Articulation and Phonology

Speech sound disorders are communication disorders in which children have difficulty saying words or sounds correctly. This can be a typical pattern as children are learning new words, but a child that produces these sounds in error past an expected age may have a speech sound disorder. 
Articulation describes how we produce certain sounds in our mouths as we produce words. A disorder in the area of articulation will typically involve a substitution, like /w/ for /r/ as in "wabbit" for "rabbit" , or distortions, such as a tongue thrust or a lisp.

Phonology describes how we use sounds as a pattern in connected speech. A disorder in the area of phonology will involve a display of errors in a consistent pattern of sound substitutions and omissions. For example, children with a phonological pattern of "fronting" will produce sounds made with the back of the tongue, like /k/ and /g/, with the front of the mouth, turning those to /t/ and /d/ sounds. So the /k/ in "key" becomes a /t/, turning the word to "tea," and a /g/ in the word "go" becomes a /d/, turning the word to "doe." The more phonological patterns produced by a child, the more difficult they are to understand. If a child cannot be understood by strangers at least 75% of the time by the age of 3, a speech assessment is recommended. ​

Expressive & Receptive Language

The development of language skills begins at birth and continues for many years, but the most important years for this development is between birth and five years of age. This is the time where children begin to understand what is being said to/asked of them, and as they grow and this skill develops, children are able to put their feelings and thoughts into words to communicate. If a child is struggling with the ability to understand or communicate, they may have a language disorder/delay. These can be broken down into two types:

Expressive Language: The ability to express thoughts and feelings to effectively communicate with others. 

Receptive Language: The ability to understand spoken language. 
Signs and symptoms of a language disorder:​
  • Child does not respond to their name
  • Delayed onset of words
  • Unable to follow simple commands
  • Struggles to identify or label objects
  • Difficulty answering questions
  • Difficulty in social settings or playing with others

Early Intervention

Early Intervention is therapy that focuses on new and developing skills that occur in children under the age of three. Babies and toddlers have many skills to learn in the first few years of life, so it is always a concern when development seems slower than expected or delays in a particular area are observed. 
Signs and symptoms of speech/language delays in children under three: 
  • Delayed onset of babbling or first words 
  • Not pairing words together by age 2
  • Not using gestures like waving and pointing
  • Saying fewer than 5o words by age 2
  • Does not understand what others say
  • Does not respond to their name

Medical & Sensory Feeding

  While feeding may seem like a simple task, it can be one of the most complex tasks an infant completes, and can take up to three years for full development of oral motor patterns required for chewing/swallowing. If a child shows signs of difficulty during this time, they may require assistance to develop correct oral motor patterns. In children with medical issues or those that struggle with sensory aspects of food, this process may become even more challenging over time. 
Pediatric feeding disorders (PFDs) are defined as impaired oral intake that is not appropriate for age and impacts a child in at least one of four domains: medical, psychosocial, nutrition, and/or feeding skill. PFDs affect more than 1 in 37 children children under the age of 5 in the United States. ​
Signs and symptoms of a PFD in infants & children
  •  ​Cries during feeding​
  • Inability to latch during feeding
  • Insufficient latch 
  • Takes a long time to complete a meal​​
  • ​Refuses to eat
  • Eats fewer than 20 foods
  • Used to eat foods that they now refuse
  • Falls asleep during feeding​
  • Gags/coughs/chokes during meals
  • Losing or inability to gain weight
  • Difficulty breathing during feeding​
  • Impaired chewing or swallowing
  • Anxious to try new foods​​

Orofacial Myofunctional Disorders

Orofacial Myofunctional Disorders​ (OMDs) refer to abnormal resting posture of the lips and tongue, atypical chewing and swallowing patterns, blocked airways, and speech sound production disorders. You will often see this referred to as a "tongue thrust," as the tongue protrudes out of the mouth or against the back of the teeth when swallowing or talking. 
Signs and symptoms of an OMD:
  • Open mouth resting posture​
  • Mouth breathing
  • Messy eating or feeding difficulty
  • Restless sleep
  • Tongue sits low and forward in the mouth​​
  • Dental malocclusions (overbite, underbite, etc.) 
  • Limited tongue movement
  • Drooling
  • Difficulty with speech sounds (i.e. /sh/ in "shy," /s/ in "sit," or /j/ in "jeep."