Paediatric speech therapy services

Language can be broken into 2 main parts; receptive language which is what you can understand, and expressive language which is how you use words.

Common symptoms of a language disorder include:

Receptive Language difficulties:

• following instructions 
• comprehension of stories
• understanding of basic concepts (long vs short, in/on/under)

Expressive Language difficulties:

• shorter utterances and sentences
• smaller, less varied vocabulary
• incorrect use  of morphology (eg 'I falled down', 'two mouses')

Early intervention speech therapy is very important for language disorders.  Children are not likely to 'catch up' without dedicated help.

Difficulties learning to read and write can occur by itself, or secondary to a wide range of other conditions.  Pre-literacy skills usually develop in toddler to preschool aged children, while literacy often begins with formal schooling.  Some children will be identified by their prep teacher as having difficulties learning to read or write.  Some children can 'fly under the radar' for a year or two, relying on good memory skills for sight words rather than truly learning to decode words, until this becomes too difficult.

Literacy Approach

The multi-sensory,  synthetic phonics approach used is suitable to be taught both in person and through telehealth.  Pre-literacy skills (or phonological awareness skills), can start at preschool age, literacy therapy (reading, writing, spelling) can be from prep all the way through formal schooling up to grade 12.

Toddlers between 18 months and 3 years of age who are not using as many words as their peers but are otherwise playing and developing typically may be a late talker.  A typical toddler should be using:

18 months

• at least 20 words  

2 years

• at least 50 words
• putting 2 words together
• using nouns and verbs

3 years

• saying at least 200 words
• 3 or 4 word sentences
• using a variety of word types, including nouns, verbs and adjectives

Speech sound disorder is an umbrella term covering many conditions such as an articulation disorder, phonological delay, phonological disorder, and many more.  In essence, all these conditions have something in common - the child knows what word they are trying to say, but the speech sounds are different when the word comes out.  

There is a well- researched hierarchy of when children learn to say a sound correctly. Before this age, it is very common for all children to have these errors. Have you heard a toddler talk about Peter Wabbit? Changing the 'r' to a 'w' is completely normal for preschool kids, but may need therapy if it's still happening after 5 years of age.

Telehealth is a viable option for therapy, depending on the child's age and temperament.  Early intervention speech therapy is recommended as treatment at an early age can be easier for both carers and child, and may resolve quicker.

Childhood apraxia of speech (CAS), is a relatively rare speech sound disorder.  Current research indicates there is difficulty in the planning process between what the brain wants to say and the muscles making the speech movements.

Children with CAS often make inconsistent errors, for example saying the same word in different ways.  Speech can be accompanied by 'groping' of the mouth; as if they are searching for how to say the sounds.  Vowels can also be incorrect, not just consonant sounds.

Specific treatment programs have been developed for CAS, such as Rapid Syllable Transition Training (ReST) which was developed here in Australia at the University of Sydney.  ReST can be successfully delivered face to face or through telehealth.

Lisps are another type of speech sound disorder.  The most common form is where the 's' sound is produced like a 'th' sound, with the tongue sticking out between the teeth.  A lisp can occur on other sounds (such as 'z', 't', 'd', 'n' and 'l').  A lateral lisp is where the tongue is flat instead of curved and produces very 'slushy' sounds.

Research shows that children do not 'grow out of' a lisp.  Treatment can start as young as 3 years.  Simple, fun games to play at home for homework are an important part of therapy to reduce the error as quickly as possible.

 Depending on the age and temperament of the child, telehealth is a successful alternative to face to face therapy where attending our clinic is not possible.