Common Speech-Language Therapy (SLT) Conditions

 

1. Auditory Processing Disorder (APD)

Auditory processing or listening refers to how our brains pick out and make sense of the sounds around us. Sound waves travel to our ears and convert into electrical signals interpreted by the brain. APD is also referred to as central auditory processing disorder (CAPD). Children with APD can have a range of listening difficulties.

 

Listening is complex and involves multiple steps that take place in split seconds. When we listen, we have to pay sufficient attention, detect where a sound comes from, differentiate sounds that are similar, filter important information from background noise, understand the message when parts are missing (such as when the signal is poor over the mobile phone) and more. APD is usually diagnosed when IQ is average and there is normal hearing. It can co-occur with other learning difficulties and is diagnosed by a qualified audiologist.

 

Signs of APD include difficulties:

 

• Directing or dividing attention

• Discriminating subtle differences in sounds and words

• Maintaining focus on an activity if other sounds are present

• Learning songs or rhymes

• Understanding rapid speech

• Listening in noisy settings

• Recognising and integrating a sequence of sounds into words or other combinations

• Remembering and/or comprehending verbal information

• Understanding and executing multi-step directions

• Reading, spelling, writing and understanding vocabulary or learning a foreign language

• Following long conversations

• Taking written notes from speech

• Completing verbal math problems

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2. Feeding and Swallowing Disorders

Feeding and swallowing disorders can lead to health, learning and social problems. Feeding disorders include problems sucking, eating from a spoon, chewing or drinking. Swallowing disorders, also known as dysphagia, are difficulties moving food or liquid from the mouth, throat or oesophagus to the stomach.

 

Your child may have a feeding or swallowing problem if s/he:

 

• Arches their back or stiffen when feeding

• Cries, fusses or falls asleep during feeding

• Has problems breastfeeding

• Has breathing difficulties while eating and/or drinking

• Refuses to eat or drink

• Eats only certain textures such as soft food or crunchy food

• Takes a long time to eat

• Pockets (i.e. hold food in their mouth)

• Has problems chewing

• Coughs or gags during meals

• Drools a lot or has liquid come out of their mouth or nose

• Has a gurgly, hoarse or breathy voice during or after meals

• Spits up or throws up a lot

• Is not gaining weight or growing

 

Whether your child shows a few or many of the signs, your child may be at risk for:

 

• Dehydration or poor nutrition

• Aspiration i.e. food or liquid going into the airway

• Pneumonia or other chest infections

• Feeling negative about eating; avoids eating or associates it with pain, frustration or embarrassment

 

3. Language delay

Language involves the words we use to get what we want connect and share ideas. Language is transmitted through listening, speaking, understanding, reading and writing. A language delay is difficulty learning vocabulary, constructing sentences and/or understanding meanings.

 

Causes of language delay may include:

 

• Prematurity

• Intellectual impairment

• Learning disability where cognition is not affected but learning skills are disrupted

• Neurological impairment such as autism spectrum disorder (ASD), attention deficit and hyperactivity disorder (ADHD), developmental language disorder (DLD), traumatic brain injury (TBI), Down syndrome, Pierre-Robin syndrome, Prader-Willi syndrome and more.

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4. Learning difficulties

Learning difficulties also termed learning disabilities, learning disorder or specific learning disabilities, is an umbrella term for a neurological disorder caused by differences in how the brain works and processes information. As such, it is a lifelong condition.

 

Learning difficulties are not related to intellectual disabilities, sensory processing or psychological issues. They vary from individual to individual and present as difficulties in one or more of the following skills:

 

• Reading, spelling (i.e. dyslexia) writing and understanding or using language

• Prioritising, organising, doing mathematics (i.e. dyscalculia) and following instructions

• Storing or retrieving information from short or long term memory

• General clumsiness and/or difficulty with handwriting (i.e. dyspraxia)

 

Individuals with learning difficulties often have average or above average IQ. Studies have shown that as many as 33% of students with LD are gifted intellectually, artistically or in other areas.

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5. Selective mutism

It is an anxiety disorder that usually affects children and may persist into adulthood. Although characterised by difficulty speaking in social situations, some can speak in settings like at home or with familiar persons. Treatment often involves behavioural therapy and understanding underlying factors.

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6. Speech delay

Speech is how we say sounds and words. It is normal for young children to say some sounds the wrong way. A speech delay refers to pronunciation difficulties resulting in unclear speech. Children can have difficulty with either speech and/or language. While both speech and language are used synonymously, the methods of assessment, diagnosis, therapy and prognosis vary.

 

Causes of speech delay may include:

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• Structural differences such as a cleft lip and/or palate, a tongue-tie and more

• Hearing loss which can range in severity

• Difficulty coordinating the lips, tongue, cheeks and jaw.
i.e. dyspraxia or childhood apraxia of speech (CAS)

• Difficulty processing speech sounds accurately.
i.e. phonological difficulties, muscle weakness as in the case of cerebral palsy, Down syndrome, etc.

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7. Speech and language delay

Many children experience a combination of speech and language issues as the causes often overlap. For example, a child with Down syndrome may have unclear speech and require more time to learn new words and construct sentences. As intellect is often impacted in Down syndrome, cognition is affected as well. Another example is when a child has learning difficulties where IQ is not affected but the child may encounter language delay, dyslexia, dyspraxia, dyscalculia and/or sensory processing difficulties, etc.