What is Apraxia?

Apraxia (otherwise known as Childhood Apraxia of Speech — CAS) is a motor planning deficit, specifically with producing speech. These children have difficulty producing sounds, syllables and words because their brains have problems planning where to place their lips and tongue and how to move those speech muscles from one placement to the next one.

Toddlers with apraxia are typically late talkers and are very difficult to understand. They may have a limited variety of speech sounds, and they usually simplify their words by reducing syllables or even reducing words to just one sound.

Older children with apraxia often continue to struggle with the more complex speech sounds. They also have a tendency to distort vowels (“plah” for “play) and to use the wrong intonation patterns (stress the wrong words or syllables).

Unresolved problems with apraxia often contribute to problems with language development, reading, spelling and written expression. Due to their severe communication difficulties, those with apraxia often have difficulties with social interaction and emotional regulation as well.

What is the Optimal Treatment for Apraxia?

Research shows that children with true apraxia of speech have more success when they receive frequent (3- 5 times per week) and intensive treatment. Children seen individually for treatment tend to do better than children seen in groups. One of the most important things for the family to remember is that treatment of apraxia of speech takes time and commitment.

It is equally critical to diagnose all of the challenges related to the apraxia—social interaction difficulties, emotional regulation, language development, reading, spelling and written expression. Once challenges are identified, a treatment program should be developed and coordinated with allied professionals whenever necessary—a program that addresses the causes of the problems and targets the most crucial needs in the order of priority. Children with apraxia of speech need a supportive environment that helps them feel successful with communication, both in school and during social interaction.

Our speech-language pathologists at Therapies for Success are specialists in apraxia intervention. Treatment must start with a thorough evaluation to identify the root causes of the apraxia and coordinate a team to address them. Then a coordinated, comprehensive, customized treatment plan will be developed, starting with basic communication and then, as soon as possible, striving for the communication skills needed for satisfying social interaction and optimal academic achievement.

What is an Articulation Disorder?

An articulation disorder is a speech production problem that is characterized by difficulty forming the speech sounds and stringing them together. It usually involves substituting one sound for another (“wabbit” for “rabbit”), omitting a sound (“poon” for “spoon”) or distorting a sound (“ca uh” for “car”).

Most children make mistakes when learning to talk and practicing new words. An articulation disorder occurs when mistakes continue beyond a certain age. When that happens, a child’s speech can be difficult to understand, which can interfere with classroom performance and social interaction. The other danger of an untreated articulation disorder is the way it can impact reading fluency, spelling and written expression.

What is the Optimal Treatment for an Articulation Disorder?

Our speech-language pathologists at Therapies for Success are specialists in articulation therapy. Treatment must start with a thorough evaluation to identify the root causes of the articulation disorder and coordinate a treatment team to address them. Then a treatment plan will be developed to target the priority sounds (the ones that are interfering most with communication) and then, as soon as possible, strive to develop the communication skills needed for satisfying social interaction and optimal academic achievement.

What is an Articulation Disorder?

An articulation disorder is a speech production problem that is characterized by difficulty forming the speech sounds and stringing them together. It usually involves substituting one sound for another (“wabbit” for “rabbit”), omitting a sound (“poon” for “spoon”) or distorting a sound (“ca uh” for “car”).

Most children make mistakes when learning to talk and practicing new words. An articulation disorder occurs when mistakes continue beyond a certain age. When that happens, a child’s speech can be difficult to understand, which can interfere with classroom performance and social interaction. The other danger of an untreated articulation disorder is the way it can impact reading fluency, spelling and written expression.

What is the Optimal Treatment for an Articulation Disorder?

Our speech-language pathologists at Therapies for Success are specialists in articulation therapy. Treatment must start with a thorough evaluation to identify the root causes of the articulation disorder and coordinate a treatment team to address them. Then a treatment plan will be developed to target the priority sounds (the ones that are interfering most with communication) and then, as soon as possible, strive to develop the communication skills needed for satisfying social interaction and optimal academic achievement.

What is Asperger Syndrome?

Asperger Syndrome is a disorder on the autism spectrum that is characterized by significant social interaction difficulties related to problems with perspective taking—seeing other people’s points of view. This frequently causes difficulty with providing empathy and solving problems. These individuals also have a tendency to use restricted and repetitive patterns of behavior.

What is the Optimal Treatment for Asperger Syndrome?

Our speech-language pathologists at Therapies for Success are specialists in intervention for Asperger Syndrome. Treatment must start with a thorough evaluation to identify the root causes of the Asperger Syndrome and coordinate a treatment team to address them. Then a treatment plan will be developed to target the unexpected behaviors (the ones that are interfering most with communication) and then, as soon as possible, strive to develop the communication skills needed for satisfying social interaction and optimal academic achievement.

What is an Auditory Processing Disorder?

Auditory Processing Disorder (APD), also known as Central Auditory Processing Disorder (CAPD) refers to the way the brain processes auditory information. These individuals usually hear normally; however, they cannot process the information they hear which can lead to difficulties recognizing and interpreting sounds. Individuals with APD or CAPD can suffer from problems with sound localization, auditory discrimination, auditory pattern recognition and with differentiating competing acoustic signals. These individuals frequently have difficulty following directions and/or attending to lectures. For some individuals with APD/CAPD, these challenges surface early during reading acquisition when it is necessary to differentiate sounds in order to master phonics.

What is the Optimal Treatment for an Auditory Processing Disorder?

It is critical to start with an audiologic evaluation by an audiologist who specializes in auditory processing. An audiologist will give tests that can determine the softest sounds and words a person can hear and other tests to see how well people can recognize sounds in words and sentences.

Our speech-language pathologists at Therapies for Success will determine how well a person understands and uses language. Because the audiologist can help with the functional problems of hearing and processing, and our speech-language pathologists are focused on language, it is optimal to form a team to help individuals who suffer from auditory processing problems.

What is Autism Spectrum Disorder?

This is a group of developmental disorders that covers a broad range of symptoms, including challenges with communication. People with autism frequently have problems with speech production as well as receptive and expressive language. They also typically have difficulty with social language; particularly understanding other people’s viewpoints which, in turn, causes problems understanding feelings and solving problems. These challenges often interfere with conversation and social interaction. They also impact the skills necessary to comprehend literature and write effective compositions.

What is the Optimal Treatment for Autism Spectrum Disorders?

Our speech-language pathologists at Therapies for Success are specialists in therapy for children with autism. Treatment must start with a thorough evaluation to identify the communication challenges related to the autism disorder and coordinate a treatment team to address them. Then a treatment plan will be developed to target the priority building blocks (the ones that are interfering most with communication) and then, as soon as possible, strive to develop the communication skills needed for satisfying social interaction and optimal academic achievement.

When is Drooling Normal?

Most often drooling is related to teething, so it should ebb and flow, peaking as the primary teeth erupt and then disappearing completely by the age of three. Children whose drooling doesn’t resolve by age 3 are warning us of a potential problem. Clearly, a drooling child’s lips are frequently open, which is a sign that the lip muscles are weak.

What is the Optimal Treatment for Drooling?

Our speech-language pathologists at Therapies for Success are trained to be orofacial myologists. They have the expertise to identify the causes of excessive drooling and then work with the team to correct it. We will help you eliminate the triggers that are exacerbating the drooling and then develop a treatment plan to strengthen and coordinate the facial muscles in order to keep the lips closed and control the drooling.

What is Dysarthria?

Dysarthria is a speech disorder that results when the muscles of the jaw, lips and tongue are weak and speakers have difficulty controlling them. Dysarthria frequently results in mumbled or slurred speech that is often difficult to understand.

What is the Optimal Treatment for Dysarthria?

Treatment for dysarthria must begin with a comprehensive evaluation to identify all of the factors that are contributing to the condition. Then the treatment must be coordinated so the causal factors are eliminated (or at least addressed) and the allied professionals work together for rapid results and a life-long solution.

Our speech-language pathologists at Therapies for Success are specialists in dysarthria intervention. Treatment must start with a thorough evaluation to identify the root causes of the dysarthria and assemble a team to address them. Then a coordinated, comprehensive, customized treatment plan will be developed, starting with basic communication and then, as soon as possible, striving for the communication skills needed for satisfying social interaction and optimal academic achievement.

What is a Language Disorder?

Language Processing/Receptive Language

Language processing disorders refer to the way the brain processes language—that includes sounds, words, sentences, discourse and text. Individuals with language processing disorders often require more time than usual to assign meaning to these parts of language. Difficulties with language processing often impact students in social situations and in the classroom; information is frequently presented at a faster pace than these individuals are able to process the information.

Oral Language/Expressive Language

Oral language disorders refer to how individuals organize their thoughts into language. To accomplish this, people must choose appropriate words (vocabulary), sequence them in correct word order (syntax), make sure the nouns and verbs and other parts of speech match (grammar) and present their thoughts in sequential order. If any one of these skills fails, a person has difficulty with oral expression.

It is normal for most people to struggle with aspects of oral language from time to time. When these struggles occur often, the individual has an expressive language disorder. Left untreated, this challenge will cause problems with reading fluency and written expression, because people can only read and write as well as they can talk. These challenges will also interfere with social interaction due to the pressure to communicate clearly and tactfully with the time pressure induced by conversation.

What is the Optimal Treatment for a Language Disorder?

Our speech-language pathologists at Therapies for Success are specialists in language therapy. Treatment must start with a thorough evaluation to identify the root causes of the language disorder and coordinate a treatment team to address them. Then a treatment plan will be developed to target the priority building blocks (the ones that are interfering most with communication) and then, as soon as possible, strive to develop the communication skills needed for satisfying social interaction and optimal academic achievement.

What is the Problem with Low Muscle Tone?

Low muscle tone in the facial muscles will interfere with speech production. For example, weak lips will cause problems producing the “b” and “p” sounds. Weakness in the tongue tip will interfere with the production of “t” and “d”. Weakness in the tongue back can prevent an individual from producing “k” and “g”. Muscle groups throughout the tongue must be developed to produce complex sounds like “l”, “r” and “th”.

What is the Optimal Treatment for Low Muscle Tone?

Our speech-language pathologists at Therapies for Success are trained to be orofacial myologists. They have the expertise to identify the causes of low muscle tone and then work with the team to correct them. We will help you eliminate the triggers that are exacerbating the low muscle tone and then develop a treatment plan to strengthen and coordinate the facial muscles until the lips stay closed, the tongue rests normally on the roof of the mouth and the facial muscles develop for healthy chewing and eating habits, clear speech production and attractive facial development.

What is the Importance of Narrative Discourse?

We tell our personal stories through narratives. We must keep our stories concise and interesting to keep our listeners focused. We must also give adequate information to help our listeners understand. If our narratives are too long or they lack critical information, people don’t know what we’re talking about and then people don’t listen to us and/or eventually tune us out.

What is the Optimal Treatment for Narrative Discourse?

Our speech-language pathologists at Therapies for Success are specialists in narrative discourse. During individual language therapy sessions, they provide the support to help students tell their stories; they help their students create graphic organizations to plan and rehearse their stories. Eventually the graphics organizers are replaced by mind maps. And oftentimes, students are encouraged to tell their personal stories to one another during Therapies for Success social thinking groups.

What are Oral Motor Skills?

Oral motor skills refer to the appearance and function of the jaw, lips, tongue and teeth as well as the hard and soft palates. The movement and coordination of these structures is critical to the development of speech production as well as healthy breathing and swallowing.

What Causes an Oral Motor Disorder?

Low muscle tone is a common cause of an oral motor disorder. This can be related to respiratory problems with nasal breathing as well as a variety of neurological conditions like Downs Syndrome and cerebral palsy.

How do Oral Motor Disorders Affect Development?

Weakness in the jaw and/or lips may cause open-mouth breathing and drooling as well as difficulties with biting and chewing. Weak jaws, lips and tongues can also cause problems with swallowing and speech production.

What is the Optimal Treatment for Oral Motor Disorders?

Our speech-language pathologists at Therapies for Success are trained to be orofacial myologists. They have the expertise to identify the causes of the oral motor disorders and then work with the team to correct them. We will help you eliminate the triggers that are exacerbating the oral motor disorder and then develop a treatment plan to strengthen and coordinate the facial muscles until the lips stay closed, the tongue rests normally on the roof of the mouth and the facial muscles develop for healthy chewing and eating habits, clear speech production and attractive facial development.

What is a Phonological Disorder?

Phonological deficits are characterized as errors in patterns of spoken sounds. A child’s sound errors can include patterns such as consonant cluster reduction (e.g., deleting the “s” from “star”), substitutions (e.g., substituting a “t” for the “c” in “cup”, pronouncing it “tup”), and syllable deletions (e.g., pronouncing “bubble” as “buh”). The child communicates; however, his/her speech is difficult to understand.

While it is common for young children learning speech to omit or substitute sounds in words, it is not expected as a child gets older. If a child continues to demonstrate such speech error patterns, he or she may have a phonological processing disorder.

Frequently, these children with phonological disorders are not aware that they are making any speech errors. They are not hearing the speech sounds they are producing and recognizing the difference between their own speech and the speech of others around them. Phonological disorders are different from oral-motor weakness, where children have weak lips and tongues, or coordination problems (apraxia), where children are unable to coordinate their mouths to produce speech sounds accurately.

What is the Optimal Treatment for a Phonological Disorder?

Our speech-language pathologists at Therapies for Success are specialists in phonological disorders. Treatment must start with a thorough evaluation to identify the root causes of the phonological disorder and coordinate a treatment team to address them. Then a treatment plan will be developed to target the priority sounds (the ones that are interfering most with communication) and then, as soon as possible, strive to develop the communication skills needed for satisfying social interaction and optimal academic achievement.

What is a Pragmatic Language Disorder?

Pragmatic language disorders pertain to the way children use their language skills. Children use language for a variety of purposes including commenting (that’s a cool car), requesting (I want a cookie, please), and greetings, among others. The way children learn to adapt their language to fit different situations defines pragmatic language.

Pragmatic language disorders are closely related to social thinking disorders. When pragmatic language/social thinking is delayed or disordered, it can cause difficulties with problem solving, using expected behaviors, inference making, narrative discourse, perspective taking, conversational skills and making and keeping friends.

What is the Optimal Treatment for Pragmatic Language Disorders?

Pragmatic language can be addressed in individual language therapy sessions or social thinking groups. Some students need one-one therapy to learn to use language for a variety of purposes and to adapt their language to certain situations. To transition these skills to social situations, students are eventually enrolled in Social Thinking Groups.

At Therapies for Success, students receive a combination of individual intervention and group social thinking. Through lessons, stories and social interaction, they are explicitly taught to use language for a variety of purposes and adapt it to fit particular situations; then they practice with their speech-language pathologist coach by their sides.

What is Speech Production?

Speech production pertains to the way individuals pronounce sounds. When speech is not clear, listeners tend to focus on HOW people are talking rather than WHAT they are saying. Speech distortions call attention to themselves and distract listeners; they can even prevent listeners from understanding the message.

What is a Speech Distortion?

The most common speech distortions pertain to the “r” sounds as well as the sounds “s” and “z”. These distortions are usually caused by tongue weakness related to where the tongue is positioned in the mouth.

There are 21 different types of “r” in the English Language. Having an “r” distortion can make it very difficult for listeners to understand the message.

There are also a wide variety of “s” and “z” sounds in the English Language. In addition to all the “s” and “z” sounds used in root words, there are the “s” and “z” sounds used in plurals and possessives.

Having a distortion with either of these sound groups will interfere with communication. And distorting both groups of sounds will interfere with the listener’s understanding of almost every word.

What is the Optimal Treatment for Speech Distortions?

Treatment begins with a comprehensive evaluation to identify the cause of the speech disorder. Then the speech pathologists at Therapies for Success will assign exercises to strengthen the speech muscles and correctly produce the new sounds in controlled environments. Gradually the new sounds will be produced clearly in phrases, sentences and, ultimately, in conversational speech.

What are Stuttering and Fluency Disorders

Stuttering is a disruption in the smooth quality of speech, otherwise known as dysfluency. It usually begins during childhood and can last throughout life. Sometimes it can begin later in life following a trauma.

Some dysfluency is normal. For instance, most individuals repeat words and phrases, and they pause between words with fillers such as “um” or “uh.” That type of normal nonfluency is not a problem; however, when there are so many moments of dysfluency that it interferes with listener understanding, it turns into stuttering.

Stuttering effects the production of speech sounds. Some people who stutter appear very tense or “out of breath” when talking.

There are different types of dysfluencies.

Blocking

This happens when the mouth is positioned to say a sound, sometimes for several seconds. Eventually, with a great deal of effort, the individual completes the word. The blocking can occur at the lips, tongue or back of throat and cause a great deal of anxiety and interfere significantly with communication.

Repetitions

Repetitions can involve entire phrases (I want to…I want to…), words (I…I…I…) or parts of words (D…D…D…Do). The degree to which they interfere with communication depends on the length and force of the repetitions.

Prolongations

These occur when a sound is drawn out for a period of time (ssssss…ometimes I exercise). The length and tension related to the prolongations determines the degree to which they interfere with communication.

Interjections

These are usually filler words such as “um” or “like”. They are often used as delay tactics when individuals are anticipating that their speech will get stuck on certain sounds or words. Interjections become a problem when they are used so frequently that listeners find them distracting and focus on the delivery rather than the message itself.

In childhood, there are risk factors to predict whether or not stuttering will discontinue on its own. Factors that are noted by many specialists include the following: a family history of stuttering; stuttering that has continued for 6 months or longer; presence of other speech or language disorders; strong fears or concerns about stuttering on the part of the child or the family.

No single factor can be used to predict whether or not a child will continue to stutter. A combination of these factors can help speech language pathologists determine whether treatment is indicated. For older children and adults, the question of whether stuttering is likely to continue is less important, because the stuttering has continued long enough to become a problem in the person’s daily life.

What is the Optimal Treatment for Stuttering and Fluency Disorders?

Treatment must begin with a thorough evaluation. This consists of tests, observations, and interviews that are designed to assess the overall severity of the disorder. In addition, it is imperative to determine how severely the disorder is impacting a person’s ability to communicate and participate appropriately in daily activities. Information from the evaluation is then used to develop a specific treatment program, one that is designed to help the individual speak more fluently, communicate more effectively, and participate in life’s activities with greater enjoyment.

Therapy for stuttering may include the following:

• Control and monitor the rate of speech. When learning to control speech rate, people often begin by practicing smooth, fluent speech at rates that are much slower than typical speech, using short phrases and sentences. Over time, people learn to produce smooth speech at faster rates, in longer sentences, and in more challenging situations until their speech sounds both fluent and natural.
• Control and monitor breathing. When learning to control and monitor breathing, people often begin by using diaphragmatic breathing and pairing it with 1 – 2 syllable words. Over time, people learn to pair their breathing with multi-syllabic words, phrases, sentences and eventually, with conversational speech.
• Control and monitor eye contact. When learning to control and monitor eye contact, people often begin by learning the art of light eye contact—looking at their conversational partners briefly, looking away and then looking back again. Over time, people learn to look at their conversational partners with intent, showing genuine interest in the person and the conversation.
• Build self-confidence through practice and experience. Students practice their new skills in a hierarchy of situations starting with the least stressful and increasing to the most challenging situations.

Our speech-language pathologists at Therapies for Success are specialists in treating stuttering.

What are Voice Disorders?

A voice disorder means there is problem with vocal quality. A healthy voice is clear, strong and age/gender appropriate. A voice disorder occurs when the quality of a person’s voice is noticeably different from others their same age and sex. This abnormality is considered a voice disorder when it draws attention to a person’s manner of speaking.

Typical concerns pertain to a hoarse voice, which is usually related to growths on the vocal cords called nodules. A voice disorder can also pertain to inappropriate volume, when a person talks too loud or too soft. Nasality is also a common concern, when a person has too much nasal emission or too little. Pitch is another common concern—this happens when the voice is pitched too high or too low—both effecting the listener’s comfort level and the vocal health of the person speaking.

Voice disorders typically sound abnormal to listeners because they are:

• Harsh
• Hoarse
• Too high or too low
• Too loud or too soft

Voice problems can cause challenging symptoms such as hoarseness, or loss of voice, pain, strain and vocal fatigue. They can lead to career difficulties and social anxiety caused by stereotyping and teasing.

What is the Optimal Treatment for Voice Disorders?

Treatment must begin with a visit to the Ear-Nose-Throat Doctor to rule out any medical issues and/or physical abnormalities. Once cleared by a physician, people with voice disorders can eliminate hoarseness and improve the quality of their voices by reducing their shouting, screaming, throat clearing/coughing or excessively loud talking. They can learn:

• Excellent vocal hygiene
• Proper breathing
• Relaxation techniques

Our speech-language pathologists at Therapies for Success are specialists in treating voice disorders.