Paediatric Services

  Children usually start saying their first words at year one, though some start talking later than their siblings or peers. Parents may hear from other parents: My child was silent and suddenly by age 3 or 4 started to talk and now she doesn't stop talking! This is what typically called Late Bloomers. On the other hand, late talkers have a delay in language onset with no medical or developmental problems/diagnosis. Some children may be diagnosed with delayed language or language disorders. In fact, the speech-language pathologist can tell you after the assessment if your child has delayed language, language disorder, or if he/she is late talker. 

 A child with delayed language may or may not have a diagnosis of medical/developmental disorder or illness, and the delay may solely be in the expressive language or mixed (receptive "understanding" and expressive "verbal and gestures"). On the other hand, language disorder can be associated with certain diagnoses such as Autism. A child with language disorder may have impairment in pre-verbal skills, receptive, expressive language and social skills. The Speech-Language Pathologist (S-LP) is trained to assess your child's language abilities by using formal and informal testing, observing you and your child's interaction and communication, and we he/she will tell you the results. Then the S-LP writes the best treatment plan for your child in collaboration with the parent. For toddlers and preschoolers, a Hanen-certified S-LP will coach you how to use the best strategies to improve the interaction between you and your child, and to enhance your child's language abilities. 

 Articulation disorder is a condition when a child or an adult has a problem in producing speech sounds clearly and accurately.

A motor speech disorder is a condition when your child is having difficulty planning, controlling, and sequencing the movement of the oral structures to produce the proper speech sounds in words and phrases. Articulation and motor speech disorders may range from mild to severe depending on the impact on speech clarity. There are several causes of speech disorders. It could be functional or structural. The S-LP with motor speech training such as PROMPT is able to professionally assess your child's speech production and design a proper treatment plan in order to improve and target the oral sensory and motor structures, muscle control, and muscle movement.

  It is not uncommon to hear a child talking like this: I I I want I want a car. This disfluency is normal in children around age 3 years. On the other hand, we may hear a child speaking in a different way: 'I I wa wa wa want a ccccar'. His/her speech also may have some tension and you feel his/her words are getting stuck. This child may hesitate, block, or repeat some syllables or sounds in their speech e.g.. "which is known stammering/stuttering". Stuttering is one of the most common fluency disorders. There are other types of fluency disorders such as cluttering "mostly known as talking too fast", and high normal-disfluency. The S-LP with Lidcombe Program training is professionally trained to coach parents how to reinforce and praise fluency, and teach your child with stuttering some techniques and strategies to cope and minimize the moments of disfluency in their speech when needed (Fluency shaping Strategies).

  Have you ever heard a child with harsh or hoarse voice, or maybe that child lost his/her voice? This child may have a voice disorder. It could be due to either a medical reason or functional (voice misuse or abuse) which may lead to vocal diseases (e.g. vocal nodules, polyps, etc). Voice disorders may affect your child's voice quality, loudness (volume), and pitch (male vs female). The S-LP may need to do voice assessment (perceptual judgement and/or using special instruments) in collaboration with the ENT diagnosis and provide voice therapy based on the diagnosis and clinical findings.

Tongue thrust is an improper tongue function "pushing forward" during swallowing instead of raising up toward the alveolar ridge (the front part of the hard palate "roof of the mouth"). When the tongue is pushing forward, it causes changes in the oral and facial structure:

- Anterior Open Bite "Front teeth and front of upper jaw will be pushed forward which leads to an open space between teeth.

- Mouth Breathing: Difficulty to close the mouth.

- Speech disorders " All alveolar sounds "D, T, N, L, S, and Z" will be mispronounced: known as anterior lisping for S and Z.

- Tongue is visible while speaking or even at resting position.

- Messy or sloppy eating.

A Speech-Language Pathologist with experience or training in myofunctional therapy will correct the tongue position for swallowing and speech by providing certain instructions and exercises.

Autism Spectrum Disorder (ASD) is caused by differences and variations in the brain. The main characteristics of children with ASD are social communication and interaction difficulties. It also has other characteristics, but not limited to, that may be noted or not:

1- Poor eye contact.

2- Language Disorders.

3- Sensory Integration Dysfunction (Hyper or hyposensitive).

4- Repetitive Behaviors.

5- Restricted Interests.

6- Preverbal skills challenges (e.g. Joint Attention).

7- Emotional expression challenges.

8- Play (constructive play/functional play/ pretend play).

9- Repeat words/phrases (echolalia).

10- Cognitive and executive function disorders.

The S-LP will collaborate with other professionals (Behavioral Therapy, Occupational Therapy, Teacher, Physician, etc) to optimize treatment and improve the overall of the child's quality of life.

Some of children with ASD are speaking, while others are non-speaking. The S-LP will assess your child and will advise you the best method of communication that helps your child to express his needs, feelings, and thoughts (whether if it is spoken language, gestures, Aided or Unaided Augmentative and Alternative Communication AAC, Robust Vocabulary, or multi modal communication (mixed methods) , and to help your child improving the way of interacting and playing with other children.

To learn more about Ontario Autism Funding Program, please contact us!