A Resource for Parents and Families

Here you will find answers to our most frequently asked questions about Speech-Language Pathology

1. What is the cause of a speech or language delay?

This is one of the first questions a parent will ask about their child. It is also one of the most difficult to answer. Delays in speech and language skills can be associated with genetic, physical and environmental factors, but for most children, an obvious cause is hard to pinpoint.

Pre-and perinatal factors such as alcohol consumption during pregnancy, low birth weight and anoxia (lack of oxygen at birth) can be implicated. We also know that special populations have a higher prevalence of communication disorders, e.g. children with autism, genetic syndromes, physical problems like cerebral palsy and cleft palate, developmental delays and hearing loss.

Certain communication disorders, like stuttering, severe speech disorders (i.e. phonological, apraxic) and language based learning disabilities, appear to have a genetic link.

Most of the children that we see at our Centre have unremarkable birth, medical and developmental histories which makes early diagnosis and treatment of their communication problems a challenge! The child’s normal overall health and development can hide the problem from medical personnel with whom they have early contact.

2. What is the difference between a Speech-Language Pathologist, a Communicative Disorders Assistant and a Speech Teacher/Correctionist?

When it comes to speech and language services, job titles are important. As a consumer of professional services, it is critical that you understand how job titles signify important distinctions in roles and training.

Speech-Language Pathologists have Masters Degrees in Communicative Disorders from a recognized university, and must be registered with the College of Audiologists and Speech-Language Pathologists of Ontario in order to practice. The College protects the public from unqualified practitioners, and helps to ensure quality of services. High standards are maintained by limiting the use of the title "Speech-Language Pathologist" to graduates from recognized universities, and monitoring the continuing education of members. Only Speech-Language Pathologists are qualified to assess, treat and consult on a broad range of communication and swallowing disorders.

Communicative Disorders Assistants (CDAs) are graduates of a 12 month post-diploma program offered at Georgian College in Orillia, Ontario. CDAs are qualified to provide therapy services under the direction and supervision of a registered Speech-Language Pathologist. CDAs allow Speech-Language Pathologists to expand the reach of their services. London Speech and Language Centre offers CDA services which allows us to see more clients at a significant cost savings to families.

Speech Teachers and Correctionists are usually employed by school boards, and can have a variety of backgrounds. They may receive six weeks of formal training in speech correction services.

3. How does a Speech-Language Pathologist assess speech and language status in English as a Second Language (ESL) children?

Speech and language disorders are best treated early. This can be a challenge in multicultural communities where children are learning English as a second language. How do we differentiate between language delays that are associated with ESL status versus a language learning problem?

A Speech-Language Pathologist must be sensitive to ESL issues and their impact on language development. S/he must account for the fact that ESL children can go through normal silent periods when language skills temporarily regress. For instance, preschool children who are just learning to speak English, may have a 6 month silent period upon entering an English speaking day care. Within a year, they should begin to use short words and phrases. It may then take 3 to 4 years to become totally fluent in social conversation, and 5 to 7 years to learn the academic language of school. An assessment must also account for the social and emotional factors that can co-occur with transitions (new country, new school etc.).

Children with language based learning problems will struggle to learn both languages, and display communication skills falling well below developmental expectations. For children under 3 years of age, they will score more than 3 months behind on expressive language, social interaction and/or receptive language milestones.

4. When should a child start speech therapy. Is a one year old too young?

A child is never too young to be seen by a Speech-Language Pathologist, in fact, when you suspect a problem "sooner is better". Countless studies have demonstrated that early intervention can avert secondary problems and unnecessary suffering later in life. Early intervention capitalizes on the fact that brain development is rapid and plastic at an early age, and that young children are "ripe" for input.

The form of intervention depends upon client circumstances and need. It can consist of tracking progress, parent training, an enriched early childhood education experience, group therapy and/or individual therapy.

If your child has a communication problem, it is never too early to help.

5. Is it true that boys develop speech and language skills later than girls?

You may have noticed that your little boy doesn’t speak as well as the same age neighbour girl down the road? On average, boys do develop speech and language skills at a slightly slower rate than girls. Having said that, it is also important to recognize that speech and language assessments account for this normal variability in development. If your boy has trouble with communication, consult a Speech-Language Pathologist. Don’t let others tell you "he’s just a boy". It could be that he is behind and requires some speech and language assistance.

6. Don’t most children outgrow speech and language disorders? Why bother with therapy?

Children with significant speech and language disorders do not outgrow their problems. It is true that they may stop saying sentences like "Him goed to the store", however, language difficulties often persist in a more subtle form. These difficulties may manifest as a profound impact on learning, literacy and social-emotional development.

7. What is the impact of speech and language delays?

Language is the primary medium of learning. It is not surprising then, that speech and language disorders can interfere with academic performance. It has been said that language is not just another subject in school, it is the means by which all other subjects are learned. Everything we are expected to learn is either heard or read. Our skills are demonstrated through words or written language. The vast majority of children with learning disabilities have a language-based disorder that is amenable to treatment. Without treatment, their social, emotional, academic, and eventual vocational adjustment, is compromised.

8. How long before therapy results in a measurable difference?

Articulation therapy, which involves the correction of sound pronunciation problems, can be relatively short term. Language disorders are generally longer term. Therapy for stuttering involves fairly long-term follow up to ensure maintenance of treatment gains.

At London Speech and Language Centre, our clinicians work in three-month treatment blocks. Progress and recommendations are made at quarterly intervals.

9. How do you differentiate between speech and language delays in children, and reduced motivation or interest in communication?

Motivation is addressed specifically in assessment and therapy by using high interest activities and games. It is also considered in the interpretation of test results.

Chronic disinterest in communication is noted in testing, as it may be indicative of a pervasive developmental disorder (e.g. autism). These children are often referred on to a Pediatric Psychologist or Pediatrician for assessment as well. In treatment, improving communicative intent may be selected as a specific treatment goal.

10. Is it true that a second and third child’s speech and language development will be delayed because of older siblings speaking for them?

Although family dynamics certainly can interfere with opportunities for communication, it is rarely a reason for communication delay. Extreme child abuse and deprivation can result in aberrant or failed language development. Thankfully, these cases are rare.

11. Will alternative forms of communication (i.e. signing, pictures) delay verbal communication development?

No. Augmentative communication systems can enhance the development of verbal language.

12. When is it too late to start speech therapy?

Anyone who is motivated to improve speech and language skills can be a candidate for therapy. Speech is a learned behaviour that can be altered through practice. It is never too late to improve the way we communicate. Many corporations hire Speech-Language Pathologists to provide executives and staff with advanced training in communication skills. If they can do it, you can too.

13. I am concerned that my child may get "labeled" as a result of testing or advocacy at the school level. Do I need to be concerned about this?

The best assessment reports use descriptive language to define your child’s academic and social strengths and weaknesses and make recommendations. Behaviours and learning styles will be labeled. Your child will not.

Similarly, your child’s needs are specified on any Individualized Education Plan that is prepared for your child. This formality may be the only way that you can be assured that your child’s specific learning needs will be addressed consistently and effectively.

If you are concerned about your child getting a label, express your feelings to the professionals that assess you child and prepare reports, and to all school board personnel that are working with you. Labels are not necessary.