Services

The services offered.

Autism & Asperger's Syndrome

Autism Spectrum Disorder

Autism is a neurodevelopmental disorder that is characterized by deficits in social interaction and communication. Individuals with autism have difficulty reacting appropriately to the world around them. For example, they may have difficulty handling changes in a typical routine or play with toys and objects in unusual ways. Many experience global cognitive deficits and language delays. Speech is often characterized by echolalia, scripting, and atypical prosody. Repetitive behaviors or intense interests may also be displayed. Sensory processing and motor skills are often affected. Characteristics of this disorder, and their severity, can present very differently for each individual with autism.

Asperger's Syndrome

Asperger’s Syndrome was first described in the 1940’s by an Austrian pediatrician, Hans Asperger, for whom the disorder is named. Individuals with Asperger’s Syndrome demonstrate mild autistic-like behaviors and difficulty with social and communication skills, but have average or above average intelligence and normal language development. Because of its similarities, many professionals consider it a less severe form of autism. Some common characteristics of Asperger’s include the following:

Parent Training for Autism

For children with autism, it is important that the concerns, priorities and perspectives of the family are incorporated to actively shape treatment planning. According to research, all of the comprehensive intervention programs with the best treatment outcomes include a strong family component. Using a team approach to include all of the individuals and professionals involved in the child with autism’s life, we can provide the consistency, intensity, and support needed to see more effective treatment outcomes. It is important for family members to be supported to be effective members of the child’s team. Families need to be provided with the opportunity to learn strategies for teaching their child new skills and reducing problem behaviors.

Critical Thinking & Social Skills

People with autism have communication deficits in their capacity for joint attention to objects and events with other people and in their ability to understand the symbolic function of language.

Pragmatics is the study of social thinking. It includes communicative intent, turn-taking, topic maintenance, and emotional inference, while incorporating past knowledge and cultural rules.

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Craniofacial Syndromes

Craniofacial Syndromes

Craniofacial disorders can structurally impact normal hearing development. This can include external and middle ear anomalies and can result in hearing loss.

Many syndromes associated with craniofacial disorders also structurally impact the development of the upper and lower jaw.

Common craniofacial disorders include: clefting of the lip and/or palate, Downs Syndrome, Treacher Collins Syndrome, Crouzon Syndrome, Apert Syndrome, and Mobius Syndrome.

Feeding & Swallowing Disorders

Oromyofunctional Disorders

Orofacial myofunctional disorders are characterized by the abnormal positioning of the tongue during speech or swallowing, or when the tongue is at rest. This is also called a tongue thrust swallow and it may contribute to malocclusion, misarticulation of speech sounds, or both.

Feeding Disorders (Motor- and Sensory-based)

Feeding and swallowing disorders may be due to difficulties with the motor and/or sensory systems. Motor difficulties stem from problems with the structures of the oral mechanism (i.e., mouth, lips, tongue, and jaw). Feeding difficulties may affect both children and adults but are most obvious as a child strives to acquire new feeding skills or as a child or adult experiences a medical insult to the brain or nervous system. Some pediatric examples include infants who have difficulty latching onto a nipple, children who have difficulty chewing and breaking down solid foods into manageable pieces, children who use a “reverse” swallow, or children who have difficulty removing food from a spoon because of insufficient lip closure.

Sensory processing difficulties can negatively effect eating processes (e.g., being picky eater, especially regarding food textures; having abnormal responses to taste and smell). Some children may be predisposed to sensory-based feeding disorders. For example, children with a history of Broncho Pulmonary Displasia (BPD), cardiac defects, drug exposure, gastrointestinal diseases, prolonged periods of intubation or suction, or prolonged NG tube feeds may be at risk. The population of children with sensory-based feeding disorders often includes but is not limited to medically involved or “medically fragile” children.
 

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Language Disorders

What is Language

Language refers to the words, sounds, and gestures we use to express ourselves and to understand the world around us. It is a social tool employed to communicate ideas and/or feelings within a specific group or community.

Language is comprised of different parts:

Receptive Language Disorder

A receptive language disorder affects the ability to understand spoken and sometimes written language and often makes it difficult to respond to others appropriately. Children with receptive language disorders can have difficulty processing language and making connections between words and the ideas they represent. School-age children may experience difficulty organizing their thoughts on paper. Receptive language disorders can be associated with conditions such as dyslexia, attention deficit disorder, autism spectrum disorder, specific language impairment and pervasive developmental disorder or they may be caused by brain injuries.

Expressive Language Disorder

A developmental expressive language disorder does not have a known cause and generally appears at the time a child is learning to talk. Acquired expressive language disorder is caused by damage to the brain. It occurs suddenly after events such as a stroke or traumatic head injury. The acquired type can occur at any age.

An expressive language disorder is characterized by a child having difficulty expressing him- or herself using speech. The signs and symptoms vary drastically from child to child. The child may have problems putting sentences together coherently, using proper grammar, recalling the appropriate word to use, or other similar problems. A child with an expressive language disorder is not able to communicate thoughts, needs, or wants at the same level or with the same complexity as his or her peers. The child often has a smaller vocabulary than his or her peers.

Children with an expressive language disorder typically have the same ability to understand speech-language as their peers, and they have the same level of intelligence. Therefore, a child with this disorder may understand words that he or she cannot use in sentences. The child may understand complex spoken sentences and be able to carry out intricate instructions, although he or she cannot form complex sentences.

Language-based Learning Disability

Language-based learning disabilities are problems with age-appropriate reading, spelling, and/or writing. This disorder is not about how smart a person is. Most people diagnosed with learning disabilities have average to superior intelligence.

Dyslexia has been used to refer to the specific learning problem of reading. The term language-based learning disability, or just learning disabilities, is better because of the relationship between spoken and written language. Many children with reading problems have spoken language problems.

The child with dyslexia has trouble almost exclusively with the written (or printed) word. The child who has dyslexia as part of a larger language learning disability has trouble with both the spoken and the written word. These problems may include difficulty with the following:

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Phonological Awareness & Early Literacy

Phonological Awareness & Early Literacy

Phonological awareness is knowledge of the sounds and sound structure of words, as well as the relationships of sounds. It is an awareness of ways in which words and syllables can be divided into smaller units. Skills include the following:

Phonological awareness skills provide a foundation for achievement in literacy skills. These skills are fundamental to reading readiness (Owens, 2004).

Additional skills that contribute to Early Literacy include print awareness, vocabulary knowledge, narrative skills, and letter knowledge. Early literacy skills can be encouraged at home by reading often with your child, pointing out important words and talking about what they mean, running your finger along the title or words on the pages as you read them from left to right, talking about the pictures in books with your child and encouraging them to say what they think is happening or is going to happen, finding rhyming words in books and talking about them with your child, or creating grocery lists with your child, writing the items down as you say the word out loud. Encourage your child to tell their own stories about exciting events or experiences they have had.

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Speech Sound Disorders

What is Speech

Speech is our verbal means of communicating. Speech consists of the following:

Speech Delay

Based on research in the area of speech development, children are expected to develop and produce speech sounds by a specific age to be considered within normal limits. For example, the speech sounds /b/, /p/, /m/, /d/, and /k/ are typically expected to develop by three years of age. While speech sounds may develop slightly differently for all children, if a child has not developed age-appropriate sounds by the expected age they are considered to have a speech delay. Speech delay is characterized by reduced intelligibility and increased risk for broader communication and academic difficulties. Possible causes include: genetics, early history of recurrent ear infections, motor speech involvement associated with either developmental apraxia of speech or with mild dysarthria, and developmental cognitive involvement.

Articulation Disorders

An articulation disorder involves difficulty making sounds. Sounds can be substituted, left off, added, or changed. These errors may make it hard for people to understand a child’s message. Young children often make speech errors. For instance, many young children sound like they are making a "w" sound for an "r" sound (e.g., "wabbit" for "rabbit") or may leave sounds out of words, such as "nana" for "banana." The child may have an articulation disorder if these errors continue past the expected age.

Not all sound substitutions and omissions are speech errors. Instead, they may be related to a feature of a dialect or accent. For example, speakers of African American Vernacular English (AAVE) may use a "d" sound for a "th" sound (e.g., "dis" for "this"). This is not a speech sound disorder, but rather one of the phonological features of AAVE.

Phonological Process Disorders

A phonological process disorder involves patterns of sound errors. For example, substituting all sounds made in the back of the mouth like "k" and "g" for those in the front of the mouth like "t" and "d" (e.g., saying "tup" for "cup" or "das" for "gas").

Another example is cluster reduction, which involves words starting with two consonants, such as broken or spoon. When children use only one of the sounds (e.g., "boken" for broken or "poon" for spoon), it is more difficult for the listener to understand the child. While it is common for young children learning speech to leave one of the sounds out of the word, it is not expected as a child gets older. If a child continues to demonstrate such cluster reduction, he or she may have a phonological process disorder.

Dysarthria in Children

Dysarthria is a neurogenic speech disorder that results in weakness, slowness, and/or incoordination of the muscles of respiration, phonation, articulation, resonance and feeding. Because the child has under-responsive muscles, feeding skills are compromised and the child is at risk for aspiration and choking. Additionally, the poorly functioning muscles lead to unintelligible speech.

Childhood Apraxia of Speech (CAS)

CAS, or verbal dyspraxia/apraxia, is a neuromotor articulatory speech disorder that interferes with a child's ability to correctly pronounce sounds, syllables and words. A child with CAS cannot consistently move his or her face, tongue, lips and jaw into the correct position to make speech sounds or produce syllables or words. Speech produced by an individual with CAS is often marked by inconsistent productions of the same sound or word (e.g., a child attempting to say the word “dog” three times produces the following: “ka”, “dog”, “ga”).

Fluency Disorder/Stuttering

Stuttering is a fluency disorder characterized by an interruption in the smooth flow of speech. Several different causes are believed to contribute to the development of stuttering:

Stuttering affects approximately 1% of the population, and affects males versus females at a ratio of 4:1.  

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Voice Disorders

Functional Voice Disorders

Functional Dysphonia is a voice disorder caused by physiological function rather than a problem with anatomical structure. Stress, emotion, and psychological conflict are often presumed to cause or exacerbate the symptoms of functional voice disorders. The nature of this disorder may be labeled as one of the following: psychogenic, conversion, tension-fatigue syndrome, hyperkinetic, muscle misuse, or muscle tension dysphonia.

Vocal Hygiene

Vocal hygiene involves the science of vocal health and proper care of the vocal mechanism. Elements of proper vocal hygiene include, but are not limited to, drinking plenty of fluids, avoiding alcoholic beverages, and avoiding yelling and excessive throat-clearing.

Vocal Chord Dysfunction

Vocal cord nodules are benign (noncancerous) growths on both vocal cords that are caused by vocal abuse. Over time, repeated abuse of the vocal cords results in soft, swollen spots on each vocal cord. These spots develop into harder, callous-like growths called nodules. The nodules will become larger and stiffer the longer the vocal abuse continues.

Polyps can take a number of forms. They are sometimes caused by vocal abuse. Polyps appear on either one or both of the vocal cords. They appear as a swelling or bump (like a nodule), a stalk-like growth, or a blister-like lesion. Most polyps are larger than nodules and may be called by other names, such as polypoid degeneration or Reinke's edema. The best way to think about the difference between nodules and polyps is to think of a nodule as a callous and a polyp as a blister.

Everyone has two vocal cords in his or her larynx (voicebox). The vocal cords vibrate during speech to produce voice. If one or both vocal cords are unable to move then the person will experience voice problems and possibly breathing and swallowing problems. This is vocal cord paralysis.

There are different types of vocal cord paralysis. Bilateral vocal cord paralysis involves both vocal cords becoming stuck halfway between open and closed (the paramedian position) and not moving either way. This condition often requires a tracheotomy (an opening made in the neck to provide an airway) to protect the airway when the person eats.

Unilateral vocal cord paralysis is when only one side is paralyzed in the paramedian position or has a very limited movement. It is more common than bilateral involvement. The paralyzed vocal cord does not move to vibrate with the other cord but vibrates abnormally or does not vibrate at all. The individual will run out of air easily. They will be unable to speak clearly or loudly.