What is Speech Therapy?

Speech- language therapy is recommended for children who experience difficulty in understanding language, processing verbal information, expressing themselves, articulating speech sounds, speaking fluently, voicing correctly, interacting/ communicating with others, and/ or feeding and swallowing issues typically. Speech therapists at Noor Zainab work on helping children from birth to 18 years old, to gain abilities to become more effective communicators and improve feeding and swallowing abilities. The speech therapists’ goal is to assist children in learning new skills and becoming independent communicators through a variety of structured and non-structured activities.

Why Speech / Language Therapy?

Communication is an essential component of learning and development that begins in infancy and continues throughout adulthood. A baby’s first cries are their way of communicating basic needs- hunger, pain, boredom, etc, and then quickly develop into coos and squeals to communicate happiness and joy. A typically developing child then learns the importance of using words, gestures, body language, and facial expressions as means to express wants, needs, and feelings. All children need to communicate in some form. Children who are demonstrating difficulty with their communication abilities may not be able to successfully express themselves, gain independence, have good self- esteem, benefit fully in educational learning and development, and build healthy relationships.

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Speech-Language Evaluations

A comprehensive speech-language evaluation will look at the following:
If concerns are noted, we will also evaluate a child’s voice (pitch, rate, and loudness) and fluency (stuttering). Additionally, we may also assess oral motor and/or feeding skills if a child is having difficulty chewing, swallowing, or tolerating different textures.
Our therapists will thoroughly explain the results of the evaluation and make specific recommendations, including individualized goals. Families will also be provided with a report that give the details of the results of the evaluation, including their child’s strengths and weaknesses, and a specific treatment plan (if applicable). Your child may be referred to other specialists for additional assessment or treatment.

Treatment

Noor Zainab Speech-Language Therapists identify areas of need, evaluate, and provide ITP (Individualized Treatment Plans). Our Speech-Language Therapists use a combination of child directed and therapist directed approaches to target a variety of areas, including the following:
  • Speech Sound/ Articulation
  • Expressive & Receptive Language
  • Feeding/ Swallowing/ Oral Motor
  • Social Communication
  • Augmentative and Alternative Communication (AAC)
  • Fluency
  • Voice
  • Auditory and Language Processing
  • Executive Functioning
  • Literacy
  • Articulation and Phonological Disorders
  • Auditory Processing Disorders
  • Autism Spectrum Disorder
  • Childhood Apraxia of Speech
  • Expressive & Receptive Language Disorders
  • Pragmatic/Social Communication Disorders
  • Voice and Resonance Disorders
  • Stuttering and other Fluency Disorders
  • Feeding and other Oral Motor Disorders

Specialized Treatment

Speech- Language Therapists at Noor Zainab have also advanced their areas of training in the following treatment approaches:
  • Training in Childhood Apraxia of Speech (CAS)
  • Kaufman Speech to Language Protocol
  • Sequential Oral Sensory (SOS) Approach to Feeding
  • The Modified Barium Swallow Impairment Profile
  • Video Swallow Studies in Adults and Children
  • Beckman Oral Motor Program
  • Assessment/ Recommendation of Tongue Tie & Tongue Thrust
  • Social Thinking
  • Pragmatic Organization of Dynamic Display (PODD)
  • Picture Exchange Communication System (PECS)

Your child may benefit from speech-language therapy if they have demonstrated:

  • A decreased ability to communicate
  • Limited vocabulary for their age
  • Poor articulation or difficulty in understanding
  • Stuttering or other fluency difficulties
  • Difficulty understanding what is said to them
  • Difficulty following directions
  • Poor verbal or written expression
  • Difficulty in listening in noisy environments
  • Immature sentence structure
  • Frequent use of nonspecific words
  • Poor social skills

Developmental Speech and Language Milestones

The first 3 years of life, when the brain is developing and maturing, is the most intensive period for acquiring speech and language skills. These skills develop best in a world that is rich with sounds, sights, and consistent exposure to the speech and language of others.
These are critical periods for speech and language development in infants and young children when the brain is best able to absorb language. If these critical periods are allowed to pass without exposure to language, it will be more difficult to learn.
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What are the milestones for speech and language development?

The first signs of communication occur when an infant learns that a cry will bring food, comfort, and companionship. Newborns also begin to recognize important sounds in their environment, such as the voice of their mother or primary caretaker. As they grow, babies begin to sort out the speech sounds that compose the words of their language. By 6 months of age, most babies recognize the basic sounds of their native language.
Children vary in their development of speech and language skills. However, they follow a natural progression or timetable for mastering the skills of language. A checklist of milestones for the normal development of speech and language skills in children from birth to 5 years of age is outlined below. These milestones help doctors, speech-language pathologists, and other health professionals determine if a child is on track or if he or she may need extra help. Sometimes a delay may be caused by hearing loss, while other times it may be due to a speech or language disorder.
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Speech and Language Milestones

Birth to 3 Months

  • Reacts to loud sounds
  • Calms down or smiles when spoken to
  • Recognizes your voice and calms down if crying
  • When feeding, starts or stops sucking in response to sound
  • Coos and makes pleasure sounds
  • Has a special way of crying for different needs
  • Smiles when he or she sees you

4 to 6 Months

  • Follows sounds with his or her eyes
  • Responds to changes in the tone of your voice
  • Notices toys that make sounds
  • Pays attention to music
  • Babbles in a speech-like way and uses many different sounds, including sounds that begin with p, b, and m
  • Laughs
  • Babbles when excited or unhappy
  • Makes gurgling sounds when alone or playing with you

7 Months to 1 Year

  • Enjoys playing peek-a-boo and pat-a-cake
  • Turns and looks in the direction of sounds
  • Listens when spoken to
  • Understands words for common items such as “cup,” “shoe,” or “juice”
  • Responds to requests (“Come here”)
  • Babbles using long and short groups of sounds (“tata, upup, bibibi”)
  • Babbles to get and keep attention
  • Communicates using gestures such as waving or holding up arms
  • Imitates different speech sounds
  • Has one or two words (“Hi,” “dog,” “Dada,” or “Mama”) by first birthday

1 to 2 Years

  • Knows a few parts of the body and can point to them when asked
  • Follows simple commands (“Roll the ball”) and understands simple questions (“Where’s your shoe?”)
  • Enjoys simple stories, songs, and rhymes
  • Points to pictures, when named, in books
  • Acquires new words on a regular basis
  • Uses some one- or two-word questions (“Where kitty?” or “Go bye-bye?”)
  • Puts two words together (“More cookie”)
  • Uses many different consonant sounds at the beginning of words

2 to 3 Years

  • Has a word for almost everything
  • Uses two- or three-word phrases to talk about and ask for things
  • Uses k, g, f, t, d, and n sounds
  • Speaks in a way that is understood by family members and friends
  • Names objects to ask for them or to direct attention to them

3 to 4 Years

  • Hears you when you call from another room
  • Hears the television or radio at the same sound level as other family members
  • Answers simple “Who?” “What?” “Where?” and “Why?” questions
  • Talks about activities at daycare, preschool, or friends’ homes
  • Uses sentences with four or more words
  • Speaks easily without having to repeat syllables or words

4 to 5 Years

  • Pays attention to a short story and answers simple questions about it
  • Hears and understands most of what is said at home and in school
  • Uses sentences that give many details
  • Tells stories that stay on topic
  • Communicates easily with other children and adults
  • Says most sounds correctly except for a few (l, s, r, v, z, ch, sh, and th)
  • Uses rhyming words
  • Names some letters and numbers
  • Uses adult grammar

Birth to 2 Years:

  • When a parent is concerned about speech or language development
  • If the child is not talking at all by age 18 months
  • If there are medical or developmental concerns that may affect speech
  • If the child is embarrassed by his/her speech at any age
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At Age 2 if:

  • The child has a hearing impairment and/or does not respond to quiet sounds or voices
  • The child has a cleft palate or excessive nasal quality in voice
  • The child does not begin combining words by age 2 (e.g. “more milk”)
  • The child exhibits limited vocabulary development (e.g. uses less than 50 words)

At Age 3 if:

  • The child is nonfluent or thought to stutter for longer than six months
  • There is an absence of sentence structure
  • Speech is difficult for family to understand
  • There are many omissions of beginning and ending consonants
  • Speech is limited to echoing of other’s statements, songs, rhymes, etc.

At Age 4 if:

  • Word endings (e.g. “ed” or “ing”) are consistently dropped or used inconsistently
  • Communication skills are inadequate for interaction in school environment
  • The child has difficulty answering “wh” questions
  • The child is not demonstrating correct word order for basic sentences

At Age 5 if:

  • The child is noticeably dysfluent, or parents express concern
  • Hoarse, harsh or unusual voice quality
  • Mispronounces any sounds