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There are many reasons why a student may need speech therapy services. It's important to note that a student may qualify for speech therapy services in an outside clinic and not in the school setting. Students may qualify for speech therapy services in a school setting if it affects their ability to access the curriculum or affects their ability to communicate or participate in conversations within the classroom. Here are some of the different types of speech therapy services offered.
- Articulation Therapy
Articulation therapy is probably the type of speech therapy that most people think of when they think of "speech therapy." This type of speech therapy is needed when a student has a hard time producing sounds, therefore making their speech difficult to understand when communicating with their teachers or peers. An articulation disorder focuses on the errors of individual sounds. It's only an articulation disorder when the sounds that are mispronounced are no longer age-appropriate. Sounds my be replaced with another sound, distorted, or omitted. Articulation therapy focuses on working on the difficult to produce sounds and building on the complexity of those sounds (e.g., sounds in isolation--> sounds in syllables --> sounds in words --> sounds in phrases --> sounds in sentences). Here are some common articulation errors:
Saying "white" for light
Saying "thun" for sun
Saying "wing" for ring
*There are many more possible articulation errors but those are just a few.
- Phonology Therapy
A phonological disorder focuses on predictable and rule-based errors. Phonological development refers to the sound patterns we make as we learn new types of sounds. Certain phonological patterns are considered age-appropriate up till a certain age. Phonological therapy focuses on determining if the student can first acknowledge the difference between the sound/pattern errors produced vs. the true target sounds/patterns. Then once the student is able to tell the difference, we work on correcting the patterns with minimal pairs (i.e., words that vary by only one sound). Here are some of the common phonological patterns we work on:
Gliding: Producing /w/ for all /r/ and/or /l/ sounds (e.g., "wing" for ring)
Final Consonant Deletion: Leaving off final sounds in words (e.g., "pi" for pig)
Fronting: Replacing back sounds (e.g., /k, g/) with front sounds (e.g., /t, d/) (e.g., "tite" for kite, "doe" for go)
Cluster Reduction: Leaving out a consonant sound from a consonant cluster (e.g., "cool" for school, "bock" for block)
Stopping: Shortening or "stopping" sounds that should be held out longer (e.g., "clat" for class, "pan" for fan)
*There are other patterns that may be targeted in therapy but these are the common ones.
- Childhood Apraxia of Speech (CAS)
CAS refers to a motor speech disorder. This means the child has no oral motor weakness that makes it difficult to produce sounds but has motor planning difficulties producing the sounds. These students have a hard time combining sounds/making the oral motor movements to make syllables/words/phrases/sentences. It is hard for their brain to communicate to the different articulators (e.g., tongue, lips, jaw) to move in the patterns necessary to produce the syllables/words/phrases/sentences. Therapy would focus on sound sequences and working on the movement patterns necessary to produce syllable/words/phrases/sentences. Here are some characteristics of CAS:
Inconsistent errors
Vowel distortions
Errors in tone, stress, rhythm
- Language Disorder (Receptive, Expressive, Pragmatic)
Language disorders often refer to a student's ability to communicate their wants and needs to their communication partners (expressive language) and/or their ability to understand other people's wants and needs from them (receptive language). Pragmatic language refers to the social language skills that we use in our daily interaction with others. Language therapy may incorporate or target use of various forms of communication (e.g., verbal communication, nonverbal communication, with an AAC device). Here are some examples of goals of each type of language therapy:
Expressive Language:
Describing objects
Producing grammatically appropriate sentences
Labeling various items around them in their everyday setting
Receptive Language:
Following directions
Answering wh-questions/story comprehension questions
Making inferences
Pragmatic Language:
Identifying social problems and providing appropriate solutions
Maintaining topic of conversation
Communicating emotions appropriately
*There are other goals that may be targeted in therapy but these are just some possible goals.
- Fluency
Fluency therapy is used for students that stutter. With fluency therapy we typically utilize fluency shaping techniques or stuttering modification techniques to increase a student's "smooth" speech. Some types of stuttering include repetitions (repeating sounds/parts of words/words/phrases), prolongations (holding out a sound), blocks (a long pause between words), or interjections (inserting words such as like or um into speech). Here are some strategies we utilize in speech therapy:
Pacing Board (tapping out circles on a paper to help control the student's rate of speech. Aka slow the student's speech down)
Easy Onset (take a deep breath and slowly let the breath out while you initiate the speech slowly)
Behavior modification (decreasing extraneous movements when speaking)
Load the Boat (Waiting a few seconds before responding)
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