Speech, Language & Learning Difficulties Wiki

What is Dyslexia?

Dyslexia is a language-based learning disability. Dyslexia refers to a cluster of symptoms, which result in people having difficulties with specific language skills, particularly reading. Students with dyslexia usually experience difficulties with other language skills such as:

• spelling
• writing
• pronouncing words

Dyslexia is referred to as a learning disability because dyslexia can make it very difficult for a student to succeed academically in the typical instructional environment, and in its more severe forms, will qualify a student for special education, special accommodations, or extra support services.

What Causes Dyslexia?

The exact causes of dyslexia are not completely clear, but anatomical and brain imagery studies show differences in the way the brain of a dyslexic person develops and functions. Moreover, most people with dyslexia have been found to have problems with identifying the separate speech sounds within a word and/or learning how letters represent those sounds, a key factor in their reading difficulties. Dyslexia is not due to either lack of intelligence or desire to learn; with appropriate teaching methods, dyslexics can learn successfully.

What are the Effects of Dyslexia?

The core difficulty is with:

• word recognition
• reading fluency
• spelling
• writing

Some individuals with dyslexia manage to learn early reading and spelling tasks, especially with excellent instruction, but later experience their most debilitating problems when more complex language skills are required, such as:

• grammar
• understanding textbook material
• writing essays
• Difficulty with spoken language

These language problems are often difficult to recognize, but they can lead to major problems in school, in the workplace, and in relating to other people. The effects of dyslexia reach well beyond the classroom.

What are the signs of Dyslexia?

The problems displayed by individuals with dyslexia involve difficulties in acquiring and using written language. It is a myth that dyslexic individuals “read backwards,” although spelling can look quite jumbled at times because students have trouble remembering letter symbols for sounds and forming memories for words. Other problems experienced by dyslexics include the following:

• Learning to speak
• Learning letters and their sounds
• Organizing written and spoken language
• Memorizing number facts
• Reading quickly enough to comprehend
• Persisting with and comprehending longer reading assignments
• Spelling
• Learning a foreign language
• Correctly doing math operations

Not all students who have difficulties with these skills are dyslexic. Formal testing is the only way to confirm a diagnosis of suspected dyslexia.

Treatment for Dyslexia

The Following areas should be assessed and included in a multi-sensory Direct Instruction treatment program for an individual with Dyslexia.  

Word Attack / Word Identification

1. Phonological Awareness
2. Letter Recognition
3. Sound / Letter Correspondence
4. Orthographic Awareness

Continuous Text Reading Skills

5. Fluency
6. Comprehension

What is a Preschool Language Disorder?

What is a Language Disorder?
Language disorders in young children are characterized by deficiencies in the comprehension (understanding) and/or production (use) of spoken language.A child may have difficulties with expressive and/or receptive language skills (e.g. a child may not be able to put words together, but may be able to follow directions and identify objects).

What Is an Expressive Language Disorder?

Characteristics of an Expressive Language Disorder:

An expressive language disorder is characterized by language production (talking) skills that are below an age-appropriate level. Young children with poor expressive language skills have difficulty expressing themselves verbally. They may demonstrate some of the following characteristics: 1) using fewer words than expected for their age, 2) failing to combine words, 3) failing to ask questions, 4) having difficulty with simple story-telling, etc. Overall, young children with expressive language difficulties are unable to express themselves in an age-appropriate way.

What is a Receptive Language Disorder?

Characteristics of a Receptive Language Disorder:

Deficits in receptive language are apparent when children do not understand language at an age-appropriate level. Young children with poor receptive language skills have difficulty understanding what their parents and caregivers are trying to communicate to them. They may demonstrate some of the following characteristics: 1) difficulty following directions, 2) poor understanding of words and sentences, 3) difficulty answering questions, etc.

What is a Mixed Receptive-expressive Language Disorder?

Mixed Receptive – Expressive Language Disorder in young children is characterized by difficulties with both the talking and understanding of language.

What are some warning signs of a Language Disorder?

Parents/caregivers should seek help from a Speech-Language Pathologist if their child:

By 12 months:
• does not babble with changes in tone – e.g. dadadadadadadadada
• does not use gestures like waving “bye bye” or shaking head for “no”
• does not respond to her/his name
• does not communicate in some way when s/he needs help with something

By 15 months:
• does not understand and respond to words like “no” and “up”
• says no words
• does not point to objects or pictures when asked “Where’s the…?
• does not point to things of interest as if to say “Look at that!” and then look right at you

By 18 months:
• does not understand simple commands like “Don’t touch”
• is not using at least 20 single words like “Mommy” or “up”
• does not respond with a word or gesture to a question such as “What’s that? or “Where’s your shoe?”
• can’t point to two or three major body parts such as head, nose, eyes, feet

By 24 months:
• says fewer than 100 words
• is not consistently joining two words together like “Daddy go” or “ shoes on”
• does not imitate actions or words
• does not pretend with toys, such as feeding doll or making toy man drive toy car

By 30 months:
• says fewer than 300 words
• is not using action words like “run”, “eat”, “fall”
• is not using some adult grammar, such as “two babies” and “doggie sleeping”

By 3-4 years:
• does not ask questions by 3 years
• is not using sentences (e.g., “I don’t want that” or “My truck is broken”) by three years

By 5 years:
• is not able to tell a simple story by four or five years

Language Disorder treatment

What we can do to help:
When you contact us, we will provide all parents/caregivers with additional information to increase their knowledge of child language development and disorders. We will also provide literature on the impact of such disorders on a child’s social and academic success, and on the benefits of early intervention. Parents who would like to have their child evaluated will arrange for an assessment which will include some or all of the following procedures:

1) A pre-assessment interview with the parent/caregiver and/or daycare provider.

2) Formal assessment including the administration of formal tests and assessment measures.

3) Observation – includes observing the child engaging and interacting with their parent and/or in the daycare setting.

Following the assessment, we will determine whether your child would benefit from therapy. Therapy may take various forms, including: indirect therapy (e.g. teaching parents and/or daycare providers to elicit language from the child) and/or direct intervention (e.g. individual or group play-based whole language therapy).

What are Speech Sound Disorders?

What are speech sound disorders?
It is typical and normal for young children to make sound errors. A speech sound disorder occurs when mistakes continue past a certain age. Each sound is produced and mastered during an identified age range, and sound errors persisting past this range signal a disorder. Speech sound disorders include problems with articulation (making sounds) and phonological processes (sound patterns).

What is an Articulation Disorder?

An articulation disorder is a problem with making speech sounds. Sounds may be replaced, omitted, added or changed. Young children often make speech errors, and these errors often impact their intelligibility (i.e. the child’s ability to be understood). However, many of these errors are normal, like when a young child says “wabbit” for “rabbit”. However, if the child’s errors persist past an expected age or if a child is not acquiring the sounds he/she should have at certain age, then he/she may have articulation disorder.

What is a Phonological Disorder?

A phonological disorder is a speech sound error in which the errors follow a distinct pattern. For example, omitting all final consonant sounds (“ca” for “cat” and “ma” for “man”). While it is typical and normal for young children to demonstrate patterned speech sound errors, these errors diminish in frequency and eventually disappear with age. If these errors persist past a certain age, the child may have a phonological disorder.

Most phonological processes are gone by the time a child is 5 years old.

How much of what my child says should be clear and understandable?
24 months = speech is 50% understandable

36 months = speech is 75% understandable

48-60 months = speech is 100% understandable

What are Motor Speech Disorders?

Motor speech disorders are those which result from difficulty planning and coordinating the movements required for speech or weakness in the oral musculature, required to produce speech. Childhood Apraxia of Speech, Developmental Verbal Dyspraxia and Dysarthria are motor speech disorders that occur in childhood

What is a Childhood Apraxia of Speech?

Childhood apraxia of speech (CAS) is a motor speech disorder in which children struggle to say sounds, syllables or words. The child with CAS struggles to plan and coordinate the movements required for speech (i.e. movement of the tongue, jaw, lips, etc.). The child knows what he or she wants to say, but is simply unable to coordinate the movements required to say the particular words.

According to the American Speech and Hearing Association, the following are signs and symptoms of CAS:

A Very Young Child:

• Does not coo or babble as an infant
• First words are late, and they may be missing sounds
• Only a few different consonant and vowel sounds
• Problems combining sounds; may show long pauses between sounds
• Simplifies words by replacing difficult sounds with easier ones or by deleting difficult sounds (although all children do this, the child with apraxia of speech does so more often)
• May have problems eating

An Older Child:

• Makes inconsistent sound errors that are not the result of immaturity
• Can understand language much better than he or she can talk
• Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech
• May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
• Has more difficulty saying longer words or phrases clearly than shorter ones
• Appears to have more difficulty when he or she is anxious
• Is hard to understand, especially for an unfamiliar listener
• Sounds choppy, monotonous, or stresses the wrong syllable or word

Potential Other Problems:

• Delayed language development
• Other expressive language problems like word order confusions and word recall
• Difficulties with fine motor movement/coordination
• Over sensitive (hypersensitive) or under sensitive (hyposensitive) in their mouths (e.g., may not like tooth brushing or crunchy foods, may not be able to identify an object in their mouth through touch)
• Children with CAS or other speech problems may have problems when learning to read, spell, and write

What is Dysarthria?

Dysarthria is a motor speech disorder in which the muscles of the mouth, face, and respiratory system may become weak, move slowly, or not move at all. The type and severity of dysarthria depend on which area of the nervous system is affected. Some causes of dysarthria in children include head injury, cerebral palsy, and muscular dystrophy.

Common characteristics of dysarthria in children include:

• Slowed speech
• Difficulty coordinating breath for speech
• Unclear speech
• Slurred speech
• Voice that is too loud or too quiet
• Difficulty with using appropriate pitch and intonation
• Impaired voice quality (may sound hoarse, nasal, breathy)

What we can do to help you!

Upon contacting us, we will provide all parents/caregivers with additional information to increase their knowledge of childhood speech disorders. Parents who would like to have their child evaluated will arrange for an assessment which will include some or all of the following procedures:

1) A pre-assessment interview with the parent/caregiver and/or daycare provider.

2) Formal assessment including the administration of formal tests and assessment measures.

3) Observation – includes observing the child engaging and interacting with their parent and/or in the daycare
setting.

Following the assessment, we will determine whether your child would benefit from therapy. If your child requires therapy, we will recommend intervention to target their specific speech difficulties by teaching new sounds in place of error-sounds, targeting and reducing error patterns, teaching strategies to improve speech clarity, and working closely with family members, daycare personnel and other key individuals in your child’s life, to help make communication more successful.

Play-based Whole Language Therapy

We provide play-based whole language therapy to young children who have difficulties in understanding and using language to communicate. Whole language therapy involves targeting all the components of language – speaking, listening, reading and writing as a whole, rather than in parts. With young children, this is best achieved through facilitative play, where the child leads the interaction and the therapist follows the child, doing what he or she is doing and talking about what he is she is talking about. In a group therapy session, we use developmentally appropriate activities that are theme-related (e.g. farm) and daily routines (e.g. snack) to facilitate language.

Whatever the context, our goal is to develop your child’s speaking, understanding, pre-reading and writing skills, in an interactive play-based context. We achieve this goal through interactive games, pretend play, communicative temptations, and other age-appropriate activities.

How do we improve Reading Skills?

What are pre-reading skills?
Pre-reading or early literacy skills are skills that children need to learn before they can begin to read (or write). There are five important pre-reading skills that need to be learned before a child can read words and understand the meaning of what they read. These include:

1) Conversation – speaking and understanding language are important pre-reading skills and will later help your child understand what he/she reads.

2) Vocabulary – having a strong vocabulary in kindergarten will help your child’s reading skills.

3) Story comprehension –understanding stories is an important pre-cursor to a child’s ability to later read and write stories on their own.

• Your child is able to retell a familiar story in his own words.
• Your child can answer simple questions about a story.
• Your child asks questions (Why did the elephant laugh?) during read-alouds.

4) Print knowledge – understanding that print is made up of letters, each letter has a name, and that words are read from left to right and top to bottom. Skills to look out for include:

• Your child knows the proper way to hold a book.
• Your child understands that books are read from cover to back.
• Your child understands that sentences are read from left to right and from top to bottom
• Your child knows that words on the page can be read.
• Your child can recite the alphabet song
• Your child can recognize letters

5) Sound awareness/phonological awareness – understanding that speech can be broken down into smaller units (i.e. words, syllables and sounds). Sound awareness includes knowing that letters represent sounds. Skills to look out for include:

• Your child can rhyme. If you say <em “font-weight:=”” inherit”=””>bat, your child can come up with a rhyming word like hat.
• Your child understands word boundaries. If you say the sentence Don’t let the cat out, your child is able to separate the sentence into five individual words.
• Your child can clap syllables. If you say dog, your child knows to clap once. If you say umbrella, your child knows to clap three times.
• Your child can blend sounds to make a word. If you say the sounds sh…eep, your child responds with the word sheep.
• Your child can identify the beginning sound in a word. If you ask your child to say the first sound in pig, your child is able to respond with the sound /p/.
• Your child can identify the ending sound in a word. If you ask your child to say the last sound in the word jam, your child is able to respond with the sound /m/.

6) Motivation to Read: Being Interested in reading is a very important pre-reading skill. How do you know if your child has an interest in reading?

• Does your child enjoy being read to?
• Does your child pretend to read or write?
• Does your child ask you to read to him or her?

How do we target pre-reading skills?
We incorporate pre-reading skills into whole-language play based therapy. Specifically, we embed joint-reading activities into play-based sessions to ensure that your child learns all the early literacy skills required to become a successful reader. Books are carefully selected and often relate to a general theme (e.g. farm, summer), ensuring your child has many opportunities to learn new vocabulary and grasp the sentences in the book. Furthermore, we make sure that book reading is fun, by following the child’s lead, talking about the pictures, and acting out the story with actions or props. We know that reading is important to your child’s future academic success, and we help lay the groundwork for successful reading (and writing) skills.

How do we improve social-communication?

What is social communication?

Social communication goes beyond talking and words. It involves using nonverbal behaviour (eye gaze, facial expression, gestures and body language) to tell others what you want and how you feel, and to understand what others want and feel. Successful communicators know the unspoken rules of conversation, which include waiting and listening while someone else speaks and then following up with a comment or a question that relates back to what the speaker has just said. Learning these unspoken rules helps your child to become an effective communicator.

What are social communication difficulties?

If your child does not send clear messages with gestures (e.g. get your attention by holding up objects, wave “bye-bye” , point to get things he/she wants, or point to share items of interest) by the second year of life, he/she is likely demonstrating difficulty with social communication (i.e. utilizing and understanding non-verbal messages). If your preschooler (ages 3-5) is only talking about the things that he/she is interested in and does not connect his comments to those of others, he/she may need to work on improving his social communication skills.

How do we improve social-communication skills?

We target social-communication within whole-language play based therapy. Specifically, we model,teach social scripts and role play appropriate use of words for social communication so that children learn how to:

• ask questions
• wait their turn
• share
• explain what is on their mind

These scripts are used in the context of dramatic play, snack-time, circle time, small-group and other play-based activities.

What is a Language-based Learning Disability?

Language-based learning disabilities are problems with age-appropriate listening, verbal-problem solving, speaking, reading, and/or writing. This disorder is not about how smart a person is. Most people diagnosed with learning disabilities have average to superior intelligence

What are signs of a Language-based Learning Disability?

• Difficulty expressing ideas clearly. What the child says can be vague and difficult to understand (e.g., using unspecific vocabulary, such as “thing” or “stuff” to replace words that cannot be remembered). Filler words like “um” may be used to take up time while the child tries to remember a word.
• Difficulty learning new vocabulary that the child hears (e.g., taught in lectures/lessons) and/or sees (e.g., in books)
• Difficulty understanding questions and following directions that are heard and/or read
• Difficulty recalling information
• Difficulty understanding and retaining the details of a story’s plot given during a classroom lecture
• Difficulty reading and comprehending material
• Difficulty learning words to songs and rhymes
• Difficulty telling left from right, making it hard to read and write since both skills require this directionality
• Difficulty learning letters and numbers
• Difficulty learning the alphabet
• Difficulty identifying the sounds that correspond to letters, making learning to read difficult
• Mixing up the order of letters in words while writing
• Mixing up the order of numbers that are a part of math calculations
• Spelling
• Memorizing the times tables
• Telling Time

What areas of language do you assess?

• Reading
• Writing
• Listening and Understanding
• Speaking
• Social-Communication
• Executive Functions

Reading (decoding and comprehension)

Is your child having difficulty with reading, but you are not sure why? We offer a comprehensive assessment to determine where the difficulties lie. We will determine whether it is a pre-reading, decoding, vocabulary and/or reading comprehension difficulty.

Based on this assessment an individualized treatment program is devised. Treatment can focus on the child’s:

• Pre-reading skills including but not limited to: letter identification, phonemic awareness, syllable identification and rhyming
• Decoding skills including but not limited to: understanding prefixes, suffixes, diphthongs, consonant digraphs and syllable chunking.
• Reading comprehension skills including but not limited to: building vocabulary, visualizing, understanding and remembering details, visualizing, understanding and remembering the main idea (gestalt), understanding figurative language, understanding symbolism and understanding themes

Writing (Letters, Generation & Organization)

Is your child having difficulty with various areas of writing and you are unsure how to help? We will complete a comprehensive writing assessment and develop an individualized treatment program specific to your child’s needs.
We offer Direct instruction as well as teach strategies for sentence, paragraph and essay writing.

Listening/auditory Comprehension

Is your child’s teacher reporting that your child has difficulty understanding and/or following along during classroom teaching? We can help. We offer comprehensive auditory comprehension assessments that evaluate the processing and understanding of information at the word, sentence and paragraph level.
We assess whether the difficulty is at the level of processing, comprehension and/or retention of information.
Based on the findings of the assessment, an intervention plan is developed to target the area or areas of weakness. This is performed both from a remediation and compensatory perspective.

Remediation is conducted in a hierarchical manner inviting increasing levels of auditory distraction as the level increases. This allows the individual to attend to, process and understand information even when external noise is present (e.g., classroom, work environment etc).

Compensatory strategies are provided to ensure correct transfer of information is occurring.

Speaking/discourse

Do you find that your child has a difficult time telling you what he/she is thinking. Do you wonder whether the problem is in generation of ideas, organizing their thoughts, formulating the sentence and/or in simply the output? If so, we can help. We will analyze their discourse (Our ability to communicate our thoughts, ideas, arguments, stories, information and questions) and determine where the problem lies. We will then target that specific area so that your child can feel confident to give presentations at school, talk at home and/or tell stories to their friends.

Social-communication

Social-communication involves the use of both nonverbal behaviour (eye gaze, facial expression and gestures) and verbal behaviour (speech or spoken language) to tell others what you want, to express feelings, to share ideas and to solve problems. It involves a fair amount of speaking, but even more listening and turn-taking. It involves the ability to read facial expressions and understand tone of voice. If you find that your child is having difficulty making and/or keeping friends, he/she may be having difficulty with social-communication. Give us a call. We offer a variety of treatment programs to improve social-communication.

Executive functions

Executive function refers to a set of mental skills that are coordinated in the brain’s frontal lobe. Executive functions work together to help a person achieve goals.
During school, problems with executive functioning (EF) impacts students in almost all their subjects and daily tasks. These may present as problems with; starting work, staying focused on work, completing work, and remembering to do the work. When children present with these problems they are often labeled as; lazy, unmotivated, undisciplined, not very bright or simply not trying hard enough.

Does your child have difficulties in any of the SEVEN areas below? If so, call us, we can conduct an assessment and develop a treatment plan to improve this specific area.

1. Impulse Control — the ability to stop and think before acting.
Does you child say or does things without thinking? Do they do whatever pleasurable thing comes along without considering their obligations or commitments? Children with this weakness often speed through schoolwork, sacrificing accuracy and completeness along the way.
If your child needs help with this skill, he or she may:

• interrupt a lot, chatter excessively, speak out of turn
• not get started on homework until close to bedtime
• make impulsive decisions that interfere with school demands
• rush through assignments without reading directions or checking work
• be very inconsistent, following rules one day but not the next

2. Emotional Control — the ability to manage feelings by thinking about goals.
Does your child have difficulty maintaining emotional control when painful or unexpected things happen? Children who can’t manage their emotions have trouble accepting criticism. They’re quick to call a situation “unfair.” They overreact to losing a game or getting called on in class. They have difficulty sticking with schoolwork when they are distressed about something.

If your child needs help with this skill, she or he may

• be easily frustrated and quick to give up
• be unable to tolerate corrections or criticism
• find it difficult to calm down and do homework
• have trouble postponing play or favorite activities until work is done

3. Flexibility — the ability to change strategies or revise plans when conditions change.
Does it seem that your child behaves in ways that is inflexible, or “cognitively rigid?” Do they have difficulty when a familiar routine is disrupted or when a task that seems easy becomes complicated. Do they get frustrated when a first attempt to solve a problem isn’t successful and are unable to see other ways to do familiar tasks or to make another choice when the first choice proves unworkable?

If your child needs help with this skill, he or she may

• not tolerate a change of strategy or tactics
• have difficulty with open-ended assignments that require brainstorming or choosing a topic
• panic when there’s a lot to remember or when a task doesn’t look like it will lead to success
• have trouble with transitions

4. Self-Monitoring — the ability to monitor and evaluate your own performance.
Does your child have difficulty with self awareness? Are they weak at monitoring themselves and need others to point out their areas of weakness? Do they misjudge their own efforts and have trouble adjusting what they’re doing based on feedback or cues. Are they often completely surprised by a low grade on a test or project?

If your child needs help with this skill, he or she may

• have trouble proofreading and checking work
• not notice when off on a tangent or not following directions
• lose sight of goals and endpoints
• skip test questions without noticing
• do things too fast or not pay attention to time limits and end up running out of tim

5. Planning and Setting Priorities — the ability to create steps to reach a goal and to make decisions about what to focus on.
Does your child have difficulty planning and setting priorities? Are they easily overwhelmed by complicated, multi-part tasks? Do they have difficulty independently imposing structure and order on their ideas? Do they have trouble thinking through the steps required to achieve a goal? Do they underestimate a project’s complexity and time requirements?
If your child needs help with this skill, she or he may

• come to class unprepared
• underestimate how much time and effort a project will take
• become overwhelmed trying to juggle multiple projects and classes
• have trouble identifying the main idea or most important information in what is read or heard

6. Task Initiation (Getting Started) — the ability to recognize when it’s time to get started on something and then to begin without procrastinating.
Does your child have trouble starting homework? Do they put off projects until the last minute? Do they seem lazy or unmotivated? Keep in mind that this child may procrastinate because he or she really doesn’t know how to start. Many children who have difficulty getting started also have trouble with planning and organizing. They get overwhelmed by all they have to do, so they don’t do anything.

If your child needs help with this skill, he or she may

• have trouble getting started even after being given directions and told to begin
• find reasons not to begin homework at the agreed-upon time
• be unable to complete three or four assignments in a row
• have difficulty following multi-step routines
• often turn assignments in late
• stare at a paper or screen, unable to begin writing

7. Organization — the ability to create and maintain systems to keep track of information or materials.
Does your child have difficulty planning, setting priorities, and getting started on a task? Do they often lose permission slips, assignment sheets, notebooks, and library books? Do they seem to never learn from their disorganization and not come up with a solution to improve? Children with poor skills in this area may understand the value of organization but are unable to discover ways to keep track of things.

If your child needs help with this skill, she or he may

• do homework but neglect to turn it in
• have trouble organizing their work and living space, materials, paperwork, and computer files
• come into class without needed materials
• often arrive late or turn in assignments late
• do sloppy or incomplete work

As schoolwork gets harder and students are asked to be more independent learners, children with weak executive skills fall further and further behind

What is a Speech Sound Disorder?

It is typical and normal for young children to make sound errors. A speech sound disorder occurs when mistakes continue past a certain age. Each sound is produced and mastered during an identified age range, and sound errors persisting past this range signal a disorder. Speech sound disorders include problems with articulation (making sounds) and phonological processes (sound patterns).

What is an Articulation Disorder?

An articulation disorder is a problem with making speech sounds. Sounds may be replaced, omitted, added or changed. Young children often make speech errors, and these errors often impact their intelligibility (i.e. the child’s ability to be understood). However, many of these errors are normal, like when a young child says “wabbit” for “rabbit”. However, if the child’s errors persist past an expected age or if a child is not acquiring the sounds he/she should have at certain age, then he/she may have articulation disorder.

Speech Sound Acquisition Chart

What is a Phonological Disorder?

A phonological disorder is a speech sound error in which the errors follow a distinct pattern. For example, omitting all final consonant sounds (“ca” for “cat” and “ma” for “man”). While it is typical and normal for young children to demonstrate patterned speech sound errors, these errors diminish in frequency and eventually disappear with age. If these errors persist past a certain age, the child may have a phonological disorder.

Most phonological processes are gone by the time a child is 5 years old.

How much of what my child says should be clear and understandable?
24 months = speech is 50% understandable

36 months = speech is 75% understandable

48-60 months = speech is 100% understandable

What is a Motor Speech Disorder?

Motor speech disorders are those which result from difficulty planning and coordinating the movements required for speech or weakness in the oral musculature, required to produce speech. Childhood Apraxia of Speech, Developmental Verbal Dyspraxia and Dysarthria are motor speech disorders that occur in childhood.

What is Childhood Apraxia of Speech?

Childhood apraxia of speech (CAS) is a motor speech disorder in which children struggle to say sounds, syllables or words. The child with CAS struggles to plan and coordinate the movements required for speech (i.e. movement of the tongue, jaw, lips, etc.). The child knows what he or she wants to say, but is simply unable to coordinate the movements required to say the particular words.

According to the American Speech and Hearing Association, the following are signs and symptoms of CAS:
A Very Young Child:

• Does not coo or babble as an infant
• First words are late, and they may be missing sounds
• Only a few different consonant and vowel sounds
• Problems combining sounds; may show long pauses between sounds
• Simplifies words by replacing difficult sounds with easier ones or by deleting difficult sounds (although all children do this, the child with apraxia of speech does so more often)
• May have problems eating

An Older Child:

• Makes inconsistent sound errors that are not the result of immaturity
• Can understand language much better than he or she can talk
• Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech
• May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
• Has more difficulty saying longer words or phrases clearly than shorter ones
• Appears to have more difficulty when he or she is anxious
• Is hard to understand, especially for an unfamiliar listener
• Sounds choppy, monotonous, or stresses the wrong syllable or word

Potential Other Problems:

• Delayed language development
• Other expressive language problems like word order confusions and word recall
• Difficulties with fine motor movement/coordination
• Over sensitive (hypersensitive) or under sensitive (hyposensitive) in their mouths (e.g., may not like tooth brushing or crunchy foods, may not be able to identify an object in their mouth through touch)
• Children with CAS or other speech problems may have problems when learning to read, spell, and write

What is Dysarthria?

Dysarthria is a motor speech disorder in which the muscles of the mouth, face, and respiratory system may become weak, move slowly, or not move at all. The type and severity of dysarthria depend on which area of the nervous system is affected. Some causes of dysarthria in children include head injury, cerebral palsy, and muscular dystrophy.

Common characteristics of dysarthria in children include:

• Slowed speech
• Difficulty coordinating breath for speech
• Unclear speech
• Slurred speech
• Voice that is too loud or too quiet
• Difficulty with using appropriate pitch and intonation
• Impaired voice quality (may sound hoarse, nasal, breathy)

Watch this video below to understand how we help children at school

What we can do to help you!

Upon contacting us, we will provide all parents/caregivers with additional information to increase their knowledge of childhood speech disorders. Parents who would like to have their child evaluated will arrange for an assessment which will include some or all of the following procedures:

1) A conversation/pre-assessment interview with the parent/caregiver.

2) Formal assessment including the administration of formal tests and assessment measures.

3) Observation – includes observing the child engaging and interacting with their parent and/or in the school
setting.

Following the assessment, we will determine whether your child would benefit from therapy. If your child requires therapy, we will recommend intervention to target their specific speech difficulties by teaching new sounds in place of error-sounds, targeting and reducing error patterns, teaching strategies to improve speech clarity, and working closely with family members, teachers and other key individuals in your child’s life, to help make communication more successful.