Speech-Language Therapy: Areas of Service
Author: Kendra Wormald, Reg. CASLPO Speech Language Pathologist
Date: Wednesday, June 05, 2024
Table of Contents
Speech Production
Fluency
Language
Cognition
Voice
Resonance
Transgender Communication
Preventive Vocal Hygiene:
Business Communication:
Accent/dialect Modification:
Professional Voice Use:
What is Speech-Language Therapy?
When you think about speech-language therapy, the thought of a child who struggles with their ‘th’ or ‘s’ may come to mind. However speech-language therapy can support a diverse set of skills for anyone, across the lifespan. The following article will outline the basics of speech and language therapy, areas and methods of intervention and signs or symptoms that may prompt a speech-language therapy visit.
The type of assessment and subsequent intervention for speech-language therapy, may look different for each person, however all intervention will following principles of intervention that are research-based and specific to the client.
Service Delivery Areas
Speech Production: The things you do with your jaw tongue and mouth to make the specific sounds. These involve:
Motor Planning and execution: Coordination of articulators to create speech.
Example:Knowing that your tongue goes to the top front of your mouth (hard palate), close to the root of your top teeth. Then the tongue taps that spot as it released one burst of air (also called a stop).
When making the ‘f’ sound your top teeth press against your bottom lip with slight pressure while air continues to flow out, also called a fricative.
Articulation: How you move your mouth to make certain speech sounds
Example:
Putting your tongue behind your teeth instead of between your teeth with your lips open when making the ‘th’ sound. This may lead to your ‘th’ sounding like a ‘t’ or even a ‘s’ depending on where your tongue is and the airflow behind it.
Phonological: How sound contrasts which create differences in meaning within a language.
Example: The speech sound (phoneme) /ɛ/ is different from the phoneme /i:/, so if we use the word set [sɛt] instead of seat [si:t], the meaning of the word will change.
Fluency: The forward flow of your speech
Stuttering: Difference in speech patterning involving disruptions in speech flow. These may include blocks, repetitions, prolongations or a combination of these.
Example:
(AHSA, 2024)Repetitions of sounds, syllables, and one syllable words (e.g., “Look at the b-b-boy” “I told him- him- him…”).
Prolongations of consonants when it isn’t for emphasis (e.g., “Ssssssunny days are very nice”).
Blocks. You go to make the sound but the sound is truly are truly ‘blocked’.
Cluttering: Speech that is rapid, unclear or disorganized.
Example:
Using several interjections also called fillers (um, uh, so um, ya know etc.) Speaking at a rapid and/or irregular pace, irregular pauses, leaving out syllables, language. formulation issues, starting sentences then restarting with different words (maze behaviors):
“I need to go to...I mean I’m out of cheese. I ran out of cheese and bread the other day while making sandwiches and now I’m out so I need to go to the store” (ASHA, 2024). Also, leaving off the ending of words and words sliding into each other “remember thatime when”.
Language
Phonology: Patterns of sounds in and across languages.
Example:
In Mandarin, each word or character could be said in one of four tones and mean something different when said with another tone.
Whereas, English uses rising and falling pitch and melody patterns, which are used to express emotion or give options or to end the sentence.
Morphology: Words and their parts (prefixes, suffixes and base words).
Example: sing-ing, stuff-ed, anti-inflammatory
Syntax: How words are arranges and the rules that govern this, grammar.
Example: Based on English rules, it would be hard to understand a sentence formed as:
Sun we the sit is shining on while swing. But according to the “rules” it ‘should’ sound like: The sun is shining while we sit on the swings.
Semantics: Meaning of language.
Example: The understanding that the word sky and shoes can’t be used interchangeably.
Pragmatic: How language is used, social components of communication.
Example: “ The phrase ‘Will you crack open the door? I am getting hot’, semantically, the word means "crack" would mean to break, but pragmatically we know that the speaker means to open the door just a little to let in some air.”
Paralinguistic communication: signaling, gestures, body language/ non-verbal communication joint attention, intentionality.
Example: Crossing your arms while someone is speaking to you can signal that you are closed off, and may be interpreted as rude, angry or resistant.
Literacy: reading, writing, spelling.
Example: Magic ‘e’ rule - “ When the ‘e’ is the last letter in the word, and there is only one other vowel in the same syllable, that first vowel is long (says its letter name) and the ‘e’ is silent. (e.g. inside, sale, cake).
Cognition
Attention: Sustained, divided, selected, focused, limited.
Example:
Sustained Attention: focusing on a specific person, activity or task for a certain time such as a conversation.
Selective attention: Being able to focus on something while blocking out background noise or stimuli such as when studying at a noisy cafe.
Executive attention: Intentional prioritization and only focusing on activities that will help to achieve a certain predetermined goal.
Focused attention refers to focusing on a single stimulus.
Divided attention refers to the attention that is directed to more than one stimulus at a time, such as when cooking a meal while talking to a friend or driving a car and talking to a passenger.
Alternating attention occurs when attention switches back and forth between different stimuli such as when reading a recipe, performing a step, then referring back to the recipe.
Memory: Encoding, storage and retrieval of information over time.
Examples:
Working memory refers to the short term storage of information such as when asking for directions and remembering them until your destination, or learning someone’s name.
Episodic memory refers to memories from your own history such as when you got your driver’s license, your graduation day, your wedding.
Semantic memory refers to general knowledge including facts such as knowing what a car is.
Prospective memory refers to remembering to perform an action in the future such as taking your medication or asking your boss a question about your project at your next meeting.
Application of these in the workplace may look like needing to switch focus from one task and prioritize a project your boss provides you and needs completed asap, or remembering verbal to apply to your report.
Executive functioning - Skills that facilitate the behaviors required to plan and achieve goals The seven executive functions are: Adaptable thinking, planning, self-monitoring, self-control, working memory, time management, and organization.
Examples:
Cognitive flexibility can support the ability to manage everyday tasks and decision making.
Inhibitory control helps support self-regulation of impulses and distractions, which may support task completion and behavior regulation. This may come in to play when speaking assertively to a coworker about a conflict or being able to take time enunciating your speech to increase your clarity.
Voice
Phonation: Quality and tone.
Example: Throughout and/or at the ends of your sentences you may go into ‘glottal fry’, where the voice is low in pitch, creaky, and breathy. This may be perceived as hesitant or less confident, and can reduce the clarity of the words or overall emotion of your message.
Pitch: Measure of sound frequency (Hz)
Example: When you get nervous, you may speak in a higher pitch. Or, you may speak with a monotone voice which may make you lose your listeners attention, or they may miss out on key ideas.
Loudness: Measured in dB
Example: Keeping your volume consistent across your sentence is vital. Not doing so may cause the listener to miss out words or parts of words.
Resonance: Intensity/quality of the tone.
There are 6 main resonating areas in the body: the larynx, pharynx, the mouth (oral cavity), nasal cavity, upper skull cavity & the chest.
The Larynx (voice box) is the start of a chain reaction as sound travels to the next vocal resonance point, changing and possibly intensifying depending on how you maneuver your muscles.
Too much focus on the mouth as a resonator can result in a weaker shallower tone & over used tight jaw muscles.
The Pharynx is the passageway between the nasal cavity & the larynx.
Nasal cavity is where you can add colour to your sound which may sound more theatrical or modern.
Some times called head voice the upper skull is what will help you reach higher notes with fullness.
Chest voice is where low vibrations are produced. When used effectively you will feel the rumble in your ribcage.
Transgender Communication: Creating a vocal identify with focus on voice, verbal and nonverbal communication that feel authentic and representative of who you are.
Preventive Vocal Hygiene: Ensuring you are performing daily habits to that support a healthy voice such as reducing how frequent you yell by using a microphone or hand signals, or drinking enough water in a day in relation to caffeine.
Business Communication: Supporting your ability to facilitate meeting, execute effective presentations, and speak confidently to stakeholders.
Accent/dialect Modification: Focus may be placed on how your are articulating specific speech sounds, your intonation patterns and rate.
Professional Voice Use: Optimizing on voice characteristics to support clarity, pitch variability, consistent volume and pacing when communicating.
What’s great about speech-language therapy is that various skills often support other skills. So, working on several of these areas may be possible, depending on your targets and current abilities. Speak with your Speech-Language Therapist to discuss areas of intervention that may best fit your needs and goals.
To speak with a psychotherapist or one of the speech-language pathologists at Well Said: Toronto Speech Therapy, schedule an initial consultation by clicking the link below or calling (647) 795-5277.
