HELP ALONG THE JOURNEY TO CONFIDENT COMMUNICATION

STUTTERING

LITERACY

SPEECH

LANGUAGE

STUTTERING TREATMENT

PRESCHOOL

Roughly 8% of all children stutter. Stuttering typically develops between the ages of 2 and 5 after the child has had a period of normal language development. You may notice your child:

  • Repeats sounds syllables or words
  • Prolongs a sound (e.g., mmmmm)
  • Has a block that stops the flow of speech

Some children may also develop behaviours related to their discomfort with stuttering such as avoiding eye contact, facial grimaces, or increasing the pitch or loudness of their voice.

Many children will recover naturally from stuttering whereas some children may not. There are several factors that can help us decide whether it is likely that the child will recover naturally or not, whether we should continue to monitor before starting treatment or whether treatment should begin as soon as possible. 

I draw on several approaches to stuttering treatment which are known to be effective for the preschool age group.  These include the Lidcombe program and the RESTART-DCM program.  In all cases, a comprehensive assessment is the first step in determining which approach or combination of approaches would best suit your child. The treatment approach may include indirect approaches that modify the communication environment, support the child’s emotional development and self-regulation, and promote development of language and conversational skills. Direct approaches may also be used where a parent gives verbal feedback to the child about the child’s stuttering or the child learns techniques to reduce tension during moments of stuttering. The approach  we decide on will consider the characteristics of the child and family as well as parent preferences. We may also decide to try different approaches throughout the course of treatment. In collaboration with the parent we determine your goal for your child’s speech and plan from there.

As a parent, you will develop tools and strategies to help your child who stutters. The potential for full recovery from stuttering during the preschool years is high. In the event that full recovery does not happen, you will have built a strong foundation for communicative confidence with your child.

SCHOOL AGE

I can help your school-aged child decrease the severity of stuttering and increase their confidence in communicating. Although full recovery from stuttering is less likely at this age than in the preschool years, there is much that can be done to help your child understand what stuttering is, speak with more ease, and communicate well and with confidence.

A comprehensive assessment is completed to guide the treatment approach and tailor it to your child’s needs. Some aspects that may be included as part of your child’s treatment are:

  • Learning about stuttering and how speech works
  • Addressing thoughts and feelings about stuttering
  • Minimizing bullying
  • Techniques that can reduce tension to make stuttering easier
  • Language and conversational skills that can enhance fluency
  • Parent-child interaction that can enhance fluency
  • Parent provided feedback about fluency as well as the child’s self-evaluating aspects of their speech
  • Group sessions with other children who stutter depending on interest and availability

Contact me to discuss your school-age child and how I may be able to help along the journey to more confident communication.

ADOLESCENTS

I can help teens work through the multifaceted aspects of stuttering. The teenage years can be challenging as teenagers are experiencing increasingly complex and demanding social situations, they are seeking to assert themselves and their independence, and they are navigating increasingly demanding academic content.

A teen who stutters may benefit from support to:

  • Build healthier thoughts and feelings about stuttering
  • Develop self-advocacy skills
  • Learn to use speech strategies to help increase fluency or stutter with less tension or struggle
  • Say what they want to say without avoiding sounds, words, or situations

If the teenager who stutters has had previous speech therapy, we discuss what they liked or disliked about previous treatment. We then work together to determine what the teenage client would be doing if they wanted to make positive changes to their stuttering. I can then help the teenager get ready for change, and work through aspects of stuttering that will be most helpful for the client. We do this in a way that promotes lasting change. I use creativity to make the therapy relevant for the teen and to transition what is learned in therapy to everyday life. 

Contact me if you would like to further discuss treatment options for stuttering in adolescence.

READING AND WRITING (including dyslexia)

SCHOOL-AGE & ADOLESCENTS

Learning to read and write is not a natural process, we must re-wire parts of our brain to develop reading and writing abilities. Reading and writing are based in oral language skills which makes speech-language pathologists with the appropriate training very well suited to provide reading and writing intervention. Through coursework, constant professional development, and practical experience in the schools I have developed substantial skills in this area, although I continue to learn more all the time!

I use a structured literacy approach to intervention, incorporating the essential elements for learning to read and write in a systematic and explicit way based on your child’s unique set of needs. I do an in-depth diagnostic assessment to identify specific areas within reading and writing intervention that will most benefit your child (this doesn’t provide a diagnosis, it tells us what’s going on and what areas to work on). I then target those areas of need in multisensory (i.e., hearing the sounds or words, reading them, and writing them), engaging and motivating ways to support your child’s reading and writing growth. Important foundational skills for reading and writing including oral language, phonological awareness, phonics, morphology, orthography, syntax, vocabulary, fluency, and comprehension are targeted in a systematic and simultaneous way that is tailored to your child to provide maximum success. A speech-to-print approach for treatment may also be an option for your child.

Does my child need a diagnosis? No, your child does not need to have a diagnosis for me to support their reading and writing growth. I can determine the child’s areas of difficulty within reading and writing and provide intervention to target these areas. Some children may have a diagnosis provided by a psychologist which could include a Language Based Learning Disability or Dyslexia. I can provide reading intervention for these and other types of diagnoses as well.

When should I seek reading support?If you are here it is likely you have some level of concern for your child’s reading and writing development. Trust your gut on this one! I encourage you to book a free consultation with me to further discuss your child.

Foundational skills for reading and writing start developing early and reading and writing skills can be improved at any age. For literacy intervention, I work with children aged 5 years up to the end of high school.

A list of signs that your child may struggle to learn to read is provided by the Yale Centre for Dyslexia and Creativity

What if my child is learning English as their second language? Children learning English are good candidates for structured literacy intervention. Through the assessment I can determine if the child is having difficulty because they are at the beginning stages of learning English, or whether the child’s difficulties are unrelated to their exposure to English. Children who are learning English as a second language are often under-identified for reading and writing interventions in schools (IDAOntario, 2021).

How common are reading challenges? In Ontario, the grade 3 province-wide reading assessment found that 26% of students did not meet the provincial standard for reading (EQAO, 2019). In contrast, over 95% of elementary students are cognitively capable of learning to read well when provided with appropriate instruction (EAB Global Inc., 2019; Moats, 2020, Young 2021). The 5% who are left are also capable of learning to read at a level that matches their language abilities. If your child is struggling with learning to read they may need reading intervention that is well matched to their needs to reach maximum success. Contact me to set up a time to discuss your child’s literacy needs.

TREATMENT FOR SPEECH SOUND PRODUCTION

CHILDREN & YOUTH

Difficulty with producing sounds in speech accurately is common in children: 16% of preschoolers, 11-13% of 5-7 year olds, and 10% of 9-11 year olds. The underlying cause for the child’s difficulty with speech sound production can be a difficulty with the motor movements, or it can be a linguistic difficulty in recognizing the difference between sounds. The child could also have difficulty with both of these underlying causes. I can complete a comprehensive assessment to determine what may be underlying the speech sound production difficulty, and choose treatments that align best with the suspected underlying issue. Speech therapy activities are done during games, storytelling, or in natural everyday settings to make the activities fun and motivating for the child (and parent!)

50% of children with speech sound production difficulties experience difficulty with reading (Tambyraja, Farquharson & Justice, 2020). Speech sounds are the same sounds we use for reading. If something is impacting the child’s access to these sound representations, then it will impede reading as well. It is common for difficulty with speech sounds and dyslexia to overlap. Early identification and early intervention can help remediate the speech sound difficulty and alleviate the impact on reading. I can complete screening or more in-depth assessment to determine if reading skills would be beneficial to include alongside your child’s speech sound production treatment.

Nearly all speech sounds are typically acquired by age 6; many by age 4. For most children, their intelligibility of speech grows fastest between 2.5 years of age and 3.5 years of age. By age 4, a completely unfamiliar person with no context about what the child is talking about should understand 50% of what the child says, and by age 5 an unfamiliar person should understand about 75% of what a child says (Hustad et. al. 2021).

Contact me if you have concerns about your child’s speech sound production or if you are not sure whether to seek treatment.

GROW LANGUAGE SKILLS

CHILDREN & YOUTH

Some children have difficulty developing language skills – understanding language in their environment and using language to express themselves to others. Sometimes a parent may notice that their child is behind on meeting language developmental milestones early on. These late talkers can be supported through fun targeted interactions with their caregivers that focus on the words that may interest the child or have value for the child. These interactions take practice to figure out as a parent before they become second nature. I can help you along the journey of building your child’s early language skills – contact me for a free phone conversation.

Some children may have challenges with language that are suspected only once the child enters school and the demands of communication, learning, and eventually reading and writing increase. The child requires increasingly complex language skills to manage the social and academic aspects of school. Difficulties with a child’s language skills can be difficult for parents and teachers to detect because language is so fleeting and many children have strategies that help them cope early on. When a child is having difficulty learning to read or understanding what they read, this might be a signal to consider if the child is having difficulty with language.

I can help if you or your child’s teacher suspect your child may have difficulty with:

  • understanding of language and complex concepts
  • production of oral language
    • grammar
    • sentence structures
    • vocabulary use or word retrieval difficulties
    • organization of their ideas in oral communication
  • difficulty learning to read or understanding what they read
  • difficulty expressing themselves in writing

Contact me to discuss your child and how I can help along their learning journey.