Since the parent or caregiver is with the child most often, Toby works with the parents to help them understand the disorder and the treatment. The parent is trained to work with the student on a daily basis to facilitate home practice and carryover of a new skill into different contexts and with different communication partners.
In order to accommodate the student’s busy academic schedule, Toby offers after school hours and home based appointments.
Besides the convenience to the parent of the a home visit, speech and language therapy may “stick” better due to the proven theory of context dependent learning. A skill learned in a particular context can be more readily retrieved in the same or a similar context. So, for example, if a child learns how to say /r/ at his home, he can more easily retrieve the learned skill at home, facilitating carryover.
Early Intervention services are provided for free by the NYS Department of Health’s Early Intervention Program. These in-home services are for infants and toddlers, ages 0-3, if they qualify.
A child’s treatment plan is dependent on the type and severity of the delay or disorder. The age of the client and his/her preferences and temperament are important to consider when deciding on the means through which the treatment will be provided.
As a speech and language pathologist for over 25 years, I have worked with hundreds of students of different ages and abilities. The role of the speech pathologist is both specific and detailed at the same time. It is specific in its definition, of evaluating, diagnosing, and treating a range of disorders affecting speech articulation, voice and fluency, and expressive and receptive language skills. It becomes detailed in the sense that one single disorder never manifests itself in the same way. Every child is special and unique.
Speech articulation disorders are delays or deviations in the acquisition of speech sounds, known as phonemes. Etiology, or cause, can be different for each case. Therapy is usually direct and focuses on teaching the sound in error (omission, substitution, or distortion). Parent involvement is crucial for the sound to be successfully integrated into the student’s spontaneous speech. Phonological delay, or use of patterns of speech are developmental, but need intervention if symptoms persist longer than developmentally appropriate. Additionally, use of many phonological simplification processes at once can create unintelligible speech and may result in extreme frustration for the youngster. The child’s level of frustration must come into account when determining the appropriateness of timely intervention. Motor speech disorder and dysarthria are neurologically based and intervention is slightly different. I am PROMPT trained and have found this method to work well for students who demonstrate apraxic (motor sequencing) errors.
Voice and fluency disorders are often grouped together and refer to disorders affecting resonance (how the sounds are vibrating in the larynx, and oral and nasal cavities), prosody (rate, intonation, loudness, stress) and disorders of fluency (typically known as stuttering). Parents may notice some stuttering as the child develops growths or bursts of language. If a parent is concerned, consultation with a speech and language pathologist is important in determining if intervention is needed. Stuttering can worsen quite quickly if intervention is indicated but not begun.
Disorders of language is the broadest category and many volumes have been written on this subject. In brief, language disorders can be expressive or receptive in nature. Speaking mirrors reading and writing and if language development is impaired or delayed, reading and writing skills need to be included in treatment plans. A language delay can be viewed as a delay in the acquisition of language yet follows a normal developmental model. When the development of language is outside of the typical, a disorder may be diagnosed such as aphasia, autism spectrum disorder, dyslexia, or a disorder with co-morbidity of a psychological, cognitive disturbance, or sensory disturbance (i.e. difficulty with vision or hearing).