About Speech Pathology

Posted by Talking Matters on 7 August 2016

A speech and language assessment may be recommended if your child is having difficulties communicating, shows speech or language skills below the level expected for their age or is having difficulties with learning.

Speech and language skills may also be assessed if:

there are things in your child’s development or history which increase the chances of language difficulties such as hearing problems, prematurity, developmental delay or some disabilities such as autism
your child's speech is hard to understand
if they have a stutter,
if their voice sounds unusual,
if they have trouble understanding the speech of others
if they have feeding or eating problems.

A speech and language assessment usually begins with gathering information from the parent about their concerns as well as information about the child’s medical and developmental history. Information from school is also useful and often the child’s teacher is asked to complete a questionnaire about the child’s abilities. Reports from any previous assessments that the child has had are also taken into account.

A number of activities are used to assess your child’s communication skills. This may involve use of formal tests or less formal play and book based activities or a combination of both depending on the child’s age and abilities. The speech pathologist will first watch your child and take into account information from the parent to choose the most useful assessment activities for each child. Parents are welcome and encouraged to be in the room for the assessment in most cases.

A speech pathology assessment covers a range of skills areas:

Speech: This relates to the sounds that are used to make spoken words. Children who have speech difficulties may be hard to understand or develop speech sounds more slowly that others of the same age.

Receptive language: This refers to understanding what others say. Children with receptive language or comprehension problems have difficulty understanding words, sentences, questions and stories, following instructions and understanding concepts. Receptive language is closely linked to reading comprehension.

Expressive language: This refers to how a child expresses their own needs, wants and ideas. It relates to the way children use words, sentences and grammar as well as things like describing events and telling stories. Writing is dependent on expressive language skills. Some children may need alternative ways to express themselves such as signing, picture cards or special technology and speech pathologists can help with that too.

Social communication: This is also called pragmatics and refers to the way children understand and communicate in social situations. Children with social communication difficulties have trouble using and understanding facial expressions and body language, holding conversations with others and communicating in a socially accepted way.

Fluency: This refers to how smoothly speech is produced. Children with fluency difficulties are often referred to as having a stutter. Speech pathologists can help a child to learn to speech more smoothly.

Voice: Children with voice problems may speak too loudly or softly, or have a husky, breathy or nasal sounding voice. Speech pathologists can help correct this by teaching children to use their voice correctly.

Literacy: As reading and writing are communication skills, speech pathologists are often the best people to help children who are struggling in these areas.

Feeding and eating: As the same muscles are used for both eating and speaking speech pathologists also work with children who have trouble with sucking, chewing and swallowing as well as fussy eaters.

Assessment may include observation or assessment of:

• the meaning aspects of language such as understanding and using words and concepts,

• the way words are put together to form sentences and use of grammar,

• forming longer pieces of language such as stories,

• how language is used such as in holding a conversation and solving problems,

• speech production or way the child uses sounds to form spoken words,

• written language skills including forming written words, sentences and stories,

• phonological awareness such as understanding sounds, syllables and rhyme, hearing sounds, using letters, breaking down words into separate sounds and blending sounds together to form words

• when stuttering is of concern the child’s speech will be assessed during different tasks

• when eating is of concern your child may be observed eating different types of foods

• when voice quality is of concern this will be observed in different activities

This information allows the speech pathologist to pinpoint the child’s strengths and weaknesses. At the end of the assessment the results are discussed with the parents. The parents and other relevant people are then provided with a written summary of the assessment outcomes and activities and strategies to assist the child. A range of support options such as individual therapy and/or group programs may then be offered.

When your child has a speech pathology assessment it may be recommended that they attend some speech therapy sessions. Here is an outline of what may happen in your speech therapy session:

Before your session your speech pathologist will select some therapy goals, based on the information gathered from you and the results of your child’s assessment.

Goals will be chosen according to:

• The skills which are most important to you and your child.

• The skills which are most important to develop for ongoing progress.

• The things that will have the biggest positive change on your child’s communication and learning are usually targeted first.

• The sequence which is most effective. Some skills will have a flow on effect to other skills. Some skills are difficult to develop when other skills are not yet in place. For example because action words or verbs are the basis of forming a sentence, we would work on sentence structure after a child had learned to use a good range of verbs.

• Your child’s age and level of development. Skills which develop at a younger age are usually targeted first.

During your session:

• Your child will be taught some new skills related to the goals which were chosen for your child. Many skills need to be broken down into a number of steps. For example to learn a new sound your child needs to learn how to make the sound by itself, then in a word, then in a sentence, then in conversation. Children vary in the speed that they move through these steps which usually take a number of sessions.

• Your child will practice these skills using fun activities. These activities may look like play but they are designed to keep your child motivated and give lots of chances to repeat and practice the new skills.

• You will usually be involved in the session by watching the session and discussing the new skills with your therapist or by taking part in the activities with the therapist’s support so that you can later help your child practice their new skills at home.

• At the end of the session your therapist will discuss with you some ways that you can help your child to practice or use their new skills at home and may give you some information or activities to take home.

After the session:

• Read through the information you have been about the new skills that your child is learning and ways that you can support this learning at home. You may wish to share this information with other people in your child’s life such as teachers or carers.

• You may have been given specific “homework” activities to practice. These will usually be in a folder, which you should bring to each session so they can be updated as your child progresses. Practice should be fun and motivating for your child. Short frequent practice sessions are best. Your therapist will discuss with you how to best do your practice at home. You may wish to share these with teachers and carers too.

• When you practice at home make a note of how your child does and any things that are tricky for your child. Discuss these at your next session so that activities can he updated and modified as needed.

Common questions:

How frequently do we need to attend? Most children attend weekly sessions. This is frequent enough to allow activities to be updated as skills develop while still allowing time between sessions for consolidation. Some children may benefit from more frequent sessions. Some families may choose to attend less frequently such as fortnightly. You can discuss your preferences with your therapists at the beginning of therapy and you can discuss changes if you need to as your child progresses.

How long will I need to come for? This varies from child to child and depends on what your goals are. Some children attend for long periods while others need only a few sessions. Your therapist will monitor your child’s progress and discuss with you if they feel it is time to reduce therapy sessions, take a break or if your child has achieved their goals and no longer needs to attend. If you would like to discuss these things you can talk about this with your therapist at any time.

Why do I need to practice with my child at home? Practising your child’s speech or language work at home means that therapy is much more effective. If a therapist is working with your child for half an hour a fortnight, but you do ten minutes of practice each day, that is the equivalent of getting four extra therapy sessions per fortnight for free! In doing this your child will learn and progress much more quickly. Practicing new skills at home helps your child to use these skills in their natural environment not just the therapy room. The combination of direct therapy and home practice allows your child to maximize their potential and means you get the most out of your investment in therapy.

Looking for support for your child? If you have concerns about your child's speech or language skills the Talking Matters website has information about these skills. We provide individualised assessments and therapy for children with speech, language and learning difficulties and other disabilities. Our aim is to help parents help their child reach their potential.

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About Speech Pathology

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