Introduction to Speech Therapy


What is Speech and Language Therapy?


Speech therapy is the assessment and treatment of communication problems and speech disorders. Speech Therapy is performed by speech-language pathologists (SLP’s), often referred to as speech therapists.


Speech therapy techniques are used to improve communication. These include articulation therapy, language intervention activities, and other practices activities depending on the type of speech or language disorder.


Speech therapy may be needed for speech disorders that develop in childhood or speech impairments in adults caused by an injury or illness, such as stroke or brain injury.

Do you or someone you know need speech therapy? There are several speech and language disorders that can be treated with speech therapy.


Which Language Disorders Can Be Addressed with Speech Therapy


Articulation disorders.


An articulation disorder is the inability to properly form certain word sounds. A child with this speech disorder may drop, swap, distort or add word sounds. An example of distorting a word would be saying “thith” instead of “this”.


Fluency disorders.


A fluency disorder affects the flow, speed, and rhythm of speech. Stuttering and cluttering are fluency disorders.


Stuttering is a speech disorder characterized by repetition of sounds, syllables, or words; prolongation of sounds; and interruptions in speech known as blocks. An individual who stutters exactly knows what he or she would like to say but has trouble producing a normal flow of speech.

A person with cluttering often speaks very fast and merges words together. Cluttering involves speech that sounds rapid, unclear, and/or disorganized. The listener may hear excessive breaks in the normal flow of speech that sounds like disorganized speech planning, talking too fast or in spurts, or simply being unsure of what one wants to say.



Resonance disorders. 


A resonance disorder occurs when a blockage or obstruction of regular airflow in the nasal or oral cavities alters the vibrations responsible for voice quality. It can also happen if the velopharyngeal valve doesn’t close properly. Resonance disorders are often associated with cleft palate, neurological disorders, and swollen tonsils.


Receptive disorders. 


A person with a receptive language disorder has trouble understanding and processing what others say. This can cause you to seem uninterested when someone is speaking, have trouble following directions, or have a limited vocabulary. Other language disorders, autism, hearing loss, and a head injury can lead to a receptive language disorder.



Expressive disorders. 


Expressive language disorder is difficulty conveying or expressing information. If you have an expressive disorder, you may have trouble forming accurate sentences, such as using incorrect verb tenses. It’s associated with developmental impairments, such as Down syndrome and hearing loss. It can also result from head trauma or a medical condition.



Cognitive-communication disorders.


Difficulty communicating because of an injury to the part of the brain that controls your ability to think is referred to as cognitive-communication disorder. It can result in memory issues, problem-solving, and difficulty speaking or listening. It can be caused by biological problems, such as abnormal brain development, certain neurological conditions, a brain injury, or stroke.





This is an acquired communication disorder that affects a person’s ability to speak and understand others. It also often affects a person’s ability to read and write. Stroke is the most common cause of aphasia, though other brain disorders can also cause it.





This condition is characterized by slow or slurred speech due to a weakness or inability to control the muscles used for speech. It’s most commonly caused by nervous system disorders and conditions that cause facial paralysis or throat and tongue weakness, such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), and stroke.



How Do You Determine If Speech Therapy is Needed?


How can a parent, an individual, or a caregiver determine if speech therapy is needed?

Speech therapy usually begins with an assessment by an SLP who will identify the type of communication disorder and the best way to treat it.


If the concern is related to a child at his or her first stages of development, parents or caregivers should observe if that child is making steady progress in his/her communication skills:


  • Is he learning new words and/or stating longer sentences?
  • Is she understanding new commands?
  • Is she able to use words/sentences to express her feelings?
  • Is he able to play functionally with toys and peers?

If for some reason, parents or caregivers noticed that their children should do more than what they are capable of, then, it is a good idea to consult a specialist (SLP).


In the case of school-age children, the assessment tends to be more related to his pronunciation/articulation skills. 


Occasionally, speech and language challenges come along with pre-existing conditions; for example, hearing loss, Down syndrome or other syndromes, autism spectrum disorders, cerebral palsy, etc. In any case, the treatment will be different and we will have an approach that suits the child’s needs.


When there isn’t an associated condition to the speech and language impairments but we can detect a difficulty in the perception, organization and production of the speech, we talk about “phonological simplification processes”.


These processes are present during language acquisition and are expected to fade as the children have a better competence in their articulation skills. The persistence of these processes into the school-age stage is unwanted and considered to be treated and, eventually, corrected.


The most common phonological simplification processes are:


  • Assimilation: A consonant sound in a word takes the same sound as another consonant in that word (“mame” for “name”; “wawa” for “water”).
  • Substitution: A sound is replaced by a different one (“wed” for “red”; “tup” for “cup”)


Syllable structure process:  Syllables are reduced or omitted at the beginning, middle or end of the word (“tee” for “tree”; “ca” for “cat”; “og” for “dog”; “ephant” for “elephant”).

When the person who needs assessment is an adult; it is usually his or her primary care physician or neurologist who refers to that patient and the reasons may vary from stroke, trauma, degenerative diseases, etc. 


Speech Therapy for Children


For your child, speech therapy may take place in a small group, or one-on-one, depending on the speech disorder and child’s needs. 

  • What to expect from a therapy session?

Depending on the patient’s age and capabilities, the material used during the session includes toys, flashcards, books, word games, ruled games, technology, and other resources that involve language and might help for the communication process. 

It is important to know what are the children’s interests to keep their attention and make the therapy more effective; resulting in obtaining better outcomes. 

Since speech therapy is provided some days a week for a short period of time, it is very important that parents or caregivers encourage children to practice at home what they learned or practiced during the therapy sessions. 


Speech therapy for adults


Speech therapy for adults also begins with an assessment to determine the patient’s needs and the best treatment possible. Speech therapy exercises for adults help people with their language expression and comprehension, and cognitive communication.

An adult who needs speech and language therapy is most likely somebody who never had communication impairments but as a consequence of a certain critical event in their lives (stroke, trauma, degenerative disease, etc.), they may have disabilities in their receptive and/or expressive language.

The main goal is always to help the patients to be as independent as possible, using their communication skills in everyday life.

Exercises may involve:

· Games such as word-finding, crosswords, stop (for categorizing), anagrams, rearrange sentences, and other word-related practices.
· Problem solving, memory, and organization, and other activities geared at improving cognitive communication.
· Conversational tactics to improve social communication; for example, role-playing, description of pictures, personal situation telling, turn-taking practice.

· Exercises for treating resonance and to strengthen oral muscles.
Please note that the material used for children and adults will not be the same. Whereas to work with children, especially with young children, we use more children’s drawings or toys; with adults, we are going to be supported more by exercises that involve written language and if we need images, we will do so with photographs mainly. 

Nor will the vocabulary be the same, since even if the adult has communication disabilities, we will continue to treat him as such and not as a child.

Additional Resources for Speech Therapy

There are also resources available online which may be helpful to promote speech therapy exercises at home, including:

  • Speech therapy apps
  • Flashcards
  • Workbooks
  • Activity sheets