Speech Therapy

Speech sound disorders is an umbrella term used to refer to any difficulty, or combination of difficulties, with how speech sounds are perceived, produced, or represented in the brain.

Speech sound production requires both the phonological knowledge of speech sounds (i.e., awareness of how sounds are used in a particular language) and the ability to coordinate the jaw, tongue, and lips with breathing and vocalization to produce meaningful sounds.

Individuals with a speech sound disorder may have difficulty with the phonological knowledge of speech sounds and/or the ability to coordinate the movements necessary for speech.

You can learn more about speech sound disorders by clicking on this link and exploring the American Speech-Language-Hearing Association (ASHA) website: ASHA - Speech Sound Disorders

My assessment process typically involves gathering a comprehensive case history (e.g., information about growth and development, speech concerns, history of ear infections, family history of speech or language difficulties, etc.), followed by assessments of the orofacial complex (i.e., the muscles of the face and mouth) and articulation (i.e., how speech sounds are produced using the tongue, teeth, lips, jaw, vocal cords, etc.).

Developmentally appropriate errors and patterns are taken into consideration to differentiate typical errors from those that are not age-appropriate, are unusual, or may be caused by other factors. For example, persistent speech sound disorders (those that don’t resolve quickly to traditional speech therapy) may have an underlying structural or muscular component.

When appropriate, collaboration with other professionals may occur for additional insight into possible contributing factors. This may include identifying

• AIRWAY PATENCY (i.e., the ability of a person to breathe). Does the client have enlarged tonsils or adenoids, allergies, or blocked nasal passages?

• DENTAL OR ORTHODONTIC CONCERNS. Does the client have teeth misalignment, tethered oral tissues (i.e., tongue-tie or lip-tie), or a high-arched and/or narrow palate?

• ORAL HABITS. Does the client have any habits such as thumb/finger sucking, lip sucking/biting, and/or nail biting?

I will then explore the best approach to treatment based on what a client’s history and assessment indicates.

Given the many possible reasons for a speech sound disorder, before targeting speech sounds, we first work to ensure the muscles of the face and mouth are working optimally. This leads to a much better chance of positive change and long-term success.

Depending on the age, abilities, and needs of the client, intervention may include

DIRECT THERAPY:

• speech therapy exercises that focus on building familiarity with certain sounds or words.

• physical exercises that focus on stabilizing, coordinating, and/or strengthening the muscles that produce speech sounds.

PARENT/ CAREGIVER COACHING & COLLABORATION

• parents/caregivers are encouraged to participate in the therapy sessions with their child so they feel best equipped to practice at home.

COLLABORATION WITH OTHER PROFESSIONALS

• to deliver the most effective and integrated care, collaboration with teachers, school-based speech-language pathologists, occupational therapists, physiotherapists, psychologists, doctors, dentists, orthodontists, ENT/otolaryngologists, allergists, etc. may occur.

The treatment goals and approach will typically depend on the severity of the speech sound disorder and its underlying cause.

Some examples of treatment goals include:

• improving the production of speech sounds

• increasing awareness of lip, tongue, and jaw muscles

• improving oral resting postures of the lips and tongue

• improving oral muscle stability, strength, and coordination

• improving coordination of breath

While there is no set answer to that question, research does indicate that frequency, intensity, and duration of treatment impacts outcomes. Recommendations regarding how often, how intense, and how long treatment should be will vary and depend upon the individual.

Therapy may require a few sessions, or may last over the course of several months, and sometimes over the span of years, depending on the severity or complexity of the problem. Home practice between sessions, as assigned by the treating Speech-Language Pathologist, helps to reduce the amount of time that therapy will take.

Therapy sessions are usually weekly during the establishment phase of therapy, and may decrease in frequency as newly acquired skills transfer into every day talking. In some cases, two sessions per week may be recommended.

The duration of therapy sessions varies depending on the number of goals to be achieved, or what is involved in achieving them.

There are various factors that may impact the prognosis for treatment and the length of intervention. These include:

• Severity – Typically, the more speech sounds in error, the longer the duration of treatment.

• Motivation - Success in therapy is directly dependent upon an individual’s motivation, cooperation, and self-discipline with the home assignments.

• Family involvement and encouragement.

• Age and maturity of the individual.

• Attention span of the individual.

• Attitude of the individual and parents/caregivers.

• Completion of assigned homework

It’s also important to know that the most success occurs when treatment is aligned with a family’s schedule, budget, needs, and how a child is progressing.

Dedication and consistency are key to success and lasting results.