Common Speech and Language Terms

At the start of speech and language services it may be overwhelming for parents.  There are many terms that speech pathologists use that parents may not be familiar with.  As SLPs it is important that we ensure our parents understand everything we are discussing when it comes to their child as this will optimize treatment and carryover at home.  Since many of the words SLPs use are unique to our field and the field of special education it is important to educate parents on the meanings of these terms.

Here are a few of the common terms that parents may come across during the course of their child’s treatment.

  • Speech/Language Difference vs. Speech/Language Disorder:
    • Speech/language difference refers to a difference or variation in the child’s language background which may cause differences in their speech and language.  For example, children who are bilingual may exhibit differences in their speech or language production of their second language due to the impact of  their first language, dialect or accent.
    • Speech/Language disorder refers to an actual impairment resulting in atypical development of the child’s speech/language development when compared to their age-matched peers.  Children exhibiting a language impairment should seek a comprehensive speech/language evaluation to determine if speech therapy is necessary.
  • Articulation vs. Phonology
    • Articulation refers to the actual production of speech sounds.  Articulation errors are different from phonological errors because these are errors occur due to difficulties executing the proper production of the speech sound.  An example of an articulation error is a lisp.
    • Phonology refers to how speech sounds go together and follow patterns to create words. Phonological disorders occur when a child’s speech does not follow the correct pattern for how to correctly produce specific sounds.  An example of a phonological deficit is a child who produces the /t/ sound for the /k/ sound and the /d/ sound for the /g/ sound.  This is known as velar fronting, which is a phonological process that results in a velar sound being replaced by a sound that is produced anteriorly in the mouth.
  • Augmentative Communication vs. Alternative Communication
    • Augmentative Communication is a device that helps a child who is limited in their verbal expressive language communicate by adding to their communication.  These devices or tools can be utilized in conjunction with the child’s verbal language to help them better communicate their wants/needs.  An example is using picture cards in conjunction with verbal words to better communicate their wants/needs.
    • Alternative communication is a new/different type of communication that replaces another form of communication such as speaking.  These devices can be utilized for children who are nonverbal and need an alternative form of communication to express themselves.
  • MLU: Mean Length Utterance
    • MLU is another term which is often utilized by speech language pathologists and may be unfamiliar to parents as it is specialized to this field.  MLU refers to the mean or average length of a child’s utterance.  Many children with language delay have deficits in MLU as they have often exhibit shorter utterance length.  MLU corresponds to a child’s age and increases as a child grows older.  A child of 1 year of age should be speaking in single word utterances which correlates to an MLU of 1.  This MLU increases as the child gets older with an MLU of 2 or more at 2-years of age, 3 or more at 3-years of age and 4 or more at 4-years of age.
  • Syntax vs. Semantics
    • Syntax refers to the structure of language and how sentences should be constructed.  Syntax encompasses the grammatical rules of a given language.  A child with a poor understanding of grammar such as verb tenses or plurals will have deficits in the area of syntax.
    • Semantics refers to the meaning of words and correlates to the child’s vocabulary development.  Children who have a limited understanding of age appropriate vocabulary and concepts will have deficits in the area of semantics.
  • Prosody
    • Prosody is another common speech and language term which refers to the melody of speech including suprasegmental features such as rate, rhythm, intonation, volume, stress and pitch.  Prosody helps individuals convey emotions, sarcasm a question verse a statement and energy.
  • Pragmatics
    • Pragmatic language refers to the social use of language, including tone of voice, turn taking, topic maintenance, providing context to a story, and appropriate usage of words given a specific audience or situation.  Pragmatic deficits are often associated with specific disorders such as those included under the realm of Autism Spectrum Disorders.
  • Resonance
    • Resonance refers to the flow of air through the nose or mouth during speech.  The velum is an essential structure within the vocal tract as it helps control resonance.  The velum closes off airflow to the nose for all English phonemes except nasal sounds /m/, /n/ and /ng/. Resonance disorders are often associated with cleft palate or velopharyngeal incompetence.

SOURCE: Super Duper Publications,  ASHA

-Jenna Oldfield MA, CF-SLP, TSSLD


Strategies for Auditory Processing

According to the American Speech-Language and Hearing Association (ASHA), Central Auditory Processing includes the auditory mechanisms that underlie the following abilities or skills:

  • sound localization and lateralization
  • auditory discrimination
  • auditory pattern recognition
  • temporal aspects of audition, including temporal integration, temporal discrimination (e.g., temporal gap detection), temporal ordering, and temporal masking
  • auditory performance in competing acoustic signals (including dichotic listening)
  • auditory performance with degraded acoustic signals.

Central Auditory Processing Disorder refers to difficulties in the perceptual processing of auditory information in the Central Nervous System as demonstrated by poor performance in one or more of the above skills.

What can we do to help individuals with deficits in auditory processing?

Strategies for Central Auditory Processing Disorder:

  1. Identify the KEY Information: Individuals with auditory processing deficits often struggle identifying the key information from ideas, instructions or other types of information presented to them.  Teaching individuals to gather the key or most important information out of longer materials such as stories or directions can help the individual better understand and process that information.
  2. Chunking: When using this strategy individuals learn how to break down information into smaller parts or chunks.  This strategy is great for remembering telephone numbers or locker combinations and allows the individual to better process and remember this information.
  3. Linking: When using this strategy individuals learn how to form connections between ideas presented to them.  The ability to categorize their thoughts is very helpful when processing information and can allow individuals with auditory processing deficits to better retain and understand information.
  4. Make a list: Making lists is an external memory strategy that can help individuals with auditory processing deficits better remember information.  Lists also provide additional modalities to process information.  The individual will hear the information verbally, write the information down which allows for a tactile and kinesthetic modality for processing and then refer back to this information which adds a visual modality for processing.
  5. Rehearsal: Repeating information over and over again can help the individual retain this information.  This is very helpful when given complex or multi-step directions and can help the individual remember these instructions.
  6. Paraphrase: When using this strategy individuals learn to better understand information by putting the information into their own words.  This can allow for the information to be simplified and allows the individual to better understand the information.
  7. Visualize: During this strategy individuals with auditory processing deficits can close their eyes and picture the information in their mind.  This adds an additional modality for processing the information as the individual can now interpret the information both visually as well as the auditory modality.
  8. Drawing: During this strategy individuals can trace, write or draw in order to connect information.  The individual is then able to process the information through multiple modalities: visual, auditory and tactile-kinesthetic modalities.

Sources: ASHA,

-Jenna Oldfield, MA, CF-SLP, TSSLD


Transitioning Is Hard….

At first glance, little things like transitioning from one activity to the next may seem like an easy task.  We do it everyday… when we go to school, to go grocery shopping, when it’s time for bed.  However, many children struggle with this task due to their difficulty with accepting change within their environment.  This is especially difficult for children who are on the Autism Spectrum as these children have a hard time with change and benefit from a repetitive and routine schedule.  Deviating from routine can result in changes in moods, behaviors and could impact their performance on certain academic tasks.  So what can parents or teachers do to help these children?


  • Visual Schedules:
    • Visuals are key for children with Autism Spectrum Disorder as it adds an additional modality for processing new information.  Parents can create visual schedules for daily routines at home such as morning routine, bedtime routine or weekend routines.  Parents should go over these routines with their children to ensure the child understands what is going to happen for that day.  It is especially important for parents to inform their children if changes to the routine are expected for that day such as additional events (e.g. birthday parties, trips etc.) as this will help the child expect and prepare for these changes to their daily routine.  If last minute changes are to be made and there is no time to tell the child beforehand, parents should inform the child verbally but still change the picture on the visual schedule when they get home.  When the parents change the picture, they should educate the child on what this event may have replaced on the schedule so the child isn’t expecting an event that is no longer happening.
    • Benefits for teachers: Many changes and transitions happen during a typical school day.  Teachers can create each students schedule before the children arrive for the day.  These visual schedules should include all events that are to take place for the day such as related services, morning circle, lunch, recess, extracurricular activities, and bus pick up.  This allows the students to prepare for their day and expect changes that will occur during their day.  Each student’s schedule should be individualized to them and should be created in the order that the events will take place.  Student’s can take off pictures for completed tasks which adds an additional visual of what is to come and what has already happened.
  • Sequencing Schedules for Activities of Daily Living:
    • Facilitating independence is an essential part of helping and teaching children with Autism Spectrum Disorder.  Parents and teachers should always presume competence.  Sequencing schedules are beneficial for teaching daily routines.  These can be created for any routine such as brushing your teeth, washing your hands, folding laundry etc.  These visuals help children understand the order and steps that are included in a task and allows them to perform tasks independently.


Okay, the child has their visual schedule for the day and it is time to transition from one activity to the next.  You show them their visual schedule… but wait…. the visual schedule is not working and the child is still demonstrating difficulty transitioning…. what else can you do?

  • Visual timers
    • Visual timers are a great tool for helping children better understand when a task will be completed and how much time is left on a specific task.  This helps with transitioning from preferred activities but also helps motivate children during non-preferred activities.
    • Preferred Activities: It’s play time during school or at home and you want to prepare the child for the end of this activity.  This may require a little more help than the visual schedule alone.  Visual timers are great for transitioning from preferred activities.  The timer can be set to the allotted amount of time and as the timer ticks down it creates a visual for the child.  There are many visual timer apps available for children.  I prefer using the app “Timer for Kids” by Idea4e.  This app allows the child to pick an animal and as the timer ticks down the animal begins to appear until the time is up and the full picture of the animal is shown.  This app also has background music which is comforting for the child.  The child should be informed of the amount of time the timer will be set to and verbal reminders can be given throughout the activity.  Visual timers help the child understand when their preferred activity will be over and helps them prepare for that transition.
    • Non-preferred Activities: Visual timers are also very helpful for motivating children for non-preferred activities such as classroom work or daily routines such as brushing their teeth.  Visual timers can be set and the child can be informed that the task will only last for the amount of time decided upon by the teacher.  This is also a great way to help children work up to longer tasks.  For example, the first week during classroom work the child may only sit for 5 minutes at the table.  The teacher can set the timer for 5 minute increments and allow breaks in between.  The next week the teacher may choose to increase the time on the timer and have the child sit at the table for longer.  The teacher can continue increasing this time for each week until the child sits at the table for the entire time during classroom work.

Source: Super Duper Handout #134

-Jenna Oldfield MA, CF-SLP, TSSLD



Voice Therapy Tips for SLPs

“To remediate a voice disorder, we must have the skills to counsel and motivate and to remember that the voice is a mirror of the soul”. Being that voice therapy is a particular specialization within our field, it is imperative for clinicians to research current therapy techniques and select and implement an appropriate voice therapy program. In addition, the SLPs role is to develop an appropriate relationship with the patient and caregivers, consistently provide ongoing education in regards to the voice disorder along with treatment, help the patient develop self-monitoring skills and always refer with sensitivity. Further, the SLP should analyze the patient’s life-style and environmental factors relating to their vocal behaviors, present hierarchies and strategies to reduce and eliminate vocal abuse behaviors, explain and model facilitative techniques, use materials/strategies that interest the patient, collect data, document progress, refine goals, model excellent vocal use and always counsel! Individualization of voice therapy is dependent on the patient’s diagnosis, need for medical intervention and patient motivation.

Long term goals of voice therapy are to:

  • Optimize function of the larynx
  • Eliminate vocal pathology
  • Produce optimal vocal quality
  • Rebalance the subsystems of respiration, phonation, and resonance.

Management strategies may include patient education and counseling, vocal hygiene counseling, elimination of vocal misuse/abuse, management of Gastroesophageal Reflux Disorder (GERD) and Laryngopharyngeal Reflux (LPR), tension reduction exercises, vocal warm-ups, abdominal breathing, respiratory training and easy onset phonation.

Patient education and counseling may include instruction in the anatomy and physiology of the vocal mechanism, along with discussion in regards to the three subsystems. Vocal hygiene counseling includes discussions about hydration (e.g. drinking water, carbonated waters, herbal teas), lubrication (personal steam inhalers, shower steaming, room air humidifier) and vocal rest, whether it be complete or modified. Eliminating vocal misuse/abuse involves educating the patient on the effects of their misuse or abuse (e.g. smoking, alcohol, caffeine, yelling, screaming, habitual throat clearing, and/or coughing).

Management of GERD and LPR involves educating the patient about their diagnosis and discussing medical management. With these specific diagnoses, it is imperative that the patient be compliant with medication. Tension reduction exercises include stretches for the neck, shoulders, back, jaw, tongue, lips, soft palate, and respiratory muscles. Vocal warm-ups include the yawn-sigh, hum-sigh, glides, lip-trills and musical scales. Abdominal breathing and respiratory training involves exercises that focus on the lower thoracic abdomen rather than the shoulder muscles for breathing. Easy onset phonation involves easing into vowel-initiated words and practicing throughout a hierarchy (e.g. nonsense syllables → words → phrases → structured sentences → paragraphs → conversation).

It is extremely important for SLPs to be knowledgeable of Vocal Function Exercises, Lessac-Based Resonant Voice Training and Lee Silverman Voice therapy. Lastly, always remember that comprehension involves compliance. As for anything else, the patient needs to be fully educated and fully understand the exercises prior to independently completing them at home.

-Kristen Meaney, MA, CF-SLP

Lecture: Yvonne Knapp, LIU Post Spring 2017

Phonological Processes: At What Age Should They Be Suppressed?


Phonological Processes

Phonological processes are sound errors that typically developing children use to simplify speech as they are developing speech and language skills. A phonological disorder occurs when a child has not outgrown, or suppressed the phonological process past the expected age.

Phonological Process Description Age suppressed
Unstressed Syllable Deletion Children delete the unstressed syllable. (e.g. telephone → telephone) 3 years of age
Final Consonant Deletion Children delete the last consonant of a word. (e.g. hat → ha) 3 years of age
Consonant Assimilation One consonant influences another (e.g. bed → beb) 3 years of age
Reduplication The child repeats the first syllable two times. (e.g. bottle → baba) 3 years of age
Velar Fronting Back phonemes /k/ and /g/ are replaced by front phonemes /t/ and /d/. (e.g. cookie → tootie) ~ 3 years of age
Affrication A non-affricate sound is replaced by an affricate (“ch” or “j”). (e.g. door → joor) 3 years of age
Stopping A fricative sound like /f/ or /s/ or affricate sound like “ch” or “j” is substituted with a stop consonant like /p/ or /b/. (e.g. jump → dump) Between 3 and 5 years of age
Deaffrication An affricate “ch” or “j” is replaced with a fricative or stop like /sh/ or /d/. (e.g. chips → ships) 4 years of age
Cluster Reduction A consonant cluster is reduced to a single consonant (e.g. blue → bu) Between 4 and 5 years of age
Gliding Phonemes /r/ and /l/ are replaced by /w/ (e.g. love → wove; road → woad) 6 years of age
Epenthesis A vowel sound is added between two constants. (e.g. blue → bu-lue) 8 years of age

It is important for parents, caregivers and teachers to be knowledgeable of phonological processes. If any process is evident in the child’s speech past the age of seven years old, it is imperative that they are evaluated by a speech-language pathologist. Phonological processes can lead to significantly reduced speech intelligibility if they are left untreated.

Sources: Super Duper Publications; Mommy Speech Therapy.

-Kristen Meaney, MA, CF-SLP


Sensory Integration

Sensory Integration

Does your child demonstrate oversensitivity to certain noises, tastes, smells, or textures? They may be showing signs of sensory defensiveness. Sensory defensiveness is a negative reaction to a stimulus that most people would not perceive as negative. Children with sensory defensiveness show negative reactions to one or more types of sensations (e.g. touch, texture, taste, smell, or sound). Children with sensory defensiveness over-react to sensory input and become easily frustrated and/or bothered. These children may have difficulty processing sensory information. There are four different types of sensory defensiveness, including tactile defensiveness, gravitational defensiveness, auditory defensiveness and oral defensiveness.

  • Tactile defensiveness involves the tactile system, which is our sense of touch. Children with tactile defensiveness may overact to touch experiences, avoid daily activities (e.g. brushing their teeth, taking a bath), avoid light touch (e.g. taps on the shoulder, kissing, etc.), or seek deep pressure.
  • Gravitational defensiveness involves the vestibular system, which is our sense of movement and balance. Children demonstrating gravitational defensiveness may have abnormally fearful emotional reactions to something like swinging or climbing.
  • Auditory defensiveness involves fearful reactions to sound, such as covering ears when exposed to loud noises. Children with auditory defensiveness may display atypical emotional reactions when they hear a vacuum cleaner or leaf blower.
  • Oral defensiveness involves taste, smell, and tactile input. Children with oral defensiveness may be picky eaters, gag from certain textures, tastes, and/or smells during meals, and/or dislike brushing their teeth.

Sensory stimulation kits are utilized by parents, speech-language pathologists, occupational therapists, and teachers. Sensory kits are used to expose children to new feelings and encourage responses.  Sensory kits can be used for children of all ages to build schema, describe sensations, incorporate motor movements and play. When a child plays with a sensory bin, they are playing with a variety of materials and textures which stimulate the mind beyond what other toys can achieve. Sensory stimulation can help children develop focus, expand vocabulary, engage their mind through senses, improve fine motor skills, etc. Sensory kits can be paired with any of your favorite books! Here are some examples of easy sensory bins to make:


-Kristen Meaney, MA, CF-SLP

Source: Super Duper Publications

Central Auditory Processing Disorder in Children (CAPD)

Central Auditory Processing Disorder (CAPD) is defined as a breakdown of auditory information beyond the physical ability to hear, at the level of the central nervous system. In other words, CAPD occurs when the central nervous system has problems processing information that comes through listening. Research suggests that 3% to 20% of children have CAPD, and that a significant number of those children also have attention issues, along with Attention Deficit Hyperactivity Disorder (ADHD).

Although children with ADHD, autism, pervasive developmental disorder, and other global deficits may demonstrate poor listening skills, they do not necessarily have CAPD. Other disorders such as these often affect a child’s ability to attend to and interpret auditory information because they usually affect the same areas of the central nervous system. This can make the differential diagnosis quite difficult. However, CAPD is not a symptom, nor a result of global deficits (Bellis, n.d.).

Children with CAPD display several behaviors similar to symptoms associated with sensorineural hearing loss. For example, children with CAPD often demonstrate significant difficulty in the presence of background noise. In addition, they may have difficulty recognizing subtle differences between sounds in words or may have difficulty with interpretation of longer strands of auditory information, such as verbal directions. In school, children with CAPD may have difficulty spelling, reading, and understanding information presented verbally in the classroom. In addition, these children may demonstrate a significantly higher performance in classes that don’t rely heavily on listening (Bellis, n.d.). These behaviors may become apparent in the early school years, such as kindergarten or first grade, or at a later stage of the child’s life. This is likely due to increased academic demands placed on children in the elementary grades.

To diagnose CAPD, an audiologist administers a variety of tests that require the child to attend to a variety of signals and to respond to them via repetition, pushing a button, or in some other way. Most CAPD assessments require the child to be at least seven years of age because younger children do not have the advanced brain function to interpret auditory stimuli of each assessment.

Speech-language pathologists help to treat children with CAPD and incorporate goals targeting the child’s strengths and weaknesses. It is important to provide the child with a quiet environment, especially when listening to important information and completing homework tasks. In addition, it is important to have the child keep a visual day planner and write down important information as soon as it is presented. Parents and caretakers should decrease their rate of speech when talking to the child and allow more time for the child to answer questions. Furthermore, it is extremely important to follow any goals and/or recommendations set up by the child’s audiologist and speech-language pathologist.

-Kristen Meaney, M.A. CF-SLP