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Speech-Language Pathology Services at Tri-County

Mandy Smidt, M.S., CCC-SLP


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Welcome to the Speech-Language Services page.  This article is simply an introduction to Speech-Language Services, intended to define what types of need areas warrant Speech-Language Services in the schools, and to give readers an idea of what Speech-Language Services may look like for a variety of situations.

The traditional understanding of Speech-Language Services is typically therapy provided to students with speech sound disorders, sometimes known as articulation disorders.  Speech sound disorders are present when a student mis-produces a target sound, which likely interferes with the child's intelligibility, or how well they are understood by others.  Based on developmental norms and other assessments, a school speech pathologist determines whether a student's speech errors constitute a delay or disorder and require school-based services.  Children's errors often occur in patterns and are addressed through a phonological approach, which supports their acquisition of an accurate sound production system.  Articulation and/or phonological therapy can involve direct instruction at the child's level of production with strategies applied to challenge the student to use target sounds at a more complex level with increased independence.  Instruction and practice activities are often play-based for younger students, with targets embedded within a naturalistic and/or motivating activity.  The clinician will elicit target sounds at a more advanced level than the child is routinely able to produce in order to increase accuracy and independence.  Older students may be engaged in more discourse/conversation-based activities that provide social motivation with prompts for self-monitoring with a goal of independence.

Speech-Language Services in the schools actually address a much wider range of need areas, beyond speech sound disorders, including expressive and receptive language deficits, social communication disorders, and voice and fluency concerns.

Expressive and receptive language deficits are present when students struggle to understand and use age appropriate vocabulary at the word, sentence, or conversation/instruction level.  They require more exposures to new words and concepts than do typically developing children and may require specialized instruction to support their learning in this area.  Interventions targeting language take on many forms depending on the goal of the student.  Therapy activities may be literacy-based, play-based, and/or curriculum based, depending on the learning target, child's developmental level, and other factors.  Activities are varied as well to increase student motivation and likelihood of carryover and generalization across learning contexts.

Social communication disorders are observed in students who have difficulty interacting appropriately, knowing and following conversation rules, and/or engaging with others.  These types of challenges are often, but not always, associated with autism spectrum disorders.  Similarly, executive functioning challenges can occur along with social issues, impacting a student's ability to exercise self-control and self-management. Social learning support must be provided in natural, meaningful contexts, with activities customized to meet the student's goals and objectives.

Fluency disorders, commonly known as stuttering, are treated in the schools when students' difficulty with smoothly expressing themselves interferes with academic and social participation.  Fluency therapy involves instruction in strategies that the learner must use to address factors contributing to his/her stuttering, including cognitive (knowledge of stuttering), affective (feelings about stuttering), linguistic (language skills and knowledge), motor (physical aspects of stuttering like tightness in the voice mechanism), and social (how others perceive stuttering and/or how stuttering affects interactions with others) aspects.  Voice disorders occur infrequently but are also a focus of services in the schools when necessary and appropriate.  Voice therapy requires a student to learn how to take care of his/her voice and use his/her voice in a healthy way.