FAQ Speech-Language Pathology

Speech-Language Pathology – Frequently Asked Questions

FAQ Speech-Language Pathology

 What is a Speech-Language Pathologist? 

Speech-Language Pathologists diagnose and provide treatment for children and adults with a variety of speech-language, communication, cognitive and feeding-swallowing issues.


What kinds of speech and language disorders affect children?

Speech and language disorders can affect the way children talk, understand, analyze or process information.  Speech disorders include the clarity, voice quality and fluency of a child’s spoken words.  Language disorders include a child’s ability to hold meaningful conversations, understand others, problem solve, read and comprehend and express thoughts through spoken or written words.


At what age should I seek out help for my child? 

While there are developmental standards, every child will grow their skills at a different pace.  If you are concerned whether your child is functioning at a level consistent with their peers, it is recommended you seek a speech-language evaluation.

The early months of your baby’s life are a critical period during which the development of strong social and communication skills, emotional growth and intelligence takes place.  These skills serve as the foundation for which all other learning will be built upon as they grow older.  For this reason, early intervention is of utmost importance.


What are the warning signs of a communication disorder in my young child?

Below are some common developmental warning signs separated by age range.  Please note: this list is simply a general guideline and should not be construed as a comprehensive list.

 Birth to Six Months

  • Developmental or medical problems

  • Lack of response to sound

  • Lack of interest in speech

  • Limited eye contact

  • Feeding problems

  • Lack of any vocalizations

  • Difficulties with attachment

  • Lack of interest in socializing

 Six to Twelve Months

  • Limited sound production, lack of variety or amount.

  • Groping or awkward movements when attempting to make or imitate sounds.

  • Oral-motor problems such as excessive drooling, trouble with solid foods, intolerance to touch in and around the mouth.

  • Lack of interest in sound-making toys, radios, TV, music, voices, etc.

  • Developmental or medical problems

  • Lack of response to sound

  • Lack of interest in speech

  • Limited eye contact

  • Feeding problems

  • Very limited vocalizations

  • Difficulties with attachment

  • Lack of interest in socializing

Twelve to Eighteen Months

  • Easily distracted

  • Does not understand any words or directions

  • Limited sound production, lack of variety or amount

  • Groping/awkward movements when attempting to make or imitate sounds

  • Oral-motor problems such as excessive drooling, trouble with solid foods, intolerance to touch in and around the mouth

  • Lack of interest in sound-making toys, radios, TV, music, voices, etc

Eighteen to Twenty-four Months

  • Communication without words at times

  • No interest in imitation

  • Will not play games

  • No jargon

  • Grunting and pointing as primary means of communication

  • Easily distracted

  • Does not understand any words or directions

  • Limited sound production, lack of variety or amount

  • Groping movements when attempting to make or imitate sounds

  • Oral-motor problems such as excessive drooling, trouble with solid foods, intolerance to touch in and around the mouth

  • Lack of interest in sounds-making toys, radios, TV, music, voices, etc.

Two to Three Year Old

  • Not combining words

  • Must be told and retold to carry out simple directions (outside of non-compliance)

  • Using only nouns

  • Poor eye contact

  • No rapid increase in number of words understood and used

  • Does not tolerate sitting for listening activity/looking at books, etc.

Three to Four Year Old

  • Not speaking in full sentences

  • Not using “I” to refer to self

  • Cannot relate experiences, even in simple telegraph sentences


What is a receptive language disorder?

Receptive language includes the skills involved in understanding language. Receptive language disorders are difficulties in the ability to attend to, process, comprehend and/or retain spoken language. 

Is my child showing signs of a receptive language disorder?

Some early signs and symptoms of a receptive language disorder include:

  • Difficulty following directions

  • Repeating back words or phrases either immediately or at a later time (known as “echolalia”)

  • Difficulty answering questions appropriately

  • Use of jargon while talking

  • Difficulty attending to spoken language

  • Inappropriate and/or off topic responses to questions


What is an expressive language disorder? 

Expressive language includes the verbal skills required in order to communicate one’s thoughts and feelings to others.  An expressive language disorder can be characterized as difficulty with verbal expression. 

 Is my child showing signs of an expressive language disorder?

Some signs and symptoms of an expressive language disorder include:

  • Omitting word endings, difficulty acquiring forms such as plurals, past tense verbs, complex verb forms or other grammar forms

  • Limited vocabulary

  • Repetition of words or syllables

  • Difficulty understanding words that describe position, time, quality or quantity

  • Word retrieval difficulties

  • Substituting one word for another or misnaming items

  • Relying on non-verbal or limited means of communicating


 Is my child showing signs of Autism?

 Signs of autism may begin to be detected as early as 12 months of age. Symptoms of autism can occur in isolation or in combination with other conditions. The National Autistic Society has compiled some early indicators of autism spectrum disorder which include:

  • Delayed development of the ability to draw the attention of parents and others to objects and events

  • Little or no use of pointing to encourage another person to look at what (s)he sees (i.e., “joint attention”)

  • Little or no attempt to gain attention by bringing or showing toys/objects to others

  • Little or no eye contact

  • Participates in repetitive patterns of activities

  • Aloofness and indifference to other people

  • Lack of understanding that language is a tool for conveying information.

  • Tendency to select for enjoyment trivial aspects of things in the environment (e.g., attending to a wheel on a toy car and not the whole car for imaginative play)

  • Odd responses to sensory stimuli, such as hypersensitivity to sound, fascination with visual stimuli, dislike of gentle touch but enjoyment of firm pressure

  • Uses senses of taste and smell rather than hearing and vision

  • Poor coordination including clumsiness, odd gait and posture

  • Over or under activity

  • Abnormalities of mood, such as excitement and misery

  • Abnormalities of eating, drinking, and sleeping

More Signs of Autism Spectrum Disorder:

  • Flicking fingers, objects, pieces of string, etc.

  • Watching things that spin

  • Tapping and scratching on surfaces

  • Inspecting, walking along and tracing lines and angles

  • Feeling special textures

  • Rocking, especially standing up and jumping from back foot to front foot

  • Tapping, scratching or otherwise manipulating parts of the body

  • Repetitive head banging or self injury

  • Teeth grinding

  • Repetitive grunting, screaming or other noises

  • Arranging objects in a line

  • Intense attachment to particular objects for no apparent reason

  • A fascination with regular repeated patterns of objects, sounds


What is a Social Pragmatic Language Disorder?

Children with social pragmatic difficulties demonstrate deficits in social and/or cognitive functioning. Diagnostic terms include: Asperger Syndrome, hyperlexia, High Functioning Autism, Semantic-Pragmatic Disorder, Pervasive Developmental Disorders NOS and Non-Verbal Learning Disabilities. 

Is my child showing signs of a Social Pragmatic Language Disorder? 

Persons with social-pragmatic deficits have significant difficulties in their ability to effectively communicate and problem solve. Some signs and symptoms may include:

  • Difficulties with personal problem solving

  • Literal/concrete understanding of language

  • Difficulty engaging in conversational exchange

  • Difficulty with active listening, including participating through observation of the context and making logical connections

  • Aggressive language

  • Decreased interest in other children

  • Difficulty with abstract and inferential language

  • Lack of eye contact

  • Difficulty interpreting nonverbal language

  • Difficulty with adequately expressing feelings


Is my child’s “Stuttering” normal? 

Non-fluent speech is typical between the ages of two and six years.  It is typical for non-fluent speech to last up to six months, improve and then return. Any child who is demonstrating any “struggle behaviors” (e.g., facial/bodily tension, breathing disruptions, blocks, grimacing) should be referred to a speech-language pathologist. 

What is an Articulation Disorder? 

Articulation is the production of speech sounds.  An articulation disorder occurs when a child does not make speech sounds correctly due to incorrect placement or movement of the lips, tongue, velum and/or pharynx. It is important to recognize that there are differences in the age at which children produce specific speech sounds in all words and phrases. Mastering specific speech sounds may take place over the course of several years. 

What is a Phonological Disorder? 

Phonology refers to the speech sound system of language.  A phonological disorder occurs when a child is not using speech-sound patterns appropriately.  A child whose sound structures vary from the speech typical for their stage of development, or who produce unusual simplifications of sound combinations, may be demonstrating a phonological disorder. 

What are some signs of an Articulation/Phonological Disorder in my child? 

Signs of a possible articulation/phonological disorder in a preschool child may include:

  • Drooling, feeding concerns

  • Omits medial (chronic ear infections)

  • May be difficult to understand

  • Little use of continuing consonants such as /w, s, n, f/

  • Limited variety of speech sounds

  • Omits initial consonants

  • Asymmetrical tongue or jaw movement

  • Tongue protruding between or beyond teeth for many sounds

Signs of an articulation/phonological disorder in a school age child may include:

  • Omissions/substitutions of speech sounds

  • Difficulty with consonant blends

  • Frontal and/or lateral lisps

  • Difficulty producing consonant /s, r, l, th/.


What tips can I use or activities can I do to support my child’s communication at home?

Reading books and playing with toys are a few of the many activities that can help stimulate language in your child.  We can support their communication by interacting and engaging in conversations and during play.  Some tips include modeling words/sentences, correcting them (with moderation), using a rewards system and giving praise.

  • Speak clearly and at a slow conversational rate.

  • Know which sounds are expected to be pronounced correctly at your child’s age – encourage only the speech sounds, which are appropriate.

  • Model correct pronunciation at natural times during the day. Do not correct your child. For example, if your child says, “I got a pish”, you could say, “Yes, you have a fish”. You may want to emphasize the target sound slightly.

  • Play sound games if your child is interested. This will increase his/her overall awareness and discrimination of sounds.

  • Tell your child when you don’t understand what was said. Let your child know that you will listen and try to understand. Have your child gesture or show you what he/she is attempting to tell you.  Explain that sometimes you may not understand what he/she says and that you know this must be frustrating.  Let your child know you understand how they feel.


What happens during Speech-Language Evaluation? 

During the evaluation, your child’s medical, developmental and educational history is reviewed.  Parents are interviewed regarding their concerns and the child’s history on the day of the evaluation.  This information will assist the Speech-Language Pathologist in identifying specific areas to focus on during the evaluation.  A variety of methods, including formal and informal tests, observation, parent/caregiver interview and play-based activities will be used to evaluate your child’s speech, language, cognition and voice.  Selection of testing methods is based on your child’s individual needs.

Following the evaluation, initial results of the evaluation and recommendations are reviewed with you (and your child if age appropriate). 

How often will I come in? How long will treatment last?

Every child is unique, therefore factors effecting the duration of therapy will vary. The clinician will recommend a frequency based on the child’s evaluation results and treatment goals.   As treatment progresses and your child begins to achieve their working goals, new goals will be added and or/modified.  Based on the goals and your child’s response to therapy, the frequency and duration of treatment may be refined. 

What is a Treatment Plan? 

A treatment plan is an individualized set of goals created by the Speech-Language Pathologist to address your child’s speech, language, cognitive and/or communication needs.  The treatment plan may include:

  • Initial and long term goals to be addressed during therapy and at home

  • Referrals to other professionals (i.e., audiologist, medical specialist, occupational/physical therapist, etc.)

  • Suggestions for parents/caregivers and educators


Do speech-language disorders affect learning?

Speech and language skills are essential to academic success and learning.  Language is the basis of communication.  Reading, writing, gesturing, listening, and speaking are all forms of language.  Learning takes place through the process of communication. The ability to communicate with peers and adults in the educational setting is essential for a student to succeed in school.


What is Augmentative and Alternative Communication (AAC)?

Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas.  We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write.

People with severe speech or language problems rely on AAC to supplement existing speech or replace speech that is not functional.  Special augmentative aids, such as picture and symbol communication boards and electronic devices, are available to help people express themselves.  This may increase social interaction, school performance, and feelings of self-worth.

AAC users should not stop using speech if they are able to do so.  The AAC aids and devices are used to enhance their communication.


Sound Hearing Audiology and Speech – Dr. Robin Zeller, Ph.D.
50 Hazelwood Drive, Jericho NY 11753
Audiologist, Speech Language Pathologist, Speech Therapy, Hearing Aids, Hearing Loss Treatments for Adults and Children