You may find your toddler’s lisp rather cute, but as the years go by, it can become a thornier problem. She might grow out of it, or it could be indicative of a deeper issue.
“Speech therapy is so, so broad,” says Bonita Adams, MED CCC-SLP, an early intervention speech language pathologist for the state. She explains there are many different angles to examine, from seemingly basic things like eating and swallowing, to more complex issues like permanent hoarseness or traumatic brain injuries.
First steps to a screening
Adams says the first step for parents who have any concerns about their children’s speech—a lisp, a stutter, limited sounds or words, the inability to be understood by others—is to make sure their children’s ears are working correctly. Your pediatrician can provide a referral to an audiologist for a hearing evaluation. If the audiologist reports that the hearing is fine, the next step is a screening with a speech language pathologist.
At the first appointment, you’ll discuss things like the child’s background, his medical history and your concerns. You’ll either be provided with an evaluation and a therapy plan, or be given some exercises to go over with your child and a timeline to re-screen, with the course of future therapy guided by how your child does with those exercises.
Raemi Satkamp of Metairie says she initially looked into speech therapy for her now three-year-old daughter Marlie following some MRI results when she was around five months old. Her neurologist advised early intervention in several areas, including speech, saying that if she waited, Marlie might be delayed in multiple areas of function, including cognition. This would be an extra hurdle for Marlie, who is legally blind.
Raemi says she needed cues and instruction from the speech pathologist, Bonita Adams, to make sure that she had the correct tools to narrate Marlie’s life, because “s
he has no visual stimulus, and [I needed to] know how to revise my spoken language to her in a way that would promote the most learning in regards to her language development.”
Expectations, and patience
What is actually involved in therapy will depend on the age of the child. “Therapy for very young children is play-based,” explains Gina Knight, M.A., CCC-SLP.
“For example, we may work on animal names and sounds while playing with a toy farm set and singing ‘Old McDonald’ while looking at the book. For school-aged children, therapy tends to be a little more structured to simulate the activities they do in the classroom environment. One of the first activities I do with the beginning of the new school year is to make sure each child can pronounce each of his teacher’s and classmate’s names.”
Parents are often curious how long it will take to see the results of therapy working for their child. Knight says, “‘How long will it take?’ is the hardest question I am asked.” It’s difficult to assign a timeline of definite success; it’s very personal to each child. It also depends upon the severity of the impediment, and the involvement of the parents. Adams says, “You can practice [the “homework” exercises] anywhere. You can run articulation drills in the park, in the car, anytime. It’s a team effort.” She says that she can tell when work “occurs at home, and when it doesn’t.” When it does, progress is steadier.
The sooner any speech progress can start, the better. Knight says, “A child may be self-conscious and avoid social interactions. As the child gets older, articulation issues can affect their reading, spelling, and phonological skills, and these need to be monitored very closely. The more weaknesses that the child needs to work on, and the more severe the delays, the longer one can expect therapy to be needed.”
Ellen Manning of Uptown agrees with Knight on early intervention. Her son Heid, now eight years old, went through speech therapy with Knight for two years, beginning when he was about three and a half. Ellen says she is always surprised when she encounters older children and adults with speech issues that could have been addressed when they were younger.
“It floors me that people won’t clear it up when they were young and it wasn’t a habit. I wanted to take care of that for him before he got older,” she says.
As for Marlie, she’ now in a pre-K program and continuing with her speech therapy. Raemi says she can see the positive results clearly in her daughter. “She knows the power of her words as her greatest gift—her words are her eyes.”
Lora Ghawaly is a freelance journalist living in Metairie.
What might warrant a speech-language screening
- When a child consistently has difficulty following directions.
2. When a child is echolalic (repeats everything that is said, rather than responding appropriately).
3. When a child has difficulty using or understanding either vocabulary or grammar, like pronoun use or verb tenses.
4. When a child has difficulty in social situations or peer relationships.
5. When a child’s conversational speech is not able to be understood by unfamiliar listeners.
6. When a child has difficulty expressing themselves and/or relies on non-verbal communication, like pointing or pulling an adult to the desired item or activity.
-from Gina Knight, M.A., CCC-SLP