How will a speech-language pathologist help my child?
The speech-language pathologist (SLP) will assess your child’s communication through activities, tests and observations, using informal and formal methods. These will be tailored to meet your child’s needs. For younger children, a large part of assessment is done through play. The goal is to help improve your child’s communication and work to their strengths.
SLPs will offer parents, caregivers and the medical team ideas to help them communicate more effectively with children who have had changes to their communication. SLPs may provide individual therapy for children who are in the hospital for longer periods of time.
A child may receive SLP assessment and support for any of the following areas.
Non-verbal communication
When a child is late to acquire words or becomes unable to speak (e.g., due to an illness, injury or medical procedure), an SLP may help you find signals that your child can use in place of speech. For example, one thumb up could mean "yes", and a thumb down could mean "no". A few other examples include getting them to squeeze your hands or blink their eyes: one time for "yes", two times for "no". It may be helpful to speak to your child in simple sentences that ask for a "yes" or "no" answer, for example, "Are you cold?" or "Do you want a blanket?"
Augmentative and alternative communication (ACC)
If a child communicates without speaking words or the words are not clear (intelligible) AAC may be used. Some children may experience changes in their communication access. This may be reduced ability to speak or use their voice due to intubation or tracheostomy, significant neurological changes impacting speech/voice, or motor changes impacting speech, writing, typing, gesturing or device access.
AAC is augmentative when used to supplement existing speech, alternative when used in place of speech that is absent or not functional, or temporary as when used in intensive care after surgery.
SLPs can support children with changes in communication access by providing the following forms of AAC:
- no tech (e.g., thumbs up/down, head nod/shake)
- low tech (e.g., communication boards, yes/no cards, writing tools, whiteboard)
- high tech (e.g., speech output devices, communication switches, iPad apps, eye gaze tracker)
Many of these tools and devices can be created and personalized to meet your child’s wants and needs.
Speech
Speech is how we say sounds and words. SLPs can support children with developmental speech difficulties (e.g., articulation/sound errors); speech changes, including motor speech difficulties (e.g., dysarthria, apraxia); structural changes impacting clarity; and changes in fluency or prosody (e.g., rate of speech, inflection).
Voice/resonance
When we speak, the air from our lungs passes through our vocal cords, making them vibrate. Voice problems may affect the pitch (how high or low), volume or quality (breathy, rough, strained) of your child’s voice. Resonance problems occur when there is a change in the way the air and sound move through your child’s throat, mouth and nose. This could be too much or too little air moving through the nose, for example, which is known as hypernasality or hyponasality.
SLPs can support children with voice changes, including aphonia (no voice), dysphonia (rough, breathy, strained quality) and changes to or atypical pitch or volume, as well as children with resonance changes involving hypernasality.
Fluency
Fluency refers to the continuity, smoothness, rate and effort in speech production. An SLP can help by providing strategies and therapy techniques to achieve fluent speech.
Language
Receptive language is the ability to understand spoken language and written language. SLPs can help children with receptive language difficulties, such as following verbal directions, following conversation, understanding narratives and understanding or responding to questions.
Expressive language is the ability to express everyday wants, needs and feelings. Expressive language includes verbal, written and sign language and use of body language, including facial expressions and gestures. SLPs can help children with expressive language changes, including reduced verbal expression, word-finding difficulty, expressive aphasia (trouble communicating because of damage to the area of the brain responsible for language) or narrative difficulties.
Social communication
Social communication is how and why we use language to interact with others. SLPs can support children with social communication difficulties, including verbal impulsivity, difficulty identifying inappropriate topics, difficulty with topic maintenance or topic shifting, inappropriate turn-matching, tangential speech or verbosity (using more words than necessary).
Cognitive communication
Cognitive communication refers to the thinking skills involved in language and successful interactions. SLPs can assess and provide intervention for children who have new difficulties in attention, memory, organization, processing, problem-solving, reasoning, executive functioning, insight and metacognition impacting communication.
Swallowing
In many settings, an SLP is part of a multi-disciplinary team to help assess and manage your child’s unique feeding and swallowing needs. This multi-disciplinary team works with you to develop a plan to improve your child’s swallowing safety and feeding skill development. Recommendations could include changes to the types of food or liquid provided, change in feeding techniques, therapy strategies or referrals to other health professionals as appropriate.