In a recent parent-teacher conference, your child's teacher expressed concern that your child may have a problem with certain speech or language skills. Or perhaps while talking to your child, you noticed an occasional stutter. You're not sure that your child has a problem - what should you do?

Whatever your particular circumstances, it's wise to intervene quickly. A speech-language evaluation conducted by a certified speech-language pathologist can help you determine the nature of your child's difficulties.

What Is Speech-Language Therapy?
Speech-language therapy is the treatment for most children with speech and/or language disorders. A speech disorder refers to a problem with the actual production of sounds, whereas a language disorder refers to a difficulty understanding or putting words together to communicate ideas.

Speech Disorders and Language Disorders
Speech disorders include the following problems, according to Diane Paul-Brown, PhD, director of clinical issues in speech-language pathology at the American Speech-Language-Hearing Association (ASHA):

• Articulation disorders include difficulties producing sounds in syllables or saying words incorrectly to the point that other people can't understand what's being said.
• Fluency disorders include problems such as stuttering, the condition in which the flow of speech is interrupted by abnormal stoppages, repetitions (st-st-stuttering), or prolonging sounds and syllables (ssssstuttering).
• Resonance or voice disorders include problems with the pitch, volume, or quality of a child's voice that distract listeners from what's being said. These types of disorders may also cause pain or discomfort for the child when speaking.

Language disorders can be either receptive or expressive. Receptive disorders refer to difficulties understanding or processing language. Expressive disorders include difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.

Specialists in Speech-Language Therapy
According to ASHA, speech-language pathologists (SLPs), who are often informally known as speech therapists, are professionals educated in the study of human communication, its development, and its disorders. They hold at least a master's degree and state certification/licensure in the field.

By assessing the speech, language, cognitive-communication, and swallowing skills of children and adults, speech-language pathologists can determine what types of communication problems exist and the best way to treat these challenges.

"Speech-language pathologists typically treat problems in the areas of articulation; dysfluency; oral-motor, speech, and voice; and receptive and expressive language disorders," says Julie Foley, a pediatric speech-language pathologist.

Remediation
Speech-language therapy involves having a speech-language specialist work with a child on a one-to-one basis, in a small group or directly in a classroom, to overcome difficulties involved with a specific disorder. Speech-language therapy uses a variety of therapeutic strategies, including:

• language intervention activities - These exercises involve having a speech-language specialist interact with a child by playing and talking to him. The therapist may use pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct pronunciation and use repetition exercises to build speech and language skills.
• articulation therapy - Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables for a child, often during play activities. The level of play is age-appropriate and related to the child's specific needs. Articulation therapy involves physically showing a child how to make certain sounds, such as the "r" sound. A speech-language therapist may demonstrate how a child should move his tongue to produce specific sounds.

When Is Therapy Needed?
"Children require speech-language therapy for a variety of reasons," Foley explains, indicating that children with the following conditions may need speech or language therapy:

• hearing impairments
• cognitive (intellectual; thinking) or other developmental delays
• weak oral muscles
• birth defects such as cleft lip or cleft palate
• autism
• motor planning problems
• respiratory problems (breathing disorders)
• swallowing disorders

Foley advises that therapy should begin as soon as possible. Children enrolled in therapy early in their development (younger than 3 years) tend to have better outcomes than children who begin therapy later.

This does not mean that older children can't make progress in therapy; they may progress at a slower rate because they often have learned patterns that need to be modified or changed, Foley explains.

Finding Care for Your Child
It's important to make sure that the speech-language therapist is certified by ASHA, says speech-language pathologist Judi Barnes. ASHA certification means the specialist has at least a master's degree in the field, has passed a national examination, and has successfully completed a supervised clinical fellowship.

Sometimes speech assistants (who have typically earned a 2-year associate's or 4-year bachelor's degree) may assist with speech-language services under the supervision of ASHA-certified SLPs. "Your child's SLP should be licensed in their state, and have experience working with children, and your child's specific disorder," Barnes explains.

To find a specialist for your child, click on the Additional Resources tab on the right side of this page. You may also find a specialist by asking your child's doctor or teacher for a referral or by checking your local telephone directory. "The state associations for speech-language pathology and audiology also maintain listings of licensed and certified therapists," Barnes suggests.

Helping Your Child
Speech-language experts agree that parental involvement is crucial to the success of a child's progress in speech or language therapy.

"Parents are an extremely important part of their child's therapy program. Parents help determine whether their child's experience in speech-language therapy is a success. I have seen over and over again during my years as a speech-language specialist that the children who complete the program most quickly and with the most lasting results are those whose parents have been involved," explains speech-language pathologist Carol Casserly.

Ask your child's therapist for suggestions on how you can help your child, such as performing speech-language exercises with him at home. The process of overcoming a speech or language disorder may take some time and effort, so it's important that all family members be patient and understanding with the child.

Reviewed by: Julie Foley, MS
Date reviewed: July 2001