Speech therapy – areas speech therapists or pathologists can help with
The name of our profession “speech therapy” can be quite misleading. Speech therapists/pathologists also help with many other areas across the lifespan, including:
- Social skills
- Pre-literacy & literacy, especially synthetic phonics
- Reading/writing – includes literacy, as well as meta-cognitive skills such as answering questions, writing text forms (e.g. reports/essays/stories).
- Reading comprehension
- Oral narrative/creative writing
- Planning/organising skills that affect learning (e.g. high school)
- Swallowing/feeding with infants
- Swallowing difficulties (dysphagia) for all ages
- Feeding development/fussy eaters etc (in conjunction with OT’s)
- Voice problems (e.g. loss of voice/hoarseness/pathological causes ie. nodules etc)
How do these speech therapy areas relate to young children?
Below are some ways speech therapy can assist kids under 4 years:
SOCIAL COMMUNICATION SKILLS
For children under 3 years of age, speech therapists/pathologists will identify children who have difficulties with early social skills, and help parents develop these certain skills. Examples of early social skills are things such as:
- Using eye contact
- Joint/shared attention by looking and smiling back and forth between an object/person of interest
- Using communicative gestures (e.g. waving, reaching to request, pointing)
- Using gestures and eye contact in coordination (e.g. reaching for item and looking at adult).
- Social smiling
- Gaining others attention to things by pointing and showing items (e.g. waving, showing items, reaching to request
You might also hear professionals refer to this area as pragmatic skills – the ability to communicate effectively within a social context. Some children may have the ability to imitate certain social skills, but don’t use the skill effectively within a social context (e.g. playing with peers, or for a social purpose).
In fact, it’s rather common for speech therapists to help young children in this area because social skills/pragmatics are often troublesome for kids with severe communication delays.
Speech therapists can also assist young children who have trouble with eating and drinking. Difficulties in this area will include things such as:
- Difficulties progressing onto harder/chewier foods (due to oral motor delays). A speechie may support parents to progress their child along the developmental trajectory of foods (e.g. puree> soft > bite-dissolve > finger foods etc)
- Fussy or problematic eaters (closely working alongside occupational therapists)
- Swallowing problems, due to physical abnormalities/disability. (e.g. aspiration where food is likely to pass into the airway).
- Infant feeding – this is much more specialised and you usually see these speechies work in acute-infant hospital settings.
- Speech therapists will assist with the physical/mechanical aspect of chewing/eating, but also implement environmental and diet modifications to ensure adequate eating/feeding.
Mealtimes and feeding is an area where some speechies choose to upskill in. So you usually have to find a speechie who has a special interest in this domain.
In Australia, this is a domain that has exploded for speech therapists/pathologists. It seems to be a less common area of expertise for speech therapists in the UK and possibly other countries.
For children under the age of 4, speechies usually assist with phonological awareness (PA) skills. Phonological awareness refers to the ability to hear, identify and manipulate the sounds in words (in the oral form only).
Early PA skills include rhyming, syllable identification, and identifying first sounds in words. For kids not yet in kindy/prep-school, PA skills are not explicitly focused on but are taught incidentally through singing, book share and nursery rhymes. Many children with speech disorders need support in this area, due to an inherent difficulty with tuning into sounds.
Oral narrative skills are an important skill that starts very early in the form of personal narrative (i.e. sharing a past personal experience). At school age, children learn to add more detail, use the written form, then learn about other forms of oral narratives and written text structures.
For children under 4 years, personal narratives are usually the focus. Kids who are late to talk or have a language disorder/delay struggle with this domain. So speechies will assist by explicitly teaching a child the structure of a simple personal narrative (e.g. Who & what / Who, when, what).