There are two specialties that are experiencing rapid growth in the field of speech pathology, geriatrics and pediatrics. One of the reasons speech therapy for children is experiencing such rapid growth is because of the Individuals with Disabilities Education Act passed in 2004. This is a federal law that guarantees services to all children with disabilities who are eligible. The eligibility process requires an evaluation of the child by the appropriate authority. When a speech delay or impediment is a possibility, that authority is a speech therapist. With older children, a school official will typically be the one to initiate the evaluation process. But what about toddlers and children who are not yet in school? Usually, a pediatrician will notice something abnormal and write a prescription for an evaluation or the parent will request a screening because of concerns.
Evaluations will vary by state, but in general, the same types of things will happen. During the evaluation, the therapist will get on the child’s level and bring out toys or games. Then, using the toys to engage the child, he or she will begin asking questions and playing with the child in order to evaluate the child’s ability to communicate. Often, a child who is in for evaluation will not be able to fully communicate, and so the therapist may ask the parent or guardian for feedback about the child’s behavior and abilities as demonstrated in the home.
Some of the specific skills the therapist will look for include:
- Receptive language – what the child understands
- Expressive language – what the child can say
- Alternative communication – the ability of the child to communicate in a nonverbal way such as with gestures, pointing, and head movement
- Clarity of speech and the ability to make sounds
- Oral-motor skills – the ability of the child to control mouth and tongue movement for speech as well as eating or swallowing
Speech or Language Delay
One of the most common reasons for a toddler to begin speech therapy is a speech or language delay. Speech is the ability to verbally express language which includes the ability to form words. Language is the ability to retrieve and express information in a way that is meaningful through nonverbal, verbal, or written communication. These two delays will often overlap, although not always. Because of how closely the two are related, therapy for both may be similar.
During therapy sessions the speech pathologist will play with the child for a half hour to an hour in a way that will encourage communication – for example, repeating a phrase as they do the action, such as throw the ball up. Then the therapist may drop a word in the phrase and have the child fill it in before completing the action, dropping more words until the child is able to say the entire sentence independently.
Working with toddlers with speech or language delays is very rewarding. You are able to watch as a child transforms from a frustrated toddler who is unable to express his needs and wishes to a happy little chatterbox. Do you work with toddlers? What is your favorite part of the job?