If you’ve read the first of this two-part series on Speech and Language: What’s the Real Difference, you will know that ‘speech’ refers to when a child makes the different sounds needed to communicate in words and that ‘language’ refers to the ability of a child to understand and use words and sentences to share thoughts and feelings.
In that first post you will have read that there is a difference between speech and language:
speech development starts in infancy
infant's speech development is 'babbling'
there are two language developmental trajectories
analytical (or typical) language development is for kids who start with words and build up
gestalt language development is for kids who start with large chunks and break them down into moveable words
In today's second part of this blog series on the difference between speech and language, I will go over:
who diagnoses speech and language
what a speech and language evaluation typically looks like
what is done differently for speech versus language evaluations
some tips on how parents who start speech or language therapy
how to discuss concerns with your child’s pediatrician
So let’s start by talking about some of the professionals who look at speech and language.
Who Diagnoses Speech and Language?
Parents have a pretty good gut, I say, so if you feel there is something off in the development of your younger child's speech or language skills, please don't put pressure on yourself to know everything. Your community has resources and as a smart parent, you are already tapping into them.
Whether it's your child's pediatrician, a teacher, or a family member, there are the people in your child's life who can sometimes spot potential indicators of communication delay, deficit, or difference.
Professionals like these are the initial point of contact a first referral source for parents seeking guidance. However, it's important to note not even a physician, a developmental neurologist, or a highly experienced teacher can officially diagnose a child's speech or language delay. That training is solely in the scope of a certified speech-language therapist, and one with pediatric experience.
So, who is the very best person to consult about whether your child may have a speech and language delay, disorder, or difference?
For example, I sometimes read or see parents mention that their doctor or neurologist has diagnosed their child with apraxia of speech. In reality, only an apraxia-trained SLP can diagnose this particular speech disorder. The role of a physician in something like apraxia is to make note of and refer to an SLP. The role of a neurologist is to rule out other possible co-existing neurological issues.
So, who is the very best person to consult about whether your child may have a speech and language delay, disorder, or difference? Guess what? Speech disorders are diagnosed only by speech-language pathologists!
Guess what? Speech disorders are diagnosed only by speech-language pathologists!
X Developmental pediatrician
X Family or friends
√ Speech-Language Pathologist
Difference Between Speech and Language Evaluations
To find out if your child has a speech or language delay, deficit, or difference that would benefit from speech therapy, a speech and language evaluation is needed. This type of evaluation is the first step after a consultation with an SLP. Your SLP will determine what types of assessments are needed to determine if any delay exists for either speech or language.
A Speech Evaluation
For a speech evaluation, the SLP will typically show pictures or play items and prompt your child to name them as best they can. This is done by using a standardized or informal articulation assessment.
The SLP will often also include something called an "oral mechanism examination" with a speech assessment. Similar to when a physician asks a patient to open wide and say 'Ahhh', the SLP's oral exam looks for structure and function of the specific parts of the mouth used in speech.
In some cases, an apraxia-trained SLP may conduct a second exam to obtain information related to apraxia. And usually, a portion of the time is spent just chatting and connecting, which can tell the SLP a lot about the child's temperament, readiness for therapy, and use of speech sounds in conversation.
Speech Evaluations can include:
an articulation assessment tool
an oral mechanism exam
an apraxia assessment
A Language Evaluation
For a language evaluation, the SLP will also likely show some pictures or items and interact with the child to elicit some spoken language. This is done by using a standardized language assessment tool.
The SLP will likely also converse or play with the child and record what he says. These language samples can give additional insight into where your child is at now with their self-generated language. Language samples are especially useful to discover what stage of gestalt development a suspected gestalt language processor is at.
Sometimes the parent is given a checklist or questionnaire to answer based on their own observations at home.
Language Evaluations can include:
a language assessment tool
a language sample
a parent/caregiver checklist
Overall, whether it's for speech or language, the results of an evaluation will give a lot of clarity on what is going on with the child's communication and what types of therapy can help. This is equally true of evaluations that take place at an in-person clinic or at an online speech therapy clinic.
Parent Tips for Speech or Language Therapy
Read the evaluation and treatment plan
If your child is evaluated by an SLP and found to have a delay in speech or language, you will then be offered an evaluation report and a treatment plan. The evaluation provides the diagnosis. The treatment plan will have specific goals. I urge parents to read both documents fully. Be sure to find the goals section and read the goals. You want to know what the therapist thinks is best to work on with your child.
Read the evaluation; know the diagnosis
Read the treatment plan; know the goals
At AnetSpeech, following an evaluation appointment, I arrange a session with parents to review the evaluation report and objectives outlined in the preliminary treatment plan. During this discussion, I encourage parents to share their insights into a collaborative approach to finalize the goals. It's important to me that parents understand the objectives and the reasons behind them. I also encourage parents to be willing to work with me on homework I give them.
Once therapy starts, then what can parents do?
Be a team player with your SLP
Depending on the age of the child, parents can be present at the speech session. Some in-person clinics may not allow this. At my virtual clinic, parents are encouraged to join the video session. This is especially true for younger children where my focus may be a parent-coaching approach. A parent-coaching approach for younger kids surrounds those children with more learning opportunities more days of the week.
With some clients I use the direct-child approach, working directly with the child in the video session. Once the child begins to make some progress I will create individualized homework for the child and demonstrate the homework to the parent in the last few minutes of the session. Again, I want parents to be part of the team and for the child to receive specific, targeted support many days of the week.
Attend the speech session if possible
Learn the parent technique to practice
Help your child with speech homework
Discussing Concerns with Your Pediatrician
Pediatric physicians play such an important role in guiding parents of young children! Well-child visits every few months as infants, twice a year as toddlers, and then annually after age three are essential to keeping tabs on your child’s overall health and development.
When talking to your physician about your child at annual well-visits, it's a great idea to print out a speech and language development milestone chart, take it with you, and tell your physician things you may not be seeing yet. You can download my Quick Speech and Language Milestones handout for that purpose. It can help you when talking about the difference between speech and language skills your child has or doesn't have.
Give your pediatrician specific examples of areas of your concerns. Even if your pediatrician suggests 'wait and see', I suggest parents "follow their gut" and ask anyway for an SLP referral. You can download my free physician prescription form, in case that's helpful to you. With speech therapy, the earlier the better. Identification of needs and intervention with well-matched speech therapy help a child’s potential to close the gap between him and his peers.
Take any concern to your pediatrician
Take a communication milestone chart with you
Be careful about 'wait and see' advice
Ask for an SLP referral/prescription
Some families, when advised to wait and see, and to get speech services after their child turns three, end up on waiting lists that can be several months long. However, with the increase of trained online speech therapists, parents now have many more options for avoiding long waitlists.
Additionally, every state provides free speech therapy from birth to three years old, and every school district is obligated to evaluate children in their boundaries starting at three years of age. There really is no reason to 'wait and see'.
An Extra Tip!
When looking for a speech therapist, remember most search engines are only going to show you SLPs whose main office is near your zipcode. But zipcode results don't give you all your options. I encourage parents to search for "SLP in CITY" and to do this search for various cities anywhere in their state. Look at results and follow up with a consultation request to SLPs who offer teletherapy services for your communication concerns.
Search engines like Google and Bing have not yet caught up in their algorithms to give people results outside of the searcher's zipcodes. But doing multiple searches across cities in your state will allow you to access more online speech therapy options.
In this post, I've covered a few topics about the difference between speech and language. We've talked about:
Who can diagnose a speech and language disorder
What to expect at a speech and language evaluation
What are some parent tips for both speech and language therapy
An extra tip for avoiding long waiting lists
How to talk to your pediatrician about communication concerns
By now you should feel more confident in knowing the differences between speech and language and what typical milestones will look like for each. You now have tools and resources to support your child’s speech and language development at home and can feel empowered when talking to your child’s pediatrician about your concerns. Remember, the ‘wait and see’ model is not recommended these days, so don’t be afraid to ask for an SLP referral to get your child the speech therapy they may need! If you want to know more in relation to your child, whether your child is age 3 to 11, or anywhere between, feel free to connect with me for a consultation!
Most of all, know that you are a wise parent, who is going the extra mile for your child!