Speech Language Therapy FAQs

1. What is speech & language therapy?
2. Who needs speech & language therapy?
3. What is a speech therapist or speech pathologist? What do they do?
4. Do I need a doctor's referral to see a speech therapist?
5. Why does a child have speech and language difficulty?
6. Can my child outgrow his speech & language difficulties?
7. What can I expect at the initial speech & language therapy consultation?
8. How long does my child have to attend for speech & language therapy?
9. Are the sessions conducted in a one-to-one setting?
10. When will I know my child can stop speech & language therapy?

1. What is speech & language therapy?

There are many definitions for "speech therapy" available on the Internet. In general, speech therapy is the diagnosis and treatment of children or adults with communication and/or swallowing difficulty. Speech therapy also includes treatment of speech difficulties such as lisp and stuttering / stammering.

Speech and language disorders in individuals can be due to developmental delay, congenital anomalies, medical conditions and brain injury etc.

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2. Who needs speech & language therapy?

Anyone (child or adult) who has a communication disability or difficulty will benefit from professional help from a speech therapist.

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3. What is a speech therapist or pathologist? What do they do?

"A speech pathologist (therapist) assesses and treats people who have a communication disability. Speech pathologists (therapists) work with all aspects of communication including speech, writing, reading, signs, symbols and gestures. They also work with people who have difficulties swallowing food and drink." - Speech Pathology Australia

A speech therapist also has a particular interest in preventing any problems and educating the public about normal speech and language development.

Speech therapists (or speech pathologists) may also be known as speech and language therapists (or speech language pathologists). This is to help the general public to be more aware of their role in working with other aspects of communication and not just speech or articulation problems.

There should be no stigma attached to speech & language therapy as many otherwise healthy and intelligent children do see a speech therapist and enjoy the therapy sessions.

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4. Do I need a doctor's referral to see a speech therapist?

This varies from country to country. In some areas, a referral directly from a parent is acceptable. Most General Practitioners (GPs) or Family Physicians will refer your child to see a speech therapist if they suspect your child has communication difficulties.

In Singapore, a doctor's referral is usually not necessary to see a speech therapist in private practice. However, in public health sector you may need to see a doctor first for them to refer you to a speech therapist in a public hospital.

Your speech therapist may refer your child to other professionals such as medical doctors or specialists if necessary after seeing your child.

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5. Why does a child have speech and language difficulty?

Your child's speech and language difficulties may be due to any of the following:

- Speech / Verbal Dyspraxia, Articulation or Phonological difficulties.
- Autism: Autistic Spectrum Disorder (ASD), Pervasive Developmental Disorder (PDD).
- Auditory Processing Disorder (APD).
- Dyslexia.
- Specific Language Impairment (SLI).
- Learning Disability (LD).
- Speech and/or Language Delay.
- Stuttering / Stammering in Speech.
- and others.

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6. Can my child outgrow his speech & language difficulties?

If a child has speech or language difficulties, he may not 'grow out of it'. Without speech & language therapy, his speech or language could fall further behind his peers as he grows older.

If you have any doubts or concerns, it is best to seek professional advice from a speech therapist (pathologist).

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7. What can I expect at the initial speech & language therapy consultation?

The first visit is typically an formal assessment to find out your child's problem and details of your child's development. The speech therapist will spend quite a lot of time talking to you and understand from the parents' perspective what are the child's communication difficulty.

The speech therapist will also chat and play with your child and likely to perform some formal assessment. Most children will enjoy the session and not realized that they are being assessed.

The speech therapist will then share her observations and make her recommendations if your child requires therapy. This will include frequency of therapy and advice on activities to carry out between appointments.

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8. How long does my child have to attend for speech and language therapy?

You can ask your speech therapist to give you an estimate of how long treatment will take. After a few sessions, ask her how your child is progressing.

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9. Are the sessions conducted in a one-to-one setting?

Speech and language therapy sessions can be conducted in a one-to-one setting or in a group. Sometimes the therapist may recommend group sessions for your child. This does not mean that your child is getting less therapy. S/he may respond better in a more natural communication environment that a group setting provides.

You may ask the speech therapist to explain the reasons for recommending either individual or group sessions for your child.

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10. When will I know my child can stop speech & language therapy?

Again, you should check with your speech therapist as she is probably the best person to know how well your child has progressed so far.

This is especially true if you child has seen the therapist for some time. As you have invested time and effort, it is always in your best interest to discuss any changes in the therapy schedule with your therapist. She should be happy to discuss your needs.

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Speech Language Therapy Glossary

The following is a list of common terms you may encounter when you speak to your speech language therapist or pathologist.

Such words include, for example: learning difficulties, auditory processing difficulties / disorders, Auditory Processing Disorder (APD), Dyslexia, Specfic Language Impairment (SLI), mumbling or unclear speech, speech delay, stuttering, lisp etc.

We will continue to expand the list over time so please refer to this list when you need.

Articulation The way speech sounds are produced. Children who mis-articulate sounds usually have difficulties saying sounds such as 's', 'l', 'g', 'k' correctly in words. Articulation problems can be caused by poor listening ability, developmental delay, dental problems, or poor control of the lips and tongue.

Attention The ability to focus on things that you see or hear.

Attention Deficit-Hyperactivity Disorder (ADHD) Individuals diagnosed with ADHD tend to be easily distracted, do not seem to think before doing something, and are almost constantly active.

Audiological Test A test for how well you can hear.

Auditory Memory The ability to remember things you have heard, both short-term and long-term.

Auditory Processing How our brains work to understand and remember information we hear: paying attention to a sound in the presence of background noise, auditory memory, auditory discrimination between different sounds, sequencing the order of what we hear, forming a concept or image or idea.

Autism or Autism Spectrum Disorder (ASD) This is a developmental disability that hinders a person's ability to communicate and develop social relationships. People with Autism or ASD may have severe communication and behaviour problems. Autistic individuals are characterised by impairment in communication skills, poor social skills and repetitive stereotyped behaviour.

Auditory Processing Disorder (APD) APD is used to describe individuals with normal hearing who have auditory-based receptive communication or language learning problems. According to the American Speech and Hearing Association (ASHA) panel, APD can result from a "dysfunction of processes dedicated to audition" while other factors include a general dysfunction that affects performance across modalities (e.g., attention deficit disorder).

Cluttering Cluttering is a relatively little known fluency disorder characterised by excessive breaks in the normal flow of speech that seem to result from disorganised speech planning, talking too fast or in spurts, or simply being unsure of what one wants to say. It is often accompanied by other symptoms such as language or phonological errors and attention deficits.

Cognitive Ability Generally used as an umbrella term to include the overall mental ability for different thinking processes that the brain is capable of.

Consonant Any letter of the alphabet other than the vowels A, E, I, O, or U.

Consonant Blend 2 or more consonants that appear together in a word but keep their individual sounds e.g. the "bl" in "black". In general, consonant blends are more difficult to articulate and children may leave out one of the sounds. For example, children may leave out the 's' sound when they say 'school'.

Delayed language development This describes a child whose level of talking and understanding would be more appropriate to a younger child. Sometimes a child can understand at an appropriate level for his age but his sentence structure and vocabulary are delayed.

Delayed speech development This describes a child whose use of speech sounds would be more appropriate to a younger child. For example, a four-year-old who still says 'tat' for 'cat' would have delayed speech (or phonology). Children with delayed language development will often have delayed speech as well because language and speech normally develop alongside each other.

Developmental Disability A slowdown in learning and thinking abilities that affect a child's physical or mental progress in learning new skills or other forms of development.

Discrimination The ability to tell the difference between different sounds or visual symbols.

Dyslexia A specific difficulty in understanding visual symbols for reading. It is different from other factors that may contribute to reading difficulties such as attention deficit disorder, and/or speech and language difficulties.

Elective mute A child who can talk well but has decided not to communicate either all the time or in set situations, such as at school.

Expressive Language The ability to express ideas in communication either verbally through speech, through writing, or through other means such as sign language or using assistive communication devices.

Generalize To learn one skill and be able to apply it to various different situations.

Glue ear (secretory otitis media) Fluid in the middle ear which causes a temporary hearing loss. This is sometimes treated with

Grommets which are surgically implanted in the ear to create an even pressure between the different sections of the ear.

Hearing Disability Hearing impairment due to problems with the ear, the nerves, or the brain, which affect how sound is processed.

Impulsivity Reacting without thinking, and not being able to adjust behaviour from past experiences or lessons. If this is persistent, it might be due to conditions such as ADHD (Attention deficit-hyperactivity disorder).

Language The understanding and usage of symbols with the correct rules in order to communicate. When symbols used are written alphabets and words, we are using written language, as in writing and reading. When symbols used are the speech sounds for a particular language such as English, we are using verbal language for speaking and listening. The rules for the use of the symbols or words in a language form the grammar.

Language processing Receiving and understanding verbal symbols in reading or listening.

Lisp A form of speech difficulty where the person has difficulty in pronouncing 's' and 'z' sounds, which may sound like 'th' to a listener. A certified Speech Therapist / Pathologist can help an individual to correct a Lisp through speech therapy.

Phonics A method of teaching beginners to read by recognizing the sounds of different letters or groups of letters i.e. learning to read parts of words, rather than memorizing the sounds of entire words visually by sight.

Pragmatics The social aspect of language; using language for certain functions such as making requests or indicating refusal. Good understanding and use of pragmatics are essential for good social skills.

Receptive Language The ability to receive ideas in communication and understand what someone means either verbally through speech, through writing, or through other means such as sign language, Braille, or using assistive communication devices.

Rhyme Words with the same vowels and sound similar at the end, e.g. "wild" and "child". They may not be spelt with the same letters e.g. 'bee' and 'sea'.

Sequencing Remembering the order of sounds, words or events. Some examples of sequencing problems are: seeing "13" but writing "31", mixing up letters when spelling words, not being able to answer questions about simple series e.g. "What day comes before Thursday?", or not being able to do something step by step in the right order e.g. applying glue behind a picture, turning over the picture and then pasting it onto paper.

Specific Language Impairment (SLI) Specific Language Impairment (SLI) is a developmental language disorder that can affect both expressive and receptive language. SLI is an impairment that is not related to or caused by other developmental disorders, Autistic Spectrum Disorder (ASD), hearing loss or brain injury. Research in the past decade showed that as many as 1 in 7 children in kindergarten can have Specific Language Impairment.

Speech Delay Refers to a delay in the use of body mechanism to produce sound. There are three broad causes of speech delay: problems with input of speech (difficulty in hearing), problems with processing speech (difficulty in working with what is heard) and problems with output of speech (difficulty due to physiological constraints).

Stuttering (stammering) Speech that is choppy due to hesitation, repeated sounds, or unnecessary blocks when speaking. Young children who have hesitant speech, repeating sounds and words in a fairly easy manner are not usually called stammerers. They are described as non-fluent and have a good chance of growing out of this phase. However, a very small percentage do go on to be teenage and adult stammerers. These people are very aware of their problem, their communication skills are affected and in some cases there is an effect on personality. There is no known cause for stammering, although there are many theories. Many people believe it is a disorder you are born with and there is a hereditary factor.

Tongue-tie The frenum of the tongue (the bit that joins the tongue to the bottom of the mouth) is very short and impedes tongue movement. Contrary to popular belief, this rarely affects speech, but when it does, there will probably be an associated difficulty with feeding.

Vocal cord nodules These will cause voice problems and may be the result of recurrent laryngitis or misuse of the voice. They can be cured with voice rest. Surgery is sometimes needed.

Vocal Disorder Problems in voice production: poor quality (hoarse or nasal), pitch (too high or low pitched), or intensity (loudness). Hoarse voices, very nasal or breathy voices or a delay in a boy's voice breaking may all be problems looked at by a speech and language therapist. These children will already have been seen by the ear, nose and throat (ENT) specialist and may be treated in that department. The speech and language therapist is particularly interested in children who don't use their voices properly (perhaps they force their voice when they sing or shout) and children who need therapy following surgery.

Vowel The letters A, E, I, O, and U.

Our Contributor

Ms. Magan Chen trained in London, U.K. (M. Sc.) and Sydney, Australia (B. App. Sc. in Speech Pathology) and has more than 29 years of speech and language therapy experience. She has helped more than 1500 individuals to overcome their communication or learning difficulties.

Magan is a registered Speech Therapist with the Allied Health Professions Council (AHPC) in Singapore and a Certified Practising Speech Language Pathologist (CPSP) with the Speech Pathology Australia.

Together with a few speech therapists, she helped found the Speech Language and Hearing Association Singapore (SHAS) (thanks for the privilege, Helen, Praema, Poh Sim and company!) and served as its first President.

Magan is currently practising at Leo Magan Speech Sanctuary in Singapore. If you would like to see a highly experienced speech language therapist / pathologist for an initial consultation, please call us at (65) 6386-7532. Alternatively, please use the feedback form on our Contact Us page.

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