Assessment & Intervention 

Speech Sound Production

Articulation refers to the way we produce sounds using our tongue, teeth, lips and jaw. Children acquire different sounds at different stages of their language development. Speech sound delays or disorders are often characterised by a child making errors that are no longer age-appropriate, or atypical errors, when attempting to produce a sound or group of sounds. The two main types of errors include:

• Articulation Errors – errors in forming the sound
• Phonological Processing Errors – errors in the patterns of sounds

Common signs your child may have a speech delay include:

• Poor speech intelligibility or ‘slushy speech’
• Replacing sounds e.g. pronouncing “cat” as “tat” or “dog” as “gog”
• Leaving off sounds in speech e.g. “stop” as “top”

Apraxia of Speech

Apraxia of Speech is a neurological disorder that affects the motor planning of speech production. Motor planning is needed to organise the movements of the muscles used in speech. Difficulties with motor planning leads to struggles with coordinating the correct muscles needed in order to produce the intended sound or word.

Common signs your child may have Childhood Apraxia of Speech (CAS) may include:

• Difficulty imitating words and sounds
• Mixing up other sounds within a word
• Trouble moving the muscles in their mouth and throat e.g. chewing, blowing, sucking and making speech sounds
• Pronouncing the same word differently each time they say it e.g. pronouncing “water” as “waka” on one occasion and “wawa” on another

Speech pathology intervention is essential in treating speech production delays and disorders. Ongoing speech production difficulties may lead to difficulties developing language skills, social communication skills, and literacy skills.

Language Skills

Expressive Language

Expressive language refers to the use of words, sentences and gestures when communicating. The development of these language skills is important as they allow children to communicate their needs and wants, and create relationships with others through meaningful interactions.

Children with expressive language delays/disorders often have difficulty:

• Using grammar correctly e.g. Them drank their drinks (They drank their drinks)
• Using the correct/appropriate words when communicating
• Combining words to create sentences
• Engaging in a conversation
• Retelling/writing stories

Receptive Language

Receptive language refers to the ability to understand verbal or written language. The development of these language skills is important as they support children to understand visual cues/signs in their environment, help them follow instructions correctly, and understand concepts and questions across their daily routines.

Children with receptive language delays/disorders often have difficulty:

• Following and comprehending a story
• Answering questions or responding to requests appropriately
• Following instructions
• Demonstrating ‘appropriate’ or ‘good’ behaviour as they appear to be noncompliant, however may not be understanding what has been requested

Play Skills

Play skills support children when exploring the world around them. Play allows children to experiment with new ideas/concepts, develop their imaginations and progress social skills necessary for adult life.

Play skills assist in the development of:

• Social skills
• Problem solving skills
• Receptive/expressive communication skills
• Self-awareness and regulation
• Planning and sequencing within tasks
• Executive functioning and reasoning
• Later literacy skills

Common signs your child is struggling with their play skills:

• Difficulty playing independently
• Difficulty using toys functionally
• Difficulty making eye contact
• Difficulty engaging in turn-taking or group games
• Limited/repetitive play sequences
• Limited imaginative play skills
• Constant need for adult support to play/problem solve

Social Language (Pragmatics)

Pragmatics refers to the verbal and non-verbal skills we use to communicate. They refer to what we say, how we say it, and how appropriate the language used is to different situations we are in. Individuals experiencing difficulties with pragmatic skills may demonstrate reduced:

• Eye contact
• Ability initiating/maintaining conversations, including greetings, turn taking & topic maintenance
• Ability to appropriately ask/answer questions
• Ability to identify/understand social cues, gestures or emotions

Voice Production

Voice disorders are typically a result of issues within the vocal cords effecting pitch, tone, volume, and/or vocal quality. Voice disorders may be caused by a number of different factors. Some examples include:

• Talking excessively and using excessive volume (shouting)
• Emotional/psychological issues
• Medical conditions

Common signs your child might have a voice disorder:

• Their voice is too high/low
• Their voice is too loud/quiet
• They sound congested/nasally or like their nose is blocked
• Their voice is harsh/hoarse

It is important to determine the cause of the voice disorder in order to provide appropriate treatment. The Speech Pathologist can refer for medical assessment if required.

Fluency

Fluency refers to the individual’s ability to speak clearly. Stuttering occurs when the fluency or flow of speech is interrupted. Stuttering may impact on a child’s confidence when speaking. This may lead to them feeling embarrassed in social situations, talking in front of a class, talking on the phone, and so on.

Common signs of stuttering can include:

• Repetitions of sounds, parts of words or whole words
• Blocks in speech or struggling to get words out
• Frequent interjections such as “um”
• Extended pauses

Phonological Awareness

Phonological awareness refers to the ability to recognise and manipulate sounds in spoken language. This may include breaking up words into sounds or syllables, recognising and producing rhymes, and blending sounds together. Such skills are essential in developing literacy skills that support reading and writing.

Children with phonological awareness difficulties may:

• Guess words based on the first sound
• Mispronounce letters/words e.g. they may be unable to distinguish between similar sounds
• Have difficulty identifying letter-sound patterns

Literacy (Spalding Certified Tutor)

Difficulties with reading, writing and spelling make everyday tasks at school extremely challenging for children.

Children experiencing difficulties with literacy skills may have issues with:

• Completing tasks at school
• Spelling
• Reading age-appropriate texts
• Understanding written instructions
• Reading and/or writing sentences and stories

Developmental Delays & Disability

Many children have communication difficulties as a result of a genetic syndrome or intellectual disability. We strive to support children in developing their communication skills in a way best suited to their needs. Communication skills are important as they support children/individuals to make requests or choices, as well as initiate and respond to communicative interactions with others.

Strategies supporting communication may include:

• Assistive & Augmentative Communication (AAC devices)
• Key Word Sign (KWS)

Autism

A child with Autism may demonstrate differences in the way they interact with others and relate to their environments.

Individuals with Autism may:

• Show differences in interacting with others
• Have different learning styles
• Demonstrate different verbal/non-verbal language skills, including gestures, facial expressions and body language
• Display particular sensory interests/aversions
• Display repetitive behaviours or interests
• Have unique play skills

Auditory Processing

Auditory processing disorders (APD) influence the way in which the brain recognises and interprets speech sounds and verbal language. This makes it difficult to identify slight differences between sounds and words, particularly in louder environments such as the classroom or playground.

Children with auditory processing difficulties often:

• Mishear sounds/words
• Become overwhelmed by noisy environments when trying to listen
• Display better listening behaviours in quiet settings
• Have trouble following verbal instructions
• Have trouble with spelling or phonics
• Have trouble following conversations/stories

Life Skills

Therapy sessions at Star Communicators Speech Pathology will support clients to achieve a variety of life skills, allowing them to be independent, confident, and active members of their community. Life Skills based learning will target a range of areas including:

Pragmatic skills

• Turn taking in conversation
• Topic initiation/maintenance & entering/exiting conversations
• Understanding perspective, body language and gestures
• Active listening, commenting & asking questions

Daily routines/tasks

• Grocery shopping
• Clothes shopping
• Making/attending appointments
• Going to a restaurant/café
• Travel training on public transport
• Time management
• Money management skills e.g. budgeting and practical spending
• Independent self-help skills e.g. cooking and cleaning

Orofacial Myology

Orofacial myology refers to the study of the muscles of the face and mouth, particularly their function and coordination. It focuses on the relationship between the muscles involved in oral, facial, and respiratory movements, including the lips, tongue, jaw, and soft palate. These muscles play a key role in actions such as speaking, eating, swallowing, and breathing.

In the context of speech pathology, orofacial myology is important because dysfunctions or imbalances in these muscles can contribute to a range of speech, language, and swallowing disorders. Here’s why it’s significant:

1. Speech Production

Articulation: Proper movement and coordination of the tongue, lips, and jaw are essential for clear speech. Any weakness, tension, or abnormality in these muscles can lead to speech sound disorders, such as difficulty producing certain consonants or vowels.

Breathing and Resonance: The muscles of the face and mouth influence breath control, which is crucial for proper speech production. Additionally, abnormal muscle tone or movement can affect the resonance of speech, leading to hypernasality or hyponasality.

2. Swallowing (Dysphagia)

Orofacial myology plays a key role in the processes of chewing, swallowing, and managing food in the mouth. Dysfunctional muscle patterns can lead to difficulty swallowing (dysphagia), aspiration, or feeding issues.

3. Oral Habits

Behaviours like thumb sucking, tongue thrusting, or mouth breathing can affect oral and facial muscle development and alignment. These habits can also influence speech clarity, dental health, and overall orofacial function. Addressing these habits through orofacial myology can help improve speech and swallowing skills.

4. Feeding and Early Development

In children, orofacial myology is integral to developing proper feeding skills. Weak or poorly coordinated orofacial muscles can delay feeding milestones and later result in speech delays. Intervening early with orofacial therapy can have long-term benefits for communication and development.

5. Facial Aesthetics and Alignment

Orofacial myology can also help with facial alignment and symmetry. For example, improper tongue posture or muscle tone can influence the development of the dental arch or facial features, which may affect speech, appearance, and overall oral function.

Conclusion

For speech pathologists, understanding orofacial myology is vital for diagnosing and treating conditions that affect communication and swallowing. Therapy focused on strengthening or retraining the muscles of the face and mouth can significantly improve a person’s speech clarity, swallowing function, and overall orofacial health. It’s a critical part of a holistic approach to managing speech and language disorders