Speech & Language Therapy

Expressive language skills refer to a child’s ability to convey thoughts, feelings, and ideas through words, sentences, and gestures. Speech-Language Pathologists (SLPs) work on enhancing expressive language by helping children expand their vocabulary, form coherent sentences, and use correct grammar. Through engaging activities and personalized strategies, SLPs support children in developing the language skills necessary for effective communication and social interaction.

Typical milestones for expressive language development include:

• By age 1: Most children begin using single words like “mama” or “ball” to express their needs and wants.
• By age 2: Children start combining two words into simple phrases, such as “want cookie,” and have a vocabulary of around 50 words.
• By age 3: Vocabulary expands to 200-1,000 words, and children begin using three- to four-word sentences to express more complex ideas and ask questions.
• By age 4-5: Children typically use complete sentences, tell simple stories, and use a variety of grammar rules, such as past tense verbs and pronouns.

If your child is having difficulty expressing themselves, early intervention with an SLP can be crucial in helping them develop strong communication skills.

Receptive language skills involve a child’s ability to understand and process the language they hear or read. These skills are crucial for following directions, comprehending stories, and engaging in effective communication. Speech-Language Pathologists (SLPs) work on receptive language by helping children improve their understanding of vocabulary, sentences, and complex concepts. Through targeted activities and interventions, SLPs support children in developing the skills necessary to understand and interact with the world around them.

Typical milestones for receptive language development include:

• By age 1: Most children can understand simple commands like “no” or “come here” and recognize familiar names and words.
• By age 2: Children typically follow simple two-step directions, such as “pick up the toy and give it to me,” and understand basic questions like “where’s the ball?”
• By age 3: A child’s understanding expands to more complex instructions and “who,” “what,” and “where” questions. They can follow a sequence of actions, such as “first wash your hands, then sit down.”
• By age 4-5: Children can comprehend more abstract language concepts, such as time-related words (“yesterday,” “soon”), and follow multi-step directions with greater complexity.

If your child is struggling to understand spoken language, early intervention with an SLP can significantly enhance their ability to process and respond to language effectively.

Language processing refers to the ability to make meaning from what we hear and then formulate an appropriate response. This involves understanding vocabulary, syntax, and sentence structure to communicate effectively. Difficulties with language processing can significantly impact a child’s ability to receive and use important information functionally, affecting their speech, language development, and even academic performance.

Children with language processing disorders may struggle to follow directions, not because they are unwilling, but because they have difficulty understanding or organizing their thoughts. These challenges can sometimes be mistaken for misbehavior. For example, a child might hear a direction but fail to follow through because they can’t fully process or remember the steps involved, a function closely tied to working memory.

Other signs of language processing difficulties include trouble with word retrieval, the use of vague or incorrect language, and impaired social skills. Additionally, children with these challenges might struggle with figurative language, taking expressions like “it’s raining cats and dogs” literally instead of understanding the intended meaning.

Early intervention with a Speech-Language Pathologist (SLP) can help children improve their language processing skills, leading to better communication, academic success, and social interactions.

Social communication, also known as pragmatics, involves the ability to use language appropriately in social contexts. This includes understanding and following the rules of conversation, using language to express thoughts and emotions, and interpreting nonverbal cues like facial expressions and body language. Strong social communication skills are essential for building relationships, navigating social interactions, and effectively participating in daily activities.

Typical milestones for social communication and pragmatics include:

• By age 2: Children begin to use gestures and simple words to express needs and engage in basic turn-taking during interactions.
• By age 3: Children start to engage in short conversations, use polite forms like “please” and “thank you,” and begin to understand the concept of taking turns in conversation.
• By age 4: Children typically can tell simple stories, understand basic humor, and use language to express a wider range of emotions and intentions.
• By age 5: Children should be able to participate in more complex conversations, understand and follow social rules like staying on topic, and interpret nonverbal cues such as tone of voice and facial expressions.

Children with difficulties in social communication may struggle with starting or maintaining conversations, understanding others’ perspectives, or interpreting social cues, which can impact their ability to form friendships and interact successfully with peers.

Speech-Language Pathologists (SLPs) work with children to develop these essential skills, using targeted strategies and activities to help them navigate social situations more effectively and build meaningful relationships.

Play skills are fundamental for a child’s development, encompassing the ability to engage in various types of play that promote cognitive, social, and emotional growth. Play helps children learn problem-solving, creativity, and social interaction, making it a crucial component of their overall development. Developing these skills involves mastering different types of play, such as solitary play, parallel play, and cooperative play, and using play to explore and understand the world around them.

Typical milestones for play skills include:

• By age 1: Children engage in simple exploratory play, such as banging objects together or examining toys with curiosity.
• By age 2: Children start to participate in parallel play, where they play alongside other children with similar toys, though not yet interacting directly.
• By age 3: Children begin to engage in associative play, sharing toys and ideas with peers, and showing an interest in role-playing and simple cooperative activities.
• By age 4-5: Children typically engage in more complex, cooperative play, including organized games with rules, role-playing scenarios, and collaborative projects.

Children with delays in play skills may struggle with initiating or participating in play activities, interacting with peers, or using imaginative play effectively. Speech-Language Pathologists (SLPs) use targeted interventions to support the development of these essential skills, helping children build social connections and enhance their overall development through structured play.

Fluency skills involve the smooth and uninterrupted flow of speech, crucial for clear and effective communication. This includes the ability to speak without excessive pauses, repetitions, or disruptions. Stuttering and cluttering are the most common fluency disorders, impacting how fluently a child speaks. Fluency is essential for expressing thoughts coherently and confidently and plays a significant role in a child’s overall communication abilities and social interactions.

Typical milestones for fluency development include:

• By age 2: Children may exhibit occasional hesitations or repetitions, such as repeating syllables (“ba-ba-ba”), which is common and usually resolves with age.
• By age 3: Many children still show some repetition or hesitations, but these are typically not frequent or disruptive to their communication.
• By age 4-5: Most children’s speech becomes more fluent, with fewer repetitions and pauses, although some minor disfluencies can still occur.
• By age 6 and older: Fluency should be well-developed, with the ability to speak smoothly and clearly, though occasional disfluencies may still happen, especially during stress or excitement.

Children who experience persistent disfluencies, such as frequent repetitions or prolonged sounds, may have fluency disorders like stuttering or cluttering. Speech-Language Pathologists (SLPs) work with children to improve fluency through targeted strategies and exercises, helping them communicate more effectively and build confidence in their speech.

Augmentative and Alternative Communication (AAC) includes a range of tools and strategies designed to support individuals with challenges in spoken or written communication. This encompasses light-tech options like picture boards and communication books, as well as high-tech devices such as speech-generating devices and specialized apps. AAC is valuable for individuals with conditions like autism spectrum disorder (ASD), cerebral palsy, or severe speech impairments, and can also assist those with speech and language delays in facilitating their language development.

AAC supports a continuum of communication independence:

• Emergent Communicators: Individuals at this stage use non-symbolic communication methods such as facial expressions, body language, gestures, and vocalizations, which may be unique and not easily understood by others. They typically communicate about immediate, tangible topics and may be trialing AAC with inconsistent interactions. The focus for emergent communicators is to enhance their non-symbolic communication, build multimodal communication skills, and introduce symbolic communication methods.
• Context-Dependent Communicators: These individuals have reliable symbolic communication but are limited to specific contexts or communication partners. They may have a restricted vocabulary and can communicate effectively only in familiar settings or with familiar people. The goal for context-dependent communicators is to broaden their vocabulary, expand their range of communication partners, and increase their ability to communicate across various contexts.
• Independent Communicators: Individuals at this stage can communicate effectively and efficiently in any situation, expressing themselves freely on a wide range of topics. They can create novel messages, spell new words, and use multiple communication modes and strategies. The goal for independent communicators is to continue refining their communication skills to meet their personal goals.

At On Track Pediatric Therapy, we facilitate the entire AAC process, from initial trial and funding application to education and training for effective home and community use. We are experienced with various AAC systems, including LAMP WFL, TD Snap, and other language systems, ensuring tailored support for each individual’s needs.

Feeding and swallowing are crucial aspects of daily functioning that impact a child’s health, development, and quality of life. Challenges in these areas can affect a child’s ability to eat, drink, and participate in mealtime activities comfortably and safely. At On Track Pediatric Therapy, we provide comprehensive assessments and interventions to address feeding and swallowing difficulties.

Feeding and swallowing issues may include:

• Difficulty with Oral Motor Skills: Struggles with chewing, biting, or managing different food textures can impact a child’s ability to eat a variety of foods and may lead to nutritional concerns.
• Swallowing Difficulties (Dysphagia): Problems with swallowing can result in choking, coughing, or aspiration (food or liquid entering the airway), which can pose significant health risks.
• Picky Eating or Food Aversion: A reluctance to try new foods or refusal to eat certain textures can affect a child’s nutritional intake and overall health.

Our approach includes:

• Comprehensive Assessment: Evaluating a child’s oral motor skills, swallowing function, and feeding behaviors to identify specific challenges and needs.
• Individualized Therapy: Developing customized therapy plans to address issues such as improving oral motor skills, modifying food textures, and creating strategies to manage swallowing difficulties.
• Family Education and Support: Providing guidance and training for parents and caregivers on feeding techniques, safe swallowing practices, and strategies to encourage a positive mealtime experience.

At On Track Pediatric Therapy, we are dedicated to helping children achieve safe and enjoyable mealtimes. Our team works closely with families to ensure effective interventions and support tailored to each child’s unique needs.