Focus on errors in the production of individual speech sounds (e.g., difficulty producing “R” or a lisp). Articulation therapy may be completed in addition to supporting how to use correct placement of articulators (jaw, teeth, lips, tongue, etc.).
This type of treatment typically starts with mastery at the sound level ("r"), working up to the word level ("red"), and then phrases and sentences to ensure generalization.
Are a type of speech sound disorder that focus on predictable, rule-based error patterns (often atypical, unexpected or inconsistent) that affect more than one sound. Some examples include:
"fronting" = when a child produces a sound made in the front like "t" or "d" for a sound produced in the back such as "k" or "g". Ex: "key"-->"tea"
"gliding" = when a child produces a "w" for "r" and a "w" or "y" for "l". Ex: "red"-->"wed"; "yellow"-->"yeyo"
There are several different treatment approaches and no “one size fits all”. Therapy approaches will be chosen based on individual client needs and will include phonological awareness skills.
These include two primary conditions:
-dysarthria = weak motor movements and lack of muscle coordination and
-apraxia of speech = difficulty producing sounds, syllables and words. An individual with apraxia is aware of what they want to say but the brain is unable to plan and execute the necessary muscle movements.
In these conditions, it can be difficult to control and/or coordinate the muscles of the face, tongue, or larynx for the purposes of speaking. Treatment for these types of disorders focuses on a limited number of target words, high repetitions, and the movement of speech to increase and re-train motor planning abilities.
These are many of the skills needed to effectively communicate and interact with others. Social communication and pragmatic skills can include turn-taking, conversation skills, perspective taking, reading non-verbal language (facial expressions, body language, gestures, etc.), problem solving, understanding thoughts and feelings, joint attention, collaboration/play skills, and more.
There are many approaches to treat social communication and pragmatic goals. My sessions often include social thinking vocabulary, video modeling, books, and targeted skills in play/real life tasks to provide intervention to target the skills needed in the most naturalistic and neurodivergent-affirming way.
LLE is diagnosed when language development trajectories are below age expectations without another diagnosis. Toddlers who exhibit LLE may also be referred to as "late talkers" or "late language learners."
Children with LLE may have expressive language delays only, or they may have mixed expressive and receptive delays. Children with expressive delays show delayed vocabulary acquisition and often show delayed development of sentence structure and articulation (sound production). Children with mixed expressive and receptive language delays show delays in oral language production and in language comprehension.
Family participation is highly encouraged in these treatment sessions. Parent coaching is used to support families with the skills they need to feel confident to work on speech, language, and play skills in everyday routines. Many strategies will be modeled and parents will be guided along the way. Communication styles will be taken into consideration and a multi-modal communication approach will be used in order to provide children with optimal opportunities to communicate in various ways (sign language, gestures, verbal communication, augmentative and alternative communication devices).
An interruption in the flow of speaking characterized by atypical rate, rhythm, and disfluencies (see examples below). There may also be excessive tension, speaking avoidance, and other related behaviors. People with fluency disorders also frequently experience psychological, emotional, social, and functional impacts as a result of their communication disorder (Tichenor & Yaruss, 2019a).
Stuttering, the most common fluency disorder, is an interruption in the flow of speaking characterized by the following:
-repetitions of sounds, syllables, and monosyllabic words (e.g., “Look at the b-b-baby,” “Let’s go out-out-out”);
-prolongations of consonants when it isn’t for emphasis (e.g., “Ssssssssometimes we stay home”); and
-blocks (i.e., inaudible or silent fixation or inability to initiate sounds)
There may also be secondary behaviors present ( e.g., eye blinks, facial grimacing, changes in pitch or loudness), avoidance behaviors, and negative reactions/frustration.
Characterized by the following:
-Excessive moments of over-coarticulation, meaning that sounds and syllables are blended together “too much” so that it can sound like all sounds are syllables are not present (e.g., speaker says “ferchly” for “fortunately”).
-Excessive use of “normal disfluencies” such as interjections (e.g. "um, uh, er") and revisions (e.g., "I would like to go—I was thinking about taking a drive").
-Pauses in places not expected grammatically, often making the speech sound "jerky" or "spurty"
In cluttering, there is often a lack of awareness, no physical tension, and confusing/disorganized language or conversational skills.
Treatment encompasses strategies that go beyond just stuttering less. The overall goal is to make communication feel easier. This includes learning more about the speech mechanism, teaching clients and families more about stuttering in order to have a better understanding, having positive discussions, reducing anxiety, increasing self-advocacy and a positive identity, and learning acceptance, openness and a sense of empowerment to feel comfortable in all communication without fear.
These are disorders of the muscles and functions of the face and mouth. OMDs may affect, directly and/or indirectly; breastfeeding, facial skeletal growth and development, chewing, swallowing, speech, occlusion, temporomandibular joint movement, oral hygiene, stability of orthodontic treatment, facial esthetics, sleep and more.
Most OMDs originate with insufficient habitual nasal breathing/mouth breathing or anything that causes the tongue to be misplaced at rest.
A person with an OMD may experience any of the following, however, one or more of these symptoms alone does not mean you have an OMD:
-open mouth with low resting tongue position
-incorrect swallow pattern ("tongue thrust")
-oral habits (thumb/finger sucking, fingernail biting, clenching/grinding teeth, etc.)
OMDs can lead to symptoms including:
-speech difficulties (lisps, difficulty producing sounds like "R")
-dental issues
-difficulty eating and swallowing
-mouth breathing and other sleep/airway concerns
A thorough evaluation is recommended if you have concerns regarding any of these symptoms and the functional impact on voice, speech, eating/swallowing and breathing.
This is a method of exercising the mouth and facial muscles in order to ensure that the muscles of the face, mouth and throat work in harmony for their appropriate functions.
Orofacial Myofunctional Therapy (OMT) is a systematic, multidisciplinary approach performed by a licensed professional. OMDs require an interdisciplinary team including, but not limited to: Dental Hygienists, Speech Pathologists, Dentists, Orthodontists, Chiropractors, Craniosacral therapy/bodywork, Physical Therapists and Occupational Therapists. OMT is a not a "cookie cutter" approach and involves an individualized program with a multidisciplinary team to help the patient retrain dysfunctional, adaptive patterns of muscle function for a healthy orofacial environment.
After breathing and airway issues are medically evaluated and addressed if necessary, treatment goals may include the following:
--increasing awareness of mouth and facial movements
--producing speech sounds more clearly
-- Normalize tongue and lip resting postures
-- Establish nasal breathing patterns
-- Adapting improper chewing and swallowing patterns
-- Stabilize the dentition from extraneous orofacial muscle movement
--practicing different breathing patterns
Address harmful oral habits including:
- Prolonged pacifier use
- Thumb and/or finger sucking
- Fingernail, cheek, or lip biting
- Tongue sucking
- Clenching or grinding of the teeth
Treatment plans and goals are customized to each client based on their needs to build confidence and ensure generalization across settings.
-- Correcting and improving tongue and lip postures which can aid in the development of normal patterns of dental eruption and alignment.
-- Supporting the remediation of speech errors by targeting correct posture/placement and oral muscle function needed for particular speech sounds.
-- Supporting nasal breathing through the identification of airway obstruction, tethered oral tissues (tongue tie, lip tie, etc.), and other structural anomalies.
Cognitive Processes and Executive Function (EF) Skills include:
Planning
Time Management
Task Initiation
Organization
Problem Solving/reasoning
Flexibility
Memory
Emotional Control
Impulse Control
Attention
Self-Monitoring
Difficulties in these areas can impact verbal and nonverbal communication and can be seen in both children and adults. Problems with these skills can also impact activities of daily living, academic and work performance.
It's very broad but we can help! Some examples of diagnoses associated with executive function difficulties include but are not limited to:
-Learning Disabilities
-Auditory Comprehension deficits
-Language Disorders
-Developmental Delays
-Executive Functioning Deficits/ADHD
-Neurologically Based Communication Disorders (Aphasia, Apraxia of Speech, Dysarthrias, Dementia, Traumatic Brain Injury)
The skills listed above can be targeted along with language strategies, memory strategies and metacognitive skills ('thinking about thinking'=planning, mental scripting, positive self-talk, self-questioning, self-monitoring and a range of other learning and study strategies).
These skills are often targeted in collaboration with other related professionals (pediatricians, psychologists, and other service providers). This ensures that treatment is provided in a holistic approach to support areas of need and any pre-existing diagnoses.
This refers to the understanding or comprehension of spoken and written language. Children who have difficulty following directions (oral or written), processing information in order to effectively respond to questions, identifying items when named, and drawing meaning from books/stories may need support to target their receptive language skills.
This refers to verbal or written expression. Expressive language goals and treatment may be related to functional communication (increasing overall communication), answering questions, increasing vocabulary skills, targeting grammar/syntax (word order), narrative formulation, and sequencing.
The ABClinic offers teletherapy/virtual sessions that can be completed from the comfort of your home. This format is a great option for families with difficulty commuting to the clinic, when clients are feeling ill but able to participate via virtual session, or when the virtual platform is preferred and appropriate for the individual's goals.
The ABClinic plans to offer group therapy options in the future. This treatment approach is designed to create more of a community for families, for children who would benefit from peer interaction, and targeting therapeutic goals in an environment suited for carryover practice and generalization of skills.
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