Speech Therapy Services

Aphasia is a language disorder that occurs when there is damage to portions of the brain responsible for speech and understanding language. Common causes for aphasia include a stroke, brain tumor, head injury, or an infection. A person with aphasia may have difficulty finding the right words when speaking, formulating sentences, understanding words or sentences when someone is speaking to them, reading, and/or writing.

Apraxia is a motor speech disorder that occurs when brain pathways to the mouth are disrupted. The interruption of pathways makes it difficult for a person to control the movement of their mouth, lips, and tongue. A person with apraxia may know what they want to say but are unable to properly plan and sequence movements of the mouth to create words and sounds. With apraxia, a person may mispronounce words, or say a word right the first time and then say it differently the next time.

Articulation and phonological disorders refer (to the way sound is produced) are types of speech sound disorders. A person diagnosed with articulation disorder struggles to make proper sounds for a word. Listed below are 4 types of articulation disorders. The acronym for remembering these disorders is S.O.D.A. Substitution, Omitting, Distorting, Adding.

• Substituting one or more sounds in a word. For example, “wabbit” instead of “rabbit.”
• Omitting certain sounds, for example, the word “banana” may be pronounced “nana.”
• Distorting sounds by changing letters in a word, for example, the distortion of the letter “s” would be “th.” Instead of saying the word “sound,” they would say “thound.” This is also known as having a lisp.
• Adding extra sounds to a word, for example, the word “play” would be pronounced “puhlay.”

Phonological disorders refer to patterns that help form sounds for a word. A person with a phonological disorder has difficulty learning and processing language patterns. Sounding out words correctly is challenging.

Dysphagia is defined as difficulty swallowing. This can happen when something goes wrong with the muscles that direct movements of the mouth, throat, and/or esophagus. Some people have problems swallowing certain foods or liquids, while others are unable to swallow at all. Symptoms of dysphagia may include, but are not limited to, pain while swallowing, coughing, choking, or gagging while swallowing, drooling, difficulty chewing, a gurgly-wet-sounding voice when eating or drinking, bringing food back up, sometimes through the nose, or a sensation that food is stuck in their throat or chest. If left untreated, dysphagia can also cause symptoms such as weight loss due to malnutrition or dehydration, and repeated chest infections such as pneumonia.

Expressive language is the ability to formulate sentences and express thoughts and feelings using words. Receptive language is the ability to understand words and sentences. A child with an expressive language disorder may have a reduced vocabulary for their age or struggle with using appropriate grammar and making sentences that are clear to their communication partners. A child with a receptive language disorder may have following instructions or understanding questions.

Fluency disorders are characterized by difficulty with the flow and rhythm of speech. A person with a fluency disorder may have atypical rhythm and rate, as well as disfluencies (e.g., sound, word and phrase repetitions, blocks, and prolongations).

• Stuttering is the most common fluency disorder. A person who stutters may repeat sounds, whole words, or parts of words, block words (e.g., unable to start a sound), or drag out syllables. Stuttering can make being understood difficult and lead to negative associations with speaking. 
• Cluttering may present with or without stuttering. Cluttering is characterized by inappropriate pausing, rapid rate of speech, irregular rate of speech, frequent disfluencies, collapsing syllables, omitting syllables, and/or difficulty formulating sentences. These difficulties often make it challenging to effectively participate in conversations.

There are three types of hearing loss - conductive, sensorineural, and mixed. A person’s type of hearing loss depends on which part of the ear is damaged. Conductive hearing loss is caused by damage in the outer and/or middle ear that prevents sound from getting to the inner ear. Sensorineural hearing loss is caused by damage to the inner ear. Mixed hearing loss is caused when conductive and sensorineural hearing loss occurs at the same time, meaning there is damage in the outer or middle ear as well as damage in the inner ear. Hearing loss is diagnosed by an audiologist, who will make recommendations regarding amplification (e.g., hearing aids). People with hearing loss may require speech therapy to improve their quality of life.

Pragmatics refers to social skills and the ability to interact appropriately with others. People with pragmatic disorders may present with poor eye contact, difficulty taking turns in conversations, difficulty understanding sarcasm and metaphors, and challenges making and keeping friends.

Speech sound disorders refer to difficulty with perception, motor production, and/or phonological representation of speech sound and segments.  Speech sound disorders include apraxia of speech, articulation disorders, dysarthria, phonological disorders, structural differences, and difficulties secondary to hearing loss.

• Apraxia of speech (AOS), or verbal apraxia, is a motor speech disorder that occurs when brain pathways involving the planning and sequencing of movements for speech are disrupted. The interruption of pathways makes it difficult for a person to control the movements of their mouth, lips, and tongue properly. People with AOS know what they want to say but are unable to properly plan and sequence the movements to create the desired sounds and words.  A person with AOS may distort lots of sounds, especially vowels. They may make sound substitutions, grope for sounds, and make errors in tone, stress, or rhythm. Making inconsistent errors in speech is also common for people with AOS. The severity of AOS varies from person to person and can be acquired, by either a stroke or occurrences in childhood, which is present from birth and is classified as developmental. The causes of childhood apraxia (CAS) are not yet well understood.
• Articulation disorders are characterized by difficulty with making individual speech sounds. For example, a child with an articulation disorder (such as a frontal lisp) may say, “thing” for “sing.” 
• Dysarthria is a disorder caused by muscle weakness that impacts both speech and voice. It causes difficulty speaking, often characterized by slurred or slow speech, which can make it difficult for others to understand.  
• Phonological disorders are characterized by predictable error patterns that impact more than one sound. For example, children with a phonological disorder may present with gliding in which they substitute /w/ for /r/ or /l/ (e.g., “wabbit” for “rabbit” and “wike” for “like”). 
• Structural differences such as cleft lip and/or palate, underbites, overbites, open bites (where teeth don’t touch in the center), severely narrowed nasal passages, and tongue ties can all negatively impact the way a person is able to produce speech sounds.