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If your child has difficulties articulating certain sounds in words, especially if they are school-aged, you may wonder if your child has an articulation disorder. Perhaps, even a pediatrician or teacher has suggested you seek additional evaluation. As a parent, it can be scary to face the prospect of a speech sound disorder diagnosis. Yet, there are many resources available to support and treat children who have difficulty producing sounds. Articulation disorder is one of many speech sound disorders diagnosed in children. We will dive into a thorough explanation of the definition, causes, symptoms, diagnosis, and treatment options for children with articulation disorder. What is Articulation Disorder in Children? Articulation disorder is part of a family of disorders labeled as Speech Sound Disorders. These include a wide variety of difficulties people may have in producing sounds common in speech. According to American Speech-Language-Hearing Association (ASHA), “articulation disorders focus on errors (e.g., distortions and substitutions) in the production of individual speech sounds.” Also known as functional speech disorder and articulation delay, articulation disorder, more specifically, is when a child has difficulty with sound production. They may also produce certain sounds incorrectly. For example, he or she may use the “f” sound instead of the “th” sound. Children with this disorder struggle to get their lips, tongue, teeth, lungs, and palate to coordinate to produce the needed sounds. The National Institute on Deafness and Other Communication Disorders explains that the difficulty in motor control is because of the “imprecise placement, timing, pressure, speed, or flow of movement” of these body parts. This leads to the child swapping out sounds for ones they can produce. It can also cause them to have distorted speech. This disorder is often confused with phonological disorder. These two disorders are difficult to distinguish many times and children can have both simultaneously. Children with an articulation disorder are unable to produce the sound in isolation or as part of a word. Articulation disorders are about the motor functions associated with producing sounds. In contrast, with a phonological disorder, children can produce the sounds, they just have difficulties putting them together correctly. Articulation disorder can affect a child’s self-esteem. Sometimes other children may make fun of a child who has difficulties making sounds correctly. It can also be associated with learning difficulties, troubles in reading, writing, and listening, and can be paired with other language and speech disorders. What are The Causes of Articulation Disorders in Children? Articulation disorders in children usually have no known cause. However, certain factors can make a child more at risk of developing an articulation disorder. Alternately, adults who develop speech sound disorders usually do so after traumatic brain injury. Males have a higher incidence of speech sound disorders than females. It is unknown why this is the case. Children with a family history of speech sound disorders are also more likely to have difficulties with speech themselves. Pregnancy complications, pre-term deliveries, and low birth weight are also associated with speech sound disorders. Stanford Medicine also lists some of the following as possible risks: Hearing loss Genetic disorders like Down Syndrome Developmental disorders, such as autism Nervous system disorders like cerebral palsy Frequent ear infections Cleft lip or palate Too much thumb-sucking or pacifier use Parents with low education levels Lack of learning support at home These are simply risks of articulation disorders, not the actual causes. The true cause is unknown in articulation disorders. Symptoms of Articulation Disorder in Children To determine for certain that your child has an articulation disorder, it is important to get your child evaluated by a speech-language pathologist (SLP). Children can be screened for this disorder and many other language, speech, and learning disorders with a speech-language assessment. Yet, common symptoms of articulation disorder involve specific speech sound errors. If you are hearing these articulation errors consistently and your child is 4 or older, you may want to get him or her evaluated: Distortions: A child uses different sounds or changes a typical sound in words. A lisp is an example of a distortion Substitutions: A child replaces particular sounds for one the child can produce more easily. Consonant sounds can be especially difficult. For example, he or she may use the “th” sound for “s.” Another example is using “wabbit” instead of “rabbit.” Omissions: This is when a child leaves out a sound in a word. This could be at the beginning, middle, or end of a word. (e.g. “ca” instead of “cat”). Syllable-level errors: The weaker syllables in words are deleted. (e.g. “elphant” instead of “elephant” Additions: Extra sounds are added to words (e.g. “buhbaby” instead of “baby”) It is important to note that not all substitutions and omissions are speech errors. Some may be a part of a speaker’s dialect. A dialect is a regional way of using language. They can vary greatly across any given language. They have different patterns and compositions. This is another reason it is important to have a speech-language pathologist evaluate any child suspected to have a speech sound disorder to help distinguish between regional differences and actual difficulties with speech. Also, some sound errors are common as a child is developing speech. Children can produce different letter sounds at different ages. Typically, by 6 years old, most children without speech issues can say almost all of the speech sounds. The following is a list of sounds children are typically able to produce by age: 2-3 years old: P, B, D, M, N, H, W; a child is about 15% intelligible at age 3. 3-4 years old: T, K, G, NG, F, Y; a child is about 50% intelligible at age 4. 4-5 years old: V, S, Z, SH, CH, J, L; a child is about 75% intelligible at age 5. 5-6 years old: voiced TH, ZH, R; a child is about 80% intelligible by age 6. 6-7 years old: voiceless TH; a child is about 90% intelligible at age 7. Remember that different children develop differently. This is merely a guide and not necessarily any hard and fast rule. If you think your child isn’t developing speech at the correct rate, it is important to get your child evaluated. What is Involved in Screening for Articulation Disorder in Children? If you suspect your child has a speech sound disorder, you can begin by taking your child to a pediatric healthcare provider. This professional will informally evaluate a child for errors in speech and physical barriers. If the professional believes your child may need a more comprehensive assessment, they will refer you to a speech-language pathologist. A speech-language pathologist will perform a more comprehensive assessment to decide whether your child has a delay in speech development. Some errors may be due to typical developmentally appropriate patterns in young children or the result of regional dialects or accents. This more comprehensive assessment will use formal and informal assessment tools to evaluate any body structure impairments, deficits, conditions, limitations, social, and/or environmental factors that may play into the child’s speech issues. The assessment will include an oral examination to check the structures in the mouth for any obstructions, such as cleft palate, that may be causing a physical barrier to speech. A hearing test will also be performed to check for any auditory conditions. A speech-sound assessment will be used to determine the severity of the child’s articulation disorder. And a phonological processing assessment will be given to assess how the child processes spoken language. They will also be tested on their spoken and written language skills since children with speech sound disorders often develop difficulties with language development. It is completely normal to see children with speech problems also diagnosed with language disorders. Then, a diagnosis and a recommendation for treatment will be given to the child’s caregiver. Often this diagnosis also comes with a severity rating. Severity is judged by the SLP based on the impact the disorder has on the child’s ability to communicate. The scale for severity is usually given using a number rating. More severe cases will have extensive omissions and many substitutions, whereas milder cases will only have a few of these. The severity determines the length and approach of the treatment plan. Treatment Options for Articulation Disorder in Children Once a diagnosis has been made, a treatment plan can be put into action. If physical barriers are preventing your child from creating the appropriate sounds, they will be referred to a medical professional who can suggest treatment for their physical condition. However, the most common treatment option is speech therapy. A speech therapist can provide your child with articulation therapy based on the child’s individual needs. In a speech therapy session, your child will learn to notice their sound errors and correct the sounds. They will practice the sounds they have difficulty with and learn how to correctly produce those sounds. They will learn how to move their muscles, lips, and tongues to produce the needed sounds. Practice does make perfect, so the SLP will also spend time having the child practice words and sounds over and over until he or she gets them right. They will also provide the caregiver with strategies and activities you can try to work on the sounds at home. Speech therapy can go a long way in building your child’s confidence back, as they become more successful in producing sounds that were once difficult for them. If other developmental delays or disorders are diagnosed along with the articulation disorder, there may be other strategies and treatments suggested alongside speech therapy. These could include interventions at school. Ways to Support Your Child At Home One of the best ways to support a child with an articulation disorder is to make sure he or she makes it to all their appointments, including health and speech therapy appointments. It is important to keep an open line of communication between yourself and your child’s healthcare providers to let them know any concerns you may have. If your child is in school, make sure to let the school know. Advocate for additional support for your child at the school level. According to the severity of the case, your child may need special services or interventions to help Practice the strategies your child is learning with the SLP at home to continually reinforce that development. The more your child practices, the better he or she will become. Your child may need more reassurance during this time, too. They will be having to do a lot of new and different things that may be scary and/or frustrating. If you think any of the symptoms become more severe, make sure you contact your child’s healthcare provider as soon as possible. Finding a Speech-Language Pathologist Seeking out a professional in speech-language pathology doesn’t have to be difficult, The California Scottish Rite Foundation can help connect you with a skilled SLP. We are partnered with many practitioners throughout California. Our SLPs can provide your child with the speech, learning, and language help that he or she needs to be more confident in social situations and more successful in academics. We not only provide services at locations across California, but we also partner with universities and private practices to offer a greater breadth of services to children. And, the best part is that these services are offered free of charge, making it easier for you to get your child the services he or she needs. Conclusion An articulation disorder doesn’t have to be scary. Knowing what it is, the symptoms to look out for, the risks of developing it, and the treatment options can give you peace of mind. You can take this knowledge to help you find a treatment plan that is best for your child. This will give your child the tools to be successful and confident. The earlier a speech disorder is treated, the better. So, if you are still worried your child may have an articulation disorder, make sure to get him or her evaluated by a Speech-Language Pathologist sooner rather than later.

Social Pragmatic Communication Disorder (SCD) affects between 7-11% of eighth graders. This condition affects a child’s conversation skills. It’s harder for children with SCD to make friends and maintain close relationships. Their difficulties with social situations can lead to mental health issues and feelings of isolation. As a caregiver, you want to advocate for your child to make sure that he or she receives the best education and the best opportunities at improving their social skills possible. Below, we will dive into what SCD is, how the diagnosis has changed in recent years, and how this disorder affects children’s daily lives. Then, we will discuss ways you can advocate for your child and give them the preparation they need to be successful in every aspect of life. What is Social Pragmatic Communication Disorder? Social Pragmatic Communication Disorder, according to the American Psychiatric Association, “Is characterized by a persistent difficulty with verbal and nonverbal communication that cannot be explained by low cognitive ability.” Most of the difficulties have to do with social interaction, social understanding, pragmatics, and language processing. The disorder can encompass all or a mixture of these difficulties. Children with this disorder have trouble with typical social behaviors such as eye contact, facial expressions, and body language. They struggle with pragmatic language, which is the when how, and why of communication. The expectations for these behaviors can vary greatly between families, cultures, and even individuals. So, a trained clinician must evaluate a child for this condition. One who can discern between actual social barriers versus cultural differences. According to the American Speech-Language-Hearing Association (ASHA), the symptoms of this disorder are the following: Inappropriate greetings Having trouble changing the style of speaking based on setting or person Difficulties telling or understanding stories Trouble initiating or entering a conversation Trouble keeping up a topic during conversation Inability to take turns, respond appropriately, or provide the right information in conversations Difficulty rephrasing when misunderstood Uses inappropriate verbal and nonverbal signals during interactions Has difficulties interpreting verbal and non-verbal cues from others Does not understand figurative or ambiguous language Has trouble making inferences Difficulty forming and maintaining relationships Males are more likely to be diagnosed with this developmental disability. Also, people with schizophrenia, who were born preterm, and people with developmental language disorders were at a higher risk of developing SCD. Children who had the following conditions were also more likely to have language pragmatic difficulties: Aphasia attention-deficit/hyperactivity disorder (ADHD) Autism spectrum disorder (ASD) Cerebral palsy Down syndrome Fetal alcohol syndrome Traumatic brain injuries This disorder is caused by a disruption in the language centers of the brain, but the exact reason those centers are disrupted is unknown. These symptoms may not be obvious during early childhood. Social communication skills become most apparent in school-age children. It takes time for people to notice social communication problems, so many children will not get a diagnosis until they are adolescents. Social Pragmatic Communication Disorder vs. Autism Spectrum Disorder The diagnosis of social communication disorder can oftentimes be confused with autism spectrum disorder (ASD). The two share several of the same symptoms. For years, they were classified under the same umbrella of terms. Yet, the main difference is that children with autism have trouble with social skills and exhibit repetitive behaviors such as repeated body movements, obsessive fixations, or repeating sounds, etc. Whereas, children with SCD do not have these repetitive actions. A professional diagnosis will help determine whether your child has a social communication disorder or if they are autistic. What has changed about Social Pragmatic Communication Disorder in Recent Years? Recently, Social Pragmatic Communication Disorder (SCD) was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This means that SCD is no longer simply treated as a speech disorder. Its addition to the DSM-5 represents new treatment options in the realm of psychiatry. The reason for this change is that many children with SCD have normal phonological processing, vocabulary, and higher-order grammatical skills, which places them on the outside of many of the speech-language treatments. Another reason for this change, according to Amoretti, Lalumera, and Serpico in an article for History and Philosophy of the Life Sciences, was the change in the definition of Autism Spectrum Disorder. Previously, SPD would have been grouped in with autism, but the diagnostic criteria for autism have changed. How Does Social Pragmatic Communication Disorder ASffect a Child’s Daily Life? SCD can make it difficult for your child to develop friendships and maintain effective communication with peers. Oftentimes, they will have inappropriate responses in conversation which can end up isolating them from their peers. Their inability to change their style of communication with different people can make it difficult for them to maintain close relationships with others. Others may see their inappropriate responses as rude or unfeeling when they just don’t understand what is appropriate in certain contexts. They may also have trouble understanding jokes. They also may not complete instructions that are only implied rather than explicitly stated. Their stories may go on too long or meander in an unconventional way, which can make them hard to understand or follow. They can also struggle with the use of written language, which can make school difficult for them. Especially, since many children diagnosed with SCD are also diagnosed with other language disorders. Children with social communication disorders are smart and can learn. They just need to practice communication skills to improve their interactions. However, many times people think that since these children say the wrong thing or don’t interact in a typical way in social situations that they are “weird” or intentionally acting callous. Children with SCD take things very literally. They do not understand the social norms expected of them in the classroom, peer-to-peer interactions, and other social situations. Since this disorder is often mistaken for ASD, the stigmas associated with it also affect children with SCD. With time and proper treatment, these kids can thrive in social situations. Many of the social skills they lack can be taught in speech therapy. Ways to Advocate for a Child With Social Pragmatic Communication Disorder As a caregiver, advocacy for your child in school and other social situations is essential. They may need extra support and patience to be able to achieve at the same level as their peers. The following tips are ways to ensure your child has the best opportunities possible. #1 Get Your Child Evaluated for SCD The first step in advocating for your child is to make sure they are properly diagnosed. If you suspect your child is struggling with pragmatic language impairments, let your child’s pediatrician know. They can evaluate your child informally. Then, if they suspect SCD, they can refer you to a Speech-Language Pathologist (SLP). Once you get an SLP, they can do a thorough evaluation of your child to determine how they use and understand pragmatic language. If your child gets diagnosed with a social communication disorder, they will recommend a treatment plan that is individualized to your child’s specific needs. This will involve a combination of interventions between the SLP, parent, and teacher. A clinician will offer one-on-one language therapy to help teach and practice interactions in a social setting. Early intervention makes a world of difference. In speech therapy, your child will get help building their language skills to succeed in social contexts. SLP's often use role-playing during their sessions to help their child practice social skills as if they were in a real setting. This will teach your child the ways to interact with his or her peers. They will also give your child a toolbox of strategies to help with communication problems. Speech therapists are trained to provide children with SCD with the knowledge they need to tackle social situations. #2 Inform the School If your child has received a diagnosis of SCD, it is important to let your child’s teacher know. This will help the teacher understand that your child may need accommodations. The teacher may even be able to give you more insight into how your child interacts with peers. Your SLP may even request an interview or statement from the teacher. Also, once the diagnosis is made, your child may need special education services, especially if their condition is paired with learning disabilities. An Individualized Learning Plan (IEP) or 504 plan may be needed. These plans are ways for you to ensure your child’s special learning needs are being taken into consideration by the school. Schools can assist with speech-language pathology services and communication intervention. These plans also give your child accommodations in the classroom to make them more successful. Contacting your school and keeping open communication with them will make sure that your child is getting the best available resources. #3 Practice at Home There are several ways you can support your child with SCD at home. You can read books with them and take turns communicating about the book to practice a conversation-like setting. This will also help your child to understand the structure of stories. Make sure to practice taking turns. Also, try to get your child to consider what the different characters must be thinking and why. Play games with your child. This will help them practice turn-taking. You can practice dialogue while playing games and even ask open-ended questions. If your child is having trouble communicating themselves, they could use props, toys, or pictures to show you what they mean when they can’t find the right words. More than anything, just give your child the affection, time, and patience they need. Your stability and care will go a long way in helping them to be successful. They are so much more than their SCD, and sometimes they need a reminder that their other interests and accomplishments matter, too. #4 Give Your Child Opportunities to Practice Social Skills Invite similarly aged children over for a playdate. Start with only one child, at first. Let your child practice interacting with them. Guide them, as needed. As your child becomes better at interacting with one peer, introduce another. Try inviting the children out to different settings such as your home, the other child’s home, or the playground. This will give your child the opportunity to practice their social skills with people their age. Eventually, you should be able to allow your child to interact with a small group of children. This will help them to learn how to deal with different situations that may arise. #5 Get Augmentative and Alternative Communication (AAC) If your child is younger, they may not be able to find the right words or even know the right words to communicate with others. AAC can give children another way to communicate. There are several options. These include the following: Pointing at pictures Drawings Gestures Technology devices Sign language AAC can give a child with communication difficulties the ability to get their ideas and thoughts across, which goes a long way in making them able to interact in social situations. Many children will learn to lean less on AACs as they get older, but others rely on them throughout their lifetime. These communication alternatives are a great way to boost confidence in your child with small successes and give them a way to make their needs and wants known. Conclusion There are many ways to advocate for your child with Social Pragmatic Communication Disorder. With regular speech therapy, additional support at school, practice at home, practice with peers, and Augmentative and Alternative Communication, your child can learn to function well in social situations. If you are looking to get a speech-language pathologist, it is easy with the California Scottish Rite Foundation. With locations throughout California, you can get free speech, language, and learning programs to support your child and give them the confidence they need to succeed. We partner with private providers as well as universities to offer a large range of services for every individual need.

A child with a fluency disorder can feel a lack of confidence, negative emotions toward themselves, and anxiety about speaking. As a caregiver, it can be painful to watch your child struggle emotionally and socially. With early intervention and extra care taken to support your child’s emotional needs, there is hope for a brighter future. Let’s explore the emotional toll a fluency disorder can take on a child and discover some tips for helping your child cope. What is Fluency Disorder? A fluency disorder is when a person has difficulties speaking fluidly. The person may have trouble with the rate, rhythm, and fluency of speech. This may be in the form of stuttering (when a person says a word part or whole word more than once. This is sometimes called stammering, as well) or cluttering (when a person speaks fast and jams words together). Oftentimes, a person who has a fluency disorder also struggles with physical tension, speaking avoidance, and secondary mannerisms. Secondary stuttering behaviors include eye blinking, head nodding, tightening of the jaw, and other behaviors used by the child to People use secondary stuttering behaviors to try to get the words out. These behaviors are a natural response to feeling “stuck” when speaking. However, they can make the stuttering pattern tense, painful, and full of struggle. According to American Speech-Language-Hearing Association (ASHA), children with fluency disorder will have the following symptoms: Repetitions of sounds or words Prolongations of consonants Blocking (inaudible fixations or unable to start a sound) Physical struggle while producing words Deleting syllables or word endings Excessive disfluencies or revisions (filling sentences with lots of “uhs”) Atypical pauses Rapid speech or irregular speech rate Unusual prosody (This is usually similar to the speech sound of children with autism) Childhood-onset fluency disorders affect around 5-10% of preschoolers. This communication disorder is caused by both genetic and neurophysiological factors. Children with autism, attention-deficit/hyperactivity disorder, seizures, and learning disorders are at a higher risk of developing a fluency disorder. Environmental factors can make the disfluency worse. Boys and children with a family history of stuttering are at a higher risk of developing fluency disorders. Young children may have developmental stuttering. This is when a child’s language skills aren’t developed enough to communicate what they want to say. Most children outgrow this type of stuttering. How Does Fluency Disorder Affect a Child’s Everyday Life? The emotional toll of fluency disorders can impact your child’s everyday life from their habits at school to how they act at home. Children with fluency disorder can suffer secondary effects. Dr. Sander and Dr. Osborne explain in their 2019 publication in American Family Physician that children with fluency disorder often deal with negative self-perception, negative perception by others, anxiety, and depression. Early childhood intervention for children with fluency disorders is essential. With early intervention, children can receive speech therapy to help develop techniques to overcome their impairment and eliminate secondary behaviors that may be getting in the way. Children with early intervention may avoid the risk of developing social anxiety, impaired social skills, maladaptive compensatory behaviors, and negative attitudes toward communication. Yet, even with early intervention, childhood stuttering may persist into adulthood. Depression Children with fluency disorders are at risk of developing depression. They can begin to associate their self-worth with the ability to communicate. They may begin to feel sad and hopeless. If you notice your child is showing the following symptoms, according to the CDC, you may want to seek out professional help for your child: Feeling sad, hopeless, or irritable most of the time Not enjoying fun things Eating more or less than usual Sleeping more or less than usual Acting tired and restless a lot of the time Difficulty paying attention Feeling worthless, guilty, or useless Evidence of self-injury Depression can sometimes be hard to spot. Young people aren’t always willing to talk about these difficult feelings, especially if they have a language disorder. It is also even more difficult with especially young children who are unable to fully express their emotions in words. So, if you have any suspicions that your child may be dealing with this condition, get them evaluated by a healthcare professional. Anxiety Another risk with a speech disorder is for your child to become overwhelmed with the pressure to speak correctly. School and other places where there are speaking situations can be hard for a child who has fluency problems. Your child may even begin to avoid social situations or speaking altogether. They may also get bullied by other children for the way they speak or inadvertently treated differently for their struggles in speaking fluently. They may feel constant rejection and humiliation. Your child may develop social anxiety due to the pressures of speaking fluently. Signs of social anxiety include the following: Blushing Fast heartbeat Trembling Sweating Upset stomach Trouble catching breath Dizziness or lightheadedness Feeling your mind is blank Muscle tension Young children often show social anxiety through temper tantrums, clinging to caregivers, and refusing to speak in social situations. If your child shows signs of social anxiety disorder, it is important to contact your healthcare provider to get your child evaluated by a behavior and mental health specialist. A clinician will be able to offer you the support and strategies your child needs to overcome these mental health conditions. Tips to Help Children with Fluency Disorder Cope As a caregiver, you want to give your child the best quality of life possible. So, you want to support your child in any way you can, especially if you notice them harboring negative feelings. The following tips can help support your child through the emotional toll of living with a fluency disorder. #1 Listen To Your Child It is important for family members and you to show your child support. When your child speaks to you, maintain natural eye contact. This will let them know you are listening and paying attention to their words. Be patient. It may feel quicker or easier to speak for your child or complete their sentence or word. However, this can undermine all the hard work your child is doing. It is also essential to set aside a time of day when there are minimum distractions so you can focus on your child’s conversation. This will give you to speak one on one with your child about things that are important to him or her. Giving them this time to speak to you openly regularly will make them more comfortable with talking to you about any feelings of low self-esteem they may have. It lets them have an outlet for their emotions and a low-stakes environment for your child to practice fluent speech. #2 Model Slower Speaking This may seem like an odd suggestion, but if you speak slowly, your child usually mirrors that behavior. This helps decrease stuttering. You don’t have to alter the way you speak to your child. You are simply showing them it is ok to take your time when speaking. Once again, modeling this behavior is great practice for your child. It allows them to become comfortable with slowing down speech before using that skill in real social situations. #3 Create a Calm Environment No matter your child’s stuttering severity, an anxious or fast-paced atmosphere will exacerbate the fluency disruptions. Stuttering increases when your child is stressed. It is best to provide a calm environment at home where your child feels comfortable speaking as they are. This isn’t the case always out in social situations or, for school-aged children, in the classroom setting. Often there are a lot of stimuli that encourage fast, hurried speech in these situations. Yet, if their home is a calm place, this will go a long way in helping them manage their feelings. If the home is their calm and safe space, they will feel more comfortable talking to you about what’s going on in the rest of their lives. #4 Focus on the Child as a Whole Person It’s easy to want to help your child fit in. But, focusing on their stuttering can make them more self-conscious. Also, be mindful of situations in which your child may feel pressured to speak. This can increase those feelings of anxiety in your child. Make sure to praise them for all their hard work, especially when they try a new speaking situation. Remember that there is so much more to your child than their speaking issue. They can be a great artist or play sports like a pro. Try to focus on the whole child, letting them know that there is so much of them to love and care about. This will show them that they are more than their stuttering, as well. #5 Seek Out Support There are support groups both online and in person for people with speech fluency disorders. It can be good for families of children with a stutter to get together. This can help normalize the condition and allow you to lean on others. It also gives your child a friend with similar hurdles to overcome. Support groups are also great for offering advice and other coping tips. Seeing how others cope with negative feelings can help you develop new strategies for your family. Getting Treatment One of the best ways to support the emotional and physical needs of a child with a fluency disorder is to make sure to get them the evidence-based treatment they need. First, you will need to get your child evaluated by a speech-language pathologist (SLP). This evaluation will determine whether your child’s fluency disorder is caused by developmental or neurophysiological factors, which influence the treatment approach. Next, the SLP will determine how severe the case is. Then, the clinician can recommend the best treatment plan for your child. There are a few different ways to improve speech fluency in your child. These treatment options include the following: Speech therapy: Speech therapy is a regular meeting with an SLP that teaches your child to slow down, notice patterns, and speak more deliberately. With time, natural speech patterns can be achieved in many children. Electronic devices: Some electronic devices are available for children with speech fluency disorders. They work to enhance fluency through delayed auditory feedback, which makes a child speak slower. There are other types of devices. These can be worn during daily activities but should be recommended by your SLP Cognitive behavioral therapy: Your child may need to participate in a type of psychotherapy called cognitive behavioral therapy. This will help identify and change the ways of thinking that make stuttering behaviors worse. This can also help to resolve stress, anxiety, and issues with self-esteem. Parent-child interaction: Many of the tips mentioned in the section above help with this. A key part of helping your child cope with the emotional toll of stuttering is to offer support and guidance at home. Practicing speaking at home also helps your child become more fluent. Your child may use some or all of these approaches, based on your child’s individual needs. Part of the treatment will focus on providing your child with strategies for speaking more fluently, another part will focus on reducing the secondary mannerisms children use to try to overcome the “stuck” feeling they have when stuttering. They will learn to replace these behaviors with strategies that work to help the child speak more fluently. Conclusion There is a lot of support available for children with fluency disorders. Getting a diagnosis and treatment plan with a speech-language pathologist, as well as offering your child support at home or with a mental health specialist can ease the emotional toll your child suffers. If you are looking for a speech-language pathologist to assist your child in becoming more fluent in their speech, RiteCare Clinics offer free services to California residents in 17 locations across the state. Our trained professionals will provide your child with strategies to help increase your child’s fluency. Ritecare Clinics assists children by providing childhood speech-language, literacy, and education programs to improve communication and confidence.

Language is an essential part of our everyday lives. It helps us communicate our thoughts, feelings, and desires. But for some children, speaking correctly can be a challenge. Phonological disorders are incredibly common in children and can significantly impact their ability to communicate effectively. In this blog post, we will discuss the importance of early intervention in addressing phonological disorders in children. What Are Examples of Phonological Disorders? Phonological disorders are a type of speech disorder that affects a person's ability to understand and use sounds within words. These disorders can be mild or severe, and they can affect a person's speech production, language development, and communication skills. There are a few types of speech sound disorders to be aware of. The good news is that most are fairly easy for clinicians to diagnose based on listening to abnormalities in speech patterns and phonological errors - and there are plenty of potential treatments to improve a child's speech, too. Let's take a closer look at some of the most common developmental phonological disorders. 1. Articulation Disorders Articulation disorders are the most common types of phonological disorders, usually affecting children. This disorder occurs when a child has difficulty producing sounds or making specific sounds in words. The symptoms of this disorder include distortions of sounds, repetition of syllables, omitting sounds, and adding different sounds or consonants in words (usually either final consonant deletion or initial consonant deletion). 2. Phonemic Awareness Disorders Phonemic awareness disorders occur when a child cannot differentiate between the sounds produced in words. Children that suffer from this disorder usually struggle with phonological processes such as blending, segmenting, or manipulating sounds in words, which may lead to reading and writing difficulties in the future. Phonemic awareness disorders are treated by teaching children phonological awareness skills, such as recognizing sounds in words or breaking sounds into separate phonemes. 3. Childhood Apraxia of Speech Apraxia of speech (AOS) is a neurological condition whereby a person has difficulty coordinating their oral muscles to produce speech sounds. People with this type of speech delay may struggle to plan and coordinate the movements required for speech, leading to inconsistent speech output with distorted or slurred sounds. Speech therapy can help treat AOS by building muscle memory and giving a structured approach for better speech production. 4. Phonological Delay Phonological delay refers to the development of speech sounds in a child that is slower than in typically developing children. While every child develops speech sounds at their own pace, a phonological delay refers to children who are significantly behind in their speech sound development. This may result in difficulty with language development, making it difficult to understand or produce spoken language. 5. Dysarthria Dysarthria refers to a physical condition that affects the part of the brain responsible for speech production, which might affect the nerves and muscles associated with speaking. These disabilities can affect a person's volume, tone, and phonetic pronunciation of words, which can make it challenging for others to understand them. Treatment for this disorder includes specialized exercises to help strengthen muscles involved with speech, such as the jaw, lips, and tongue. What Causes Phonological Disorders? There are a few potential causes for phonological disorders, and often, these various causes work together in tandem, rather than just being one overarching root cause. This can sometimes make it tough to diagnose or treat a phonological disorder, but the good news is that there are many evidence-based treatments for these speech problems and communication disorders, and understanding potential causes can help clinicians treat the speech issues a bit better. Here are some of the most common causes: Family History: Research has shown that genetic factors play a role in the development of phonological disorders. Children with a family history of speech and language difficulties are at an increased risk of developing phonological disorders. Thus, it is important for parents to inform their child's speech-language pathologist of any family history of speech and language difficulties so appropriate intervention can be provided. Environmental Factors: Environmental factors, such as exposure to toxins or infections during pregnancy, can also contribute to the development of phonological disorders. For instance, exposure to lead during pregnancy or early childhood has been linked to speech and language delays. Moreover, children exposed to chronic ear infections have an increased likelihood of experiencing speech and language difficulties. Social Factors: Children who grow up in homes with limited opportunities or resources may struggle with phonological disorders. These children may not have enough chances to socialize with others or access a rich language environment. Children who experience trauma or neglect may also have affected speech and language developmental processes. Biological Neurological Factors: Phonological disorders can result from various biological and neurological factors that influence the brain's ability to process auditory information. For instance, children with hearing loss may struggle with processing and articulating speech sounds, eventually experiencing a delay in language development. For example, children with dyslexia or attention deficit hyperactivity disorder(ADHD) are at an increased risk of developing phonological disorders. A neurological disorder can also result from a brain injury or stroke, affecting an individual's ability to produce, process, and comprehend speech sounds. Other biomedical factors that trigger phonological disorders and their resulting speech sound errors in young children include cleft palate or cleft lip, Down syndrome, cerebral palsy, and others. In such situations, it is crucial to diagnose the problem early, followed by various therapies to help the child develop speech and language. Developmental Factors: Phonological disorders can also result from developmental factors, such as delayed phonological development or language impairment. Children develop speech sounds at different rates, but phonological development typically follows a predictable sequence. If a child deviates from this sequence or experiences delays, it can result in a phonological disorder. Tone of Voice and Speech Modeling: Phonological disorders may also occur when children are exposed to poor tone of voice and speech models. Children have an innate ability to mimic sounds and language models that they encounter in their environment. For instance, ESL children who grow up in households with strong accents may have difficulty articulating speech sounds, leading to a phonological disorder. Socioeconomic Factors: Research has also shown that socioeconomic factors, such as poverty or low parental education, can increase the risk of children experiencing speech and language delays. Children from lower socioeconomic backgrounds are less likely to have access to quality healthcare and early intervention services, such as speech therapy, which can negatively affect their speech and language development. How Are Phonological Disorders Diagnosed? If you suspect that your little one is having trouble with speech, you're not alone. Parents all over the world notice their kids stutter, have trouble pronouncing certain sounds or struggle with reading and writing. But how do you know when it's nothing to worry about or if it's something more serious - that is if your child has a phonological disorder? If you're concerned about your child's speech intelligibility at all, you need to talk to a pediatric doctor first, who will likely refer you to speech-language pathology services. To diagnose a phonological disorder, a speech-language pathologist (SLP) will evaluate your child's speech in various contexts while examining their ability to understand and use language. During the assessment, the SLP will look for patterns in the errors your child makes and determine if they're typical of a phonological disorder. The SLP will also ask your child to say various words and sounds while examining their fluency, tone, and pitch. The SLP will also evaluate your child's receptive and expressive language skills, which include language comprehension, vocabulary, and syntax. The assessment may include standardized tests that measure your child's ability to follow instructions, repeat phrases, and match sounds to letters. Based on the findings from these tests, the SLP will determine if your child's speech difficulty is related to a phonological disorder or another issue. How Are Phonological Disorders Treated? Once the assessment is completed, the therapist will create a treatment plan that is tailored to the child's specific needs and goals. The type of treatment, duration, and frequency will depend on the severity of the phonological disorder, the age of the child, and the child's motivation and ability to engage in therapy. One of the most common approaches for treating phonological disorders is speech sound therapy. This therapy involves working on the specific sounds that are causing difficulties through repetition, practice, and feedback from the therapist. Another approach is phonological awareness therapy, which focuses on helping the child to recognize and manipulate the sounds and patterns of language. This approach can be particularly helpful for children with more severe phonological disorders. In some cases, a combination of therapies may be used, depending on the child's needs. For example, a therapist may combine speech sound therapy with phonological awareness therapy to ensure that the child is building a strong foundation for effective communication. They'll work closely with the child based on the errors and the known cause of the speech issues. It's not a one-size-fits-all approach. For some kids, working on consonant sounds might be the goal, but for others, improving overall speech intelligibility might be the goal. It is important to note that phonological disorders are not always cured completely, and ongoing support may be needed to maintain progress. This support may include regular check-ins with the therapist or home practice tasks to reinforce the skills learned in therapy. In some cases, follow-up therapy sessions may be necessary to monitor progress and make adjustments to the treatment plan as needed. Parents and caregivers can also play an important role in maintaining progress by reinforcing the concepts and strategies learned in therapy in the child's everyday communication and language development. This can include praising the child for using correct sounds and patterns and providing corrective feedback when needed. The Importance of Early Intervention for Phonological Disorders Now that you know about the potential treatments for phonological disorders in children, you might be curious about the role that early intervention plays. The short answer - a big one. Here are five ways early intervention is key in helping children overcome phonological disorders. Early Intervention Improves Language Development: Phonological disorders can have a significant impact on a child's ability to develop language. If these disorders go untreated, they can lead to further struggles with reading, writing, and social interactions. Early intervention can help children develop their language skills by addressing phonological difficulties through therapy and other interventions. Children who receive early intervention have more opportunities to practice and refine their language skills, increasing their chances of success in school and beyond. Early Intervention Supports Emotional and Behavioral Health: Phonological disorders can also have a negative impact on a child's emotional and behavioral health. Struggling with language can lead to frustration, low self-esteem, and social isolation. Early intervention can help children develop their language skills and reduce the emotional and behavioral challenges associated with phonological disorders. Children who receive intervention early on are more likely to feel confident and successful in their language abilities, leading to increased social connections and overall happiness. Early Intervention Reduces the Need for Special Education Services: Phonological disorders can lead to difficulties with reading, which can result in children being classified as having a learning disability. Early intervention can reduce the need for special education services by addressing phonological difficulties before they become more significant problems. By addressing these challenges early on, children can develop necessary language skills, reducing the likelihood of requiring more intensive interventions in the future. Early intervention can ultimately save children time, frustration, and stress associated with special education needs. Early Intervention Enhances Academic Success: Phonological disorders often lead to difficulties with reading, writing, and other academic tasks. Early intervention can help children develop their language skills, leading to better outcomes in all academic areas. Children who receive early intervention often have improved grades, higher graduation rates, and increased opportunities for post-secondary education. Early intervention can set children on a path towards academic success and increase their chances of achieving their goals. Early Intervention Supports Family Communication: Phonological disorders can be a challenge for families, with many feeling overwhelmed and unsure of how to support their child's language development. Early intervention can help families better understand their child's phonological challenges and how to support their language development at home. By providing strategies and resources early on, families can play a crucial role in their child's language success, leading to better communication and stronger bonds between family members. Treating Phonological Disorders: Addressing Language Disorders from an Early Age Early intervention is crucial in managing phonological disorders in children. Children who receive early treatment are more likely to overcome these disorders and make more significant progress than those who do not. These disorders can be challenging and frustrating for children and their families, but early intervention can play a crucial role in helping these children overcome their challenges and improve their speech. By understanding the causes and symptoms of phonological disorders, parents and caregivers can work alongside speech therapists to support children in their speech development journey. If you want to support the cause further, consider donating to an organization that works specifically toward increasing awareness and providing treatment for kids with phonological disorders, like the California Scottish Rite Foundation. After all, all children deserve a chance to communicate effectively - and early intervention can make all the difference in their lives.

It can be unsettling to see a child suffering from Selective Mutism. You probably aren’t sure how to help them or where to turn. This condition can interrupt daily life for this child, causing them to suffer in school and routine social situations. Yet, there’s hope. There are several strategies you can try with a child with selective mutism to help them manage this anxiety disorder. Let’s explore these strategies and a step-by-step guide for how to implement them in the child’s daily life. What is Selective Mutism? This complex anxiety disorder is sometimes difficult to diagnose. With selected mutism, the child does not choose when they speak and when they do not. The failure to speak is also not about the child’s knowledge of the language. Instead, the child repeatedly shows a failure to speak in specific social situations. There may be certain people the child is more comfortable speaking around. There may also be certain situations in which the child speaks freely. Yet, he or she becomes selectively mute in other situations or the same situation around different people. The variables differ from child to child. This anxiety disorder is often diagnosed between the ages of 3 to 6, around the time that school begins. However, selective mutism is not limited to school settings. Children may exhibit symptoms of this disorder around extended family members or in community settings. Along with not being able to speak, they may have a “deer in the headlights” look, which is characterized by a lack of facial expressions and sometimes difficulty making eye contact. According to the American Speech-Language-Hearing Association (ASHA), the cause of the condition is complex. It can often be attributed to a combination of the following: Genetics social phobia separation anxiety obsessive-compulsive disorder Parenting style Delays in speech or fine motor skills Shy temperament Overactive autonomic nervous system A Speech-Language Pathologist is essential in the diagnosis of selective mutism. They assess and differentiate it from other disorders such as autism spectrum disorder, schizophrenia, etc. Strategies for Helping Children with Selective Mutism On your journey to help your child with selective mutism break the silence, caregivers can try the following strategies. To truly treat the condition, a speech pathologist is necessary, but these tips will give you some ways to help reinforce what the speech therapist is working on with your child. Avoid Negative Reinforcement Well-intentioned people try to speak for the child with selective mutism in situations where they are unable to speak. However, this behavior works to negatively reinforce the child’s non-speaking behaviors. The University of Central Florida explains that negative reinforcement is when “[s]omething is removed to increase the likelihood of a behavior.” In the case of speaking for the child, you are removing their need to speak, so they continue to not speak in that situation. Although it may seem natural, especially as a parent or caregiver, to swoop in a rescue a child struggling to speak, they need to try to do it on their own. Give them plenty of time to speak. They need time to process questions and formulate an answer the way they can. This may seem like forever to you, but it is necessary in helping them to communicate in difficult situations. If they still can’t speak, try giving them alternative ways of communicating like writing down their answer on a notepad or whiteboard. If they are pre-literate, consider teaching them or asking them to use gestures, pictures, or other forms of non-verbal communication. Acknowledge Their Strengths When your child is struggling to communicate in certain scenarios, it can be easy to focus on that behavior rather than all the ways they are doing well. Even if your child is still not managing to speak in social situations, they may be trying to participate in these situations non-verbally. Observe your child’s behaviors closely, and praise them for their efforts. Be mindful of the types of praise you offer in public and in private. Non-verbal behaviors can be praised in public like you would with any other child. Praise for speaking more should be done in private to avoid embarrassing the child. Social interaction is especially hard for children with selective mutism, so any progress toward communicating with others is worthy of praise. These children may struggle with low self-esteem, so reminding them of what they do well and their hard work can go a long way. Don’t limit your praise to their speaking, though. There is so much your child can do! They may be great at art or sports or writing or any number of things. They still want praise for these activities, too. The child needs to know that they are more than their weaknesses and that they can accomplish great things, even if they have trouble speaking. Understand the Nature of the Condition As a caregiver, it’s important to realize that your child’s silence is not a choice. It is a social anxiety disorder. Mute children want to have play dates and interact in social settings, but they have social anxiety that is preventing them from speaking. They also won’t likely have a pattern of behavior that you can understand. They may speak perfectly fine to one aunt but remain silent with another. The people, places, and activities that cause your child anxiety may not make sense to you, but your child can’t help their response. So, even though offering your child a reward for speaking in certain situations, like a classroom setting, may seem like a way to motivate your child, it is counterproductive. Be Mindful About What You Say You may not realize it, but sometimes you can criticize a child with selective mutism unintentionally. Comparing your child’s speaking ability to siblings or comparing their speaking abilities from one instance to the next doesn’t seem to be harmful, but children usually perceive them as criticism. This criticism can discourage the child from speaking or affect their mental health. Additionally, questioning the child when they are struggling to speak can compound the issue. They are already having difficulties and the questions pressure the child further. You don’t even realize that the questions are becoming overwhelming, but your child simply can’t process the questions when they are already struggling to speak. Encourage Physical Activity Children with selective mutism still need to get out and exercise and interact with others. Plus, studies show that exercising can reduce anxiety in people experiencing symptoms. This will also give you a chance to bond with your child. Adolescents and young children alike will enjoy playing a sport or exercising with you. They could try organized sports, running, cardio, yoga, or even a dance party. Get your kid moving their body to help them manage their anxiety, especially after a difficult interaction. This can help boost your child’s mood and relieve some of the symptoms of anxiety. Make Mistakes Seem Less Scary Many people, not just children with selective mutism, have trouble overcoming mistakes. They may feel like a failure if they can’t speak correctly or say the wrong thing. However, they are learning opportunities and chances for your child to practice. Encourage your child to see each speaking opportunity as a learning experience and don’t punish or criticize your child for mistakes. As long as they are trying, that’s all that matters. This includes when children fail to say niceties like “please and thank you.” You may be worried others will perceive your child as rude, but they aren’t trying to be rude when they leave these out. Your child likely isn’t trying to be oppositional, they just struggle to say the words sometimes. They may even have trouble making eye contact. Let them know that they will get better with more practice and that you understand they are trying. Try to make talking in social situations seem like something exciting or gamelike, not a big hurdle to overcome. Your child takes a lot of cues based on the way you react to situations. If you are looking for more resources to navigate through this journey with your child, check out Selective Mutism Association’s website. Strategies for the Classroom The most common place where Selective Mutism interrupts your child’s daily life is in school. Often, the disorder becomes most apparent when a child enters elementary school, especially at the beginning of the school year. There are several ways to advocate for your child in the classroom. Teachers can also use these tips to help them to accommodate children with selective mutism in their classrooms. Get an IEP An Individual Education Plan (IEP), is a plan created by the special education department at your school in conjunction with you and the teachers to outline the strengths and weaknesses of your child and make appropriate learning goals. This plan gives your child an opportunity for special education services. It also provides them with legal protection against discrimination in the classroom. To be considered for an IEP, children must undergo an evaluation. Once they are determined eligible for an IEP, a plan is created by stakeholders and is implemented in the school environment. Small Group Work Whole group discussions can be a nightmare for some children with selective mutism. Small groups and pairs can be better for getting these children to speak up and answer questions in class. Try to identify other students in the classroom that the child feels comfortable speaking around to set them up for success. Caregivers can help their children by letting teachers know the particulars of their child’s dos and don’ts when it comes to speaking. Allow Alternatives Some assignments where speaking in front of the class can be difficult for kids with selective mutism. Allowing them to present these to a smaller group or the teacher alone can go a long way in helping the child complete the task. Parents can ask for this in the IEP meeting or let the teacher know ahead of time that there may be issues with presenting. Most teachers are willing to adapt the assignment for children with selective mutism. Getting Treatment In addition to the aforementioned strategies, it is important to get your child seen by a clinician. This disorder is categorized as an anxiety disorder, so it requires a behavioral approach. Behavioral therapists are trained in providing support to children with childhood anxiety disorders. Not only can they assess and diagnose the disorder, but they can also work in conjunction with behavioral therapists to treat Selective Mutism. Behavior therapy involves gradual exposure, contingency management, and stimulus fading. This treatment plan can work to get an anxious child to overcome their fear of speaking. Some children with Selective Mutism will also have delays in language development. In these cases, you’ll need to seek out a Speech-Language Pathologist (SLP) to assist the Behavioral therapist in working with the child. RiteCare Clinics can help connect you with a skilled SLP to get your child the treatment he or she needs. With locations in both North and South California, we can provide a variety of care to patients with speech, learning, and language disorders. These SLPs will provide your child with practice speaking in social situations and reinforce successful speaking experiences. These services are offered free of charge. A combination of these two treatment programs can give your child the ability to increase their verbal responses. Conclusion: As a concerned caregiver, you want to provide your child who has selective mutism with the best quality of life. There are several strategies you can try at home to encourage your child to speak more and give them the love and praise they need. You can also advocate for your child in the classroom to reinforce positive speaking behaviors. These strategies, paired with behavioral and/or speech-language therapy, will help your child overcome their fear of speaking. Breaking the silence of selective mutism is a journey you and your child will take together. Practice, perseverance, and patience are the keys to success.

As a parent of a child with apraxia of speech, you are concerned about how this language disorder will affect your child’s schooling. Verbal communication is found in every aspect of the classroom from answering the teacher’s questions to presenting projects. There are even exams that require students to verbally recite key concepts. To make sure your child gets the best education, you’ll need to advocate for your child with apraxia of speech from the very beginning of their educational journey. These tips will help you to navigate the education system as your child’s chief advocate. What is Apraxia of Speech? Apraxia of Speech (AOS) is a neurological disorder that interrupts the brain’s language-producing pathways. According to the American Speech-Language-Hearing Association (ASHA), it occurs in about 1 - 2 children per 1,000. There is a higher incidence in males versus females. Students who suffer from this impairment generally have a higher risk of other language, reading, and spelling disorders. Children with this language disorder will have the following symptoms: Makes inconsistent errors in speech Trouble with articulation Searching for the right sounds (a.k.a. babbling) Use incorrect tone, rhythm, or stresses These children generally understand language well, but they are unable to communicate effectively. There are two types: Acquired Apraxia of speech (which is usually the result of brain injury to certain parts of the brain) and Childhood Apraxia of Speech (which is also known as developmental apraxia of speech). Many with developmental apraxia have no brain damage or evidence of brain abnormalities. This language impairment can be difficult to diagnose. It often has similar symptoms to other language disorders, so it needs to be diagnosed by a speech-language pathologist (SLP). This is a motor-speech disorder, so it not only affects a child’s speech but also their fine motor skills. The National Institute on Deafness and Other Communication Disorders (NIDCD) explains that eye movement, coordinating multiple movements, responding to commands, making mouth movements (dysarthria), and making precise leg and arm movements may be difficult for apraxia kids. This disorder is treatable and your child can make a lot of progress in their speech development, but they will never outgrow it. How Does Apraxia of Speech Affect Schooling? As you can imagine, being able to think of the answer to a question or the right word, but not being able to say it can be very frustrating for your child. They not only can’t think of words, though, but they also have difficulty with vowel sounds, leave out consonant sounds at the beginning or end of words, struggle with longer and more complex words, and can even substitute incorrect words (aphasia). Children with apraxia of speech often have trouble in spelling, reading, writing, and even math. These children may have difficulties understanding instructions and being able to communicate a lack of understanding. They can also develop anxiety. This stems from their inability to speak clearly in social settings. Some children may avoid situations in which speaking is key. They may also suffer from bullying by other students. Tips for Navigating the Education System There are several ways you can advocate for your child in the education system. There are many ways to ensure your child is successful in school. Even before school begins, you can prepare for ways to make sure your child’s needs are met. #1 Get an IEP or 504 Plan The Individuals with Disabilities Education Act (IDEA) is a law guaranteeing free, public education for children with disabilities. As a part of this law, there are two types of plans available for children with disabilities. These plans are agreed on by the family members, teachers, and the child as a way to accommodate the disability. An Individualized Education Plan (IEP) is a plan created to support the student with accommodations and special education instruction to help them thrive in school. First, students are evaluated for their strengths and weaknesses. Then, the IEP is developed based on that information providing goals and the means to reach those goals. An IEP also protects children with disabilities from discrimination in the classroom. A 504 Plan is slightly different from an IEP. It is still a plan that provides teachers, parents, and children with goals and accommodations, but it is more about removing barriers in the classroom that keeps the student from learning with his or her peers. IEPs are more specific, regulated more closely, and provide special education services. In contrast, 504 plans are more generic, less regulated, and work to make the classroom more accessible for children with disabilities. Both services are free, so the choice depends on your child’s individual needs. Having these plans in place lets teachers know what your child needs to be successful. It also gives them scaffolding to help them achieve more. #2 Ask for Preferential Seating Even if you decide against an IEP or 504, you can ask for preferential seating in the classroom. But, note that IEPs and 504s ensure, legally, that your child gets this preferential seating. Preferential seating refers to placing the child in the best spot within the classroom for their success. Sometimes that means placing them close to the teacher. This can be beneficial for apraxia kids because the teacher can quietly lean in and give the student extra help without drawing attention or repeating instructions. This can also make it easier for a child to hear the instructions or see visual cues. #3 See if Your Child Needs Augmentative and Alternative Communication For children with apraxia of speech, communicating with others is hard. Severe cases may require assistive devices. But, all children with apraxia of speech can benefit from augmentative and alternative communication (AAC). AAC just refers to all communicating without using words. This is helpful for people who have language development issues. AACs can be used temporarily or throughout a child’s lifetime, based on the individual’s needs. Speech tablets are one example of these devices. Ipads or other tablets loaded with special speech apps. These help the child to communicate with others. They are easy to use and are often more cost-effective than other assistive technologies. Another option is to get a speech-generating device. These are computers that are catered specifically to a child’s speech sound disorders. These devices can even be used to help children learn speech sounds. These devices are more expensive and need to be developed specifically for the child. You can also go much more essential for your child if they are old enough to read and write. They can use pen and paper, spell a word by pointing to letters, or using a whiteboard to communicate with others. Drawing pictures, using facial expressions and gestures, and pointing to photographs can be good methods for pre-literate children. Children with apraxia of speech can also benefit from American Sign Language (ASL). Sign language can give children who have difficulties with speech production a way to communicate with those around them. This method is not recommended for children who may also have muscle weakness or issues with motor movements. #4 Have a Plan for Missed Class Time Since your child may need to miss class to go to special speech therapy sessions or attend doctor’s visits, you’ll need to make a plan for how your child will make up missed work. You can include this in your IEP or 504 plan. You can also speak to the teacher directly. There are ways to set up a system for getting missed work. There could be a special folder the student keeps with missing work. That way, he or she can quietly access the work when they come back to school. There are also many digital options available nowadays. You will need to work out this system with the teacher. In addition, due to lost class time, you may need to invest in a tutor. You will want to make sure to hire a tutor who is familiar with your child’s special needs and can work along with your child’s speech problems. #5 Alternative Assignments for Speaking Projects In the case of individual assignments, IEPs, and 504s help your child get the right alternatives while still performing a speaking assignment that is appropriate for their skill level. However, even if you do not have one of these plans, you can communicate with the teacher to ask them for an alternative for your child that allows them to communicate in a way that is more accessible to them. Alternative assignments don’t have to be obvious or disruptive. It could be as simple as asking if your child can present their verbal report individually to the teacher rather than in front of the class. #6 Enroll Your Child in Speech Therapy Sometimes it’s hard to know if your child needs speech therapy. Parents and children often find a way of communicating with each other even if there are speech distortions. You and your child probably have an expressive language all your own. That’s why it’s important to get your child evaluated by a Speech-Language Pathologist (SLP) if you even slightly suspect there may be speech deficits. Your child may need speech therapy if they have issues with language skills such as, processing or understanding sounds Blending sounds in the correct sequence Expressing themselves in the correct grammatical structure and order Using language in a meaningful way A speech therapist can help your child to develop clearer speech. They will work on getting your child to move their muscles correctly to produce sounds. They will also emphasize practice and slowing down speech to help make communication more clear. In severe cases, they may also help guide children to use Augmentative and Alternative Communication (AAC). Where Can You Find a Speech Therapist? For free-of-charge speech, language, and literacy across the state of California, check out California Scottish Rite Foundation. We partner with universities, private practices, and donors who support Ritecare Childhood Language Centers of California. Our organization has served over 2,300 students each year who struggle with language, speech, and learning disorders. The Ritecare Childhood Language Centers of California provide evaluation and treatment to children. There are 4 locations in Southern California and 2 in Northern California. We are also partnered with the following universities: California State University Long Beach California State University Los Angeles Chapman University in Orange County University of the Pacific in Stockton This partnership helps to expand our services offering a wider breadth. It also allows aspiring graduate students to get hands-on experience in this field. Our foundation also partners with several private practices to fully round out the services we can provide to children with language, speech, and learning disorders. These individual practices also provide aspiring speech therapists to participate in internships that grow the future of speech pathology experts. We currently partner with Sunrise A Speech Pathology Corp in Fresno, Speech-Language Learning Associates, Inc. in Sacramento, and Speech Goals in Burlingame, Oakland, and San Francisco. Here at Scottish Rite, our goal is to “help children communicate.” We are dedicated to making access to these services available to children no matter the race, creed, or family’s ability to pay. If you are looking to get your child evaluated for speech therapy, you can communicate with any of our locations for more information. Final Thoughts A child with apraxia of speech can benefit from a parent who knows how to advocate for them in the education system. There are several steps you can take to ensure your child has the best quality of education. Get your child an IEP or 504 plan to protect them legally and to set up a plan for them to be successful in the classroom. Talk to your child’s teacher about ways you can adapt their classroom interactions with preferential seating, alternative assignments, and a missing work plan. Your child may also need Augmentative and Alternative Communication (AAC) to help them communicate with those around them. They also may need speech therapy. With these tools in your toolbelt, your child is sure to succeed in school.

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The California Scottish Rite Foundation annually provides up to $200,000 in Scholarships to 100 deserving applicants. The Scholarship Committee reviews and evaluates each application to determine scholarship placement. Tanner was the California Scottish Rite Foundation 2018 Scholarship recipient! With that, he has been able to accomplish many achievements since then. Tanner was also grateful enough to send us a thank you letter. Please give it a read below! "Dear California Scottish Rite Foundation, I was your 2018 scholarship winner. I want to thank you all for the love, encouragement, and financial support that you have given me. I couldn’t have accomplished my dreams without your financial assistance. I want to give you a little life update. When I think about the past four and half years, I am amazed by how fast they flew by. On December 13th, 2022, I graduated Magna Cum Laude from California Baptist University with a Bachelor of Science in Nursing. I enjoyed my time at California Baptist studying, working, and building new, lifelong friendships. My time was filled with many life-changing opportunities and experiences. My favorite part of the nursing program was being able to experience a variety of different specialties and hospital floors. I was fortunate enough to be able to experience clinicals during Covid and my favorite floor was the emergency department. Each summer, while not in school, I worked alongside my fellow lifeguards to run junior lifeguard programs at the beach. At these multi-week camps, we shared the responsibilities of keeping the general beach safe while also educating groups of children on ocean safety and what it takes to become a lifeguard. Working with children has been extremely rewarding because I know that I am instilling in them the skills that will help keep them safe even when there aren’t any lifeguards on duty watching out for them. In addition to beach lifeguarding, I worked as a River Rescue Lifeguard on the Colorado River providing first responder medical care to the visitors of the Colorado River, and performed rescues as a deckhand on a police boat. Currently, I am studying to take the NCLEX-RN Exam. I am very excited about my future as a nurse to help the sick and weary. My career goal is to become a trauma flight nurse because I love fast-paced emergency medicine. However, when flying becomes too physically taxing at an older age, I would like to transition into hospice nursing because I have seen first-hand the amazing impact it can have on people’s lives. Again, thank you for your support! I wouldn’t be where I am today without the help of all the volunteers that support your organization." Much Gratitude, Tanner Curnow Tanner is one of many graduates the California Scottish Rite Foundation has helped financially to achieve their goals! To learn more check out our scholarship page at casrf.org/scholarship.

The California Scottish Rite Foundation offers free evaluation, assessment, and therapy to all children who need it. However, if circumstances constrain you from this amazing opportunity, you may need other professionals who will charge for the services. CostHelper reports that the average cost of speech therapy in the United States can range from $100 to $600 per hour, depending on many factors. The costs of speech therapy will likely increase in the near future due to the growing demand for these services. That is a lot of money because your child may need more than 5 sessions to be successful. Then you can turn to your insurance company for help. However, the question remains, Is speech therapy covered by insurance? Is Speech Therapy Covered By Insurance? There is no straight answer to the question of what health insurance covers. However, you must remember that insurance plans can vary in terms of coverage and benefits. This can make it challenging to determine whether your insurance covers speech therapy. Insurance companies have their own unique policies, and the coverage of each family's plan can differ. The amount of your deductible, the benefits you're entitled to, the available options, and the reimbursement protocols may also vary. This article will assist you in determining whether your insurance plan covers speech therapy. Some children may need speech therapy to address communication challenges, both in how they speak and how they understand communication. Perhaps your child is slow in speech and language processing or cannot communicate at all. Speech therapy can help improve a child's communication skills, self-confidence, and quality of life. Early intervention is usually recommended to ensure children can develop the necessary communication skills. When Does Insurance Cover Speech Therapy? Generally, health insurance covers the costs associated with preventive care, including routine check-ups, vaccinations, and screenings. It may also cover the costs of medical treatments for illnesses, injuries, and chronic conditions. Many insurance plans provide coverage for speech therapy as part of a rehabilitation process in cases where it is required due to a significant medical event, such as injury or acute illness. This coverage may extend to children born with cleft palates and those recovering from a stroke or traumatic brain injury. The benefits and coverage options can vary widely depending on the insurance plan. However, health insurance may cover common medical expenses, including hospital stays, surgery, medical tests and procedures, prescription drugs, medical equipment, therapy, and counseling. Not all health insurance plans cover every medical expense, and some may have deductibles, copays, or coinsurance requirements that must be met before coverage kicks in. It's essential to review your insurance plan's coverage details and limitations to fully understand what your insurance covers and what it doesn't. But does insurance cover speech therapy only for major medical issues? The answer is not that simple. The availability of coverage for speech therapy varies depending on the insurer and their coverage options. Typically, therapy required due to an unforeseen tragic event is more likely to be covered. However, insurance providers may exclude coverage for speech therapy related to chronic or developmental disorders, such as articulation issues, lisps, or speech delays. These exclusions can make it challenging to determine whether insurance covers speech therapy when it is not linked to a major injury or medical condition. How to Know if Your Insurance Covers Speech Therapy Contact your insurer to determine whether your speech therapy is covered by insurance. This can be as simple as calling the number on the back of your insurance card or contacting your insurance agent. When you call, ask about the specifics of speech therapy coverage, including the deductible, out-of-pocket limits, and the number of covered sessions. If you have already selected a speech therapist, inquire whether they are in your insurer's network. If they are not, ask about reimbursement options for using out-of-network providers. Your speech pathologist can also be a valuable resource in navigating the insurance process. They can develop a treatment plan that can be submitted to your insurer to determine the services and fees that will or will not be covered. Common Reasons Why a Speech Therapy Insurance Claim is Denied We typically associate health insurance companies with useless boring meetings and bureaucracy. How can you avoid issues with your child's coverage for speech therapy? You have to be aware of common reasons why an insurance claim for speech therapy may be denied before submitting your paperwork. Be sure to thoroughly review your healthcare policy and submit the claim with all required supporting documents. If your claim is denied, you can always file an appeal. 1. “Medical Necessity.” Insurance companies may decline coverage for treatments that they do not consider to be "medically necessary." This means that the insurer may reject the claim if there is no known disease, injury, or condition causing the ailment. Health insurance companies use the term "medical necessity" to decide whether a particular medical service or treatment is adequately reasonable for treating specific conditions. Typical standards exist, and these help companies to decline or approve such coverage. A lack of medical necessity refers to when an insurance company refuses coverage for treatment as it believes the treatment is nonessential for diagnosis or treatment. The causes of speech impediments are often difficult to identify and often relate to an unknown neurological origin. The insurance company can deny meritorious claims unless supported by a doctor's or speech therapist's statement that the treatment is necessary. In some instances, the healthcare provider can appeal and dispute insurance denial for medical necessity if the insured believes it's the wrong decision. The provider may need to present additional documentation or other evidence to support their position that treatment is necessary for the patient's care. When Is Speech Therapy Medically Necessary? Speech therapy is commonly considered a medical necessity for individuals with swallowing disorders and communication disabilities. However, for other conditions, the following criteria must be met for speech therapy to be considered medically necessary: A doctor must determine that speech therapy can lead to significant improvement for the patient within a reasonable and predictable timeframe. Licensed and certified providers must provide services. Therapy services must follow the care plan developed by the treating physician and comply with applicable laws and policies. Therapy services must be provided by a licensed SLP or under the supervision of a licensed aide in accordance with state laws. Insurance may cover speech therapy for members aged 18 months or older who have idiopathic speech and language delays and have been diagnosed by a qualified provider as a treatable communication issue. Home-based speech therapy may be covered if the member is homebound, such as after transitioning from hospital care to home health care. Insurance may cover your child’s speech therapy if these criteria are met. When Is Speech Therapy NOT Medically Necessary? Speech therapy may not be covered by insurance in the following scenarios: When the patient can receive the required treatment from another service, such as occupational or physical therapy. When multiple treatments are administered, there is no separate treatment plan for speech therapy, indicating its significant difference from other procedures. Furthermore, insurance contracts usually do not cover maintenance programs that preserve present cognitive function and delay regression. These programs are exercises, techniques, and drills that start after the therapeutic plans have achieved their desired goal. In addition, speech therapy may not be covered when it is used to treat chronic coughs or when the skills of a licensed speech-language pathologist are not required for treatment. These treatments usually involve routine and reinforced procedures that professional or family caregivers can carry out. If insurance does not cover speech therapy in these scenarios, it is important to explore alternative payment options. 2. Developmental Disorder Insurance companies may reject a claim if a speech disorder is classified as a developmental disorder. "Developmental disorder" in health insurance refers to a classification of disorders that typically manifest in childhood and affect a child's development and functioning. Examples of developmental disorders include autism, attention deficit hyperactivity disorder (ADHD), and intellectual disability. Insurance companies may use this classification as a reason to deny coverage for speech therapy services, as they may assume that the child will eventually outgrow the language impediment. However, it's important to note that early intervention and treatment for developmental disorders can significantly improve a child's outcomes and quality of life. However, seeking treatment for a child with a developmental disorder is crucial, regardless of insurance coverage. If the speech disorder or delay is labeled as developmental, ask the speech therapist not to use that term or its corresponding medical billing code on any paperwork. 3. Public School Services When seeking coverage for your child's speech therapy, your health insurance company may argue that the therapy provided by the public school system is sufficient and that additional therapy outside of the school setting is unnecessary. However, it's important to remember that speech therapy is not just an educational issue but also a medical one. You can inform your health insurance company that reputable organizations like the Health Insurance Association of America and the Joint Commission on Accreditation of Healthcare Organizations recognize speech therapy as a legitimate healthcare service. Supporting documentation can also be provided to demonstrate why your child requires private speech therapy, such as a long waiting list for school-based therapy or your child's inability to qualify for services in school due to test scores or the nature of their disorder. What to Watch for with Speech Therapy Insurance Coverage Here are some key things to consider when gathering information about speech therapy insurance coverage: Exclusions Exclusions are provisions in your insurance policy that exclude coverage for certain services. It's important to review your policy for any speech therapy exclusions, such as those for developmental issues. If you need clarification, contact your insurance carrier to confirm. Limitations Limitations are restrictions that limit the benefits you can receive. For example, your health insurance agreement may limit reimbursement for speech therapy by capping the number of sessions covered or setting a dollar amount that may or may not reset annually. Benefits Benefits can vary depending on whether you use an in-network or out-of-network provider. In-network providers can typically bill the insurer directly, but some plans require the use of in-network providers. If your plan requires this, make sure your speech therapist is in-network. Out-of-network providers may still be an option, but accessing them may limit your reimbursement to only a portion, if any, of your out-of-pocket costs. Even if out-of-network services are covered, your insurance carrier will likely only cover part of the provider charges. These out-of-network benefits are often only available with preferred provider organization (PPO) plans. If your coverage request is denied, you can appeal the denial. What Is the Best Age to Start Speech Therapy? Although developmental speech delays can be noticed as early as three months, it is still possible that your child will meet their speech milestones on time. Therefore, starting treatment for your child right away may not be necessary, although it's good to talk to a therapist to address your concerns. The therapist may suggest early intervention and monitoring signs at home before recommending treatments. If communication issues persist well into your child's first year, it may be appropriate to consider seeing a specialist. By 12 months, your child should already be using gestures to communicate, which is a sign of their understanding of communication and possession of basic communication skills. Find A Speech Language Pathologist The worst thing that could happen to a family is a false assumption. The best thing to do is to first consult with a professional. All our services at the California Scottish Rite Foundation are free. Hence, you don't have to worry about payment or insurance bureaucracies. You can allow our professional SLPs to assess your child, and they will advise you on how to best file your insurance claim. The first appointment with a speech therapist is typically the initial evaluation, where the therapist evaluates your current communication strengths and weaknesses to determine if speech therapy is necessary. Following the evaluation, the therapist will create a report with this information and send it to your insurance company for review.

Speech disorders can be frustrating. Imagine watching your child struggle to speak or communicate with you. There are different reasons why your child may have delayed speech or reach certain milestones later than their peers. One of the reasons may be muscle weakness or what professionals call Dysarthria. Many children may have trouble saying some sounds clearly, and you can find it hard to understand what they say. However, it is easy to misdiagnose the problem. That is why we will critically explain dysarthria and how you can identify it and help a child. What is Dysarthria? As a parent, you take all possible measures to ensure your child's safety. However, despite taking all safety measures, accidents can still occur, and your child may suffer a head injury that could result in one of the many speech disorders in children, like dysarthria. Dysarthria is a type of language disorder categorized as a motor speech disorder. It arises when a child faces difficulties utilizing their oral motor muscles to generate speech. The disorder leads to weakened or improper movements of the muscles in the mouth and face and may also impact the respiratory system. The exact symptoms and severity of dysarthria depend on the extent of damage to the nervous system. We use several muscles in our face, lips, tongue, throat, and respiratory system when we speak. Weakness in these muscles makes speech difficult. Dysarthria is a motor speech disorder that occurs due to weakened muscles resulting from brain damage. The disorder can range from mild to severe. Dysarthria can co-occur with other speech and language difficulties. Apraxia, characterized by difficulty sending messages from the brain to the muscles to initiate movement, and aphasia, which involves difficulties understanding language and expressing thoughts, are typical examples. Dysarthria results from impaired muscle control due to damage in the brain areas responsible for speech. Non-brain-related issues such as muscular and nerve disorders affecting the mouth and throat can also lead to dysarthria. Typically, dysarthria presents as slurred speech, with variations in speech rhythm and voice quality based on the specific type of dysarthria. Although dysarthria is not a medical emergency, the sudden onset of dysarthria due to a stroke or brain injury warrants urgent medical attention. While dysarthria cannot be cured or fully reversed, specific therapies can help improve communication and speaking abilities. The Difference Between Language Disorders and Speech Disorders Dysarthria is not a genuine language disorder, unlike language disorders such as Aphasia. Instead, it is caused by inadequate motor and sensory processes required for speech production. Dysarthria affects a child's ability to articulate words properly despite having normal cognitive abilities and an understanding of language. The disorder occurs due to impaired movement of the muscles involved in speech. It is common to mistake language and speech disorders as interchangeable, but this is inaccurate. A language disorder refers to the misinterpretation and mismanagement of environmental stimulus signals. It may impact a child's cognitive development, but not always associated with an intellectual disability. The inability to understand, learn, and articulate words are the primary characteristics of language disorders, which can extend to reading and writing abilities. Language disorders are not linked to any muscular or respiratory dysfunction. On the other hand, speech disorders are motor-based and involve the improper management of neuro-muscular signals required for word articulation. Unlike language disorders, speech disorders do not imply cognitive under-development. Speech disorders only affect the control of muscles used for speech production and do not affect intellectual capacity, senses, or the nervous system's functioning. Causes of Dysarthria Disorder in Children Dysarthria, similar to other language or speech disorders in children, can stem from several causes. Dysarthria in children can have pathological causes, such as cerebral tumors or amyotrophic sclerosis, which interfere with cerebral function. It can also be caused by cranial contusions or excessive medication use that affects the cerebral cortex or medulla oblongata. Let us now talk about the specific causes. Some of them are: 1. Brain Damage or Injury If your child falls and hits their head, there may be a case of TBI. The fall can affect the neural pathways that control speech production. These neural pathways connect the brain to the muscles involved in speaking, including the muscles in the face, lips, tongue, throat, and respiratory muscles. When these neural pathways are damaged, the muscles may weaken, move improperly, or become spastic, making it difficult to produce clear speech. The specific symptoms and severity of dysarthria will depend on the location and extent of the brain damage or injury. In some cases, the condition may be mild and only affect certain sounds or words; in others, it may be severe and make speech nearly impossible. 2. Muscular and Nerve Disorders Muscular and nerve disorders can cause dysarthria by affecting the normal functioning of the muscles and nerves involved in speech production. For example, a muscular disorder such as muscular dystrophy can weaken the muscles of the tongue, lips, and face, making it difficult to move these muscles properly to produce clear speech. Similarly, a nerve disorder such as Parkinson's can affect the nerves that control the mouth and throat muscles, leading to speech difficulties. In both cases, the neural pathways responsible for the coordinated movements of the muscles involved in speaking are disrupted, resulting in dysarthria. The specific symptoms of dysarthria will depend on the location and severity of the muscular or nerve disorder. 3. Developmental Delays Developmental delays can cause dysarthria by affecting the normal development of the muscles and nerves involved in speech production. During normal development, children learn to coordinate the movements of their lips, tongue, and other oral muscles to produce clear speech. A child with a developmental delay may have difficulty coordinating these muscles correctly, resulting in dysarthria. For example, a child with a developmental delay may have weaker oral muscles or struggle with motor planning, making it difficult to produce clear speech. A child with a speech and language development delay may not receive good practice using their oral muscles to produce sounds and words, leading to dysarthria. The severity and specific symptoms of dysarthria caused by developmental delays will depend on the underlying cause and the child's individual abilities and needs. Early intervention and therapy can help children with developmental delays improve their speech and language skills, including dysarthria. To get an accurate diagnosis of dysarthria, we recommend you consult a pediatric neurologist or a specialist in child behavior. What Dysarthria Means for Your Child Children with dysarthria may have difficulty controlling the volume, pitch, and quality of their speech. This can cause slurred, slowed, or labored speech and problems with breath control. They may also have trouble articulating multisyllabic words and exhibit nasal or hoarse sounds. Dysarthria can affect saliva control, chewing, and swallowing. Dysarthria can significantly impact a child's ability to communicate effectively. The child may have difficulty pronouncing words and expressing their thoughts clearly, leading to frustration and difficulty in social situations. The child may also have trouble understanding others, which can further impact their ability to communicate. In addition to speech and language difficulties, dysarthria can affect a child's physical health. The child may have difficulty chewing and swallowing, leading to malnutrition and dehydration. They may also be at an increased risk of choking or aspirating food or liquid into their lungs. Dysarthria can also affect a child's self-esteem and emotional well-being. Children with dysarthria may become socially isolated and avoid speaking to others due to frustration, embarrassment, and fear of ridicule. They may develop psychological disorders such as social anxiety over time without proper speech therapy and family support. However, with appropriate treatment and support, children with dysarthria can make progress in their communication abilities and improve their overall quality of life. Symptoms of Dysarthria Disorder in Children The signs of dysarthria may vary from child to child. However, the American Speech-Language-Hearing Association highlights the common symptoms or signs of dysarthria in children. It may be a sign of dysarthria if your child exhibits the following: Slurred or mumbled speech that can be hard to understand. The child can or would only speak slowly. The child talks too fast. Speaking too softly. The child cannot move their tongue, lips, and jaw well. The child sounds robotic or choppy. The child sounds hoarse or breathy or like they have a stuffy nose or are talking out of their nose. You must seek medical attention immediately if your child is experiencing difficulty using their muscles, especially to speak. A Speech-Language Pathologist can assess your child’s speech and language to determine whether they have dysarthria or another issue. The SLP will evaluate your child’s ability to move their mouth, lips, tongue, and breathing. The professional will also assess your child’s speech in various contexts, including single words, sentences, and conversations. They will also assess your child’s ability to comprehend and communicate effectively. Treating Dysarthria in Children Treating dysarthria in children is based on rehabilitating the muscles affected by the underlying lesion or pathology. Therapy typically involves breathing exercises, phonetic training, and oral-facial exercises to improve muscle sensitivity and control. Your healthcare provider will develop a treatment plan tailored to the severity of your symptoms. Speech therapy is beneficial for individuals with dysarthric speech to improve their communication skills. Speech-language pathologists can also collaborate with your family and loved ones to help them improve communication with you. In speech therapy sessions, you can learn techniques such as: Exercises to strengthen mouth muscles Techniques to slow down speech Strategies to speak louder, such as using more breath Methods to articulate sounds clearly Movements to chew and swallow safely Various communication techniques, such as gestures or writing In more severe cases, a communication device may be necessary. These devices may include a letterbox, a picture board, or a special computer with a keyboard and message display. Since speech disorders in children can vary greatly, a customized treatment plan is necessary. An SLP will assess the child's symptoms and develop a treatment plan that may include strengthening oral motor muscles, improving muscle movement, improving breath support, correcting the rate of speech, and articulation practice. Focusing on vocalizing consonants can be particularly beneficial for children with ataxic dysarthria. Social anxiety and other psychological disorders may develop over time without appropriate therapy and family support. Living with Dysarthria Disorder in Children The family and a child with dysarthria must work together to enhance communication. Here are some suggestions for both the child (as the speaker) and the parent or caregiver (as the listener). Tips for the child: Begin with a single word or short phrase before moving on to more complete sentences Check with the listener(s) to make sure they understand what you are saying Speak slowly and loudly, and take frequent pauses Keep conversations shorter when you feel tired, as your speech may be harder to understand If you feel frustrated, try using gestures or pointing to help get your message across, or take a break and try again later. Younger children may need extra help remembering to use these strategies. Tips for the listener: Reduce distractions and background noise Pay close attention to the child when they are speaking Watch the child's mouth as they speak Let the child know if you are having trouble understanding them Repeat only the parts of the message you understood so the speaker does not have to repeat the whole message If you still don't understand, ask yes/no questions or have the child write down their message for you Get the Right Care For Your Child At Our RiteCare Centers RiteCare is a program that provides speech and language services to children who have communication disorders such as dysarthria. RiteCare clinics are located throughout the United States and are staffed by licensed speech-language pathologists who specialize in diagnosing and treating communication disorders. RiteCare can help a child with dysarthria by providing speech therapy tailored to their needs. The speech-language pathologist will work with the child to improve their speech clarity, breathing, and oral motor control through exercises and techniques that strengthen the muscles involved in speech production. The RiteCare program can also provide support and education to parents and caregivers, helping them better understand their child's condition and how to support their communication development. Additionally, RiteCare may offer assistive technology and devices to help children with severe dysarthria communicate effectively.

The ability to speak is a remarkable inborn skill. Children need ample opportunities to hone this skill. Like any physical skill, children improvise and do their best to articulate themselves clearly. Baby talk can be cute, and you may remember some of them as phonological processes. Babies use these patterns to simplify the speech sounds of adults. Since children cannot coordinate their articulators, such as their lips, tongue, and teeth, for producing "adult-like" speech, they use these processes during their speech and language development. As a result of this developmental stage, children follow predictable routes to simplify words until they acquire the necessary skills to pronounce them clearly. One of the predictable routes is called deaffrication. We will explain everything you need to know about deaffrication in this article. Follow along. What is Deaffrication? First, deaffrication is like a move over affrication. So let's start from there. When we speak, we use different sounds. These sounds have names or classifications. Now, one of the classes of sounds is affricate. An affricate is a type of consonant sound in which there is a brief period of friction (like a consonant produced by forcing air through a narrow channel made by placing two articulators close together) followed by a sudden release of air (like a stop). In other words, it combines the features of both friction and stopping. Examples of affricates in English include "ch" (as in "chair") and "j" (as in "jump"). When pronounced, the speaker creates friction by partially blocking the airflow with the tongue and then releases the airflow suddenly by opening the oral cavity. That is an affricate. Imagine that a baby is trying to produce a sound that is this complex when they have not yet mastered the control of their articulators. They make it simple with deaffrication. So what is deaffrication? Deaffrication refers to a substitution pattern in which an affricate, such as "ch" or "j," is replaced with a fricative or stop, such as "sh" or "d." If you've ever heard a child say "ships" instead of "chips," you've witnessed deaffrication in action. Deaffrication is a phonological process where an affricate sound, such as "ch" or "dj", is transformed into a stop, such as "p", "b", "t", or "d", or a fricative, such as "s", "z", or "sh". For instance, "shop" instead of "chop" or "tear" instead of "chair" are examples of deaffrication. Like other phonological processes, deaffrication is common among young children and typically resolves by the age of 4. However, it may be considered a phonological disorder if it persists beyond this age. The professional can use a "minimal pairs" approach to target deaffrication in speech therapy. This involves having the child repeat pairs of words that differ by only one sound, typically the target sound and the corresponding substituted sound. For example, the word list could focus on "ch" and "sh" minimal pairs, such as "CHIP" and "SHIP." Another effective strategy is auditory discrimination, which involves training children to accurately distinguish sounds. Asking children to identify whether a word includes the "ch" or "j" sound can help promote attentive listening and facilitate correct sound production. Why Understanding Deaffrication is Important Understanding deaffrication is crucial because it can impact a child's communication and social interactions. If a child consistently replaces affricate sounds with fricatives or stops, their speech may be difficult for others to understand. When a child still uses it while all their peers have started speaking normally, it can lead to frustration and social isolation. It can also cause potential academic and career difficulties later in life. If deaffrication persists past the age of 4, it may indicate a phonological disorder that requires professional intervention. By identifying and addressing deaffrication early on, parents and educators can help children develop clear and practical communication skills that will serve them well throughout their lives. How to Identify Deaffrication in Children The signs and symptoms of deaffrication in children can vary depending on the severity and stage of the condition. Here are some common signs and symptoms that parents and caregivers should look out for: Pronouncing "ch" and "j" sounds like "sh" and "zh," respectively, such as saying "ship" instead of "chip" or "measure" instead of "treasure". Difficulty with enunciating certain words or sounds, especially those that contain affricate sounds. Stuttering or struggling with speech, particularly when trying to say certain words or phrases. A slow rate of speech or hesitation when speaking. Difficulty with language comprehension and production, such as difficulty following directions or expressing thoughts coherently. It's important to note that some degree of deaffrication is common in young children as they are still developing their speech and language skills. However, if the symptoms persist or interfere with a child's ability to communicate effectively, it may be a cause for concern and require professional evaluation and treatment. Why Do Children Use Deaffrication? Young children use phonological processes to simplify the language they hear from adults. These processes consist of three components: syllable structure, substitution, and assimilation. If these processes persist beyond the age of four, it is advisable to seek the opinion of a speech pathologist with a speech evaluation. Regardless of the child's age, speech therapy or a literacy program is often recommended. Fronting refers to the substitution of a back-of-the-mouth sound with a fronting sound (e.g., "tee" for "key") and typically resolves by 3.5 years of age. Young children use phonological processes to simplify the language spoken by adults, as they cannot coordinate their lips, tongue, teeth, palate, and jaw to produce clear speech. The child's brain creates rules to simplify speech sounds, making it easier to learn and speak. While some of these processes are typical for all children, some may indicate an abnormality that requires investigation by a speech-language pathologist. Treatment involves retraining the brain to eliminate the rule. The syllable structure is present in both hemispheres of the brain. Fronting refers to the pronunciation of a vowel on the front of the tongue (palatal) in a word, such as the 'i' sound in 'sip.' Consonant harmony occurs when all consonants in a word are pronounced the same way, as in the 'cup' sound made by the front of the tongue on the roof of the mouth. Weak syllable deletion is the removal of a syllable from a word, such as the omission of 'tele' in 'telephone.' Clustering is the grouping of syllables to form one long syllable, as in the 'y' sound produced by the front of the tongue on the roof of the mouth when pronouncing 'try.' Assimilation is the process of combining sounds from one word into another, such as the 'f' sound in 'teffone,' which results from the front tongue on the roof of the mouth. If phonological processes persist beyond the age of four, it is recommended to consult a speech pathologist for a free phone consultation or speech evaluation, and speech therapy may be necessary regardless of the child's age. When to See a Professional If your child is still using deaffrication patterns after the age of four, it is recommended to seek the advice of a licensed speech-language pathologist. Early intervention can be beneficial in addressing the issue and promoting clear speech. A speech-language pathologist can conduct a thorough assessment and provide individualized therapy to target the specific areas of difficulty. Delaying intervention can lead to more persistent speech difficulties and may affect your child's communication and academic success. Therefore, it is important to seek professional help when you have concerns about your child's speech development. Available Treatment for Deaffrication Several treatment options are available for deaffrication in children, depending on the severity of the condition and the child's individual needs. Some of the most common treatment options include: Speech Therapy: This is the most common and effective treatment option for deaffrication in children. A speech therapist will work with the child to identify the specific sounds that are causing the deaffrication and develop a treatment plan that includes exercises and activities to help the child produce the correct sounds. Minimal Pairs Approach: This approach involves using pairs of words that differ by only one sound, such as "chip" and "ship", to help the child hear and produce the correct sounds. Auditory Discrimination Training: This involves helping the child learn to distinguish between different sounds by practicing listening exercises and games. Articulation Therapy: This therapy focuses on helping the child learn how to move their mouth, lips, and tongue to produce the correct sounds. Parental Involvement: Parents can play an important role in helping their child overcome deaffrication by practicing speech exercises at home, providing positive reinforcement, and creating a supportive environment for their child's speech development. It is important to note that the specific treatment approach will depend on the severity of the child's deaffrication and the condition's underlying cause. A speech therapist will work with the child and their family to develop a personalized treatment plan tailored to their needs. Tips for Parents and Caregivers Parents and caregivers can play an essential role in helping their children overcome deaffrication. Here are some ways they can assist: Model correct speech sounds: Children learn from the speech sounds they hear around them. Parents and caregivers can model correct speech sounds by pronouncing words clearly and accurately. Use minimal pairs: As mentioned earlier, a minimal pairs approach can be useful in correcting deaffrication. Parents and caregivers can create word lists with minimal pairs, such as "chip" and "ship" or "jump" and "gum," and practice them with their children. Encourage listening: Listening is a crucial skill in developing correct speech sounds. Parents and caregivers can encourage children to listen carefully to the sounds around them, such as the sounds of different animals, cars, or musical instruments. Practice tongue and mouth exercises: These exercises can help children develop stronger oral muscles and coordination. Parents and caregivers can consult with a speech-language pathologist to learn about exercises to help their child. Be patient and supportive: It is essential to be patient and supportive when helping a child overcome deaffrication. Children may become frustrated or self-conscious about their speech difficulties. Encouragement, positive reinforcement, and a non-judgmental attitude can go a long way in building their confidence and helping them progress. However, it's important to note that while parents and caregivers can help, it's best to seek the guidance of a licensed speech-language pathologist for professional assessment and treatment. Strategies For Promoting Speech Development Here are some strategies that parents and caregivers can use to promote speech development in children: Talk to your child: Engage in regular conversation with your child, even if they are not yet able to speak in full sentences. Speak to them in a clear, slow, and calm manner and use simple language that is appropriate for their age. Read to your child: Reading to your child is a great way to promote speech development. Choose books with simple language and colorful illustrations to which your child can relate. Sing songs and nursery rhymes: Singing songs and nursery rhymes with your child can help them develop their language skills and improve their memory and attention span. Encourage imitation: Encourage your child to imitate the sounds and words they hear around them. Repeat the words and sounds they make and praise them for their efforts. Play games: Play games with your child that involve language skills, such as naming objects or describing actions. This can help them develop their vocabulary and sentence structure. Limit screen time: Excessive screen time can interfere with speech development. Limit your child's screen time and encourage them to engage in other activities that promote language development. Seek professional help: If you are concerned about your child's speech development or if they have difficulty with deaffrication or other speech sounds, seek professional help from a speech-language pathologist. They can provide a proper diagnosis and recommend treatment options to help your child overcome their speech difficulties. Typically, young children, particularly those aged 2 and 3, make multiple speech errors within the same sentence, which can pose communication challenges for unfamiliar adults. While this article suggests that you seek assistance when your child is four or five, parents and caregivers should ultimately rely on their knowledge of their child's speech development and feel comfortable discussing any concerns with a speech pathologist. As a general rule, it may be wise to consult with a professional if a child's speech appears less developed or less understandable than that of their peers. If the child seems anxious or frustrated about their speech, or if they are self-conscious or experiencing bullying because of their speech, they may have an issue. Consult a professional if concerns are raised by childcare, preschool, or school teachers. You can also consult a therapist or pathologist if you simply want to ensure there are no underlying issues with your child.

This is a real issue. Some children act awkwardly around people they don’t know well. Have you ever been with a child that gets quiet around certain people? For example, your child would not talk in daycare or with other kids but does with you. Or the child freezes and looks to the ground if someone, even other kids, tries to interact with him. The child will be energetic, silly, and talkative with people they’re comfortable with. That means there is no language or speech development disorder. That child may have selective mutism. This article explains everything you need to know about selective mutism and what it can mean for your child. We will also discuss how you can help a child with this condition. What is Selective Mutism? Selective mutism (SM) is an anxiety disorder that affects children's ability to speak in certain settings or to certain individuals. School is the most common setting where children with selective mutism struggle. Despite being able to speak comfortably and easily at home, children with SM feel so much anxiety in certain situations that they become unable to speak. Adults may find this disorder confusing, and children may find it painful. Children with SM may not exhibit physical signs of anxiety and may appear frozen or stare back when asked a question or prompted to engage. Parents may not realize that their child has trouble speaking around others because their child does not have difficulty speaking at home. Parents may also mistake their child's anxiety for shyness and underestimate the severity of their child's disorder. Children with selective mutism may whisper when speaking to teachers or peers or be completely unable to speak, going an entire school year without speaking once. They may have difficulty answering questions in class, asking for help, or initiating conversations. Many children with SM may struggle to ask to use the bathroom, leading to them going hours without using it or having accidents. Signs a Child Might Have Selective Mutism How can you identify SM in a child? It is important to understand what selective mutism is. Early detection and intervention in selective mutism are crucial for a child's emotional and social development. The longer the child goes without appropriate support, the more challenging it can be to overcome. Here are common signs of selective mutism: Refusing to speak in specific social situations, such as school, extracurricular activities, or social events, despite being able to speak at home or in other comfortable environments. Limited social interactions or lack of verbal communication with peers or adults in certain settings. Extreme shyness or social anxiety, particularly in unfamiliar situations or with unfamiliar people. Appearing paralyzed with fear or shutting down when unable to speak. Difficulty making eye contact or exhibiting other physical signs of anxiety, such as sweating, trembling, or avoiding social situations altogether. Refusal to participate in classroom activities, answer questions, or speak to teachers, even when they know the correct answers. Speaking freely and being sociable at home, but being entirely or mostly nonverbal at school or around strangers. Limited or nonexistent communication with classmates, teachers, or other adults, even through nonverbal means, such as nodding or gesturing. Fear or avoidance of situations where they may be required to speak, such as public speaking or presentations. Difficulty expressing emotions or needs, leading to frustration, tantrums, or emotional outbursts. It is important to note that some children may exhibit only a few of these signs, and the severity of their symptoms can vary widely. A diagnosis of selective mutism should only be made by a trained mental health professional. This is an anxiety disorder that may have different signs in each child. Some children with SM may be able to talk to peers but unable to talk to their teacher, while others will stay silent around peers. Many children with selective mutism enjoy school and have friends but interact nonverbally during playtime. Some may be able to speak to their classmates in their own homes, but many cannot. Some children with SM may be able to smile and point to things they want, while others will struggle with even these gestures. Children with selective mutism are typically diagnosed between the ages of 3 and 8. In hindsight, professionals often observed that these children displayed signs of severe anxiety and inhibited temperament in social settings as infants and toddlers, but the adults thought they were just being very shy. These children typically have a history of separation anxiety and may be slow to warm up to new people or situations. The signs of selective mutism may not become apparent until the child enters school, when there is a greater expectation to perform, interact, and speak. In such cases, teachers may inform parents that their child is not speaking or engaging with other children. Alternatively, parents may notice early on that their child is only speaking to a select few individuals outside the home. While it may take time for children to adjust to a new classroom environment, being nonverbal for over a month can cause concern. It is essential to note that these signs can vary widely in their severity and presentation. A diagnosis of selective mutism should only be made by a trained mental health professional. Importance of Early Intervention Here are some reasons why early detection and intervention in SM are essential: Improved social and emotional functioning: SM can cause significant distress and impair a child's ability to form relationships, communicate their needs, and participate in social situations. Early intervention can help children develop communication skills and socialization strategies, leading to improved emotional and social functioning. Better academic performance: Children with SM may struggle in academic settings due to their difficulty communicating with teachers and peers. Early intervention can help children overcome their anxiety and communicate more effectively in the classroom, leading to improved academic performance. Preventing comorbid disorders: Untreated SM can increase the risk of developing other anxiety disorders, such as social anxiety disorder or separation anxiety disorder. Early intervention can prevent the development of comorbid disorders. Greater treatment success: The earlier SM is identified and treated, the more likely it is that the child will respond well to treatment. Early intervention can help prevent the disorder from becoming chronic, which can be more challenging. Decreased emotional distress: Children with SM may experience significant emotional distress due to difficulty communicating in certain situations. Early intervention can help reduce this distress and improve the overall quality of life. In conclusion, early detection and intervention of selective mutism are crucial for a child's emotional, social, and academic development. Parents and teachers need to recognize the signs of SM and seek professional help as early as possible. What Looks Like SM But Isn’t Oppositional Behavior Selective mutism is often confused with oppositional behavior because a child with SM may appear to be refusing to answer questions. However, this is not the case, as children with SM are very anxious and may find it impossible to speak even when they want to. It is important to note that children with SM are not choosing not to speak; they are simply unable to do so. Autism Autism and SM can be challenging to differentiate since both conditions affect socialization. However, children with SM can still understand nonverbal cues and emotional subtleties, while autistic children may struggle with social nuances and the limits of conversation even in familiar surroundings. Trauma While trauma can cause a child to become mute, they will more likely avoid talking about aspects of the trauma rather than becoming completely silent. PTSD has additional symptoms such as difficulty sleeping, nightmares, and the need to recreate the traumatic event during play, differentiating it from SM. Second Language When a child speaks a different language at home, it is essential to consider whether difficulty with the second language could cause their reluctance to speak before diagnosing them with SM. However, bilingual children can still develop SM, which is more common among those who speak multiple languages. Social Anxiety Disorder This can occur alongside SM, as children with a social anxiety disorder may also be anxious about speaking or performing in front of others. A thorough evaluation should be done to determine if a child has a social anxiety disorder. Causes of Selective Mutism Since selective mutism is relatively uncommon, the risk factors associated with this disorder are not well established. However, a few triggers have been identified: Temperamental factors: Children with a history of behavioral inhibition and parents with a tendency towards shyness, social isolation, and social anxiety may be at risk for developing selective mutism. Additionally, some children with selective mutism may also have receptive language difficulties. Environmental factors: Parents who exhibit social inhibition may model this behavior for their children. Furthermore, overly controlling or overprotective behavior from parents can also increase the risk of selective mutism. Genetics: Since selective mutism and social anxiety share similarities, the two disorders may have a shared genetic component. How Selective Mutism Is Treated If a professional has assessed your child and confirmed that the child has selective mutism, you must immediately commence treatment with a psychologist with experience. You can also find RiteCare Clinics to help you. The recommended treatment is specialized behavior therapy involving techniques that encourage speech and reinforce successful speaking experiences with labeled praise and small incentives. The treatment also involves helping children confront the situations that trigger anxiety instead of avoiding them, which helps to reduce anxiety gradually over time. However, children should not be coerced or pressured to speak, and the pace of treatment should be gradual. The objective is to build the child's confidence by accumulating successful speaking experiences. Demanding more than the child can handle may harm the child's progress and self-esteem. Since children with selective mutism are typically young, treatment should involve direct work with parents, caregivers, and other supportive adults to learn how to help the child communicate and engage in conversation. Treatment providers should teach caregivers to avoid answering for the child or relying too heavily on nonverbal communication, as this can reinforce the child's SM. Knowing when and how to encourage participation from a child with selective mutism can be challenging. Therefore, you must understand the child's treatment goals and receive guidance on how to best support and reinforce progress. Collaboration between the child's therapist and teachers is essential for successful treatment, as progress made in the clinician's office must translate into progress at home. Strategies to Help A Child With Selective Mutism To help a child who has struggled with selective mutism, you need to make them feel comfortable. Here are some suggestions: Act like a sportscaster: Give a play-by-play commentary of what the child is doing, such as "You're drawing a flower" or "I see you're pointing to the picture in the book." This demonstrates your interest in the child's activities and can be a useful technique when the child is nonverbal. Allow for a five-second wait time: Giving the child enough time to respond is important when asking questions. Waiting five seconds without repeating the question or prompting someone else to answer can be a good guideline. This helps the child learn to tolerate anxiety and build confidence in their ability to communicate. Use labeled praise: Instead of generic praise like "Great job!" try being specific and saying something like, "Great job telling me you want water!" This lets the child know exactly what they did well and motivates them to continue to use their communication skills. Rephrase questions: Instead of asking yes-or-no questions or questions that the child can answer can answer nonverbally, try giving the child choices or asking open-ended questions that are more likely to prompt a verbal response. For example, "Would you like a puppy sticker or a star sticker?" or "What do you think we should play next?" Practice echoing: Repeat or paraphrase what the child says to show that you understand and have heard them. This can be reinforcing and help the child feel more comfortable participating in larger group settings, especially if they speak quietly. While the behavior of children with selective mutism may appear deliberate, it is rooted in anxiety. Prompt intervention can aid these children in increasing their communication and enhancing their academic and social success.