What is speech therapy? Isn’t speech therapy and language therapy the same thing?

Technically speaking, when we talk about “speech therapy” we refer to the work we do to treat issues related to

  1. The pronunciation of words in a conversation
  2. Speech fluency (stuttering)
  3. Resonance or voice; and/or 4) oral motor skills for feeding and speech

The Different Speech Sound Disorders

If your child is not quite talking as a child his/her age should, or your child’s speech is difficult to understand, he/she may be facing challenges related to speech sound disorders. When we evaluate a child’s speech, we want to determine first what is the nature of the speech disorder so that we can use the appropriate therapy approach and technique. Using a therapy approach without considering the nature of the problem can result in little or no progress.

Here is a quick overview of the different types of speech sound disorders your child could be experiencing (please note that this is not meant as a guide to diagnosing your child, as only a licensed Speech-Language Pathologist can do so after conducting a thorough speech evaluation).

Motor Speech Disorders: a neurological motor deficiency cause.

  • Childhood Apraxia of Speech, related to motor planning/programing difficulties.
    • Unusual and inconsistent speech sound errors
    • Difficulty sequencing multisyllabic words
    • Vowel/consonant distortions
  • Dysarthria, related to difficulties in the execution of muscles involved in speech.
    • Slow, labored, imprecise articulation of consonants
    • Imprecise articulation
    • Sound prolongations
      Irregular pausing between words, syllables, and sounds
      (Speech Characteristics: Selected Populations—ASHA.org)

Speech Articulation Disorders related to a structural problem such as Cleft Lip/Palate.

    • Hypernasal resonance of vowels, vocalic consonants, glides, and liquids
    • Reduced or diminished intraoral pressure during production of pressure consonants
    • Nasal air emission on production of pressure consonants
    • Compensatory errors (e.g., glottal stops for stop consonants, pharyngeal fricatives for sibilants)
    • Consonant cluster reductions and placement or omission errors
      (Speech Characteristics: Selected Populations—ASHA.org)

Speech Articulation Disorders related to a sensory/perceptual cause such as hearing loss/impairment.

    • Consonant deletions (especially of final consonants)
    • Consonant substitutions with specific features.
    • Vowels tend to be neutralized
    • Reduced overall speech intelligibility
    • Particularly as linguistic complexity increases
    • Reduced speech rate
    • Poor coordination of breathing with syntactic phrasing, use of duration to create stress patterns
    • Distorted resonance

Speech Articulation disorder related to myofunctional challenges such as frontal lisps.

Speech Articulation Disorders with no known cause.

    • Consonant substitutions such as “w” for “r”
    • Consonant distortions and/or omissions
Speech Sound Disorders Umbrella from ASHA.org

Figure 1 – Speech Sound Disorders-Articulation and Phonology (ASHA)

After conducting a thorough speech evaluation, we will have the necessary information to be able to conclusively diagnose the child’s speech problem.

Speech Evaluation

For speech therapy to be effective, we will first conduct a thorough speech evaluation involving the following steps. First, a parent/caretaker interview for a detailed case history to better understand the complaint, the child’s family history of any speech-language disorders, the child’s medical history starting at the womb, and the developmental milestones achieved.

We also want to understand what languages are spoken at home, how often, and by whom; as well as the child’s proficiency in any other language(s). In addition, we need to know how much the child’s speech issue is impacting communication both in the family and in the community. And whether that is impacting the child’s emotion and behavior.

After interviewing the caretakers, we will move on to directly assessing the child’s speech by first recording (with parents’ permission) the child’s spontaneous speech during interactions in the family and with the SLP via a free play activity.

This is so we can obtain speech samples, which will be used to:

a) Judge how much the child can be understood

b) Assess how fluent the speech is

c) Determine the child’s speech sound inventory

d) Analyze any speech errors at the conversation level (as opposed to single words)

By now we are able to rule out or identify if the problem relates to fluency of speech/Stuttering, voice or resonance, and/or speech mispronunciation. Next, we will use specific test(s), to further look at the suspected speech problem.

Last but not least, we will conduct an oral motor examination to assess the child’s oral motor structure and function of articulators (i.e., jaw, tongue, lips, palate, and teeth). Finally, we will analyze and synthesize all the information gathered to be able to conclusively diagnose the child’s speech problem, identify strengths and weaknesses, and design a plan of intervention.


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