Understanding Speech and Language terminology can be very overwhelming for a family who is just beginning the process of speech therapy. Here are two case scenarios, as presented by the American Speech and Hearing Association (ASHA), as well as definitions to help break it down, so that you can benefit from these examples.
Two Case Study Examples:
1. Kelly’s 4-year-old son, Tommy, has speech and language problems. Friends and family have a hard time understanding what he is saying. He speaks softly, and his sounds are not clear.
2. Jane had a stroke. She can only speak in one- to two-word sentences and cannot explain what she needs and wants. She also has trouble following simple directions.
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Language is made up of socially shared rules that include the following:
- What words mean (e.g., “star” can refer to a bright object in the night sky or a celebrity)
- How to make new words (e.g., friend, friendly, unfriendly)
- How to put words together (e.g., “Peg walked to the new store” rather than “Peg walk store new”)
- What word combinations are best in what situations (“Would you mind moving your foot?” could quickly change to “Get off my foot, please!” if the first request did not produce results)
Speech is the verbal means of communicating. Speech consists of the following:
Articulation: How speech sounds are made (e.g., children must learn how to produce the “r” sound in order to say “rabbit” instead of “wabbit”).
Voice: Use of the vocal folds and breathing to produce sound (e.g., the voice can be abused from overuse or misuse and can lead to hoarseness or loss of voice).
Fluency: The rhythm of speech (e.g., hesitations or stuttering can affect fluency).
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.
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.
In our example, Tommy has a speech disorder that makes him hard to understand. If his lips, tongue, and mouth are not moving at the right time, then what he says will not sound right. Children who stutter, and people whose voices sound hoarse or nasal, have speech problems as well.
Jane (the stroke victim) has a receptive and expressive language disorder. She does not have a good understanding of the meaning of words and how and when to use them. Because of this, she has trouble following directions and speaking in long sentences. Many others, including adults with aphasia and children with learning disabilities, have language problems.
Language and speech disorders can exist together or by themselves. The problem can be mild or severe. In any case, a comprehensive evaluation by a speech-language pathologist (SLP) certified by the American Speech-Language-Hearing Association (ASHA) is the first step to improving language and speech problems.
If you have concerns about a loved one’s speech and/or language, visit ASHA’s Find a Professional.
A study published in PEDIATRICS (the official journal of the American Academy of Pediatrics) details some of the use statistics of the Early Intervention program. Their findings indicate:
• Average age at which families report concerns about their child 7.4 months.
• Diagnoses made on average 1.4 months later (average age 8.8 months).
• Children referred to Early Intervention on average 5.2 months after diagnosis (average age 14 months).
• Individualized family service plans developed on average 1.7 months after referral (average age 15.7 months).
• There is a large cluster of children who begin Early Intervention by 7 months (usually born with a substantial disability).
• A second large cluster of children beginning Early Intervention includes those between 23 and 30 months (these later children tend to have real but less intense developmental delays).
• 86% of families with children with delays talk to a doctor or medical professional about their concerns. Physicians are at the front line the referral process.
• 76%-82% of families report that the the EI services their child receives are sufficient in terms of quantity
• 93% indicate that the services are either good or excellent.
These findings suggest that nationally, physicians are referring early and that users are generally happy.
(Bailey, Hebbeler, et al., 2004, First experiences with early intervention: A national perspective, v 113, no 4, 887-896).
An interesting statistic found to support early intervention is that if we invest in our children at an early age, the benefits will pay off in the long run by minimizing crime and other social problems they may face in the future.
Referral Process in Georgia:
• Birth – 3 years of age Referrals are made through your home county’s Early Intervention Program (AKA Babies Can’t Wait). Call (404) 657-2878 and they will help guide you through the process.
The Georgia Department of Public Health can be reached at (404) 657-2700.
Or, the 24/7 Public Health Emergency line is 1-877-782-4584.
For school-age children contact your local school district:
Fulton Special Education Department @ 404-763-5600
Forsyth County Schools (Press 6 for Special Ed.) @ 770-887-2461
Gwinnett Instructional Support Center @ 678-301-6000
Cherokee Special Education Department @ 770-704-4386 (Contact: Charlotte Green).
Cobb County School District @ 770-426-3300
The Bottom line…
1. Trust your gut. If it doesn’t feel right that your child isn’t speaking clearly compared to others in your play group or your child is gesturing more than talking, seek out an SLP to get an evaluation. The worst that can happen is that you were right and your child needs therapy – but you caught it early.
2. Don’t let other people convince you otherwise. You know your child best.
3. Let a test guide you – if you are not sure – better to evaluate than wait. Because the longer you wait the harder it will be for your child to communicate – not just in school but in other areas as well.
4. While there is no data to statistically support early intervention, this website on the importance on the first 3 years may answer some of your questions…*link*
5. If you have concerns about Autism, here is a link on Early Signs of Autism in Infants.
Check out more developmental milestone charts at www.advantagespeech.com. Additional resources are also available.
If you would like to schedule an evaluation to determine if your child needs speech and language services, don’t hesitate to contact Brook Todd with Children’s Therapy Services at 678-858-4777 or [email protected] or Robyn Drothler with Advantage Speech Services at 404-784-1252 or [email protected].