- What is a speech pathologist?
- Is there a difference between a speech pathologist and a speech therapist?
- What credentials do speech pathologists have?
- What is the difference between speech and language?
- What is the difference between a delay and a disorder?
- As a parent, when should I be concerned?
- What can I do to help my child’s speech and language development?
- My child is being raised in a bilingual household. How will that affect his or her development?
- Ok, I am concerned. Now what?
- Do you accept insurance?
- How can I obtain reimbursement from my insurance provider?
A speech pathologist is a professional who evaluates, diagnoses, and treats speech, language, and/or swallowing disorders in children and adults.
The word ‘pathologist’ refers to a professional who studies and diagnoses diseases. The word ‘therapist’ refers to a professional who is skilled in a particular type of therapy. The two words, although different, are used interchangeably to describe a professional who assesses and treats speech, language, and/or swallowing disorders.
All practicing speech pathologists are required to hold a license in the state in which he or she practices. Most speech pathologists have attained and maintained ASHA (American Speech, Language and Hearing Association) certification. ASHA ensures that speech pathologists possess a Certificate of Clinical Competency (CCC) and are held to high standards in regard to education and practice. School-based speech pathologists are required to hold an additional certification granted by the New York State Education Department known as TSSLD or Teacher of Students with Speech and Language Disabilities.
Speech, often referred to as articulation, is the formulation of speech sounds. In order to produce speech sounds effectively, the coordination of the speech subsystems (i.e., respiration (breathing), phonation (voice), resonation (sound), prosody (rhythm and stress), and articulation (using the tongue, lips, teeth, and palates to form sounds)) is required. If there is a breakdown anywhere along the continuum, the production of speech sounds will be affected.
Language, a method of understanding (receptive language) and using (expressive language) communication, includes what words mean, how to make new words, how to put words together, and which words combinations best suit a given situation. Content (i.e., the meaning of a message), form (i.e., the organization and structure of words to form sentences), and use (i.e., the function of language or why people communicate) comprise language. Language consists of gestural communication (e.g., pointing, showing, demonstrating), oral communication (i.e., speaking), and written communication (i.e., reading and writing). Through language, one’s knowledge, beliefs, and behavior can be experienced, conveyed, and shared.
A speech or language delay refers to the development of skills in a fairly predictable manner, but at a slower rate than what would typically be expected. A child with a speech or language delay displays skills that are developing at a slower rate than their same-age peers, but with time, age-appropriate communication skills can develop. Treatment is beneficial. Please see related research.
A speech or language disorder refers to abnormal development of language skills and the presence of deviant speech sound production. Speech and language disorders are common, especially during preschool, where approximately one out of every ten children is affected. Unlike speech or language delays, speech or language disorders will NOT remediate with time alone. Treatment is required.
If you have any concerns at all, you should consult with your child’s pediatrician as soon as possible. As a parent, it is difficult not to compare your child’s development with that of his or her peers. Please keep in mind that within the realm of ‘normal’ development, there is a lot of variability. My biggest piece of advice to parents is to trust your judgment and act in a time efficient manner. Please refer to the following chart detailing typical speech, language, and hearing milestones.
- Communicate with your child frequently and provide quality responses. Modeling appropriate language provides children with words, nuances, and patterns to emulate.
- Explain away! Even when your child doesn't ask, explain away. Explain your reasoning as you're going through the day; explain why you need that morning coffee, why ice-cream doesn't go in the pantry, why you blow-dry your hair, why the dog can't have chocolate milk for breakfast. Reasoning skills require a higher-level thought process, which are difficult and may take years to master. Providing explanations frequently throughout the day as opportunities arise is a naturalistic way to encourage the development of such skills.
- When your child initiates an appropriate conversation, try your best to expand his or her thoughts. Phrases such as "Why do you ask?", "Tell me more about that.", or "How do you feel about ...?" are good thought-provoking questions.
- Sing common tunes with your child. Create your own song to the tune of your child’s favorite song (I often use “If You’re Happy and You Know It” or “London Bridges” advantageously to teach language concepts).
- Read with your child every day. Please see Tanya’s book of the month.
- Use subtle language. Phrases such as "I'm sooooo thirsty", "My stomach hurts", or "my hair is in my face, and it's bothering me" are good examples to try and elicit theory of mind (to be able to reflect on the contents of one’s own thoughts and attribute those thoughts to someone else) and deductive reasoning skills (applying general knowledge to a specific instance; the basic idea that if something is true for a class, it will be true for every member in that class).
- Encourage interactive play. Games like ‘I Spy’ (one player picks an item in his/her environment and describes it thoroughly while other players guess at what it could be), ‘Hot and Cold’ (one player hides a predefined object and directs the other player toward the object by using the words hot and cold (and derivatives thereof; e.g., cool, cooler, ice-cold, warm, warmer, boiling)), and refrigerator box spaceship (or castle, racecar, truck, or house) capture all domains of development beautifully (cognitive-linguistic (intellectual development), physical (development of body structure), social-emotional (development of interaction with others)).
- Allow your child to be the teacher. Day trips to museums, zoos, parks, swimming pools and nature reserves provide the perfect forum for the expression of ideas. Play along, act surprised! Pretend that you don’t know the information your child is presenting you with. Pretending presented information is novel or that you forgot how to complete a routine task lends nicely to the expression of language. As a speech pathologist, there is not a day that goes by when the children I work with don’t look at me with wide eyes, laughing hysterically, saying how silly I am as I pretend to forget routine concepts. At which point I am beyond delighted to hear, “Tanya, the book is under the chair!” or “It’s not Sunday, it’s Thursday!” Is there any better naturalistic expression of language?
According to a research study conducted by Cole and Cole in 1993, children acquiring language typically, without the presence of a deficit or delay can acquire more than one language rapidly between the ages of 2 and 6 and that by age 6, they are competent language users and the acquisition is seemingly effortless in nature. Learning two languages will often take a slightly longer time; however, most children will still meet major developmental milestones appropriately (e.g., producing first words around 12 months of age and combining words around 24 months of age). Most children being raised in a bilingual household will go through a period of time where they ‘code switch’, or switch between languages within the same sentence or phrase. Children acquiring two languages simultaneously often display strong receptive language skills (comprehension of language) in both languages, strong gestural communication skills (e.g., pointing, showing, demonstrating), and strong play skills. Expressive language skills (use of language) may take slightly longer to emerge, especially when the second language is initially introduced (if both languages were not acquired simultaneously). Between the ages of 4 and 6, the mastery of both languages develops and the child is able to display age-appropriate communication skills in both languages.
If you have concerns about your child’s speech and language development, a comprehensive speech and language evaluation might be warranted. An evaluation will determine whether or not your child is developing speech and language skills appropriately. Through formal and informal assessment measures, a speech pathologist is able to verify whether or not your child would benefit from speech therapy services.
In order to provide the quality of service and clinical judgment our clients have come to expect, we have elected not to participate directly with insurance plans. However, clients may be able to obtain reimbursement for our services directly from their insurance providers.
In order to process a reimbursement claim, your insurance company will require a script from your child’s pediatrician indicating that a speech and language evaluation is warranted. After the evaluation is completed, you will be provided with an invoice for services rendered. You may then submit the script, invoice, and completed evaluation to your insurance provider. Since Tanya Hefets is considered an ‘out of network’ provider, you may be required to meet a deductable prior to receiving reimbursement. You will likely be assigned a case manager to keep in touch with regarding reimbursement claims. All necessary paperwork will be provided to you upon request.