Pediatric Speech and Language Therapy

Coastal Speech Therapy provides pediatric assessment and treatment for a wide variety of speech and language disorders. Individualized treatment plans are provided to each client, based on their unique, specific language goals.  We believe that therapy needs to be individually tailored and continually modified in order to meet the client’s needs.

Therapy for the younger child is primarily play-based, helping the child to learn and to use language within functional activities. An older child may need a combination of various styles of therapy in order to address specific speech and language difficulties that may be impacting overall communication and academic performance.

The following programs are some of the treatment methodologies that we specialize in at Coastal Speech Therapy:

Auditory Bombardment and Traditional Articulation Training:  When children have difficulty producing age-appropriate sounds, it is important for the clinician to model the correct sound by repetitively over-articulating the correct production both in isolation and at the word level.  The child’s incorrect productions are then systematically and structurally targeted through a hierarchy of difficulty beginning in isolation and gradually increasing to the word, sentence, and conversational speech level.

Floor Time Therapy:  The therapist determines the child’s neurological developmental stages and stimulates the environment to promote developmental growth.  It is critical to follow the child’s lead and current neurological levels to design intervention.  It is also extremely important to establish rapport, likeability, and trust with the child prior to implementing measurable goals. Cites referenced by Stanley Greenspan (997).

Hodson’s Cycles Approach: Phonological processing disorders are patterns of articulation errors that children produce to simplify speech.  By cycling through groups of sounds, the therapist is able to target many sounds with similar characteristics in a systematic, structured way. Cites referenced by Hammer (2003), Hodson, (2014).

P.R.O.M.P.T (Prompts for Restructuring Oral Muscular with Physical
Targets):  Therapy has been found to be effective in treating verbal apraxia.  PROMPT is about integrating all domains and systems towards positive communication outcome. It may be used (with varying intensity and focus) with all speech production disorders from approximately 6 months of age onward.  PROMPT uses tactile-kinesthetic information directed to the jaw, face, lips or tongue. These PROMPTs, which are all provided externally, facilitate jaw/facial control and amount of movement required. The physical “PROMPTing “is dynamic and may be used to create and organize a single sound, word, phrase, or sentence. Cites referenced by Hayden (1984). 

Kaufman Treatment:   This program teaches children to combine consonants and vowels to form words while controlling for oral-motor difficulty. The 225 visual referent cards were selected specifically to target and teach the syllable shapes children need to master to become effective vocal/verbal communicators. Treatment methods employ a systematic and progressive approach of simplifying word pronunciation patterns to shape and expand verbal expression and make communication easier for children with childhood apraxia of speech and other speech sound disorders. This highly effective approach builds intelligibility through a hierarchy of successive “word shell” approximations based on least physiological effort of target words. The clinician also is able to introduce more complex phoneme patterns as the child’s ability improves, thus maintaining the child’s ability to speak at his or her maximum level.  These methods can help children progress quickly from a simple core vocabulary toward becoming effective, functional, intelligible communicators. Works cited by Nancy Kaufman (2011).

Social Stories:  Developed in 1991 by Carol Gray as a tool for teaching social skills to children with autism.  Addresses “Theory of Mind” deficits which is the ability to understand the mental states of other individuals; to put oneself in another’s perspective of intention beliefs, desires, and emotions, resulting in “mind-blindness”.   Social stories focuses on teaching the child to develop the abilities in reading the emotional intensions of others.  The stories can be written by anyone and frequently incorporate the use of pictures, photographs, or music.  These stories teach the necessary social skills in specific situations to help an individual function more productively.  Subtle social aspects are presented in a direct, clear story format to explicitly teach appropriate responses in social situations.  Works cited by Carol Gray (1995).

Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH):  This is a developmental program including routines, schedules, and visual supports.  It teaches adaptive skills in a very structured environment with close collaboration between the clinician and parent.  Includes early identification, parent training, education, social and leisure skill development, and communication training.  This is a broad intervention philosophy that is interdisciplinary and advocates the understanding of the culture of autism to design treatment programs.  Works cited by Panerai, Ferrante, and Caputo (1997), Ozonoff and Cathcart (1998), Short (1984), Gary Mesibov (1995), and the University of North Carolina.

Picture Exchange Communication System (PECS):  It is
helpful to improve functional language and provide a way for the child to communicate his/her wants and needs for those children who do not talk.  This behavior based program uses pictures and symbols to develop functional communication.  It is an alternative augmentative communication system to precede speech and establish the concept of interactive communication exchange.  The idea of physically presenting the message (picture) to accomplish a goal is emphasized.  Developed at the Delaware Autistic Program.  Works cited by Bondy & Frost (1994).

Lindamood-Bell:  We incorporate both visualization and verbalization (V V) to improve reading comprehension by thinking in pictures and the “Lips” program to improve decoding, encoding, spelling, reading, and writing.  Specifically, the Lips program develops the ability to produce spoken language by discriminating and producing individual phonemes. Both of these efficacious Lindamood-Bell programs are taught to self-correct errors through the kinesthetic and visual approach.  Works cited by Lindamood, Bell & Lindamood (1997).

Auditory Processing Therapy:  Children with an auditory processing deficit have difficulty understanding language, as evidenced by the following behaviors: short term memory difficulties, confusion, and difficulty following multi-step directions, inattention, hyperactivity, impulsivity, increased response time, and difficulty comprehending questions to formulate appropriate responses. By targeting auditory number and word memory, immediate recall, delayed recall, auditory sentence memory, auditory interpretation of directions, word discrimination and thinking and reasoning, the child’s ability to process auditory information can become more efficient. Gardner (1996).

Preschoolers Acquiring Language Skills (PALS):  These are center-based activities with parents as partners.  Child centered, small-group language facilitation classes  with parent education.  Works cited by Carol Buteau and Kathryn Konhert (2000)

Visual Schedules:  This visual treatment approach assists in organizing the world, predicting events, understanding expectations, anticipating changes in routine making choices, and functional independence.  By presenting pictures of the scheduled activities for the session, the child naturally becomes less anxious and more aware of behavioral expectations.

Stutter-Free Speech, Fluency Shaping, The Fluency Development System for Young Children:  It is important to not only improve the client’s smoothness of speech by teaching strategies of easy onset, pull-outs, pausing, and slow and easy speech, but also to address the socio-emotional aspects resulting from the dysfluency.  Cites referenced by Charles Van Riper (1980), Ryan and Ryan (1983), Meyers and Woodford (1991).

The following are some of the therapy techniques that Coastal Speech Therapy’s therapists specialize in:

ABA and PECS  trained for children on the Autism and Asperger’s Spectrum.

Apraxia (P.R.O.M.P.T. Trained)

Oral Motor Specialist (Attended courses taught by Pam Marshalla, Sara-Rosenfeld Johnson, Char Boshart).

Reading Disorder Specialists (Lindamood Bell Trained i.e., Lips and Visualization and Verbalization V V)

Auditory Processing Trained (Fast ForWord and Lindamood Bell)

Stutter-Free Speech and Fluency Shaping Trained

Social Skills Training Through Workshops by Michelle Garcia Winner

Floortime Trained (Attended courses which taught Greenspan)