Speech & Language Services
Coastal Therapies Speech & Language offers comprehensive pediatric services, including evaluations and treatment for toddlers, elementary school-aged children, and adolescents with speech-related disorders, delays, or difficulties.
Speech & Language Evaluations
If you think your child might have a communicative disorder or speech-related today, one of our caring, experienced Speech-Language Pathologists may conduct an evaluation to determine the nature of the delay
Speech & Language Treatment
Our speech staff will develop a care plan with highly-functional goals for your child that allow for significant progress. We consider variables such as session activities, frequency and duration as we craft an individualized plan.
Social Skills Groups & Pragmatics
Many children can benefit from social interaction with peer in a safe, structured environment. Coastal Therapies offers social skills and pragmatics groups to facilitate the building of pragmatics and social skills.
Speech & Language Services
We believe communication is the greatest gift of all.
It is the mission of Coastal Speech Therapy to provide the highest quality of services available utilizing current best practices to identify, diagnosis, treat, and prevent speech and language disorders.
We are committed to ensuring that all children with speech, language, and developmental disorders receive services to help them communicate more effectively. Research continues to demonstrate that improving a child’s speech, language and behavioral skills at an early age prevents future delays in social, cognitive, and academic development. Through early identification and intervention, a child is able to reach his/her true potential.
Our Speech-Pathologists have written numerous parent-friendly brochures on the following topics: ADHD, Bridging Social Skills From Therapy to Home, Stuttering, Myofunctional Therapy/Tongue Thrust, Executive Functioning Disorder, Auditory Processing Disorders, Encouraging Early Communication, Developmental Verbal Dyspraxia, Articulation, Sensory Processing Disorders, and Autism Spectrum Disorders.
Our experienced professionals can help with stuttering / fluency, developmental verbal dyspraxia (Apraxia), Autism-related delays, articulation disorders, auditory processing disorder, phonological processing disorder, and expressive and receptive language disorders.
Speech & Language Pediatric Models of Intervention
Programs and methodologies we implement in the treatment of speech and language disorders
Coastal Speech Therapy provides pediatric assessment and treatment for a wide variety of speech and language disorders. Individualized treatment plans are provided to each client, based on their unique, specific language goals. We believe that therapy needs to be individually tailored and continually modified in order to meet the client’s needs.
Therapy for the younger child is primarily play-based, helping the child to learn and to use language within functional activities. An older child may need a combination of various styles of therapy in order to address specific speech and language difficulties that may be impacting overall communication and academic performance.
Auditory Bombardment and Traditional Articulation Training: When children have difficulty producing age-appropriate sounds, it is important for the clinician to model the correct sound by repetitively over-articulating the correct production both in isolation and at the word level. The child’s incorrect productions are then systematically and structurally targeted through a hierarchy of difficulty beginning in isolation and gradually increasing to the word, sentence, and conversational speech level.
Floor Time Therapy: The therapist determines the child’s neurological developmental stages and stimulates the environment to promote developmental growth. It is critical to follow the child’s lead and current neurological levels to design intervention. It is also extremely important to establish rapport, likability, and trust with the child prior to implementing measurable goals. Cites referenced by Stanley Greenspan (997).
Hodson’s Cycles Approach: Phonological processing disorders are patterns of articulation errors that children produce to simplify speech. By cycling through groups of sounds, the therapist is able to target many sounds with similar characteristics in a systematic, structured way. Cites referenced by Hammer (2003), Hodson, (2014).
P.R.O.M.P.T (Prompts for Restructuring Oral Muscular with Physical
Targets): Therapy has been found to be effective in treating verbal apraxia. PROMPT is about integrating all domains and systems towards positive communication outcome. It may be used (with varying intensity and focus) with all speech production disorders from approximately 6 months of age onward. PROMPT uses tactile-kinesthetic information directed to the jaw, face, lips or tongue. These PROMPTs, which are all provided externally, facilitate jaw/facial control and amount of movement required. The physical “PROMPTing “is dynamic and may be used to create and organize a single sound, word, phrase, or sentence. Cites referenced by Hayden (1984).
Kaufman Treatment: This program teaches children to combine consonants and vowels to form words while controlling for oral-motor difficulty. The 225 visual referent cards were selected specifically to target and teach the syllable shapes children need to master to become effective vocal/verbal communicators. Treatment methods employ a systematic and progressive approach of simplifying word pronunciation patterns to shape and expand verbal expression and make communication easier for children with childhood apraxia of speech and other speech sound disorders. This highly effective approach builds intelligibility through a hierarchy of successive “word shell” approximations based on least physiological effort of target words. The clinician also is able to introduce more complex phoneme patterns as the child’s ability improves, thus maintaining the child’s ability to speak at his or her maximum level. These methods can help children progress quickly from a simple core vocabulary toward becoming effective, functional, intelligible communicators. Works cited by Nancy Kaufman (2011).
Social Stories: Developed in 1991 by Carol Gray as a tool for teaching social skills to children with autism. Addresses “Theory of Mind” deficits which is the ability to understand the mental states of other individuals; to put oneself in another’s perspective of intention beliefs, desires, and emotions, resulting in “mind-blindness." Social stories focuses on teaching the child to develop the abilities in reading the emotional intensions of others. The stories can be written by anyone and frequently incorporate the use of pictures, photographs, or music. These stories teach the necessary social skills in specific situations to help an individual function more productively. Subtle social aspects are presented in a direct, clear story format to explicitly teach appropriate responses in social situations. Works cited by Carol Gray (1995).
Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH): This is a developmental program including routines, schedules, and visual supports. It teaches adaptive skills in a very structured environment with close collaboration between the clinician and parent. Includes early identification, parent training, education, social and leisure skill development, and communication training. This is a broad intervention philosophy that is interdisciplinary and advocates the understanding of the culture of Autism to design treatment programs. Works cited by Panerai, Ferrante, and Caputo (1997), Ozonoff and Cathcart (1998), Short (1984), Gary Mesibov (1995), and the University of North Carolina.
Picture Exchange Communication System (PECS): It is
helpful to improve functional language and provide a way for the child to communicate his/her wants and needs for those children who do not talk. This behavior based program uses pictures and symbols to develop functional communication. It is an alternative augmentative communication system to precede speech and establish the concept of interactive communication exchange. The idea of physically presenting the message (picture) to accomplish a goal is emphasized. Developed at the Delaware Autistic Program. Works cited by Bondy & Frost (1994).
Lindamood-Bell: We incorporate both visualization and verbalization (VV) to improve reading comprehension by thinking in pictures and the “LIPS” program to improve decoding, encoding, spelling, reading, and writing. Specifically, the LIPS program develops the ability to produce spoken language by discriminating and producing individual phonemes. Both of these efficacious Lindamood-Bell programs are taught to self-correct errors through the kinesthetic and visual approach. Works cited by Lindamood, Bell & Lindamood (1997).
Auditory Processing Therapy: Children with an auditory processing deficit have difficulty understanding language, as evidenced by the following behaviors: short term memory difficulties, confusion, and difficulty following multi-step directions, inattention, hyperactivity, increased response time, and difficulty comprehending questions to formulate appropriate responses. By targeting auditory number and word memory, immediate recall, delayed recall, auditory sentence memory, auditory interpretation of directions, word discrimination and thinking and reasoning, the child’s ability to process auditory information can become more efficient. Gardner (1996).
Preschoolers Acquiring Language Skills (PALS): These are center-based activities with parents as partners. Child centered, small-group language facilitation classes with parent education. Works cited by Carol Buteau and Kathryn Konhert (2000)
Visual Schedules: This visual treatment approach assists in organizing the world, predicting events, understanding expectations, anticipating changes in routine making choices, and functional independence. By presenting pictures of the scheduled activities for the session, the child naturally becomes less anxious and more aware of behavioral expectations.
Stutter-Free Speech, Fluency Shaping, The Fluency Development System for Young Children: It is important to not only improve the client’s smoothness of speech by teaching strategies of easy onset, pull-outs, pausing, and slow and easy speech, but also to address the socio-emotional aspects resulting from the dysfluency. Cites referenced by Charles Van Riper (1980), Ryan and Ryan (1983), Meyers and Woodford (1991).
A speech and language evaluation is the best way to comprehensively assess a child's communication and developmental levels
One of our Speech-Language Pathologists will provide your child with a comprehensive speech and language evaluation. This assessment consists of both standardized and non-standardized assessment tools to assess your child’s baseline developmental age levels in the following areas: articulation, oral motor, language comprehension, language expression, voice, fluency, and pragmatics.
A detailed language sample may be audio-recorded during the evaluation to ensure valid transcription when writing the report. We understand that your child may feel nervous, shy, or scared when talking and playing with a new person in an unfamiliar environment. Our speech professionals are skilled at helping your child feel comfortable, calm, and safe throughout the entire evaluation process. Depending on your child’s comfort level, we also welcome, and even encourage parents to be in the room during the evaluation.
Once the assessment is completed with your child, we will inform you on typical speech and language acquisition as well as developmental milestones so that you can better understand where your child is performing compared to his or her peers. We will discuss our impressions, recommendations, goals, objectives, and prognosis in addition to providing you with the type, duration, and frequency of therapy recommended, if any. As part of the extensive and comprehensive written report, the Speech-Language Pathologist will create appropriate, measurable goals so we can track progress throughout the course of treatment.
Speech & Language Evaluations
Speech & Language Treatment
Some of the most types of therapy treatment we offer include the following
Early Intervention Therapy
The intervention approaches that we typically implement for children between the ages of 0-3 truly depends on the child’s initial diagnosis, attention, cognition, learning modality, and severity. With language delayed children, we implement Greenspan Floor time therapy, Preschoolers Acquiring Language Skills (PALS), thematic lessons, functional signing paired with oral language, and Kauffman Apraxia photos, should there be any motor planning delays. Depending on the child’s interests and personal motivators, we incorporate music, pediatric yoga, early nursery rhymes, music and motion, and art.
Articulation and Oral Motor Disorders (Including Dyspraxia of Speech and Dysarthria)
Our oral motor and articulation therapies address a child’s ability to correctly pronounce standard English speech sounds. The term Oral Motor refers specifically to the muscular movement of the mouth. In many cases, the etiology of a child’s articulation issues may be the results of weakened and uncoordinated movements of the lips, tongue and jaw. Oral Motor and Articulation therapies often include physical exercises to strengthen the muscles used in speech and speech drills to improve clarity.
Autistic Spectrum Disorders
Autism refers to a broad range of conditions that often appear early in life, generally before the age of three. Children with Autism often have issues with social interaction, communication, imagination. and behavior. Autistic traits persist into adulthood, but vary in severity. With more severe cases of Autism, and those children who are nonverbal, we are able to incorporate PECS and work with speech-generating apps and devices. Our speech staff may also collaborate with our behavior professionals, who utilize Applied Behavior Analysis techniques to encourage positive behaviors and improve attention, social skills, and communication.
For those children on the Autism Spectrum who are higher functioning, we incorporate principles of Theory of Mind, including: flexibility, perspective taking, problem solving, problem prevention, self-awareness, impulse control, frustration tolerance, emotional regulation, social stories, social filter, social fake, reading nonverbal body language, and understanding the intentions of others. Our therapy focuses on functional, pragmatic, real life problems that children are facing with peers and adults. Through role playing, videotaping, creating personalized social stories, and video feedback, true modification of a behavior can occur with efficiency and effectiveness utilizing best practices.
Myofunctional and Tongue Thrust Disorders
Children with tongue thrusts often display a lisping speech pattern. However, mispronouncing the letter /s/ is not the only consequence of a tongue thrust. Tongue thrusts play a major role in dental mis-alignment that leads to orthodontic care. Because of this, we frequently work with orthodontists to determine effective schedules to address these issues through both clinical approaches. For example, the remediation of a lisp may be recommended prior to the application of orthodontic braces. However, in situations where palate expansion is also necessary, speech therapy might be delayed until after a palate expander is inserted for a period of time.
Voice and Fluency (Stuttering) Disorders
Stuttering or stammering is a speech disorder in which the flow of a person’s speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words or phrases; and/or involuntary silent pauses or blocks in which the speaker is unable to produce sounds.. Many young children display developmental dysfluencies. These issues can be frustrating for parents but are not necessarily indicative of a true stuttering issue and don’t necessarily warrant immediate intervention. The key is to determine whether the dysfluencies are typical or atypical.
Receptive and Expressive Language Disorders
A person’s language skills break down into three separate, overlapping areas; receptive language, expressive language and pragmatic (or social) language. Receptive language skills can be described as one’s ability to take in and comprehend language that is presented textually, orally or visually. When a child has difficulties in this area it might manifest itself in the following ways: difficulty following directions; limited vocabulary; an inability to process information in environments with competing stimuli; difficulty in identifying and understanding salient information and main ideas. Expressive language skills might similarly be defined as one’s ability to access and utilize information that has been received. Deficits in this area often are indicated by poor word retrieval, disorganization of thoughts (either verbal or written), limited vocabulary and grammar.
Social Skills Therapy
Pragmatic language skills take these two areas one step further, requiring a person to employ these skill sets when interacting with peers. Examples of this are reading social cues, taking other people’s perspectives or taking conversational turns. It is not unusual for both children and adults to have proficient receptive and expressive skills, and still have difficulties employing those skills with other people. Pragmatic language therapy is most often conducted in a group setting. Once a deficit in one of these areas has been identified, language therapy can teach strategies to improve performance and rebuild or open new neural pathways.
Auditory Processing Difficulties
Auditory Processing Disorders are a specialized subset of receptive language issues. When an auditory processing component exists, it means that, when placed in an environment that includes competing auditory stimulation (i.e., classroom) a child has difficulty distinguishing subtle differences in the presented information, even though the hearing is normal. The child may have difficulty storing, memorizing, retrieving, recalling, and retelling auditory information especially when visual cues are not provided.
Selective Mutism / Social Anxiety
Selective Mutism is a childhood anxiety disorder characterized by a child’s inability to speak in select social settings due to feelings of fear and anxiety. The child can speak in settings where they are comfortable, secure, and relaxed. It is usually first noticed when the child starts school, however, prognosis is better if diagnosed prior to starting school. Children who suffer from Selective Mutism speak effortlessly in at least one setting and are rarely mute in all settings. Their “mutism” is a means of avoiding the anxious feelings elicited by others’ expectations and the possibility of being judged. Most children with Selective Mutism are as socially appropriate as any other child when in a comfortable environment. Parents will often comment how boisterous, social, funny, inquisitive, and extremely verbal they are at home. Some children with Selective Mutism feel as though they are on stage every minute of the day, which causes anxiety before and during most social events.
Social Skills Groups & Pragmatics
Pediatric Social Skills Therapy
Pragmatics is the effective and appropriate social use of communication in relation to varying social expectations, contexts, intentions, and conversational rules. Pragmatic deficits, while usually understand to impact social interaction, may also affect academic performance. In the classroom, children may not demonstrate what they know if they cannot volunteer to respond, focus, attend, answer appropriately, or stay on a topic. Children may have difficulty acquiring new information if their listening behavior is poor, fail to ask for more information, or consistently interrupt others. In social situations, a child’s verbal and nonverbal behavior is reflected in their ability to take turns, use polite conventions, and communicate differently with adults versus peers.
Pragmatics, or the social use of language, includes the following functions: commenting, requesting, greeting, polite negation, turn taking, eye contact, joint attention, polite protesting, directing others, asking and answering questions, relating and expanding ideas, initiating and maintaining a conversation, staying on topic, and waiting. Skills in the language pragmatics area are typically commensurate with a child’s overall expressive language skills.
Coastal Therapies offers social skills group therapy to assist children with concentration, cooperative play, imitation, and symbolic play skills. Through positive reinforcement, social skills therapy focuses on improving a child’s social awareness, behavioral skills, language and conversation skills, as well as school readiness skills. Each group is designed to best serve the needs of the individual children within. Groups are kept small (3-4 children) so that children are given many opportunities to use the concepts they are learning within each session. When developing new groups many factors are considered: age, cognitive functioning, language functioning, and individual areas of social needs. Social learning groups typically meet 1-2 times a week for 60 minute sessions. By combining direct instruction with incidental learning, social skills therapy offers an extraordinary opportunity for learning strategies to develop friendships with peers in a safe and fun environment.