“How do I know when to refer my child to Speech Pathology? Other people have trouble understanding him but I can understand everything he says.”
It is quite common that caregivers are able to understand most or all of their child’s speech. After all, they are the people who are with the child almost all of the time.
It is important to take note of the fact that other people are having difficulty understanding your child’s speech.
Children’s speech and language abilities develop over time and there can sometimes be a wide range of what is within normal limits.
“Researchers in toddler speech development have found that most three-year-olds are understandable about 75 percent of the time. By age four, this increases to 90 percent or even higher” (Apel K & Masterson, Julie. Beyond Baby Talk. Three Rivers Press, 2001)
The Speech Pathology Australia website (www.speechpathologyaustralia.org.au) has useful ‘fact sheets’ about early speech and language development, as well as other areas relating to speech pathology.
Caroline Bowen, Speech-Language Pathologist, has a very informative website that discusses many areas of speech pathology, including early speech and language development (normal acquisition). It is well worth a look: www.speech-language-therapy.com
If you have any concerns at all, it is advisable to seek the opinion of a Speech Pathologist. There are usually things you can do to assist your child’s speech, language and literacy development at home and your speech pathologist can provide you with this information.
“What if my child doesn’t talk during the first visit?”
It takes children different lengths of time to become comfortable interacting with an unfamiliar person and in an unfamiliar setting. If you know or suspect that your child will take a little time to get to know the speech pathologist that is no problem at all. It is advisable to let your therapist know this, and it may be worth having a very short ‘get to know you’ visit initially. But bear in mind that the speech pathologist can gain a lot of information about your child’s communication skills informally through play and observation, so it is never a waste of time. If more formal assessment is required (e.g. a speech or language test), it may be appropriate to do this in a second visit. Speech Pathologists can be very creative and have many ‘tricks of the trade’ to encourage children to participate in activities. You might be surprised how quickly your child warms to the therapist and really has fun!
“How much should my little girl be talking at the age of 2?” As a general guide, by the age of two, your toddler should be able to: - Say the names of simple body parts, such as nose or tummy - Listen to stories and say the names of pictures - Understand simple sentences, such as “where’s your shoe?" - Use more than fifty words such as “no”, “gone”, “mine”, “teddy” - Talk to themselves or their toys during play - Sing simple songs, such as “Twinkle, twinkle, little star” - Use some pronouns instead of names, such as “he”, “it” - Try simple sentences, such as “milk all gone”
In fact, by the time your toddler is three, she will probably be using over 1,000 words and understanding even more! (Apel K & Masterson, Julie. Beyond Baby Talk. Three Rivers Press, 2001)
“My doctor has suggested speech pathology to help me improve my voice? Why a speech pathologist and what can they do to help me?”
Speech pathologists are trained to work with people who have communication difficulty and this includes people who have voice disorders. Speech pathologists have knowledge about the nerves in the brain (cranial nerves) and how they affect the muscles in the head and neck region. A voice disorder may be the result of damage to one of the cranial nerves that affects how the voice box (larynx) and vocal cords work (for example, after thyroid surgery). A voice disorder may also be the result of how the voice is used, for example, excess muscle tension in the hroat. Teachers are professionals that are at a high risk of voice disorders due to the extent of talking they need to do on a daily basis and the fact that they often need to project their voice to be heard.
There are many causes of voice disorders. So, if you have experienced any changes to your voice (for example, losing your voice for periods, the onset of a husky or raspy sounding voice), it is advisable to seek the assessment of your doctor (who may advise some medical treatment). Your doctor may refer you to an Ear Nose and Throat (ENT) specialist, who can have a closer look at your vocal cords and suggest management options. Management options may include seeing a speech pathologist that will assess your voice and work through a program with you to both improve your voice quality and maintain your improved voice quality.
“What has a speech pathologist got to do with swallowing? I feel like food gets stuck in my throat when I eat and my doctor has referred me to a speech pathologist.”
Speech pathologists have knowledge about the nerves in the brain (cranial nerves) and how they affect the muscles in the head and neck region. These muscles are the ones we use for the movements requires for eating and drinking. For example, closing the lips, using the tongue, using the jaw to chew, the movement of the voice box (larynx) to protect the airway and so on.
There are a number of reasons why people may experience the feeling of food getting stuck in the throat. A speech pathologist is a specialist in this area and can assess your swallowing ability to determine a cause and suggest management options.
Sometimes an x-ray of the swallow (called a videofluoroscopy or modified barium swallow) may be appropriate and this will be discussed with your doctor who can refer for this procedure. A videofluoroscopy involves you eating food and drinking liquids that have barium in them. Barium is a substance that allows the food and drinks to be observed as they travel throughout your mouth and throat. This process is viewed by your speech pathologist and a doctor (radiologist) and then viewed with you. We can then suggest options for management of your swallowing difficulty.
“My 3 year old has started stuttering all of a sudden and it hasn’t gone away. Some people tell me to not worry and he will grow out of it. But I am worried. What should I do?”
If you have any concerns at all about your child stuttering, it is advisable to seek the opinion of a speech pathologist. Stuttering may include repeating sounds, words and phrases, stretching sounds or getting stuck on words (struggling). Children usually repeat words sometimes, particularly around the age of 2-3 when their language and speech is going through a rapid period of development. However, it is the role of the speech pathologist to determine: is what your child is exhibiting just part of normal development or is your child showing signs of a stutter.
Some people advise that children will ‘grow out’ of stuttering. However, if this was true, there would be no cases of adult stuttering. There is no way of knowing if your child will overcome their dysfluency without treatment. So it is definitely best to seek the advice of a speech pathologist.
The Lidcombe Program is an evidence based program for pre-school aged children and treatment is much more effective in these early years. Your speech pathologist may advise to monitor your child initially and then commence the Lidcombe Program at a later date if it appears they are presenting with a stutter. Early intervention is the key with managing stuttering.