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Child Services

Although all children may reach developmental milestones at slightly different ages due to individual differences, the development of speech and language skills have been widely researched and are understood to follow a typical pattern in childhood.

All children will present with age-appropriate ‘errors’ as they learn the speech sounds, grammar structure and use of language in early childhood. When children do not develop their speech and language skills consistent with this typical pattern, it can be indicative of a speech or language delay or disorder.

We have provided a number of checklists you can see here if you are unsure as to whether your child’s speech or language skills are developing age appropriately or not. If you are concerned about your child’s communication skills, we highly advise that you seek an assessment with a paediatric speech pathologist as soon as possible.

At Speak Volumes, we provide thorough assessments to determine whether your child’s speech and language errors are age appropriate, which are the areas affecting intelligibility or education the most, and what are your child’s most appropriate speech and language goals to target in therapy. We provide play-based therapy for younger children, and work with older children at an age appropriate level while considering their interests, skills, and school curriculum in each session. An enormous amount of research has been conducted to highlight the importance of early detection and treatment of communication delays or disorders in children, and the importance of early intervention is now widely understood. Don’t hesitate to get in touch and we will help you to decide the best direction from here.

What is the difference between speech and language?

Language is made up of socially shared rules and grammatical structures such as:

  • The meaning of words (definitions that we are taught or create ourselves to understand meaning).
  • How to create new words (e.g., happy, happily, unhappy)
  • How words go together (e.g., “I saw my friend at the shops” rather than “I see shops friend”)
  • Which words are suitable in different situations (“Could you please stop yelling?” could quickly change to “Stop yelling, please!” if the first request was unsuccessful).

When a person has trouble understanding others (receptive language), or sharing thoughts, ideas, and feelings completely (expressive language), then he or she has a language disorder.

Speech is the verbal side to communicating, which consists of:

  • Articulation – How speech sounds are produced (e.g., children must learn how to produce the “d” sound in order to say “dog” instead of “gog”).
  • Voice – How we use our vocal folds and breathing to produce speech sounds (e.g., teachers who use their voices incorrectly may develop a hoarseness or lose their voice completely).
  • Fluency – The rhythm of speech (e.g., hesitations or stuttering).

When a person is unable to produce speech sounds correctly or fluently, or has problems with his or her voice, then he or she has a speech disorder.
Some examples of speech disorders include:

  • Childhood apraxia of speech (motor speech disorder where the muscles require ‘ retraining’ to produce sounds correctly and create words)
  • Dysarthria (motor speech disorder where the muscles of the mouth, face and respiratory system may be weak, move slowly or not at all. Common causes include stroke, head injury, cerebral palsy and muscular dystrophy).
  • Speech sound disorders (articulation and phonological processes)
  • Stuttering
  • Voice

Some examples of language disorders include:

  • Language based learning disabilities (e.g. dyslexia)
  • Expressive / receptive language disorder
  • Preschool language disorder
  • Selective mutism
  • Pragmatic language disorder

Feel free to browse our resources section for checklists, handouts and other information that you may find useful!

We are currently in the process of creating informative handouts for a wide range of diagnoses for parents and health professionals to download from the website. These will include descriptions, signs/symptoms, and the role of the speech pathologist. Feel free to ‘like’ our facebook page to stay updated for when these handouts are released!

At Speak Volumes, we provide assessment and treatment for children with feeding and swallowing disorders, and may include other

professionals such as an occupational therapist, physiotherapist, dietitian, or developmental paediatrician to form a comprehensive feeding team to effectively meet your child’s needs and achieve adequate intake. These professionals may be included as part of the feeding team to further examine self-feeding abilities, posture, medical status and nutritional intake, if necessary. During a paediatric feeding or swallowing assessment, we will ask you questions regarding your child’s medical and developmental history, and the areas you are concerned about. We will then assess the strength and movement of the muscles involved in swallowing, and observe your child feeding to allow us to evaluate posture, behaviour, and oral movements while eating and drinking.

The treatment that we provide will vary greatly depending on the cause and symptoms of the swallowing problem. Our principal speech pathologist (Amber Allen) has received post-graduate training in the Sequential Oral Sensory approach to feeding, which can be used to assess and successfully treat children with problematic feeding behaviours in a variety of different settings.

At Speak Volumes we may target any of the following goals during a feeding or swallowing intervention program:

  • Increasing strength of oral musculature
  • Increasing tongue movement
  • Improving ability to effectively chew
  • Increasing acceptance of different foods, textures, temperatures and liquids
  • Altering food textures and liquid thickness to ensure safe swallowing

It is imperative to seek treatment as soon as possible if you suspect you child has a feeding or swallowing disorder. Children with feeding or swallowing disorders may be at risk of dehydration, poor nutrition, aspiration, social embarrassment, pneumonia or repeated upper respiratory infections that can lead to chronic lung disease. At Speak Volumes, we understand the importance of providing effective therapy to children with feeding and swallowing disorders, and we are committed to providing a holistic intervention plan to help maximise oral intake and nutritional status.

What are feeding and swallowing disorders?

Feeding disorders include problems gathering food and getting ready to suck, chew, or swallow it.
Swallowing disorders, also called dysphagia, are described according to the phase of the swallow that is affected. This may include the oral phase (sucking, chewing and moving to food from the front of the mouth to the back of the throat), pharyngeal phase (swallow initiation, squeezing the food down the throat, closing off the airway to prevent aspiration/choking), and the oesophageal phase (relaxing and tightening the openings of the oesophagus to squeeze food into the stomach).

Some causes of feeding and swallowing disorders in children include:

  • nervous system disorders (e.g., cerebral palsy, meningitis, encephalopathy)
  • gastrointestinal conditions (e.g., reflux, “short gut” syndrome)
  • difficulty processing sensory input (e.g. Autism)
  • prematurity and/or low birth weight
  • heart disease
  • cleft lip and/or palate
  • conditions affecting the airway
  • head and neck abnormalities
  • muscle weakness in the face and neck
  • respiratory difficulties
  • medications that may cause lethargy or decreased appetite
  • problems with parent-child interactions at meal times

What are some signs or symptoms of feeding and swallowing disorders in children?

Children with feeding and swallowing problems have a wide variety of symptoms. The following are some of the signs and symptoms of feeding and swallowing problems which may be observed in very young children:

  • arching or stiffening of the body during feeding
  • irritability or lack of alertness during feeding
  • refusing food or liquid
  • failure to accept different textures of food (e.g., only pureed foods or crunchy cereals)
  • long feeding times (e.g., more than 30 minutes)
  • difficulty chewing
  • difficulty breast feeding
  • coughing or gagging during meals
  • excessive drooling or food/liquid coming out of the mouth or nose
  • difficulty coordinating breathing with eating and drinking
  • increased stuffiness during meals
  • gurgly, hoarse, or breathy voice quality
  • frequent spitting up or vomiting
  • recurring pneumonia or respiratory infections
  • less than normal weight gain or growth

Source: http://www.asha.org/public/speech/swallowing/Feeding-and-Swallowing-Disorders-in-Children/

In order to communicate effectively with other people, we require an understanding of social skills (pragmatics).

Some important social skills include:

  • Gaining someone’s attention
  • Listening to a speaker
  • Being relevant
  • Maintaining an appropriate distance from the listener
  • Using body language and gestures
  • Maintaining eye contact
  • Engaging in activities with peers
  • Being assertive to stand up for themselves while maintaining appropriate politeness
  • Taking turns in a conversation
  • Using language appropriately for different purposes (e.g. demanding vs. requesting vs. informing)
  • Resolving conflicts with friends, family, peers, colleagues, employers etc
  • Changing language depending the conversational partner (e.g. friends vs. teachers, colleagues vs. employer).
  • Giving background information for an unfamiliar listener.
  • Using appropriate volume, rate and intonation in order to match the verbal message that is being conveyed.

When children have difficulties with social skills this can manifest into limited friendships, isolation, negative school experiences, and difficulties obtaining or maintaining employment. At Speak Volumes, we provide intervention for children with difficulties using appropriate social skills to limit the impact on friendships, employment, and daily living activities. We currently provide individual therapy, and are working on a tailored group therapy intervention plan to promote generalisation into the school, home and/or work environments. Contact us today to find out how we can work together to maximise your child’s communication potential.
For some useful tips to improve pragmatic skills – see here.

We are currently in the process of creating informative handouts for a wide range of diagnoses for parents and health professionals to download from the website. These will include descriptions, signs/symptoms, and the role of the speech pathologist. Feel free to ‘like’ our facebook page to stay updated for when these handouts are released!

“Autism can’t define me, I define autism.” ~ Kerry Magro

Autism Spectrum Disorder (ASD) is a developmental disability which can range in severity from mild to severe. Children on the autism spectrum have difficulties with language and social communication. They also have restricted or repetitive patterns of behaviour. Some children may seek out or avoid certain types of sensory input.

Speech pathology for children on the autism spectrum may include early language intervention to maximise verbal output, or social communication skills to teach children how to develop and maintain relationships (including friendships, client-teacher relationships and client-employer relationships). Speech pathology intervention can help your child understand and produce language, read and write. Intervention may also target joint attention, using gestures, following directions, asking for help, appropriately asking/answering questions and the rules of conversation such as turn taking and how to start or stop a conversation. Other areas that may be targeted include reading books, telling stories, writing letters, words and sentences and using higher level language to interpret the subtle cues of language such as sarcasm, humour, and appropriate use of language (e.g. how you talk to a friend will differ to how you talk with an employer).

As many children on the spectrum may find it difficult to accept the look, taste, texture or smell of foods, intervention may also target acceptance of new foods and increasing reducing the avoidance behaviours associated with eating different foods. Our principal speech pathologist (Amber Allen) has received post-graduate training in the SOS approach to feeding, which is a program specifically designed to target problematic feeding behaviours.

Characteristics of Autism Spectrum Disorder:
Just like every other child, children on the autism spectrum are each very different and the characteristics that each child displays will differ between individuals. The following are difficulties that are often faced by children on the spectrum:

Social Skills

  • sharing a common focus with another person about the same object or event-known as joint attention;
  • playing with others and share toys;
  • understanding feelings;
  • making and keeping friends.

(For more information about social skills see here) (link to the paediatric social skills page)

Communication Skills

Your child may have trouble with communication skills like understanding, talking with others, reading or writing. Sometimes, she might lose words or other skills that she’s used before. Your child may have problems

  • understanding and using gestures, like pointing, waving, or showing objects to others;
  • following directions;
  • understanding and using words;
  • having conversations;
  • learning to read or write. Or she may read early but without understanding the meaning—called hyperlexia.

Your child also may

  • repeat words just heard or words heard days or weeks earlier-called echolalia (pronounced ek-o-lay-le-a);
  • talk with little expression or use a sing-song voice;
  • use tantrums to tell you what he does or does not want.

Common Behaviors

  • have trouble changing from one activity to the next;
  • flap hands, rock, spin or stare;
  • get upset by certain sounds;
  • like only a few foods;
  • have limited and unusual interests-for example, talk about only one topic or keep staring at one toy. 

Source: http://www.asha.org/public/speech/disorders/Autism/

“ A disability is usually defined in terms of what is missing. … But autism … is as much about what is abundant as what is missing, an over-expression of the very traits that make our species unique. ”— Paul Collins

We are currently in the process of creating informative handouts for a wide range of diagnoses for parents and health professionals to download from the website. These will include descriptions, signs/symptoms, and the role of the speech pathologist. Feel free to ‘like’ our facebook page to stay updated for when these handouts are released!

At Speak Volumes we provide services for children with a range of diagnoses and medical conditions. Some examples include Childhood Apraxia of Speech, Attention Deficit/Hyperactivity Disorder, developmental disorders (e.g. autism), genetic syndromes (e.g. Down syndrome), neurological disorders (e.g. cerebral palsy), hearing impairment, dyslexia, selective mutism, cleft lip and palate, right hemisphere brain damage and traumatic brain injury.

We are currently in the process of creating informative handouts for a wide range of diagnoses for parents and health professionals to download from the website. These will include descriptions, signs/symptoms, and the role of the speech pathologist. Feel free to ‘like’ our facebook page to stay updated for when these handouts are released!

The language skills that we start to develop from birth form the foundation of our ability to develop literacy skills. Literacy is our ability to read and write. Research shows that children with communication disorders have more difficulties learning literacy skills and this often manifests into poor performance at school. Literacy skills are also important in the workplace and society.

At Speak Volumes, we provide a comprehensive range of assessments to help diagnose or determine the reason behind why a child is struggling to read.

These may include assessments of phonological awareness (understanding and manipulating parts of words), auditory processing (how the brain processes auditory input), auditory discrimination (the ability to differentiate between spoken sounds) and language (how a child understands and uses language).

With in-clinic and mobile services available, we can see your child from our clinic, in their home, or at school – providing flexibility for busy families.

The following remedial reading groups are now available:

Reading seeds – Emergent literacy group for children aged 2-4 years (Weekly 30 min sessions).

Rising readers – Emergent literacy group for children aged 4-6 years (Weekly 30 min sessions).

The ELF program – Early literacy foundations program for children aged 6-8 years (Weekly 1 hour sessions).

The PAL program – Phonological Awareness for Literacy program for children aged 8-12 years (Weekly 1 hour sessions).

Launching children into the world of literacy – A research-based workshop for educators targeting emergent literacy in early childhood settings. (2 hours)

Adults may also have problems with literacy, either from childhood or after a stroke or brain injury.
Dyslexia is a language-based learning disability which affects an individual’s ability to read. Language-based learning disabilities affect an individual’s ability to read, write and/or spell. They are not associated with intelligence. Individuals with language-based learning disabilities may have difficulty expressing ideas clearly, learning new vocabulary, recalling numbers, learning words to songs, learning the alphabet, matching written letters to the phonetic sound, mixing up the order of letters in words, spelling and telling the time.

We are currently in the process of creating informative handouts for a wide range of diagnoses for parents and health professionals to download from the website. These will include descriptions, signs/symptoms, and the role of the speech pathologist. Feel free to ‘like’ our facebook page to stay updated for when these handouts are released!

What is stuttering?

Stuttering disrupts the fluency of speech. It often begins during childhood and, in some cases, lasts throughout life. People without a stutter are often dysfluent on about 2% of words – this is a normal part of spoken language. However, when speech dysfluencies increase beyond this level, they often impact on activities of daily living at varying levels for different individuals. People who stutter are often observed to limit their participation in activities due to concern for how others may react to dysfluent speech. Some may try to rearrange the words in their sentence (circumlocution) to avoid ‘trigger’ sounds or pretend to forget what they were saying. The extent of the impact that stuttering may have on an individual’s daily life often depends on how the individual and those around them react to the disorder. At Speak Volumes, our speech pathologists understand the impact that dysfluent speech can have on an individual’s life, and we are passionate about improving outcomes for children and adults who stutter. We have received training in the Lidcombe Program and Camperdown program (discussed below) and are committed to providing evidence based services for effective intervention.

What treatments are available?

Most treatment programs for people who stutter are “behavioural.” Stuttering behaviours in young children (aged 2-10 years) may be shaped using a behavioural method such as the Lidcombe Program, which is a highly researched and evidence based program which we provide at Speak Volumes. Older children and adultsattending stuttering therapy at Speak Volumes are introduced to the Camperdown Program, which is a highly effective, evidence based program for adults which involves learning to speak with a slightly different speech pattern that controls stuttering, while still sounding quite natural.

Both the Lidcombe Program and the Camperdown Program have been developed by the Australian Stuttering Research Centre and are highly regarded worldwide as effective, evidence based treatments for stuttering in both children and adults.

Do these programs work?

Yes, independently replicated clinical trials show that they do work to get rid of stuttering. Clinical trials have also shown that they work in a telehealth setting, where the speech pathologist and family actually never meet; the treatment is done either by telephone or, more commonly these days, with Skype over the internet.

For children, research has also shown that the Lidcombe program is safe. It does not appear to interfere with parent-child relationships and has no apparent effect on other aspects of communication. Indeed, parents report that their children are more outgoing and talk more after treatment because they are no longer stuttering.

With this in mind, we are pleased to say that at Speak Volumes we are able to offer stuttering therapy either in-clinic, or using telehealth (Skype/telephone) to enable all individuals with a stuttering problem to access world leading, evidence based programs resulting in effective treatment and better outcomes.

For more information regarding the Lidcombe Program or the Camperdown Program please see here:
http://sydney.edu.au/health-sciences/asrc/clinic/parents/lidcombe.shtml
http://sydney.edu.au/health-sciences/asrc/clinic/adults/camperdown.shtml
http://sydney.edu.au/health-sciences/asrc/research/publications.shtml

What can I do to communicate better with people who stutter?

People who stutter generally want you to talk to them as you would anyone else! They are usually very aware that their speech is dysfluent, and at times it may take them longer to finish their sentence. This often hurries them to speak, leading to even more difficulties with producing smooth speech. Unfortunately, though, this sometimes leads the person to feel pressure to speak quickly. Try not to look away, interrupt, fill in words, or ask them to “slow down”, “breathe” or “try it again”. These pressures hurry them to speak, leading to more pressure and more dysfluencies. By making well-meaning suggestions you may be implying that the stutter should be easy to overcome – but it is not.

When talking with people who stutter, the best thing you can do is give them the time they need without commenting or hurrying them.

When an individual is unable to speak, they lose one of their most basic human rights. In order to maximise communication potential, reduce frustration, and/or promote speech and language development, we may look at alternative options such as Augmentative and alternative communication (AAC).

AAC includes all forms of communication (other than speech) as a means to express thoughts, needs, wants, and ideas. AAC can be basic (such as facial expressions, gestures, writing, or use of symbols and pictures), or it can be more high tech such as speech generating devices and electronic communication aids. People with severe speech or language problems may require AAC to support existing speech or provide verbal output for non-verbal clients. This may increase social interaction, school performance, and feelings of self-worth.

Clients using AAC should not stop using speech if they are able to do so. AAC is used as a way to promote and enhance effective communication skills, not as a replacement for speech.

When looking at available AAC options, we consider the client’s skills and abilities to determine the most appropriate AAC device for each client (e.g: use of fingers/hands/feet/eye gaze/cognition and ability to see/write/gesture).

For more information please see:

The International Society for Augmentative and Alternative Communication (ISAAC)
https://www.isaac-online.org/english/home/

The AAC institute
http://www.aacinstitute.org/