Frequently Asked Questions

If you are unsure if your child needs Speech Pathology, it is best to seek professional advice.  The team at Barwon Speech Pathology will be able to discuss typical communication patterns, assess your child’s communication and discuss your concerns with you.  The following is a general guide. Please contact us to discuss this in more detail.

A child’s speech should be intelligible (easily understood) to unfamiliar listeners:

• At 1 year, 25% of the time,
• At 2 years, 50% of the time,
• At 3 years, 75% of the time,
• At 4 years, 100% of the time.

An assessment by a Speech Pathologist is recommended if:

• by 12 months the child is not using simple gestures (e.g. waving goodbye), pointing, eye contact and attempting to communicate.
• by 12-15 months the child is not babbling.
• by 18 months the child is not using single words, or if the child cannot follow simple instructions.
• by 2 years the child is not using short phrases or is saying less than 50 words.
• by 3 years the child is not using sentences.
• by 4-5 years the child cannot tell a simple story.
• the child has difficulty relating to peers, poor social skills, or a suspected diagnosis of autism spectrum disorder
• the child has a history of recurrent middle ear infections and/or hearing loss
• a school-aged child is experiencing difficulties with literacy, comprehension, or expressing their thoughts

Parents can become worried that their child is not speaking, or that they are screaming and becoming frustrated. Firstly, it is worth having your child’s hearing tested and you could discuss this with your GP.  Your child’s communication skills can be assessed by a speech pathologist who can provide suggestions and advice for things you can do at home to encourage development of your child’s speech and language skills.

There is no magic age. If you are concerned with your child’s speech then seek out assistance from a Speech Pathologist. Research shows that the best intervention is early intervention.  It is best to act early before delay to communication affects social and emotional development.

You may see some or all of these signs that your child needs therapy:

• You have trouble understanding your child’s words more than once per day
• Other people have trouble understanding what your child is trying to say
• Your child is becoming frustrated
• Your child uses ‘his own language’ with babble and signs, when old enough to use words
• There seems to be a big gap between what your child can understand, and what he is able to say, or say clearly.

 ‘Autism Spectrum Disorder’ (ASD) is a lifelong condition that affects the way a person makes sense of, and interacts with, other people and their environment.  Many children with ASD have delayed onset of speech and atypical social interaction. To receive a diagnosis of ASD a child must receive a multidisciplinary assessment but therapy can start before a child receives a diagnosis.

Please click  here to read the detailed factsheet from Speech Pathology Australia.

Social skills are how communicate and interact with other people.  They include verbal and non-verbal communication, such as speech, gesture, facial expression and body language.

A person has strong social skills if they have the knowledge and skills of how to behave in social situations and understand the ‘hidden rules’ when communicating with others.

Some children who have challenges with social skills may have a diagnosis of Autism Spectrum Disorder (ASD) or Asperger’s.

Social skills are vital to enable an individual to develop and maintain positive interactions with peers.  These skills are crucial in making and sustaining friendships.  Social skills are needed to successfully share a space with other people, know how to cooperatively play or work with others, deal with conflict and help find resolutions and understand what another person may thinking and feeling.

If a child has difficulties with social skills they might:

• Play on their own and not know how to successfully join in with others.
• Insist on playing games their way and find it difficult to take on other’s ideas
• Use fleeting eye contact, does not consistently use eye contact or stares at you fixedly.
• Lack imagination in play and conversation.
• Be unable to start and end conversations appropriately.
• Not be able to take turns when talking to their communication partner.
• Talk ‘at you’ in a conversation as opposed to engaging in a two way conversation ‘with’ you.
• Enjoys talking about a favourite topic frequently and may not know when or how to change the topic.
• Struggle with using appropriate body language (e.g. stands too close/far to another person).
• Difficulty saying hello and goodbye to someone
• Interrupt others frequently.
• Be unable to maintain a topic of conversation and provides irrelevant comments during a conversation.
• Show little or no interest in what the other person has to say.
• Is very literal in their interpretation of language.  Eg.  Jump into the shower and they actually ‘jump’ into the shower
• Talk with unusual rhythm, intonation, pitch and tone of voice.  May seem as though they have an accent.
• Unable to read body language, facial expressions or tone of voice of others.
• Appear unaware of others and fail to read other people’s feelings based on their verbal and non-verbal cues.
• Be unable to adjust or modify their language appropriately according to the communication situation.
• Lack empathy (i.e. is not able to imagine what it is like to be somebody else or in their situation).
• Appear self-centered.

The Social Thinking program is an excellent approach to target social skills in children. Please see www.socialthinking.com/LandingPages/Mission

Childhood Apraxia of Speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.

Not all children with CAS are the same.  All of the signs and symptoms listed below may not be present in every child. It is important to have your child evaluated by a Speech Pathologist (SP) who has knowledge of CAS to rule out other causes of speech problems. General things to look for include the following:

A Very Young Child

• Does not coo or babble as an infant
• First words are late, and they may be missing sounds
• Only a few different consonant and vowel sounds
• Problems combining sounds; may show long pauses between sounds
• Simplifies words by replacing difficult sounds with easier ones or by deleting difficult sounds (although all children do this, the child with apraxia of speech does so more often)
• May have problems eating

An Older Child

• Makes inconsistent sound errors that are not the result of immaturity
• Can understand language much better than he or she can talk
• Has difficulty imitating speech, but imitated speech is more clear than spontaneous speech
• May appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
• Has more difficulty saying longer words or phrases clearly than shorter ones
• Appears to have more difficulty when he or she is anxious
• Is hard to understand, especially for an unfamiliar listener
• Sounds choppy, monotonous, or stresses the wrong syllable or word

PROMPT therapy uses touch cues on speech articulation muscles (jaw, tongue, lips) to manually guide through a targeted word, phrase or sentence, while eliminating unnecessary muscle movements such as jaw sliding and inadequate lip rounding.

Traditional speech therapy relies on the child being able to copy clear speech said by adults or other children. PROMPT therapy shows the child how to say the sounds and words.

PROMPT therapy is highly recommended for Dyspraxia, but also for any muscle or coordination difficulty in the facial muscles, including speech sound delays and children who are slow to talk.