I think my child needs speech therapy, now what?

I think my child needs speech therapy, now what?

You may have some concerns about your child’s speech and language skills, but you aren’t sure what to do about your concerns. Perhaps your child is having difficulty saying certain sounds, does not have the vocabulary you think they should have at their age, or is having difficulty producing words verbally at all.  Maybe they are having difficulty with fluent speech, and stutter when they are speaking. Or they could be able to say their sounds correctly, have a good vocabulary and sentence structure, but are having trouble with communicating with adults and/or peers in socially appropriate ways. What do you do with these concerns? Who do you talk to?

First, it is important to remember that your concerns are valid. If you are worried about your child’s ability to communicate, there are professionals available who can discuss your concerns and guide you in the right direction. Having a concern does not necessarily mean that your child has a speech and/or language disorder (problem), it just means you have a concern, and are looking for help in determining if your child might need help. So where should you turn?

First, it is always a good idea to talk to your child’s pediatrician. They know your child, and their medical history, and have basic knowledge of normal speech and language development. Consider making an appointment to talk to them about your concern’s, and see if they recommend a further course of action. In many cases, if your child is experiencing delays and/or differences with their speech, your pediatrician will be able to guide you on next steps. Please keep in mind that some pediatricians have a very cautious, wait and see approach. If your pediatrician suggests you wait and see, but you still feel like something is going on, by all means, pursue additional help.

The next step you can take, (or you can do this in the first place!!) is to contact a speech language pathologist (SLP) and consult with them about your concerns. After talking to them, they may suggest your have your child’s speech and language skills evaluated to determine if there is a speech and/or language disorder, and if there is, what course of treatment/therapy they recommend. SLPs (also commonly referred to as speech therapists) have specialized training in a wide variety of speech and language disorders, including how to both evaluate and treat speech and language disorders. But where should you look for an SLP to help you?

There are two main types of environments where SLPs work, the medical environment and the school environment. Depending on the difficulty your child is having, if they are having difficulty, you may choose to seek out assistance in one, or both environments. But which environment should you look to for help?

There are SLPs that work in the education environment through the public school system. The public schools are required by law to evaluate children ages 3+ with suspected speech and language disorders. If a child qualifies (states have varying state specific criteria for qualifying for services), the schools are then responsible for providing speech therapy. All of this is free. So although I now own my own private practice in speech therapy, as an SLP who spent the first twenty years of her career working in the schools, I highly recommend you start here first if your child is at least 3 (information on children under three in a moment). If your child is currently enrolled in school, let his or her teacher, (or school counselor), know that you would like to request a speech and language evaluation. I highly recommend you do this in writing. If your child is not yet enrolled, call your local school district special education department (you can just call the school district main line and ask for the special education department) and tell them you want to request a speech and language evaluation for your child. They will take you through this process at that point.

If your child is under 3, services that are available to them publically are provided through a program called Early Intervention (EI). Early Intervention services are available to you as a parent, and cost varies based on a variety of factors such as your income. You will want to contact your local EI service coordinator to request an evaluation for a child under 3. If you are not able to find their contact information, your local school district will be able to get you that information. Keep in mind that unlike services to children 3 and up, EI services are not necessarily free. They are however, typically available at a reduced cost.

SLP’s also work in a variety of medical environments including hospitals, outpatient clinics, home health (they come to your house), and in private practices (some are clinic based, some home based). Families who are interested in seeking evaluation, and potentially speech therapy services in the private environment simply call or email local practices to schedule an evaluation. Some, but not all SLPs in private practice offer short phone and/or email consultations (I do within my local area!) But why would you seek out the services of an SLP in a medical environment if school services are free? This is a very good question, and there are varied reasons families make this choice. Here are some of the reasons they do:

  • They want their child to get additional services outside of the school environment to maximize their potential for success.
  • Their child was evaluated by the school system, but was not eligible for speech and language services. Simply having a speech and/or language disorder does not always mean that a child will qualify for services. There are many reasons they may not, and it doesn’t necessarily mean they don’t need help. Sometimes, there is a need, but the school district isn’t able to meet that need because of state eligibility criteria.
  • Their child was eligible for services in the schools, but is embarrassed to be pulled out of class and the family prefers the private afterschool environment private therapy can provide.
  • Their child was eligible for services in the schools, but the family does not want them to miss any academic classes so they choose afterschool private therapy.
  • The family has chosen to homeschool, and as such, is not eligible for services in the schools. (Note: this is state specific. Some states do offer speech therapy services to children who are homeschooled and some do not. Texas WILL offer speech therapy to children who qualify who are homeschooled, however it is almost always offered at the local school building).
  • It is summertime, and families want their child to continue to receive the benefits of speech therapy over school break.
  • They want their child to receive the expert services of a private therapist who has dedicated their career to focusing in on specific types of speech and language disorders, and as such, can provide more specialized speech therapy for their child.

So there you have it. Some basic information on what to do if you are concerned about your child’s speech and/or language skills. Do you have specific questions that I might be able to answer for you? Please contact me and let me know, and I will do my best to help you help your child. Your concerns are valid, and your questions are welcomed.

Building speech & language skills in young children using repetitive line books

Building speech & language skills in young children using repetitive line books

One of the best ways you can help your younger child build their speech and language skills is through repetitive line books. Repetitive line books can be used to help with literacy skills, as well as with the following speech and language skills:

  • Learning sentence structure (grammar)
  • Working on articulation (pronunciation) if the sound the child is working on is in the repetitive line
  • Improving motor planning for children that have apraxia and/or other motor planning issues affecting their speech
  • Teaching inferencing and predicting skills
  • Using an Augmentative and Alternative Communication System (AAC) system: can be used with non talking systems such as Core Vocabulary Systems, single cell systems (like a Big Mac or Step by Step Sequencer), and with multiple types of robust electronic systems (including, but not limited to iPads with communication apps)
  • Teaching Easy Talking (using a moderate rate of speech with natural pauses) to help improve fluency in children that stutter

Using repetitive line books with your child is easy. Here is how you can do it:

  1. During the first read through, you read the entire book
  2. During the second read through, when you get to the repetitive line, leave out the very last word in the line when you read it, pause and see if you child will say it. If they don’t, just hold your pause for a few seconds, then say it and turn the page. Try again with that word on the next occurrence until they get that last word themselves. It is OK if they do not articulate it perfectly. If your child is using an AAC system, following the pause, wait for them to find the word in their AAC system and point to it, or touch it.
  3. On each subsequent time you read the book, once your child has been able to communicate the last word, reduce more words you read from each phrase, moving from the end of the phrase to the beginning

For example, for the repetitive line: “No more monkeys jumping on the bed”

First Read: “No more monkeys jumping on the bed”

Second Read: “No more monkeys jumping on the ____”

Third Read: “No more monkeys jumping on ___ / ____”

Fourth Read: “No more monkeys jumping ___ / ___ / ____ “

And so on until your child is saying the whole line.

There are many wonderful repetitive line books out there. Your local librarian is a great resource to help you find them. Here are some favorites to help get you started:

5 Monkeys Jumping on a Bad: Varied Authors

Are you my Mother? By P.D. Eastman

Bear Snores On By Karma Wilson

Brown Bear, Brown Bear: What Do You See? By Bill Martin Jr. and Eric Carle

Chicka Chicka Boom Boom By Bill Martin Jr.

Dear Zoo By Rod Campbell

Go Away Big Green Monster! By Ed Emberley

Jesse Bear, What Will You Wear? By Nancy White Carlstrom 

Jump, Frog, Jump! By Robert Kalan

Have You Seen my Cat? By Eric Carle

Is Your Mama a Llama? By Deborah Guarino

It Looked like Spilt Milk By Charles G. Shaw

One Duck Stuck By Phyllis Root 

Panda Bear, Panda Bear, What Do You See? By Bill Martin Jr. and Eric Carle

Pete the Cat: I Love my White Shoes By Eric Litwin

Polar Bear, Polar Bear, What Do You Hear? By Bill Martin Jr. and Eric Carle

Sheep in a Shop By Nancy E. Shaw

Silly Sally By Audrey Wood

There was an old Lady Who Swallowed a Fly (and other Old Lady Books, authors vary)

The Grouchy Ladybug By Eric Carle

The Jacket I Wear in the Snow By Shirley Neitzel

The Little Engine That Could By Watty Piper

The Napping House By Audrey Wood

The Very Busy Spider By Eric Carle

The Very Hungry Caterpillar By Eric Carle