Early detection of any communication impairment in a child is critical. The ability to communicate is essential to learning during their developmental years.
If you suspect your child may have a delay in communication development, an evaluation will provide valuable information. It is never too early to have your child evaluated. For children as young as 12-15 months, an evaluation can ease concerns and provide a base-line for follow-up visits to ensure continued progress.
These are just a few issues that parents may recognize their children are experiencing.
Autism Spectrum Disorders (ASDs) are severe disorders of development that can affect social interaction, communication, play, and learning.
ASDs represent three of the pervasive developmental disorders defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and DSM-IV-TR (text revision):
- Autistic disorder
- Pervasive developmental disorder-not otherwise specified
- Asperger syndrome.
During the past decade, there has been growing national awareness and concern about the increase in the occurrences of ASD. Approximately 1 in 88 children meet the diagnostic criteria for one of the disorders listed above.
Communication is conducted primarily through receptive and expressive language skills. The expressive language skill can be summarized by how a person conveys meanings and intentions to another. Receptive language is the process of understanding that which is conveyed to us.
As stated in Receptive vs Expressive Communication, “Expressive language involves making requests, giving information, and labeling things. Expressive language is more difficult because the individual has to recall the word or words they want to communicate and then be able to express. A lack of expressive language skills is often the cause of frustration and behavior in individuals with language disorders.”
The ability to follow directions, socialize and identify items are examples of receptive language. Difficulties in receptive language skills are not always recognized. A receptive language disorder may be overlooked as disagreement to a stated command, when the problem may really be a misunderstanding of the statement that was made.
There is a difference between a language disorder and a speech disorder. A child with a language disorder may have difficulty understanding what another person is saying or is not understood by others because they have difficulty expressing their thoughts. Apraxia of Speech is an example of a speech disorder.
Developmental apraxia of speech (DAS), also known as childhood apraxia of speech (CAS), occurs in children and is present from birth. It is usually detected around 2 years of age when speech development appears to be delayed. A child’s speech may be unintelligible and sound like ‘babbling’ or jargon. The child may show symptoms by having difficulty saying what he or she wants to say correctly and consistently. However, DAS is not due to simply weakness or a paralysis of the speech muscles. The child will generally not have trouble chewing or biting down on objects.
Individuals that have learned English as a second language may recognize the need for assistance pronouncing words in a more understandable manner. This need may occur even if an adult has been an English speaker for many years. The person may recognize the need to improve communication skills to enhance their public speaking or interpersonal communication skills.
A foreign language speaker wanting to improve their pronunciation can enter a classroom setting for ESL (English as a Second Language). This approach generally uses the method of listening to words pronounced correctly and then imitating that sound. Unfortunately, many people are unable to ‘imitate’ sounds, although they think they are saying a word correctly. However, the person can also reach out to a Speech Language Pathologist.
A Speech Pathologist is able to assist a bilingual adult that is seeking improved communication abilities, even though this problem is not considered a speech disorder. The need to improve an accent is considered a speech modification in Speech Language Pathology. A Speech Pathologist teaches the person ‘how’ to produce the sound…where to place the tongue and how to shape the lips so that the word is intelligible. For example, foreigner speakers often pronounce the words ‘cup’, ‘cop,’ and ‘cap’ the same way. There are subtle differences in tongue placement and duration of sound that change the word.
A lisp in a child can be developmental or from incorrect placement of the tongue on the roof of the mouth, such as a lateral lisp. A lateral lisp is caused by the child directing air flow down the sides of the tongue rather than directly down the middle of the tongue. This causes the pronunciation of the letters ‘S’ and ‘Z’ to be muffled or slushy.
What may not be obvious to the parent is that the child with a lisp does not perceive themselves as speaking differently from the children or adults around them. Therefore, waiting for the child to “grow out of it” is not advisable, because children very rarely outgrow a ‘lateral’ lisp. The longer a child continues to pronounce words incorrectly, the more difficult it can be to correct the problem as the child grows older.
The result of waiting too long can be especially problematic as the child enters school. The child has the probability of being teased by peers and will not understand why. The child will perceive themselves as speaking flawlessly.
Beth Fine, of Fine Communication in Manhattan, New York, New York, had a young patient that, as an 8th grade student, had her dreams of having leading roles in school plays shattered because of her lateral lisp. She did not perceive her speech to be any different from her peers. With speech therapy, the student became aware of correct tongue placement and corrected her lisp in a relatively short period of time. Now a college student, she speaks in front of large groups of people and has chosen to be a mentor to other girls.
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I have referred many patients to Beth Fine. She has demonstrated expertise in her field in both diagnostics and treatment for speech-language disorders. The feedback from patients and their parents has always been positive. Martin B. Cohen, M.D.
I have known Beth Fine for over ten years. She is an extremely competent and well trained speech therapist. Over the years, with very thorough patient care, she has helped many of my patients overcome their speech problems. Paul W. Shineman, M.D.
I am a business owner of a successful IT company in New York and am from Hong Kong. Before I met Beth 2 years ago, I had many words that I couldn’t pronounce correctly. I would use alternative words, skip the words, or fake the pronunciation. I was embarrassed about the fact that I’ve been in USA for 27 years but I can’t master English pronunciation. I would feel uncomfortable to speak with anyone in a party with strangers. When I started with Beth, Beth taught me how to pronounce sounds and where to put my tongue. After weekly sessions with Beth for 3 months, I was able to pronounce most of common words that I had trouble with. After 6 months, I was able pronounce words that I couldn’t have pronounced before. Now, everyone understands me and I have confidence to speak with anyone because I don’t have to worry about if they understand my pronunciation. Eddy Wong
I offer my highest recommendation for Beth Fine’s services. After being diagnosed with a nodule in my vocal cord, Ms. Fine not only cured me of my ailment, but in the process also corrected a 40 year old lateral lisp. She is professional, attentive and honestly cares about her patients’ outcomes. If there is a better speech therapist in New York city, I have yet to find that person. J.B.
Letter from parents of an autistic child: ‘Thank you Diane for working with our son, with so much patience and believing that he learn his way! Your approach to making A. think and learn is truly unique! Many thanks to you for playing a role as a friend and a speech therapist at the same time!!’ A.C.
It’s my daughter’s second year with Cindy and we couldn’t be more happy that she’s under her therapeutic “wings”. During this time her vocabulary, grammar structure, overall speech fluency and most important CONFIDENCE improved dramatically!
Cindy is an excellent therapist. She has a very encouraging, flexible and creative attitude and approachable disposition but at the same time knows when and how to draw the line when my daughter wants to test or push the “barriers”. She’s also very attentive and willing to discuss ANY aspect of therapy or my daughter’s circumstances that might influence her performance.
Her experience in the special education is a big plus and makes her a more knowledgable and empathetic therapist.
Would highly recommend! Beata, Forest Hills