Speech & Language Disorders

Autistic Spectrum Disorder (ASD)

ASD is a developmental disability which affects the development of social interactions and communication skills. People with ASD may repeat certain behaviours and may not want  change in their daily activities. Signs of ASD begin in early childhood and typically last throughout a person’s life.

As difficulties with social skills and communication are central to a diagnosis of ASD, speech and language therapists have a unique role in the diagnoses and treatment of this condition.

At the SpeechClinic, our overall goal when working with children with ASD is to teach functional communication. We want to improve the person’s ability to communicate about things that motivate them, helping to reduce inappropriate behaviour and improve social interactions. This improves the quality of life for the person with ASD and their family. We at the SpeechClinic welcome the opportunity to help your child with ASD to realise their communication potential.

Language Disorders

A language delay/disorder is when a child does not have age-appropriate vocabulary or grammar.

They may have difficulties with:

• Understanding
• Using language
• Reading
• Writing

What is Developmental Language Disorder (DLD)?

A diagnosis of DLD is made when a child fails to learn language in the typical way. DLD is not caused by a medical condition e.g., hearing loss or brain injury. It can affect a person throughout their life. 1 in 15 children have DLD.

Early intervention is key in the treatment of language difficulties. If you think your child has difficulty understanding or that they are not using enough words for their age, contact us at the SpeechClinic and we can determine if there is a problem and can work with you on strategies to enhance your child’s language development.

Speech Disorders

By 3 years of age, most of what a child says should be understood.

Children may substitute one sound for another, leave out sounds or distort sounds.

Typical acquisition of speech sounds by age are:

Speech Disorders; ages

• 1.5 to 2 years: p, b, m, w, h
• 2 years: n, t, d, f, y
• 2 to 3 years: k, g, ng
• 3 to 4 years: s, z, v, l
• 3.5 to 6 years: sh, ch, j
• 4 to 6 years: r, th, consonant blends

Difficulty with speech sounds can impact expressive language skills and literacy, so early intervention is crucial. If you are concerned about your child’s clarity of speech contact us for an assessment.

Reading difficulties and Dyslexia

It is difficult to over estimate the importance of reading success in school. All children need to be taught how to read. 70 % will learn easily, 30% will need more explicit help. Children with a history of speech and language difficulties are more likely to develop literacy problems.

When provided with the right type of intervention, research has shown that nearly all children can develop and maintain age-appropriate reading skills. Early intervention is key and will allow for teaching strategies to be modified, in order to facilitate classroom learning.

What is Dyslexia?

Dyslexia refers to a difficulty in the development of word level reading skills, despite adequate instructional opportunities.

Signs of struggling readers

• Difficulty sounding out words
• Difficulty recognising words
• Confusing similar looking words
• Dislike of or anxiety around reading
• Unable to read vowel diagraphs e.g. a-e, ea, oa
• Difficulty spelling/writing
• Guessing at words or using the pictures to try and work out what the word is.

Phonemic Awareness

This is the ability to manipulate individual sounds and spoken words. (without letters) and include the following skills:

• Recognise and separate how many sounds are in a word
• Blend sounds to make a word
• Substitute a sound to make a new word e.g. – mat, change |m| to |c|. What new word do you make? cat.

80% of poor readers have weak phonemic awareness skills.  Intervention reduces and alleviates reading and spelling difficulties.

The three pillars which support successful reading are:

• Phonemic Awareness
• Sound/letter knowledge
• Exposure to print

Difficulties in phonemic awareness can be detected in preschool/school years by a speech and language therapist.

We at the SpeechClinic have extensive knowledge and training in the treatment of reading difficulties. Please contact us to make an appointment if you are concerned about your child’s literacy skills. It is never too soon, or too late to start intervention.

Stammering

Stammering affects the fluency of speech. Overt features are those aspects that others might hear or see such as involuntary repetitions and prolongations of sounds, syllables, words or phrases and/or involuntary silent pauses and blocks. Stammering can be variable in severity across different settings.

Covert features of stammering are those that are those that are experienced internally i.e. thoughts, feelings, things you do to cope with stammering. 

Stammering affects approximately 5% of the Irish population at some point in life. It is important to have a child with a stammer seen by a speech and language therapist in order to determine appropriate timing for intervention.

Our therapists are trained in the early intervention Lidcombe programme and the Fun with Fluency programme, both of which are extremely successful for children who stammer.

Risk factors for stammering include:

• Family history of stammering
• Repetitions persisting for greater than 3 months
• Physical tension, blocks
• Male (4:1 higher incidence of stuttering among males)

It is thought that 1-2% of the adult population have a stammer, some of whom have their stammer under control through taught techniques. Long term stammering can be associated with low self-esteem issues, avoidance of speaking in certain situations and physical movements, which also occur in conjunction with stammering.

The cause of stammering is not fully understood; however, the most recent research suggests there is a genetic cause.

A speech and language therapist will be able to advise on stammering and the best intervention suited to you/your child. It is best to seek help as soon as possible, to determine the nature and severity of the stammer.

With adults, fluency shaping and management techniques such as cognitive behaviour therapy can be helpful. As with most therapy, a continuous and supportive method of intervention is important.

Upper Airway Disorder

Upper Airway Disorders affect the coordination of muscles in the throat (larynx). It can occur independently or can coexist with lower respiratory disease, e.g., asthma, COPD and bronchiectasis. These disorders result from heightened sensitivity in the throat and hyperactivity of throat muscles, which can result in the vocal cords shutting unnecessarily.

They include:

• Inducible Laryngeal Obstruction ILO (previously known as Vocal Cord Dysfunction).
• Exercise Induced Laryngeal Obstruction – frequently occurs during sport/exercise.
• Chronic Cough – dry coughing bouts, which persist for more than 8 weeks and does not respond to medication.
• Throat Clearing – often a response to an irritation in the throat that will not clear.
• Globus Pharyngeus – A lump sensation in the throat in the absence of a physical lump.
• Voice Difficulties – Due to muscle tightness/inflammation
• Swallowing Difficulties – often associated with altered laryngeal sensitivity and/or constriction in the throat.

Speech and Language Therapists support people with Upper Airway Disorders through teaching new breathing strategies, throat and upper body relaxation exercises and giving advice on how to maintain a relaxed larynx including throat care advice, behaviour change techniques and offering psychological support.

Deirdre Kiernan specialises in Upper Airway Disorders and sees clients nationwide.

Voice Disorders

Voice disorders can be extremely distressing, as your voice is unique to you and  is essential for effective communication. However, with the correct diagnosis and treatment, improvements can be made in most cases.

Deirdre Kiernan is a voice specialist and sees people from all over the country, often via online therapy which has proven to be extremely successful.

Voice disorders can occur in both adults and children. They can be associated with a person’s occupation e.g., teaching, singing, acting, sales, customer service etc.

Voice disorders have a multitude of causes, the most common being muscoskeletal tension, vocal misuse, reflux and vocal cord pathologies e.g., vocal nodules, laryngitis and vocal cord paralysis.

Symptoms of voice difficulties include:

• Strain/discomfort when speaking/singing
• Vocal fatigue/weakness
• Hoarseness/inconsistent quality
• Unable to sing/loss of pitch range
• Discomfort in the larynx/neck area
• Complete loss of voice
• Difficulty with projection

Treatment can include:

• Sharing of information on the specific nature and cause of your voice difficulties
• Correct maladaptive vocal behaviours
• Vocal exercises to reduce tension of the internal muscles of the larynx and integrate these into daily routines.
• Exercises to increase vocal stamina
• Examine and massage the external muscles of the neck (Laryngeal Massage Therapy)
• Teach correct breathing techniques to improve singing/performing
• Teach specific singing techniques e.g., Estill, sob/twang
• Teach the client to self-monitor vocal strain
• Liaise with singing teachers/voice coaches

Voice therapy is typically 4-6 sessions however depending on the severity of the problem it can take longer.