Conditions Treated by Pediatric Speech Language Pathology
There are many reasons children are referred for speech language pathology. Our Pediatric Speech Language Pathology Team helps children with an incredible range of needs. The areas of child development that are treated include developmental delays/disorders, auditory processing, medical conditions that cause oral-motor, feeding, or communication difficulties, language-based learning disabilities, and developmental delays. Below is a list of the more common conditions that pediatric speech language pathologists treat.
- Attention Deficit (Hyperactivity) Disorder (ADD/ADHD)
- Autism Spectrum Disorders
- Childhood speech & language delay/disorders
- Cleft Palate
- Cochlear Implant / Auditory Processing
- Developmental apraxia / Dyspraxia of speech
- Down Syndrome
- Neurological disorders
- Oral Motor – Feeding Difficulties
- Orofacial myology
- Phonological & Articulation Disorders
- Pragmatic Disorders
- Traumatic Brain Injury
Detailed Information on Speech Disorders
Childhood Apraxia of Speech (CAS): CAS is a motor speech disorder, affecting a child’s ability to say sounds, syllables, and words. CAS is not due to muscle weakness; it is due to difficulty coordinating the muscle movements necessary to say target sounds, syllables, and/or words.
Dysarthria: Dysarthria is a motor speech disorder, affecting the necessary muscles for speech production. The lips, tongue, vocal folds, and/or diaphragm may have impaired movements, resulting in unintelligible speech. The following speech characteristics may be present in a child with dysarthria: slurred speech, slow rate of speech, rapid rate of speech, limited movement of the mouth, abnormal rhythm while speaking, and abnormal vocal quality.
Orofacial Myofunctional Disorders (OMD): OMD, also known as a “tongue thrust”, is characterized by exaggerated tongue motions during speech and swallowing. When a child has OMD, their tongue may rest too far forward or come out between their teeth during speech and swallowing tasks. A child may say, “thoup” instead of “soup”, so the /s/ phoneme becomes a “th” sound while speaking.
Articulation Disorder: An articulation disorder is characterized by a child having difficulty producing various sounds. Sounds can be distorted, omitted, or substituted for different sounds. These errors make it hard to understand what the child is saying. For example, a child may say “wabbit” for the word “rabbit”; the child is substituting the /w/ phoneme for the /r/ phoneme.
Phonological Disorder: A phonological disorder is characterized by a child making speech sound errors in patterns. For example, a child may say “tup” for “cup” and “dum” for “gum”; this phonological process disorder would be defined as fronting (substituting all sounds that are typically made in the back of the mouth to sounds that are made in the front of the mouth).
Fluency Disorder (Stuttering): A fluency disorder, or stuttering, affects the fluidity of speech. Children who are 3-to-5 years of age experience some dysfluencies, usually they include the following:
- Whole-Word Repetition: I-I-I-want a toy
- Interjections: Would you-um um, like, um, you know-like to play?
*Other dysfluencies that are considered atypical at any age include the following:
- Single-Sound Repetition: t-t-t-toy
- Part-Word Repetition: Pup-pup-puppies are cute
- Sound Prolongation: MMMM ore chicken please
- Blocking: The sound or air is stopped in the lungs, throat, mouth, lips, or tongue. Can……..we go outside
- Abandoning: When the speaker abandons (does not say) what they would have said, avoiding the dysfluency
Voice Disorder: A voice disorder is characterized by abnormalities in the volume, quality, pitch, and prosody of the voice. Some common types of voice disorder include: vocal cord nodules, vocal cord polyps, vocal cord paralysis, paradoxical vocal fold movement, and spasmodic dysphonia.
Vocal Cord Nodules: Vocal Cord Nodules are noncancerous growths on the vocal cords that are caused by vocal abuse (yelling, excessive amounts of caffeine, constant throat clearing). As vocal abuse continues, the growths become larger and harder; making the vocal quality hoarse, breathy, harsh, or scratchy.
Vocal Cord Polyps: A vocal polyp is a blister-like growth and is usually larger than a nodule. Polyps may also be caused by vocal abuse (yelling, excessive amounts of caffeine, constant throat clearing). Polyps may make the vocal quality hoarse, breathy, harsh, or scratchy.
Vocal Cord Paralysis: Vocal cord paralysis occurs when one or both of the vocal cords are unable to move. Bilateral vocal cord paralysis occurs when both vocal cords are unable to move and are stuck halfway between open and closed. Unilateral vocal cord paralysis occurs when one vocal cord is stuck halfway between open and closed or has limited movement. Symptoms may include: hoarseness, breathy voice, limited variation in volume, and choking and/or coughing while eating.
Paradoxical Vocal Fold Movement: Paradoxical vocal fold movement occurs when the vocal cords intermittently close when they should open, and open when they should close. Paradoxical vocal fold movement may be mistaken for asthma because it often leads to wheezing and difficulty breathing.
Spasmodic Dysphonia: Spasmodic dysphonia is a chronic voice disorder, resulting in a strained vocal quality with periods of aphonia (no sound), and periods of normal voice.
Detailed Information on Language Disorders
Receptive Language Disorder: A receptive language disorder is characterized by deficits in the ability to understand language. The following are signs of a preschool receptive language disorder, difficulties in: understanding what gestures mean, following directions, answering questions, identifying objects and pictures, taking turns when talking with others.
Expressive Language Disorder: An expressive language disorder is characterized by deficits in the following areas: asking questions, naming objects, using gestures, putting words together into sentences, learning songs and rhymes, using correct pronouns (“he” or “they”), and knowing how to start a conversation and keep it going.
Auditory Processing Disorder: An auditory processing disorder, also known as: auditory perception problem and auditory comprehension deficit. An auditory processing disorder occurs when the central nervous system has trouble receiving and interpreting auditorily received information. The speech-language pathologists at The Therapy Tree are able to identify and treat children with auditory processing disorder.
Central Auditory Processing Disorder (CAPD): refers to a difference in how an individual uses the information that they hear. An individual may have good hearing, but not use the information in a manner that is efficient for communicating with others. CAPD involves auditory attention, auditory discrimination, analysis of auditorily received information, synthesis of information, association, and organization. CAPD may be diagnosed by a specialist in the field of audiology. Treatment may be provided by our team of speech-language pathologists at The Therapy Tree.
Language-Based Learning Disability (Reading, Spelling, and Writing): A language-based learning disability occurs when there are difficulties with age-appropriate reading, spelling, and/or writing. A speech-language pathologist will assess spoken language (speaking and listening) and written language (reading and writing).
Pragmatic Language Disorder: A pragmatic language disorder refers to children who are struggling to interpret or use language in social situations. Examples may be, difficulty entering a conversation, difficulty interpreting social cues, and difficulty identifying emotions in others.
Selective Mutism: Selective mutism occurs when a child does not speak in certain situations, such as at school or at a friend’s house, but then speaks at home. Children with selective mutism may also exhibit signs of an anxiety disorder, excessive shyness, fear of social situations, and social isolation.
Detailed Information on Other Medical & Developmental Conditions
Angelman Syndrome: Angelman Syndrome is a genetic disorder resulting in global developmental delays. Receptive language abilities are typically more advanced than their expressive language abilities, resulting in a limited expressive vocabulary.
Attention Deficit/Hyperactivity Disorder (ADD/ADHD): ADHD is a neurobehavioral disorder, resulting in inattentiveness, impulsivity, over-activity, or a combination.
Autism Spectrum Disorders (ASD): ASD, also referred to as Pervasive Developmental Disorder (PDD), is a large spectrum, in which children may exhibit repetitive behaviors, nonverbal communication, or limited social skills; there is a wide range of symptoms and intensity of the behaviors.
Cerebral Palsy: Cerebral Palsy affects body movement and muscle coordination. Cerebral Palsy occurs due to trauma to the brain before, during, or shortly after birth. Cerebral Palsy can impact clarity of speech due to limited control of muscle coordination.
Cleft Lip and Palate: A cleft lip is a separation between the sides of the upper lip, and a cleft palate is an opening on the roof of the mouth. Children with a cleft lip and cleft palate often have difficulties with feeding and may develop speech delays/errors.
Deafness/Hearing Loss: Signs of a hearing loss may include the following: lack of attention to sounds (birth -1 year), lack of response when name is called (7 months-1 year), inability to follow simple directions (1-2 years), demonstrates delays in speech and language development (birth-3 years).
Down Syndrome: Down Syndrome is a chromosomal abnormality, with a diagnosis typically made at the time of birth due to the physical characteristics such as flat facial features, poor muscle tone, heart problems, and an enlarged tongue. Speech and language may be delayed.
Fragile X Syndrome: Fragile X Syndrome is a genetic disorder which is more common in boys than girls. Physical features of Fragile X Syndrome include: long face, large prominent ears, and hyperextensible joints. Speech and language delays are present.
Landau-Kleffner Syndrome (LKS): LKS is diagnosed through sleep EEG due to frequent nighttime seizure activity. LKS is characterized by a progressive loss in the ability to understand and use spoken language.
Oral-Motor Disorders: Oral-motor disorders are caused by incorrect motor programming of the muscles of the mouth; which may lead to difficulty with eating and speaking. Oral motor exercises are used to strengthen, improve coordination, and improve range of motion of the articulators (e.g., jaw, lips, and tongue). Activities may include blowing bubbles, using straws, and blowing horns.
Prader-Willi Syndrome (PWS): PWS is a chromosomal disorder, affecting the #15 chromosome. Signs of PWS include the following: hypotonia (lack of muscle tone), global developmental delay, feeding problems, narrow face, almond-shaped eyes, small mouth, hypopigmentation (loss of skin color), motor planning problems, behavioral problems, sleep disturbances, and compulsive eating problems.
Swallowing/Feeding Disorders: Swallowing and feeding disorders include problems with gathering food and getting ready to suck, chew, or swallow it. Swallowing disorders are also called dysphagia. Dysphagia may occur in one or all of the following phases: oral phase (sucking, chewing, and moving food/liquid to the throat), pharyngeal phase (starting swallow, squeezing the food down the throat, and closing off the airway), and the esophageal phase (relaxing and tightening the openings at the top and bottom of the esophagus and getting the food into the stomach).
Traumatic Brain Injury (TBI): A TBI is caused by sudden damage to the brain. The consequences of a TBI may include deficits in swallowing/feeding, understanding spoken language, using spoken language, cognition, behavior, sensory, and physical problems.
Williams Syndrome: Williams Syndrome is a genetic disorder which is present at birth, affecting the #7 chromosome. The following physical features are typically present in Williams Syndrome: elfin-like facial features, heart and blood vessel problems, elevated blood calcium levels, slow weight gain, feeding problems, colic, dental problems, kidney problems, hernias, and hypotonia (low muscle tone). Children with Williams Syndrome may be extremely social, have attention deficits, learning disabilities, and a developmental delay.
This information is brought to you by Abby Badgley, SLP and has been summarized from The American Speech-Language-Hearing Association, First Signs, and Dr-Ferre.com.