speech and language impairment modifications

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Speech and Language Impairments

The Individuals with Disabilities Education Act, or IDEA, defines the term “speech or language impairment” as follows:

“(11)  Speech or language impairment  means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance.” [34 CFR §300.8(c)(11]

(Parent Information and Resources Center, 2015)

Table of Contents

What is a Speech and Language Impairment?

Characteristics of speech or language impairments, interventions and strategies, related service provider-slp.

• A Day in the Life of an SLP

Assistive Technology

Speech and language impairment  are basic categories that might be drawn in issues of communication involve hearing, speech, language, and fluency.

A speech impairment is characterized by difficulty in articulation of words. Examples include stuttering or problems producing particular sounds. Articulation refers to the sounds, syllables, and phonology produced by the individual. Voice, however, may refer to the characteristics of the sounds produced—specifically, the pitch, quality, and intensity of the sound. Often, fluency will also be considered a category under speech, encompassing the characteristics of rhythm, rate, and emphasis of the sound produced.

A language impairment is a specific impairment in understanding and sharing thoughts and ideas, i.e. a disorder that involves the processing of linguistic information. Problems that may be experienced can involve the form of language, including grammar, morphology, syntax; and the functional aspects of language, including semantics and pragmatics.

(Wikipedia, n.d./ Speech and Language Impairment)

*It’s important to realize that a language delay isn’t the same thing as a speech or language impairment. Language delay is a very common developmental problem—in fact, the most common, affecting 5-10% of children in preschool.  With language delay, children’s language is developing in the expected sequence, only at a slower rate. In contrast, speech and language disorder refers to abnormal language development.  Distinguishing between the two is most reliably done by a certified speech-language pathologist.  (CPIR, 2015)

The characteristics of speech or language impairments will vary depending upon the type of impairment involved. There may also be a combination of several problems.

When a child has an  articulation disorder , he or she has difficulty making certain sounds. These sounds may be left off, added, changed, or distorted, which makes it hard for people to understand the child.

Leaving out or changing certain sounds is common when young children are learning to talk, of course. A good example of this is saying “wabbit” for “rabbit.” The incorrect articulation isn’t necessarily a cause for concern unless it continues past the age where children are expected to produce such sounds correctly

Fluency  refers to the flow of speech. A fluency disorder means that something is disrupting the rhythmic and forward flow of speech—usually, a stutter. As a result, the child’s speech contains an “abnormal number of repetitions, hesitations, prolongations, or disturbances. Tension may also be seen in the face, neck, shoulders, or fists.”

Voice  is the sound that’s produced when air from the lungs pushes through the voice box in the throat (also called the larnyx), making the vocal folds within vibrate. From there, the sound generated travels up through the spaces of the throat, nose, and mouth, and emerges as our “voice.”

A voice disorder involves problems with the pitch, loudness, resonance, or quality of the voice. The voice may be hoarse, raspy, or harsh. For some, it may sound quite nasal; others might seem as if they are “stuffed up.” People with voice problems often notice changes in pitch, loss of voice, loss of endurance, and sometimes a sharp or dull pain associated with voice use.

Language  has to do with meanings, rather than sounds.  A language disorder refers to an impaired ability to understand and/or use words in context. A child may have an expressive language disorder (difficulty in expressing ideas or needs), a receptive language disorder (difficulty in understanding what others are saying), or a mixed language disorder (which involves both).

Some characteristics of language disorders include:

• improper use of words and their meanings,
• inability to express ideas,
• inappropriate grammatical patterns,
• reduced vocabulary, and
• inability to follow directions.

Children may hear or see a word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to communicate. These symptoms can easily be mistaken for other disabilities such as autism or learning disabilities, so it’s very important to ensure that the child receives a thorough evaluation by a certified speech-language pathologist.

(CPIR, 2015)

• Use the (Cash, Wilson, and DeLaCruz, n.d) reading and/or the [ESU 8 Wednesday Webinar] to develop this section of the summary. 

Cash, A, Wilson, R. and De LaCruz, E.(n,d.) Practical Recommendations for Teachers: Language Disorders. https://www.education.udel.edu/wp-content/uploads/2013/01/LanguageDisorders.pdf 

[ESU 8 Wednesday Webinar] Speech Language Strategies for Classroom Teachers.- video below

Video: Speech Language Strategies for Classroom Teachers (15:51 minutes)’

[ESU 8 Wednesday Webinars]. (2015, Nov. 19) . Speech Language Strategies for Classroom Teachers. [Video FIle]. From https://youtu.be/Un2eeM7DVK8

Most, if not all, students with a speech or language impairment will need  speech-language pathology services . This related service is defined by IDEA as follows:

(15)  Speech-language pathology services  include—

(i) Identification of children with speech or language impairments;

(ii) Diagnosis and appraisal of specific speech or language impairments;

(iii) Referral for medical or other professional attention necessary for the habilitation of speech or language impairments;

(iv) Provision of speech and language services for the habilitation or prevention of communicative impairments; and

(v) Counseling and guidance of parents, children, and teachers regarding speech and language impairments. [34 CFR §300.34(c)(15)]

Thus, in addition to diagnosing the nature of a child’s speech-language difficulties, speech-language pathologists also provide:

• individual therapy for the child;
• consult with the child’s teacher about the most effective ways to facilitate the child’s communication in the class setting; and
• work closely with the family to develop goals and techniques for effective therapy in class and at home.

Speech and/or language therapy may continue throughout a student’s school years either in the form of direct therapy or on a consultant basis.

A Day in the Life of an SLP

Christina is a speech-language pathologist.  She works with children and adults who have impairments in their speech, voice, or language skills. These impairments can take many forms, as her schedule today shows.

First comes Robbie.  He’s a cutie pie in the first grade and has recently been diagnosed with childhood apraxia of speech—or CAS. CAS is a speech disorder marked by choppy speech. Robbie also talks in a monotone, making odd pauses as he tries to form words. Sometimes she can see him struggle. It’s not that the muscles of his tongue, lips, and jaw are weak. The difficulty lies in the brain and how it communicates to the muscles involved in producing speech. The muscles need to move in precise ways for speech to be intelligible. And that’s what she and Robbie are working on.

Next, Christina goes down the hall and meets with Pearl  in her third grade classroom. While the other students are reading in small groups, she works with Pearl one on one, using the same storybook. Pearl has a speech disorder, too, but hers is called dysarthria. It causes Pearl’s speech to be slurred, very soft, breathy, and slow. Here, the cause is weak muscles of the tongue, lips, palate, and jaw. So that’s what Christina and Pearl work on—strengthening the muscles used to form sounds, words, and sentences, and improving Pearl’s articulation.

One more student to see—4th grader Mario , who has a stutter. She’s helping Mario learn to slow down his speech and control his breathing as he talks. Christina already sees improvement in his fluency.

Tomorrow she’ll go to a different school, and meet with different students. But for today, her day is…Robbie, Pearl, and Mario.

Assistive technology (AT) can also be very helpful to students, especially those whose physical conditions make communication difficult. Each student’s IEP team will need to consider if the student would benefit from AT such as an electronic communication system or other device. AT is often the key that helps students engage in the give and take of shared thought, complete school work, and demonstrate their learning. (CPIR, 2015)

Project IDEAL , suggests two major categories of AT computer software packages to develop the child’s speech and language skills and augmentative or alternative communication (AAC).

Augmentative and alternative communication  ( AAC ) encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production or comprehension of spoken or written language. Augmentative and alternative communication may used by individuals to compensate for severe speech-language impairments in the expression or comprehension of spoken or written language. AAC can be a permanent addition to a person’s communication or a temporary aid.

(Wikipedia, (n.d. /Augmentative and alternative communication)

Center for Parent Information and Resources (CPIR)  (2015), Speech and Language Impairments, Newark, NJ, Author, Retrieved 4.1.19 from https://www.parentcenterhub.org/speechlanguage/

Wikipedia (n.d.) Augmentative and alternative communication. From https://en.wikipedia.org/wiki/Augmentative_and_alternative_communication 

Wikipedia, (n.d.) Speech and Language Impairment. From  https://en.wikipedia.org/wiki/Speech_and_language_impairment 

Updated 8.8.23

Understanding and Supporting Learners with Disabilities Copyright © 2019 by Paula Lombardi is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Top IEP Accommodations for Your Student with a Language-Based Learning Disorder

Having a language-based learning disorder can present unique challenges for students in the classroom. However, with the right accommodations, students with these challenges can excel in their academic pursuits. Here are the top 10 accommodations that you should request for your student with a language-based learning disorder:

Preferential seating

Students with language-based learning disorders often benefit from sitting near the front of the classroom, or away from distractions, to better hear and process information.

Extended time on tests and assignments

Allowing students extra time to complete assignments and tests can alleviate stress and allow for more thorough understanding and completion of the task at hand.

Audio recordings of lectures

Recording lectures can help students with language-based learning disorders to better process and retain information, as they can listen to the lecture multiple times if needed.

Use of assistive technology

Assistive technology such as text-to-speech software or speech-to-text software can help students with language-based learning disorders to better access and understand information.

Visual aids

Visual aids such as diagrams, pictures, and graphs can help students to better understand complex information and retain it more effectively.

Note-taking assistance

Students with language-based learning disorders may struggle with taking notes during lectures. Providing note-taking assistance, such as a copy of lecture notes, can help these students to better understand and retain the information presented.

Use of a calculator

Students with language-based learning disorders may struggle with mathematical calculations. Allowing the use of a calculator can help these students to better understand and complete mathematical tasks.

Reduced workload

Providing a reduced workload can help alleviate stress and allow students to focus on the most important tasks at hand.

Breaks during class or testing

Students with language-based learning disorders may benefit from short breaks during class or testing to alleviate stress and refocus their attention.

One-on-one instruction

Providing one-on-one instruction or tutoring can help students with language-based learning disorders to better understand and retain information in a more individualized setting.

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Teaching Strategies for Students with Communication Disorders

• Stephanie Torreno
• Categories : Teaching students with speech disorders
• Tags : Special ed information for teachers & parents

Teaching Strategies

Speech impairments include difficulties with articulation, voice strength, or the complete inability to produce speech. Stuttering, stammering, disfluency, hoarseness, breathiness, or breaks in volume or pitch are considered impairments as well. Speech impairments can be caused by cleft lip or palate, or by cerebral palsy, autism, learning disabilities, intellectual disabilities or have no known cause. This article will give you some teaching strategies for students with communication disorders. 

[caption id=“attachment_130917” align=“aligncenter” width=“640”]

Students with speech impairments may be difficult to understand and experience problems expressing ideas. These students may be reluctant to answer questions in class, and in particular, give presentations individually or in a group. Educators must be patient and encourage the student to participate in classroom activities, giving her adequate time to speak. Teachers should speak to the student as they would any other student. Do not interrupt or try to complete her thoughts. Ask her to repeat her message when necessary; do not feign understanding.

Specific Strategies for Teachers

Educators should create an environment of acceptance and understanding in the classroom, and encourage peers to accept the student with speech impairment. Practice and maintain easy and effective communication skills by modeling good listening skills and by facilitating participation of all students in classroom discussions and activities. If a student requires a sign language interpreter or the use of augmentative communication, provide adequate space and time to accommodate these forms of communication.

Some students with severe communication disorders will have deficits with the analytical skills required to read and write. Individual instruction may be necessary to remediate these deficits, but should be provided discreetly to avoid embarrassment and possible resistance. Teachers should constantly model the correct production of sound. Maintain eye contact with the student, then tell her to watch the movements of your mouth when providing direct instruction. Ask her to copy these movements when she produces the sounds.

When introducing new vocabulary, help a student with speech impairment practice difficult words. Dividing words into syllables and pronouncing each syllable will improve speech, reading and writing. Using many different listening activities will also aid the student in comprehending and determining her own production of sounds. Ask her if she hears the individual sounds in words by having her answer “yes” or “no.”

More specific teaching strategies for students with communication disorders include:

• Allowing more time for a student to complete activities, assignments and tests.
• Having a student sit near you to easily meet her learning needs.
• Discussing possible areas of difficulty and working with the student to implement accommodations.
• Always asking before providing assistance, and using positive reinforcement when the student completes an activity independently.
• Using peer assistance when appropriate.
• Modifying activities or exercises so assignments can be completed by the student, but providing the same or similar academic objectives.
• Creating tests that are appropriate for the student with speech impairment (for example, written instead of oral or vice versa.)
• Providing scribes for test taking if a student needs assistance.
• Making sure the student understands test instructions completely and providing additional assistance if needed.

Remember, patience is extremely necessary in teaching students with speech impairments. Accepting and accommodating an individual’s speech will benefit educators, classmates, and of course, the student herself by sharpening listening skills and promoting learning and understanding. After all, everyone’s voice deserves to be heard.

Image by  Henning Westerkamp  from  Pixabay

Language and Speech Disorders in Children

Helping children learn language, what to do if there are concerns.

• Detecting problems

Children are born ready to learn a language, but they need to learn the language or languages that their family and environment use. Learning a language takes time, and children vary in how quickly they master milestones in language and speech development. Typically developing children may have trouble with some sounds, words, and sentences while they are learning. However, most children can use language easily around 5 years of age.

Parents and caregivers are the most important teachers during a child’s early years. Children learn language by listening to others speak and by practicing. Even young babies notice when others repeat and respond to the noises and sounds they make. Children’s language and brain skills get stronger if they hear many different words. Parents can help their child learn in many different ways, such as

• Responding to the first sounds, gurgles, and gestures a baby makes.
• Repeating what the child says and adding to it.
• Talking about the things that a child sees.
• Asking questions and listening to the answers.
• Looking at or reading books.
• Telling stories.
• Singing songs and sharing rhymes.

This can happen both during playtime and during daily routines.

Parents can also observe the following:

• How their child hears and talks and compare it with typical milestones for communication skills external icon .
• How their child reacts to sounds and have their hearing tested if they have concerns .

Learn more about language milestones .  Watch milestones in action.

  Top of Page

Some languages are visual rather than spoken. American Sign Language uses visual signals, including gestures, facial expressions, and body movement to communicate.

Some children struggle with understanding and speaking and they need help. They may not master the language milestones at the same time as other children, and it may be a sign of a language or speech delay or disorder.

Language development has different parts, and children might have problems with one or more of the following:

• Not hearing the words (hearing loss).
• Not understanding the meaning of the words.
• Not knowing the words to use.
• Not knowing how to put words together.
• Knowing the words to use but not being able to express them.

Language and speech disorders can exist together or by themselves. Examples of problems with language and speech development include the following:

• Difficulty with forming specific words or sounds correctly.
• Difficulty with making words or sentences flow smoothly, like stuttering or stammering.
• Language delay – the ability to understand and speak develops more slowly than is typical
• Aphasia (difficulty understanding or speaking parts of language due to a brain injury or how the brain works).
• Auditory processing disorder (difficulty understanding the meaning of the sounds that the ear sends to the brain)

Learn more about language disorders external icon .

Language or speech disorders can occur with other learning disorders that affect reading and writing. Children with language disorders may feel frustrated that they cannot understand others or make themselves understood, and they may act out, act helpless, or withdraw. Language or speech disorders can also be present with emotional or behavioral disorders, such as attention-deficit/hyperactivity disorder (ADHD) or anxiety . Children with developmental disabilities including autism spectrum disorder may also have difficulties with speech and language. The combination of challenges can make it particularly hard for a child to succeed in school. Properly diagnosing a child’s disorder is crucial so that each child can get the right kind of help.

Detecting problems with language or speech

If a child has a problem with language or speech development, talk to a healthcare provider about an evaluation. An important first step is to find out if the child may have a hearing loss. Hearing loss may be difficult to notice particularly if a child has hearing loss only in one ear or has partial hearing loss, which means they can hear some sounds but not others. Learn more about hearing loss, screening, evaluation, and treatment .

A language development specialist like a speech-language pathologist external icon will conduct a careful assessment to determine what type of problem with language or speech the child may have.

Overall, learning more than one language does not cause language disorders, but children may not follow exactly the same developmental milestones as those who learn only one language. Developing the ability to understand and speak in two languages depends on how much practice the child has using both languages, and the kind of practice. If a child who is learning more than one language has difficulty with language development, careful assessment by a specialist who understands development of skills in more than one language may be needed.

Treatment for language or speech disorders and delays

Children with language problems often need extra help and special instruction. Speech-language pathologists can work directly with children and their parents, caregivers, and teachers.

Having a language or speech delay or disorder can qualify a child for early intervention external icon (for children up to 3 years of age) and special education services (for children aged 3 years and older). Schools can do their own testing for language or speech disorders to see if a child needs intervention. An evaluation by a healthcare professional is needed if there are other concerns about the child’s hearing, behavior, or emotions. Parents, healthcare providers, and the school can work together to find the right referrals and treatment.

What every parent should know

Children with specific learning disabilities, including language or speech disorders, are eligible for special education services or accommodations at school under the Individuals with Disabilities in Education Act (IDEA) external icon and Section 504 external icon , an anti-discrimination law.

Get help from your state’s Parent Training and Information Center external icon

The role of healthcare providers

Healthcare providers can play an important part in collaborating with schools to help a child with speech or language disorders and delay or other disabilities get the special services they need. The American Academy of Pediatrics has created a report that describes the roles that healthcare providers can have in helping children with disabilities external icon , including language or speech disorders.

More information

CDC Information on Hearing Loss

National Institute on Deafness and Other Communication Disorders external icon

Birth to 5: Watch me thrive external icon

The American Speech-Language-Hearing Association external icon

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Home / Resources

Speech Disorder Resource Guide for K-12 Students

August 20, 2021 

With a little help, K-12 students with speech and language disorders can find support and success in classroom settings. This guide includes organizations, support groups, articles and tools for middle school and high school students with speech disorders, as well as their parents and educators. These resources offer information for students with Autism Spectrum Disorder (ASD), students who stutter, students with aphasia, students with apraxia and students with other communication disorders.

Click or tap the links below to jump to resources for educators, parents and students.

Speech Disorder Resources for K-12 Educators and School Staff

Resources for parents of k-12 students with speech disorders.

• Resources for Middle School and High School Students With Speech Disorders
• Apps and Supportive Technology for Students with Speech Disorders

Speech disorders in children can affect academic performance. These resources can help educators who teach students with speech disorders.

General Resources for Educators

Australian Journal of Teacher Education : “Children with Speech Sound Disorders at School: Challenges for Children, Parents and Teachers” (PDF, 483KB) This research explores how language disorders in children affect their classroom performance and the frustrations experienced by their parents and educators.

The Hanen Centre: Hanen Programs for Educators This organization provides training for educators of young children with language delays and resources for parents and speech-language pathologists (SLPs). 

National Council for Special Education: Strategies for Learning and Teaching These tips can help educators teach students with speech and language disorders.

National Science Teaching Association: Communication Disorders This association offers resources and tips for science educators who teach students with communication disorders.

Resilient Educator : “Supporting Students with Communication Disorders in Schools” This article outlines tips for educators who work with students with communication disorders, including being a role model, employing patience and using technology. 

University of Florida Institute of Food and Agricultural Sciences: Teaching Students with Disabilities: Speech and Language Impairments (PDF, 508KB) This paper explains different communication disorders in children and outlines strategies for agriculture teachers who work with students with speech and language impairments.

We Are Teachers: What Teachers Need to Know About Language Disorders  This article underscores the challenges students with language disorders face in class and offers advice for how teachers can support them.

Resources For Educators of Students who Stutter

FRIENDS: The National Association of Young People Who Stutter: For Teachers FRIENDS serves young people who stutter, their families and health care providers through education, outreach, workshops and conferences. Its resources for educators include stories and letters from children who stutter that shed light on how the speech disorder affects students in class.

National Stuttering Association (NSA): Stuttering: Answers for Educators (PDF, 3.2 MB) The NSA serves children and adults who stutter. This brochure includes information about speech therapy, individualized education plans, bullying and suggestions to help students who stutter.

The Stuttering Foundation: For Teachers This foundation serves people who stutter and their families and supports research into the causes of stuttering. Free resources for teachers include FAQs, handbooks and brochures to help students who stutter.

Resources For Educators of Students with Aphasia

Teachnology: Aphasia and Dysphagia in the Classroom This article explains the effects of dysphagia and aphasia on students and offers tips for helping students with these conditions succeed.

The Edvocate: Assistive Technology to Help Students With Aphasia Succeed Academically Tools and technology can help students with aphasia, and this article suggests some technology that may help, including calendar programs, apps to improve attention span and voice generators.

Resources For Educators of Students with Autism Spectrum Disorder (ASD)

Autism Society: Academic Success This page explains the rights of students with Autism Spectrum Disorder (ASD) in public schools, including information about individualized education.

Scholastic: Teaching Students with Autism Spectrum Disorder These 10 tips can help educators support students with ASD.

The Tech Edvocate: Assistive Technology to Help Children with Autism Spectrum Disorder (ASD) Succeed Academically This article offers ideas for technology to help students with Autism Spectrum Disorder (ASD), including apps for organization, alternative communication and teaching social skills. 

BACK TO TOP

The following speech and language impairment resources for parents are designed to help parents of children with speech disorders, including those with specific conditions listed below.

General Resources for Parents

American Speech-Language-Hearing Association (ASHA): How to Help Children with Speech and Language Disorders in Virtual and Modified In-Person Classroom Settings This article offers tips for parents to help children with specific challenges around speech and language disorders, including understanding and being understood in virtual settings, combating distractions and using masks for in-person learning.

ASHA: Speech and Language Services in Schools This resource explains how speech and language problems affect learning and how SLPs can help students who struggle with communication in school. 

Bilinguistics: Communication Disorder Resources for Parents This Austin, Texas, speech therapy clinic offers information for parents about different communication disorders in children, treatments and support.

The Hanen Centre In addition to training for educators, the Hanen Centre offers resources for parents and SLPs to help children with language delays, Autism Spectrum Disorder (ASD), Asperger Syndrome and other language development issues. Paid resources include  programs for parents to help children with language delays, ASD and literacy  and  guidebooks and DVDs for parents . The  Autism Corner  features resources to build communication skills in children with ASD.

Mommy Speech Therapy: Free Downloads   This blog created by mother and SLP Heidi Hanks offers worksheets and other free activities for parents of children with speech disorders.

Selective Mutism Foundation: Treatment and Resources This Florida foundation offers free treatment, consultations and other resources for families and individuals with selective mutism. 

Speech Buddies This paid speech therapy service offers resources for patients of different ages, from 0-3, 4-7, 8-17 and 18 and older. Speech Buddies helps connect parents to speech therapists and offers speech tools for use at home or in therapy. Articles specific to parents include:

• Speech Disorders and Kids: Finding Support for Parents
• Support for Families of Children with Speech Disorders

Resources For Parents of Children who Stutter

FRIENDS, the National Association of Young People Who Stutter: For Parents FRIENDS’ resources for parents of children who stutter include  virtual parent groups  for parents to learn how to support children who stutter and  virtual kids groups  facilitated by an adult and designed for children 6 to 11.

National Stuttering Association: Parents This page helps parents learn about treatments for children who stutter, find local family chapters and connect with therapists.

SAY: The Stuttering Association for the Young This nonprofit organization provides support and experiences for young people who stutter. SAY can help parents enroll young children in speech therapy. Programs for younger children include  speech therapy for preschoolers (ages 2-6)  and  speech therapy for school-age children (ages 7-12) .

The Stuttering Foundation This organization’s pages for parents include  resources for parents of preschoolers ,  information for parents of school children  and  other resources for kids .

Resources For Parents of Children with Aphasia

Aphasia Institute: Family Support Groups Monthly, online support groups for family members of people with aphasia are available through this group.

National Aphasia Association: Aphasia Caregiver Guide This free guide offers information for caregivers of people with different types of aphasia in home or hospital settings.  

San Diego State University Aphasia Network: Information for Persons with Aphasia and Caregivers This page includes information about aphasia and COVID-19; California, national and international organizations for aphasia support; and online resources for caring for people with aphasia. 

Resources For Parents of Children with Autism Spectrum Disorder (ASD)

Autism Parenting : Assistive Communication Devices for Children with Autism This article outlines how assistive communication devices and strategies can help children with ASD communicate more effectively.

Center on Secondary Education for Students with Autism Spectrum Disorder: Supporting Communication and Social Skills These resources discuss supporting communication for high schoolers on the autism spectrum, deepening support for teenagers with Autism Spectrum Disorder (ASD) and other information for parents assisting adolescents with ASD.

Resources For Parents of Children with Apraxia

Apraxia Kids This nonprofit organization works on education, community engagement, advocacy and research around apraxia. It offers a range of services for families and children with apraxia, including: 

• Support groups for children with apraxia .
• Resource guides for apraxia  books, apps, homeschooling information and local and national support. 
• Brochures and printable materials  for sending children to school, raising awareness around apraxia and other tips.

Resources for Middle School and High School Students with Speech Disorders

These organizations, support groups and tools are geared to middle schoolers and high schoolers with speech disorders.

Resources For Students who Stutter

SAY: The Stuttering Association for the Young   SAY’s services and resources for youth include the  My Stutter video series , which highlights the stories of young people who stutter.

National Stuttering Association: Teens Who Stutter This initiative helps teenagers (ages 13-17) connect with peers who stutter through local NSA chapters and social media communities and learn from adult mentors.

FRIENDS: The National Association of Young People Who Stutter FRIENDS’ resources for students include  inspirational videos, personal stories from teenagers who stutter, inspiration for classroom settings  and  virtual teen groups  that allow teenagers who stutter to connect when in-person meetings are not possible.

The Stuttering Foundation: For Teens This foundation offers readings, videos and guides for teens who stutter. 

Resources For Students with Autism Spectrum Disorder (ASD)

The Autism Project: Social Groups This organization hosts  in-person and virtual social groups  for children, teens and adults with ASD.

Center on Secondary Education for Students with Autism Spectrum Disorder: Peer-to-Peer Series These resources were written by students with ASD and include information on planning for life after high school, communicating with professors, online dating and other topics.

Apps and Supportive Technology for K-12 Students with Speech Disorders

The following apps and other technologies may help K-12 students with speech and language disorders communicate more easily. 

Apps and Devices for Students who Stutter

• FluencyCoach  is a free mobile and desktop app that provides Altered Auditory Feedback (AAF) for users. The mobile app requires headphones but does not support Bluetooth headphones.
• Stamurai  is a free mobile app offering therapy exercises and analytics for people who stutter.
• DAF Pro  is a paid app that helps people who stutter slow their speech.
• Fluency SIS  is a paid iPad app for SLPs to use with children 8 to 12 years old who stutter.
• SpeechEasy  uses an AAF device worn in one ear paired with support from an SLP to help reduce stuttering. The company offers four paid wearable models.

Augmentative and Alternative Communication (AAC) Apps

• MyTalkTools  offers a suite of AAC products for mobile and desktop devices, including free mobile app versions. 
• iCommunicate  is a paid iPad app that functions as an Augmentative and Alternative Communication (AAC) device and a platform for creating flashcards, visual schedules and other tools.
• LAMP Words for Life  is a paid AAC app for iPads.
• Predictable  offers a variety of paid AAC bundles for mobile, tablet and desktop use. 
• Proloquo2Go  is a paid AAC iOS app for children, teens and adults.
• TouchVoice  offers paid AAC apps for mobile devices, tablets and desktop computers.
• Voice4U  provides paid AAC and text-to-speech mobile apps.

Text-to-Speech Apps

• iSpeech  is a free text-to-speech app and interface that can improve accessibility for people with language-based learning disabilities.
• Read&Write  is a free text-to-speech app for iPad that can help students.
• Talk for Me  is a free text-to-speech app for iPad and iPhone that allows users to create custom phrases. 
• ClaroSpeak  is a reading and writing app that includes a text-to-speech function. There is  a free trial period and a paid premium version.

Other Apps for Students with Speech Disorders

• Little Bee Speech  offers free speech and language apps for parents and SLPs working with children, as well as some paid apps.
• QuestionIt  is a free app to teach children with Autism Spectrum Disorder (ASD) and other communication disorders how to answer different types of questions.
• Conversation Builder  is a paid app to help elementary school children practice conversing with peers.
• Splingo  offers paid speech and language apps for mobile devices and tablets to engage children around different aspects of language.

For a list of similar communication disorder resources for college students, see  Speech Disorder Resources for College Students.

Please note that this article is for informational purposes only. Individuals should consult their health care provider before following any of the information provided.

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Speech and Language Topic Categories

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Acronyms, Abbreviations, Definitions

• Acronyms, Abbreviations, Definitions - A list of acronyms, abbreviations, and definitions related to speech and language disorders.

Activities for Speech

• Resources and support library - A list of resources and support tools related to speech and language disorders.
• Speech Paths - Speech Paths is a speech pathology community resource providing resources and information to speech language pathologists and related medical specialties including audiology, occupational therapy, physical therapy, respiratory therapy and dysphagia clinicians.
• Speech Therapy Activities - This site has a variety of printable activities and ideas for different ages, all FREE! Help yourself and share with your colleagues. Parents are also encouraged to enjoy the activities.

American sign Language

• American sign language browser - 1. Click on desired letter below to open an index of words that begin with that letter to the right. 2. Then click on a word to the right to obtain its sign.
• American Sign Language - American Sign Language (ASL) is a complete, complex language that employs signs made with the hands and other movements, including facial expressions and postures of the body. It is the first language of many deaf North Americans, and one of several communication options available to deaf people. ASL is said to be the fourth most commonly used language in the United States.
• Anatomy & Physiology of the Larynx - Voice production is a complex action, and involves practically all systems of the body.  Voice production begins with respiration (breathing).  Air is inhaled as the diaphragm (the large, horizontal muscle below the lungs) lowers.  The volume of the lungs expands and air rushes in to fill this space.
• Aphasia-Overview - Aphasia is a disorder that results from damage to language centers of the brain. For almost all right-handers and for about 1/2 of left-handers, damage to the left side of the brain causes aphasia. As a result, individuals who were previously able to communicate through speaking, listening, reading and writing become more limited in their ability to do so.
• Aphasia Therapy in the New Millennium - This article highlights national and international developments in aphasia therapy research over the past two years. We will focus on three areas: 1 ) the emergence of nontraditional treatments for aphasia, 2) the need to place aphasia treatment within the context of the complex brain mechanisms involved in the recovery process as well as the need for clinicians to apply theoretical frameworks in deciding the course of patient treatment, and 3) developments in the frontiers of neuroscience.
• Understanding Primary Progressive Aphasia - Primary progressive aphasia is a rare neurological syndrome in which language capabilities become slowly and progressively impaired. This information sheet was prepared by the NAA to help explain the condition of Primary Progressive Aphasia to the general public.
• Diagnosing Primary Progressive Aphasia - Aphasia usually results from damage to the left side of the brain; it is unusual for aphasia to result from right-sided brain damage. The severity of aphasia and prognosis for recovery depend on the volume of tissue damage and its exact location(s), the type of injury, and whether other parts of the brain are also damaged. The onset of aphasia is usually sudden as the cause is most often stroke or traumatic brain injury. Infection can also cause the rapid onset of aphasia.
• Effective Tools for Family Education - There is no doubt that the education of family members about the nature of an acquired communication disorder and effective communication strategies has a significant positive effect on social relationships. It also may positively affect perceived quality of life and ultimate functional abilities.
• Booklets, Books, and Newsletters on Aphasia - A list of books, booklets, and newsletters related to aphasia.  Appropriate for individuals with aphasia, their families, and professionals.
• Apraxia - Apraxia (also referred to as apraxia of speech, verbal apraxia, or dyspraxia) is a motor speech disorder caused by damage to the parts of the nervous system related to speaking. It is characterized by problems sequencing the sounds in syllables and words and varies in severity depending on the nature of the nervous system damage.
• Apraxia in Adults - People with apraxia know what words they want to say, but their brains have difficulty coordinating the muscle movements necessary to say those words and they may say something completely different, even nonsensical. For example, a person may try to say "kitchen", but it may come out "bipem". The person will recognize the error and try again, sometimes getting it right, but sometimes saying something else entirely. This can become quite frustrating for the person.
• Apraxia of Speech-signs and symptoms - Apraxia of speech is a motor-speech programming disorder resulting in difficulty executing and/or coordinating (sequencing) the oral-motor movements necessary to produce and combine speech sounds (phonemes) to form syllables, words, phrases and sentences on voluntary (rather than only reflexive) control.  Many children are able to hear words, and are able to understand what they mean, but they can’t change what they hear into the fine-motor skill of combining consonants and vowels to form words.
• Apraxia, Hypernasality and Velopharyngeal Incompetence (VPI) - A list of online resources to learn about hyponasality, hypernasality, and Velopharnygeal Insufficiency (VPI).
• Characteristics of Children with Apraxia of Speech - This list was compiled from professional literature which is referenced at the end. Professionals and researchers do not all agree on the characteristics that define apraxia and some of those listed below may also be present in children with other severe speech sound disorders.
• Childhood Apraxia of Speech - Childhood apraxia of speech is a disorder of the nervous system that affects the ability to sequence and say sounds, syllables, and words. It is not due to muscular weakness or paralysis. The problem is in the brain's planning to move the body parts needed for speech (e.g., lips, jaw, tongue).

Articulation Disorder

• Articulation Disorders- signs and symptoms - Articulation disorders are speech sound errors that do not change in different word contexts. These errors occur during the production of isolated speech sounds (phonemes) and are thus misarticulated at the syllable and word levels as well. Articulation errors on individual consonants or vowels do not necessarily change due to context. 
• The Uses and Misuses of Processing Tests - If you have ever been involved in an educational evaluation for learning disabilities---whether as a parent, teacher, or in some other role---you have probably heard about "processing tests" and "processing disorders." Many aspects of these evaluations can be problematic, but perhaps none more so than those entailing the use (and potential misuse) of processing measures. Yet the right measures, carefully interpreted, can be enormously helpful in education.

Auditory Processing Disorder

• Auditory Processing Disorder (APD) — An Overview - Auditory Processing Disorder (APD) is a complex problem. The term is used by many people, in very different ways. There is research underway to help understand this disorder. There also is research to investigate therapies that will help individuals who may have an auditory processing disorder.
• Auditory Processing Disorder in Children - Human communication relies on taking in complicated perceptual information from the outside world through the senses, such as hearing, and interpreting that information in a meaningful way. Human communication also requires certain mental abilities, such as attention and memory. Scientists still do not understand exactly how all of these processes work and interact or how they malfunction in cases of communication disorders. Even though your child seems to "hear normally," he or she may have difficulty using those sounds for speech and language.
• Basic Principles of Auditory Processing Disorder - Management of APD should incorporate three primary principles: (I) environmental modifications, (2) remediation (direct therapy) techniques, and (3) compensatory strategies. All three of these components are necessary for APD intervention to be effective.

Central Auditory Processing Disorder

• Central Auditory Processing (CAP) - A number of children with learning disabilities demonstrate Central Auditory Processing (CAP) problems. These children usually have normal hearing and normal intelligence. They are unable to effectively utilize auditory information, especially when competing sounds are present. They are described as inattentive, easily distracted by background noise, and exhibit difficulty following verbal directions.
• Central Auditory Processing Disorder — An Overview - Auditory Processing Disorder (APD) is a complex problem. The term is used by many people, in very different ways. There is research underway to help understand this disorder. There also is research to investigate therapies that will help individuals who may have an auditory processing disorder.
• Central auditory processing disorder-about CAPD - Life is complicated these days, for children as much as adults. There's a lot to remember and a lot to do. But sometimes a child may seem to be more than simply distracted by a complex life. Although their hearing may be normal, kids with central auditory processing disorder (CAPD) can't process the information they hear in the same way as others because their ears and brain don't fully coordinate.
• Central Auditory Processing Disorders (CAPD's) - Not all the hearing is done in the ear. In fact, simply stated, the ear merely brings in all the environmental sounds human beings can hear and delivers them unseparated to the bottom of the brain in the brain stem (just above the spinal cord). As the hearing nerves criss-cross up these several inches the "sorting out" or processing begins.
• Central Auditory Processing Disorders-signs and symptoms - A CAPD is a receptive language disorder. It refers to difficulties in the decoding and storing of auditory information (typically incoming verbal messages). This type of receptive language disorder is a result of genetic factors and/or early otitis media though causal factors may not be able to be found.
• Treatment For Central Auditory Processing Problems - One approach focuses on training certain auditory and listening skills such as auditory discrimination (e.g. telling the difference between peas and bees), localization of sound, sequencing sounds, or identifying a target sound in a noisy background. Training these skills in isolation, however, may not help a child to understand complex language, such as a teacher's instructions. Therefore, another approach concentrates on teaching more functional language skills (e.g., vocabulary, grammar, conversational skills) and uses strategies (e.g., visual aids and repeating directions) to facilitate the processing of languages.

Cleft Lip and Palate

• Cleft Lip and Palate Resource - One child in 700 is born with a cleft. It is the fourth most common birth defect, and the first most common facial birth defect. And yet so many parents feel so alone. WIDE SMILES was formed to ensure that parents of cleft-affected children do not have to feel alone. We offer support, inspiration, information and networking for families everywhere who may be dealing with the challenges associated with clefting.

Developmental Milestones

• Speech & Language Milestone Chart - These milestones are behaviors that emerge over time, forming the building blocks for growth and continued learning.

Developmental Delays in Speech and Language

• Delayed speech and language development - It's important to discuss early speech and language development, as well as other developmental concerns, with your child's doctor at every routine well-child visit.
• Developmental Speech and Language Disorders - Developmental expressive language disorder is a disorder in which a child has lower-than-normal proficiency in vocabulary, the production of complex sentences, and recall of words.
• Developmental Speech Apraxia Resources - Cincinnati Children's recommends the following Web resources for more information about Developmental Speech Apraxia.
• Late Blooming or Language Problem? - Parents are smart. They listen to their child talk and know how he or she communicates. They also listen to his or her playmates who are about the same age and may even remember what older brothers and sisters did at the same age. Then the parents mentally compare their child's performance with the performance of these other children. What results is an impression of whether or not their child is developing speech and language at a normal rate.
• Speech delay - This website was created to help parents, caregivers, teachers, friends, therapists, and relatives of language/speech delayed children.  We cover a variety of topics, with "talking tips" for adults; a speech forum to communicate with a speech-language and/or hearing expert, or peers; links to many other helpful sites, a sign language section with multiple common signs, and a "books/products" section if you choose to obtain further information/helpful products.
• Dysphagia - People with dysphagia have difficulty swallowing and may also experience pain while swallowing. Some people may be completely unable to swallow or may have trouble swallowing liquids, foods, or saliva. Eating then becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body.
• Feeding and Swallowing Disorders in Children - Swallowing disorders, also called dysphagia (dis FAY juh), can occur at different stages in the swallowing process.
• New Visions (Feeding and Swallowing Resource) - New Visions provides continuing education and therapy services to professionals and parents working with infants and children with feeding, swallowing, oral-motor, and pre-speech problems.

Expressive Language Disorder

• Expressive language disorder – developmental - Approximately 3 to 10% of all school-age children have expressive language disorder. The causes of this disorder may vary, or may be unknown. Cerebral damage and malnutrition may cause some cases -- perhaps in combination with genetic factors.
• Mixed receptive-expressive language disorder - Mixed receptive-expressive language disorder is a language disability which causes impairment of both the understanding and the expression of language.
• Frequently Asked Questions from Parents of Children Recently Diagnosed with Apraxia of Speech - What is apraxia of speech and how does it differ from a developmental delay of speech? What is the usual prognosis for children with apraxia of speech? What is the usual method of treatment for apraxia? What causes apraxia? Will my child ever be able to speak "normally"?  What are other associated features of apraxia? How do you know if you have a "good" therapist? Will my insurance company pay for therapy?

General Information

• How Do We Learn Language? - How do children learn so much about language in so little time? Adult-like knowledge of language requires many complex skills, and it's not at all obvious how we acquire them. We possess phonological skills: the ability to perceive and analyze sounds in real time, and to produce sounds by coordinating our larynx, pharynx, tongue, palate, jaw, and lips. We possess a lexicon: thousands of vocabulary words. And we possess syntactic skills: the grammar rules of our native language, which govern how words and morphemes can be combined to produce correct sentences.
• How to Help Your Child Get the Most Out of Speech Therapy - Parents are an extremely important part of their child’s therapy program. Parents help determine whether or not their child’s experience in speech/language therapy is a success. I have seen over and over again during my years as a speech/language specialist, that the children who complete the program most quickly and with the most lasting results are those whose parents have been involved.
• How to Think About a Speech/Language Evaluation - The following are tips for parents who suspect apraxia of speech may be an issue in their child and are seeking a speech/language evaluation. The tips were put together by an experienced mom involved with the Apraxia-KIDS (SM) Network.
• Language Disorders and Attention Deficit Hyperactivity Disorder - The child or adolescent with ADHD and learning problems will often present to the Speech Language Pathologist with a range of clinical problems in language that are contributing to the learning disorder.
• Low Cost Speech Therapy - Often universities that offer a masters degree in Communication Disorders and Sciences or Speech-Language Pathology have speech and language clinics where their students gain valuable experience under the direction of clinical faculty...
• Signs and symptoms of speech and language disorders - See the menu on the left to view an overview of the signs and symptoms of a multitude of speech and language disorders.
• Taking Care of Your Voice - We rely on our voices to inform, persuade, and connect with other people. Your voice is as unique as your fingerprint. Many people you know use their voices all day long, day in and day out. Singers, teachers, doctors, lawyers, nurses, sales people, and public speakers are among those who make great demands on their voices. Unfortunately, these individuals are most prone to experiencing voice problems. It is believed that 7.5 million people have diseases or disorders of voice. Some of these disorders can be avoided by taking care of your voice.
• Students Who May Have Word Finding Difficulties - Six different groups  of students who may have word finding difficulties are identified and described.  References about students who are affected by word finding difficulties are also presented.
• What is a language disorder? - Children whose language development lags significantly from the timetable may be considered developmentally delayed in language acquisition. A child with a language disorder may not use the language commensurate with her peers. She may be delayed in acquiring the vocabulary, syntax, grammar and pragmatics of her age mates.
• What is a speech disorder? - Although some children are precocious in the acquisition of speech and may be able to produce understandable speech by the time they are 30 months of age, in some children, it is not uncommon for one or two speech sounds to remain "unlearned" until 72 months of age. By the time a child is 48 months old, however, she should be speaking well enough to be understood all of the time.
• What is a Speech/Language Specialist? - This article will address the question, "What is a Speech/Language Specialist?"  It will discuss the various names we are known by and the various roles you might find us in.  I will also discuss the training one needs to pursue this as a career choice.
• What Is Voice? What Is Speech? What Is Language? - The functions, skills, and abilities of voice, speech, and language are related. Some dictionaries and textbooks use the terms almost interchangeably. But for scientists and medical professionals, it is important to distinguish among them.
• A general reference - A reference of frequently used medical terms related to speech and language impairments.

Hypernasality

• Hypernasality: a voice or resonance disorder? - Hypernasality is often mislabeled as a voice disorder. In fact, it is a resonance disorder! Voice disorders are caused by dysfunction of the larynx. Hypernasality is caused by a dysfunction of the velopharyngeal mechanism.

Landau-Kleffner Syndrome

• Information on Landau-Kleffner syndrome - Landau-Kleffner syndrome (LKS) is a childhood disorder. A major feature of LKS is the gradual or sudden loss of the ability to understand and use spoken language. All children with LKS have abnormal electrical brain waves that can be documented by an electroencephalogram (EEG), a recording of the electric activity of the brain. Approximately 80 percent of the children with LKS have one or more epileptic seizures that usually occur at night.

Laryngeal Papillomatosis

• Information on Laryngeal Papillomatosis - Laryngeal papillomatosis is a disease consisting of tumors that grow inside the larynx (voice box), vocal cords, or the air passages leading from the nose into the lungs (respiratory tract). It is a rare disease caused by the human papilloma virus (HPV).
• Information on lisping - A lisp is a Functional Speech Disorder (FSD). A functional speech disorder is a difficulty learning to make a specific speech sound, or a few specific speech sounds.
• Speech & language, literacy and inclusion - Narratives are important because they engage students in learning activities that support oral and written language development concurrently and interrelatedly; they provide a bridge between oral communication - regulating social interaction, and writing - providing information. With narratives, Speech Pathologists support development of specific language skills, provide repeated exposure to concepts and teach literate styles of language use.

Organizations

• American Academy of Audiology - The American Academy of Audiology promotes quality hearing and balance care by advancing the profession of audiology through leadership, advocacy, education, public awareness and support of research.
• American Speech-Language-Hearing Association - ASHA is the professional, scientific, and credentialing association for more than 123,000 members and affiliates who are speech-language pathologists, audiologists, and speech, language, and hearing scientists in the United States and internationally.
• Canadian Association of Speech and Language Pathologists - CASLPA is the single national body that supports the needs, interests and development of speech-language pathologists, audiologists and supportive personnel across Canada.
• National Aphasia Association - The NAA's mission is to educate the public to know that the word aphasia describes an impairment of the ability to communicate, not an impairment of intellect. The NAA makes people with aphasia, their families, support systems, and health care professionals aware of resources to recover lost skills to the extent possible, to compensate for skills that will not be recovered and to minimize the psychosocial impact of the language impairment.
• National Center for Voice and Speech (NCVS) - The NCVS was organized on the premise that a consortium of institutions is better able to acquire and maintain resources to fulfill the global mission of the sponsors than a single organization. NCVS members, although geographically separate, were linked by a common desire to fully understand the characteristics, limitations and enhancement of human voice and speech.
• National Student Speech Language and Hearing Association (NSSLHA) - The National Student Speech Language Hearing Association (NSSLHA) is a pre-professional membership association for students interested in the study of communication sciences and disorders.
• National Stuttering Association - If you are a person who stutters, a parent of a child or teen who stutters, a speech-language pathologist, a teacher, an employee, a doctor or other professional who works with people who stutter…you will want to take advantage of the helpful opportunities and benefits from a NSA membership!
• The National Coalition on Auditory Processing Disorders - The mission of the National Coalition on Auditory Processing Disorders, Inc. is to assist families and individuals affected by auditory processing disorders through education, support, and public awareness as well as promoting auditory access of information for those affected by auditory processing disorders.

Orofacial Myofunctional Disorders

• Information on orofacial myofunctional disorders - With an orofacial myofunctional disorder (OMD), the tongue moves forward in an exaggerated way during speech and/or swallowing. The tongue may also lie too far forward during rest, or may protrude inappropriately between the upper and lower teeth during speech, swallowing, and at rest.

Phonological Disorders

• Phonological Principles - The terms phonological therapy and phonological remediation permeate the current speech-language pathology literature. They are often used ambiguously, and it is not always clear whether they refer to intervention for developmental phonological disorders, or intervention that is, by nature, somehow 'phonological'.

Receptive Language Disorder

• Receptive language disorders-signs and symptoms - Receptive Language Disorders include: Central Auditory Processing Disorders (CAPD), Aphasia, Comprehension Deficit, "delayed language," "delayed speech." Also receptive language disorders refer to difficulties in the ability to attend to, process, comprehend, retain, or integrate spoken language.
• Overview of Receptive Language Disorder :  Receptive Language Disorder is a type of learning disability affecting the ability to understand spoken, and sometimes written, language. They often have difficulty with speech and organizing their thoughts, which creates problems in communicating with others and in organizing their thoughts on paper.
• From the National Library of Medicine:   Mixed receptive-expressive language disorder is a language disability which causes impairment of both the understanding and the expression of language.
• From ASHA : Late Blooming or Language Problem?
• Also, many students with Receptive Language Problems are actually diagnosed with Central Auditory Processing Disorder, which can be found through NASET- CLICK HERE

Resources to Use in the Classroom

• Hard of Hearing and Deaf Students: A Resource Guide to Support Classroom Teachers - If you are a classroom teacher who for the first time is about to have a student who is hard of hearing or deaf, this guide can be helpful. Your new student is likely to be as excited and anxious as you are, and that human energy can be used for remarkable learning relationships in the classroom.

Semantic and Pragmatic Difficulties

• Information on semantic and pragmatic difficulties - Semantics is the aspect of language function that relates to understanding the meanings of words, phrases and sentences, and using words appropriately when we speak. Children with semantic difficulties have a very hard time understanding the meaning of words and sentences.

Sensory Integration and Motor Disorders

• Sensory integration and motor disorders - signs and symptoms - Not all children with learning, developmental, or behavioral problems have an underlying sensory integrative disorder. There are certain indicators, however, that can signal a parent that such a disorder may be present.

Spasmodic Dysphonia

• Spasmodic Dysphonia-Overview - We have all experienced problems with our voices, times when the voice is hoarse or when sound will not come out at all! Colds, allergies, bronchitis, exposure to irritants such as ammonia, or cheering for your favorite sports team can result in a loss of voice. But, people with spasmodic dysphonia, a chronic voice disorder, face the persistent question: "What's wrong with your voice?"
• Spasmodic Dysphonia-About - Spasmodic dysphonia (or laryngeal dystonia) is a voice disorder caused by involuntary movements of one or more muscles of the larynx or voice box. Individuals who have spasmodic dysphonia may have occasional difficulty saying a word or two or they may experience sufficient difficulty to interfere with communication. Spasmodic dysphonia causes the voice to break or to have a tight, strained or strangled quality. There are three different types of spasmodic dysphonia.
• Early childhood stuttering - This site is dedicated to providing information about the nature of early childhood stuttering and ways to prevent its development. You will find numerous articles about early childhood stuttering, including warning signs, ways to reduce communication demands for children, and intervention programs for preventing and treating early childhood stuttering.
• Stuttering - Stuttering is a communication disorder that affects the fluency of speech. It begins during childhood and, in some cases, persists throughout the life span. The disorder is characterized by disruptions in the production of speech sounds. Speech-language pathologists refer to these disruptions as "disfluencies."
• Stuttering-Overview Stuttering-About - Stuttering is a disorder of speech that affects the fluent production of sounds, words, phrases, and sentences. Repetitions, hesitations, or prolongation of speech sounds at the beginning of words or within words are frequently heard, as are repetitions, single or multiple, of entire words or phrases.
• The Stuttering Homepage - The Stuttering Home Page, created by Judith Maginnis Kuster and maintained at Minnesota State University, Mankato, is dedicated to providing information about stuttering for both consumers and professionals who work with people who stutter.
• Research and Comment from the Researchers at East Carolina University on stuttering - Instead of being the core stuttering ‘problem’, syllabic repetitions may be a biological mechanism, or ‘solution’, to the central involuntary stuttering block. Simply put, stuttering is an endogenous transitory state of ‘shadowed speech’, a choral speech derivative that allows for a neural release of the central block.
• NASET's comprehensive overview of 18 different types of transition services

Velocardiofacial Syndrome

• Information on velocardiofacial syndrome - Velocardiofacial syndrome (VCFS) is a disorder that has been associated with over thirty different features. (A disease or disorder that has more than one identifying feature or symptom is a syndrome.) The name velocardiofacial syndrome comes from the Latin words "velum" meaning palate, "cardia" meaning heart and "facies" having to do with the face.

Voice Disorders

• Vocal Abuse and Misuse - When you abuse or misuse your voice, you can damage your vocal folds, causing temporary or permanent voice changes.
• Vocal Cord Paralysis - Vocal cord paralysis is a voice disorder that occurs when one or both of the vocal cords (or vocal folds) do not open or close properly. Vocal cord paralysis is a common disorder, and symptoms can range from mild to life threatening.
• Voice problems in children - Pediatric voice problems involve pathologic laryngeal conditions, including inflammation of the vocal folds, chronic laryngitis, vocal nodules, vocal polyps and contact ulcers, all of which can be identified by the child’s Ear, Nose and Throat doctor. These conditions, usually caused by vocal abuse, are normally reversible with the elimination of laryngeal overuse and tension, along with a program of vocal hygiene.

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Speech and Language Impairment

‘How can I teach English to a learner who has difficulty speaking and understanding their own language?’

As teachers we know that good communication is vital for successful learning, so it is not surprising that this is a worry for English language teachers across the world. Communication skills help children to understand and explain the world around them, share their ideas and feelings and make friends. Good language skills enable a child to reason and learn. They also help to develop a sense of self and the feeling of belonging to a group or community.

If we discover that there is a learner with speech and language difficulties in our class we might wonder how to help them to get the most from our lessons. By understanding the different kinds of speech and language impairment and knowing some useful teaching strategies we can really make a difference to these learners and help them to experience enjoyable and successful learning.

What is speech and language impairment?

Speech and language impairment varies from person to person and can range from mild to severe. A learner may have difficulty with speaking, ‘expressive language’ or understanding, ‘receptive language’. They may have problems expressing feelings and interacting with others. This can cause low self-esteem and frustration, and may lead to behaviour problems in the class. As speech and language problems are not always obvious, we have to think about what lies behind the behaviour and the need the learner may be trying to express.

Most children with speech or language impairment are of average intelligence, but may have other specific learning difficulties such as dyslexia, dyspraxia or ADHD. Speech and language impairment is sometimes linked with conditions such as hearing loss, Down syndrome, cerebral palsy or autism. Chronic ear infections may also be a cause. Some learners have difficulty with both language input and output and need to be taught the communication skills that other learners learn automatically.

Expressive language difficulties

Some learners have problems with the muscular movements needed to form words. They may have trouble producing certain sounds and simply leave them out, or substitute one sound for another. This can make them difficult to understand and result in delayed or unclear speech.

Expressive language difficulties can also affect the ability to put words in the right order in a sentence and tell stories with the events in the right sequence. Their speech can be jumbled up and hard to understand. Sometimes the learner will use inappropriate grammatical structures and their speech may sound immature for their age. They may also have trouble with learning and accessing vocabulary. These problems occur in their own language and will also appear when learning English. Having trouble explaining and describing things makes it hard to join in class discussions.

Receptive language difficulties

Some learners have problems with the way they hear and process language. This can impact on the ability to understand what others are saying and respond appropriately. Learners with hearing impairment have a physical barrier to understanding speech, but there are can also be ‘pragmatic language’ difficulties where, although the learner can hear what is being said, they do not understand the meaning. They may not know how to use social language and lack an intuitive understanding of social cues and conventions. There can also be problems understanding ‘figurative language’, which includes the use of irony, humour and metaphor. This can lead to a tendency to take things too literally. A learner with receptive language difficulties may have trouble in one or more of these areas.

• Following instructions
• Understanding abstract concepts
• Concentration
• Understanding stories, both written and spoken
• Understanding metaphorical language
• Making friends
• Listening to others

Teaching and learning strategies – how can we help?

1. Encourage and accept all forms of communication

Learners with speech and language difficulties are often lacking in confidence and shy about speaking in public, so avoid asking them to repeat mispronounced words or finish their sentences for them. It is better to model the correct form in your response. Concentrate on the message the learner is trying to communicate rather than the grammar. Allow alternative ways of communicating like gestures, writing or drawing.

2. Be conscious of your own communication style

Make sure your language is clear and direct and face the class so that learners can see your expressions and read your lips if necessary. Give instructions one at a time in the order you want them to be carried out, using visual cues and gestures to support them. If you say the learner’s name before asking them a question they will know you want their attention. Try to avoid ambiguous language and always be prepared to repeat anything the learner does not understand.

3. Teach active listening skills

Explain to the whole class that it is important to be attentive and look at someone when they are talking to you, and not to interrupt. You can teach turn-taking by having a special object which is the ‘speaker’s token’. The holder of the object is the only person who may speak. When they have finished they pass it on.

4. Give time to think and respond to questions

All learners can benefit from this. Using the ‘think, pair, share’ model in class provides the time needed to process information and organize thoughts before having to answer.

5. Use sound discrimination exercises

We know that phonemes are the building blocks for language. You can help learners who have difficulty recognising and decoding phonemes through multisensory activities like clapping and stomping out syllables in new vocabulary or colour-coding the different groups of phonemes. Rhyming bingo and card games where the learner can match the same sounds can be really helpful.

6. Help with sequencing and word order

If the learner has difficulty explaining things or telling stories in the right order, just ask them to give bullet points of what they want to say and put them in the correct sequence on a timeline. It is also helpful to cut up stories so they can practice putting them in order - you can use pictures for younger learners.

7. Build vocabulary

Use pictures, objects and photos to help understand and remember new vocabulary. Encourage learners to use their visual memory by making a personal vocabulary box of key words on picture cards.

8. Help build self-esteem

Make sure to notice and praise good interactions and speech. Describe what they do well and identify and work with their other strengths, such as creativity and physical talents.

9. Help learners to make their needs known

Always check that the learner has understood the task and clarify any misunderstandings. Encourage them to let you know if they have not understood by using a pre-arranged signal.

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Speech and Language Impairments

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Table of Contents

A Day in the Life of an SLP

Christina is a speech-language pathologist. She works with children and adults who have impairments in their speech, voice, or language skills. These impairments can take many forms, as her schedule today shows.

First comes Robbie. He’s a cutie pie in the first grade and has recently been diagnosed with childhood apraxia of speech—or CAS. CAS is a speech disorder marked by choppy speech. Robbie also talks in a monotone, making odd pauses as he tries to form words. Sometimes she can see him struggle. It’s not that the muscles of his tongue, lips, and jaw are weak. The difficulty lies in the brain and how it communicates to the muscles involved in producing speech. The muscles need to move in precise ways for speech to be intelligible. And that’s what she and Robbie are working on.

Next, Christina goes down the hall and meets with Pearl in her third grade classroom. While the other students are reading in small groups, she works with Pearl one on one, using the same storybook. Pearl has a speech disorder, too, but hers is called dysarthria. It causes Pearl’s speech to be slurred, very soft, breathy, and slow. Here, the cause is weak muscles of the tongue, lips, palate, and jaw. So that’s what Christina and Pearl work on—strengthening the muscles used to form sounds, words, and sentences, and improving Pearl’s articulation.

One more student to see—4th grader Mario , who has a stutter. She’s helping Mario learn to slow down his speech and control his breathing as he talks. Christina already sees improvement in his fluency.

Tomorrow she’ll go to a different school, and meet with different students. But for today, her day is…Robbie, Pearl, and Mario.

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There are many kinds of speech and language disorders that can affect children. In this fact sheet, we’ll talk about four major areas in which these impairments occur. These are the areas of:

Articulation | speech impairments where the child produces sounds incorrectly (e.g., lisp, difficulty articulating certain sounds, such as “l” or “r”);

Fluency | speech impairments where a child’s flow of speech is disrupted by sounds, syllables, and words that are repeated, prolonged, or avoided and where there may be silent blocks or inappropriate inhalation, exhalation, or phonation patterns;

Voice | speech impairments where the child’s voice has an abnormal quality to its pitch, resonance, or loudness; and

Language | language impairments where the child has problems expressing needs, ideas, or information, and/or in understanding what others say. ( 1 )

These areas are reflected in how “speech or language impairment” is defined by the nation’s special education law, the Individuals with Disabilities Education Act, given below. IDEA is the law that makes early intervention services available to infants and toddlers with disabilities, and special education available to school-aged children with disabilities.

Definition of “Speech or Language Impairment” under IDEA

The Individuals with Disabilities Education Act, or IDEA, defines the term “speech or language impairment” as follows:

Development of Speech and Language Skills in Childhood

Speech and language skills develop in childhood according to fairly well-defined milestones (see below). Parents and other caregivers may become concerned if a child’s language seems noticeably behind (or different from) the language of same-aged peers. This may motivate parents to investigate further and, eventually, to have the child evaluated by a professional.

______________________

More on the Milestones of Language Development

What are the milestones of typical speech-language development? What level of communication skill does a typical 8-month-old baby have, or a 18-month-old, or a child who’s just celebrated his or her fourth birthday?

You’ll find these expertly described in How Does Your Child Hear and Talk? , a series of resource pages available online at the American Speech-Language-Hearing Association (ASHA): http://www.asha.org/public/speech/development/chart.htm

Having the child’s hearing checked is a critical first step. The child may not have a speech or language impairment at all but, rather, a hearing impairment that is interfering with his or her development of language.

It’s important to realize that a language delay isn’t the same thing as a speech or language impairment. Language delay is a very common developmental problem—in fact, the most common, affecting 5-10% of children in preschool. ( 2 ) With language delay, children’s language is developing in the expected sequence, only at a slower rate. In contrast, speech and language disorder refers to abnormal language development. ( 3 )  Distinguishing between the two is most reliably done by a certified speech-language pathologist such as Christina, the SLP in our opening story.

Characteristics of Speech or Language Impairments

The characteristics of speech or language impairments will vary depending upon the type of impairment involved. There may also be a combination of several problems.

When a child has an articulation disorder , he or she has difficulty making certain sounds. These sounds may be left off, added, changed, or distorted, which makes it hard for people to understand the child.

Leaving out or changing certain sounds is common when young children are learning to talk, of course. A good example of this is saying “wabbit” for “rabbit.” The incorrect articulation isn’t necessarily a cause for concern unless it continues past the age where children are expected to produce such sounds correctly. ( 4 ) ( ASHA’s milestone resource pages , mentioned above, are useful here.)

Fluency refers to the flow of speech. A fluency disorder means that something is disrupting the rhythmic and forward flow of speech—usually, a stutter. As a result, the child’s speech contains an “abnormal number of repetitions, hesitations, prolongations, or disturbances. Tension may also be seen in the face, neck, shoulders, or fists.” ( 5 )

Voice is the sound that’s produced when air from the lungs pushes through the voice box in the throat (also called the larnyx), making the vocal folds within vibrate. From there, the sound generated travels up through the spaces of the throat, nose, and mouth, and emerges as our “voice.”

A voice disorder involves problems with the pitch, loudness, resonance, or quality of the voice. ( 6 )   The voice may be hoarse, raspy, or harsh. For some, it may sound quite nasal; others might seem as if they are “stuffed up.” People with voice problems often notice changes in pitch, loss of voice, loss of endurance, and sometimes a sharp or dull pain associated with voice use. ( 7 )

Language has to do with meanings, rather than sounds. ( 8 )  A language disorder refers to an impaired ability to understand and/or use words in context. ( 9 ) A child may have an expressive language disorder (difficulty in expressing ideas or needs), a receptive language disorder (difficulty in understanding what others are saying), or a mixed language disorder (which involves both).

Some characteristics of language disorders include:

• improper use of words and their meanings,
• inability to express ideas,
• inappropriate grammatical patterns,
• reduced vocabulary, and
• inability to follow directions. ( 10 )

Children may hear or see a word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to communicate. These symptoms can easily be mistaken for other disabilities such as autism or learning disabilities, so it’s very important to ensure that the child receives a thorough evaluation by a certified speech-language pathologist.

What Causes Speech and Language Disorders?

Some causes of speech and language disorders include hearing loss, neurological disorders, brain injury, intellectual disabilities, drug abuse, physical impairments such as cleft lip or palate, and vocal abuse or misuse. Frequently, however, the cause is unknown.

Of the 6.1 million children with disabilities who received special education under IDEA in public schools in the 2005-2006 school year, more than 1.1 million were served under the category of speech or language impairment. ( 11 ) This estimate does not include children who have speech/language problems secondary to other conditions such as deafness, intellectual disability, autism, or cerebral palsy. Because many disabilities do impact the individual’s ability to communicate, the actual incidence of children with speech-language impairment is undoubtedly much higher.

Finding Help

Because all communication disorders carry the potential to isolate individuals from their social and educational surroundings, it is essential to provide help and support as soon as a problem is identified. While many speech and language patterns can be called “baby talk” and are part of children’s normal development, they can become problems if they are not outgrown as expected.

Therefore, it’s important to take action if you suspect that your child has a speech or language impairment (or other disability or delay). The next two sections in this fact sheet will tell you how to find this help.

Help for Babies and Toddlers 

Since we begin learning communication skills in infancy, it’s not surprising that parents are often the first to notice—and worry about—problems or delays in their child’s ability to communicate or understand. Parents should know that there is a lot of help available to address concerns that their young child may be delayed or impaired in developing communication skills. Of particular note is the the early intervention system that’s available in every state.

Early intervention is a system of services designed to help infants and toddlers with disabilities (until their 3rd birthday) and their families. It’s mandated by the IDEA. Through early intervention, parents can have their young one evaluated free of charge, to identify developmental delays or disabilities, including speech and language impairments.

If a child is found to have a delay or disability, staff work with the child’s family to develop what is known as an Individualized Family Services Plan , or IFSP . The IFSP will describe the child’s unique needs as well as the services he or she will receive to address those needs. The IFSP will also emphasize the unique needs of the family, so that parents and other family members will know how to support their young child’s needs. Early intervention services may be provided on a sliding-fee basis, meaning that the costs to the family will depend upon their income.

To identify the EI program in your neighborhood  | Ask your child’s pediatrician for a referral to early intervention or the Child Find in the state. You can also call the local hospital’s maternity ward or pediatric ward, and ask for the contact information of the local early intervention program.

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Help for School-Aged Children, including Preschoolers

Just as IDEA requires that early intervention be made available to babies and toddlers with disabilities, it requires that special education and related services be made available free of charge to every eligible child with a disability, including preschoolers (ages 3-21). These services are specially designed to address the child’s individual needs associated with the disability—in this case, a speech or language impairment.

Many children are identified as having a speech or language impairment after they enter the public school system. A teacher may notice difficulties in a child’s speech or communication skills and refer the child for evaluation. Parents may ask to have their child evaluated. This evaluation is provided free by the public school system.

If the child is found to have a disability under IDEA—such as a speech-language impairment—school staff will work with his or her parents to develop an Individualized Education Program , or IEP . The IEP is similar to an IFSP. It describes the child’s unique needs and the services that have been designed to meet those needs. Special education and related services are provided at no cost to parents.

There is a lot to know about the special education process, much of which you can learn at the Center for Parent Information and Resources (CPIR). We offer a wide range of publications and resource pages on the topic. Enter our special education information at: http://www.parentcenterhub.org/repository/schoolage/

Educational Considerations

Communication skills are at the heart of the education experience. Eligible students with speech or language impairments will want to take advantage of special education and related services that are available in public schools.

The types of supports and services provided can vary a great deal from student to student, just as speech-language impairments do. Special education and related services are planned and delivered based on each student’s individualized educational and developmental needs.

Most, if not all, students with a speech or language impairment will need speech-language pathology services . This related service is defined by IDEA as follows:

(15) Speech-language pathology services includes—

(i) Identification of children with speech or language impairments;

(ii) Diagnosis and appraisal of specific speech or language impairments;

(iii) Referral for medical or other professional attention necessary for the habilitation of speech or language impairments;

(iv) Provision of speech and language services for the habilitation or prevention of communicative impairments; and

Thus, in addition to diagnosing the nature of a child’s speech-language difficulties, speech-language pathologists also provide:

• individual therapy for the child;
• consult with the child’s teacher about the most effective ways to facilitate the child’s communication in the class setting; and
• work closely with the family to develop goals and techniques for effective therapy in class and at home.

Speech and/or language therapy may continue throughout a student’s school years either in the form of direct therapy or on a consultant basis.

Assistive technology (AT) can also be very helpful to students, especially those whose physical conditions make communication difficult. Each student’s IEP team will need to consider if the student would benefit from AT such as an electronic communication system or other device. AT is often the key that helps students engage in the give and take of shared thought, complete school work, and demonstrate their learning.

Tips for Teachers

— Learn as much as you can about the student’s specific disability. Speech-language impairments differ considerably from one another, so it’s important to know the specific impairment and how it affects the student’s communication abilities.

— Recognize that you can make an enormous difference in this student’s life! Find out what the student’s strengths and interests are, and emphasize them. Create opportunities for success.

—If you are not part of the student’s IEP team, a sk for a copy of his or her IEP . The student’s educational goals will be listed there, as well as the services and classroom accommodations he or she is to receive.

— Make sure that needed accommodations are provided for classwork, homework, and testing. These will help the student learn successfully.

— Consult with others (e.g., special educators, the SLP) who can help you identify strategies for teaching and supporting this student, ways to adapt the curriculum, and how to address the student’s IEP goals in your classroom.

— Find out if your state or school district has materials or resources available to help educators address the learning needs of children with speech or language impairments. It’s amazing how many do!

— Communicate with the student’s parents . Regularly share information about how the student is doing at school and at home.

Tips for Parents

— Learn the specifics of your child’s speech or language impairment. The more you know, the more you can help yourself and your child.

— Be patient. Your child, like every child, has a whole lifetime to learn and grow.

— Meet with the school and develop an IEP to address your child’s needs. Be your child’s advocate. You know your son or daughter best, share what you know.

— Be well informed about the speech-language therapy your son or daughter is receiving. Talk with the SLP, find out how to augment and enrich the therapy at home and in other environments. Also find out what not to do!

— Give your child chores. Chores build confidence and ability. Keep your child’s age, attention span, and abilities in mind. Break down jobs into smaller steps. Explain what to do, step by step, until the job is done. Demonstrate. Provide help when it’s needed. Praise a job (or part of a job) well done.

— Listen to your child. Don’t rush to fill gaps or make corrections. Conversely, don’t force your child to speak. Be aware of the other ways in which communication takes place between people.

— Talk to other parents whose children have a similar speech or language impairment. Parents can share practical advice and emotional support. See if there’s a parent nearby by visiting the Parent to Parent USA program and using the interactive map.

— Keep in touch with your child’s teachers. Offer support. Demonstrate any assistive technology your child uses and provide any information teachers will need. Find out how you can augment your child’s school learning at home.

Readings and Articles

We urge you to read the articles identified in the References section. Each provides detailed and expert information on speech or language impairments. You may also be interested in:

Speech-Language Impairment: How to Identify the Most Common and Least Diagnosed Disability of Childhood http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2491683/

Organizations to Consult

ASHA | American Speech-Language-Hearing Association Information in Spanish | Información en español. 1.800.638.8255 | [email protected] | www.asha.org

NIDCD | National Institute on Deafness and Other Communication Disorders 1.800.241.1044 (Voice) | 1.800.241.1055 (TTY) [email protected] | http://www.nidcd.nih.gov/

American Cleft Palate and Craniofacial Association (ACPA) 1.800.242.5338 | https://acpacares.org/

Childhood Apraxia of Speech Association of North America | CASANA http://www.apraxia-kids.org

National Stuttering Foundation 1.800.937.8888 | [email protected] | http://www.nsastutter.org/

Stuttering Foundation 1.800.992.9392 | [email protected] | http://www.stuttersfa.org/

1 | Minnesota Department of Education. (2010). Speech or language impairments . Online at: http://education.state.mn.us/MDE/EdExc/SpecEdClass/DisabCateg/SpeechLangImpair/index.html

2 | Boyse, K. (2008). Speech and language delay and disorder . Retrieved from the University of Michigan Health System website: http://www.med.umich.edu/yourchild/topics/speech.htm

4 | American Speech-Language-Hearing Association. (n.d.). Speech sound disorders: Articulation and phonological processes . Online at: http://www.asha.org/public/speech/disorders/speechsounddisorders.htm

5 | Cincinnati Children’s Hospital. (n.d.). Speech disorders . Online at:  http://www.cincinnatichildrens.org/health/s/speech-disorder/

6 | National Institute on Deafness and Other Communication Disorders. (2002). What is voice? What is speech? What is language? Online at: http://www.nidcd.nih.gov/health/voice/pages/whatis_vsl.aspx

7 | American Academy of Otolaryngology — Head and Neck Surgery. (n.d.).   About your voice . Online at:  http://www.entnet.org/content/about-your-voice

8 | Boyse, K. (2008). Speech and language delay and disorder . Retrieved from the University of Michigan Health System website: http://www.med.umich.edu/yourchild/topics/speech.htm

9 | Encyclopedia of Nursing & Allied Health. (n.d.). Language disorders . Online at: http://www.enotes.com/nursing-encyclopedia/language-disorders

10 | Ibid .

11 | U.S. Department of Education. (2010, December). Twenty-ninth annual report to Congress on the Implementation of the Individuals with Disabilities Education Act: 2007 . Online at: http://www2.ed.gov/about/reports/annual/osep/2007/parts-b-c/index.html

Collaborative working in speech and language therapy for children with DLD-What are parents' needs?

Affiliations.

• 1 Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.
• 2 Institute for Language Sciences, Utrecht University, Utrecht, The Netherlands.
• 3 Department of Education, University Medical Centre Utrecht, Utrecht, The Netherlands.
• 4 Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
• 5 De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
• PMID: 37715545
• DOI: 10.1111/1460-6984.12951

Background: Collaborative practice between therapists and parents is a key element of family-centred care and is essential if we want to address family priorities and needs in interventions. However, collaborative practice is challenging for speech and language therapists (SLTs) and parents. To facilitate collaboration, collaborative practices need to be implemented into speech and language therapy for young children with developmental language disorders (DLD) and their families. Actual change and implementation of collaboration in practice will be successful only when it corresponds with patients' needs, in our case the needs of parents of young children with DLD.

Aims: To explore parents' needs in their collaboration with SLTs during therapy for their young child with DLD.

Methods & procedures: Parents of children with (a risk of) DLD in the age of 2-6 years were eligible for participation. We recruited parents via SLTs. Twelve parents of children with DLD participated in semi-structured interviews about their needs in collaboration with SLTs. We used a phenomenological approach focusing on parents' lived experiences. We transcribed the interviews verbatim. All interviews were read/listened to and discussed by our parent panel, multiple researchers and the interviewer. Two researchers independently analysed the data using the reflective thematic analysis of Braun and Clarke.

Outcomes & results: The analysis of the interviews resulted in six themes: (1) knowing what to expect, (2) knowing how to contribute, (3) feeling capable of supporting the child, (4) trusting the therapist, (5) alignment with parents and children's needs, preferences and priorities and (6) time and space for asking questions and sharing information.

Conclusions & implications: Parents want SLTs to invest time in collaborating with them. Parents need SLTs to empower them to become a collaborative partner and enable them to support their child in daily life. Parents need knowledge about the therapy process and diagnosis and skills in how to support their child's language development. Also, they need emotional support to feel secure enough to support their child, to ask questions to therapists and to bring up their own thoughts and opinions in therapy. Parents' needs are in line with collaborative working as described in literature, which underlines the importance of implementing collaborative working in speech and language therapy for young children with DLD.

What this paper adds: What is already known on the subject Several reviews have explored parents' perspectives on speech and language therapy. Results reveal parents' experiences with speech and language therapy in general, and parents' perspectives on specific topics such as shared decision-making and parents/therapists roles in therapy. What this study adds This study adds insights into parents' needs to ensure collaboration with speech and language therapists (SLTs). Parents of young children with developmental language disorders (DLD) need SLTs to invest time to create optimal collaboration. It is important for parents to have enough knowledge about DLD and the SLT process, skills and confidence in how to support their child and opportunities to share thoughts and questions with SLTs. Our results underline the importance of parents being empowered by SLTs to become a collaborative partner. What are the clinical implications of this work? When children are referred to speech and language therapy, parents often venture into an unknown journey. They need support from SLTs to become a collaborative partner in speech and language therapy. Parents need SLTs to invest time in sharing knowledge, skills and power and align therapy to parents' and child's needs, preferences, priorities and expectations.

Keywords: DLD; collaboration; parents’ needs; speech and language therapy.

© 2023 The Authors. International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

• Child, Preschool
• Language Development Disorders* / psychology
• Language Development Disorders* / therapy
• Language Therapy* / methods
• Parents / psychology
• Speech Therapy / methods

Grants and funding

• RAAK-MKB10.023/Taskforce for Applied Research SIA (Regieorgaan SIA)