EARLY LANGUAGE INTERVENTION
The first 3 years of life, when the brain is developing and maturing, is the most intensive and critical period for acquiring speech and language skills. By one year of age, toddlers typically say their first words (e.g., mama, dada, baba). By two years of age, vocabulary typically increases to about 100-150 words, with the use of 2 to 4 word combinations (e.g., Daddy hat. Truck go down.)
Children sometimes experience delays with talking. While some toddlers who are late in talking will catch up to their peers on their own, 20-30% won’t catch up without intervention. Late talkers are at risk of continued language difficulties and/or literacy difficulties as they grow.
Early intervention is important. Through parent coaching and a play-based approach, a Speech-Language Pathologist can provide strategies and activities that can be incorporated in your everyday routine in order to stimulate your child's overall communication development. This Communication Checklist from birth to age four can be used to help you decide if your child needs help with their speech and language development.
Language is a set of shared rules that allow people to express their ideas in a meaningful way. Language Delay is the term used when language development trajectories are below age expectations.
Children with receptive language difficulties experience challenges understanding what others say due to struggles comprehending age-appropriate vocabulary, grammar, and/or sentence structure. They may have difficulty understanding stories, as well as following instructions.
Children with expressive language difficulties struggle to express themselves by using age-appopriate vocabulary, grammar and/or sentence structure. They may also struggle to properly organize and verbally express their thoughts and ideas in a clear and concise manner when telling stories, when talking about their favorite movie, or when describing an event that happened.
SPEECH / ARTICULATION
Speech/articulation involves the precisely coordinated muscle movements of the tongue, lips, jaw, and vocal tract to produce the recognizable sounds that make up language. Children with articulation difficulties have difficulty producing speech sounds correctly. For example, a child may pronounce the "s" and "z" sounds with a frontal lisp, that is, with the tongue between their top and bottom teeth. A child may experience difficulty accurately pronouncing the 'r' sound. A child may not pronounce final sounds in words.
Speech sounds appear in typically developing children’s speech at different times - with easier sounds emerging earlier, and more difficult sounds emerging later. A speech delay exists if a child cannot produce a sound when most children their age have acquired that sound.
Speech difficulties can be accompanied by motor speech difficulties, which include struggles in coordinating movement of the articulators (lips, tongue, and jaw) to result in appropriate speech pattern movement.
If not addressed through intervention with a Speech-Language Pathologist, speech delays can result in reading and writing difficulties. It can also lead to frustration and embarrassment, and can impact one's motivation to socialize.
For more information on speech development, this Articulation Developmental Norms Chart, created through Markham Stouffville Hospital's Child Development Programs, can be consulted.
STUTTERING / FLUENCY
Stuttering is a disruption in the forward flow of speech. It is characterized by:
Repeating sounds, syllables, words and/or phrases (repetitions). For example, D-d-d-d-d-do you want to play with me?, I-I-I-I-I want some., Can you-can you-can you help me?
Stretching out a sound for a long time (prolongations). For example, Lllllllllook at my cat.
Having a hard time getting a word out, as though it is stuck in the throat (blocks). For example, I see a (pause) dog.
Stuttered words can be produced with an excess of physical tension or struggle. Children can also experience challenging feelings about speaking due to their stutter, resulting in the avoidance of specific sounds or words, and/or the avoidance of certain social speaking situations.
Stuttering can change from day to day, with excitement, fatigue, and stress potentially leading to an increase in frequency and severity.
Research shows that most children who stutter tend to start between the ages of 2½ and 4. Research also shows that at least 75% of young children will eventually stop stuttering and go on to develop typically fluent speech, even without fluency therapy. However, this leaves 25% of young children who don't "grow out of it" and are at risk of developing a lifelong problem.
Persistent stuttering does not resolve over time. It is impossible to determine with certitude which children will continue to stutter as they grow older. However, there are risk factors which suggest a greater probability, such as:
Sex of child - boys are at higher risk than girls
Family history of persistent stuttering
Time duration since onset - the longer a child stutters, the greater the risk of persistent stuttering
Age of onset - children who start stuttering at 35 months or later
Consistency - less chances of recovery in children who show an increase in stuttering throughout their development
Co-occurring speech and language impairment
Regardless of risk factors, research shows that early fluency intervention through a Speech-Language Pathologist can have significant positive effects and is key in preventing chronic stuttering. On the contrary, the 'wait-and-see' approach has greater likelihood to result in persistent stuttering.
Social communication or pragmatics includes the understanding and use of body language (e.g., gestures, facial expressions, eye contact) and oral language (words) during daily interactions with others, such as:
Joint attention - This occurs when two people pay attention to the same thing, intentionally and for social reasons. For example, when a child follows someone's gaze or pointed finger to look at something, such as when receiving instructions.
Requesting - Expressing a need or desire. For example, asking for help, for a toy, for a snack, etc.
Commenting - Making comments. For example, making a comment about a friend's toy, about a snack, about the weather, etc.
Social greetings - For example, saying "Hello", and asking someone "How are you?"
Sharing - of toys, etc.
Resolving conflicts by using language. For example, telling a child who takes a toy away: "I was playing with that car. I'll give it to you when I am done."
Turn taking - in games and in conversation.
Understanding that social games have rules to follow.
Using appropriate volume, speed, intonation and body distance during conversation.
ASD (AUTISM SPECTRUM DISORDER)
Autism Spectrum Disorder (ASD) is a developmental disability affecting the development of communication and social interactions skills. People with ASD vary widely in their communication abilities. Some have no verbal speech. Others may be limited to repeating commonly heard phrases, known as echolalia. Those with higher level language skills may be verbally fluent, however restricted to a small range of topics and have difficulty with social conversations.
Speech-language therapy helps people with autism improve their verbal, nonverbal, and social communication, with the overall goal of teaching them to communicate in more useful and functional ways.
A total communication approach is used so that your child has the best opportunity to communicate their message whether verbally and/or through non-verbal means which may include gestures, picture communication, or adaptive devices, all of which fall under Alternative and Augmentative Communication (AAC).
GROUP THERAPY / SUMMER CAMPS
PROFESSIONAL DEVELOPMENT / COURSES