Speech & Language Therapy

In a recent parent-teacher conference, the teacher expressed concern that your child may have a problem with certain speech or language skills. Or perhaps while talking to your child, you noticed an occasional stutter. Could your child have a problem? And if so, what should you do?
It's wise to intervene quickly. An evaluation by a certified speech-language pathologist can help determine if your child is having difficulties.

What Is Speech-Language Therapy?

Speech-language therapy is the treatment for most kids with speech and/or language disorders. A speech disorder refers to a problem with the actual production of sounds, whereas a language disorder refers to a difficulty understanding or putting words together to communicate ideas.

Speech Disorders and Language Disorders

Speech disorders include the following problems, according to the American Speech-Language-Hearing Association (ASHA):

Articulation disorders include difficulties producing sounds in syllables or saying words incorrectly to the point that other people can't understand what's being said.
Fluency disorders include problems such as stuttering, the condition in which the flow of speech is interrupted by abnormal stoppages, repetitions (st-st-stuttering), or prolonging sounds and syllables (ssssstuttering).
Resonance or voice disorders include problems with the pitch, volume, or quality of the voice that distract listeners from what's being said. These types of disorders may also cause pain or discomfort for the child when speaking.
Dysphagia/oral feeding disorders, including difficulties with eating and swallowing.

Language disorders can be either receptive or expressive:

Receptive disorders refer to difficulties understanding or processing language.
Expressive disorders include difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.

Specialists in Speech-Language Therapy

Speech-language pathologists (SLPs), often informally known as speech therapists, are professionals educated in the study of human communication, its development, and its disorders. They hold at least a master's degree and state certification/licensure in the field, as well as a certificate of clinical competency from ASHA.
By assessing the speech, language, cognitive-communication, and swallowing skills of children and adults, speech-language pathologists can identify types of communication problems and the best way to treat them.
SLPs treat problems in the areas of articulation; dysfluency; oral-motor, speech, and voice; and receptive and expressive language disorders.

Remediation

In speech-language therapy, an SLP will work with a child one-to-one, in a small group, or directly in a classroom to overcome difficulties involved with a specific disorder.
Therapists use a variety of strategies, including:

language intervention activities. In these exercises an SLP will interact with a child by playing and talking. The therapist may use pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct pronunciation and use repetition exercises to build speech and language skills.
articulation therapy. Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables for a child, often during play activities. The level of play is age-appropriate and related to the child's specific needs. The SLP will physically show the child how to make certain sounds, such as the "r" sound, and may demonstrate how to move the tongue to produce specific sounds.
oral motor/feeding therapy. The SLP will use a variety of oral exercises, including facial massage and various tongue, lip, and jaw exercises, to strengthen the muscles of the mouth. The SLP may also work with different food textures and temperatures to increase a child's oral awareness during eating and swallowing.

When Is Therapy Needed?

Kids might need speech-language therapy for a variety of reasons, including:

hearing impairments
cognitive (intellectual; thinking) or other developmental delays
weak oral muscles
birth defects such as cleft lip or cleft palate
autism
motor planning problems
respiratory problems (breathing disorders)
swallowing disorders
traumatic brain injury

Therapy should begin as soon as possible. Children enrolled in therapy early in their development (younger than 3 years) tend to have better outcomes than those who begin therapy later.
This does not mean that older kids can't make progress in therapy; they may progress at a slower rate because they often have learned patterns that need to be changed.

Finding a Therapist

It's important to make sure that the speech-language therapist is certified by ASHA. That certification means the SLP has at least a master's degree in the field, and has passed a national examination and successfully completed a supervised clinical fellowship.
Sometimes speech assistants (who have typically earned a 2-year associate's or 4-year bachelor's degree) may assist with speech-language services under the supervision of ASHA-certified SLPs. Your child's SLP should be licensed in your state, and have experience working with kids and your child's specific disorder.
You might find a specialist by asking your child's doctor or teacher for a referral or by checking your local telephone directory. The state associations for speech-language pathology and audiology also maintain listings of licensed and certified therapists.

Helping Your Child

Speech-language experts agree that parental involvement is crucial to the success of a child's progress in speech or language therapy.
Parents are an extremely important part of their child's therapy program, and help determine whether it is a success. Kids who complete the program quickest and with the most lasting results are those whose parents have been involved.
Ask the therapist for suggestions on how you can help your child. For instance, it's important to help your child do the at-home stimulation activities that the SLP suggests to ensure continued progress and carry-over of newly learned skills.
The process of overcoming a speech or language disorder may take some time and effort, so it's important that all family members be patient and understanding with the child.

ARTICULATION

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First Thing You MUST do: Get a hearing test!

Many children, especially young children, develop fluid behind the eardrum that can cause a temporary or fluctuating hearing loss. This should be checked by a pediatrician or audiologist as soon as possible.

First Week:

Just practice the sound you are targeting. For example, if you want to practice /s/, then say the sound 10 times twice each day. Just be sure NOT to add a syllable after the sound. Practice "s-s-s-s", not "sah"

Second Week:

Now it's time to add the syllable. Just work on the target sound in one position. Consonants can be in the beginning of words, "sun", middle of word, "beside" or end of words, "mess". For the second, third, and fourth week, pick one position (beginning, middle, or end) and get comfortable before moving to another position.

BeginningMiddle	End
sahahsah	ahs
sayaysay	ays
seeeesee	ees
sighighsigh	ighs (ice)
sooso	os
suusu	us

This is only a guide and other vowel sounds can and should be included.

Third Week:

If syllables are now easy and pronounced right, it's time to move to words. Practice words in the position you are targeting. If you have targeted the sound in the beginning of words, then find 10-20 words and practice them using different types of games.

Fourth Week:

If you're ready to move on, put the target words into phrases and sentences. You can make up phrases and sentences, or use pattern sentences like "I want a _____."

Fifth Week:

Listen for the correct sound during normal conversation. If it is mispronounced, call attention to it and repeat to correct it.
Start over with another position of the same sound.
This is only a guide. Use your own judgment on how fast or slow to proceed.
Extra tidbits that may help to get started:
1. Sounds that have air that continues out, (s, sh, f) are easier if you start with syllables and words that have those sounds at the end.
2. Label the target sound with something related: