When a birth injury occurs or when babies are born with deficits that prevent them from developing and thriving in a typical progression, they may benefit from a special type of therapy known as speech pathology. In many instances, these babies exhibit feeding difficulties. In turn, they may participate in speech therapy in order to learn to feed properly (ex. Suck, swallow, breathe). In other instances, children with disorders such as cerebral palsy, autism, and other debilitating conditions may benefit from speech therapy by learning techniques on how to communicate most efficiently.
What is Infant Speech Pathology?
Infant speech pathology is a form of therapy in which an infant learns how to feed safely and competently and/or learns to develop the most functional and appropriate communication skills. A certified speech-language pathologist (SLP) helps infants learn to feed and learn communication skills in a number of ways. These therapists also work with infants to prevent swallowing and feeding disorders. In addition, nutritionists, nurses, lactation consultants, physical therapists, occupational therapists and physicians typically all play a part in the speech pathology collaborative team. Toddlers and children with speech impediments are also treated by SLPs and can learn effective communication skills via a variety of therapy and learning modalities.
Infant Speech Pathology Evaluations
As mentioned earlier, babies go through extensive evaluations prior to starting speech therapy treatment. Evaluations are important as they help to assess how severe the infant’s feeding and swallowing issues are. During an evaluation, physicians will:
- Review the infant’s medical records, including feeding intake, overall growth since birth, and feeding issues symptoms
- Examine the baby’s mouth and throat to observe the strength of the muscles
- Identify risk factors that may be causing feeding issues
- Ensure that a true medical condition is causing feeding issues (as opposed to normal developmental stages that may hinder feeding)
Infant Speech Pathology and Feeding
Speech pathology for feeding issues can begin as early as birth, after a problem with feeding is recognized. Infants who have difficulties with feeding may benefit greatly from speech pathology for infants, but before beginning treatment, they usually undergo an in-depth oral motor and swallowing evaluation to determine the kind of feeding issues, how severe the problems are and how the problems can be treated.
After doing a thorough assessment and evaluation on pre-feeding and an oral motor and swallowing evaluation, infant speech therapy may include:
- Practice oral stimulation with infants who cannot yet bottle or breast feed.
- Utilize feeding interventions to help improve skills
- Individualized treatment plans
- Feeding and dysphagia therapy
- Parent and caregiver education.
- Feeding and dysphagia therapy
- Tube weaning (for infants who are being fed through a tube)
- Specialized activities that help babies learn to bottle and/or breast feed
- Stimulation and oral motor activities to promote the early development of speech
What Are The Signs That an Infant is Having Feeding Problems?
Before referring infants to speech pathology, there are generally a number of signs to look out for. These types of problems can be identified in numerous ways, including:
- Not meeting appropriate developmental milestones (ex. babbling)
- Frequent coughing, gagging, and/or choking during feeding sessions
- Lacking alertness during feeding sessions
- Poor weight gain
- Poor growth
- Crying and pulling away from the bottle or breast during feeding sessions
- Excessive drooling
- Spitting up and/or vomiting frequently
- Low or hoarse voice when crying
Benefits of Infant Speech Pathology for Feeding Issues
There are a number of benefits for infants with feeding difficulties who participate in speech therapy, including:
- Weight gain
- Improved swallowing function
- Ability to feed safely and efficiently
- More alert when feeding
Speech Pathology for Children with Speech Disorders
Speech disorders can happen for a variety of reasons. For example, speech problems occur in toddlers and children with autism, cerebral palsy, a cleft lip/palate, attention deficit hyperactivity disorder (ADHD), and for those who had a brain injury or stroke. Dysarthria and apraxia also cause speech problems as do aphasia, stuttering and swallowing difficulties.
Speech pathology for infants and toddlers and children with speech disorders require individualized assessments and treatments as each case is different and unique and each case may stem from different disorders. As a result, treatments will vary. However, the most common forms of treatment include:
- For apraxia, the PROMPT technique may be utilized, which entails touching cues to the mouth, tongue, and jaw to promote targeted phrases or words
- Cognitive training
- Auditory processing treatment
- Voice disorder treatment
- Augmentative communication therapy
- Audio and verbal therapy
- Articulation therapy
- Language intervention activities
- Oral motor therapy
Prior to treatments, patients will undergo an evaluation to determine what issues are causing the speech problems. Generally, an evaluation consists of:
- Receptive, expressive, and pragmatic language evaluations
- An oral peripheral exam
- Voice fluency evaluation
- Feeding and swallowing evaluation
How Can I Tell if My Child has Speech Issues?
There are various signs that indicate an infant/toddler/child may need speech pathology. It’s important, however, not to confuse speech problems with normal developmental delays. In general, however, some of the most common signs of speech delay include:
Infants (3-12 months):
- Does not babble or interact with others
- Doesn’t smile
- Only makes a few sounds
- Doesn’t wave or point
- Doesn’t respond to sounds (may indicate a hearing issue)
Toddlers (1-3 years of age):
- Has a difficult time understanding what others say
- Fails to say complete sentences
- Only knows/says a few words
- Trouble talking and playing with other kids
- Excessive stuttering
- Consistently fails to follow easy directions
What are the Benefits of Speech Pathology For Speech Problems?
Fortunately, speech pathology helps most toddlers and children articulate themselves better when communicating. Keep in mind that each child is unique and may benefit differently. Other benefits include:
- Improvement in understanding and expressing ideas and thoughts
- Increase in the ability to solve problems
- More fluent in speech
- Improvement in vocal quality
- Better self-esteem, mostly due to the ability of increased speech performance
In some cases, children do not develop audible and/or efficient speech despite treatment efforts with a speech therapist. In these instances, toddlers or children can continue to work with a SLP to identify alternative forms of communication, such as communication systems.