Receptive Language Delays/Disorders

April 19, 2009

Receptive language delays and disorders can impact the way a child takes in and comprehends spoken and written language. Parents feel that they must repeat themselves many, many times before their child figures out what it is they want them to do. In therapy, we can help develop a system of cues and strategies that will assist your child as he struggles to comprehend the language presented to him. Your therapist is also available to assist your child in his classroom/course tasks. This is an area that frustrates parents to a large degree and we have often worked with children who have been punished because parents feel there is a behavioral concern versus a language issue. Rarely do children show only a receptive language delay. This type of delay/disorder usually coincides with other areas of concern (expressive language delay, learning disabilities and more).

Auditory Processing Delays/Disorders fall under the receptive language delay/disorder umbrella as well. Please see that section for more information.

Expressive Language Delays/Disorders

April 18, 2009

Expressive language delays and/or disorders are characteristic in a child who has difficulties or inabilities to express himself through spoken language. Many parents identify concerns in their child by the apparent gap in what the child understands versus what he is able to communicate. Expressive language delays are often evident in early developmental stages. For example, at 18 months of age, a child should be producing 15 – 20 words and possibly be beginning to put 2 words together (“more juice”, “mommy up”). If, at 18 months, your child is not saying any words, treatment would be recommended.

Many children with expressive language difficulties show frustration at their inability to communicate. Language therapy will help address these frustrations and provide your child with alternative ways to communicate (ie, sign language, picture communication symbols, etc) in conjunction with treatment until the verbal language begins to emerge.

Please see our Developmental Milestones article for more information on what to expect at different age levels.

Oral Motor

April 18, 2009

Oral motor therapy is FUN! This type of therapy is used to promote strength, coordination, control and range of motion of the muscles of the mouth. Children with speech, phonological, feeding and swallowing disorders as well as children with apraxia benefit greatly from oral motor therapy. By using items children love, we are able to get into their mouths and provide input and stimulation to the cheeks, lips, tongue, jaw and palate. These critical, intricate muscle groups begin working together to improve speech sounds, improve eating and drinking skills, increase effective swallowing, and decrease drooling amongst a host of other benefits.

Aphasia

April 18, 2009

Aphasia is a language impairment that is a result of stroke, brain injury or disease that impacts brain tissue. It is more typically diagnosed in adults, however children may also receive a diagnosis of aphasia following a traumatic brain injury or stroke/neurological incident. There are varying degrees and classifications to aphasia based upon which part of the brain is impacted. Language impairments with aphasia present in varying degrees. The ability to express oneself, understand spoken and written language, sequence thoughts, and formulate sentences are among some of the characteristics. Memory and social skills may also be impacted as well as many other aspects.

Specific treatment plans will be developed by your therapist in conjunction with your child’s neurologist and other specialists to target difficulties present.

Dysphagia

April 18, 2009

Dysphagia is a disorder of the swallow. Individuals with dysphagia do not have a normal or strong enough swallow adequate to manage foods and/or liquids and sometimes even their own saliva. Instead of the food/liquid/saliva moving from the mouth through the esophagus, the food/liquid/saliva moves into the airway and there is a dangerous risk of aspiration. Obvious signs of dysphagia are choking, coughing, or clearing of the throat following a swallow and a “gurgly” quality to the swallow. Continuing to ingest foods or liquids when dysphagia-like symptoms are present can be very dangerous. Silent aspiration is even more dangerous. Silent aspiration occurs when the food and/or liquid is going into the airway undetected. Individuals with silent aspiration do not exhibit any obvious symptoms and often end up with pneumonia due to the presence of the food/liquids in the lungs.

Dysphagia can only be diagnosed by certain tests. Typically, our clients with dysphagia are referred to us from pediatricians or other physicians who have documented the presence of the dysphagia following a Video Swallow Study (VSS) or Fiberoptic Endoscopic Evaluation of Swallowing (FEES). These tests are performed using barium in varying consistencies of liquid and food to determine how well a person can protect their airway naturally against each consistency. The stage and location of the dysphagia will be identified and your therapist will then implement a treatment plan consisting of exercises to strengthen and coordinate the muscles in question to strengthen the swallow. Alterations to diet are also necessary to prevent aspiration and protect the airway.

Constant communication with you and your child’s physicians is a top priority, as well as follow up swallow studies to monitor progress.

Apraxia

April 17, 2009

Apraxia of speech is a motor based speech disorder. Children with apraxia have difficulty planning and executing the movements needed to produce intelligible (understandable) speech.

Characteristics of apraxia include:

Inconsistent speech sound productions: your child may say a sound or word correctly once, but incorrectly the next time he uses that same sound or word.

“Groping”: your child’s mouth may move as if it is searching for the correct way to make a sound or say a word, but the actual sound/word is never produced.

Distorted vowel production: your child may say words that sound nothing like what they should. For example, the word “red” may sound like “rode”.

Difficulties imitating speech sounds/words: your child may be able to say “ball”, but has great difficulty imitating that same word when someone asks him to do so.

Difficulties performing movements on request, yet able to produce that same movement involuntarily: your child may have no ability to stick out his tongue while imitating someone performing that movement, but he is able to stick his tongue out to lick an ice cream cone.

Apraxia may also be called verbal apraxia, developmental apraxia of speech, or verbal dyspraxia.

Articulation

April 13, 2009

Articulation delays and disorders are the incorrect pronunciation of speech sounds. These speech sounds in error may be omitted, distorted, substituted or have additional sounds added to them to cause your child’s speech to be difficult to understand. These errors will be classified on the degree of intelligibility of your child’s speech; that is, how easy or difficult it is for your child to be understood. Children with articulation concerns consistently produce the same speech sound incorrectly in most or all words.

Speech sounds are developmentally acquired and not all errors will require immediate treatment. Your child’s therapist will be able to identify and explain the hierarchy of speech sound acquisition and develop a developmentally appropriate treatment plan for your child.

Diagnosis Experience

April 13, 2009

Here is a list of diagnosis we have had experience working with:

  • Aphasia
  • Apraxia
  • Autism / Asperger’s / Pervasive Developmental Delay
  • Down’s Syndrome
  • Central Auditory Processing Disorder
  • Cri da Chat
  • Cleft Lip & Palate
  • Craniofacial Abnormalities
  • Cerebral Palsy
  • Shaken Baby Syndrome
  • Attention Deficit Disorder
  • Attention Deficit Hyperactivity Disorder
  • Dysphagia
  • Dysarthria
  • Fetal Alcohol Syndrome
  • Learning Disabilities
  • Selective Mutism
  • Prader-Willi Syndrome
  • Nodules / Polyps / Vocal Abuse
  • Pierre-Robin Syndrome
  • DiGeorge Syndrome
  • Angelman’s Syndrome
  • Rubenstein-Taybi Syndrome
  • Sensory Processing Disorders

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