18 April 2017
The Cora Barclay Centre mainly supports children who are deaf or hearing impaired, but some of our services are open to the public; audiology and speech pathology.
We’ll save audiology until next week, and this week we want to focus on the speech pathology services we offer to our deaf and hearing impaired clients and the general community.
What is speech pathology?
Often referred to as speech therapy, speech pathology is the study, diagnosis and treatment of communication disorders including difficulties with speaking, listening, understanding language, reading, writing, social skills, stuttering (also known as fluency), voice disorders and swallowing dysfunction (known as dysphagia)(1).
Why do children with a hearing impairment need a speech pathologist?
You may wonder why, if children with a hearing impairment are already receiving Auditory-Verbal Therapy, why they may also require a speech pathologist? It may be that there are particular problems with articulation (making sounds) or phonological processes (sound patterns). Articulation problems are not part of the core therapy taking place in AVT and therefore additional support is required.
As an example a child with a speech delay may substitute one sound for another as they have not yet learned how to make or articulate the sound. For example using a ‘w’ instead of an ‘r’ (wabbit for rabbit) or a ‘t’ instead of a ‘k’ (tat for cat). Cluster reduction would be one example of a phonological error and occurs in many typically developing children up to the age of around 4. When a child reduces a consonant cluster, they drop one sound in the cluster (e.g. stop become s_op or _top, blue becomes b_ue or _lue).
In these examples the issue is not related to the child not being able to hear or process the sound correctly, but instead they are problems with the creation of speech.
Certain sound substitutions or “error patterns” can be age-appropriate and are present in many typically developing children. Children are expected to have developed most sounds by around ages five to six , and have fully developed all sounds by age 8 (including the /th/ sound).
There are many common speech errors that children with hearing loss exhibit such as difficulties hearing or correctly using soft sounds (s-f-th-sh). These errors are identified by therapists and supported through Auditory-Verbal Therapy.
Not just for hearing impaired children
You can probably tell that the issues a child from the Centre may see our speech pathologist about are not confined to children with a hearing loss. Therefore, given that we have great internal expertise in the area of speech pathology, the Centre has opened up its services to the wider community.
Anyone who suspects their child might need a speech and language assessment or therapy is welcome to make an appointment to see our in house team. In the interests of transparency our fees and services are laid out on the speech pathology section of the website.
How do I know if my child needs to see a speech pathologist?
It can be hard to know when a child needs a speech pathologist. They may exhibit what seem, to an adult, like speech and language issues, but they can be totally age appropriate. Below are some red flags to watch out for with your child, depending upon their age. If you feel like your child might need some intervention please call the Centre on 8267 9200 to arrange an appointment.
Under 18 months
No babbling by 12 months
Does not respond to name by 12 months
No sharing / reciprocal interactions like points, sharing, reaching or waving by 12 months
Does not understand simple common words like mama
Is not using any words by 16 months
Does not imitate gross motor movements (e.g. stamping, clapping)
By 18 months
Has less than 8-10 meaningful words
Does not follow simple commands like come, stop or give me the bowl
Does not engage in pretend play
Does not like to play close to other children
By 2 years
No meaningful 2 word phrases
Does not follow simple 2 step commands (e.g. pick up the cup and put it on the table)
Only 50% of speech is understandable
Cannot point to pictures in books when asked
By 3 years
Is not using 3 or 4 word sentences
Is not using the following consonants: t-d-n-h-y-m-w-b-p-k-g
Less than 75% of speech is understandable
Child leaves off the beginning or end of most words
Cannot accurately answer yes/no questions
Cannot answer simple ‘wh’ questions (e.g. where is dad? Who is that?)
Does not play with other children
Experiences stuttering for more than 6 months
By 4-5 years
Strangers can understand almost all words (accounting for age appropriate articulation errors)
Is not using the following consonants: s-sh-f-v-ch-j by age four and l-r by age five
Does not use complex sentences with four or more words regularly
Does not ask a variety of questions to gain information
Has difficulty with grammar or using pronouns
Cannot tell a simple story and stay on topic
Cannot follow 2 step directions
Has difficulty with simple ‘wh’ questions
Overall Red Flags
Any loss of speech or babbling
Does not gesture or imitate
Does not seem to understand speech
Never develops words beyond repetition
What about for adults?
The Centre can support speech pathology in adults, but the most common area we support is aural habilitation. Adults with a hearing loss who have recently been fitted with a new speech processor, receive a cochlear implant or feel their listening and speech has deteriorated or needs improving can contact the Centre to receive support.