetitions, blocks, and prolongations
- Cluttering: abnormally fast and/or irregular rate of speech
Voice refers to the quality, pitch, and volume of an individual’s voice. A voice disorder is present when one or more of these voice qualities are perceived as different or inappropriate for an individual’s gender, age, culture, and geographic location. Causes for variation in voice can be organic (e.g., structural changes due to aging, vocal fold paralysis) or functional (e.g., vocal fatigue). Below are some examples of the service delivery areas we treat regarding voice:
- Pitch: how “high” or “low” one’s voice is
- Loudness: the volume of one’s voice
- Alaryngeal speech: speech production utilizing a substitute for the vocal folds in the larynx
Resonance in speech refers to the production of a filtered sound, beginning at the vocal folds. The sound travels through the pharynx and oral and nasal cavity. As it passes through, it is filtered and enhanced based on the shape and/or size of an individual’s vocal tract. Below are some examples of the service delivery areas we treat regarding resonance:
- Hypo- and hypernasality: not enough or too much sound energy in the nasal cavity
- Cul-de-sac resonance: when sound energy is “trapped” in the oral, nasal, or pharyngeal cavity due to an obstruction
Typically, when discussing the pediatric population, Auditory Habilitation instead of rehabilitation is used as rehabilitation refers to restoring a skill that was lost. Often, a young child who presents with hearing loss or is Deaf has not yet developed age-appropriate auditory skills and therefore is not restoring the skill. Below are some examples of the service delivery areas we treat regarding aural habilitation/rehabilitation:
- Auditory processing: comprehension and interpretation of auditory information
- Speech, language, communication, and listening skills: as affected by deafness, hearing loss
Learn more about our audiology services here.
Speech-language pathologists also provide services for individuals with Cognitive-Communication Disorders. In the pediatric population, the most common etiologies for cognitive-communication disorders are autism spectrum disorder, cerebral palsy, developmental delay, and traumatic brain injury. Below are some examples of the service delivery areas we treat regarding cognitive communication:
- Executive functioning: includes working memory, inhibitory control, and cognitive flexibility
- Attention: ability to attend to someone or something
- Memory: includes episodic, semantic, procedural, short-term and working, sensory, and prospective memory
- Problem–solving: obtaining, processing, and collaborating the information needed to find a solution to a simple or complex issue
Feeding and Swallowing
Feeding and swallowing refer to how individuals transport food and drink from their environment into their bodies. Speech-language pathologists are involved in the parts of this process that involve the mouth, pharynx, and esophagus. We collaborate with other specialists, such as nutritionists, occupational therapists, and gastroenterologists, to meet each child’s individual feeding and swallowing needs. Below are some examples of the service delivery areas we treat regarding feeding and swallowing:
- Oral, pharyngeal, and esophageal phase of swallow: components of the swallow that occur in the mouth, pharynx, and esophagus; abnormal swallow can occur in one or multiple phases
- Atypical eating: (e.g., food refusal, food sensitivity, negative physiological response)
Learn more about our feeding clinic here.
Augmentative and Assistive Technology
Augmentative and Assistive Communication (AAC) includes all forms of communication that are used to supplement or replace oral speech to express thoughts, needs, wants and ideas. AAC allows children to communicate more easily and, in doing so, reduces frustrations for the individual and his or her family. There are several forms of AAC ranging from light tech to high tech. Below are some examples of the service delivery areas we provide in AT services:
- Diagnostic Therapy – working with a child to explore access methods that are consistent and least restrictive to a robust communication system
- Assistive Tech/ Speech Therapy – building language skills and learning how to operate the communication system to be able to express wants and needs
- Customization of systems – setting up, maintaining, or generalizing communication systems to all environments
- Consultations – may work with other providers/school team members to ensure consistency of aided language partners
- Parent training – provide parents the tools to implement operations of communication systems and to be a language model
Learn more about our Assistive Technology (AT) and Augmentative and Alternative Communication (AAC) services here.
Speech-Language Therapy at Easterseals DuPage & Fox Valley
If you are concerned about your child’s language or other development, take our free online developmental screening tool for children birth to age five. The Ages and Stages Questionnaire (ASQ) will showcase your child’s developmental milestones while uncovering any potential delays. Learn more at askeasterseals.com.
To learn more about Speech Language services at Easterseals DuPage & Fox Valley, click here or call us at 630.282.2022.