We offer a comprehensive assessment of speech, language and oral motor skills.
The following tests may be used during an evaluation.
How a child understands his environment.
This includes: identifying pictures of objects, actions, adjectives, prepositions, sequencing 3-4 part picture stories, categories, identifying pronouns, identifying colors, and letter recognition.
How a child uses sounds, words and gestures to communicate wants and needs.
This includes: imitating phrases/signs, spontaneously using phrases/signs, labeling objects, actions, adjectives, prepositions, creating grammatically correct phrases, answering “what, where, who, when, why, how” questions, retelling stories, and appropriate conversational skills.
How a child uses speech sounds in words and phrases.
Specific speech sounds develop at various ages. If a child does not use age-appropriate sounds, we target these in therapy. We also look at speech intelligibility – how well can you understand what your child says? If your child has low speech intelligibility at the word or phrase level, we work on repeating words/phrases until they sound clear. We look at 3 main areas of articulation: manner, place, voicing.
Manner - how a sound is made (plosive, fricative, affricate, nasal)
Place - where the oral structures move in the oral cavity (lips, tongue tip, tongue base, tongue back)
Voicing - whether the vocal folds are vibrating or not (voiced, voiceless)
Examples of articulation:
P – plosive, lips, voiceless
G – plosive, tongue back, voiced
S – fricative, tongue base, voiceless
How a child understands the rules of putting sounds together to make words.
Several common phonological processing disorders include:
Final consonant deletion: putting ending sounds on words (“ba” for “ball”)
Syllable reduction: using the correct number of syllables (“nana” for “banana”)
Stopping: stopping sounds where the air needs to flow continuously (“tun” for “sun”)
Fronting: using front instead of back sounds ( “tar” for “car”)
Backing: using back instead of front sounds (“guggle” for “bubble”)
Another term for this is motor planning. The child may have the word he wants to say in his brain, but is unable to get the “message” from his brain to his mouth. The neural connections may line up some days, but not on others. This is why a child may use words inconsistently. Intervention includes: using high-low (sing-song) intonation, elongating vowel sounds, emphasizing syllables and oral motor exercises.
How a child understands or misunderstands auditory input.
Children with an auditory processing disorder may have difficulty understanding sounds, words and/or phrases. Things we may work on include: wh- questions (what, where, who, when, why), yes/no questions, auditory closure, main idea of a story, rhyming, identifying beginning/ending sounds of words, and short/long term memory tasks/activities.
How a child interacts in social settings.
This includes interaction with peers and adults. It also includes how a child reacts in comfortable settings, new environments and easy-to-difficult distractions. Things we may work on include: greetings, inviting someone to play, asking for help, problem solving, giving/receiving compliments, politeness, following directions, staying on topic, reading feelings of others, expressing feelings, giving information, asking questions, being flexible, and dealing with teasing.
Some children present with characteristics or have a diagnosis of Autism Spectrum Disorder.
These children have difficulty in social settings and interacting appropriately with their family and friends. Goals that we make work on include: eye contact, joint attention to a toy/activity, turn-taking, sharing, showing interest in others, playing with others and various conversational skills.
When a child uses senses from his body and environment to make his body functional in his environment.
If a child has difficulty processing senses (vision, auditory, tactile, olfactory, taste), it may become difficult for this child to understand his environment and communicate effectively. These children are referred for an Occupational Therapy (OT) evaluation and possibly treatment from an Occupational Therapist. Treatment may include: brushing protocol, joint compressions, deep pressure to muscles, swings, ball pits, sensory tables, sensory balls, trampolines, weighted vests and fine motor skills activities. It is often recommended that parents read “The Out-of-Sync Child Recognizing and Coping with Sensory Processing Disorder” by Carol Stock Kranowitz, MA.
How a child with a hearing impairment understands and interacts in his environment.
A child with a hearing impairment has a choice of communicating with verbal communication or sign language. At Speak To Me, we promote verbal communication through strategies of auditory verbal therapy.
How a child’s oral structure functions, including strength and coordination.
Our main concentration is on 5 areas: cheeks, lips, tongue, jaw and breath support. Things we may work on include: deep pressure to cheeks, lip stretches, deep pressure to tongue tip, back and sides, jaw strength with chewy tubes and blowing exercises for increased breath support.
How a child eats and drinks, including food aversions.
Speak To Me works with physicians and medical SLPs to review modified barium swallow studies and feeding protocol with high regard to risk of aspiration. We look at 3 areas for food aversions: taste, texture, temperature. Things we may work on include: thickening agents in liquids, bottle drinking, cup drinking, straw drinking, spoon feeding and self feeding.
A child with a cleft lip and/or palate will often have difficulty with oral vs. nasal airflow. Things we may work on include oral motor exercises, blowing exercises, and production of “p, b, t, d, k, g, s, z, sh, f”.
How a child produces sounds, words and phrases with fluency.
Modalities would include slow, easy onset of speech.
When a child presents with poor vocal quality.
This may sound hoarse or raspy voice. Interventions would include: increasing awareness of proper vs. improper vocal quality, increasing awareness of loudness and pitch and how to change a child’s vocal behavior.