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SPEECH THERAPY 101

 

I’m a first time mom of an eleven-month-old.  Little Charlotte is crawling, climbing up stairs, cruising from couch to couch, and trying to take her first steps.  She’s babbling, laughing, and squealing with delight.  I’ve even taught her a few signs, like “all-done” and “more.”  She loves looking at books, dancing after she activates musical toys, and putting blocks in holes.  Even with all of these beautifully developed skills in place, I await anxiously for her first real word.  Sure, we hear “da-da-da” and “ma-ma-ma” all day long, but I want her to look at me and say “mama” deliberately and consistently day after day.  I know Charlotte will most likely speak her first meaningful word in the next couple of months, but even as a speech-language pathologist (SLP), I’m nervous.

First and foremost, I’m a mommy, which is why I worry about typical things mommies worry about.  My second role is that of an SLP.  Many people often ask what I do and assume I sit in a sterile office with a mirror and help children say their “r” sound as they repeat word lists after me.  They’re not completely off base, but helping kids say their “r” sound is probably only about 5% of what I do.  Let’s take a look at the role of speech-language pathologist and how they may help someone in your life.

What qualifications do SLPs have?

All speech-language pathologists must have master’s degrees and should be licensed in the state in which they work.  Many SLPs are certified through the American Speech-Language-Hearing Association (ASHA), which expects them to meet certain continuing education requirements ever year.  You’ll know if an SLP is certified by whether or not she has “CCC” listed behind her name.  For example, I’m Megan Keller, MS, CCC-SLP.

Where can SLPs work?

SLPs can work in many different settings.  The most common settings are:

  • neonatal intensive care units (NICU)
  • early intervention settings
  • elementary, middle, and high schools
  • private practice
  • hospitals
  • skilled nursing facilities or rehabilitation centers
  • universities

So wait, speech therapy is not just for correcting speech sounds?

Nope.  We can work with children before they even begin talking.  I think people are most surprised to find out that speech pathologists can begin working with children at birth.  As mentioned above, we can work in the NICU, helping tiny babies learn to feed.  Here are some other skill areas that SLPs assess and remediate in the pediatric population:

  • delays in receptive language (what we understand)
  • delays expressive language (what we say)
  • delays or disorders in articulation and phonology (the actual sounds we say that make up words)
  • disorders in motor speech skills (i.e., Apraxia or Dysarthria)
  • communication skills in those with hearing loss
  • disorders of fluency (i.e., stuttering)
  • social/pragmatic skills
  • disorders in swallowing (if working in a medical setting)
  • disorders in feeding
  • disorders in voice and resonance

Needless to say, our scope is pretty big!  I work full-time in an elementary school but also see children privately in their homes.  In a given day I can go from working with a three-year-old on developing more than a few words, to working with a fifth grader on saying his “s” sound, to working with a child with autism who uses an iPad to communicate, to working with a group of students on social skills, to helping a little guy who stutters.  Though these cases are extremely diverse, all of these kiddos have something in common- they all need explicit instruction on communicating more efficiently and effectively. 

Though it’s not my specialty, many SLPs work with adults.  Usually SLPs treat adults who have sustained some kind of injury to the brain, such as a stroke.  They assess and remediate difficulties with:

  • disorders of receptive language (what we understand)
  • disorders of expressive language (what we say)
  • disorders of motor speech skills (i.e., Apraxia or Dysarthria)
  • disorders in swallowing (common in stroke survivors)
  • disorders of voice and resonance (also common in stroke survivors)
  • disorders in cognitive reasoning and executive function
  • disorders in fluency (i.e., stuttering)

What do sessions look like?

Many parents wonder how we work on these skills and what happens in a typical session.  While that varies from therapist to therapist, child to child, age to age, and from session to session, there are some commonalities.  I’ll guide you through a few “typical” sessions.

For a student who is working on articulation, or sound patterns, I generally follow this structure:

  • review last session
  • read a word list aloud to the student so they can hear the targeted pattern over and over (called “auditory bombardment”)
  • practice the sound pattern in isolation/words/sentences/conversation (whatever level the child is at) in a drill-like fashion
  • correct errors as necessary by providing verbal cues, physical prompts, visual cues and feedback, etc.
  • play a game while practicing the sound (say a word five times, take a turn)
  • review and give “homework”
  • talk with parent(s) about generalizing skills at home

For a student who is working on expressive and receptive language, I might:

  • review last session
  • read a book and target particular skills (answering questions, describing pictures, vocabulary, sequencing, etc.)
  • use follow-up activities to reinforce target skills (crafts, matching games, bingo)
  • review and give “homework”
  • talk with parent(s) about generalizing skills at home

For students who are working on social skills, I typically give direct instruction on a particular skill, such as eye contact, and then we do some kind of game or activity to practice.

So, if you are a parent, family member, or caregiver of a child who has difficulties communicating, how do you even begin getting help?

I always recommend that families first contact their pediatrician.  He or she can help you locate your local early intervention program, which is federally funded through the Individuals with Disabilities Education Act (IDEA).  These services are available for all children (who are found eligible) in the USA from birth to 21.You can also go to your state’s website for information on how to obtain an assessment and any services needed.  If a child is assessed and services are deemed necessary, an Individualized Family Service Plan (IFSP) is developed. This document outlines the child’s current strengths and weaknesses, goals for the child to meet in a specific period, and the services/programs that will help the child to achieve those goals. 

In most states, if a child is older than three, assessments and services are provided by the school district in which you reside.  For example, even though the elementary school I work at begins at kindergarten, I see children who are three and four because they were found eligible through the school system.  Their parents bring them in for their speech sessions during the week before or after they attend preschool at a different location. 

Sometimes children do not qualify for services through the county or school. Or maybe you feel like you’d like more services than what the county provides. Whatever your personal reasons, you can always have your child assessed by a local SLP who works for a private company. To find one of these therapists, you can:

  • Check the American Speech-Language-Hearing Association’s (ASHA) online database for SLPs in your area. You can access this database HERE.
  • Ask your pediatrician for a list of local providers.
  • Ask the SLP at your local public school.  They are often familiar with private providers.
  • Call a local university or college and see if they have a Speech and Hearing/Communication Disorders Clinic. Here, graduate level students in Communication Disorders provide assessments and therapy at a minimal cost (and sometimes FREE) under the supervision of a professor.

I hope that this information helps you understand what speech-language pathologists do, who we work with, and what to do if you have concerns about your child.  There is A LOT of help out there and it is never too early to begin. 

 

Megan Keller graduated from The University of Virginia in 2008, double-majoring in Psychology and Communication Disorders.  She received a Master of Science in Speech-Language Pathology from James Madison University in 2010. She is state licensed in Virginia and has the Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association (ASHA).

Currently, Megan works full-time in the Loudoun County Public School system, where she has worked since 2010.  Megan has worked part-time in private practice since 2012 and opened her business, KellerSpeech LLC, in 2015.  She is particularly interested in Childhood Apraxia of Speech and articulation/phonological disorders.

Teacher speech therapist with young child learning speech development