Speech Therapy

People of any age can have speech disorders. Speech therapy starts with an assessment by a Speech Language Pathologist (SLP) who will distinguish the type of speech disorder and the best technique to treat it. Disorders of speech may include difficulties with articulation, phonology, speech fluency, or other disorders in speech production. 

Speech disorders are treatable. Early intervention and treatment can favorably affect the client, both socially and academically. A speech therapist can validate the cause and outline treatment with the client and family. Treatment may include routine check-ups and activities to help at home.

What is Articulation Therapy?

An articulation disorder is the inability to make specific types of sounds correctly. A person with an articulation or phonological disorder may add, distort, drop, or swap sounds. 

Articulation, or sound production, therapy includes having the therapist assist the client in accurately pronouncing speech sounds and repeating these throughout therapy. 

During articulation therapy, your speech-language pathologist will traverse a hierarchy of levels, starting with proper sound production, including the ability to move the tongue, teeth, lips, and jaw to create speech sounds, progressing through all levels until the sound is deemed mastered. A speech sound is mastered when a client can adequately produce it in a normal conversation with minimal prompting.

What is Phonological Therapy?

Children with a phonological disorder keep using incorrect speech patterns beyond the age they should have eliminated them. Children with a phonological disorder may be able to produce a sound accurately in one word but find it hard to produce the same sound in other words. Children may leave out a sound even if they can produce the same sound when it appears in other words or nonsensical syllables. For example, a child who deletes final consonants may say “ca” for “cat” yet may have no difficulty pronouncing words like “to” or “toe”. 

Treatment for children with phonological disorders often involves focusing on the phonological processes at fault as identified by the speech therapist. Phonological therapy approaches are intended to nurture the child’s phonological system instead of just teaching new sounds, with generalization being the primary goal. Activities aim to promote age-appropriate phonological patterns through exercises that support the improvement of the proper cognitive organization of the child’s underlying phonological system.

There are several evidence-based treatment methods for phonological disorders, including:

Minimal Pairs

It consists of two words with sounds that are very similar but have different meanings because of a phoneme that differs by one sound or feature. 

Multiple Oppositions

Multiple Oppositions is much like Minimal Pairs. However, it features two to four targets that are different from one another and different from the substituted sound. For example, targets may include a set of words like “tap,” “clap,” “map,” and “snap”.

Maximal Oppositions

Targets are chosen that differ in phonetic features of place, manner, and voicing, which are then used in contrast with a sound the child can produce. For example, targets may include words like “see” and “knee”.

Empty Set

Treatment using an empty set consists of two target words that a child cannot produce, that also differ in phonetic features of place, manner, and voicing.

What is Fluency Therapy?

A speech fluency disorder, also called stuttering or stammering, is described as a frequent disruption in the flow, rate, and timing of speech. A person who stutters has difficulty producing sounds and words fluently. 

Fluency disorders may include speech disruptions or other accompanying factors, including:

• Blocks – speech muscles come to a halt when producing a word, with no sound coming out
• Sound or Word Repetition – a whole word or part of a word is repeated, such as “my my my dog” or “d-d-d-dad”
• Sound Prolongation – a sound in a word is produced for a longer than typical amount of time, such as “sssssssnake” or “I want mmmmmmilk”
• Cluttering – excessively fast rate of speech with poor word arrangement or grammar, and incomplete production of words
• Physical Concomitants – visible tension and extra movements of the body as the person tries to speak, such as head movements, loss of eye contact, eye blinking, facial grimace, clapping/tapping hands, or stomping feet
• Avoidance or Use of Filler Words – some words may be avoided or filler words may be added such as “um,” or “uh,” by a person who stutters if it is anticipated that they may stutter on a word. 

Fluency therapy is appropriate and effective for both children and adults who stutter. Although some stuttering disorders persist into adulthood, therapy for fluency disorders has been proven to improve both communication skills and the underlying thoughts or feelings about communication for people who stutter. As life circumstances and demands change over time, it can be helpful for a person who stutters to return to fluency therapy periodically over their lifetime. Therapy techniques may include fluency shaping techniques, environmental enhancement, and strategies to address the underlying thoughts and feelings about speech fluency. 

Other Speech Disorders

Other speech disorders include motor speech disorders and resonance disorders. Motor speech disorders, including dysarthria, can result in slurred or otherwise impaired speech production caused by weakness or incoordination of the muscles used for speech. Resonance disorders are characterized by a change in the airflow within the mouth and nose when an individual is talking.  Tonsillitis, cleft palate, and neurological events or disorders are directly related to this speech disorder. Speech therapy is an appropriate and effective treatment for most motor speech and resonance disorders, with a multidisciplinary team approach or referrals to specialists when appropriate for the management of related conditions.

How long must a client attend speech therapy?

There are several factors that affect the frequency and duration of treatment. A client might visit a speech therapist one to several times per week. Treatment may occur over a span of weeks, months, or even years.  Several factors dictate how long you should expect therapy to take:

• The nature of the client’s speech difficulty
• The severity of the speech difficulty
• Other coexisting problem(s)
• The proficiency of the therapist
• How involved parents, caregivers, and other support personnel are