If you’re not aware that your child may be in need of a speech therapist, you are not alone. I remember one of my closest friends revealing that her two sons were in speech therapy, and the emotions underlying that. With her first son, she explained, “I didn’t even know [it was unusual that] he wasn’t speaking because I didn’t have kids and I didn’t have friends with kids.” It was a pediatrician who suggested she get her son evaluated. In talking to Speech Pathologist, Bill Pinajian, who works mostly in pediatric ages two years and up, he reveals, “The way people come to me is via referrals from pediatricians, psychiatrists, and teachers. Most parents grow accustomed to their child’s speech so often someone other than the parent will tell them this is what’s happening.”
This was true of my friend. She was told by the evaluator that at 18 months, her son’s “gibberish was on the level of a six month old,” and she thought, “Jeez, that’s bad.” She wondered if it was because she didn’t talk a lot and if that had anything to do with it. She would see mothers strolling with their kids pointing out trees and other words, and being a quiet person by nature, she didn’t do that. But even when she had her second child, both boys had it. “I didn’t know as a first time mom in a new city without other mom friends if I was supposed to be talking to them all the time.” She adds, “And I was really sad because people always had stories of the cute and funny things kids say…and I didn’t have any of those stories.” She is happy to report that today both of her kids, with a few years of speech therapy under their belts, are doing great.
In exploring more of how Bill works with children he revealed that most of his patients are either not speaking, or their speech is delayed, or they are talking but their speech is unintelligible. He also gets a lot of referrals from dentists or orthodontists: “If kids are doing something incorrectly with their mouths or tongue, such as a tongue thrust or lisping, it’s making their teeth push forward. So they are going to need braces in the future and their teeth are out of alignment.” The dentist wants the speech issues addressed before the braces can come on. Bill then works to keep everything in the mouth in the correct place for speech production.
Children with Delayed Speech
For the child not speaking, Bill explains his method thus: “Like with any language, if you or I would learn a language now, you work with the core vocabulary. With a child who doesn’t have a lot of language, you start with a core vocabulary and work with survival language that they would need with their family. If you work in the right way, it kicks in and the child starts developing and the speech starts to come on spontaneously as the child matures.”
Children with Unintelligible Speech
“The first thing you try to find out is what sounds they are distorting and then you start teaching those sounds. Say if a third grader is not making the ‘r’ sound then you try to work with it to improve their intelligibility. I try to find the sound that they are distorting and then the sound that’s easiest to correct and then you move onto the next sound. It lets them experience success very quickly and some are easier to correct than others. Some kids are unintelligible because they clutter up their speech, they speak way too quickly. You want to teach the child to speak with a more appropriate rate of speech. “
Children who Stutter
“One of the tougher speech issues is stuttering and that happens to be a speech problem that definitely interferes with the child’s development. And that’s not always an easy speech problem to correct. Those techniques used in the movie The King’s Speech are the same ones used today. It was pretty interesting to see that movie.”
Catching the Issues at an Early Age
Bill talks about the importance of helping your children as soon as possible with these issue. “If you don’t work on it, sometimes kids will correct it on their own, but many times it doesn’t happen. And it can interfere with their socially emotional development. If a child has a speech delay or speech problem, their peers can start teasing them and making fun of their speech issues and you run the risk of the child not wanting to talk because their speech is unintelligible or distorted.”
Bill adds, “Sometimes it interferes with their reading skills. If they’re not producing the correct speech sounds it can affect development of phonics skills and reading.” Getting behind on education can just compound the issue and put even more pressure on your child. Bill suggests that the earlier you catch these problems, the better, because children do so much better at an earlier age. However, it’s never too late to correct these issues.
How the Parents and Family are Involved
Once Bill does the assessment, he then talks to the parents. “Part of my practice is the family’s ongoing involvement. The parents sit in on the session so they can go home and practice with the kids. My big thing is I want the parents to know totally and completely what’s wrong and I try to teach them my techniques, as they are a big part of the remediation program. “
For example, “If a child is comes in and is unintelligible and the parents aren’t even bringing the child—the nanny is—then the parent will have no idea what to do at home. I insist that if they can’t come in we talk regularly on the phone or via email so that I can really train the parents and give the information so they can reinforce what we’re doing at home. It’s really a team approach. Often the school will be involved. I’ll let the teacher know what the child is working on and what to look for.” Bill puts emphasis on the team effort: “Parents, siblings and teachers all need to support the child once they leave here.”
Other Professionals
Bill advises that often in conjunction with a speech therapist there may be the need for other professionals. “One of the things parents would want to look for is if their child has an early history of ear infections, because if a child is having lots of problems with their ears it’s going to limit the amount of input they get which will limit their acquisition of speech. A voice disorder is a problem where a child can be extremely hoarse, talking at the wrong pitch, issues with vocal nodules on the chords.” Again, when working on voice disorders, Bill lets us know that you are working with an ear, nose and throat specialist. And in some cases, he continues, “there’s the speech issues that come with socially emotional problems like a child who is selectively mute, a child who is choosing not to talk. Often with a child with that kind of problem you are working with a psychologist or therapist who is working with the family as well.”
Lastly he suggests, “If you’re a parent, look for other people having trouble understanding your child. If all of a sudden you realize that grandparents, cousins, neighbors are having a hard time understanding your child, you might want to have their speech assessed to see if they need help.”
Should you have any concerns with your child, no matter the age, consult with your pediatrician to see if an evaluation is appropriate. Know that this is more common than you think, and treatable.
