The difficulty: Child is non-verbal or speech is severely limited. Non-speech communication methods are needed for effective communication at this time.

This may result from: Autism, cerebral palsy, physical limitations, or other causes.

Therapy emphasis: Developing successful communication through a variety or modes, while enhancing verbal skills to the highest level possible. 

The difficulty: Speaking, listening, communicating, reading or writing, which impacts a child’s learning and daily social interactions.

This may result from: 

• Autism spectrum disorders
• Brain injury
• Cognitive delay
• Developmental delay
• Down syndrome
• General delay in acquiring language skills
• Genetic syndromes
• Head injury
• Hearing impairment
• Language or learning disability
• Unknown origin

Therapy emphasis: Improving language skills for more effective communication and learning.

The difficulty: Speech sounds are unclear and hard for others to understand.

This may result from: 

• Cerebral palsy
• Childhood apraxia of speech
• Cleft palate
• Delay in acquiring age appropriate speech sounds
• Genetic syndrome
• Hearing impairment
• Oral motor delays/impairment
• Phonological impairment
• Unknown origin

Therapy emphasis: Facilitating clear speech development for effective communication.

The difficulty with stuttering: Frequent disruptions in the forward flow of speech, such as repetitions of words or parts of words, prolongations of sounds, or complete blockages of sounds. Speech disruptions may be accompanied by physical tension or struggle.

The difficulty with cluttering: Rapid and/or irregular speaking rate, excessive disfluencies, and often other symptoms such as language or phonological errors and attention deficits.

This may result from: Genetically-influenced conditions involving different neurological development in childhood.

Therapy emphasis: Teaching the child to change speech movements and to participate with confidence and success in speaking situations, and eventually to advocate for themselves. Teaching parents and teachers to provide support and acceptance at home and at school.

Special considerations: Children stuttering for more than six months should be referred for assessment.

Resources

The difficulty: Disturbances in vocal quality resulting in the production of voice characterized by harshness, hoarseness, nasality or other faulty patterns. Respiratory disorders related to laryngeal functioning.

This may result from: 

• Chronic cough
• Chronic laryngitis
• Laryngeal webbing
• Paradoxical vocal fold movement dysfunction (PVFM)
• Respiratory disorders
• Vocal misuse/abuse (e.g. excessive screaming or loud voice)
• Other medical conditions

Therapy emphasis: FImproving voice quality and function through direct intervention and environmental changes.