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As you read about speech-language disorders, you may have many questions. We hope to help you find out more about what a speech-language specialist can offer. Below you will find a glossary of terms, as well as a rubric for determining whether or not an assessment is indicated.
Glossary of Communication Disorders
Speech: Speech disorders refer to difficulties producing specific speech sounds. Children with speech or articulation disorders often have difficulty being understood by others.
Language: A language disorder is an impairment in the ability to: understand, follow directions or answer questions (Receptive) and/or use words, produce narratives, and use grammatical markers (Expressive). Other characteristics of language disorders may include an impaired ability to organize information and express ideas, as well as a reduced vocabulary.
Fluency: Disorders of fluency are characterized by an interruption in the rhythm and flow of speech and include stuttering and cluttering.
Auditory Processing Disorders: A disorder in the ability to accurately detect and understand incoming auditory information from simple sounds/noises to the speech of others (despite the fact that the child has normal hearing). The ability to follow directions, answer questions and follow lengthy conversation may be impaired as a result.
Apraxia: Also referred to as Childhood Apraxia of Speech, this disorder is characterized by difficulties with the programming, planning and production of oral and verbal movements necessary for the production of speech.
Pragmatic Language: Pragmatic language includes expressive language skills such as maintaining eye contact, turn taking, topic initiation and maintenance, and understanding figurative language.
Disorders of Play: There are numerous levels of play in which children progress through which serve as an important part of language development. Deficits present in any of these levels or with the progression through these levels may include difficulties with object use, engaging with others, and using imagination to invent different play schemas.
Tongue Thrust: Tongue thrust is an incorrect pattern in which the tongue moves anteriorly within the oral cavity at rest, during speech and when swallowing. A tongue thrust can cause problems with dentition and bite as well as articulation.
Speech: Speech disorders refer to difficulties producing specific speech sounds. Children with speech or articulation disorders often have difficulty being understood by others.
Language: A language disorder is an impairment in the ability to: understand, follow directions or answer questions (Receptive) and/or use words, produce narratives, and use grammatical markers (Expressive). Other characteristics of language disorders may include an impaired ability to organize information and express ideas, as well as a reduced vocabulary.
Fluency: Disorders of fluency are characterized by an interruption in the rhythm and flow of speech and include stuttering and cluttering.
Auditory Processing Disorders: A disorder in the ability to accurately detect and understand incoming auditory information from simple sounds/noises to the speech of others (despite the fact that the child has normal hearing). The ability to follow directions, answer questions and follow lengthy conversation may be impaired as a result.
Apraxia: Also referred to as Childhood Apraxia of Speech, this disorder is characterized by difficulties with the programming, planning and production of oral and verbal movements necessary for the production of speech.
Pragmatic Language: Pragmatic language includes expressive language skills such as maintaining eye contact, turn taking, topic initiation and maintenance, and understanding figurative language.
Disorders of Play: There are numerous levels of play in which children progress through which serve as an important part of language development. Deficits present in any of these levels or with the progression through these levels may include difficulties with object use, engaging with others, and using imagination to invent different play schemas.
Tongue Thrust: Tongue thrust is an incorrect pattern in which the tongue moves anteriorly within the oral cavity at rest, during speech and when swallowing. A tongue thrust can cause problems with dentition and bite as well as articulation.
Does My Child Need Speech/Language Therapy?
Red Flags for Toddlers and School-Age Children
The following information includes general guidelines of what is expected during typical speech/language development. Should any or all red flags be demonstrated, a referral to a Speech Language Pathologist is indicated.
ARTICULATION
Your child’s speech should be 80% intelligible to the unfamiliar listener by 3 years of age. Though most parents are able to understand what their child is saying, this refers to how well your child can communicate their message to the average person in your community.
Red Flags:
RECEPTIVE & EXPRESSIVE LANGUAGE
Your child should be able to clearly communicate his/her ideas, wants and needs. He/she should be able to demonstrate an understanding of basic concepts, answer questions and follow directions.
Red Flags:
FLUENCY
Your child should be speaking with a prosodic pattern including appropriate rate and rhythm without getting stuck on his/her words.
Red Flags:
AUDITORY PROCESSING
Your child should be able to follow commands and directions, answer questions without difficulty despite distractions in the environment.
Red Flags:
APRAXIA
Your child should be able to imitate and produce oral movements and speech sounds without any difficulty in the organization and sequence of those movements as the complexity increases.
Red Flags:
PRAGMATIC LANGUAGE/PLAY
Your child should be able to engage with peers, play alongside and later participate in cooperative play. Skills including the initiation of conversation and play, topic maintenance, turn taking, and eye contact should all be present.
Red Flags:
Red Flags for Toddlers and School-Age Children
The following information includes general guidelines of what is expected during typical speech/language development. Should any or all red flags be demonstrated, a referral to a Speech Language Pathologist is indicated.
ARTICULATION
Your child’s speech should be 80% intelligible to the unfamiliar listener by 3 years of age. Though most parents are able to understand what their child is saying, this refers to how well your child can communicate their message to the average person in your community.
Red Flags:
- Child starts talking, is hard to understand, then stops
- Child leaves the ending off many words
- Child lacks a variety of sounds and syllable shapes
- Child has difficulty producing even simple words
- Excessive drooling
- Difficulty imitating sounds or mouth postures
RECEPTIVE & EXPRESSIVE LANGUAGE
Your child should be able to clearly communicate his/her ideas, wants and needs. He/she should be able to demonstrate an understanding of basic concepts, answer questions and follow directions.
Red Flags:
- Child is not approximating words or imitating sounds by 16-18 months of age
- Child is not combining words by 2½ years of age
- Child is difficult to understand, cannot express ideas logically or clearly
- Child cannot maintain a topic, even for a brief period of time
- Child has difficulty recalling names of common objects
- Child has difficulty answering “who”, “what”, “where”, “when” and “why” questions
- Child has difficulty talking about events, people, or things that are not in the immediate environment
- Child has trouble following directions or commands
FLUENCY
Your child should be speaking with a prosodic pattern including appropriate rate and rhythm without getting stuck on his/her words.
Red Flags:
- Child exhibits atypical disfluencies which include:
- Initial sound or syllable repetitions (i.e., “a...a…a…apple”, “do…do…do…donut”)
- Prolongations (i.e., “that’s mmmmmmmmmy toy”)
- Blocking- the stoppage or obstruction when attempting to talk, temporarily preventing the smooth progression of voice
- Phrase repetitions (i.e., “I want…I want….the juice”)
- Whole word repetitions, when demonstrated with additional stuttering behaviors (i.e., “you…you…you...can come to my house”)
- Child demonstrates secondary behaviors which may include:
- Facial grimacing
- Jaw movement
- Change in eye gaze
- Arm and hand movements
- Changes in pitch or volume
AUDITORY PROCESSING
Your child should be able to follow commands and directions, answer questions without difficulty despite distractions in the environment.
Red Flags:
- Child has average or above average intelligence but experiences academic difficulties, may repeat a grade or be labeled a “slow learner”
- Child exhibits a decreased attention span and may forget what was said within minutes
- Child has an inability to block out background noise
- Child may listen attentively but have difficulty following complex directions
- Child has difficulty answering questions
- Child has challenges with reading, writing and spelling
- Child appears pre-occupied or to be day dreaming
- Child presents with hyperactivity or Attention Deficit Disorder
- Child does not remember simple daily routines
APRAXIA
Your child should be able to imitate and produce oral movements and speech sounds without any difficulty in the organization and sequence of those movements as the complexity increases.
Red Flags:
- Child often described as a “quiet baby”
- Child does not correctly produce sounds in some words that are produced in other words (i.e., child says “tut” for “shut” but says “shun” for “sun”)
- Child does not consistently use sounds or leaves out sounds
- Child has difficulty with the production of vowels
- Child has increased errors with longer words or sentences
- Child produces a word then loses it
- Child has significant difficulty imitating words/phrases and/or oral postures
- Child’s melody is often altered
- Child’s gross motor skills may be slow in developing
PRAGMATIC LANGUAGE/PLAY
Your child should be able to engage with peers, play alongside and later participate in cooperative play. Skills including the initiation of conversation and play, topic maintenance, turn taking, and eye contact should all be present.
Red Flags:
- Child prefers to play alone and engage in isolated play
- Child does not initiate conversation, play or turn taking with others
- Child’s play is very simplistic with limited imagination
- Child does not make eye contact with others
- Child does not demonstrate attention or desire to what is going on around him/her