Speech Language and Learning Programs
All of our therapy programs are based on supporting areas of need that have been identified by our initial assessments. As speech pathologists we work within a multi disciplinary team as we do not necessarily cover all of the areas of need that can be present in developing children and adolescents. For this reason, parents are always advised if referral to another professional is recommended. Referral might be to an Audiologist, Occupational Therapist, Psychologist, Learning Support or Guidance Officer, Developmental Optometrist, Physiotherapist or Medical Specialist such as Paediatrician, Neurologist or Ear Nose and Throat Specialist.
Click on the hexagons below to learn more about each program.
Speech Sound Clarity / “Childhood Apraxia of Speech” / “Dyspraxia”
As children develop speech, they use a range of sound substitutions which they usually self-correct by certain ages. These stages of development are called ‘phonological processes’. Some children have unclear speech due to:
a) ‘speech sound delays’ and some intelligibility issues although these substitutions are usually predictable for the listener e.g. ‘tat’ for ‘cat’, ‘bish’ or ‘bit’ for ‘fish’ and ‘wub’ for ‘love’ etc.;
b) difficulty developing phonological rules, a ‘phonological disorder’. Some children may be consistent and others more inconsistent in their substitution of sounds, resulting in speech sound disorders; or
c) difficulty feeling, imitating and planning the movements with their mouth, or remembering the plan for the next time they want to say the same word. This is called ‘dyspraxia’, ‘childhood apraxia of speech’ or ‘developmental verbal dyspraxia’ and the severity may range from severe (i.e. very few sounds being copied or used spontaneously) to mild (i.e. words used in sentences that are unclear or poorly produced if the word or sentence is longer than usual).
Assessments guide us to diagnose whether one of these issues is present as each of these 3 areas requires a different program approach, focused on developing the core deficit areas. Programs such as Better Meta (developed and researched by Sue), Core Vocabulary, the Nuffield Program and the R.E.S.T are dyspraxia programs used and a range of traditional phonological programs are also implemented.
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Auditory Processing /ADD /ADHD
Children who have auditory processing and attentional difficulties are also likely to experience language comprehension and literacy learning difficulties (further described below). Similarly, children who have attentional difficulties may also experience auditory processing difficulties. For this reason, we will recommend referral to experienced audiologists who are able to identify these in appropriate testing environments. Often recommendations from them focus on working with children’s phonological awareness and literacy or listening skills.
We are very aware that children who have Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder may have sensory differences and individualised needs to help them sit still and concentrate. As we have a multidisciplinary focus, we are able to accommodate these adjustments to facilitate therapy outcomes. Listening programs may be delivered with a variety of approaches, including computer based programs and apps. Refer also to Literacy/ Phonological Awareness and Language program descriptions.
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Eating & Swallowing/ Tongue Tie
Some mothers experience feeding difficulties with their newborn babies. This can sometimes be due to a tight ligament under the tongue or inside the upper lip i.e. ‘tongue tie’ which restricts lip and tongue movements. Research indicates that speech difficulties can follow unless the ligament is released surgically by a specialist. Some children do not have a tongue tie but continue to have feeding and drinking difficulties and this may be due to low muscle tone (and strength to sustain sucking) or some sensory or motor planning and coordination difficulties. If eating and drinking difficulties persist, a speech pathologist should be consulted to assist with strategies to assist in developing more mature chewing and swallowing patterns.
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Language Understanding, Vocabulary Development and Verbal / Written Expression
Children learn the meaning of words from before 12 months, as names of objects, people and actions. Comprehension development then expands to include labels for abstract concepts of increasing complexity and includes sentences or instructions containing these terms. Language Understanding also includes the awareness of word associations such as classification names and examples that are used together.
Children who have weaknesses in these areas benefit from explicit, direct teaching so that they can follow directions, understand vocabulary and deal with language in a classroom or social situation. Vocabulary needs to expand to include adjectives and adverbs, alone and in sentences. Expressive language develops from early on, with children combining key words increasingly over time until proper sentences develop, and they are able to convey a message to request, describe or respond to questions using correct word order (syntax). Word grammar also develops as sounds or syllables to express plurals, verb tense, comparatives etc.
Our language programs are tailored to meet each child’s individual needs as undeveloped areas are addressed developmentally. These include the Derbyshire Language Scheme, Blades Program, Hanen Training, Concept Vocabulary Teaching, Visualising & Verbalising and Colour-Coded Grammar. Augmentative Communication can include Paget- Gorman signing, Makaton/ Auslan signing and PECS (Picture Exchange Communication System).
Educational iPad apps are also used as necessary, including Key Word Kids and Key Verbs with Steffy & James which were designed and produced by Sue and Guidance Counsellor/ Specialist Teacher colleague, Janet Eales, based on the Derbyshire Language Program (UK). Janet and Sue are the Australian trainers of the program (see links to Language and Learning Steps). Children also need to develop expressive language into story structures and our therapy programs assist with both the understanding and planning of sentences and information using various story structures which will be required in school from Prep onwards.
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Literacy: Phonological Awareness & Processing, Reading & Spelling
As speech pathologists, we have had extensive university level training in developing awareness of sounds for both speech and literacy learning and with supporting language and learning difficulties. Majority of children learn literacy in the early years of schooling almost automatically but some children struggle and others have significant difficulties, such as dyslexia.
Research has shown that assessment and identification of underlying difficulties followed by direct intervention with sound awareness and processing in conjunction with explicit teaching of phonics, symbol imagery, memory training and rule-governed reading and spelling makes a significant difference. We have had extended specialized training in assessment and U.S. based literacy programs such as the Lindamood Phoneme Sequencing Program (LI.P.S.) which Sue has adapted for our Australian vowels, and for children with speech, language and learning difficulties and Lindamood Seeing Stars (a sight word training program) which is more recently developed.
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Reading Comprehension / Memory/ Academic Skills
A number of children have literacy and learning difficulties which need to be identified as soon as possible so that support and strategies can be provided to assist their academic achievements. While some children may have reading and spelling difficulties, others progress well in this area but fail to develop skills in Listening and Reading Comprehension.
This can be due to language based weaknesses, such as vocabulary development, grammatical weaknesses or due to difficulties in higher order thinking and problem-solving skills. Other students can have memory and processing difficulties dealing with longer and more complex grammatical sentences or with language-based information in specific subject areas such as Maths, SOCE and Science as well as with English.
Language Processing Assessment helps us to identify areas of weakness and strengths and specific program recommendations can be made. We are all trained and experienced in Visualising and Verbalising and Talkies Programs (Lindamood trained) and work with extended Vocabulary Development from Early Childhood to Secondary School levels.
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Social Communication Behaviour/ Pragmatic Language Skills
Children who have delayed and disordered language can experience difficulties in understanding the way our communication and behaviours are established. Some may have sensory processing differences which affect the ways in which they respond in social situations. As speech pathologists, trained in specialised and evidence-based programs such as Secret Agent Society and Michelle Garcia’s programs, we can assist with these individual or group social language skills based programs. Often these skills are facilitated in conjunction with other program areas rather than being treated in isolation, particularly if children are younger and require support in language through play.
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Fluency / Stuttering
As they are acquiring and using an increased vocabulary repertoire, children can go through a short but normal stage of stuttering, or repeating sounds or syllables at the start of words. This becomes of concern if it continues for longer than a month and early speech pathology intervention using the Lidcombe Program can make a significant difference with parent training and home practice involved for younger children.
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Voice Quality / Vocal Nodules
Some children can develop a hoarse sounding or raspy voice at any age. Specific exercises and retraining in voice use can assist them to regain a normal sounding voice, when vocal nodules are the cause, saving the need for surgery. At other times, voice exercises are recommended following surgery, such as with the removal of polyps. Sue and Jo have had specialized voice training and accreditation with Estill Voice Training and Voicecraft which they are able to apply in a way that is suitable for younger children and allow them to have fun while doing the voice exercises. Home practice is required for the best results to be achieved.
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English Accent Improvements
Australia is a predominantly English-speaking but multi-cultural country. Many students arrive from foreign countries having learnt a little English, or having learnt to listen and speak from others in their country who have retained characteristics and subtleties of their own first language, such that their English does not really represent the true Australian English accent.
There are different ways we produce several consonant sounds, that are not produced in some languages. The Australian vowels are different to those spoken in Britain and the USA. The manner in which we use our voice quality, voiced or voiceless consonants and the speed and rhythm of our connected speech may vary significantly from other languages or the ‘English’ taught to students overseas.
As speech pathologists working in this area, we can assist with the modification of accents to resemble our Australian English. For some professionals, it is critical that they are easily understood in their role, so for this reason we have helped teachers and health professionals to achieve specific modifications relevant to their first language. We find working in this area extremely rewarding as ‘corporate development’ assistance.
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