The following are types of speech therapy most commonly seen in the SCHOOL SETTING. While there are other speech/language/hearing/swallowing disorders addressed in other settings (i.e. hospitals, private clinics), these are the most common at Stone Academy.
Articulation
An Articulation disorder occurs when a child has difficulty making certain sounds, therefore making it difficult for others to understand their speech. They may substitute other sounds, leave the sound off, add a sound, or change the sound. Articulation therapy focuses on how to say specific speech sounds. We work first on the sound in isolation (by itself), going over how to make it. We focus on how to move our lips, teeth, tongue and cheeks to make our target sounds. Then we work on saying the sound in a syllable, then words, phrases, sentences and finally, carrying it over into conversation. The goal is use the correct sound pronunciation in all settings, and not just the speech room. Common articulation errors include:
Replacing /r/ with /w/ (i.e. saying "wabbit" instead of "rabbit)
Replacing /th/ with /f/ (i.e. saying "free" instead of "three")
Distorting /s/, /z/, /ch/, /sh/, and /j/
There are many more possibilities!
Phonology
Phonological development refers to specific sound patterns we make in words. Phonological errors occur when people make consistent errors in sound processes. Phonology therapy does not necessarily focus on producing each sound correctly, but rather on producing all of the sounds in words. Common phonological errors include:
Deletion of final consonant- leaving off word endings (i.e. saying "bee" instead of "beet")
Cluster reduction- leaving out sounds in sound cluster (i.e. saying "sing" or "wing" instead of "swing")
Stopping- shortening long sounds (i.e. saying "kit" instead of "kiss")
Fronting- replacing sounds that you make in the back of your mouth with sounds you make in the front of your mouth (i.e. saying "bit" instead of "big" or "tup" instead of "cup")
Gliding/liquid simplification- replacing "liquids" (/l/ and /r/) with /w/ (i.e. saying "wabbit" instead of "rabbit")
Apraxia
Childhood Apraxia of speech (CAS) is different from articulation and phonology, although it may seem similar because children with CAS also have difficulty making their speech sound clear to listeners due to diffiuculty saying sounds, syllables and words. CAS is a motor speech disorder, meaning there is no muscle weakness that makes it hard to produce sounds, but rather difficulty with the motor planning in the brain. Children with apraxia have the physical ability to produce sounds, but their brain has problems planning to move the body parts needed for speech (i.e. the lips, jaw, tongue, etc.) This can be very frustrating, because the child knows what they want to say, but their brain has difficulty coordinating the muscle movements needed to say the words. There are no common error patterns with apraxia, because it is characterized by inconsistent error patterns in speech.
Language
Language can be expressive: how we express ourselves verbally or non-verbally, and also receptive: how we understand what is communicated to us.
Examples of expressive language include:
Pragmatics (social language)
Use of complete sentences
Use of appropriate grammar for children the same age (subject-verb agreement, verb tenses, etc.)
Describing an object's attributes
Examples of receptive language include:
Following directions
Answering questions (who? what? when? where?)
Auditory closure/completing a sentence
Understanding figurative language
Fluency
Fluency is how "smooth" our speech is. Fluency therapy is often used with children who stutter (produced prolongations, blocks, or repetitions in their speech) or clutter (rapid and/or irregular speaking rate, disfluent speech). There are many different fluency shaping techniques that we can use, including:
Deep Breathing – Breath deep by moving your belly in and out not just your chest.
Wait and Think – Waiting 1-3 seconds before you respond helps you to not feel rushed when speaking.
Easy Onset – Let air out before starting to speak (ex. E—ats) and stretch sounds to help air flow.
Light Consonant Contacts – Lightly say your words. Do not speak hard or emphasis sounds.
Speech Rate – Speak slowly do not rush to get all of your words out.
Pausing and Chunking – Pause at natural breaks and take a breath so that you have air to finish.
Behavior Modification – Increase eye contact and decrease extra movements when speaking.