Effective Speech Therapy for Kids: Enhancing Communication and Confidence
Speech
Speech refers to the accurate production of sounds. Young children between ages one to three may simplify words, such as “na na” for banana” or “tat” for “cat.” Up to age 3, these are appropriate productions.
All children make predictable pronunciation errors when learning to speak. A child will generally have speech that is normally clear:
- 25 percent of the time by 18 months.
- 50 to 75 percent of the time by 24 months.
- 75 to 100 percent of the time by 36 months.
Children who have unclear speech may be at risk of an articulation or phonological delay. It is important to seek advice as phonological disorders can affect children's abilities to learn reading or spelling.
Speech Sound Disorders
1. Articulation and Phonological Delays
An articulation delay or disorder occurs when your child has trouble physically producing a sound or sounds.
Children typically learn to produce different speech sounds gradually. To track your child's progress and gain insights into your child's speech development journey, this chart below showcases the typical acquisition timeline for various consonant sounds.
A phonological delay occurs when your child makes predictable patterns of speech sound errors. For example, “tar” for car, “gog” as dog, “wed” as red or “tar” as star.
Disclaimer: Age of elimination can vary widely among individuals. This is not a complete list of ALL phonological processes but is some of the most common ones seen among children.
Signs To Look For
- Family members, friends, or teachers find it difficult to understand the child.
- The child substitutes or leaves out sounds in a word (e.g. “poon” for “spoon”)
- The child is left out during play, feels frustrated, is teased, or may be self-conscious because of the speech difficulty.
Common Speech Problems That Impact Speech Clarity Include:
- Mispronunciations: Common mispronunciations include substituting, omitting, deleting, adding or distorting sounds, such as saying 'fish' as “pish” or 'car' as “tar”
- Interdental or lateral Lisp where "S" or “Z” sounds are incorrectly pronounced. For instance, “yes” becomes "yeth". A lateral lisp is often a “wet” slushy sound where air escapes over the sides of the tongue.
- Resonance problems impacting on speech clarity.
Treatment For Articulation and Phonological Disorders
The following treatment options are available for children and adolescents at The Speech Practice:
- Use of Speech Buddies (a specialised tool) to aid in accurate production of S, R, L, SH, and CH sounds.
- P.R.O.M.P.T. Therapy (Prompts for Restructuring Oral Muscular Phonetic Targets) involving touch cues on the child’s face to guide his/her jaw, lips, and tongue to move correctly to form words. The child’s functional core vocabulary are used (everyday words that are relevant and meaningful e.g. More, milk, go).
- Oral Placement Therapy using TalkTools® - Horn Hierarchy, Duration Tubes, Bubble Blowing to aid in tongue retraction, lip closure, lip rounding and abdominal grading. Bite Blocks to promote symmetrical jaw strength, stability, and jaw grading (i.e. controlled movements of the jaw at various jaw heights to produce vowels and consonants).
- ARK Probe Z-Vibe®. for proper tongue placement.
- See-Scape for hypernasality treatment.
2. Childhood Apraxia of Speech (CAS)
Childhood apraxia of speech (CAS) is a neurological speech sound disorder where children have difficulties planning the sequence of movements (i.e. their lips, tongue, and jaw) to produce speech sounds. Children will not outgrow the disorder.
Childhood Apraxia of Speech (CAS) is also known as:
- Speech Dyspraxia
- Verbal Dyspraxia
Sometimes, CAS is accompanied by oral apraxia. Oral dyspraxia occurs when the child has difficulty doing oral movements on command. For example, a child can lick a lollipop but cannot stick out their tongue when commanded.
Signs of Childhood Apraxia of Speech:
- Little to no babbling.
- Vowel distortions.
- Limited vowel or consonant sounds.
- Difficulty copying speech sounds or sequences of words.
- Groping behaviours and effort associated during speech production.
- Inconsistent speech errors (e.g. saying fish as ‘bis’, ‘sif’ and then ‘fish’).
- History of pop-out words (child says a word clearly once or for a brief period and then never repeats it).
- Ability to produce a speech sound in one word but not in other words (e.g .saying /m/ for mama but not in ‘moo’ or ‘me’).
- On demand speech is most challenging; more success with automatic, well-rehearsed speech.
- May have problems eating.
- Comprehension skills are usually more advanced than expressive language skills.
- Speech melody (prosody) may be choppy or too slow.
Treatment for Childhood Apraxia of Speech
- P.R.O.M.P.T. Therapy (Prompts for Restructuring Oral Muscular Phonetic Targets) is a tactile-kinesthetic approach that uses touch cues to a child’s articulators (jaw, lips, and tongue) to form words. The child’s functional core vocabulary are used (everyday words that are relevant and meaningful e.g. Up! Car, Eat).
- Oral Placement Therapy using TalkTools® - Horn Hierarchy, Duration Tubes, Bubble Blowing to aid in tongue retraction, lip closure, lip rounding and abdominal grading. Bite Blocks to promote symmetrical jaw strength, stability, and jaw grading (i.e. controlled movements of the jaw at various jaw heights to produce vowels and consonants).
- Visual cues: For example, putting your finger on your child’s lips when saying the “p” sound as a reminder to close the lips.
- Visual cues: Looking into a mirror when making sounds.
- Using music and melody: Leaving out the last sound in your child’s favourite song. For example: Old MacDonald had a farm, EE- YA- EE- YA- __?” OHHH!
- Body awareness and movement cues: Introducing a word with play-based movement (going down a slide while saying “Weee!”)