Speech and Language Disorders

Perhaps you’ve just been told that your child requires speech or language therapy. Or maybe you suspect that your child may have some communication delays.  Either way, it is very helpful to have a basic understanding of speech and language therapy before diving in.  Today, I’m going to answer some basic questions that you as parents may have about speech and language therapy.  My name is Carrie Mills and I am a speech-language therapist in Columbia, Missouri.  I work primarily with children who have speech and language disorders and I have experience in the school setting as well as in private practice.

First of all, what does “SLP” mean?

“SLP” stands for speech-language pathologist, which is the formal name of a speech therapist.  Speech-language pathologists, or SLPs, must have a master’s degree in  communication disorders and be licensed by their state licensing agency (in Missouri, the Missouri Board of Healing Arts).  Most SLPs also hold certificates of clinical competency (CCC), which is a certification from the American Speech-Language and Hearing Association.  This is granted when an SLP has completed a master’s program in the field, a nine-month clinical fellowship, and a passing score on a national examination (The Praxis). You can tell if an SLP “has their C’s” if they carry the following credentials after their name: Carrie Mills, CCC-SLP.  Speech-Language Pathologists work with all kinds of speech and language disorders.

What is an IEP?

IEP stands for Individualized Education Plan.  This is the paperwork that a school must create (with your input) before they can serve children with speech and language disorders.  When a school district suspects that a child may have a speech or language problem (or any other disability), they can conduct an evaluation.  If the results of that evaluation indicate that the child does in fact qualify for services, the child’s team (including you!) will write an IEP which outlines the child’s strengths, weaknesses, and educational needs.  The plan will also include yearly goals for the child to work on as well as services required to address those goals.  This could include only services by an SLP or services by other professionals as well.

What’s the difference between speech and language?

This is probably the most common question I get from parents when discussing IEPs.  In the public school system, children can qualify for speech services, language services, or both. A child with speech difficulties has trouble producing specific sounds.  This could be due to physical problems, such as cerebral palsy or cleft palate, or due to a child learning the sound incorrectly.  Some speech problems may be limited to a single sound, such as producing all /s/ sounds with a lisp, or a group of sounds, such as producing all sounds that should be in the front of the mouth at the back (/k/ for /t/ or /g/ for /d/).  A child with language difficulties on the other hand, has trouble understanding when others communicate with him and/or has trouble communicating his own thoughts and ideas.  Children with language problems may have trouble following directions, labeling objects, using complete, grammatically correct sentences, and/or participating in conversations or social interactions with peers/adults.

What’s the difference between a delay and a disorder?

Sometimes, professionals will describe a communication problem as a delay or a disorder. At times, some will use the terms interchangeably, but by the strictest definition, there is a difference.  Typically developing children acquire speech and language skills in a standard order.  There are certain errors or mistakes that are developmentally normal at a certain age.  For example, most children have difficulty saying /r/ and will replace it with a /w/ for a time, particularly preschoolers.  When children have a speech or language delay, they are developing speech and/or language skills in the same order as children but they do so at a slower rate.  This may be a child who is a late talker but once he starts talking, does so in the same way that typically developing children learn to talk.  It could also be a child who holds on to a normal error (such as the /w/ for /r/) longer than expected, such as until the age of 9 or 10.  On the other hand, a child with a speech or language disorder develops speech and/or language in an atypical way.  He may produce errors that typically developing children do not usually produce (such as a distorted /s/) or he may be a late talker who suddenly begins speaking in full sentences that don’t make sense instead of one word at a time.

What does it mean if my child has difficulty with fluency?

“Fluency” is another way to refer to stuttering.  A child with fluency concerns may repeat phrases, words, syllables, or single sounds when speaking.  She may also seem to get stuck on a sound and not be able to get it out or may excessively interject extra words or syllables such as “um” or “like”.  Almost all preschoolers go through periods of disfluency during typical development and this is completely normal.  However, there are certain risk factors that can lead to a child being less likely to recover from a period of disfluency without therapy.  An SLP can help you determine if your child’s stuttering is typical or if it requires additional attention.

What is a voice disorder?

Speech therapists also help children who have voice disorders.  This includes a range of problems that lead to a child’s voice sounding hoarse, scratchy, rough, breathy, too high/low, too soft/loud, etc.  Sometimes these are caused by physical problems, such as calluses or sores on the vocal cords, and sometimes they are caused by a child using his voice inappropriately, such as by yelling or screaming too much.

What are pragmatic language skills?

Pragmatics deals with a child’s ability to use language socially to interact with peers and adults.  A child with difficulties in pragmatics may have trouble gaining a listener’s attention before speaking, beginning an interaction with a friend, responding to friend’s requests to play, maintaining a topic of conversation, introducing new play ideas, or staying with a social interaction for very long.  These skills can cause a child to have difficulty making friends, keeping friends, and negotiating problems during play with friends.
I hope this has helped to clear a few things up about the field of speech and language therapy and speech and language disorders.  If you are concerned that your child may have difficulty with any of these areas, please contact your local school district and ask to speak with a speech-language pathologist.  In Columbia, Missouri, you can contact me for a free consultation at: Carrie@SpeechTherapyCoMo.com