Navigating the world of pediatric therapies can be a daunting and overwhelming challenge for many parents. Oftentimes, parents, caregivers, or even pediatricians notice changes in a child resulting in the need for an evaluation by a pediatric therapist. A pediatric speech-language evaluation is comprised of 3 parts: parent interview, assessments, and feedback following assessment.
SPEECH-LANGUAGE DIAGNOSES: WHAT DO THEY MEAN?
Following the initial evaluation, your child may receive a diagnosis from a licensed speech-language pathologist. Here’s a breakdown of many common diagnoses:
Language Disorder: A language disorder is characterized by difficulty with one or more aspects of language, including receptive, expressive, and pragmatic language. Children with a language disorder may have difficulty formulating sentences, following directions, using appropriate verb tenses, or asking/answering questions. The language disorder umbrella also can include late-talking toddlers.
Articulation Disorder: An articulation disorder occurs when a child has difficulty with place, manner, or voice of production for a given speech sound. Some errors in articulation are expected, depending on a child’s age and which sound he is trying to produce. For example, between two- and three-years-old, a typical child will master /p, b, m, n, h, d, t/ sounds; the same child, however, would not be expected to accurately produce an /r/ sound until closer to 7 years old. Common articulation errors include a “lisp” or other distortions with /s/ and /z/ sounds.
Phonological Disorder: A phonological disorder also pertains to speech sound production, however, these children substitute one sound for another. This predictable pattern of substitution occurs at different ages for many children, and may include substituting /w/ for /r/ sounds (e.g., “wabbit” for “rabbit”), or /f/ for /th/ sounds (e.g., “fumb” for “thumb”).
Fluency: Fluency disorders or “stuttering” commonly occur when an individual has whole and part-word repetitions (“can, can, can I have the iPad?”), prolongations (“s-s-s-s-s-sister”), or blocks, which are silent stops during connected speech. Some children will also demonstrate secondary behaviors including grimaces or tension in their face and/or neck.
Childhood Apraxia of Speech (CAS): This disorder also impacts how a child produces sounds. Children with CAS know what they want to say, but they have difficulty coordinating their muscles and articulators to accurately produce sounds. There is, in other words, a disconnect between a child’s brain and mouth to plan the movements for speech sounds.
Voice Disorder: A voice disorder is characterized by anything that disturbs or alters one’s regular voicing (talking). This may be the result of vocal abuse or misuse, including: yelling, gastro-esophageal reflux, or excessive coughing or throat clearing. Allergies and other environmental factors may also contribute to a voice disorder.
Depending on the severity of difficulties that your child is having, a Speech Language Pathologist might recommend one to two times per week for therapy, or even more.