1. What is the difference between a speech and language therapist and speech and language pathologist?
Nothing. Different countries may use different terms.
2. What types of speech and language issues affect school-aged children?
School-aged children may present with speech difficulties attributed to:
- Developmental delay, i.e. not acquiring speech sounds in line with expectations for their age. For example, the child says “waining” instead of ‘raining’ or uses a ‘slushy’ sounding ‘s’.
- Childhood Apraxia of Speech (CAS). This may also be referred to as verbal apraxia or dyspraxia, just to confuse everyone! CAS impacts on speech clarity as the child has difficulties sending accurate messages from the brain to the speech muscles.
- Stammering. Th-th-th-i-s is when a ch-ch-ch-ch-i-l-d does not sound fluent when speaking.
- Other speech production difficulties may present in children with specific facial/oral malformations and genetic disorders. For example, cleft lip and palate, Down’s Syndrome.
Language difficulties may include:
- Trouble understanding spoken and/ or written language. For example, when peers and adults speak to them.
- Limited use of words and ability to formulate extended or accurate sentences
- Trouble thinking of words to use, i.e. word-finding difficulties. This is likened to the commonly experienced tip-of-the-tongue phenomenon when we are temporarily unable to remember someone’s name.
3. Is there a difference between communication, speech and language?
Yes, there is.
Communication is the sharing of information. Speech and language are the tools we use to achieve this. Specifically, speech is the physical act of talking – the coordination of anatomical structures (e.g. lips, tongue, jaw) to produce recognisable speech sounds (e.g. sh, p ah, ee, t, etc.), Language is a set of shared rules that allow people to express their ideas in a meaningful way. This may be through spoken, written or manual (signing) modes or through non-verbal language (e.g. gestures, eye contact, facial expressions).
If the seaweed around a piece of sushi represents communication, the rice and cucumber in it are the speech and language components. If the rice or the cucumber falls out, the seaweed is affected. Similarly, if a child experiences speech or language difficulties, their ability to communicate is compromised.
4. What is the minimum age to assess a child’s speech and language skills?
There is no minimum age. As long as there are concerns about the child’s speech and language development, a referral for an assessment is highly advisable. Research continues to indicate that the earlier the intervention, the better the outcome. Following the assessment, the speech and language therapist will advise if your child needs therapy, a future review or perhaps explain why there may actually be nothing to worry about after all.
5. What is a difference between sending a child for speech and language therapy and attending a language enrichment program?
A speech and language therapist has specialist knowledge of language acquisition and development to offer intervention that addresses the specific language needs of the child. These are likely to differ from typically developing children who can be expected to continue developing language in an unstructured and natural way through incidental learning (which can be offered by a language enrichment program). Additionally, children with co-occuring difficulties will receive the necessary specialist support through speech and language therapy versus a language enrichment programme.
6. Is it true that the window of opportunity for a child to develop speech and language will close after a certain age?
The window does not necessarily ‘close’; however the brain has greater plasticity in younger children. This means that it is easier for them to reorganise their neural pathways to learn and retain new information; hence, the importance of early intervention. As we age, our brain becomes more ‘hard-wired’ which can make it trickier to achieve this. It is also important to note that the speech and language development potential amongst children will differ amongst individuals.
7. If my child has delayed language, can I only teach my child one language?
No. The ease with which the child could acquire another language will depend on the nature and severity of their difficulties in their first language and pattern of development. The speech and language therapist will be able to offer further information about the individual child’s potential depending on their specific difficulties.
8. What are the red flags for speech and language difficulties?
Parents might just get a ‘feeling’ that something is not quite right. There is a lot of information available on the Internet which provides expected milestones for infants, toddlers and children’s across various aspects of development. These can be a useful starting point. If in doubt, it is certainly worth contacting a speech and language therapist anyway.
9. Will my child recover from speech and language difficulties?
There is no straightforward response to this. A child’s outcomes will vary greatly depending on the nature of their difficulties, family and social factors, access and quality of education and consistency of relevant professional input, and ultimately, the child’s individual progress. Again, the speech and language therapist should share some expectations about the individual child’s predicted outcomes based on the assessment.
10. Would it matter if the assessment or therapy is done in a language that is not the child’s first language?
Ideally, the therapist should speak the same language as the child.
11. What qualifications should I expect a speech and language therapist to have?
All speech and language therapists must have a Bachelor’s or Masters in Speech and Language Therapy. In countries like the UK, USA, Canada and Australia, it is mandatory for therapists to have a license to practice with likely additional membership with their national association for speech and language therapists. Unfortunately, speech and language therapists are not regulated in Malaysia. Sometimes, a simple phone call may be helpful for parents or other referring professionals to decide if a therapist is suitably qualified for their child’s needs. Therapists are trained to manage both communication and swallowing; however depending on their individual experiences and additional training, therapists may vary in terms of their specialist areas. Onward referrals to specialist colleagues may be suggested as appropriate.
12. What can I expect from a speech and language therapy session?
These are likely to vary depending on an individual therapist’s style and the child and family’s needs. Therapy may be conducted in a clinic setting, at home or school. Typically, the duration of therapy ranges from 30 minutes to an hour. The frequency of therapy depends on the therapist’s recommendations and possibly logistical considerations. Sessions may include a combination of direct therapy with the child or indirect intervention with parents and other adults who work with the child.
13. How do I know if I should stop sending my child for speech and language therapy?
The therapist should advise on the probable duration of therapy following the assessment. This may be short-term (e.g. a few weeks or months) or long-term (several months or years). Ongoing evaluations should be in place to monitor the child’s progress and determine, in due course, if therapy need to continue. Parents may of course decide themselves that they would like to stop therapy. It is highly advisable that they discuss their thoughts with the therapist.
14. Is speech and language therapy covered by insurance?
This will need to be checked with individual policies.
15. Do speech and language therapists help with public speaking skills?
While speech and language therapist do no typically offer this service in many parts of the world, their specialist knowledge in communication and voice are useful for those who would like professional recommendations in this area.
16. Do speech and language therapists help with accent modification?
Yes, they can.
17. Is there anything else that speech and language therapists can address?
Yes. They can support children and adults with difficulties in social communication, voice disorders and feeding and swallowing too.