The Ultimate Parents' Guide to Speech Therapy
Published: Aug 22, 2023
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Updated: Sep 24, 2023
Written by Monika Guzek (She/Her)
Speech Language Pathologist
Reviewed by Angela Becka
Sr. Speech Language Pathologist
Navigating the world of speech and language disorders as a parent is an expedition filled with emotions, challenges, discoveries, and rewards. For many, it’s an unexpected journey -one they hadn’t planned for- yet one that ultimately enriches their lives in unimaginable ways.
When your child is diagnosed with a speech or language disorder, it propels you into a fascinating exploration of the human brain and the complexities of communication. It’s not just about learning; it becomes a deeply personal journey. The brain is remarkably complex, and as you explore your child’s unique challenges, you uncover its incredible potential to adapt, grow and learn.
Undoubtedly, this journey also comes with its fair share of hurdles. Balancing therapy sessions, follow-up activities, and regular life commitments can feel overwhelming at times. The continual quest for information and the best resources for your child requires persistence. Speech therapy, aids, and specialised educational resources can be expensive. The costs, both direct and indirect, can weigh heavily on families.
Despite the challenges, the most enriching part of this journey is knowing that your relentless efforts have a singular aim: to champion your child's success. Every strategy you learn, every hour spent in therapy, and every dollar invested converges into one outcome—helping your child find their voice, express themselves, and lead a fulfilling life.
This guide is designed for parents navigating this terrain in Australia and New Zealand. It’s a comprehensive resource that walks you through the complexities, offers support through the challenges, and celebrates the joys of the many milestones along the way. You're not just a parent; you're an advocate, a learner, and the most significant supporter your child could ever have. Most importantly, you’re not alone.
Welcome to this transformative journey.
Introduction to Speech and Language Development
Children's speech and language development involves a series of predictable milestones. These milestones serve as markers indicating typical growth, but can vary slightly from one child to another. Recognising and understanding these milestones can empower you as a parent to support your children’s communication skills and identify potential issues early on.
Differences between Speech and Language
While the terms "speech" and "language" are often used interchangeably, they have distinct meanings in the context of child development:
Speech
“Speech” refers to the physical production of sounds and words. It involves articulation (how speech sounds are made), voice (how vocal cords produce sound), and fluency (the rhythm of speech).
Language
“Language” is a broader concept that involves expressing and receiving information. It can be broken down into:
Receptive Language: Understanding what is being said to you.
Expressive Language: Being able to express your thoughts and ideas to others.
Both speech and language are crucial for effective communication. While speech focuses on (producing sounds correctly in) verbal expression, language includes comprehension (vocabulary meaning) and the grammatical rules that connect a specific communication system.
Typical Milestones and Timelines
Pro Tip: Speech Pathology Australia has a fantastic interactive booklet outlining normal communication milestones for children in Australia.
Birth to 3 months
Reacts to loud sounds.
Turns head towards a sound.
Begins to make cooing sounds.
4 to 6 months
Babbles with expression (e.g., "ba-ba-ba").
Listens to music and voices with interest.
Recognizes tone changes in the caregiver's voice.
7 to 12 months
Begins to respond to simple verbal requests (e.g., "come here").
Uses gestures, like waving or pointing.
Babbles chains of consonants (e.g., "mamama" or "dadada").
1 to 2 years
Says a handful of words by 18 months.
Begins to combine two words to make simple sentences (e.g., "more juice").
Recognizes pictures in books and might name them.
2 to 3 years
Vocabulary expands rapidly.
Speaks in two to three-word phrases.
Can be understood by familiar listeners most of the time.
3 to 4 years
Uses full sentences.
Talks about activities and includes details.
Asks a lot of questions.
4 to 5 years
Uses past tense.
Can tell a basic story.
Speaks clearly enough for strangers to understand.
Keep in mind that children develop at their own pace. Some might reach milestones earlier or later than the typical timeframe. Frequent interaction, reading, playing and talking to and with your child can foster their speech and language development.
Signs of Speech and Language Disorders
Just as there are milestones to indicate typical speech and language development, there are also signs that may suggest a child might be facing challenges in these areas. Being vigilant about recognising these signs can lead to timely intervention, which is crucial for optimising potential growth.
Infants/Toddlers (0-2 years)
Limited or no babbling by 12 months.
Doesn’t gesture, such as pointing or waving, by 12 months.
Doesn’t respond to their name as frequently as other babies might by 12 months.
Hasn't spoken a single word by 16 months.
Doesn’t play pretend or mimic actions by 18 months.
Doesn’t point to familiar objects or pictures when named by 24 months.
Preschoolers (2-4 years)
Struggles to be understood, even by family members.
Doesn’t engage in conversations or play with peers.
Can't form sentences or often mixes up words.
Has difficulty following simple two-step instructions.
Shows frustration when trying to communicate.
School-age (5-7 years)
Struggles with learning new words or vocabulary.
Often mispronounces words or uses them inappropriately in sentences.
Struggles with basic sentence structure.
Has difficulty telling or retelling a simple story.
Finds it challenging to understand age-appropriate stories or lessons.
All Ages
Shows issues with swallowing or drooling beyond the infant/toddler stage.
Stutters or frequently repeats sounds, syllables, or words. This can involve blocking on a sounds (typically a hard sound like t, p, b, or d), prolongations (typically a soft sound like ssssssss, or ffffffff), or groping (this is typically distinguished by the individual having difficulty forming the sounds of the words they want to say, e.g. for “Can you…” “Caaaaaah, caaaah ca”
Has a hoarse voice without a clear cause, like a cold.
Recognising early signs of speech and language disorders and seeking timely intervention can pave the way for better outcomes. Early diagnosis often translates to more effective treatments and can significantly impact a child’s communication skills, academic achievements, and overall confidence. If you suspect your child may have a communication disorder, seek professional help as soon as possible.
Types of Speech and Language Disorders
Speech and language disorders can manifest in various ways, affecting various aspects of a child's ability to communicate. Understanding the various types of speech and language disorders can help parents, caregivers, and educators provide targeted support.
Articulation Disorders
Articulation disorders are characterised by difficulties in pronouncing speech sounds correctly. Children with articulation disorders might substitute one sound for another ("wabbit" instead of "rabbit"), omit a sound ("cu" for "cup"), or distort sounds (the s sound may sound slushy).
Signs
Omitting sounds in words, or not saying all of the phonemes in a blend.
Mispronouncing vowels.
Consistently making the same sound errors past the expected age.
Fluency Disorders
Fluency refers to the rhythm and flow of speech. The most common fluency disorder is often referred to as stuttering, which is characterised by disruptions in the flow of speech, including repetitions of sounds or words, prolonged sounds, or blocks (unwanted interruptions in the flow of speech). Fluency disorders can be accompanied by secondary characteristics, such as groping, muscle tension, and eye blinking.
Signs
Frequent repetition of sounds or syllables.
Prolongation of sounds.
Using "um" or "uh" often.
Tension in the voice or facial muscles.
Voice Disorders
Voice disorders are related to the pitch, volume, or quality of the voice that distracts listeners from what's being said. They can be caused by vocal cord damage, infections, or other underlying factors.
Signs
Persistent hoarseness or breathiness.
Chronic sore throat or voice fatigue.
Speaking too loudly or too softly.
Lack of, or difficulty with, intonation
Receptive Language Disorders
A receptive language disorder involves difficulty understanding written and spoken language. Children with receptive language issues often struggle to grasp what is being said to them or comprehending text.
Signs
Difficulty following verbal instructions.
Asking for information to be repeated often.
Trouble with understanding complex sentences.
Expressive Language Disorders
An expressive language disorder involves difficulty putting words together, limited vocabulary, or difficulties producing coherent sentences and stories.
Signs
Limited vocabulary for age.
Frequent errors in verb tense.
Difficulty recalling words or producing complex sentences.
Social Communication Disorders
Children with social communication disorders find it challenging to use and understand verbal and nonverbal language in social settings.
Signs
Difficulty with making and keeping friends.
Challenges in understanding social cues, like facial expressions or body language.
Trouble with taking turns in conversations.
Cognitive-Communication Disorders
These disorders involve cognitive processes like attention, memory, organisation, regulation, and problem-solving. Cognitive-communication disorders can be present from birth due to genetic factors, prenatal influences or complications during pregnancy, or result from a traumatic brain injury or other neurological issues.
Signs
Difficulty organising thoughts.
Trouble staying on topic during conversations.
Challenges with understanding abstract concepts.
Children can experience more than one type of speech or language disorder simultaneously. Additionally, some disorders might seem like normal developmental phases. If you're concerned about your child's speech or language, it's crucial to consult with a qualified professional to get an accurate diagnosis and appropriate intervention.
Common Causes of Speech and Language Disorders
Understanding the root causes of speech and language disorders can help parents make informed decisions and provide the necessary support for their children. Here are some of the common causes:
Genetics
Family history can play a role in the presence of a speech and/or language disorder. If a parent or close relative had a speech or language disorder, the child might be at a higher risk. Hereditary factors can influence disorders like stuttering or certain articulation issues. Genetic syndromes can also be linked to speech and language challenges.
Hearing Loss
For children, hearing is a critical part of learning to speak and developing their language skills. Hearing loss can be temporary, due to frequent ear infections, or permanent. Regular hearing screenings are essential to catch and address any issues early on.
Neurological Disorders
Conditions like cerebral palsy, muscular dystrophy, or traumatic brain injuries can impact the muscles needed for speech and the brain areas responsible for language. The severity and type of speech or language disorder will depend on the specific neurological condition and its impact. Many children with neurological disorders benefit from tailored speech therapy interventions.
Physical Impairments
Conditions such as cleft lip or cleft palate can affect the structure of the mouth, making feeding or articulation challenging. Surgical interventions combined with speech therapy often lead to significant improvements. Early intervention is crucial to address speech issues related to physical impairments.
Vocal Abuse or Misuse
Excessive shouting, throat clearing, or even singing can strain the vocal cords and lead to voice disorders. Children who misuse their voices might develop nodules on their vocal cords, leading to hoarseness. Proper voice care and training can prevent and address these issues.
Developmental Delays
Children with global developmental delays or specific conditions like autism spectrum disorder might experience speech and language challenges. The spectrum of speech and language issues can vary widely among these children. Tailored interventions based on the child's unique needs are often beneficial.
Environmental Factors
A lack of exposure to language-rich environments or neglect can impact a child's speech and language development. It's essential for children to be exposed to consistent, clear speech and opportunities for conversation.
For parents who are bilingual, we in no way intend to suggest that you should be monolingual in the house. There are many developmental benefits for children who learn multiple languages, one of which is increased cognitive abilities. Being bilingual often results in advantageous structural differences in the prefrontal cortex later on in life. However, during the critical period, children should be supported in whichever languages they are learning.
Understanding possible causes of speech and language disorders can provide clarity for parents and allow them to seek the most suitable intervention and support for their children. Often, a combination of factors might contribute to a child's challenges, so a comprehensive evaluation by professionals is essential for a holistic approach to treatment.
The Importance of Early Intervention
Recognising and addressing speech and language disorders as early as possible can significantly influence a child's developmental trajectory. Australia and New Zealand have embraced early intervention in their healthcare and educational systems, acknowledging its significance in shaping positive outcomes.
Benefits of Early Diagnosis and Treatment
Optimal Development: Early intervention can set the foundation for the development of essential communication skills. Addressing issues early can prevent many of them from becoming deeply ingrained, making them easier to manage. Not all disorders will be resolved with early intervention, but many can be minimised as the child develops into a healthy adult, ultimately helping the child achieve their potential.
Improved Academic Outcomes: Children who receive early speech and language support are often better equipped to handle academic challenges, leading to a more successful schooling experience. This may not be true for all disorders, with severity of the disorder being a factor, but generally speaking, a child who is a better communicator will experience better academic outcomes.
Enhanced Social Skills: Addressing speech and language challenges early on can boost a child's confidence in social settings, enabling better interactions with peers and fostering friendships.
Reduced Need for Intensive Therapy Later: Early identification and intervention can often reduce the need for more intensive and prolonged therapy in later years. Again, this depends on the specific disorder and its severity, but generally speaking, early assistance can reduce the burden on the child (who will become an adult) later on in life. Children with severe communication challenges may need extensive support throughout each stage of their life to be able to function independently.
Empowerment for Families: Early intervention not only benefits the child but also equips parents and caregivers with tools and strategies to support their child's development at home.
Early Intervention Programs
Both Australia and New Zealand recognise the benefits of early intervention in optimising a child's future health, academic success, and social well-being. Parents are encouraged to seek assistance at the first sign of a potential speech or language disorder, using the available support systems in both countries.
Australia
Better Start for Children with Disability Initiative: This federal initiative provides funding for early intervention services, which include speech therapy, for eligible children.
National Disability Insurance Scheme (NDIS) Early Childhood Early Intervention (ECEI): This approach supports children aged 0-6 years who have a developmental delay or disability. It focuses on providing timely support without the need for a formal diagnosis.
State-specific programs: Various states and territories in Australia have their own early intervention programs, often operating through community health centres and public hospitals.
Clinics: Many clinics will offer free 15-minute consultations for preschoolers. They’re filled with fun activities and can be a good starting point for you and your child.
New Zealand
Ministry of Health's Early Intervention Service: This service assists families of children with developmental or behavioural challenges, including speech and language disorders.
TalkLink Trust: Specialising in assistive technologies for communication, TalkLink provides early intervention support for children with severe communication difficulties.
The B4 School Check: A free health and development check for 4-year-olds that can flag potential speech and language issues, allowing for timely intervention.
How to Seek Professional Help
While every child is unique and develops at their own pace, if you notice consistent delays or several of the warning signs mentioned above, it's essential to consult a professional
Consult with your Paediatrician: Your child's primary healthcare provider is a good place to start. They can offer a preliminary assessment and, if they see any concerns, they refer you to a specialist. This is often needed for insurance purposes, but even if you wish to pay privately, a referral can often mean that you get seen sooner.
Early Intervention Services: For children under age three, early intervention services can evaluate your child and offer therapy if they qualify.
Seek a Speech-Language Pathologist (SLP): An SLP specialises in evaluating and treating children with speech and language disorders. They can provide a comprehensive assessment of your child's communication skills and recommend appropriate interventions.
Educational Evaluation: If your child is in school and struggles functionally or academically due to speech or language challenges, you can request an evaluation through the school district.
Remember, it's always better to be proactive. Even if your child doesn't have a speech or language disorder, consultations can provide you with peace of mind and strategies to support your child's development.
The Role of a Speech Therapist (Speech-Language Pathologist)
Speech-Language Pathologists (SLPs), commonly referred to as speech therapists, play an integral role in diagnosing, treating, and supporting individuals with speech and language disorders. Here's a closer look at their education, qualifications, and the breadth of their practice.
Education and Qualifications
Bachelor's Degree: Most SLPs start with a bachelor's degree in communication sciences and disorders or a related field. However, a specific undergraduate degree might not always be a requirement for pursuing advanced studies in the field.
Master's Degree: In some countries, to become a licensed SLP, one must obtain a Master's degree in Speech-Language Pathology in addition to the Bachelor’s. In Australia, the minimum requirements are a Bachelor of Speech Pathology, or a Master of Speech Pathology in addition to another undergraduate program. These graduate programs cover anatomy, physiology, principles of acoustics, and developmental and acquired disorders.
Clinical Experience: Graduate students undergo supervised clinical experience, working with both children and adults, to gain hands-on skills and understanding.
Licensure: After completing the educational requirements and clinical experience, aspiring SLPs must obtain licensure in their state or country. Requirements can vary, but often include passing a national examination.
Certification: Many SLPs also earn professional certification. While certifications and membership requirements might differ slightly, they universally uphold the standards of the profession. Whether you're an SLP, a client, or an employer, these certifications instil confidence in the expertise and ethics of the professional. Some of the well-known certifications are listed below by country.
Country | Certification | Note |
---|---|---|
United States | Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) | Offered by the American Speech-Language-Hearing Association (ASHA), this certification is widely recognized within the U.S. It requires the completion of graduate education, supervised clinical practice, continued participation in professional development, and a successful score on a national exam. |
Australia | Certified Practising Speech Pathologist (CPSP) | This credential is conferred by Speech Pathology Australia. It signifies that an SLP has met the rigorous standards for professional practice in Australia and participates in ongoing professional development. |
New Zealand | Membership with the New Zealand Speech-Language Therapists' Association (NZSTA) | While not a certification per se, membership with the NZSTA is considered a standard for practising SLPs in New Zealand. Members adhere to a code of ethics and standards of practice and are expected to partake in continuous professional development. |
United Kingdom | Health and Care Professions Council (HCPC) Registration | To practise as an SLP (referred to as a Speech and Language Therapist in the UK), professionals must be registered with the HCPC. This registration assures that the therapist meets the standards for training, professional skills, behaviour, and health. |
United Kingdom | Membership with the Royal College of Speech & Language Therapists (RCSLT) | While optional, this membership provides professionals with access to resources, training, and advocacy opportunities. |
Canada | Certification from the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA) | hough the certification process might vary by province, the CASLPA offers a nationally recognized certification. SLPs in Canada usually need to be registered with their provincial regulatory body to practise. These bodies ensure that professionals meet the necessary standards of practice and ethics. |
Continuing Education: To maintain licensure and stay updated with the latest techniques and findings, SLPs often participate in ongoing professional development.
Scope of Practice
A speech pathologist’s scope of practice includes evaluating and providing intervention for communication challenges resulting from conditions such as developmental delays, stroke, brain injuries, or hearing loss. They work with individuals across all age groups, from infants to the elderly, and often collaborate with other healthcare professionals to ensure holistic care. In addition to direct therapy, SLPs also advise on augmentative and alternative communication (AAC) strategies and devices, support swallowing and feeding issues, and engage in research, education, and advocacy within their field.
Assessment and Diagnosis: SLPs evaluate individuals to identify speech, language, voice, and fluency disorders. This process often involves standardised tests, observations, and consultations with the individual or their parents and other professionals.
Treatment Planning and Implementation: Based on the initial assessment, SLPs design individualised therapy plans and then work directly with clients to improve or restore their communication abilities.
Counselling: SLPs provide guidance and counselling to individuals and families to help them understand the challenges and coping strategies.
Collaboration: SLPs collaborate with other professionals, like educators, audiologists, occupational therapists, and doctors, to offer holistic care to clients.
Prevention and Education: SLPs often engage in proactive measures, providing screenings in schools or communities to identify potential disorders early on. They also educate the public about speech and language disorders.
Research: Some SLPs contribute to the field by conducting research, aiming to discover more effective interventions or to better understand the underlying causes of speech and language disorders.
Advocacy: SLPs support people with communication disorders by advocating for their clients’ needs as well as raising public awareness about their challenges.
Specialisations: While many SLPs work broadly across various speech and language issues, some specialise in areas such as dysphagia (swallowing disorders), voice disorders, or working with specific populations like children with autism.
Evaluation and Diagnosis
The evaluation and diagnosis phase is the first and most important step in the speech therapy process. It offers a comprehensive understanding of an individual's speech and language abilities and paves the way for targeted interventions. For parents, knowing what to expect can ease concerns and make them more active in the process.
What to Expect During an Assessment
Intake Interview
The assessment often starts with an interview where the therapist gathers background information about the child's developmental history, medical history, family history of speech or language disorders, and any concerns the parents might have.
Observation
The therapist may observe the child in various settings—interacting with parents, playing, or even during structured tasks. This helps the therapist understand the child's communication style and any potential issues.
Structured Testing
Using standardised tests, the therapist evaluates the child's speech and language abilities as compared to their age-matched peers.
Interactive Activities
The child might engage in tasks or games designed to assess specific aspects of speech, language, or communication. These activities allow the therapist to gauge the child's abilities in a less formal setting.
Feedback Session
After the assessment, the therapist usually discusses preliminary findings with the parents, providing insights into areas of strength and concern.
Report Generation
A detailed report is often provided after the assessment, outlining the findings, diagnosis (if any), and recommended next steps.
Types of Tests and Tools Used
In Australia, speech-language pathologists use a combination of international and locally developed standardised tests to assess speech and language abilities. These tests are adapted to the Australian context, accounting for local linguistic and cultural differences.
Standardised Speech and Language Tests
Some of the most commonly used standardised speech and language tests in Australia include:
Clinical Evaluation of Language Fundamentals - Australian and New Zealand Fifth Edition (CELF-5 A&NZ): This is used to assess a child's language and communication abilities.
Preschool Language Scale - Fifth Edition Australian and New Zealand Language Adapted Edition (PLS-5 A&NZ): Designed for younger children, this test evaluates both expressive and receptive language skills.
The Australian Standardised Spelling Age Test (ASSAT): As the name suggests, this test is focused on spelling abilities.
The Assessment of Literacy and Language (ALL): This assesses the link between language and literacy in primary school-aged children.
The Fluharty Preschool Speech and Language Screening Test - Second Edition Australian and New Zealand Adapted Edition (Fluharty-2 A&NZ): This is a screening tool used to identify preschool children who may be in need of a more comprehensive speech and language evaluation.
Nuffield Dyspraxia Programme – Third Edition (NDP3): Used to assess and guide therapy for children with speech sound disorders, especially developmental verbal dyspraxia.
Secord Contextual Articulation Tests (SCATs): This focuses on evaluating articulation in context.
In addition to these, internationally recognised tests like the Peabody Picture Vocabulary Test (PPVT) and the Goldman-Fristoe Test of Articulation are also used, but might be supplemented with locally developed tools or used in their Australian-adapted versions.
Hearing Screenings
Since hearing is vital for speech and language development, a basic hearing screening might be conducted to rule out any hearing issues.
Oral-Motor Assessment
This evaluates the strength and coordination of the muscles involved in speaking and swallowing. The therapist will check the child's lips, tongue, palate, and facial muscles.
Fluency Assessments
For children with suspected stuttering or other fluency issues, specialised assessments like the Stuttering Severity Instrument (SSI) might be used.
Voice Assessments
These evaluate the quality, pitch, volume, and resonance of the child's voice, helping identify potential voice disorders.
Pragmatic Language Assessments
These focus on social communication skills, gauging how a child uses language in social settings. Tools might include observational checklists or structured tasks.
Dynamic Assessments
These evaluate a child's ability to learn a new skill during the assessment, offering insights into their potential to benefit from therapy.
Knowing what to expect during the evaluation and diagnosis process can help parents to actively participate, ask questions, and better understand the needs and potential interventions for their child. It also helps set realistic expectations and understand the journey ahead in speech therapy.
Therapeutic Interventions
Effective speech therapy tailors interventions to the unique needs of each individual, drawing from a variety of techniques and methodologies. The approach chosen depends on the nature of the speech or language disorder, the age of the individual, and the individual’s goals of and response to therapy.
Individual Therapy
This is a one-on-one session between the therapist and the individual. It offers personalised attention, ensuring that interventions are specifically targeted to the individual's needs. Individual therapy allows for a deep dive into specific areas of concern. The therapist can adjust the pace, methods, and focus based on real-time feedback and progress.
Group Therapy
Group sessions involve multiple individuals working together under the guidance of a therapist. These sessions often target social communication, fluency, or other areas where group interaction is beneficial. Group therapy offers opportunities for peer interaction, role-playing, and the practice of skills in a social setting. It can help in building confidence and providing a support system.
Group vs Individual Therapy for Children
In Australia and New Zealand, both individual and group therapies are utilised for speech and language intervention, depending on the specific needs and circumstances of the client.
Typically, when a child first presents with speech or language concerns, individual therapy sessions are more common. This is because individualised attention is important for building a trusting relationship, identifying the child’s interests, strengths and challenges, and evaluating the child’s response to interventions.
In certain areas or settings, resources and time might dictate the availability of group versus individual sessions. For example, in schools and some rural or remote areas, group sessions might be organised as a way to provide services to multiple clients simultaneously.
Australia places a strong emphasis on early intervention for speech and language concerns. Programs like the National Disability Insurance Scheme (NDIS) offer support services for younger children. Given the diverse development of young children, individual sessions are often preferred to meet the unique needs of each child.
Group therapy sessions can sometimes be more cost-effective for families, especially if they are self-funding the sessions. However, government programs or insurance schemes, such as NDIS, might provide funding that covers individual therapy sessions, influencing a family's choice.
There's been a growing recognition of the value of group therapy in addressing certain skills, especially for school-aged children. Skills like social communication, turn-taking, and group interaction can be practised effectively in group settings.
While individual therapy remains a cornerstone of speech and language intervention in Australia, group therapy's role and prominence has grown, particularly in specific contexts and for certain skills. The best approach often depends on the specific needs of the child, therapist recommendations, and available resources.
Common Speech Therapy Techniques Used for Children
Name | Description | Usage |
---|---|---|
PROMPT Therapy | PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) involves tactile cues to support and shape oral muscular movements during speech. | It's often used for children with articulation disorders or motor speech disorders like apraxia. |
Auditory Verbal Therapy | This method focuses on teaching children with hearing loss to use their residual hearing, often amplified by hearing aids or cochlear implants, to interpret and process spoken language. | Primarily used for children with hearing impairments. |
Lidcombe Program | A behavioural treatment for young children who stutter. It involves parents or caregivers giving feedback to the child about their speech in everyday situations. | Used primarily with young children who stutter, often under the age of six. |
Westmead Program | A program designed for older children who stutter, focusing on using syllable-timed speech various times throughout the day, which has been shown to improve fluency over time. This program does not rely on feedback from parents as in the Lidcombe Program, however, does encourage parent participation in the syllable-timed speech conversations. | Typically used for children aged 7 to 12 who stutter. |
Oakville Program | This is a stuttering treatment program that combines aspects of both the Lidcombe and Westmead Programs. It is structured yet flexible, allowing for tailoring to individual children's needs. | Designed for children who stutter. |
Hanen (ITTTT) | The Hanen Program is designed to help parents enhance their child's social, language, and literacy skills through natural, everyday situations. | Commonly used for children with language delays and their families. |
Sounds-Write | A phonics program developed to teach reading, spelling, and writing. It aims to teach children to understand the relationship between spoken and written language through a synthetic phonics approach. | Used to teach early literacy skills, often used in schools. |
Differences Between The Stuttering Programs
There are three main stuttering programs used in Australia. They share a lot of features, but there are subtle differences between them.
Age Group
Lidcombe: Best suited for younger children, typically under 6 years of age.
Westmead: Designed for older children, usually between 7 to 12 years.
Oakville: A hybrid that can be adapted for various age groups.
Parental Involvement
Lidcombe: High parental involvement, where parents provide real-time feedback.
Westmead: Conversational opportunities with parents are encouraged, but parental feedback is not required.
Oakville: Blends both approaches.
Focus
Lidcombe: Emphasises positive reinforcement for fluent speech.
Westmead: Prioritises training the child to use smooth speech.
Oakville: Combines elements of both.
Some SLPs approach stuttering in young children with Lidcombe first, as it's the most effective, and one of the other two as a last resort if Lidcombe is not producing an optimal result.
Role of Family in Therapy
Family members provide essential emotional and moral support, motivating the child throughout their therapeutic journey. Therapy sessions are limited, and real progress happens when exercises and practices are done consistently at home. Families play an important role in ensuring regular practice and consistency.
Regular communication between the therapist and family can ensure that everyone is on the same page. Families can provide valuable information about the child's behaviour and challenges at home, helping the therapist customise treatments and recommendations.
Lastly, family members can advocate for the child in various settings, ensuring that the child receives the necessary accommodations and understanding, be it at school, extracurricular activities, or in social situations.
Incorporating interventions in therapy and at home is crucial for tackling speech and language challenges. The active involvement and relationship between families and therapists can result in children making significant strides in their communication journey.
Creating a Supportive Environment
Making a supportive home environment is crucial for reinforcing the strategies learned from therapy. Parents and caretakers play a pivotal role in this, giving the child plenty of opportunities to practise and improve their speech and language abilities.
Here’s how families can foster a supportive setting:
Enhancing Communication at Home
Active Listening: Always give your child your undivided attention when they are speaking. This boosts their confidence and encourages them to communicate more.
Simplify Language: For children with language delays, using short sentences and simpler words can be helpful. It offers them a model of clear speech without overwhelming them.
Expand on Their Language: If a child says a word or a short phrase, you can expand on it. For example, if they say "car," you can say, "Yes, that's a big red car."
Avoid Interrupting: Allow your child to express themselves fully without jumping in, even if they are taking time or making errors.
Using Appropriate Toys and Games
Educational Toys: Toys like puzzles, shape sorters, or building blocks can stimulate cognitive development and problem-solving skills while also enhancing fine motor skills which can indirectly support speech development.
Interactive Games: Board games or card games can be great for promoting turn-taking, listening skills, and vocabulary development.
Role-Playing Toys: Dollhouses, action figures, or playsets allow children to enact scenarios, encouraging imaginative play and vocabulary expansion.
Sound and Music Toys: Instruments or toys that make various sounds can be beneficial for auditory discrimination and imitating sounds.
Establishing a Routine
Consistency is Key: Children, especially those with speech or language disorders, often thrive on routine. Predictable routines can reduce anxiety and create more opportunities for meaningful communication.
Visual Schedules: For children who struggle with transitions or understanding the sequence of events, visual schedules, a schedule that includes pictures, can be beneficial.
Routine Activities: Incorporate speech and language exercises into daily routines. For example, naming body parts during bath time or discussing the colours of clothes during dressing.
Encouraging Social Interaction
Playdates: Arrange for playdates with peers. Social interactions can be a rich source of language exposure and practice.
Group Activities: Enrolling your child in group activities such as art classes, music groups, or sports can enhance their social communication skills.
Family Time: Engage in family activities like board games, storytelling sessions, or group cooking, where everyone gets a chance to speak, listen, and interact.
Feedback: After social interactions, discuss with your child what went well and areas they can work on. Praise their efforts and provide gentle guidance on areas of improvement.
A supportive home environment is critical in a child's speech and language journey. It provides the consistency, reinforcement, encouragement, and opportunities for practice which are crucial for progress, complementing formal therapeutic interventions.
Incorporating Technology
Digital technology has revolutionised the field of speech therapy. Advanced tools and platforms make therapy more interactive, engaging, and efficient. From software applications to hardware devices, technology plays a pivotal role in modern speech and language intervention.
Speech Therapy Apps
These are specially designed applications that cater to a variety of speech and language needs. They offer exercises, games, and structured challenges aimed at enhancing specific skills.
Advantages
Flexibility: These apps can be used anytime and anywhere, allowing for frequent practice.
Engagement: Many of these apps are gamified, making therapy exercises more enjoyable and motivating for children.
Feedback: Instant feedback can be provided, allowing for real-time adjustments.
Popular Apps
SpeechFit: SpeechFit keeps track of stuttering progress and engages with a clinician through annotated audio.
Articulation Station: Focuses on improving articulation through fun activities.
Speech Tutor: Provides visual insights into how sounds are produced.
Toca Boca series: Encourages expressive language and vocabulary development through interactive scenarios.
Considerations
Ensure the app is suited to the child's specific needs and challenges.
It's essential to strike a balance between screen time and other activities.
Augmentative and Alternative Communication (AAC) Devices
AAC devices are used to assist those who cannot rely on speech to communication. They are particularly beneficial for individuals with severe communication disorders.
Often, there is a negative association with AAC devices. Parents may be afraid that if their child uses one, it will prevent their child from talking because they will just communicate with the AAC device. However, the AAC device is meant to help the child communicate when they are unable to do so verbally. There are multiple developmental benefits to communicating, and parents may find that the assistance actually encourages their child to speak more.
Types of AAC Devices
Low-tech devices: These can be as simple as picture boards or communication books where users point to symbols or pictures to convey their messages.
High-tech devices: Sophisticated electronic devices, including speech-generating devices (SGDs) or tablets with specialised software. Users may point, use a switch, or even eye-track.
Advantages
Empowerment: AAC devices provide a voice to those who might otherwise struggle to communicate, fostering independence and self-confidence.
Social Interaction: They facilitate better interaction with peers, family, and educators, enhancing social experiences and relationships.
Considerations
Proper training is essential. Both the user and their communication partners should understand how to use the AAC device effectively.
The choice of AAC device should be based on the individual's needs, abilities, and daily environments. Periodic assessments can ensure that the device remains suitable as needs change.
Embracing technology in speech and language therapy offers many benefits. It can make interventions more flexible, customised, and efficient. However, it's crucial to remember that technology is just a tool. The expertise of a skilled therapist, coupled with the dedication and involvement of families, remains at the heart of successful communication interventions.
Working with Schools
For many children with speech and language disorders, the school environment plays a fundamental role in their therapeutic journey. Schools not only provide academic instruction, but can also offer essential support services that can enhance communication skills. Collaborating with schools can ensure a holistic, consistent, and efficient approach to speech and language intervention.
Individualised Education Plans (IEPs)
An IEP is a legally binding document outlining a student's specific learning needs, the services the school will provide, and how progress will be measured.
Components
Current Performance: A description of the student's current academic and functional performance.
Goals: Annual goals to track the student’s progress.
Services: Specific services, including speech therapy, that the school will provide to help the student meet these goals.
Participation: How the student will participate in standardised tests and what accommodations will be provided.
Transition: Plans for transitioning to post-school activities (relevant for older students).
Advantages
Tailored Approach: Ensures a customised educational experience catering to the student's unique strengths and needs.
Accountability: With specific goals and regular reviews, IEPs ensure that schools are accountable for providing the necessary support.
Collaboration
Parents, teachers, therapists, and often the students themselves contribute to creating and reviewing the IEP. This team-based approach ensures all perspectives are considered.
School-based Therapies vs. Private Therapies
When navigating school-based support, it's essential for parents to be proactive, informed, and collaborative. Communicating with educators and therapists, understanding available resources, and advocating for the child's needs can ensure a comprehensive and effective approach to speech and language development. Combining the strengths of both school-based and private therapies can often provide the most well-rounded support system for a child.
School-based Therapies Advantages
Convenience: Therapy is provided within the school setting, eliminating the need for external appointments.
Integration: Therapy goals align with academic goals, offering a more holistic approach.
Cost: Generally provided at no extra cost to families as part of the public education system.
School-based Therapies Limitations
Scope: Therapy in schools is usually focused on educational outcomes. It might not address all communication needs, especially those not directly impacting educational performance.
Frequency: Depending on the school's resources, frequency of sessions might be limited.
Private Therapies Advantages
Comprehensive: Can address a broader range of communication challenges, not just those linked to educational performance.
Flexibility: Scheduling can be more flexible, and session frequency can be adjusted based on need.
Private Therapies Limitations
Cost: Though insurance or other funding sources might cover private speech therapy, there may be an additional cost to the family.
Logistics: Requires additional scheduling and potentially travelling to an external location.
Cost and Coverage
Navigating the financial implications of speech therapy is an essential part of ensuring your child receives the necessary support. Both Australia and New Zealand have healthcare systems and community programs in place to assist families. However, understanding the landscape and knowing where to look can help parents make informed choices.
Learn about the intricacies of funding speech therapy in our guide to funding speech therapy in Australia.
Handling Emotional and Social Challenges
Children with speech and language disorders often face emotional and social challenges that extend beyond the primary disorder. Parents can help their children navigate them with resilience and confidence.
Building Self-esteem and Confidence in Your Child
Positive Reinforcement: Regularly acknowledge and celebrate your child's accomplishments, no matter how small. This promotes a sense of achievement.
Encourage Participation: Enrol your child in activities they are passionate about, such as arts, sports, or other hobbies. Achievements outside of school can be a confidence booster.
Open Conversations: Foster an environment at home where your child feels comfortable sharing their feelings. Regularly check in with them about their day, their friends, and any challenges they might be facing.
Professional Support: Consider enrolling your child in counselling or therapy sessions to build coping mechanisms and strengthen their self-worth, especially if they display signs of lowered self-esteem.
Addressing Bullying or Social Isolation
Educate and Advocate: Educate your child's peers and their parents about speech and language disorders. A better understanding can lead to increased empathy.
School Liaison: Regularly communicate with teachers and school counsellors to keep an eye out for signs of bullying. Schools in Australia and New Zealand have anti-bullying policies in place which can be activated if needed.
Social Skills Training: Some children benefit from social skills training, which equips them with strategies to interact positively with peers and assert themselves when necessary.
Build a Support Network: Encourage friendships and playdates with understanding peers. Group activities or clubs can be an avenue for your child to meet and bond with like-minded individuals.
Supporting Siblings
Open Dialogue: Siblings may have feelings of confusion, jealousy, or frustration. It's essential to keep an open dialogue with them, acknowledge their feelings and offer support.
Include Them: Involving siblings in therapy or counselling sessions can help them better understand the challenges their brother or sister faces.
Quality Time: Ensure that each child gets individual attention. Designate "special days" or activities where you spend one-on-one time with each sibling, focusing on their interests and needs.
Access to Resources: Just as there are resources for parents, there are books and websites tailored for siblings. Sharing these can provide them with a better understanding and coping strategies.
Many community and government programs are dedicated to supporting children with disabilities and their families. Using these resources, coupled with a proactive and empathetic approach, can lessen emotional and social struggles, ensuring a supportive environment for the entire family.
Transitioning and Future Planning in Australia and New Zealand
The journey of a child with a speech or language disorder doesn't end as they transition out of childhood. This phase requires planning and continued support, ensuring that they can navigate the challenges of the adult world with confidence. Both Australia and New Zealand offer resources and programs to aid this transition.
Preparing for Adolescence and Adulthood
Individualised Transition Plans: Much like IEPs (Individualised Education Plans) at schools, parents can collaborate with educators, therapists, and counsellors to craft transition plans that address the unique needs and aspirations of the adolescent.
Life Skills Training: Training focuses on honing essential skills that go beyond speech and language, such as financial literacy, self-care, and navigating public transportation. Some community programs and schools offer workshops and courses to equip young adults with these skills.
Continued Therapy: As children mature, their therapy needs may evolve. Continuing with speech and language therapy can address the nuanced challenges of adolescence and early adulthood.
Mental Health Support: Adolescents with speech and language disorders can sometimes grapple with anxiety, depression, or self-esteem issues. Access to counselling or mental health support can be beneficial.
Vocational Training and Job Placement
Many people who have speech and language disorders do not need assistance in integrating into the workplace. They can get the wellbeing benefits that come along with knowing you are contributing to society, and often make excellent colleagues.
Some might need a little extra help, and we are lucky that in Australia and New Zealand, there are several options which can support.
Australia
Disability Employment Services (DES): This program assists individuals with disabilities, including speech and language disorders, in gaining employment. It offers vocational training, job placement, and post-placement support.
Transition to Work (TtW) program: Aimed at young individuals, this program provides pre-employment training and support to build skills and confidence.
New Zealand
Workbridge: Workbridge aids individuals with disabilities or injuries in finding and sustaining employment. They offer career counselling, job search assistance, and support once placed in a job.
Transition Programmes: Some schools in New Zealand offer transition programs for students with disabilities, focusing on vocational skills, life skills, and preparing them for post-school education or employment.
Transitioning from childhood to the adult world presents its own set of challenges for individuals with speech and language disorders. However, with comprehensive planning, targeted support, and utilising the resources available in Australia and New Zealand, these individuals cannot only navigate this transition smoothly but also thrive in their chosen paths.
Tips for Advocacy
Advocacy is a crucial component for parents of children with speech and language disorders. It includes standing up for your child's needs, ensuring they get the appropriate support, and fostering an environment where they can thrive both academically and socially. Here are some essential advocacy tips for parents:
Knowing Your Child’s Rights
Education Laws: Familiarise yourself with local, state, and federal education laws that pertain to children with disabilities.
Non-discrimination: Understand that laws in many countries prohibit discrimination based on disability. This includes access to educational resources, extracurricular activities, and other school-related events.
Stay Informed: Laws and regulations can change. Stay informed of changes to ensure you're fully aware of your child's rights.
Documentation: Maintain a well-organised file of all documents related to your child's condition and therapy. This can be valuable information when discussing with providers or handling disputes about services.
Joining Parent Support Groups
Shared Experiences: Connecting with other parents can provide insights, advice, and strategies that have worked for them. Their experiences can be both informative and reassuring.
Resource Sharing: Such groups often have resources like therapist recommendations, educational material, or workshop information that can benefit your child.
Emotional Support: Parenting a child with a speech or language disorder can be challenging. Having a supportive community can provide emotional solace during tough times.
Unified Voice: As a group, parents can have a stronger voice when advocating for system changes or additional resources in schools or the broader community.
Keeping Open Communication with Therapists and Educators
Regular Check-ins: Establish a routine of regular meetings or check-ins with your child's therapist and educators to discuss progress, challenges, and consistency in usage of strategies.
Open Feedback: Encourage open lines of communication where both positive feedback and concerns can be shared candidly.
Collaborative Approach: Work as a team with the professionals. While you bring insights from home and a deep understanding of your child, they bring expertise and experience in educational and therapeutic strategies.
Stay Proactive: Don’t wait for scheduled meetings or sessions. If you notice a change in your child or have concerns, reach out promptly.
Advocacy is a continuous journey. While there might be challenges along the way, remember that your proactive stance not only benefits your child but can also pave the way for better understanding and support for other children facing similar challenges. The combined efforts of informed parents, dedicated therapists, and committed educators can create a nurturing environment where every child gets the opportunity to reach their fullest potential.
Staying Informed
Both Australia and New Zealand have a rich array of resources, organisations, and platforms dedicated to speech and language therapy and related disorders. Parents can tap into these to stay updated, gain knowledge, and connect with experts and other parents.
Recommended Books, Resources, and Websites
Books:
"The Parent’s Guide to Speech and Language Development" by a mother and a speech pathologist offers insights into speech development and disorders, advocacy, and support.
"Speech Therapy for Kids: A Parent's Practical Guide for Speech and Language Exercises for Children" by Peyton Richmor focuses on the speech therapy process for children.
Websites:
SpeechFit: SpeechFit has content on neuroscience, speech, and language that is tailored to parents, adult clients, and speech pathologists alike.
Speech Pathology Australia (SPA): The national peak body for the speech pathology profession in Australia provides resources, events, and up-to-date research findings.
New Zealand Speech-language Therapists' Association (NZSTA): A similar platform for New Zealand, offers valuable resources, news, and updates related to speech therapy.
Professional Organisations and Conferences
Australia
Speech Pathology Australia (SPA): Apart from resources, SPA also organises annual conferences, workshops, and training sessions for professionals and parents alike.
The Hanen Centre: While it's an international organisation, it has a strong presence in Australia and offers training programs for parents and professionals focusing on early childhood language development.
New Zealand
New Zealand Speech-language Therapists' Association (NZSTA): This body represents speech-language therapists in New Zealand. They conduct regular conferences, seminars, and workshops, creating a platform for learning and networking.
TalkLink Trust: An organisation focused on assistive technologies for communication. They offer workshops, resources, and support for families and professionals.
Both countries host several conferences related to speech and language disorders. These gatherings are an excellent opportunity for parents to learn from leading experts in the field, network with other parents and professionals, discover the latest therapeutic techniques, tools, and technologies.
Staying informed is vital in the ever-evolving field of speech and language therapy. Through books, websites, organisations, and events, parents in Australia and New Zealand can ensure they're equipped with the best knowledge to support their children effectively.
Navigating your child's speech and language development may at times feel like an arduous journey, but it's one punctuated with moments of joy and revelation. The first time your child reaches the next milestone fills you with a sense of immeasurable accomplishment. These are not just your child's successes; they are your victories too. As you proceed on this transformative path, remember to breathe, relax, and enjoy the process. While challenges are a part of the journey, so are laughter, growth, and boundless love. By being present and savoring the small triumphs along the way, you not only contribute to your child's development but also enrich your own life experience.
So take heart, and make the most out of this invaluable expedition!
Author
Monika Guzek (She/Her)
Speech Language Pathologist
Monika is a licensed Speech Language Pathologist with extensive experience in working with children aged 3-12 and their parents on overcoming speech difficulties.
Reviewer
Angela Becka
Sr. Speech Language Pathologist
Angela has over 13 years of experience working with children and their parents in overcoming speech difficulties. Additionally, Angela has supervised and mentored graduating speech-language pathologists.