12/14/08

Speech & Language Concerns

It is common for my students to experience speech and language concerns in addition to stuttering. According to Kenneth J. Logan, Ph.D., it may be that families of children who have additional concerns are more likely to seek speech therapy. Dr. Logan reports that studies have discovered up to 63% of children identified as stuttering also evidence co-existing impairments of language and/or speech sound production. Even children who appear only to stutter may have other subtle difficulties. "Children who stutter also seem to take longer than nonstuttering individuals to plan syntactic information...there is growing evidence that children and adults who stutter have difficulty executing language-related tasks, particularly difficult or demanding ones, as efficiently as people who do not stutter." For more information, visit http://www.mnsu.edu/comdis/isad7/papers/logan7.html to read Logan's article, When Children Who Stutter Present Co-occuring Speech-Language Disorders: Some Clinical Considerations.

Designing speech therapy activities becomes more complex when the SLP needs to keep in mind a student's articulation, phonology, or language concerns. Traditional stuttering therapy already requires that she create engaging activities that involve speech and language simple enough to increase fluency. When a child has additional concerns, Logan suggests that she has 3 choices:

1. treat both the stuttering and speech/language issues simultaneously

2. treat the stuttering and other issues in a cyclic fashion - treating only 1 issue for a set period of time, then switching to another issue for a set period of time, etc.

3. treat each speech/language concern in sequence - remediating one communication issue first before moving on to another

"Research has repeatedly shown that fluency, articulation, and language skills are interrelated. For instance, the syntactic complexity of a sentence affects how fluently children speak and how accurately they produce consonants. So, regardless of which intervention approach is selected, SLPs need to have a keen sense of how difficult a particular articulation, fluency, or language target is." Logan offers some advice, but allows for the SLP's discretion. The SLP may have a personal preference or collaborate with family and other professionals in this decision making process.

Literacy is one issue I've encountered repeatedly in my practice. I have included many literacy based activities in a casual way, from letter identification all the way up to analyzing narratives at the high school level. The American Speech Language Hearing Association produced a Position Statement in 2001 stating that SLPs "play a critical and direct role in the development of literacy for children and adolescents with communication disorders." Published Guidelines, Technical Report, and Knowledge and Skills documents describe the SLP's scope of practice in the area of literacy. The interested SLP can purchase an ASHA Professional Development course entitled Roles and Responsibilities of Speech-Language Pathologists With Respect to Reading and Writing in Children and Adolescents (ASHA Self-Study 7421) for a detailed introduction to this area of practice.

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.