Speech Therapy

We offer outpatient evaluations and treatment for children who have difficulty understanding what others are saying and expressing themselves. This is a common communication disorder in young children. Children often have difficulty understanding directions and/or communicating their wants and needs in an effective verbal manner.

An articulation disorder is a speech disorder involving difficulties in producing specific types of sounds. Articulation disorders often involve substitutions of one sound for another, distortions or omissions, slurring of speech, or unclear speech. Speech therapy is often the course of treatment is often the course of treatment and we offer clinicians with certification in PROMPT therapy.

PROMPT, an acronym for PROMPTS for Restructuring Oral Muscular Phonetic Targets, is a multidimensional approach to speech production disorders and has come to embrace not only the well-known physical-sensory aspects of motor performance but also its cognitive-linguistic and social-emotional aspects. PROMPT is about integrating all domains and systems towards positive communication outcome. It may be used (with varying intensity and focus) with all speech production disorders from approximately six months of age onward. To achieve the best outcome with PROMPT, it should not be thought of or used mainly to facilitate oral-motor skills, produce individual sounds/phonemes, or as an articulations program to develop motor skill in the development of language for interaction.

Our speech pathologists have specialized training in fluency disorders such as stuttering and cluttering and can evaluate your child to determine the appropriate treatment. Fluency is the part of speech that refers to continuity, smoothness, rate, and effort. Stuttering is the most common fluency disorder. It often includes repetitions of words or parts of words as well as prolongations of speech sounds.

Cluttering, another fluency disorder, is characterized by a rapid rate of speech, erratic rhythm, and poor syntax and grammar, making speech difficult to understand. Stuttering typically begins in childhood. Most children who stutter begin to do so when they are 2. Approximately 95 percent of children who stutter start to do so before age 5.

Treatment is highly individualized. In creating a treatment plan and setting goals for fluency, our speech language pathologists use linguistically and culturally appropriate stimuli and are sensitive to the unique values and preferences of each individual. 

• Read more at the National Stuttering Association
• Read more at The Stuttering Foundation

Common voice disorders may include: 

• Neurological voice disorders (spasmodic dysphonia)  
• Vocal cord spasms that disrupt speech and voice quality 
• Polyps, nodules or cysts on the vocal cords  
• Growths on the vocal cords that may cause hoarseness; breathiness; harsh-sounding voice 
• Vocal cord paralysis or weakness  
• Abnormal function of the nerves that control your voice box muscles  
• Vocal Cord Dysfunction (VCD) 

Some children also have swallowing problems, or dysphagia.

 A speech-language pathologist trained in feeding and swallowing can look at how your child eats and drinks. They may ask questions about your child's medical history and development; see how your child moves his mouth and tongue; watch your child eat to see how she picks up food, chews, swallows, and drinks; and watch how your child behaves during meals.

Your child may need feeding or swallowing treatment where we will work on: 

• making the muscles of the mouth stronger
• helping tongue movement
• helping chewing
• getting try new foods and drinks
• improving sucking from a bottle or drinking from a cup
• helping learn how to breathe while sucking and swallowing.
• changing food textures and liquid thickness to help swallow safely
• getting your child to focus during meals
• helping with sensory issues
• Improving the way you hold your baby or how your child sits when eating

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We provide cognitive-communication rehabilitation to address problems with thinking that children may experience following a brain injury or concussion. 

Children with a cognitive communication disorder may experience difficulty with memory, attention, problem-solving, reasoning, planning, and executive functions such as inhibition, initiation, cognitive organization, self-monitoring, and cognitive flexibility. These challenges may impact a child’s functioning at home, at school and within the community. It may be more difficult for them to remember and understand information, complete tasks within a reasonable amount of time, manage their time, remain focused on a task, or learn new information. 

Therapy is highly individualized, guided by thorough cognitive-communication assessments, to target the functional needs of each individual and their family. A treatment plan is developed to help the child achieve the greatest level of success as they transition back to their daily routines and return to school. Therapy usually consists of exercises to improve the child’s cognitive skills as well as compensatory strategies. These strategies are often a mix of metacognitive strategies that the child is trained to use on their own and environmental strategies that parents and caregivers can use to increase their child’s performance. 

The Bioness Integrated Therapy System (BITS) is utilized to evaluate and improve abilities with deficits resulting from traumatic brain injuries and movement disorders, as well as improve performance in competitive athletes. The BITS is an excellent therapy tool used to address deficits in immediate and working memory, processing speed, problem solving and visual scanning. Adaptations can be made using the BITS to alter difficulty to meet the level of disability specific to each patient. The BITS can be used as a measurable modality that is rewarding and interactive. 

Recent advances in hearing technology have provided children with even the most profound hearing loss the potential to gain access to sound and achieve typical skills in listening, language, cognition and conversational competence.

Many families are choosing listening and spoken language as the choice for their young hearing impaired child. Auditory-Verbal Therapy (AVT) guides parents through the technology, therapeutic and educational services needed for their children to develop spoken language skills.

Through AVT, parents and caregivers gain the tools they need to become the child's primary language facilitator. Therapy is guided by a speech pathologist that has undergone extensive training in coaching, providing appropriate techniques to access sound and language as well as knowledge of the latest technology available for the child to be successful.  

• Read more at Virginia Department for the Deaf and Hard of Hearing

CHKD offers literacy evaluations and treatment at our outpatient sites. Our speech pathologists that specialize in providing literacy evaluations and treatment have completed their training in speech-language pathology at the master's degree level. They have additional training in the areas of phonological awareness, reading, spelling, and written expression sciences as recommended by the American Speech Language Hearing Association and the International Dyslexia Association standards. 

We can evaluate and treat children for literacy concerns as early as the second semester of kindergarten through high school. If therapy is indicated, we formulate individual treatment plans based on evidence-based research and the needs of the child.  All literacy therapy requires caregiver involvement and a home practice plan.

• Read more at International Dyslexia Association

CHKD offers augmentative and alternative communication evaluations and treatment that encompass communication methods used to supplement or replace speech for those with impairments in the production of spoken or written language.

 AAC is used by those with a wide range of speech and language impairments, including congenital impairments such as cerebral palsy, intellectual impairment, genetic disorders or autism, and acquired conditions such as amyotrophic lateral sclerosis, stroke, traumatic brain injury, or Parkinson's disease.

AAC can be a permanent addition to a person's communication or a temporary aid. AAC devices are able to be accessed by direct selection, switches, eye gaze, or head tracking.

Devices range from low tech, such as use of ASL signs or writing down thoughts and ideas on paper, to high tech, such as use of a computer-based system.  CHKD offers both AAC evaluations and AAC therapy sessions. AAC evaluations are completed with both speech therapists and occupational therapists. The speech therapists assess expressive and receptive language deficits, as occupational therapists address fine motor impairments and accessing of the device.