What is speech therapy?

Speech therapy is a clinical program aimed at improving speech and language skills and oral motor abilities. This means talking, using sign language, or using a communication aid. Depending on the area of deficit, speech therapy may focus on improving several different areas such as speech production, understanding language and expressing language, and social skills.

How do I know if my child needs speech therapy?

If your child’s disability is present at an early age, your health care team may recommend speech therapy as part of your child’s early intervention plan. There are also language developmental milestones that you can monitor to make sure your child is on track and talk to your doctor if you suspect any problems. Certain articulation errors such as substituting “w” for “r” may be developmentally appropriate for children under age 5. However, if these errors persist after age 7, intervention may be warranted.

Will my insurance cover speech therapy?

Depending upon your insurance policy, speech-language therapy may be a covered benefit. Benefits vary greatly from policy to policy so it is important to take the time to become acquainted with your individual benefits. Although Communication Bridges is not a participating provider with any insurance carriers, we will support you by providing appropriate documentation of the speech-language services received in-home or at our center.

How long will my child need speech therapy?

The length of therapy depends on the severity of the problem and the rate of progress made in the therapy sessions. It is important to note that not all treatment programs are equal. Best practices indicate that using treatment approaches that are proven effective by research based evidence hasten the rate of progress. As a policy, we use current and innovative treatment approaches to maximize the effectiveness of therapy.

What is a Speech and/or Language Disorder?

According to the American Speech-Language Hearing Association, 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. Difficulties pronouncing sounds, or articulation disorders, and stuttering are examples of speech disorders.

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. Both children and adults can have speech and language disorders. They can occur as a result of a medical problem or have no known cause.

Is my child a “late bloomer” or does he have a language delay?

Because children achieve their speech and language milestones at different ages, it is relatively difficult to predict if a young child is a “late bloomer” and will eventually demonstrate age appropriate speech and language skills. Researchers have found certain factor or “red flags” that indicate the likelihood that the child may indeed have a true language delay. However, it is important to note that these are predictions made by observations and studies done on groups of children. Individual children may not behave like children in a group. Group data can only be used to predict what most children who are very similar to the children in a study might do. Predictions, by their very nature, are not always correct. Some factors that indicate a possible language delay as noted by the American Speech-Language Hearing Association (ASHA) include receptive language skills, use of gestures to communicate, age of diagnosis and progress in language development. However, parents do not have to rely on predictions or wait and see if their child will outgrow the speech and language delay. It is recommended that parents consult with a licensed speech-language pathologist who can conduct receptive and expressive language tests, analyze the child’s language sample and provide insights about possible intervention strategies.

What is the difference between speech and language?

Speech is defined as spoken language. It refers to “how” we produce sounds and words and involves articulation, voice, and fluency.

Language is a socially shared code that represents concepts with arbitrary symbols, which provides a set of rules as to how those symbols can be combined and used. It refers to the entire system of expressing and receiving information in a way that’s meaningful. It involves our understanding of others (receptive) and our meaningful expression of thoughts and feelings (expressive).

Is my child’s speech and language development normal?

The following norms are obtained from the American Speech-Language Hearing Association (ASHA)

Hearing and UnderstandingTalking

Birth – 3 Months

  • Startles to loud sounds
  • Quiets or smiles when spoken to
  • Seems to recognize your voice and quiets if crying
  • Increases or decreases sucking behavior in response to sound

Birth – 3 Months

  • Makes pleasure sounds (cooing, gooing)
  • Cries differently for different needs
  • Smiles when sees you

4 – 6 Months

  • Moves eyes in direction of sounds
  • Responds to changes in tone of your voice
  • Notices toys that make sounds
  • Pays attention to music

4 – 6 Months

  • Babbling sounds more speech-like with many different sounds, including p, b and m
  • Chuckles and laughs
  • Vocalizes excitement and displeasure
  • Makes gurgling sounds when left alone and when playing with you

7 Months – 1 Year

  • Enjoys games like peek-a-boo and pat-a-cake
  • Turns and looks in direction of sounds
  • Listens when spoken to
  • Recognizes words for common items like “cup”, “shoe”, “book”, or “juice”
  • Begins to respond to requests (e.g. “Come here” or “Want more?”)

7 Months – 1 Year

  • Babbling has both long and short groups of sounds such as “tata upup bibibibi”
  • Uses speech or noncrying sounds to get and keep attention
  • Uses gestures to communication (waving, holding arms to be picked up)
  • Imitates different speech sounds
  • Has one or two words (hi, dog,dada, mama) around first birthday, although sounds may not be clear

1 Year – 2 Years

  • Points to a few body parts when asked.
  • Follows simple commands and understands simple questions (“Roll the ball,” “Kiss the baby,” “Where’s your shoe?”).
  • Listens to simple stories, songs, and rhymes.
  • Points to pictures in a book when named.

1 Year – 2 Years

  • Says more words every month.
  • Uses some one- or two- word questions (“Where kitty?” “Go bye-bye?” “What’s that?”).
  • Puts two words together (“more cookie,” “no juice,” “mommy book”).
  • Uses many different consonant sounds at the beginning of words.

2 Years – 3 Years

  • Understands differences in meaning (“go-stop,” “in-on,” “big-little,” “up-down”).
  • Follows two requests (“Get the book and put it on the table”).
  • Listens to and enjoys hearing stories for longer periods of time

2 Years – 3 Years

  • Has a word for almost everything.
  • Uses two- or three- words to talk about and ask for things.
  • Uses k, g, f, t, d, and n sounds.
  • Speech is understood by familiar listeners most of the time.
  • Often asks for or directs attention to objects by naming them.

3 Years – 4 Years

  • Hears you when you call from another room.
  • Hears television or radio at the same loudness level as other family members.
  • Answers simple “who?”, “what?”, “where?”, and “why?” questions.

3 Years – 4 Years

  • Talks about activities at school or at friends’ homes.
  • People outside of the family usually understand child’s speech.
  • Uses a lot of sentences that have 4 or more words.
  • Usually talks easily without repeating syllables or words.

4 Years – 5 Years

  • Pays attention to a short story and answers simple questions about them.
  • Hears and understands most of what is said at home and in school.

4 Years – 5 Years

  • Uses sentences that give lots of details (“The biggest peach is mine”).
  • Tells stories that stick to topic.
  • Communicates easily with other children and adults.
  • Says most sounds correctly except a few like l, s, r, v, z, ch, sh, th.
  • Says rhyming words.
  • Names some letters and numbers.
  • Uses the same grammar as the rest of the family.

What age groups does Communication Bridges treat?

Communication bridges works with children from ages 1 year to adolescents and early adulthood. Research strongly suggests that early intervention is vital to speech and language development. Hence, we recommend that you consult with a licensed speech language pathologist as soon as possible, if you suspect your child has speech or language delays.

Do I need to stay with my child during therapy?

Parents are not required, but are welcome to stay when their child receives therapy. We encourage parents to be active participants in their child’s services. If the parent is not present during therapy, the parent should return five to ten minutes before the conclusion of therapy so the therapist can review the session and possible homework.

Is there a waiting list?

Please contact the office regarding availability.

Do you have specialists in Apraxia?

Yes, we use the latest techniques for treatment of apraxia of speech. Sonali is also P.R.O.M.P.T. trained. Apraxia of speech remains a controversial diagnosis, particularly among young children. This is perhaps because for many children with childhood apraxia of speech or developmental apraxia of speech, there may be concomitant language delays. In addition, many Apraxia tests require higher level speech skills, making the tests irrelevant for very young children with limited speech. Therefore, we use our clinical experience and observations to diagnose suspected apraxia of speech. It is not uncommon to use strategies and techniques that are developed for childhood apraxia to assess if the child responds positively. Notable improvement in speech skills with the use of these strategies may provide further evidence of the presence of motor planning difficulties.

What is a Phonological Process Disorder?

A phonological process disorder involves patterns of sound errors. For example, substituting all sounds made in the back of the mouth like “k” and “g” for those in the front of the mouth like “t” and “d” (e.g., saying “tup” for “cup” or “das” for “gas”).

Another rule of speech is that some words start with two consonants, such as broken or spoon. When children don’t follow this rule and say only one of the sounds (“boken” for broken or “poon” for spoon), it is more difficult for the listener to understand the child. While it is common for young children learning speech to leave one of the sounds out of the word, it is not expected as a child gets older. If a child continues to demonstrate such cluster reduction, he or she may have a phonological process disorder.

Do you use different treatment techniques for a traditional articulation disorder and phonological process disorder?

Yes. Articulation disorders without an oral motor component, such as errors in the production of “r” or “s” sounds respond well to traditional treatment techniques such as building auditory awareness and teaching appropriate placement of articulators for the target sound.

Phonological process disorders however impact a wide variety of sounds and therefore treating individual sounds in isolation would prove time consuming and inefficient. Phonological process disorders respond well to approaches such as “Cycles Approach” (Hodsen 1980). The cycles approach differs from traditional in that it targets groups of sounds rather than one speech sound at a time. In addition, instead of working on one sound till it is mastered, the target sounds change from week to week. Research shows that this approach reduces the overall treatment time while significantly increasing the child’s speech intelligibility.

Do you provide in-home therapy?

Yes, however the rates will vary depending on the location.

Are there any services provided without a cost to the parents?

Children under three years of age may be eligible for evaluations and therapy services funded through the Regional Center of Orange County (RCOC). Sonali is a RCOC vendor.

How are parents involved in evaluation and therapy?

During the evaluation process, we gather developmental history via a parent/caregiver interview to guide the initial assessment, write treatment goals and develop home programs. During therapy the clinician and parent determine the optimal approaches for the child. Clinicians provide feedback following each session. A Home Program, including suggested activities and other recommendations is provided regularly as a part of the treatment process.

What are some treatment techniques used for children on the autism spectrum?

We are proud to offer a multitude of therapy programs and techniques such as PECS, P.R.O.M.P.T., and Listening with the Whole Body for children on the autism spectrum. Our programs and lesson plans are individualized for each child. Following the initial consultation, a broad treatment plan is discussed as a team that includes the parents and caregivers. In addition, detailed goals and objectives are also delineated. A unique lesson plan is prepared for each child for every session. Detailed session notes and data collection is an integral part of therapy. Since each session is individualized for the child’s unique needs, the goals and objectives are not permanent and can be revised as the child’s skills and needs change. Since social skills or pragmatic language deficits are often present in children on the spectrum, we offer a wide variety of programs to target these as well.