Speech and Language Therapy

Speech and language therapists work with children who have problems with communication, swallowing and other oro-motor functions and they work as a part of multidisciplinary team and have close links with other professionals such as doctors, psychologists, teachers, occupational therapists and physiotherapists. They have a key role in public health, particularly through early intervention and through the promotion of independence and quality of life.

Speech Language Pathologists provides variety of services like:

Improving the cognitive aspects of communication
Improving the aspects of speech production ( phonation, articulation, fluency, resonance and voice)
Improving the aspects of language ( phonology, morphology, syntax, semantics and pragmatics aspects of communication) including comprehension and expression
Children who benefits from Speech and Language Therapy are:

• Autism Spectrum Disorders
• Learning Disabilities
• Speech and Language Delay/ Impairment
• Specific Language Impairment
• Misarticulations/ difficulties in producing specific sounds
• Hearing Impairment
• Attention Deficit Hyperactive Disorders
• Childhood Apraxia of Speech
• Cleft Lip & Palate
• Stuttering
• Voice Disorders
• Cognitive Deficit
• Cerebral Palsy
• Swallowing Disorders
• Oro- motor Difficulties and
• Genetic conditions like Down's Syndrome

When to consult Speech Therapist?

Referral to a speech pathologist is appropriate when a parent, teacher, or other professional is concerned because a child is demonstrating any of the following difficulties:

• delayed onset or delayed development of speech and language skills
• regression or loss of communication skills;
• problems with understanding spoken language;
• frustration and challenging behaviours resulting from communication difficulties
• difficulty with conversation, forming relationships, and socialising with peers, family members, and other learning difficulties.

Speech and language therapy is an important part of intervention to promote cognitive development. First, words equal knowledge and the faster a child learns vocabulary, the faster they acquire knowledge about the world. Secondly language support thinking and reasoning as it is usually carried out in mind as "silent speech". Language is equally important for children's social development as it enables them to negotiate their social world and to control their behaviours. As children acquire language they can ask for what they want, explain how they feel, describe what they have been doing and share thoughts and worries with friends. They are able to begin to control their behaviour by using silent speech to instruct themselves and to plan their actions.

At the speech clinic, children are evaluated for all types of speech and language problems, such as articulation, cerebral palsy, stuttering, cluttering, delayed speech and language, various voice problems and dyslexia. After evaluation, patients are advised speech therapy if required. Parents are also counseled regarding home training. Periodical revaluation is an ongoing process.

Speech and Language assessment is provided for children diagnosed with

• Autism
• Hearing impairment
• Cognitive delay/developmental delay
• Cerebral palsy
• Specific language impairment
• Other:
  • Misarticulation
  • Stuttering
  • Voice disorders

Role of Speech Therapist in treatment of children with Autism

Speech-language pathologists are a key part of the autism treatment team. With early screening and detection of people at risk, speech therapists often lead the way in helping with the diagnosis of autism and in making referrals to other specialists. Once autism is diagnosed, speech therapists assess the best ways to improve communication and enhance a person's quality of life. Throughout therapy, the speech-language pathologist also works closely with the family, school, and other professionals. If someone with autism is nonverbal or has major trouble with speech, the speech therapist may introduce alternatives to speech. As a member of the interdisciplinary team, the speech pathologist uses developmental and social interactive interventions in the child's natural environment. These interventions are supported by the implementation of visual aids and strategies to enhance the child's communication, social, behavioural, and play skills in all facets of his or her life.

The speech pathologist will interview the parents and observe how the child interacts with family members and other people in different contexts such as at home, preschool, or school. The type of assessment and the tools required to assess the child will vary greatly depending on the age and skills of the individual child. When a child has developed speech and language, developmental checklists and formal language tests may be used to determine whether the child's receptive and expressive language is age-appropriate, delayed, or disordered. The information gained from the speech pathology assessment will be considered in conjunction with information from the other members of the multidisciplinary team to determine whether a child is given a diagnosis of ASD. The speech pathologist will use information from the multi-disciplinary assessment to establish goals and plan an individualised communication program for the child. Because ASD is complex, therapy needs to address a number of different areas and will vary, depending on the child's current skills.

Areas of therapy may include the development of :

vocabulary, syntax, semantics, and articulation for the child who is verbal
receptive language skills.
play skills
use and understanding of body language and facial expression
conversation skills - initiation, turn taking, topic choice and maintenance
social skills
prosodic features such as intonation, volume and tone of voice
higher level language skills, such as inference, humour, and sarcasm; and/or the use of visual aids such as timetables, schedules, behavioural scripts, and social stories to assist the child with organisation and to cope with change and transitions.
alternative communication systems for the child who isn't talking e.g., use of photos, pictures, or signing
Teaching children with autism how to communicate is essential in helping them reach their full potential. There are many different approaches to improve communication skills in a child with autism. The best treatment program begins early, during the preschool years, and is tailored to the child's age and interests. It also will address both the child's behaviour and communication skills and offer regular reinforcement of positive actions. Most children with autism respond well to highly structured, specialized programs.

For older children with autism, basic communication training often emphasizes the functional use of language, such as learning to hold a conversation with another person, which includes staying on topic and taking turns while speaking. Experts estimate that as many as 25 percent of all children with autism may never develop verbal language skills. For some of these children, the goal may be to acquire gestured communication, such as the use of sign language. For others, the goal may be to communicate by means of a symbol system in which pictures are used to convey thoughts. Symbol systems can range from picture boards or cards to sophisticated electronic devices that generate speech through the use of buttons that represent common items or actions.

As Speech language pathologists, our aim is to make each child independent through functional communication and thus improving their quality of life.

Playstreet approach for Speech Therapy

We follow Play-based approach for Speech and Language sessions for speech stimulation and thereby developing communication.
We integrate the principles of Verbal Behaviour and ABA for behaviour modification.
We provide oro-motor program using TalkTools for children with Apraxia and other oro-motor deficits
We use Alternative & Augmentative Communication methods to facilitate communication in children with communication difficulties. Some of the approaches we use are PECS, Playtalk- an inhouse AAC s/w and visual tools like communication book.
We use tactile-kinesthetic approach that uses touch cues to a patient’s articulators (jaw, tongue, lips) to manually guide them through a target word, phrase or sentence. This technique develops motor control and the development of proper oral muscular movements, while eliminating unnecessary muscle movements such as jaw sliding, and inadequate lip rounding.
Role of parents in speech therapy
Parents or primary caregivers as well as other family members should be involved in the treatment program so that it will become part of the child's daily life. They can increase a child's chance of reaching this goal by paying attention to his or her language development early on. Just as toddlers learn to crawl before they walk, children first develop pre-language skills before they begin to use words. These skills include using eye contact, gestures, body movements, and babbling and other vocalizations to help them communicate. Children who lack these skills may be evaluated and treated by a speech-language pathologist to prevent further developmental delays.